Déterminants et Techniques de Mesure du Débit Cardiaque · Cardiology Institute [email protected] Déterminants et Techniques de Mesure du Débit Cardiaque Alain Combes, MD,

alaincombesaphpfr wwwparis-ecmoorgCardiology Institute alaincombesaphpfr wwwparis-ecmoorgCardiology Institute

Deacuteterminants et Techniques de Mesure

du Deacutebit CardiaqueAlain Combes MD PhD

Cardiology Institute Hocircpital Pitieacute-Salpecirctriegravere AP-HP

Inserm UMRS 1166 iCAN Institute of Cardiometabolism and Nutrition

Pierre et Marie Curie Sorbonne University Paris Francewwwparis-ecmoorg

alaincombesaphpfr


Objectifs de la circulation

bull Apporter O2 aux organes peacuteripheacuteriquesbull Assurer adeacutequation besoins-apports

bull Systegraveme clos arteacuterio-veineuxbull Deacutebit retour veineux = Deacutebit eacutejection des

2 ventricules

bull Systegraveme en seacuterie bull VD circulation pulmonaire VG

bull Systegravemes en parallegravelebull Circulations reacutegionales


Deacutefinition laquo meacutetabolique raquoPrincipe de Fick

bull Pour un organisme agrave lrsquoeacutetat stable

bull Sans shunt intrapulmonaire

DC = VO2 (CaO2-CvO2)

VO2 = Consommation en O2(CaO2-CvO2) = Diffeacuterence des contenus arteacuteriel et veineux en O2


Deacutefinition laquo Physique raquoLoi de Poiseuille

bull Pour un fluide parfaitbull Agrave faible viscositeacute

bull Si lrsquoeacutecoulement est laminaire

DC = (PAom-POD) RVS

DP = Gradient de P Motrice mmHgR = Reacutesistances vasculaires


Deacutefinition heacutemodynamique

DC = FC x VESFC = Freacutequence cardiaquemin

VES = Volume drsquoeacutejection systoliqueValeur normale = 5 agrave 6 Lmin

IC = DC ScValeur normale gt 3 Lminmsup2


Deacuteterminants du VES

DC = FC x VES


Preacutecharge Postcharge

Remplissage Performance diastolique

EjectionPerformance systolique

Fonction POMPE ventriculaire



bull Preacute-charge

bull Fonction POMPE ventriculaire

bull Performance diastolique

bull Performance systolique

bull Post-charge


Deacutefinition de la preacutecharge du cœur

bull Ensemble des facteurs qui contribuent agrave creacuteer la contrainte

bull = STRESS

bull Qui srsquoexerce sur la paroi ventriculaire en teacuteleacutediastole

bull Juste avant la phase de contraction isovolumique


Courbes PV ventriculaires

end-diastoleend-diastole

A-B SystoleC-D Diastole

Preacute-Charge


Tension Pression StresshellipLa loi de Laplace

bullPour une sphegravere de rayon r ougrave regravegne la pression P la contrainte (stress) qui srsquoexerce par U de surface sur la paroi drsquoeacutepaisseur hbull s = P x r 2 h dynescmsup2


Preacute-charge et Loi de Laplace

bull Preacute-charge = contrainte s en fin de diastole

bull s = P x r 2h dynescmsup2

bull La preacutecharge VG est doncbull Proportionnelle agrave la pression qui regravegne dans la caviteacute et au rayon

du ventricule

bull Inversement proportionnelle agrave lrsquoeacutepaisseur de la paroi

bull Donc pression et volume (ou diamegravetres) teacuteleacute-diastoliques sont des approximations de la preacutecharge


Deacuteterminants de la preacute-charge

bull Retour veineux qui deacutependbull Volume sanguin circulant Voleacutemie

bull Apportspertes liquidiens fonction reacutenalehellip

bull Reacutesistancecompliance du reacuteseau veineux capacitif (rocircle du systegraveme nerveux autonome)

bull Pressions intra-thoracique et intra-abdominale

bull Deacutebit cardiaque (circuit fermeacute)

bull Compliance du ventricule Dt et du peacutericardebull Performance diastolique de la pompe cardiaque


Effets drsquoune modification de preacute-charge sur le DC

POD mmHg

Q Lmin

0

DC

Retour V



POD mmHg

Q Lmin

0

DC

Retour V

Deacutebit Cardiaque



POD mmHg

Q Lmin

0

Retour V

Remplissage

DC



POD mmHg

Q Lmin

0

Retour V

DQ

DC



POD mmHg

Q Lmin

0

Retour V

DQ1

DQ2

DC


Concept de preacutecharge deacutependancehellip

Volume drsquoeacutejection systolique

preacutecharge-deacutependance

preacutecharge-independance

Preacutecharge ventriculaire







bull Post-charge


Performance systolique

bull = Contractiliteacute eacutetat inotrope du myocarde

bull Proprieacuteteacute inheacuterente du myocarde agrave se contracter

bull Geacuteneacuteration drsquoune force augmentant vitesse et amplitude du raccourcissement des fibres myocardiques

bull Indeacutependamment des conditions de charge (preacute et post charge ventriculaire) et de la freacutequence cardiaque

bull Augmenteacutee par lrsquoeffort les cateacutecholamines endogegravenes ou pharmacologiques les digitaliqueshellip

bull Indices pour eacutevaluer lrsquoeacutetat inotrope

bull dPdt FE VG Travail systolique VGhellip

bull Eacutelastance en fin de systole +++






Eacutelastance en fin de systole


Effet inotrope et courbes PV

Effet inotrope positif Effet inotrope neacutegatif

Ees + Ees -


Performance diastolique

bull = Eacutetat lusitrope du myocarde

bull Diastole cardiologique bull relaxation isovolumique + remplissage ventricule

bull Au niveau moleacuteculaire capaciteacute agrave faire baisser la concentration de Ca++ intracellulaire

bull Phosphorylation de proteacuteines du SR phospholamban en particulier qui augmente la vitesse de reacuteabsorption Ca

bull Varie le plus souvent parallegravelement agrave lrsquoeacutetat inotrope du myocarde

bull Influence compliance peacutericarde + thorax

bull Un des deacuteterminants de la preacute-charge ventriculaire


Effet lusitrope et courbes PV

Effet lusitrope positif Effet lusitrope neacutegatif


Reacutegulation de la fonction contractile

bull Pharmacologique

bull Meacutecanisme de Franck-Starling

bull PositiveNegative Staircase

bull Effet Anrep


Loi de Franck-Starling

bull Loi de Starling

bull Plus le volume teacuteleacutediastolique ventriculaire augmente plus importante sera

lrsquoeacutenergie geacuteneacutereacutee par la contraction du ventricule et plus important sera le

volume de sang eacutejecteacute et la pression geacuteneacutereacutee

bull Loi de Franck

bull Lrsquoaugmentation du volume teacuteleacutediastolique srsquoaccompagne drsquoune augmentation

de la vitesse de raccourcissement des fibres drsquoune force geacuteneacutereacutee plus

importante et drsquoune acceacuteleacuteration de la relaxation

bull Donc description drsquoun effet inotrope et lusitrope positif lorsque le volume

teacuteleacutediastolique augmente




Relation force-freacutequence

bull laquo Treppe raquo laquoPositive Staircase raquo

effet escalier + Bowditch effect

bull Une augmentation de la freacutequence cardiaque entraicircne une

augmentation de la force geacuteneacutereacutee par le ventricule

bull En cas de stimulation ventriculaire rapide plus de Ca++ entre

dans la cellule que ne peuvent en laquo extruder raquo les pompes

cellulaires


Positive Staircase


Effet laquoAnrepraquo

bull Une brutale augmentation de la post-charge VG entraicircne un effet inotrope positif dans les minutes qui suiventhellip







bull Post-charge


Deacutefinition de la post-charge du cœur

bull Ensemble des facteurs qui contribuent agrave creacuteer la contrainte = stress bull Qui srsquoexerce sur la paroi ventriculaire pendant la phase de

contraction (isovolumique + eacutejection)

bull Ensemble des facteurs qui srsquoopposent agrave lrsquoeacutejection VGbull = Impeacutedance drsquoentreacutee de lrsquoaorte


Post-charge et Loi de Laplace

bull Post-charge = contrainte s VG en systole

bull s = P x r 2h

bull La post-charge VG est drsquoautant plus importante quebull La pression systolique neacutecessaire pour ouvrir la valve Ao et eacutejecter le sang

vers lrsquoaorte est plus importante bull Le volume ventriculaire systolique est plus important

bull Donc agrave P identique plus le VG est dilateacute plus la post-charge appliqueacutee aux fibres myocardiques est eacuteleveacutee


bull La contrainte ventriculaire en fin de systole est donc le reflet des composantes de la post-chargebull Maximum de pression geacuteneacutereacutee en systole par le VG bull Reacutesistances arteacuterielles peacuteripheacuteriques Compliance Ao


Deacuteterminants de la post-charge Pression geacuteneacutereacutee

bull Preacute-charge qui deacutepend du deacutebit de retour veineux bull Donc du DC

bull Eacutetat inotrope du cœurbull Meacutecanisme de Franck-Starling

bull Effet Escalier (freacutequence)

bull Effet Anrep (post-charge)


Deacuteterminants de la post-charge Reacutesistances vasculaires

bull Reacutegulation nerveusebull Fibres vasoconstrictrices sympathiques vasculaires

bull Centres bulbaires ganglions S para-rachidiensbull Action de la noradreacutenaline sur les reacutecepteurs a1

bull Fibres vasodilatatricesbull Essentiellement musculaires mises en jeu agrave lrsquoeffortbull Meacutediateur aceacutetylcholine

bull Reacutegulation humoralebull Cateacutecholamines circulantes (meacutedullosurreacutenale)bull Systegraveme reacutenine-angiotensinebull Endotheacutelinebull Vasopressinebull Kinines et prostaglandines vasodilatatrices

bull Eacutelastance et compliance aortique intrinsegravequesbull Effet de lrsquoacircge calcificationshellip


Impeacutedance arteacuterielle agrave lrsquoeacutejection

bull Meilleure deacutefinition de la post-charge VG prend en comptebull Impeacutedance caracteacuteristique aortebull Ondes de reacuteflexion geacuteneacutereacutees au niveau des vx peacuteriphbull Viscositeacute et densiteacute du sangbull Freacutequence cardiaque caractegravere pulseacute du flux

bull Par deacutefinition Impeacutedance Zbull Z = PAo QAo bull Varie donc agrave tout moment de lrsquoeacutejectionbull La deacutecomposition du spectre drsquoimpeacutedance eacutejectionnel

bull Magnitude et phase pour chaque freacutequence

bull Neacutecessite une transformation de Fourier et une mesure HiFi en continu pression et deacutebit au point consideacutereacute

bull Lrsquoimpeacutedance (et la post-charge) augmentent lorsquebull PAo augmente (HTA baisse de la compliance Ao)bull QAo diminue (RAC CMH)


