PiCCO-Technology is an easy, less invasive and cost-efficient tool for determining the main haemodynamic parameters of critically ill patients. In the following section you will find a collection of frequently asked questions and answers. If you need further help please contact us directly.
PiCCO stands for Pulse Contour Cardiac Output. The ‘i’ in PiCCO was added to create a pronounceable word.
PiCCO is indicated in all patients requiring cardiovascular and/or monitoring of circulatory volume status. This may include patients from various departments, such as surgical, medical, cardiac, neurological, paediatric and burn units, as well as other patients who require cardiovascular monitoring e.g. patients undergoing major surgical interventions.
In general, PiCCO is indicated in cases of unstable haemodynamic situations and unclear volume status as well as in therapeutic conflicts. Those situations are usually present in:
- Septic shock
- Cardiogenic shock
- Hypovolaemic shock
- Acute Respiratory Distress Syndrome
- Severe burn injury
- High risk surgical procedures
Patients with arterial access restrictions due to femoral artery grafting or severe burns are usually not qualified for the placement of a PiCCO catheter.
Note: The axillary or brachial artery can be used as an alternative site. Additionally a long radial arterial catheter can be placed for short term use (<72 hrs).
The PiCCO-Technology may give incorrect thermodilution measurements in patients with intracardiac shunts, aortic aneurysm, aortic stenosis, mitral or tricuspid insufficiency, pneumectomy, large pulmonary embolism and extracorporeal circulation. Please refer to the section ‘Medical and Physiological Questions’ for more details.
Related to the registration (CE approval) PULSION disposables can stay in place for a maximum of 28 days. From a hygienic point of view this is not recommended in clinical practice. Based on a publication by the Commission for Hospital Hygiene and Infection Prevention of the Robert-Koch Institute, Germany (Bundesgesundheitsbl – Gesundheitsforsch – Gesundheitsschutz 2002) the following recommendations are given:
- Exchange interval for PiCCO catheters: every 10 days (exception: long radial artery catheter PV2014L50: max. 3 days)
- Exchange interval for PiCCO monitoring kits: every 4 days
The exchange interval may be shorter in cases where complications associated with the use of this disposable are detected (e.g. bleeding, haematoma, signs of infection, perfusion impairment, misplacement of the catheter) or if local regulations or standard operating procedures overrule this recommendation.
The effect of MRI on the PiCCO-Catheter has been investigated in model experiments and has also been published as correspondence in congress newsletters (Kampen et al, Intensivmed Notfallmed 2002, Kampen et al Anaethesia 2004, Greco et al AnnFAR 2011). These investigations do not show any negative effects on the functionality of the PiCCO-Catheter during MRI.
However, there are currently no systematic tests for all available MRI systems under the various measurement conditions. Therefore PULSION cannot confirm the compatibility of the PiCCO-Catheter with MRI systems and must recommend the removal of the PiCCO-Catheter before MRI. It is the treating physician’s full responsibility if the decision is made to leave the PiCCO-Catheter in the patient during the MRI.
The PULSION Monitoring Kits have been tested for frequency response and are matched to the algorithms used in the PiCCO-Technology, in order to give maximum reliability. The most important factor to maintain reliability is the connection tubing used with the PULSION disposable pressure transducer. This tubing is very inflexible and has a certain length and inner diameter. If you use any other transducers or connection tubing, or try to modify the connection tubing (e.g. with a needle less blood sampling port) the Pulse Contour Cardiac Output may not be correct. To ensure correct pressure transfer, a square wave test has to be performed (please refer to the instructions for use for the PULSION disposable pressure transducers). The PiCCO-Technology is only validated with original, unmodified PULSION disposable pressure transducer systems.