12 Monitoring Cardiac Output
C.O./CCO Curve Alert
Tinj off scale
Temperature baseline drift
Small signal, more indicator
Injectate temperature too high
High ETVI, use cold injectate or
greater inj. volume
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
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
- Do not administer injections through the central line during a
- 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
May occur if patient is recovering from open heart surgery, or if
patient was cooled down for surgery and is in the process of
regaining normal body temperature when the measurement is
The peak of the transpulmonary thermodilution curve was below
0.1ºC. Increase injectate volume and/or lower injectate
The difference between the blood and injectate temperatures is
too small. The calculated value for C.O. may not be accurate.
The ETVI value is too high. The accuracy of the transpulmonary
thermodilution measurement may be reduced. Increase injectate
volume and/or lower injectate temperature following the
guidelines given in the section "Guidelines for PiCCO C.O.
Injectate" on page 204.
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