Preacute-charge eacutetat inotrope post-chargeInter-relations des 3 composantes

bull La preacute-charge deacutetermine en partie la force de contraction

geacuteneacutereacutee par le ventricule

bull Une augmentation de lrsquoeacutetat inotrope augmente le deacutebit et la

pression aortique

bull Donc augmente la post-charge

bull Lrsquoaugmentation du deacutebit Ao va augmenter le retour veineux et

donc la preacute-chargehellip


DC = FC x VES


Deacuteterminants de la freacutequence cardiaque

bull Controcircle nerveuxbull Tonus sympathique acceacuteleacuterateurbull Tonus parasympathique modeacuterateur

bull Preacutedominant agrave lrsquoeacutetat basal

bull Boucle de reacutegulationbull Reacutecepteurs (baro- chemo- meacutetabo-reacutecepteurs)bull Centres corticaux sous-corticaux bulbaires meacutedullairesbull Action sur centres nodaux cardiaques

bull Controcircle humoralbull Cateacutecholamines circulantes acceacuteleacuteratrices

bull Controcircle meacutecaniquebull Baroreacutecepteurs carotidiens aortiques et cardiaques


Controcircle nerveux de la FC


FC et DC agrave inotropisme constant


Adaptation physiologique agrave lrsquoeffort

bull Toutes les actions (contractions musculaires + actions cardiovasculaires) sont mises en œuvre par le cortex moteur (puis hypothalamus centres bulbaires Set paraS)

bull Tachycardie par activation sympathique geacuteneacuteraliseacutee

bull Hausse des cateacutecholamines circulantes qui augmentent lrsquoinotropisme et lrsquoeacutetat lusitrope du cœur

bull Activation sympathique vasculaire

bull Musculaire vasodilatatrice

bull Autres territoires vasoconstriction

bull Forte augmentation du DC (gt25 Lmin)

bull Drsquoougrave augmentation du retour veineux et augmentation de PA inotropisme (Starlinghellip)


Adaptation physiologique au passage en orthostatismebull Baisse brutale PA dans partie sup du corps et seacutequestration de

sang dans le secteur veineux capacitif des membres infeacuterieurs

bull Activation des baroreacutecepteurs bull Chute du tonus paraSbull Activation S intense

bull Tachycardie

bull Hausse des cateacutecholamines circulantes bull Qui augmentent lrsquoinotropisme et lrsquoeacutetat lusitrope du cœur bull Qui entraicircnent une vasoconstriction arteacuterielle et veineuse


Conclusion DC = FC x VEShellip


Effets des modifications preacute-charge inotropisme Postcharge et FC sur les courbes PV

httpmedicinemissouriedumppcontentfacultydavis-mModelspvmodelhtml


Techniques de mesuredu Deacutebit Cardiaque


La technique ideacutealehellipNrsquoexiste pasbull Preacutecise

bull Fiable Juste non biaiseacutee

bull Reproductible

bull Automatique et continue

bull Sans eacutetalonnage initial ou reacutepeacuteteacute

bull Non opeacuterateur-deacutependante

bull Non invasive

bull Facile agrave mettre en place et interpreacuteter

bull Peu coucircteuse


Comparaison de techniques


Bland-Altman Diagram

Identity ref line

Mean difference = Bias= Accuracy

95 Sup Limit of agreement

Biais =


95 Limit of agreement =

Precision


Percentage error (2SDmean) should be lt30


4-Quadrants Plot


Les techniques

bull Thermodilutionbull Meacutethode de Stewart-Hamilton

bull Dilution du Lithium

bull Analyse de la courbe de PA

bull Meacutethodes Doppler

bull Meacutethode de Fick

bull BioimpeacutedanceBioreacuteactance


ThermodilutionInjection du bolus froid

TInjection

tStewart-Hamilton method

D

dtT

KV)T(TCO

b

iib

Thermistance


Le catheacuteter arteacuteriel pulmonaire



bull CAP standard

bull Injections discontinues de bolus froid

bull Retenir la moyenne de trois agrave cinq mesures conseacutecutives

bull Eacuteliminer valeur manifestement aberrante

bull CAP agrave deacutebit cardiaque laquo continu raquo

bull Catheacuteters eacutequipeacutes dun filament thermique

bull Fournissent la moyenne des mesures de deacutebit cardiaque des 3 agrave 6 minutes preacuteceacutedentes reacuteactualiseacutee toutes les 30 secondes

bull Permet de saffranchir des limitations de la thermodilution discontinue fonctionnement cyclique du respirateur perfusion de liquides non reacutechauffeacutes et deacuterive lente de la tempeacuterature de base

bull Pas utilisable quand la tempeacuterature corporelle gt agrave 40 degC

bull Moins fiable si haut deacutebit cardiaque (Jaquet ICM 1996)



bull Limites de la meacutethodebull Shunts intracardiaques arythmie

bull Insuffisance tricuspide bull Sous-estimation si DC eacuteleveacute et inversementhellip

bull Remplissage rapide concomitant bull Erreur de 30 agrave 80

bull Faible volume injectatbull Surestime deacutebit

bull Bas deacutebit cardiaquebull Deacutebit surestimeacute


Limites de la technique continue


Thermodilutiontranspulmonaire


La thermodilution transpulmonaire

lt 24degC



Catheacuteter Arteacuteriel de TD

C V C injection du bolus froid

TInjection


D

dtT

KV)T(TCO

b

iib


Volume-Viewtrade

Edwardsreg


Validation de la technique

TD pulmonaire vs Transpulmonaire Sakka Int Care Med 1999


PICCO thermodilution limites

bull Limites de la meacutethodebull Shunts intracardiaquesbull Insuffisance tricuspidebull Insuffisance mitralebull Remplissage rapide concomitantbull Aneacutevrisme de lrsquoaorte abdominalebull Atheacuterome


Analyse de la dilution du Li


LiDCOplushellip Li dilution + PulseCo analysis


Analyse de la courbe de PA


Le laquo Pulse Contour raquo

Area of

pressure

curve

Shape of

pressure

curve

PCCO = cal bull HR bull

Systole

P(t)SVR + C(p) bull dP

dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]

Area of

pressure

curve

Shape of

pressure

curve


Systole


dt( ) dtPCCO = cal bull HR bull

Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]


Validiteacute de la technique PCCO

bull Plusieurs eacutetudes ont compareacute le deacutebit cardiaque mesureacute par TD et PCCO



Godje Crit Care Med 1999



bull Influence des modifications des RVS

bull laquo Deacuterive raquo en fonction du tempsbull Pour avoir Pcentage erreur (2SDmoy) lt30 calibrer lt1 hbull De mecircme si variation RVS gt 15 fiabiliteacute seult si calibration lt1h

o Hamzaoui Crit Care Med 2008 36(2)434-40

Rodig Br J Anesth 1998

PCCO Pulse contourBCO Bolus froidCCO PAC continu

phenylephrine


PiCCO Limites

o Inconveacutenients

o Catheacuteter arteacuteriel speacutecifique

o Feacutemoral le + souvent

o Inapplicable en cas de trouble du rythme

o Neacutecessite des calibrations reacuteguliegraveres par thermodilution pour

Pulse contour car laquo deacuterive raquo rapide de la valeur calculeacutee

o Au moins toutes les heures



FloTracVigileoreg LIDCORAPID reg PulsioFlexreg

bull Fonctionnent sans aucune calibration

bull Lrsquoonde de pouls est recueillie par un capteur speacutecifiquebull FloTractrade Edwards LIDCORAPID tradebull ProAQTPulsioFlex trade PULSION avec laquo autocalibration raquo initialebull Se connecte sur nrsquoimporte quel catheacuteter arteacuteriel

bull Analyse continue de lrsquoonde de poulsbull Eacutetude statistique forme du signal de P Arteacuterielle

bull gt 100 fois par seconde

bull xxx paramegravetres combineacutes algorithme non divulgueacute bull Courbe de pression sa formebull Paramegravetres biomeacutetriques bull Estimation de la compliance reacutegionale aortique etchellip


FloTracreg Vigileoreg


Overall percentage error of 459 compared

with the bolus thermodilution technique


Acute variations in arterial blood pressure alter the reliability

of the FlowTracVigileoreg device with the second generation software

Vigileo

CAP



Meacutethodes Doppler


Mesure du DCDC = FC VES = FC SurfAo ITV

S = prod D2 4 ITV


Doppler Œsophagien

bull Deacutebit cardiaque battement par battement

(volume drsquoeacutejection systolique)

bull Peu invasif

bull Simple

bull 2 appareils

bull CardioQ Deltex Estimation Diam Ao

bull HemoSonic Arrow Mesure Diam Ao

bull Approximation

bull Deacutebit Ao repreacutesente 70 du DC total


Doppler Œsophagien



Principe

DC = SurfAo V(t)dt


Reacuteglage gainidentique

Profondeur identique

Rotation sonde diffeacuterente


Excess gain

Correct gain



Doppler œsophagien avantages

bull Technique simple et peu invasive

bull Apprentissage rapide

bull Bonne reproductibiliteacute

bull Controcircle visuel de la qualiteacute du signal

bull Mesure du DC battement battement


Doppler œsophagien limites

bull Opeacuterateur-deacutependant

bull Sonde non fixeacutee repositionnement neacutecessaire

bull Approximations pour le calcul bull Surface aortique estimeacutee ou mesureacutee (Echo TM)

bull Si estimeacutee on peut sous-estimer lrsquoeffet sur le DC drsquoun RV

bull 70 du DC dans lrsquoaorte descendante

bull Faisabiliteacute bull AG avec ventilation meacutecanique indispensablebull Accegraves agrave la tecircte

bull Contre-indication en cas de bull Pathologie œsophagienne

bull Inutilisable sibull Dissection aortiquebull Clampage aortique


Meacutethode de Fick


NICO(non invasive cardiac output)

bullPrincipe de Fickappliqueacute au CO2

bullReacute-inhalation partielle des gaz expireacutes




NICO limites

bull Mesure du DC moyen

bull Mesure discontinue (toutes les 3 min)

bull Stabiliteacute heacutemodynamique pour que le Principe de Fick

soit valide

bull Approximations +++ en cas de shunt

bull Neacutecessite une AG avec curarisation


Bioimpeacutedance thoracique


BioimpeacutedanceBioreactance thoracique

bull Principe bull Agrave chaque battement le volume sanguin thoracique change et modifie

lrsquoimpeacutedance eacutelectrique du thoraxbull DVV = DZZ Bioimpeacutedance modulation amplitudebull DVV = DXX Bioreacuteactance modulation freacutequence

bull Avantage bull Caractegravere strictement non-invasif bull Simpliciteacute de mise en oeuvre (huit eacutelectrodes agrave la base du cou et du thorax)

bull Inconveacutenients bull Insuffisamment valideacuteebull Insuffisance aortique aneacutevrisme aortique shunt intracardiaque bull Arythmiesbull OAP augmentation du volume liquidien thoracique








