Monitoring physiological parameters is essential for the goal directed management of critical care patients. Highly invasive monitoring methods have been established in clinical practice for many years, but are increasingly the centre of critical discussion. The PiCCO Technology is the solution.
PiCCO-Technology is the easy, less invasive and cost-efficient tool for determining the main hemodynamic parameters of critically ill patients.
- Bedside quantification of pulmonary edema
- Quantification of cardiac preload
- Multiple arterial access points
- Precise, calibrated Cardiac Output – beat-to-beat
- Volumetric preload parameter instead of filling pressures
- Afterload, contractility, volume responsiveness
Two components of the PiCCO technology
The PiCCO technology is based on two physical principles, namely transpulmonary thermodilution and pulse contour analysis. Both principles allow the calculation of hemodynamic parameters and have been clinically tested and established for more than 20 years.
Arterial pulse contour analysis
The pulse contour analysis provides continuous information while transpulmonary thermodilution provides static measurements. Transpulmonary thermodilution is used to calibrate the continuous pulse contour parameters.
For the transpulmonary thermodilution measurement, a defined bolus (for example 15mls cold 0.9% normal saline) is injected via a central venous catheter. The cold bolus passes through the right heart, the lungs and the left heart and is detected by the PiCCO catheter, commonly placed in the femoral artery. This procedure should be repeated around three times in under 10 minutes to ensure an accurate average is used to calibrate the device and to calculate the thermodilution parameters. These thermodilution parameters (i.e. they are updated only when the thermodilution procedure is performed) should be checked whenever there is a significant change in the patient’s condition or therapy. It is recommended to calibrate the system at least 2 to 3 times per day depending on the patients condition.