Documenting C.O. Measurements

13 Monitoring Cardiac Output

If you are using the ice-bath setup, the injectate temperature probe and the injectate are both placed in an ice-bath and the probe measures the temperature of the contents of the ice bucket.

Setting the Computation Constant

Check that the correct Computation Constant is entered in the C.O. procedure window. This can be found in the documentation supplied with the catheter and is based on the injectate volume, injectate temperature and catheter type. To change the value, in the C.O. procedure window, select Computation Constant and use the pop-up keypad to enter the correct value.

Performing RH C.O. Measurements

1Enter the C.O. procedure window.

2When you see the message ...Ready for new measurement, select the pop-up key Start

C.O.

3When you hear a ready tone and see the message ...Inject now!, inject the solution into the right atrial port of the Swan-Ganz catheter. The optimal injection rate is 2.5 ml/second.

At the end of the measurement the thermodilution curve, cardiac output, index values and curve alerts (if necessary) are displayed and a message will appear ...Wait before starting new measurement.

4When you see the ...Ready for new measurement message, repeat the procedure until you have completed the measurements you want to perform. You can perform a maximum of six measurements before editing. If you perform more than six measurements without rejecting any, the oldest will automatically be deleted when a seventh curve is stored.

Editing and Saving RH C.O. Measurements

It is important to identify and reject erroneous measurements (called “trials”), as the monitor uses all the measurement trial values you do not reject to calculate the averaged cardiac output.

1Review the trials. Irregular trials or trials marked with a “?” should be reviewed carefully. Consider the similarity of the values and the shape of the C.O. curve. A normal C.O. curve has one smooth peak and returns to the temperature baseline level after the peak.

2Reject unsatisfactory trials: use the Select Trial pop-up key to move between trials, then select the Accept Reject pop-up key to accept or reject trials. If you are using a touch screen you can accept or reject trials directly by tipping on the trial curve. Discard conspicuously different values. The background of rejected trials is red and the background of accepted trials is green. The monitor recalculates the average values after you reject or accept trials.

If all values are different from each other, there may be true hemodynamic instability caused, for example, by severe cardiac arrhythmia.

3Save average C.O. values. To close a measurement series, you must save the average values by selecting the pop-up key Save C.O. This sends the average C.O. numeric to be displayed on the main screen, and stores the averaged values in the trends and calculations databases.

Documenting C.O. Measurements

You can document C.O. measurements on the default printer or recorder.

1In the C.O. procedure window, select the pop-up key Print/Record.

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Philips MP60/70/80/90 Documenting C.O. Measurements, Setting the Computation Constant, Performing RH C.O. Measurements
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MP60/70/80/90, MP40/50, MP20/30 specifications

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