PiCCO® enables continuous hemodynamic monitoring using a femoral or axillary artery catheter and a central venous catheter. Employing patented algorithms, PiCCO combines real-time continuous monitoring through pulse contour analysis with intermittent thermodilution measurement via the transpulmonary method.
In addition to PiCCO, Philips CCO/C.O. module supports traditional thermodilution cardiac output measurement from a right heart catheter.
|Patients who can benefit from PiCCO monitoring have central venous and arterial lines and require close circulatory volume and cardiovascular management. Adult or pediatric patients who have or may develop pulmonary edema or ARDS are likely candidates.|
Continuous hemodynamic analysis
PiCCO technology provides clinicians with the following clinical measurements, many of which can be displayed as absolute or indexed values:
via continuous pulse contour analysis
- Continuous pulse contour cardiac analysis (PCCO)
- Arterial blood pressure (AP)
- Heart rate (HR)
- Stroke volume (SV)
- Stroke volume variation (SVV)
- Systemic vascular resistance (SVR)
- Index of left ventricular contractility
via intermittent transpulmonary thermodilution
- Transpulmonary cardiac output (C.O.)
- Intrathoracic blood volume (ITBV)
- Extravascular lung water (EVLW) (Not Available in United States)
- Cardiac function index (CFI)
Using PiCCO typically requires insertion of a thermodilution catheter in the femoral or axillary artery instead of a standard arterial line. Any available central venous catheter can be used to inject the solution for the thermodilution analysis.
Clinically solid measure of cardiac output
An advantage of the transpulmonary thermodilution method is that it is independent of ventilator and respiratory cycles, and therefore PiCCO gives consistent, reproducible results. Clinical studies support that cardiac output measurements obtained using the PiCCO method are comparable to those obtained using traditional right heart thermodilution. (Please see references below.)
Reuter DA, Felbinger TW, Schmidt C, Kilger E, Goedje O, Lamm P, Goetz AE. Stroke volume variations for assessment of cardiac responsiveness to volume loading in mechanically ventilated patients after cardiac surgery. Intensive Care Med. 2002 Apr;28(4):392-8.
Goedje O, Höke K, Goetz AE, Felbinger TW, Reuter DA, Reichart B, Friedl R, Hannekum A, Pfeiffer UJ. Reliability of a new algorithm for continuous cardiac output determination by pulse-contour analysis during hemodynamic instability. Crit Care Med. 2002 Jan;30(1):52-8.
Sakka SG, Meiere-Hellmann A, Reinhart K. Assessment of cardiac preload and extravascular lung water by single transpulmonary thermodilution. Intensive Care Med. 2000 Feb;26(2):180-7.
* Not available in United States
PiCCO is a registered trademark of PULSION Medical Systems AG.