Setup

A Central venous catheter

B Injectate-temperature
B G sensor housing
PV4046
A (included in PV8115)

C Injectate-temperature
sensor cable
C PC80109

D PiCCO Catheter
(e.g. PV2015L20)

F E PULSION disposable
pressure transducer
PiCCO Monitoring Kit
PV8115
H
F Pressure cable
D PMK -206
E
G AUX Adapter cable
(to connect on rear panel)
PC81200

H Connection cable to
bedside monitor
PMK-XXX

PiCCO plus p1

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PULSION • 06-0294
MECH 2• 5.23.07
 Patient Admission

PULSION PiCCO plus

1 Choose <Yes> for a new patient, old data will
V6.2 be deleted, modify with - and +
Last patient calibration at a) select patient’s gender
09/12 03:33p b) select patient’s mode
Patient 201000200
Weight 75.0 kg
2 Confirm with
Height 175 cm
Gender male 3 Enter patient ID number, weight, height,
Mode adult gender and mode of the patient.
New patient? Yes 1 If ID number is changed, previously stored
- + 2 data will be deleted for safety reasons.
Arterial catheter will be detected
INPUT automatically.
Patient 201000200 4 The minimal required injectate volume
Weight 75.0 kg (PBW 70,6kg) 3 is recommended in ( ).
Height 175 cm
Gender male 15ml iced NaCl 0.9% as the default
Mode adult
Catheter type setting for adult patients.
PV 2015L20 ACC : 342
Injectate temperature < 8 °C Enter CVP.
Inj Vol (min. 15ml) 4 15 ml
CVP 10 mmHg 5 5 Upper/lower limit of the display range
Range PCCO 0..10 l/min 6 of PCCO.
Range AP 60..160 mmHg
- + 6 Upper/lower limit of the display range of
the arterial blood pressure.
<24°C = room tempered injectate; <8°C = iced injectate

PiCCO plus p2

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 Zeroing
1 1 Open transducer to the
AP Zeroing
atmospheric pressure.
Zero adjust apply 0 mmHg 2 Press zero button.
measured AP 15 mmHg Perform zeroing
first on PiCCO plus then
on bedside monitor.
3 Confirm with
Difference from pressure
2 3
transducer to patient’s
heart level can be corrected.
Default setting <0>.

PULSION PiCCO plus

4 Thermodilution screen

V6.2
5 Configuration screen
6 Input screen
7 Pulse-contour screen
CFG INP AP 8 Pressure-zeroing screen
4 5 6 7 8

PiCCO plus p3

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 Configuration

CONFIGURATION
Date 09/12 *
Time
(change delete previous results)
03:33 p *C
 aution: Modifying date and/or time
TD Sound On will automatically delete patient related data.
Parameter
selection Individual
Display span 5d
RS232 PiCCO
Printmode Basic Press CFG to Configuration-screen.
Language ENG To select most important PiCCO parameters
Weight/Height/Temp lb./in./˚F
choose <individual> and
- +
Basic setup: Cannot be changed and displays
Configure Display (individual) most common parameter as default.
(CVP) on
Individual: User can configure own
SVR on parameter selection.
SV on
SVV on

TB on

ITBV/GEDV GEDV

- +

PiCCO plus p4

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MECH 2• 5.23.07
 Thermodilution
Press for Thermodilution screen.
201000200 9/12 03:33p
Time
TB37.0
VI CI CFI GEDI EVLW AP 117
MEAN * ** *** **** **** 97
71 1 Press STA to perform a measurement.
(CVP) 12
SVR ****
PC
** **** 2 Wait until <STABLE> appears.
CI
HR 78 Perform a rapid and smooth injection.
SVI ***

0 10s 20s SVV 8% 3 Spike to saline bag.

