Error

Cause

Remedy

Pressure curve absent

• Pressure line not correctly attached

• Check pressure line, stop-cock, cable and plug

• Pressure line blocked

• Flush pressure line

• Cable or device defect

• Connect pressure transducer directly to the bedside monitor for testing

Abnormal pressure curve

• Catheter malpositioned

• Check or change catheter position

• Blocked catheter lumen

• Flush catheter

• Arrhythmia, extra systole

• Regulate
  therapeutically

• Tachycardia
  (> 240 bpm)

• Regulate
  therapeutically

Flat pressure curve

• Inappropriate scale settings

• Set scale of
  pressure curve

• Failed connection of pressure system

• Check and ensure pressure system connected correctly

• Flush has insufficient pressure

• Increase the flush pressure to 250-300 mmHg

• None or wrong zero adjustment

• Carry out / repeat zero adjustment

Damped pressure transducer transmission from:

• Airbubbles

• Modifications of pressure line
• Malposition of stop cocks
• Kinked catheter or pressure line

• Disconnect from patient and remove air bubble
• Remove any additional lines and or stop cocks
• Adjust stop cocks correctly
• Remove kinks, possibly change patient position

• Hypotonia

• Regulate therapeutically

Error

Cause

Remedy

Injection was not detected

• CVC malpositioned

• Correct position

• 3-way-stopcock incorrectly adjusted

• Adjust 3-way-stopcock

• Temperature sensor housing pin clotted

• Change temperature sensor housing

• Temperature sensor housing / sensor not connected correctly

• Check connection („click-sound“)

• Defective temperature sensor

• Check or change sensor

Error

Cause

Remedy

Results implausible

• Amount injected does
  not match amount to be
  injected displayed by device

• Inject correct volume

Error

Cause

Remedy

Calibration
PCCO not possible

• Arterial pressure curve absent or faulty

• Proof / optimise
  arterial pressure measurement

Large variation in values

• Arrhythmia, extra systoles

• Regulate therapeutically

Error

Cause

Remedy

Unstable temperature baseline measurement

• Rapid cooling or warming of patient

• Wait for stabilisation phase

• Massive volume loading

• Stop volume supply if possible

• Arterial connection cable broken or not correctly connected

• Check cable connection replace as necessary

• Faulty thermistor on PiCCO catheter

• Check temperature change when flushing catheter, replace catheter if no temperature change seen

• Parietal thermistor

• Change position, change possibly patient positioning

Thermodilution curve is not displayed

• Incorrect injection at central venous catheter

• Perform central venous injection correctly

• Faulty thermistor on PiCCO catheter

• Check temperature change when flushing catheter, replace catheter if no temperature change seen

• Broken or failed cable connection of arterial connection cable

• Check cable connection, change if necessary

Thermodilution curve display is too late (Time out limit)

• Injection too slow

• Inject faster
  (< 7s)

• Very low cardiac output or very high lung water

• Use colder and/or more injectate volume

Thermodilution curve very flat

• Inappropriate scale settings

• Adjust scaling

• Injectate too warm

• Use colder injectate

• Very low cardiac output or very high lung water

• Use colder and/or more injectate volume

Thermodilution curve displays more than one peak

• Injection not smooth

• Ensure smooth injection

• Existing Intracardiac Shunts

• Shunt diagnosis