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Cardiac output
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The technique used in performing a cardiac output.
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Temperature of the injectate solution.
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Volume of the injectate solution.
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Patient’s baseline blood temperature.
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Patient’s inspiratory/expiratory cycle.
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Placement of catheter with relation to proximity of lung field.
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The pulmonary artery catheter itself.
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The patient’s rhythm and hemodynamic status.
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Any other rapid IV solutions which are infused while the cardiac output is being
performed.
The following are suggestions about technique that can help obtain accurate cardiac
output:
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Always hold the syringe by the plunger, not the barrel.
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Inject solution rapidly and smoothly.
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Inject within four to five seconds.
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Inject at end expiration.
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When not using an automatic program, wait one minute between injections to
allow baseline to stabilize.
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The temperature of the injectate should always be colder than blood temperature.
Keep the handling and waiting time with a filled syringe before injection as short as
possible. Warm injectate may lead to erroneous C.O. values.
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The probe can be a bath probe continuously measuring the cooling bath
temperature or the infusion bag temperature. Alternatively, a flow-through probe is
used for a closed injectate delivery. With an in-line system, the displayed injectate
temperature is the lowest temperature measured during injection.
C.O. troubleshooting
Problem Solution
C.O. measurement fails? The amount of injectate is too small or the injectate
is too warm.
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Inject smoothly and within 4 to 5 seconds.
What if the C.O. value is lower than expected? Cardiac output must be computed within 20
seconds. Decreasing the volume and increasing
the temperature will give you a smaller differential
change and should increase the chance of computing
a cardiac output within the 20-second period.
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Decrease the volume injected.
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Increase the temperature of the injectate.
270 CARESCAPE Modular Monitors 2062971-001