User's Manual

12 Monitoring Cardiac Output
208
C.O./CCO Curve Alert
Messages
Possible Causes
Tinj off scale The Tinjectate is out of the range -1°C and 30°C. Cool down or
heat up the injectate or change the injectate solution and repeat the
measurement.
Noisy baseline A blood temperature baseline drift that could not be compensated
was detected during the C.O. measurement. Possible causes are:
- Interference may be caused by a ventilator.
- Interference may be caused by an infusion pump: infusions of
significant volume through the central line should be paused at
least 30 seconds before the first thermodilution measurement in a
series and should not recommence until the measurement series is
completed.
- Do not administer injections through the central line during a
measurement series.
- Electrical devices in the vicinity can cause interference: check for
infusion pumps connected to the central catheter, cables parallel to
the thermodilution cable, electrocautery. Make sure all devices are
properly grounded.
- Wait until measurement results are displayed before moving the
patient or catheter.
- Close the stopcock to the injectate syringe after the injection.
- Do not rinse the catheter during measurement, to avoid
temperature fluctuations.
Temperature baseline drift May occur if patient is recovering from open heart surgery, or if
patient was cooled down for surgery and is in the process of
regaining normal body temperature when the measurement is
made.
Small signal, more indicator
required
The peak of the transpulmonary thermodilution curve was below
0.1ºC. Increase injectate volume and/or lower injectate
temperature.
Injectate temperature too high The difference between the blood and injectate temperatures is too
small. The calculated value for C.O. may not be accurate.
High ETVI, use cold injectate
or greater inj. volume
The ETVI value is too high. The accuracy of the transpulmonary
thermodilution measurement may be reduced. Increase injectate
volume and/or lower injectate temperature following the guidelines
given in the section Guidelines for PiCCO C.O. Injectate
(“Guidelines for PiCCO C.O. Injectate” on page 206).
Disturbed injection The injection should be performed quickly and with a steady
pressure. Shaking, unsteady pressure, or injections that take longer
than six seconds may cause this message to appear; you should bear
this in mind if you are using a large injectate volume (> 10 ml).
Check Injectate Temperature
Probe Type
The recorded Tinj signal is uncharacteristic for the M1646 injectate
temperature probe. An incorrect probe type may have been used.