1. Manuals
  2. Brands
  3. Deltex Medical Manuals
  4. Medical Equipment
  5. CardioQ-ODM+
  6. Workbook

Deltex Medical CardioQ-ODM+ Workbook

Hide thumbs
Table of Contents

Advertisement

Quick Links

Download this manual
WORKBOOK

Advertisement

Table of Contents
loading
Need help?

Need help?

Do you have a question about the CardioQ-ODM+ and is the answer not in the manual?

Questions and answers

Related Manuals for Deltex Medical CardioQ-ODM+

Summary of Contents for Deltex Medical CardioQ-ODM+

  • Page 1 WORKBOOK...

  • Page 2: Table Of Contents

    Contents Contents Introduction ..............................1 Cardiac Anatomy And Physiology ........................ 2 Anatomy of the Heart ..........................2 Physiology of the Cardiovascular System ....................2 Questions ............................... 6 Oesophageal Doppler Probes ........................7 General Information ..........................7 Contraindications/Considerations ......................8 Probe Insertion ............................8 Probe Focus ............................

  • Page 3: Introduction

    8. FAQs 9. Bibliography Deltex Medical recommends that users work through sections 2-7 in order, answering the questions for each section before moving on to the next section. A basic understanding of oesophageal Doppler monitoring is recommended before starting the workbook and is available from your local Deltex Medical representative.

  • Page 4: Cardiac Anatomy And Physiology

    2. Cardiac Anatomy and Physiology 2. Cardiac Anatomy And Physiology This section briefly describes the structures of the heart and key cardio dynamic definitions. Anatomy of the Heart Figure 2.1. The heart. The heart consists of four chambers; two atria and two ventricles. However, it is better to refer to the functions of the left- or right-sided heart.
  • Page 5 2. Cardiac Anatomy and Physiology Systole  Systole is the contraction phase of the cardiac cycle.  As the left ventricle contracts, blood is ejected into the aorta.  The oesophageal Doppler monitor will detect blood flow in the descending aorta as it passes the probe tip during the systolic phase.
  • Page 6 2. Cardiac Anatomy and Physiology Heart Rate  Heart rate is the number of beats per minute. Increasing or decreasing heart rate may increase or decrease cardiac output respectively. However, changes in heart rate alone may inversely affect stroke volume because of the reduction in the diastolic filling time. The Frank-Starling Mechanism ...
  • Page 7 2. Cardiac Anatomy and Physiology Compensation mechanisms are as follows:  A decrease in blood pressure will be detected by baroreceptors in the body.  These baroreceptors will stimulate the sympathetic nervous system and cause the release of hormones (e.g. adrenaline and noradrenaline). ...

  • Page 8: Questions

    2. Cardiac Anatomy and Physiology Questions 1. What happens to blood flow during ventricular systole? 2. What happens to blood flow during ventricular diastole? 3. What is cardiac output? 4. What is stroke volume? 5. What four factors will affect stroke volume? 6.

  • Page 9: Oesophageal Doppler Probes

    These probes are intended for use on adults (16 years and above) and are single patient use.  A dedicated paediatric probe is available separately. Paediatrics are not discussed further in this workbook, but more information can be obtained through a Deltex Medical representative.  The probe is latex free.

  • Page 10: Contraindications/Considerations

    3. Oesophageal Doppler Probes Contraindications/Considerations  Doppler probes (DPn and I n) should not be placed in patients under 16 years of age.  Do not use where nasal injuries are apparent or may have occurred.  Do not use where nasal polyps exist. ...

  • Page 11: Probe Focus

    3. Oesophageal Doppler Probes Probe Focus To obtain signal:  Insert probe to depth marker 2 for oral use, 3 for nasal use.  Rotate probe slowly without letting go.  If descending aortic signal is not seen, remove the probe by approximately 1 cm. Rotate again.

  • Page 12: Questions

    3. Oesophageal Doppler Probes Questions 1. What different time limits are available on: a. DP probes? b. I probes? 2. Why is it suggested that the probe is inserted as soon after intubation as possible? 3. Which depth markers are used for: a.

  • Page 13: The Cardioq-Odm

    4. The CardioQ-ODM+ 4. The CardioQ-ODM+ General Information The CardioQ-ODM+ combines Doppler measurement of blood flow velocity in the descending aorta with pulse pressure waveform analysis (PPWA). This provides users with the proven highly sensitive ‘Flow Monitoring Mode’ (FMM) to guide intervention and the simplest calibration of a ‘Pressure Monitoring Mode’...

  • Page 14: Calibration

    4. The CardioQ-ODM+ NOTES: 1. Gender is not a requirement for calculations. 2. If the patient’s data is outside the nomogram limits, this data is displayed in red and volumetric measurements (e.g. SV, CO etc.) will not be available. However, linear measurements (e.g. FTc, SD, PV etc.

  • Page 15: Flow Monitoring Mode

    PPWA data will no longer be available. However, if there is still probe life remaining, a new calibration can be done. Deltex Medical recommends that PMM is only used for monitoring and that FMM is used for interventions. The user can move between PMM and FMM by either pressing...
  • Page 16 4. The CardioQ-ODM+  can only be calculated as a spot measurement in FMM.  If DO is to be displayed as a default in the eight boxes, create a new user if not already done so (see Customising the settings). ...

  • Page 17: Questions

    4. The CardioQ-ODM+ Questions 1. What are the nomogram limits for: a. Age b. Weight c. Height 2. What happens when the patient data entered is outside of these limits? 3. How is a snapshot recorded? 4. How is a snapshot viewed? 5.