LIDCORAPID

- Continuous pressure measurement

with CNAPTM dual finger cuff system

scaled to the brachial artery

with an arm cuff

- CNAPTM derived arterial waveform

drive the PulseCOTM algorithm

- SVV PPV HR and ΔSV obtained




Conclusionbull Monitorage du deacutebit cardiaque

bull Indispensable chez les patients les plus laquo agrave risque raquo

bull Permet de guider la reacuteanimation laquo heacutemodynamique raquo

bull Aucune des meacutethodes utiliseacutees nrsquoest parfaite

bull La plupart sont invasives (CAP+++)

bull Nouvelles techniques en cours drsquoeacutevaluation

bull Vigileo Bioimpeacutedancereacuteactance

bull Bien connaicirctre la technique utiliseacutee dans son uniteacutehellip Et ses limites+++

bull Inteacuterecirct des variations de DC ou de VES (SVV)

bull Pour preacutediction efficaciteacute eacutepreuve remplissage

bull Plus qursquoune valeur du DC au temps t


Objectifs de la circulation

bull Apporter O2 aux organes peacuteripheacuteriquesbull Assurer adeacutequation besoins-apports

bull Systegraveme clos arteacuterio-veineuxbull Deacutebit retour veineux = Deacutebit eacutejection des

2 ventricules

bull Systegraveme en seacuterie bull VD circulation pulmonaire VG

bull Systegravemes en parallegravelebull Circulations reacutegionales











DC = (PAom-POD) RVS









DC = FC x VES












bull Post-charge




bull = STRESS







Preacute-Charge









du ventricule













POD mmHg

Q Lmin

0

DC

Retour V



POD mmHg

Q Lmin

0

DC

Retour V




POD mmHg

Q Lmin

0

Retour V

Remplissage

DC



POD mmHg

Q Lmin

0

Retour V

DQ

DC



POD mmHg

Q Lmin

0

Retour V

DQ1

DQ2

DC













bull Post-charge




















Ees + Ees -


















bull Effet Anrep







bull Loi de Franck
















cellulaires


Positive Staircase










bull Post-charge









bull s = P x r 2h































pression aortique





DC = FC x VES


























bull Tachycardie












bull Reproductible




bull Non invasive







Identity ref line



Biais =



Precision




4-Quadrants Plot


Les techniques









TInjection


D

dtT

KV)T(TCO

b

iib

Thermistance





bull CAP standard























lt 24degC





TInjection


D

dtT

KV)T(TCO

b

iib


Volume-Viewtrade

Edwardsreg















Area of

pressure

curve

Shape of

pressure

curve


Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]

Area of

pressure

curve

Shape of

pressure

curve


Systole



Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]














phenylephrine


PiCCO Limites
























Vigileo

CAP






S = prod D2 4 ITV


Doppler Œsophagien



bull Peu invasif

bull Simple

bull 2 appareils



bull Approximation



Doppler Œsophagien



Principe

DC = SurfAo V(t)dt






Excess gain

Correct gain




























NICO limites




soit valide


















LIDCORAPID




with an arm cuff




























DC = (PAom-POD) RVS









DC = FC x VES












bull Post-charge




bull = STRESS







Preacute-Charge









du ventricule













POD mmHg

Q Lmin

0

DC

Retour V



POD mmHg

Q Lmin

0

DC

Retour V




POD mmHg

Q Lmin

0

Retour V

Remplissage

DC



POD mmHg

Q Lmin

0

Retour V

DQ

DC



POD mmHg

Q Lmin

0

Retour V

DQ1

DQ2

DC













bull Post-charge




















Ees + Ees -


















bull Effet Anrep







bull Loi de Franck
















cellulaires


Positive Staircase










bull Post-charge









bull s = P x r 2h































pression aortique





DC = FC x VES


























bull Tachycardie












bull Reproductible




bull Non invasive







Identity ref line



Biais =



Precision




4-Quadrants Plot


Les techniques









TInjection


D

dtT

KV)T(TCO

b

iib

Thermistance





bull CAP standard























lt 24degC





TInjection


D

dtT

KV)T(TCO

b

iib


Volume-Viewtrade

Edwardsreg















Area of

pressure

curve

Shape of

pressure

curve


Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]

Area of

pressure

curve

Shape of

pressure

curve


Systole



Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]














phenylephrine


PiCCO Limites
























Vigileo

CAP






S = prod D2 4 ITV


Doppler Œsophagien



bull Peu invasif

bull Simple

bull 2 appareils



bull Approximation



Doppler Œsophagien



Principe

DC = SurfAo V(t)dt






Excess gain

Correct gain




























NICO limites




soit valide


















LIDCORAPID




with an arm cuff






















DC = (PAom-POD) RVS









DC = FC x VES












bull Post-charge




bull = STRESS







Preacute-Charge









du ventricule













POD mmHg

Q Lmin

0

DC

Retour V



POD mmHg

Q Lmin

0

DC

Retour V




POD mmHg

Q Lmin

0

Retour V

Remplissage

DC



POD mmHg

Q Lmin

0

Retour V

DQ

DC



POD mmHg

Q Lmin

0

Retour V

DQ1

DQ2

DC













bull Post-charge




















Ees + Ees -


















bull Effet Anrep







bull Loi de Franck
















cellulaires


Positive Staircase










bull Post-charge









bull s = P x r 2h































pression aortique





DC = FC x VES


























bull Tachycardie












bull Reproductible




bull Non invasive







Identity ref line



Biais =



Precision




4-Quadrants Plot


Les techniques









TInjection


D

dtT

KV)T(TCO

b

iib

Thermistance





bull CAP standard























lt 24degC





TInjection


D

dtT

KV)T(TCO

b

iib


Volume-Viewtrade

Edwardsreg















Area of

pressure

curve

Shape of

pressure

curve


Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]

Area of

pressure

curve

Shape of

pressure

curve


Systole



Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]














phenylephrine


PiCCO Limites
























Vigileo

CAP






S = prod D2 4 ITV


Doppler Œsophagien



bull Peu invasif

bull Simple

bull 2 appareils



bull Approximation



Doppler Œsophagien



Principe

DC = SurfAo V(t)dt






Excess gain

Correct gain




























NICO limites




soit valide


















LIDCORAPID




with an arm cuff

























DC = FC x VES












bull Post-charge




bull = STRESS







Preacute-Charge









du ventricule













POD mmHg

Q Lmin

0

DC

Retour V



POD mmHg

Q Lmin

0

DC

Retour V




POD mmHg

Q Lmin

0

Retour V

Remplissage

DC



POD mmHg

Q Lmin

0

Retour V

DQ

DC



POD mmHg

Q Lmin

0

Retour V

DQ1

DQ2

DC













bull Post-charge




















Ees + Ees -


















bull Effet Anrep







bull Loi de Franck
















cellulaires


Positive Staircase










bull Post-charge









bull s = P x r 2h































pression aortique





DC = FC x VES


























bull Tachycardie












bull Reproductible




bull Non invasive







Identity ref line



Biais =



Precision




4-Quadrants Plot


Les techniques









TInjection


D

dtT

KV)T(TCO

b

iib

Thermistance





bull CAP standard























lt 24degC





TInjection


D

dtT

KV)T(TCO

b

iib


Volume-Viewtrade

Edwardsreg















Area of

pressure

curve

Shape of

pressure

curve


Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]

Area of

pressure

curve

Shape of

pressure

curve


Systole



Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]














phenylephrine


PiCCO Limites
























Vigileo

CAP






S = prod D2 4 ITV


Doppler Œsophagien



bull Peu invasif

bull Simple

bull 2 appareils



bull Approximation



Doppler Œsophagien



Principe

DC = SurfAo V(t)dt






Excess gain

Correct gain




























NICO limites




soit valide


















LIDCORAPID




with an arm cuff




















DC = FC x VES












bull Post-charge




bull = STRESS







Preacute-Charge









du ventricule













POD mmHg

Q Lmin

0

DC

Retour V



POD mmHg

Q Lmin

0

DC

Retour V




POD mmHg

Q Lmin

0

Retour V

Remplissage

DC



POD mmHg

Q Lmin

0

Retour V

DQ

DC



POD mmHg

Q Lmin

0

Retour V

DQ1

DQ2

DC













bull Post-charge




















Ees + Ees -


















bull Effet Anrep







bull Loi de Franck
















cellulaires


Positive Staircase










bull Post-charge









bull s = P x r 2h































pression aortique





DC = FC x VES


























bull Tachycardie












bull Reproductible




bull Non invasive







Identity ref line



Biais =



Precision




4-Quadrants Plot


Les techniques









TInjection


D

dtT

KV)T(TCO

b

iib

Thermistance





bull CAP standard























lt 24degC





TInjection


D

dtT

KV)T(TCO

b

iib


Volume-Viewtrade

Edwardsreg















Area of

pressure

curve

Shape of

pressure

curve


Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]

Area of

pressure

curve

Shape of

pressure

curve


Systole



Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]














phenylephrine


PiCCO Limites
























Vigileo

CAP






S = prod D2 4 ITV


Doppler Œsophagien



bull Peu invasif

bull Simple

bull 2 appareils



bull Approximation



Doppler Œsophagien



Principe

DC = SurfAo V(t)dt






Excess gain

Correct gain




























NICO limites




soit valide


















LIDCORAPID




with an arm cuff





























bull Post-charge




bull = STRESS







Preacute-Charge









du ventricule













POD mmHg

Q Lmin

0

DC

Retour V



POD mmHg

Q Lmin

0

DC

Retour V




POD mmHg

Q Lmin

0

Retour V

Remplissage

DC



POD mmHg

Q Lmin

0

Retour V

DQ

DC



POD mmHg

Q Lmin

0

Retour V

DQ1

DQ2

DC













bull Post-charge




















Ees + Ees -


















bull Effet Anrep







bull Loi de Franck
















cellulaires


Positive Staircase










bull Post-charge









bull s = P x r 2h































pression aortique





DC = FC x VES


























bull Tachycardie












bull Reproductible




bull Non invasive







Identity ref line



Biais =



Precision




4-Quadrants Plot


Les techniques









TInjection


D

dtT

KV)T(TCO

b

iib

Thermistance





bull CAP standard























lt 24degC





TInjection


D

dtT

KV)T(TCO

b

iib


Volume-Viewtrade

Edwardsreg















Area of

pressure

curve

Shape of

pressure

curve


Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]

