Piccoplus Shortsetup Us Mpi812905us r00 190407

PiCCO plus

Central venous catheter

Injectate-temperature sensor housing PV4046 (included in PV8115)

Injectate-temperaturesensor cable PC80109

PiCCO Catheter (e.g. PV2015L20)

PULSION disposable pressure transducer PiCCO Monitoring Kit PV8115

Pressure cable PMK-206

AUX Adapter cable (to connect on rear panel)

PC81200

Connection cable to bedside monitorPMK-XXX

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Setup

PULSION • SETUP GUIDE • FINPULSION • 06-0294MECH 2• 5.23.07

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PiCCO plus

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PULSION PiCCO plus V6.2Last patient calibration at 09/12 03:33p

Patient 201000200Weight 75.0 kgHeight 175 cmGender maleMode adult New patient? Yes

INPUT

Patient 201000200Weight 75.0 kg (PBW 70,6kg)Height 175 cmGender maleMode adultCatheter type PV 2015L20 ACC : 342Injectate temperature < 8 °CInj Vol (min. 15ml) 15 mlCVP 10 mmHg Range PCCO 0..10 l/minRange AP 60..160 mmHg

Choose <Yes> for a new patient, old data will be deleted, modify with anda) select patient’s genderb) select patient’s mode

Confirm with

Enter patient ID number, weight, height, gender and mode of the patient. If ID number is changed, previously stored data will be deleted for safety reasons.Arterial catheter will be detected automatically.

The minimal required injectate volume is recommended in ( ).15ml iced NaCl 0.9% as the default setting for adult patients.Enter CVP.

Upper/lower limit of the display range of PCCO.

Upper/lower limit of the display range of the arterial blood pressure.

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Patient Admission

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<24°C = room tempered injectate; <8°C = iced injectate

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PiCCO plus

Zeroing

Open transducer to the atmospheric pressure.

Press zero button.

Perform zeroing first on PiCCO plus then on bedside monitor.

Confirm with

Difference from pressure transducer to patient’s heart level can be corrected. Default setting <0>.

Thermodilution screen

Configuration screen

Input screen

Pulse-contour screen

Pressure-zeroing screen

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AP Zeroing

Zero adjust apply 0 mmHg

measured AP 15 mmHg

PULSION PiCCO plus

V6.2

CFG INP AP4 5 6 7 8

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PiCCO plus

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* Caution: Modifying date and/or time will automatically delete patient related data.

Press to Configuration-screen.To select most important PiCCO parameters choose <individual> and

Basic setup: Cannot be changed and displays most common parameter as default.

Individual: User can configure own parameter selection.

CFG

Configuration

CONFIGURATIONDate 09/12 *Time 03:33 p(change delete previous results)TD Sound OnParameterselection IndividualDisplay span 5 dRS232 PiCCOPrintmode BasicLanguage ENGWeight/Height/Temp lb./in./˚F

ConfigureDisplay (individual)

(CVP) on

SVR onSV onSVV on

TB on

ITBV/GEDV GEDV


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PiCCO plus

II

Press for Thermodilution screen.

Press to perform a measurement.

Wait until <STABLE> appears.

Perform a rapid and smooth injection.

Spike to saline bag.

Thermodilution

201000200 9/12 03:33p TB37.0Time VI CI CFI GEDI EVLWMEAN * ** *** **** ****

0 10s 20sSTABLE TI8 STA ABS CFG INFO

AP 117 97

71(CVP) 12 SVR **** PCCIHR 78 SVI ***

SVV 8% (GEDI) ****

201000200 9/12 03:33p TB37.0Time VI CI CFI GEDI EVLWMEAN * ** *** *** ****

0 10s 20s TI8 STA II ABS CFG INFO

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AP 117 97

71(CVP) 12 SVR **** PCCIHR 78 SVI ***

SVV 8% (GEDI) ****Injection

STA

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** ****

** ****


PiCCO plus

Thermodilution II

Press for further measurements.

Perform initially 3 thermodilution measurements.

* In case of EVLW >10ml/kg it is recommended to use iced injectate for further measurements.

** If ∆T <0,15°C, it may be necessary to increase the injectate amount and/or use iced injectate.

Select iced injectate <8°C in the input-screen.

Deviating measurements(“?” at value) should be deleted.

Press to change to info screen.

STA

INFO

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201000200 9/12 03:33p TB37.0Time VI CI CFI GEDI EVLW

11:49 2.92 4.5 479 *7MEAN 7

0 10s 20s **∆T0.24/TI12 STA II ABS CFG INFO

AP 117 97

71 (CVP) 12 SVRI 2157 PC CI 2.38HR 78 SVI 38

SVV 8% (GEDI) 479


PiCCO plus

201000200 9/12 03:33p TB37.0Time VI CI CFI GEDI EVLW11:49 2.92 4.5 479 7MEAN 7

0 10s 20s ∆T0.31/TI12 II ABS

Calibrate

Deviating measurements should be selected with and , confirm

by pressing once. Selected thermodilution curve is displayed.

To delete this measurement press again.

It is only possible to delete the current measurements under the dashed line.

The mean results of the thermodilution measurements of the last 10 minutesautomatically calibrate the continuous cardiac output.

