Haemodynamic monitoring with pulse-induced contour cardiac output (PiCCO) in critical care.

Abstract

Haemodynamic monitoring is essential for the management of the critically ill. Effective monitoring can give data that permit analysis of key circulatory functions and the anticipation of deterioration so that pro-active treatments can be initiated. There are many methods of monitoring the haemodynamic status of patients. The authors have compared three of the most commonly used methods in the general Critical Care Unit. These are the pulmonary artery catheter (PAC), oesophageal Doppler, and pulse-induced contour cardiac output (PiCCO) studies. The focus is upon PiCCO, which is a comparatively less invasive method than the traditionally used PAC. This has been chosen due to the authors' particular interest in the additional parameters which can be monitored using PiCCO. With the PiCCO system it is possible to measure intrathoracic blood volume (ITBV), extravascular lung water (EVLW) and cardiac function index (CFI). These parameters are of interest as they are considered to be the most specific measures of cardiac preload, pulmonary oedema and contractility and a global indicator of cardiac performance.