You are visiting a website that is not intended for your region

The page or information you have requested is intended for an audience outside the United States. By continuing to browse you confirm that you are a non-US resident requesting access to this page or information.

Switch to the US site

PiCCO Questions & Answers

Methodological PiCCO Technology FAQs

What external factors could cause the PiCCO parameters to become less accurate?

The PiCCO technology is based on transpulmonary thermodilution and arterial pulse contour analysis. Thus, the thermodilution measurement needs to be performed correctly and also the arterial pressure curve needs to be of a certain quality. The table below lists frequent errors, causes and solutions.

Error
Cause
Remedy
Pressure curve absent
Pressure line not attached correctly Check pressure line, stop-cock, cable and plug
 
Pressure line blocked Flush pressure line
 
Cable or device defect Connect pressure transducer directly to the bedside monitor for testing
Abnormal pressure curve
Catheter malpositioned Check or change catheter position
 
Blocked catheter lumen Flush catheter
 
Arrhythmia, extra systole Regulate therapeutically
 
Tachycardia (> 240 bpm) Regulate therapeutically
Flat pressure curve
Inappropriate scale settings Set scale of pressure curve
  Incorrect connection of the pressure system Check and ensure pressure system is connected correctly
  Insufficient pressure flush Increase the flush pressure to 250-300 mmHg
  None or incorrect zero adjustment Perform / repeat zero adjustment
  Damped pressure transducer transmission due to:  
  Air bubbles Disconnect from patient and de-air the system
  pressure line modifications Remove any additional lines and or stop cocks
  Malpositioning of stop cocks Adjust stop cocks correctly
  Kinked catheter or pressure line Remove kinks, possibly change patient position
  Hypotension Regulate therapeutically
Error
Cause
Remedy
Injection was not detected
CVC malpositioned Correct position
  3-way-stopcock adjusted incorrectly Adjust 3-way-stopcock
  Temperature sensor housing pin clotted Change temperature sensor housing
  Temperature sensor housing / sensor not connected correctly Check connection („click-sound“)
  Defective temperature sensor Check or change sensor

Error
Cause
Remedy
Results implausible
Injected amount does not correlate with the displayed amount on the device Inject correct volume

  Patient's medical conditions interfere with the measurement device (e.g. intracardiac shunt) Check medical conditions and possibly improve the situation
Error
Cause
Remedy
PCCO calibration not possible
Arterial pressure curve absent or faulty Check / optimise arterial pressure measurement
Large variation in values
Arrhythmia, extra systoles Regulate therapeutically
Error
Cause
Remedy
Unstable temperature baseline measurement
Rapid cooling or warming of patient Wait for stabilisation phase
 
Massive volume loading Stop volume supply if possible
 
Arterial connection cable broken or connected incorrectly Check cable connection replace if necessary
 
Faulty PiCCO catheter thermistor Check temperature change when flushing catheter and replace catheter if no temperature change is seen
 
Parietal thermistor Change catheter or patient position
Thermodilution curve is not displayed
Incorrect central venous injection Perform a correct central venous injection
 
Faulty PiCCO catheter thermistor Check temperature change when flushing catheter and replace catheter if no temperature change is seen
 
Broken or failed cable connection of arterial connection cable Check cable connection and change if necessary
Thermodilution curve is displayed too late (Time limit exceeded)
Injection was performed too slow Inject faster (< 7s)
 
Very low cardiac output and/or very high lung water Use colder and/or more injectate volume
Flat thermodilution curve
Inappropriate scale settings Adjust scaling
 
Injectate too warm Use colder injectate
 
Very low cardiac output and/or very high lung water Use colder and/or more injectate volume
Thermodilution curve displays more than one peak
Injection not smooth Ensure smooth injection
 
Existing intra-cardiac shunts Perform shunt diagnosis