2
STABLE TI8 (GEDI) ****
STA 1 II ABS CFG INFO

3
201000200 9/12 03:33p
Time
TB37.0
VI CI CFI GEDI EVLW AP 117
MEAN * ** *** *** **** 97
71
(CVP) 12
SVR ****
PC
CI ** ****
HR 78
SVI ***
0 10s 20s SVV 8%
Injection
TI8 (GEDI) ****
STA II ABS CFG INFO

PiCCO plus p5

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PULSION • 06-0294
MECH 2• 5.23.07
 Thermodilution II

1 Press STA for further measurements.

Perform initially 3 thermodilution
measurements.
201000200 9/12 03:33p TB37.0
Time VI CI CFI GEDI EVLW AP 117 *In case of EVLW >10ml/kg it is
11:49 2.92 4.5 479 *7
97
71 recommended to use iced injectate
MEAN 7 (CVP) 12
SVRI 2157 for further measurements.
PC
CI 2.38 **If ∆T <0,15°C, it may be necessary
HR 78 to increase the injectate amount and/or
SVI 38
use iced injectate.
0 10s 20s SVV 8%
** ∆T 0.24/TI12 (GEDI) 479 Select iced injectate <8°C in the
STA II ABS CFG INFO input-screen.
1 2
Deviating measurements
(“?” at value) should be deleted.
2 Press INFO to change to info screen.

PiCCO plus p6

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 Calibrate
201000200 9/12 03:33p TB37.0 201000200 9/12 03:33p TB37.0
Time VI CI CFI GEDI EVLW AP 117 Time VI CI CFI GEDI EVLW AP 117
07:02p
07:03p
0 2.81 4.0 450
0 3.06 4.2 474
8
8
97
71 11:49 2.92 4.5 479 7 97
71
(CVP) 12 MEAN 7 (CVP) 12
07:05p 0 3.16 4.1 489 8
11:56p 0 3.22 4.5 496 8 SVRI 2157 SVRI 2157
11:58p 0 2.90 4.5 475 8 PC PC 1
11:59p
05:05a
0 3.24 4.3 509
0 2.92 4.5 520
7
8
CI 2.38 CI 2.38
05:06a 0 3.15 4.5 502 6 HR 78 HR 78
SVI 38 SVI 38
05:29a 0 2.96
MEAN 2.69
4.5 480
4.5 480
8
8 SVV 8% 0 10s 20s SVV 8%
∆T 0.31/TI12 (GEDI) 479 ∆T 0.31/TI12 (GEDI) 479
X DEL II ABS

Deviating measurements should be selected with and , confirm

by pressing X DEL once. Selected thermodilution curve is displayed.
To delete this measurement press X DEL again.
It is only possible to delete the current measurements under the dashed line.
1 The mean results of the thermodilution measurements of the last 10 minutes
automatically calibrate the continuous cardiac output.

PiCCO plus p7

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PULSION • 06-0294
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 Parameters
Thermodilution results Continuous results CI = Cardiac Index
201000200 9/12 03:33p
Time VI CI CFI GEDI
TB37.0
EVLW
AP 117 GEDI or ITBI = Global End-Diastolic
03:04p 0 3.24 4.0 450
03:04p 0 2.92 4.2 489
8
8
97
71 Volume Index or Intrathoracic Blood
(CVP) 12
03:04p 0 3.15 4.5 520 8
SVRI 2157
Volume Index
03:04p 0 2.96 4.28 480 8
MW 8 PC
2.38 EVLW = Extravascular Lung Water
CI
HR 78 PCCI = Pulse Contour Cardiac Index
SVI 38
0 10s 20s SVV
1
8% 1 SVV = Stroke Volume Variation.
∆T 0.31/TI12 (GEDI) 479
STA II ABS INP INFO 2 2 Press to display arterial
pressure curve.
201000200 9/12 03:33p
AP
TB37.0
160
AP 117
97
71 3 The display range of PCCI can be
(CVP) 12 changed in the Configuration-Screen.
SVRI 2157
PC
2.38 4 NB: Values can be displayed either
20 CI
PCCI 3 6 HR 78
as index values (CCI) or absolute
SVI 38 values (CCO).
1h 0 SVV 8%
∆T 0.31/TI12 (GEDI) 479
II ABS INP INFO
4

PiCCO plus p8

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 Error Codes
* * * : Inappropriate values, unavailable or not plausible parameters.
+++ : The specification range is exceeded.
- - - : A measurement parameter is below the display range.
E : In case of errors during a thermodilution measurement the following codes (E) are displayed on the status line.