Area of

pressure

curve

Shape of

pressure

curve


Systole



Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]














phenylephrine


PiCCO Limites
























Vigileo

CAP






S = prod D2 4 ITV


Doppler Œsophagien



bull Peu invasif

bull Simple

bull 2 appareils



bull Approximation



Doppler Œsophagien



Principe

DC = SurfAo V(t)dt






Excess gain

Correct gain




























NICO limites




soit valide


















LIDCORAPID




with an arm cuff
























bull Post-charge




bull = STRESS







Preacute-Charge









du ventricule













POD mmHg

Q Lmin

0

DC

Retour V



POD mmHg

Q Lmin

0

DC

Retour V




POD mmHg

Q Lmin

0

Retour V

Remplissage

DC



POD mmHg

Q Lmin

0

Retour V

DQ

DC



POD mmHg

Q Lmin

0

Retour V

DQ1

DQ2

DC













bull Post-charge




















Ees + Ees -


















bull Effet Anrep







bull Loi de Franck
















cellulaires


Positive Staircase










bull Post-charge









bull s = P x r 2h































pression aortique





DC = FC x VES


























bull Tachycardie












bull Reproductible




bull Non invasive







Identity ref line



Biais =



Precision




4-Quadrants Plot


Les techniques









TInjection


D

dtT

KV)T(TCO

b

iib

Thermistance





bull CAP standard























lt 24degC





TInjection


D

dtT

KV)T(TCO

b

iib


Volume-Viewtrade

Edwardsreg















Area of

pressure

curve

Shape of

pressure

curve


Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]

Area of

pressure

curve

Shape of

pressure

curve


Systole



Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]














phenylephrine


PiCCO Limites
























Vigileo

CAP






S = prod D2 4 ITV


Doppler Œsophagien



bull Peu invasif

bull Simple

bull 2 appareils



bull Approximation



Doppler Œsophagien



Principe

DC = SurfAo V(t)dt






Excess gain

Correct gain




























NICO limites




soit valide


















LIDCORAPID




with an arm cuff





















bull = STRESS







Preacute-Charge









du ventricule













POD mmHg

Q Lmin

0

DC

Retour V



POD mmHg

Q Lmin

0

DC

Retour V




POD mmHg

Q Lmin

0

Retour V

Remplissage

DC



POD mmHg

Q Lmin

0

Retour V

DQ

DC



POD mmHg

Q Lmin

0

Retour V

DQ1

DQ2

DC













bull Post-charge




















Ees + Ees -


















bull Effet Anrep







bull Loi de Franck
















cellulaires


Positive Staircase










bull Post-charge









bull s = P x r 2h































pression aortique





DC = FC x VES


























bull Tachycardie












bull Reproductible




bull Non invasive







Identity ref line



Biais =



Precision




4-Quadrants Plot


Les techniques









TInjection


D

dtT

KV)T(TCO

b

iib

Thermistance





bull CAP standard























lt 24degC





TInjection


D

dtT

KV)T(TCO

b

iib


Volume-Viewtrade

Edwardsreg















Area of

pressure

curve

Shape of

pressure

curve


Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]

Area of

pressure

curve

Shape of

pressure

curve


Systole



Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]














phenylephrine


PiCCO Limites
























Vigileo

CAP






S = prod D2 4 ITV


Doppler Œsophagien



bull Peu invasif

bull Simple

bull 2 appareils



bull Approximation



Doppler Œsophagien



Principe

DC = SurfAo V(t)dt






Excess gain

Correct gain




























NICO limites




soit valide


















LIDCORAPID




with an arm cuff






















Preacute-Charge









du ventricule













POD mmHg

Q Lmin

0

DC

Retour V



POD mmHg

Q Lmin

0

DC

Retour V




POD mmHg

Q Lmin

0

Retour V

Remplissage

DC



POD mmHg

Q Lmin

0

Retour V

DQ

DC



POD mmHg

Q Lmin

0

Retour V

DQ1

DQ2

DC













bull Post-charge




















Ees + Ees -


















bull Effet Anrep







bull Loi de Franck
















cellulaires


Positive Staircase










bull Post-charge









bull s = P x r 2h































pression aortique





DC = FC x VES


























bull Tachycardie












bull Reproductible




bull Non invasive







Identity ref line



Biais =



Precision




4-Quadrants Plot


Les techniques









TInjection


D

dtT

KV)T(TCO

b

iib

Thermistance





bull CAP standard























lt 24degC





TInjection


D

dtT

KV)T(TCO

b

iib


Volume-Viewtrade

Edwardsreg















Area of

pressure

curve

Shape of

pressure

curve


Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]

Area of

pressure

curve

Shape of

pressure

curve


Systole



Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]














phenylephrine


PiCCO Limites
























Vigileo

CAP






S = prod D2 4 ITV


Doppler Œsophagien



bull Peu invasif

bull Simple

bull 2 appareils



bull Approximation



Doppler Œsophagien



Principe

DC = SurfAo V(t)dt






Excess gain

Correct gain




























NICO limites




soit valide


















LIDCORAPID




with an arm cuff


























du ventricule













POD mmHg

Q Lmin

0

DC

Retour V



POD mmHg

Q Lmin

0

DC

Retour V




POD mmHg

Q Lmin

0

Retour V

Remplissage

DC



POD mmHg

Q Lmin

0

Retour V

DQ

DC



POD mmHg

Q Lmin

0

Retour V

DQ1

DQ2

DC













bull Post-charge




















Ees + Ees -


















bull Effet Anrep







bull Loi de Franck
















cellulaires


Positive Staircase










bull Post-charge









bull s = P x r 2h































pression aortique





DC = FC x VES


























bull Tachycardie












bull Reproductible




bull Non invasive







Identity ref line



Biais =



Precision




4-Quadrants Plot


Les techniques









TInjection


D

dtT

KV)T(TCO

b

iib

Thermistance





bull CAP standard























lt 24degC





TInjection


D

dtT

KV)T(TCO

b

iib


Volume-Viewtrade

Edwardsreg















Area of

pressure

curve

Shape of

pressure

curve


Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]

Area of

pressure

curve

Shape of

pressure

curve


Systole



Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]














phenylephrine


PiCCO Limites
























Vigileo

CAP






S = prod D2 4 ITV


Doppler Œsophagien



bull Peu invasif

bull Simple

bull 2 appareils



bull Approximation



Doppler Œsophagien



Principe

DC = SurfAo V(t)dt






Excess gain

Correct gain




























NICO limites




soit valide


















LIDCORAPID




with an arm cuff























du ventricule













POD mmHg

Q Lmin

0

DC

Retour V



POD mmHg

Q Lmin

0

DC

Retour V




POD mmHg

Q Lmin

0

Retour V

Remplissage

DC



POD mmHg

Q Lmin

0

Retour V

DQ

DC



POD mmHg

Q Lmin

0

Retour V

DQ1

DQ2

DC













bull Post-charge




















Ees + Ees -


















bull Effet Anrep







bull Loi de Franck
















cellulaires


Positive Staircase










bull Post-charge









bull s = P x r 2h































pression aortique





DC = FC x VES


























bull Tachycardie












bull Reproductible




bull Non invasive







Identity ref line



Biais =



Precision




4-Quadrants Plot


Les techniques









TInjection


D

dtT

KV)T(TCO

b

iib

Thermistance





bull CAP standard























lt 24degC





TInjection


D

dtT

KV)T(TCO

b

iib


Volume-Viewtrade

Edwardsreg















Area of

pressure

curve

Shape of

pressure

curve


Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]

Area of

pressure

curve

Shape of

pressure

curve


Systole



Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]














phenylephrine


PiCCO Limites
























Vigileo

CAP






S = prod D2 4 ITV


Doppler Œsophagien



bull Peu invasif

bull Simple

bull 2 appareils



bull Approximation



Doppler Œsophagien



Principe

DC = SurfAo V(t)dt






Excess gain

Correct gain




























NICO limites




soit valide


















LIDCORAPID




with an arm cuff




























POD mmHg

Q Lmin

0

DC

Retour V



POD mmHg

Q Lmin

0

DC

Retour V




POD mmHg

Q Lmin

0

Retour V

Remplissage

DC



POD mmHg

Q Lmin

0

Retour V

DQ

DC



POD mmHg

Q Lmin

0

Retour V

DQ1

DQ2

DC













bull Post-charge




















Ees + Ees -


















bull Effet Anrep







bull Loi de Franck
















cellulaires


Positive Staircase










bull Post-charge









bull s = P x r 2h































pression aortique





DC = FC x VES


























bull Tachycardie












bull Reproductible




bull Non invasive







Identity ref line



Biais =



Precision




4-Quadrants Plot


Les techniques









TInjection


D

dtT

KV)T(TCO

b

iib

Thermistance





bull CAP standard























lt 24degC





TInjection


D

dtT

KV)T(TCO

b

iib


Volume-Viewtrade

Edwardsreg















Area of

pressure

curve

Shape of

pressure

curve


Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]

Area of

pressure

curve

Shape of

pressure

curve


Systole



Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]














phenylephrine


PiCCO Limites
























Vigileo

CAP






S = prod D2 4 ITV


Doppler Œsophagien



bull Peu invasif

bull Simple

bull 2 appareils



bull Approximation



Doppler Œsophagien



Principe

DC = SurfAo V(t)dt






Excess gain

Correct gain




























NICO limites




soit valide


















LIDCORAPID




with an arm cuff




















POD mmHg

Q Lmin

0

DC

Retour V



POD mmHg

Q Lmin

0

DC

Retour V




POD mmHg

Q Lmin

0

Retour V

Remplissage

DC



POD mmHg

Q Lmin

0

Retour V

DQ

DC



POD mmHg

Q Lmin

0

Retour V

DQ1

DQ2

DC













bull Post-charge




















Ees + Ees -


















bull Effet Anrep







bull Loi de Franck
















cellulaires


Positive Staircase










bull Post-charge









bull s = P x r 2h































pression aortique





DC = FC x VES


























bull Tachycardie












bull Reproductible




bull Non invasive







Identity ref line



Biais =



Precision




4-Quadrants Plot


Les techniques









TInjection


D

dtT

KV)T(TCO

b

iib

Thermistance





bull CAP standard























lt 24degC





TInjection


D

dtT

KV)T(TCO

b

iib


Volume-Viewtrade

Edwardsreg















Area of

pressure

curve

Shape of

pressure

curve


Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]

Area of

pressure

curve

Shape of

pressure

curve


Systole



Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]














phenylephrine


PiCCO Limites
























Vigileo

CAP






S = prod D2 4 ITV


Doppler Œsophagien



bull Peu invasif

bull Simple

bull 2 appareils



bull Approximation



Doppler Œsophagien



Principe

DC = SurfAo V(t)dt






Excess gain

Correct gain




























NICO limites




soit valide


















LIDCORAPID




with an arm cuff




















POD mmHg

Q Lmin

0

DC

Retour V




POD mmHg

Q Lmin

0

Retour V

Remplissage

DC



POD mmHg

Q Lmin

0

Retour V

DQ

DC



POD mmHg

Q Lmin

0

Retour V

DQ1

DQ2

DC













bull Post-charge




















Ees + Ees -


















bull Effet Anrep







bull Loi de Franck
















cellulaires


Positive Staircase










bull Post-charge









bull s = P x r 2h































pression aortique





DC = FC x VES


























bull Tachycardie












bull Reproductible




bull Non invasive







Identity ref line



Biais =



Precision




4-Quadrants Plot


Les techniques









TInjection


D

dtT

KV)T(TCO

b

iib

Thermistance





bull CAP standard























lt 24degC





TInjection


D

dtT

KV)T(TCO

b

iib


Volume-Viewtrade

Edwardsreg















Area of

pressure

curve

Shape of

pressure

curve


Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]

