Principles of Measurement and Parameters
Operator´s Manual PiCCO
2
Page
Version 3.1
B-1
B
Principles of Measurement and Parameters
1
Introduction
The PiCCO
2
is a device for continuous cardiac output measurement combined with monitoring of cardiac
preload volume, extravascular lung water, arterial and central venous oxygen saturation and global liver
function.
The PULSION PiCCO
2
computes the CO continuously, utilizing an improved arterial pulse contour analysis
algorithm. The Pulse Contour Cardiac Output (PCCO) is calibrated by means of a transpulmonary
thermodilution measurement. A cold or room-temperate bolus (e.g. normal saline 0.9%) is injected through a
central venous catheter. A thermodilution curve is recorded by an arterial thermodilution catheter, which also
serves for pressure monitoring. In addition to calibration of the PCCO, transpulmonary thermodilution also
yields cardiac preload by means of global end-diastolic volume (GEDV) and an estimation of both,
intrathoracic blood volume (ITBV) and extravascular lung water (EVLW).
Furthermore the PiCCO
2
continuously measures the central venous oxygen saturation (ScvO
2
) after
calibration with blood gas analysis results and can continuously calculate oxygen delivery (DO
2
) and oxygen
consumption (VO
2
).
Detection of concentration and determination of the elimination rate of a diagnostic drug, Indocyanine Green,
provide information about the global liver function. The device indicates the Plasma Disappearance Rate
(PDR) and the Retention Rate of ICG after 15 minutes (R15).
To derive parameters, the PiCCO
2
combines transpulmonary thermodilution technique with continuous arterial
pulse contour analysis and fiberoptic oximetry and pulse oximetry/densitometry. Oximetry measurements use
different wave lengths for the determination of the elimination rate of Indocyanine Green.
If a patient´s weight, height, category and gender are entered, the PiCCO
2
presents the derived parameters
indexed to the patient´s body characteristics.
