Monitoraggio con PICCO System
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(2) S vO 2. 78 3124.4. SQI. CCO. EDVI. BT 36.7 S V R 2011 O 2E I 28.9 CCI 1.7. HR. EF SV MAP CVP. EDVI CCO 300 6. S vO 2. 1. 100. CCO ru n n in g. Hom e S C. 50. 150. 3. E. R etu rn. 69. 26 57 93 5. 0. 0. 4:30a G rap h 1: S vO 2. S cale: 0 - 100. 4:45a. 5:00a. 0. 5:15a. G rap h 2: EDVI. TREND DATA. “C” CCO/CCI “S” SvO2 “E” EDV/EDVI. S cale: 0 - 300. G rap h 3: CCO. S cale: 0 -6.
(3) “Semi” - CONTINUOUS THERMODILUTION Pre-determined warming of a thermal filament placed into the RV. The system is able to evaluate all the minimal temperature changes in the pulmonary artery. The value obtained represents the mean of all data recorded in the time evaluated(at least 2 min).
(4) COpa vs CCO/PCCO. Liver Tx (Piggy Back - n=62). bias (l min-1). 95% Limits of Agreement. r2. COart vs COpa PCCO vs COpa CCO vs COpa. 0.15 0.04 0.02. -1.59 to 1.89 -1.65 to 1.73 -1.46 to 1.50. 0.86• 0.86• 0.88•. PCCO vs CCO. -0.03. -1.78 to 1.72. 0.85•.
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(7) RVEF Thermal decay. The catheter quantifies the RVEF, and then derives the RVEDV The interval of time (Dt) between the consecutive beats on the decay thermal curve is evaluated Based on the principle of the energy consevation (thermal energy within the bloodin the PA) close measures of t° are analyzed (T1, T2, T3) to obtain a differential between the points that represents the. EF.
(8) THERMODILUTION PROBLEMS. Mr. Right Ventricle EF depends on the RV afterload (only in part on the RV contractility) EF can not be measured in case of tachiarrythmias (including AF).
(9) Dimensional schematic of proposed model of RV wrapped around “bullet-shaped” left ventricle “ELIPSOIDAL SHAPE around the LV”. LV, Left ventricle; RV, right ventricle; RVOT, right ventricular outflow tract..
(10) Cheatam, Int J Int Care, 2000.
(11) 200 RVEF 0.2. 150 2. RVEDVI (ml / m ). RVEF 0.3 110. RVEF 0.4. CARDIAC INDEX.
(12) Which is the best RVEDVI ?. • Diebel 1992 e Durham 1995 identified the upper limit (130-140 ml/m2): for volumes higher than, the pt doesn’t respond to higher RVEDVI. • But, the best RVEDVI depends also on the contractility or better on the RVEF • ↓ is the contractility, ↑ is the target of RVEDVI. N. B. the normal Right VEF is < 50%.
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