Area of

pressure

curve

Shape of

pressure

curve


Systole



Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]














phenylephrine


PiCCO Limites
























Vigileo

CAP






S = prod D2 4 ITV


Doppler Œsophagien



bull Peu invasif

bull Simple

bull 2 appareils



bull Approximation



Doppler Œsophagien



Principe

DC = SurfAo V(t)dt






Excess gain

Correct gain




























NICO limites




soit valide


















LIDCORAPID




with an arm cuff




















POD mmHg

Q Lmin

0

Retour V

Remplissage

DC



POD mmHg

Q Lmin

0

Retour V

DQ

DC



POD mmHg

Q Lmin

0

Retour V

DQ1

DQ2

DC













bull Post-charge




















Ees + Ees -


















bull Effet Anrep







bull Loi de Franck
















cellulaires


Positive Staircase










bull Post-charge









bull s = P x r 2h































pression aortique





DC = FC x VES


























bull Tachycardie












bull Reproductible




bull Non invasive







Identity ref line



Biais =



Precision




4-Quadrants Plot


Les techniques









TInjection


D

dtT

KV)T(TCO

b

iib

Thermistance





bull CAP standard























lt 24degC





TInjection


D

dtT

KV)T(TCO

b

iib


Volume-Viewtrade

Edwardsreg















Area of

pressure

curve

Shape of

pressure

curve


Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]

Area of

pressure

curve

Shape of

pressure

curve


Systole



Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]














phenylephrine


PiCCO Limites
























Vigileo

CAP






S = prod D2 4 ITV


Doppler Œsophagien



bull Peu invasif

bull Simple

bull 2 appareils



bull Approximation



Doppler Œsophagien



Principe

DC = SurfAo V(t)dt






Excess gain

Correct gain




























NICO limites




soit valide


















LIDCORAPID




with an arm cuff




















POD mmHg

Q Lmin

0

Retour V

DQ

DC



POD mmHg

Q Lmin

0

Retour V

DQ1

DQ2

DC













bull Post-charge




















Ees + Ees -


















bull Effet Anrep







bull Loi de Franck
















cellulaires


Positive Staircase










bull Post-charge









bull s = P x r 2h































pression aortique





DC = FC x VES


























bull Tachycardie












bull Reproductible




bull Non invasive







Identity ref line



Biais =



Precision




4-Quadrants Plot


Les techniques









TInjection


D

dtT

KV)T(TCO

b

iib

Thermistance





bull CAP standard























lt 24degC





TInjection


D

dtT

KV)T(TCO

b

iib


Volume-Viewtrade

Edwardsreg















Area of

pressure

curve

Shape of

pressure

curve


Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]

Area of

pressure

curve

Shape of

pressure

curve


Systole



Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]














phenylephrine


PiCCO Limites
























Vigileo

CAP






S = prod D2 4 ITV


Doppler Œsophagien



bull Peu invasif

bull Simple

bull 2 appareils



bull Approximation



Doppler Œsophagien



Principe

DC = SurfAo V(t)dt






Excess gain

Correct gain




























NICO limites




soit valide


















LIDCORAPID




with an arm cuff




















POD mmHg

Q Lmin

0

Retour V

DQ1

DQ2

DC













bull Post-charge




















Ees + Ees -


















bull Effet Anrep







bull Loi de Franck
















cellulaires


Positive Staircase










bull Post-charge









bull s = P x r 2h































pression aortique





DC = FC x VES


























bull Tachycardie












bull Reproductible




bull Non invasive







Identity ref line



Biais =



Precision




4-Quadrants Plot


Les techniques









TInjection


D

dtT

KV)T(TCO

b

iib

Thermistance





bull CAP standard























lt 24degC





TInjection


D

dtT

KV)T(TCO

b

iib


Volume-Viewtrade

Edwardsreg















Area of

pressure

curve

Shape of

pressure

curve


Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]

Area of

pressure

curve

Shape of

pressure

curve


Systole



Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]














phenylephrine


PiCCO Limites
























Vigileo

CAP






S = prod D2 4 ITV


Doppler Œsophagien



bull Peu invasif

bull Simple

bull 2 appareils



bull Approximation



Doppler Œsophagien



Principe

DC = SurfAo V(t)dt






Excess gain

Correct gain




























NICO limites




soit valide


















LIDCORAPID




with an arm cuff






























bull Post-charge




















Ees + Ees -


















bull Effet Anrep







bull Loi de Franck
















cellulaires


Positive Staircase










bull Post-charge









bull s = P x r 2h































pression aortique





DC = FC x VES


























bull Tachycardie












bull Reproductible




bull Non invasive







Identity ref line



Biais =



Precision




4-Quadrants Plot


Les techniques









TInjection


D

dtT

KV)T(TCO

b

iib

Thermistance





bull CAP standard























lt 24degC





TInjection


D

dtT

KV)T(TCO

b

iib


Volume-Viewtrade

Edwardsreg















Area of

pressure

curve

Shape of

pressure

curve


Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]

Area of

pressure

curve

Shape of

pressure

curve


Systole



Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]














phenylephrine


PiCCO Limites
























Vigileo

CAP






S = prod D2 4 ITV


Doppler Œsophagien



bull Peu invasif

bull Simple

bull 2 appareils



bull Approximation



Doppler Œsophagien



Principe

DC = SurfAo V(t)dt






Excess gain

Correct gain




























NICO limites




soit valide


















LIDCORAPID




with an arm cuff
























bull Post-charge




















Ees + Ees -


















bull Effet Anrep







bull Loi de Franck
















cellulaires


Positive Staircase










bull Post-charge









bull s = P x r 2h































pression aortique





DC = FC x VES


























bull Tachycardie












bull Reproductible




bull Non invasive







Identity ref line



Biais =



Precision




4-Quadrants Plot


Les techniques









TInjection


D

dtT

KV)T(TCO

b

iib

Thermistance





bull CAP standard























lt 24degC





TInjection


D

dtT

KV)T(TCO

b

iib


Volume-Viewtrade

Edwardsreg















Area of

pressure

curve

Shape of

pressure

curve


Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]

Area of

pressure

curve

Shape of

pressure

curve


Systole



Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]














phenylephrine


PiCCO Limites
























Vigileo

CAP






S = prod D2 4 ITV


Doppler Œsophagien



bull Peu invasif

bull Simple

bull 2 appareils



bull Approximation



Doppler Œsophagien



Principe

DC = SurfAo V(t)dt






Excess gain

Correct gain




























NICO limites




soit valide


















LIDCORAPID




with an arm cuff





































Ees + Ees -


















bull Effet Anrep







bull Loi de Franck
















cellulaires


Positive Staircase










bull Post-charge









bull s = P x r 2h































pression aortique





DC = FC x VES


























bull Tachycardie












bull Reproductible




bull Non invasive







Identity ref line



Biais =



Precision




4-Quadrants Plot


Les techniques









TInjection


D

dtT

KV)T(TCO

b

iib

Thermistance





bull CAP standard























lt 24degC





TInjection


D

dtT

KV)T(TCO

b

iib


Volume-Viewtrade

Edwardsreg















Area of

pressure

curve

Shape of

pressure

curve


Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]

Area of

pressure

curve

Shape of

pressure

curve


Systole



Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]














phenylephrine


PiCCO Limites
























Vigileo

CAP






S = prod D2 4 ITV


Doppler Œsophagien



bull Peu invasif

bull Simple

bull 2 appareils



bull Approximation



Doppler Œsophagien



Principe

DC = SurfAo V(t)dt






Excess gain

Correct gain




























NICO limites




soit valide


















LIDCORAPID




with an arm cuff



























Ees + Ees -


















bull Effet Anrep







bull Loi de Franck
















cellulaires


Positive Staircase










bull Post-charge









bull s = P x r 2h































pression aortique





DC = FC x VES


























bull Tachycardie












bull Reproductible




bull Non invasive







Identity ref line



Biais =



Precision




4-Quadrants Plot


Les techniques









TInjection


D

dtT

KV)T(TCO

b

iib

Thermistance





bull CAP standard























lt 24degC





TInjection


D

dtT

KV)T(TCO

b

iib


Volume-Viewtrade

Edwardsreg















Area of

pressure

curve

Shape of

pressure

curve


Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]

Area of

pressure

curve

Shape of

pressure

curve


Systole



Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]














phenylephrine


PiCCO Limites
























Vigileo

CAP






S = prod D2 4 ITV


Doppler Œsophagien



bull Peu invasif

bull Simple

bull 2 appareils



bull Approximation



Doppler Œsophagien



Principe

DC = SurfAo V(t)dt






Excess gain

Correct gain




























NICO limites




soit valide


















LIDCORAPID




with an arm cuff























Ees + Ees -


















bull Effet Anrep







bull Loi de Franck
















cellulaires


Positive Staircase










bull Post-charge









bull s = P x r 2h































pression aortique





DC = FC x VES


























bull Tachycardie












bull Reproductible




bull Non invasive







Identity ref line



Biais =



Precision




4-Quadrants Plot


Les techniques









TInjection


D

dtT

KV)T(TCO

b

iib

Thermistance





bull CAP standard























lt 24degC





TInjection


D

dtT

KV)T(TCO

b

iib


Volume-Viewtrade

Edwardsreg















Area of

pressure

curve

Shape of

pressure

curve


Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]

Area of

pressure

curve

Shape of

pressure

curve


Systole



Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]














phenylephrine


PiCCO Limites
























Vigileo

CAP






S = prod D2 4 ITV


Doppler Œsophagien



bull Peu invasif

bull Simple

bull 2 appareils



bull Approximation



Doppler Œsophagien



Principe

DC = SurfAo V(t)dt






Excess gain

Correct gain




























NICO limites




soit valide


















LIDCORAPID




with an arm cuff





















Ees + Ees -


















bull Effet Anrep







bull Loi de Franck
















cellulaires


Positive Staircase










bull Post-charge









bull s = P x r 2h































pression aortique





DC = FC x VES


























bull Tachycardie












bull Reproductible




bull Non invasive







Identity ref line



Biais =



Precision




4-Quadrants Plot


Les techniques









TInjection


D

dtT

KV)T(TCO

b

iib

Thermistance





bull CAP standard























lt 24degC





TInjection


D

dtT

KV)T(TCO

b

iib


Volume-Viewtrade

Edwardsreg















Area of

pressure

curve

Shape of

pressure

curve


Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]