Error (E) Interpretation Possible Cause Suggested Action

0 Technically good N/A N/A
measurement

1 Injection error Erratic injection – Repeat injection.

– Perform rapid and smooth injection.

2 Injectate temp. Injectate temperature –C  heck connections of the

sensor error sensor cable or sensor injectate temperature sensor cable.
housing loose or defective If necessary change the cable.
– Change injectate temperature
sensor housing.
3 Inject over less Slow injection – Repeat injection.
than 7 sec >10 sec – Perform rapid and smooth injection.
4 DST (downslope time) – Blood temperature – Stabilize patient temperature
error fluctuations (stop infusions).
– Slow injection – Repeat injection.
(e.g. 2 ml/5s) – Perform rapid and smooth injection.

PiCCO plus p9

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Error (E) Interpretation
5 Baseline error
6 MTt (mean transit time)
calculation error
7 Time-out
(Thermodilution
curve longer than
90 sec)
8 T injection > T Blood
9 Invalid PiCCO
Calibration
PiCCO plus
Error Codes
Possible Cause Suggested Action
– Patient rewarming – Stabilize patient temperature.
(more than 0.05C/min, 3ºC/h)
– Change arterial catheter.
– Arterial thermodilution
cable loose or defective
Erratic injection – Repeat injection.
– Perform rapid and
smooth injection.
– Thermistor of arterial – Change arterial catheter.
catheter defective – Check stopcocks and make sure
– Injection outside of CVC that injectate is injected in CV-line.
– High thermal volume – Try to increase CO.
– Unlikely low CO
Injectate temperature – Use iced injectate.
too high
– No valid pressure curve –C  heck the pressure line and
– Pressure line not transducer for air bubbles.
properly connected – Check all connections from the
or broken catheter to the PiCCO plus.
p 10
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PULSION • 06-0294
MECH 2• 5.23.07
 Normal Values
Parameter Abbreviation Range Unit
Cardiac Index CI 3.0 – 5.0 I/min/m2
Stroke Volume Index SVI 40 – 60 ml/m2
Global Enddiastolic Volume Index GEDI 680 – 800 ml/m2
Intrathoracic Bloodvolume Index ITBI 850 – 1000 ml/m2
Stroke Volume Variation SVV < 10 %
Systemic Vascular Resistance Index S VRI 1970 – 2390 dyn*s*cm-5 *m2
Cardiac Function Index CFI 4.5 – 6.5 1/min
Mean Arterial Pressure MAP 70 – 90 mmHg
Extravascular Lung Water Index ELWI 3.0 – 7.0 ml/kg

WARNING: PULSION Medical Systems is a medical device manufacturer and does not practice medicine.
These normal values may not represent normal values for a particular person PULSION does not recommend
general acceptance and use of these values for a specific patient.The treating physician is in any case responsible
for determining and utilizing the appropriate diagnostic and therapeutic measures for each individual patient.
More information could be found in the PiCCO plus operator’s manual.

PiCCO plus p 11

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PULSION • 06-0294
MECH 2• 5.23.07
 Optimized Oxygenation

O2 uptake O2 transport O2 extraction O2 utilisation

O2 delivery O2 extraction

197 Route 18 South Cardiac Output

Suite 3000
East New Brunswick, NJ 08816
Phone: 732-514-6610 Stroke Heart
Volume Rate
Fax: 732-514-6614

PULSION Medical Systems AG Preload Afterload Contractiliy

Stahlgruberring 28 GEDI SVRI CFI
81829 Munich, Germany
Phone: +49-89-459914-0 Pulmonary
Fax: +49-89-459914-18 edema
info@pulsion.com ELWI

www.PULSION.com

Volume Vasopressors Inotropes

MPI812905_US R00 © PULSION 04/2007

Fast decision support!

PiCCO plus p 12

PULSION • SETUP GUIDE • FIN

PULSION • 06-0294
MECH 2• 5.23.07