X DEL

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AP 117 97


SVV 8% (GEDI) 479

AP 117 97


SVV 8% (GEDI) 479

201000200 9/12 03:33p TB37.0Time VI CI CFI GEDI EVLW07:02p 0 2.81 4.0 450 8 07:03p 0 3.06 4.2 474 8 07:05p 0 3.16 4.1 489 811:56p 0 3.22 4.5 496 811:58p 0 2.90 4.5 475 811:59p 0 3.24 4.3 509 705:05a 0 2.92 4.5 520 805:06a 0 3.15 4.5 502 6

05:29a 0 2.96 4.5 480 8MEAN 2.69 4.5 480 8

X DEL


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∆T0.31/TI12X DEL

PiCCO plus

SVV = Stroke Volume Variation.

Press to display arterial pressure curve.

The display range of PCCI can be changed in the Configuration-Screen.

NB: Values can be displayed either as index values (CCI) or absolute values (CCO).

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201000200 9/12 03:33p TB37.0Time VI CI CFI GEDI EVLW03:04p 0 3.24 4.0 450 803:04p 0 2.92 4.2 489 803:04p 0 3.15 4.5 520 803:04p 0 2.96 4.28 480 8 MW 8

0 10s 20s ∆T0.31/TI12 STA ABS INFO

Parameters

CI = Cardiac Index

GEDI or ITBI = Global End-Diastolic Volume Index or Intrathoracic Blood Volume Index EVLW = Extravascular Lung Water

PCCI = Pulse Contour Cardiac Index

Thermodilution results Continuous results

201000200 9/12 03:33p TB37.0AP 160

20 PCCI 6

1h 0 ∆T0.31/TI12 II ABS INP INFO

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AP 117 97


SVV 8% (GEDI) 479

AP 117 97


SVV 8% (GEDI) 479


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INP

PiCCO plus

Error Codes

*** : Inappropriate values, unavailable or not plausible parameters. +++ : The specification range is exceeded. - - - : A measurement parameter is below the display range. E : In case of errors during a thermodilution measurement the following codes (E) are displayed on the status line.

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Error (E) Interpretation Possible Cause Suggested Action

Technically good measurement

0 N/A N/A


1 Injection error Erratic injection – Repeat injection. – Perform rapid and smooth injection.

2 Injectate temp.sensor error

Injectate temperature sensor cable or sensor housing loose or defective

– Check connections of the injectate temperature sensor cable. If necessary change the cable.

– Change injectate temperature sensor housing.

3 Slow injection>10 sec

Inject over less than 7 sec

– Repeat injection. – Perform rapid and smooth injection.

4 – Blood temperature fluctuations

– Slow injection (e.g. 2 ml/5s)

– Stabilize patient temperature (stop infusions).

– Repeat injection.– Perform rapid and smooth injection.

DST (downslope time)

error

PiCCO plus

Error (E) Interpretation Possible Cause Suggested Action

Baseline error

9 – No valid pressure curve– Pressure line not

properly connected or broken

– Check the pressure line and transducer for air bubbles.

– Check all connections from the catheter to the PiCCO plus.

Invalid PiCCOCalibration

8 Injectate temperature too high

T injection > T Blood – Use iced injectate.

7 Time-out(Thermodilutioncurve longer than90 sec)

– Thermistor of arterial catheter defective

– Injection outside of CVC– High thermal volume – Unlikely low CO

– Change arterial catheter.– Check stopcocks and make sure

that injectate is injected in CV-line.– Try to increase CO.

5 – Patient rewarming (more than 0.05C/min, 3ºC/h)

– Arterial thermodilution cable loose or defective

– Stabilize patient temperature.– Change arterial catheter.

6 MTt (mean transit time)

calculation errorErratic injection – Repeat injection.

– Perform rapid and smooth injection.

Error Codes

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PiCCO plus

Normal Values

Cardiac Index

Stroke Volume Index

Global Enddiastolic Volume Index

Intrathoracic Bloodvolume Index

Stroke Volume Variation

Systemic Vascular Resistance Index

Cardiac Function Index

Mean Arterial Pressure

Extravascular Lung Water Index

CI

SVI

GEDI

ITBI

S V V

S VRI

CFI

MAP

ELWI

3.0 – 5.0

40 – 60

680 – 800

850 – 1000

< 10

1970 – 2390

4.5 – 6.5

70 – 90

3.0 – 7.0

I/min/m2

ml/m2

ml/m2

ml/m2

%

dyn*s*cm-5 *m2

1/min

mmHg

ml/kg

Parameter Abbreviation Range Unit

WARNING: PULSION Medical Systems is a medical device manufacturer and does not practice medicine. These normal values may not represent normal values for a particular person PULSION does not recommend general acceptance and use of these values for a specific patient. The treating physician is in any case responsible for determining and utilizing the appropriate diagnostic and therapeutic measures for each individual patient. More information could be found in the PiCCO plus operator’s manual.


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PiCCO plus

Optimized Oxygenation

O2 delivery O2 extraction

O2 uptake O2 transport O2 extraction O2 utilisation

Cardiac Output

StrokeVolume

HeartRate

PreloadGEDI

AfterloadSVRI

ContractiliyCFI

PulmonaryedemaELWI

Volume Vasopressors Inotropes

Fast decision support! p 12


197 Route 18 SouthSuite 3000East New Brunswick, NJ 08816Phone: 732-514-6610Fax: 732-514-6614

PULSION Medical Systems AGStahlgruberring 2881829 Munich, GermanyPhone: +49-89-459914-0Fax: [email protected]

www.PULSION.com

MPI812905_US R00 © PULSION 04/2007

Piccoplus Shortsetup Us Mpi812905us r00 190407

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