Area of

pressure

curve

Shape of

pressure

curve


Systole



Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]














phenylephrine


PiCCO Limites
























Vigileo

CAP






S = prod D2 4 ITV


Doppler Œsophagien



bull Peu invasif

bull Simple

bull 2 appareils



bull Approximation



Doppler Œsophagien



Principe

DC = SurfAo V(t)dt






Excess gain

Correct gain




























NICO limites




soit valide


















LIDCORAPID




with an arm cuff



































bull Effet Anrep







bull Loi de Franck
















cellulaires


Positive Staircase










bull Post-charge









bull s = P x r 2h































pression aortique





DC = FC x VES


























bull Tachycardie












bull Reproductible




bull Non invasive







Identity ref line



Biais =



Precision




4-Quadrants Plot


Les techniques









TInjection


D

dtT

KV)T(TCO

b

iib

Thermistance





bull CAP standard























lt 24degC





TInjection


D

dtT

KV)T(TCO

b

iib


Volume-Viewtrade

Edwardsreg















Area of

pressure

curve

Shape of

pressure

curve


Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]

Area of

pressure

curve

Shape of

pressure

curve


Systole



Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]














phenylephrine


PiCCO Limites
























Vigileo

CAP






S = prod D2 4 ITV


Doppler Œsophagien



bull Peu invasif

bull Simple

bull 2 appareils



bull Approximation



Doppler Œsophagien



Principe

DC = SurfAo V(t)dt






Excess gain

Correct gain




























NICO limites




soit valide


















LIDCORAPID




with an arm cuff


























bull Effet Anrep







bull Loi de Franck
















cellulaires


Positive Staircase










bull Post-charge









bull s = P x r 2h































pression aortique





DC = FC x VES


























bull Tachycardie












bull Reproductible




bull Non invasive







Identity ref line



Biais =



Precision




4-Quadrants Plot


Les techniques









TInjection


D

dtT

KV)T(TCO

b

iib

Thermistance





bull CAP standard























lt 24degC





TInjection


D

dtT

KV)T(TCO

b

iib


Volume-Viewtrade

Edwardsreg















Area of

pressure

curve

Shape of

pressure

curve


Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]

Area of

pressure

curve

Shape of

pressure

curve


Systole



Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]














phenylephrine


PiCCO Limites
























Vigileo

CAP






S = prod D2 4 ITV


Doppler Œsophagien



bull Peu invasif

bull Simple

bull 2 appareils



bull Approximation



Doppler Œsophagien



Principe

DC = SurfAo V(t)dt






Excess gain

Correct gain




























NICO limites




soit valide


















LIDCORAPID




with an arm cuff























bull Effet Anrep







bull Loi de Franck
















cellulaires


Positive Staircase










bull Post-charge









bull s = P x r 2h































pression aortique





DC = FC x VES


























bull Tachycardie












bull Reproductible




bull Non invasive







Identity ref line



Biais =



Precision




4-Quadrants Plot


Les techniques









TInjection


D

dtT

KV)T(TCO

b

iib

Thermistance





bull CAP standard























lt 24degC





TInjection


D

dtT

KV)T(TCO

b

iib


Volume-Viewtrade

Edwardsreg















Area of

pressure

curve

Shape of

pressure

curve


Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]

Area of

pressure

curve

Shape of

pressure

curve


Systole



Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]














phenylephrine


PiCCO Limites
























Vigileo

CAP






S = prod D2 4 ITV


Doppler Œsophagien



bull Peu invasif

bull Simple

bull 2 appareils



bull Approximation



Doppler Œsophagien



Principe

DC = SurfAo V(t)dt






Excess gain

Correct gain




























NICO limites




soit valide


















LIDCORAPID




with an arm cuff
























bull Loi de Franck
















cellulaires


Positive Staircase










bull Post-charge









bull s = P x r 2h































pression aortique





DC = FC x VES


























bull Tachycardie












bull Reproductible




bull Non invasive







Identity ref line



Biais =



Precision




4-Quadrants Plot


Les techniques









TInjection


D

dtT

KV)T(TCO

b

iib

Thermistance





bull CAP standard























lt 24degC





TInjection


D

dtT

KV)T(TCO

b

iib


Volume-Viewtrade

Edwardsreg















Area of

pressure

curve

Shape of

pressure

curve


Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]

Area of

pressure

curve

Shape of

pressure

curve


Systole



Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]














phenylephrine


PiCCO Limites
























Vigileo

CAP






S = prod D2 4 ITV


Doppler Œsophagien



bull Peu invasif

bull Simple

bull 2 appareils



bull Approximation



Doppler Œsophagien



Principe

DC = SurfAo V(t)dt






Excess gain

Correct gain




























NICO limites




soit valide


















LIDCORAPID




with an arm cuff




























cellulaires


Positive Staircase










bull Post-charge









bull s = P x r 2h































pression aortique





DC = FC x VES


























bull Tachycardie












bull Reproductible




bull Non invasive







Identity ref line



Biais =



Precision




4-Quadrants Plot


Les techniques









TInjection


D

dtT

KV)T(TCO

b

iib

Thermistance





bull CAP standard























lt 24degC





TInjection


D

dtT

KV)T(TCO

b

iib


Volume-Viewtrade

Edwardsreg















Area of

pressure

curve

Shape of

pressure

curve


Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]

Area of

pressure

curve

Shape of

pressure

curve


Systole



Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]














phenylephrine


PiCCO Limites
























Vigileo

CAP






S = prod D2 4 ITV


Doppler Œsophagien



bull Peu invasif

bull Simple

bull 2 appareils



bull Approximation



Doppler Œsophagien



Principe

DC = SurfAo V(t)dt






Excess gain

Correct gain




























NICO limites




soit valide


















LIDCORAPID




with an arm cuff


























cellulaires


Positive Staircase










bull Post-charge









bull s = P x r 2h































pression aortique





DC = FC x VES


























bull Tachycardie












bull Reproductible




bull Non invasive







Identity ref line



Biais =



Precision




4-Quadrants Plot


Les techniques









TInjection


D

dtT

KV)T(TCO

b

iib

Thermistance





bull CAP standard























lt 24degC





TInjection


D

dtT

KV)T(TCO

b

iib


Volume-Viewtrade

Edwardsreg















Area of

pressure

curve

Shape of

pressure

curve


Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]

Area of

pressure

curve

Shape of

pressure

curve


Systole



Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]














phenylephrine


PiCCO Limites
























Vigileo

CAP






S = prod D2 4 ITV


Doppler Œsophagien



bull Peu invasif

bull Simple

bull 2 appareils



bull Approximation



Doppler Œsophagien



Principe

DC = SurfAo V(t)dt






Excess gain

Correct gain




























NICO limites




soit valide


















LIDCORAPID




with an arm cuff



















Positive Staircase










bull Post-charge









bull s = P x r 2h































pression aortique





DC = FC x VES


























bull Tachycardie












bull Reproductible




bull Non invasive







Identity ref line



Biais =



Precision




4-Quadrants Plot


Les techniques









TInjection


D

dtT

KV)T(TCO

b

iib

Thermistance





bull CAP standard























lt 24degC





TInjection


D

dtT

KV)T(TCO

b

iib


Volume-Viewtrade

Edwardsreg















Area of

pressure

curve

Shape of

pressure

curve


Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]

Area of

pressure

curve

Shape of

pressure

curve


Systole



Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]














phenylephrine


PiCCO Limites
























Vigileo

CAP






S = prod D2 4 ITV


Doppler Œsophagien



bull Peu invasif

bull Simple

bull 2 appareils



bull Approximation



Doppler Œsophagien



Principe

DC = SurfAo V(t)dt






Excess gain

Correct gain




























NICO limites




soit valide


















LIDCORAPID




with an arm cuff



























bull Post-charge









bull s = P x r 2h































pression aortique





DC = FC x VES


























bull Tachycardie












bull Reproductible




bull Non invasive







Identity ref line



Biais =



Precision




4-Quadrants Plot


Les techniques









TInjection


D

dtT

KV)T(TCO

b

iib

Thermistance





bull CAP standard























lt 24degC





TInjection


D

dtT

KV)T(TCO

b

iib


Volume-Viewtrade

Edwardsreg















Area of

pressure

curve

Shape of

pressure

curve


Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]

Area of

pressure

curve

Shape of

pressure

curve


Systole



Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]














phenylephrine


PiCCO Limites
























Vigileo

CAP






S = prod D2 4 ITV


Doppler Œsophagien



bull Peu invasif

bull Simple

bull 2 appareils



bull Approximation



Doppler Œsophagien



Principe

DC = SurfAo V(t)dt






Excess gain

Correct gain




























NICO limites




soit valide


















LIDCORAPID




with an arm cuff
























bull Post-charge









bull s = P x r 2h































pression aortique





DC = FC x VES


























bull Tachycardie












bull Reproductible




bull Non invasive







Identity ref line



Biais =



Precision




4-Quadrants Plot


Les techniques









TInjection


D

dtT

KV)T(TCO

b

iib

Thermistance





bull CAP standard























lt 24degC





TInjection


D

dtT

KV)T(TCO

b

iib


Volume-Viewtrade

Edwardsreg















Area of

pressure

curve

Shape of

pressure

curve


Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]

Area of

pressure

curve

Shape of

pressure

curve


Systole



Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]














phenylephrine


PiCCO Limites
























Vigileo

CAP






S = prod D2 4 ITV


Doppler Œsophagien



bull Peu invasif

bull Simple

bull 2 appareils



bull Approximation



Doppler Œsophagien



Principe

DC = SurfAo V(t)dt






Excess gain

Correct gain




























NICO limites




soit valide


















LIDCORAPID




with an arm cuff


























bull s = P x r 2h































pression aortique





DC = FC x VES


























bull Tachycardie












bull Reproductible




bull Non invasive







Identity ref line



Biais =



Precision




4-Quadrants Plot


Les techniques









TInjection


D

dtT

KV)T(TCO

b

iib

Thermistance





bull CAP standard























lt 24degC





TInjection


D

dtT

KV)T(TCO

b

iib


Volume-Viewtrade

Edwardsreg















Area of

pressure

curve

Shape of

pressure

curve


Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]

Area of

pressure

curve

Shape of

pressure

curve


Systole



Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]














phenylephrine


PiCCO Limites
























Vigileo

CAP






S = prod D2 4 ITV


Doppler Œsophagien



bull Peu invasif

bull Simple

bull 2 appareils



bull Approximation



Doppler Œsophagien



Principe

DC = SurfAo V(t)dt






Excess gain

Correct gain




























NICO limites




soit valide


















LIDCORAPID




with an arm cuff





















bull s = P x r 2h































pression aortique





DC = FC x VES


























bull Tachycardie












bull Reproductible




bull Non invasive







Identity ref line



Biais =



Precision




4-Quadrants Plot


Les techniques









TInjection


D

dtT

KV)T(TCO

b

iib

Thermistance





bull CAP standard























lt 24degC





TInjection


D

dtT

KV)T(TCO

b

iib


Volume-Viewtrade

Edwardsreg















Area of

pressure

curve

Shape of

pressure

curve


Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]