  • Page 18: The Cardioq-Odm

    5. The CardioQ-ODM 5. The CardioQ-ODM General Information The CardioQ-ODM offers oesophageal Doppler monitoring. Figure 5.1. CardioQ-ODM. Getting Started  Switch on CardioQ-ODM (rear).  Select [New patient].  Press [Auto number] or use large knob to enter ID. Auto number is based on the date and time.

  • Page 19: Data Input & Recording Menu

    5. The CardioQ-ODM Data Input & Recording Menu  This menu is available in the run screen.  The following will be available depending on settings; [Cycles for calculation], [Start Stop) data recording], [Start (or stop) signal recording], [Respiratory rate] [Enter CVP].
  • Page 20 5. The CardioQ-ODM Customising the settings:  This can only be done through the ‘no probe connected’ screen.  Changes for Default 1 and Default 2 settings cannot be saved. A new user would have to be created to save changes: Press [Monitor setup] from the no probe connected screen, then...

  • Page 21: Questions

    5. The CardioQ-ODM Questions 1. What are the nomogram limits for: a. Age b. Weight c. Height 2. What happens if the patient’s data is outside of the nomogram limits? 3. How is a snapshot recorded? 4. How is a snapshot viewed? 5.

  • Page 22: Cardioq-Odm+ And Cardioq-Odm Data

    6. CardioQ-ODM+ and CardioQ-ODM Data 6. CardioQ-ODM+ and CardioQ-ODM Data Information Any known ‘normal’ values are for a resting healthy individual and may be ‘abnormal’ in some clinical scenarios. It may be more appropriate to aim for ‘optimal’ values rather than ‘normal’ ones in these situations.
  • Page 23 6. CardioQ-ODM+ and CardioQ-ODM Data  Stroke distance (SD): a Doppler only parameter. SD is the distance the blood ejected by the left ventricle travels down the aorta every beat. It is measured in cm/s. o SD will be converted to SV when the nomogram is used, however it can be used to guide fluid and vasoactive drugs since it correlates well with SV.

  • Page 24: The Decision Tree

    6. CardioQ-ODM+ and CardioQ-ODM Data CPO = MAP x CO/451. o CPO has been found to be the strongest independent haemodynamic correlate of in-hospital mortality in patients with cardiogenic shock and chronic heart failure, following the review of the SHOCK trial results in 2000. A cut off value of 0.53 watts had a predictive value for in hospital mortality.
  • Page 25 6. CardioQ-ODM+ and CardioQ-ODM Data these are widely used in haemodynamic management of patients. The Decision Tree is a rational approach to using Doppler flow based measurements to guide therapy and can be applicable for perioperative and critically ill patients. Using the Decision Tree ...
  • Page 26 6. CardioQ-ODM+ and CardioQ-ODM Data Figure 6.3. The Decision Tree. Page 24...

  • Page 27: Questions

    6. CardioQ-ODM+ and CardioQ-ODM Data Questions: 1. What is the most common cause of an increased afterload/resistance? 2. What effect will this have on the SV? 3. What does FTc stand for? 4. What could cause this to be reduced? 5.

  • Page 28: Screenshots

    7. Screenshots 7. Screenshots Anatomy of a Waveform Descending aortic flow at approximately T5/T6 areas. Flow time is the duration of flow during systole. Peak velocity is a measure of the fastest speed of flow. See Section 5 for further information on these parameters. Signal Quality A dark centre is required to indicate the probe is facing the centre of the aorta.

  • Page 29: Signals From Other Vessels

    7. Screenshots Signals from Other Vessels Coeliac axis. Distinctive tapering of diastolic flow with implausible parameters. Probe is likely to be too deep. Withdraw slightly and refocus. Pulmonary artery. Flow is seen below the line. Probe tip is likely to be too high. Advance probe until as near to appropriate depth markers as possible and refocus.

  • Page 30: Clinical Examples

    7. Screenshots Intracardiac. Flow above and below line due to different flow directions within the heart. Sounds like a ‘galloping horse’. Try rotation and refocus or change depth and refocus if necessary. Clinical Examples Aortic regurgitation. Forward flow above the line with backward flow below the line.

  • Page 31: Waveform Analysis

    7. Screenshots Reduced afterload/low resistant state. Septic patient. High flow parameters. Some horizontal diastolic flow (may be sometime seen in low resistance states). Usually give fluid as per Starling responses and if BP remains low when no further SV responses are seen, a vasonstrictor may be considered.
  • Page 32 7. Screenshots Page 30...

  • Page 33: Faqs

    A. Check that the probe is firmly connected to the PIC and that the PIC is inserted into the front of the monitor. If necessary, try a different PIC. If the problem persists, retain the probe and contact Customer Services at Deltex Medical on 0845 085 0001. Q. Why can’t I change the patient details? A.

  • Page 34: Bibliography

    Bibliography 9. Bibliography Deltex Medical Ltd at www.deltexmedical.com Fincke R., et al 2004. Cardiac power is the strongest hemodynamic correlate of mortality in cardiogenic shock: a report from the SHOCK trial registry. J Am Coll Cardiol 33(2): 340-8. Lowe et al. 2010. Oesophageal Doppler Monitor (ODM) guided individualised goal directed fluid management (iGDFM) in surgery - a technical review.

This manual is also suitable for:

Cardioq-odm

Table of Contents