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PiCCO (pulse-induced contour cardiac output)

PiCCO (pulse-induced contour cardiac output)

A special arterial line (with a thermistor to measure temperature) is inserted into the brachial or femoral artery. PiCCO uses pulse contour analysis to interpret the arterial waveform and from this the following are displayed: cardiac output (CO), arterial pressure, stroke volume, stroke volume variability, systemic vascular resistance, index of left ventricular contractility.

Monitoring washout

Figure 1. Thermodilution curve. AUC = area under the curve

Intermittent thermodilution (fig. 1) is also performed - cold solution is injected into a central vein, the temperature is detected by a thermistor in the arterial line and, similar to the PAF catheter, the temperature change can be used to calculate the cardiac output. This calibrates the derived CO from contour analysis. In addition thermodilution gives values for the intra thoracic blood volume (an indication of filling), extra vascular lung water and cardiac function index.

Complications of PiCCO

All those associated with arterial and central lines

Further reading

http://www.pulsion.com

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