Area of

pressure

curve

Shape of

pressure

curve


Systole



Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]














phenylephrine


PiCCO Limites
























Vigileo

CAP






S = prod D2 4 ITV


Doppler Œsophagien



bull Peu invasif

bull Simple

bull 2 appareils



bull Approximation



Doppler Œsophagien



Principe

DC = SurfAo V(t)dt






Excess gain

Correct gain




























NICO limites




soit valide


















LIDCORAPID




with an arm cuff











































pression aortique





DC = FC x VES


























bull Tachycardie












bull Reproductible




bull Non invasive







Identity ref line



Biais =



Precision




4-Quadrants Plot


Les techniques









TInjection


D

dtT

KV)T(TCO

b

iib

Thermistance





bull CAP standard























lt 24degC





TInjection


D

dtT

KV)T(TCO

b

iib


Volume-Viewtrade

Edwardsreg















Area of

pressure

curve

Shape of

pressure

curve


Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]

Area of

pressure

curve

Shape of

pressure

curve


Systole



Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]














phenylephrine


PiCCO Limites
























Vigileo

CAP






S = prod D2 4 ITV


Doppler Œsophagien



bull Peu invasif

bull Simple

bull 2 appareils



bull Approximation



Doppler Œsophagien



Principe

DC = SurfAo V(t)dt






Excess gain

Correct gain




























NICO limites




soit valide


















LIDCORAPID




with an arm cuff





































pression aortique





DC = FC x VES


























bull Tachycardie












bull Reproductible




bull Non invasive







Identity ref line



Biais =



Precision




4-Quadrants Plot


Les techniques









TInjection


D

dtT

KV)T(TCO

b

iib

Thermistance





bull CAP standard























lt 24degC





TInjection


D

dtT

KV)T(TCO

b

iib


Volume-Viewtrade

Edwardsreg















Area of

pressure

curve

Shape of

pressure

curve


Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]

Area of

pressure

curve

Shape of

pressure

curve


Systole



Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]














phenylephrine


PiCCO Limites
























Vigileo

CAP






S = prod D2 4 ITV


Doppler Œsophagien



bull Peu invasif

bull Simple

bull 2 appareils



bull Approximation



Doppler Œsophagien



Principe

DC = SurfAo V(t)dt






Excess gain

Correct gain




























NICO limites




soit valide


















LIDCORAPID




with an arm cuff






























pression aortique





DC = FC x VES


























bull Tachycardie












bull Reproductible




bull Non invasive







Identity ref line



Biais =



Precision




4-Quadrants Plot


Les techniques









TInjection


D

dtT

KV)T(TCO

b

iib

Thermistance





bull CAP standard























lt 24degC





TInjection


D

dtT

KV)T(TCO

b

iib


Volume-Viewtrade

Edwardsreg















Area of

pressure

curve

Shape of

pressure

curve


Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]

Area of

pressure

curve

Shape of

pressure

curve


Systole



Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]














phenylephrine


PiCCO Limites
























Vigileo

CAP






S = prod D2 4 ITV


Doppler Œsophagien



bull Peu invasif

bull Simple

bull 2 appareils



bull Approximation



Doppler Œsophagien



Principe

DC = SurfAo V(t)dt






Excess gain

Correct gain




























NICO limites




soit valide


















LIDCORAPID




with an arm cuff























pression aortique





DC = FC x VES


























bull Tachycardie












bull Reproductible




bull Non invasive







Identity ref line



Biais =



Precision




4-Quadrants Plot


Les techniques









TInjection


D

dtT

KV)T(TCO

b

iib

Thermistance





bull CAP standard























lt 24degC





TInjection


D

dtT

KV)T(TCO

b

iib


Volume-Viewtrade

Edwardsreg















Area of

pressure

curve

Shape of

pressure

curve


Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]

Area of

pressure

curve

Shape of

pressure

curve


Systole



Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]














phenylephrine


PiCCO Limites
























Vigileo

CAP






S = prod D2 4 ITV


Doppler Œsophagien



bull Peu invasif

bull Simple

bull 2 appareils



bull Approximation



Doppler Œsophagien



Principe

DC = SurfAo V(t)dt






Excess gain

Correct gain




























NICO limites




soit valide


















LIDCORAPID




with an arm cuff



















DC = FC x VES


























bull Tachycardie












bull Reproductible




bull Non invasive







Identity ref line



Biais =



Precision




4-Quadrants Plot


Les techniques









TInjection


D

dtT

KV)T(TCO

b

iib

Thermistance





bull CAP standard























lt 24degC





TInjection


D

dtT

KV)T(TCO

b

iib


Volume-Viewtrade

Edwardsreg















Area of

pressure

curve

Shape of

pressure

curve


Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]

Area of

pressure

curve

Shape of

pressure

curve


Systole



Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]














phenylephrine


PiCCO Limites
























Vigileo

CAP






S = prod D2 4 ITV


Doppler Œsophagien



bull Peu invasif

bull Simple

bull 2 appareils



bull Approximation



Doppler Œsophagien



Principe

DC = SurfAo V(t)dt






Excess gain

Correct gain




























NICO limites




soit valide


















LIDCORAPID




with an arm cuff











































bull Tachycardie












bull Reproductible




bull Non invasive







Identity ref line



Biais =



Precision




4-Quadrants Plot


Les techniques









TInjection


D

dtT

KV)T(TCO

b

iib

Thermistance





bull CAP standard























lt 24degC





TInjection


D

dtT

KV)T(TCO

b

iib


Volume-Viewtrade

Edwardsreg















Area of

pressure

curve

Shape of

pressure

curve


Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]

Area of

pressure

curve

Shape of

pressure

curve


Systole



Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]














phenylephrine


PiCCO Limites
























Vigileo

CAP






S = prod D2 4 ITV


Doppler Œsophagien



bull Peu invasif

bull Simple

bull 2 appareils



bull Approximation



Doppler Œsophagien



Principe

DC = SurfAo V(t)dt






Excess gain

Correct gain




























NICO limites




soit valide


















LIDCORAPID




with an arm cuff




































bull Tachycardie












bull Reproductible




bull Non invasive







Identity ref line



Biais =



Precision




4-Quadrants Plot


Les techniques









TInjection


D

dtT

KV)T(TCO

b

iib

Thermistance





bull CAP standard























lt 24degC





TInjection


D

dtT

KV)T(TCO

b

iib


Volume-Viewtrade

Edwardsreg















Area of

pressure

curve

Shape of

pressure

curve


Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]

Area of

pressure

curve

Shape of

pressure

curve


Systole



Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]














phenylephrine


PiCCO Limites
























Vigileo

CAP






S = prod D2 4 ITV


Doppler Œsophagien



bull Peu invasif

bull Simple

bull 2 appareils



bull Approximation



Doppler Œsophagien



Principe

DC = SurfAo V(t)dt






Excess gain

Correct gain




























NICO limites




soit valide


















LIDCORAPID




with an arm cuff


































bull Tachycardie












bull Reproductible




bull Non invasive







Identity ref line



Biais =



Precision




4-Quadrants Plot


Les techniques









TInjection


D

dtT

KV)T(TCO

b

iib

Thermistance





bull CAP standard























lt 24degC





TInjection


D

dtT

KV)T(TCO

b

iib


Volume-Viewtrade

Edwardsreg















Area of

pressure

curve

Shape of

pressure

curve


Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]

Area of

pressure

curve

Shape of

pressure

curve


Systole



Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]














phenylephrine


PiCCO Limites
























Vigileo

CAP






S = prod D2 4 ITV


Doppler Œsophagien



bull Peu invasif

bull Simple

bull 2 appareils



bull Approximation



Doppler Œsophagien



Principe

DC = SurfAo V(t)dt






Excess gain

Correct gain




























NICO limites




soit valide


















LIDCORAPID




with an arm cuff
































bull Tachycardie












bull Reproductible




bull Non invasive







Identity ref line



Biais =



Precision




4-Quadrants Plot


Les techniques









TInjection


D

dtT

KV)T(TCO

b

iib

Thermistance





bull CAP standard























lt 24degC





TInjection


D

dtT

KV)T(TCO

b

iib


Volume-Viewtrade

Edwardsreg















Area of

pressure

curve

Shape of

pressure

curve


Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]

Area of

pressure

curve

Shape of

pressure

curve


Systole



Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]














phenylephrine


PiCCO Limites
























Vigileo

CAP






S = prod D2 4 ITV


Doppler Œsophagien



bull Peu invasif

bull Simple

bull 2 appareils



bull Approximation



Doppler Œsophagien



Principe

DC = SurfAo V(t)dt






Excess gain

Correct gain




























NICO limites




soit valide


















LIDCORAPID




with an arm cuff






















bull Tachycardie












bull Reproductible




bull Non invasive







Identity ref line



Biais =



Precision




4-Quadrants Plot


Les techniques









TInjection


D

dtT

KV)T(TCO

b

iib

Thermistance





bull CAP standard























lt 24degC





TInjection


D

dtT

KV)T(TCO

b

iib


Volume-Viewtrade

Edwardsreg















Area of

pressure

curve

Shape of

pressure

curve


Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]

Area of

pressure

curve

Shape of

pressure

curve


Systole



Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]














phenylephrine


PiCCO Limites
























Vigileo

CAP






S = prod D2 4 ITV


Doppler Œsophagien



bull Peu invasif

bull Simple

bull 2 appareils



bull Approximation



Doppler Œsophagien



Principe

DC = SurfAo V(t)dt






Excess gain

Correct gain




























NICO limites




soit valide


















LIDCORAPID




with an arm cuff




























bull Reproductible




bull Non invasive







Identity ref line



Biais =



Precision




4-Quadrants Plot


Les techniques









TInjection


D

dtT

KV)T(TCO

b

iib

Thermistance





bull CAP standard























lt 24degC





TInjection


D

dtT

KV)T(TCO

b

iib


Volume-Viewtrade

Edwardsreg















Area of

pressure

curve

Shape of

pressure

curve


Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]

Area of

pressure

curve

Shape of

pressure

curve


Systole



Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]














phenylephrine


PiCCO Limites
























Vigileo

CAP






S = prod D2 4 ITV


Doppler Œsophagien



bull Peu invasif

bull Simple

bull 2 appareils



bull Approximation



Doppler Œsophagien



Principe

DC = SurfAo V(t)dt






Excess gain

Correct gain




























NICO limites




soit valide


















LIDCORAPID




with an arm cuff


























bull Reproductible




bull Non invasive







Identity ref line



Biais =



Precision




4-Quadrants Plot


Les techniques









TInjection


D

dtT

KV)T(TCO

b

iib

Thermistance





bull CAP standard























lt 24degC





TInjection


D

dtT

KV)T(TCO

b

iib


Volume-Viewtrade

Edwardsreg















Area of

pressure

curve

Shape of

pressure

curve


Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]

Area of

pressure

curve

Shape of

pressure

curve


Systole



Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]














phenylephrine


PiCCO Limites
























Vigileo

CAP






S = prod D2 4 ITV


Doppler Œsophagien



bull Peu invasif

bull Simple

bull 2 appareils



bull Approximation



Doppler Œsophagien



Principe

DC = SurfAo V(t)dt






Excess gain

Correct gain




























NICO limites




soit valide


















LIDCORAPID




with an arm cuff























bull Reproductible




bull Non invasive







Identity ref line



Biais =



Precision




4-Quadrants Plot


Les techniques









TInjection


D

dtT

KV)T(TCO

b

iib

Thermistance





bull CAP standard























lt 24degC





TInjection


D

dtT

KV)T(TCO

b

iib


Volume-Viewtrade

Edwardsreg















Area of

pressure

curve

Shape of

pressure

curve


Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]

