The PiCCO system The PiCCO system

More documents

Recommendations

Info

Start fluid loading! 17.5 EVLW 30 Stop fluid loading! A 63 years old male patient; developed fulminant pulmonary edema 4 hours into a re-total hip replacement. Hypoxemia (SaO2
R E S U L T S Decision tree for hemodynamic / volumetric monitoring** CI (l/min/m 2 ) 3.0 GEDI (ml/m 2 ) or ITBI (ml/m 2 ) ELWI (ml/kg) CI (l/m 2 ) 1.9 ITBVI (ml/m 2 ) 850 CO (L) 850 10 10 10 10 Fluids cautiously + catecholamines V+ V+! Cat Cat V+ V+! V- Cat V- T GEDI (ml/m 2 ) >700 700-800 >700 700-800 >700 700-800 700-800 H 1. or ITBI (ml/m 2 ) >850 850-1000 >850 850-1000 E >850 850-1000 850-1000 R T + 2. Optimise toSVV (%) 30 OK! SVV % 22 779 Start fluid loading! ELWI (ml/kg)* (slowly responding) ≤10 ≤10 ≤10 ≤10 EVLW (ml/kg) V+= volume loading (! = cautiously) V-= volume contraction Cat = catecholamine / cardiovascular agents + SVV only applicable in ventilated patients without cardiac ythmia arrh 23 **without guarantee *not available in USA 29 R E S U L T S Decision tree for hemodynamic / volumetric monitoring** CI (l/min/m 2 ) 3.0 GEDI (ml/m 2 ) or ITBI (ml/m 2 ) ELWI (ml/kg) CI (l/m 2 ) 3.75 ITBVI (ml/m 2 ) !!! ELWI (ml/kg)* (slowly responding) 850 EVLW (H) 850 10 10 10 10 Diuresis V+ V+! Cat Cat V+ V+! V- Cat V- Stop fluid loading! T GEDI (ml/m 2 ) >700 700-800 >700 700-800 >700 700-800 700-800 H 1. or ITBI (ml/m 2 ) >850 850-1000 >850 850-1000 E 1444 >850 850-1000 850-1000 R T + 2. Optimise toSVV (%) 30 OK! SVV % 15 ≤10 ≤10 ≤10 ≤10 EVLW (ml/kg) V+= volume loading (! = cautiously) V-= volume contraction Cat = catecholamine / cardiovascular agents + SVV only applicable in ventilated patients without cardiac ythmia arrh **without guarantee 15 *not available in USA 30 15
Page 1 and 2: HOW TO PRACTICALLY USE THE VARIOUS
Page 3 and 4: Clinical examination, vital signs,
Page 5 and 6: Whole set of CI pairs Measurements
Page 7 and 8: Global End-Diastolic Volume as an I
Page 9 and 10: Functional hemodynamic parameters (
Page 11 and 12: EVLW was markedly elevated (13.5 ml
Page 13: A patient with head injury, severe
Page 17 and 18: 34 yr female; Very severe respirato
Page 19 and 20: The accuracy of predicted cardiopul
Page 21 and 22: Initially the CI was high (5.3 L/mi
Page 23 and 24: Targeting EVLW in ARDS n=101 22 day
Page 25 and 26: When do I use the PiCCO? ‣ CHF +
Page 27: Cardiac output 6.77 L/min ScvO 2 is

The PiCCO system The PiCCO system

Create successful ePaper yourself

Delete template?

Save as template?