PICCO technology

2022-09-05 10:18:25
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  PICCO is a simple, minimally invasive and highly effective tool for the detection of major hemodynamic parameters in critically ill patients。
  Edit the rationale for this paragraph
  Transpulmonary thermodilution and pulse wave profiling techniques were used to further measure hemodynamic monitoring and volume management, eliminating the need for pulmonary artery catheters in most patients。The monitor uses a thermodilution method to measure a single cardiac output (CO) and obtains a continuous cardiac output (PCCO) by analyzing the area under the arterial pressure wave pattern curve.。Intrathoracic blood volume (ITBV) and extravascular pulmonary water (EVLW) can be calculated simultaneously,ITBV has been proved by many scholars to be a repeatable, sensitive and more accurate indicator of cardiac preload than pulmonary artery obstruction pressure (PAOP), right ventricular end-diastolic pressure (RVEDV) and central static pressure (CVP)。
  Edit this paragraph for advantages
  1.Minimal trauma - only central venous and arterial catheters need to be placed, no pulmonary artery catheters required, can be used in children。
  2.Initial setup time is short - you can start using it in minutes。
  3.Dynamic, continuous measurement - Measuring cardiac output, afterload and volume reactivity per heart beat (beat by beat)。
  4.No chest X-ray. - To confirm catheter position。
  5.Cost-effectiveness - less expensive than a continuous pulmonary artery catheter - the arterial PiCCO catheter can be placed for 10 days, reducing the time and cost of intensive care。
  6.Clearer parameters - PiCCO parameters are easy to judge and understand, even for people with little experience。
  7.Extravascular pulmonary water - quantitative measurement of pulmonary edema at the bedside。
  Edit how to use this paragraph
  The determination of PCCO by pulmonary temperature dilution and PCCO requires a special arterial catheter。The catheter is usually placed in the femoral artery or the axillary artery, but only in the femoral artery in children。Through the catheter, arterial pressure can be continuously monitored, while the monitor obtains continuous cardiac output (PCCO) by analyzing the area under the arterial pressure wave pattern curve.。The ductus arteriosus carries a special temperature probe that is used to measure the temperature change of the injection artery。A single cardiac output was measured by the monitor using a thermodilution method。A single cardiac output measurement can be used to correct for PCCO。It is usually necessary to measure 3 cardiac outputs and find their average value to correct PCCO。
  In addition to the arterial catheter, a conventional deep venous catheter is required for the injection of ice saline。A deep venous catheter is usually placed in the superior vena cava or right atrium。If only to correct PCCO, intravenous injection of ice saline is acceptable, provided that the arterial catheter can obtain a reliable temperature response curve, but the volume measurement is not accurate in this case。
  Instrumentally measured ITBV and whole-heart end-diastolic volume (GEDV) will be 75ml higher when ice saline is injected from the femoral vein (absolute value because the volume from the injection site to the measurement site is higher than when injected from the superior vena cava)。The value of EVLW is accurate。
  The injection volume of ice saline depends on the patient's weight and the amount of EVLW。If EVLW is increased, the injection volume must be increased。
  Edit the measurement parameters in this paragraph
  PiCCO continuously monitors the following parameters:
  Cardiac output per beat (PCCO) and Index (PCCI)
  Arterial pressure (AP)
  Heart rate (HR)
  Stroke Volume (SV) and Index (SVI)
  Stroke Volume change (SVV)
  Peripheral vascular Resistance (SVR) and Index (SVRI)
  Edit this normal value


参数 Normal value 单位
CI(Heart Index) 3.0-5.0 L/min/m2
ITBL(Intrathoracic Blood Volume Index) 850-1000 ml/m2
ELWI(Extravascular pulmonary water Index) 3.0-7.0 ml/kg
CFI(Heart Function Index) 4.5-6.5 l/min
HR(Heart rate) 60-90 b/min
CVP(Central Venous Pressure) 10-Feb mmHg
MAP(Invasive mean arterial Pressure) 70-90 mmHg
SVRI(Systemic Vascular Resistance Index) 1200-2000 dyn.seccm-5.m2
SVI(Output per byte index) 40-60 ml/m2
SVV(variation in output per byte) ≤10 %

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Published by Nantong First Hospital

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