Philips MP40/50, MP60/70/80/90, MP20/30 manual CCO Curve Alert Messages, Possible Causes

C.O./CCO Curve Alert Messages 13 Monitoring Cardiac Output

C.O./CCO Curve Alert Messages

After each measurement trial, the monitor analyzes the thermodilution curve. If the curve appears abnormal, a curve alert message appears in the C.O. procedure window. A question mark symbol (“?”) may appear next to the cardiac output numeric if any of these messages appear. The curve alert messages are not error messages and do not necessarily mean that the measured values are invalid.

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	May occur if patient is recovering from open heart surgery, or if
Drift	patient was cooled down for surgery and is in the process of regaining
	normal body temperature when the measurement is made.
Small signal, more	The peak of the transpulmonary thermodilution curve was below
indicator required	0.1ºC. Increase injectate volume and/or lower injectate temperature.
Injectate Temperature	The difference between the blood and injectate temperatures is too
too High	small. The calculated value for C.O. may not be accurate.
High ETVI, use cold	The ETVI value is too high. The accuracy of the transpulmonary
injectate or greater	thermodilution measurement may be reduced. Increase injectate
inj. volume	volume and/or lower injectate temperature following the guidelines
	given in the section “Guidelines for PiCCO C.O. Injectate” on
	page 170.
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).

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