Area of

pressure

curve

Shape of

pressure

curve


Systole



Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]














phenylephrine


PiCCO Limites
























Vigileo

CAP






S = prod D2 4 ITV


Doppler Œsophagien



bull Peu invasif

bull Simple

bull 2 appareils



bull Approximation



Doppler Œsophagien



Principe

DC = SurfAo V(t)dt






Excess gain

Correct gain




























NICO limites




soit valide


















LIDCORAPID




with an arm cuff





















bull Reproductible




bull Non invasive







Identity ref line



Biais =



Precision




4-Quadrants Plot


Les techniques









TInjection


D

dtT

KV)T(TCO

b

iib

Thermistance





bull CAP standard























lt 24degC





TInjection


D

dtT

KV)T(TCO

b

iib


Volume-Viewtrade

Edwardsreg















Area of

pressure

curve

Shape of

pressure

curve


Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]

Area of

pressure

curve

Shape of

pressure

curve


Systole



Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]














phenylephrine


PiCCO Limites
























Vigileo

CAP






S = prod D2 4 ITV


Doppler Œsophagien



bull Peu invasif

bull Simple

bull 2 appareils



bull Approximation



Doppler Œsophagien



Principe

DC = SurfAo V(t)dt






Excess gain

Correct gain




























NICO limites




soit valide


















LIDCORAPID




with an arm cuff






















Identity ref line



Biais =



Precision




4-Quadrants Plot


Les techniques









TInjection


D

dtT

KV)T(TCO

b

iib

Thermistance





bull CAP standard























lt 24degC





TInjection


D

dtT

KV)T(TCO

b

iib


Volume-Viewtrade

Edwardsreg















Area of

pressure

curve

Shape of

pressure

curve


Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]

Area of

pressure

curve

Shape of

pressure

curve


Systole



Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]














phenylephrine


PiCCO Limites
























Vigileo

CAP






S = prod D2 4 ITV


Doppler Œsophagien



bull Peu invasif

bull Simple

bull 2 appareils



bull Approximation



Doppler Œsophagien



Principe

DC = SurfAo V(t)dt






Excess gain

Correct gain




























NICO limites




soit valide


















LIDCORAPID




with an arm cuff




















Identity ref line



Biais =



Precision




4-Quadrants Plot


Les techniques









TInjection


D

dtT

KV)T(TCO

b

iib

Thermistance





bull CAP standard























lt 24degC





TInjection


D

dtT

KV)T(TCO

b

iib


Volume-Viewtrade

Edwardsreg















Area of

pressure

curve

Shape of

pressure

curve


Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]

Area of

pressure

curve

Shape of

pressure

curve


Systole



Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]














phenylephrine


PiCCO Limites
























Vigileo

CAP






S = prod D2 4 ITV


Doppler Œsophagien



bull Peu invasif

bull Simple

bull 2 appareils



bull Approximation



Doppler Œsophagien



Principe

DC = SurfAo V(t)dt






Excess gain

Correct gain




























NICO limites




soit valide


















LIDCORAPID




with an arm cuff





















4-Quadrants Plot


Les techniques









TInjection


D

dtT

KV)T(TCO

b

iib

Thermistance





bull CAP standard























lt 24degC





TInjection


D

dtT

KV)T(TCO

b

iib


Volume-Viewtrade

Edwardsreg















Area of

pressure

curve

Shape of

pressure

curve


Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]

Area of

pressure

curve

Shape of

pressure

curve


Systole



Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]














phenylephrine


PiCCO Limites
























Vigileo

CAP






S = prod D2 4 ITV


Doppler Œsophagien



bull Peu invasif

bull Simple

bull 2 appareils



bull Approximation



Doppler Œsophagien



Principe

DC = SurfAo V(t)dt






Excess gain

Correct gain




























NICO limites




soit valide


















LIDCORAPID




with an arm cuff



















4-Quadrants Plot


Les techniques









TInjection


D

dtT

KV)T(TCO

b

iib

Thermistance





bull CAP standard























lt 24degC





TInjection


D

dtT

KV)T(TCO

b

iib


Volume-Viewtrade

Edwardsreg















Area of

pressure

curve

Shape of

pressure

curve


Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]

Area of

pressure

curve

Shape of

pressure

curve


Systole



Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]














phenylephrine


PiCCO Limites
























Vigileo

CAP






S = prod D2 4 ITV


Doppler Œsophagien



bull Peu invasif

bull Simple

bull 2 appareils



bull Approximation



Doppler Œsophagien



Principe

DC = SurfAo V(t)dt






Excess gain

Correct gain




























NICO limites




soit valide


















LIDCORAPID




with an arm cuff



















Les techniques









TInjection


D

dtT

KV)T(TCO

b

iib

Thermistance





bull CAP standard























lt 24degC





TInjection


D

dtT

KV)T(TCO

b

iib


Volume-Viewtrade

Edwardsreg















Area of

pressure

curve

Shape of

pressure

curve


Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]

Area of

pressure

curve

Shape of

pressure

curve


Systole



Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]














phenylephrine


PiCCO Limites
























Vigileo

CAP






S = prod D2 4 ITV


Doppler Œsophagien



bull Peu invasif

bull Simple

bull 2 appareils



bull Approximation



Doppler Œsophagien



Principe

DC = SurfAo V(t)dt






Excess gain

Correct gain




























NICO limites




soit valide


















LIDCORAPID




with an arm cuff




















TInjection


D

dtT

KV)T(TCO

b

iib

Thermistance





bull CAP standard























lt 24degC





TInjection


D

dtT

KV)T(TCO

b

iib


Volume-Viewtrade

Edwardsreg















Area of

pressure

curve

Shape of

pressure

curve


Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]

Area of

pressure

curve

Shape of

pressure

curve


Systole



Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]














phenylephrine


PiCCO Limites
























Vigileo

CAP






S = prod D2 4 ITV


Doppler Œsophagien



bull Peu invasif

bull Simple

bull 2 appareils



bull Approximation



Doppler Œsophagien



Principe

DC = SurfAo V(t)dt






Excess gain

Correct gain




























NICO limites




soit valide


















LIDCORAPID




with an arm cuff






















bull CAP standard























lt 24degC





TInjection


D

dtT

KV)T(TCO

b

iib


Volume-Viewtrade

Edwardsreg















Area of

pressure

curve

Shape of

pressure

curve


Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]

Area of

pressure

curve

Shape of

pressure

curve


Systole



Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]














phenylephrine


PiCCO Limites
























Vigileo

CAP






S = prod D2 4 ITV


Doppler Œsophagien



bull Peu invasif

bull Simple

bull 2 appareils



bull Approximation



Doppler Œsophagien



Principe

DC = SurfAo V(t)dt






Excess gain

Correct gain




























NICO limites




soit valide


















LIDCORAPID




with an arm cuff




















bull CAP standard























lt 24degC





TInjection


D

dtT

KV)T(TCO

b

iib


Volume-Viewtrade

Edwardsreg















Area of

pressure

curve

Shape of

pressure

curve


Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]

Area of

pressure

curve

Shape of

pressure

curve


Systole



Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]














phenylephrine


PiCCO Limites
























Vigileo

CAP






S = prod D2 4 ITV


Doppler Œsophagien



bull Peu invasif

bull Simple

bull 2 appareils



bull Approximation



Doppler Œsophagien



Principe

DC = SurfAo V(t)dt






Excess gain

Correct gain




























NICO limites




soit valide


















LIDCORAPID




with an arm cuff































lt 24degC





TInjection


D

dtT

KV)T(TCO

b

iib


Volume-Viewtrade

Edwardsreg















Area of

pressure

curve

Shape of

pressure

curve


Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]

Area of

pressure

curve

Shape of

pressure

curve


Systole



Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]














phenylephrine


PiCCO Limites
























Vigileo

CAP






S = prod D2 4 ITV


Doppler Œsophagien



bull Peu invasif

bull Simple

bull 2 appareils



bull Approximation



Doppler Œsophagien



Principe

DC = SurfAo V(t)dt






Excess gain

Correct gain




























NICO limites




soit valide


















LIDCORAPID




with an arm cuff
























lt 24degC





TInjection


D

dtT

KV)T(TCO

b

iib


Volume-Viewtrade

Edwardsreg















Area of

pressure

curve

Shape of

pressure

curve


Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]

Area of

pressure

curve

Shape of

pressure

curve


Systole



Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]














phenylephrine


PiCCO Limites
























Vigileo

CAP






S = prod D2 4 ITV


Doppler Œsophagien



bull Peu invasif

bull Simple

bull 2 appareils



bull Approximation



Doppler Œsophagien



Principe

DC = SurfAo V(t)dt






Excess gain

Correct gain




























NICO limites




soit valide


















LIDCORAPID




with an arm cuff






















lt 24degC





TInjection


D

dtT

KV)T(TCO

b

iib


Volume-Viewtrade

Edwardsreg















Area of

pressure

curve

Shape of

pressure

curve


Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]

Area of

pressure

curve

Shape of

pressure

curve


Systole



Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]














phenylephrine


PiCCO Limites
























Vigileo

CAP






S = prod D2 4 ITV


Doppler Œsophagien



bull Peu invasif

bull Simple

bull 2 appareils



bull Approximation



Doppler Œsophagien



Principe

DC = SurfAo V(t)dt






Excess gain

Correct gain




























NICO limites




soit valide


















LIDCORAPID




with an arm cuff




















lt 24degC





TInjection


D

dtT

KV)T(TCO

b

iib


Volume-Viewtrade

Edwardsreg















Area of

pressure

curve

Shape of

pressure

curve


Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]

Area of

pressure

curve

Shape of

pressure

curve


Systole



Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]














phenylephrine


PiCCO Limites
























Vigileo

CAP






S = prod D2 4 ITV


Doppler Œsophagien



bull Peu invasif

bull Simple

bull 2 appareils



bull Approximation



Doppler Œsophagien



Principe

DC = SurfAo V(t)dt






Excess gain

Correct gain




























NICO limites




soit valide


















LIDCORAPID




with an arm cuff






















TInjection


D

dtT

KV)T(TCO

b

iib


Volume-Viewtrade

Edwardsreg















Area of

pressure

curve

Shape of

pressure

curve


Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]

Area of

pressure

curve

Shape of

pressure

curve


Systole



Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]














phenylephrine


PiCCO Limites
























Vigileo

CAP






S = prod D2 4 ITV


Doppler Œsophagien



bull Peu invasif

bull Simple

bull 2 appareils



bull Approximation



Doppler Œsophagien



Principe

DC = SurfAo V(t)dt






Excess gain

Correct gain




























NICO limites




soit valide


















LIDCORAPID




with an arm cuff



















Volume-Viewtrade

Edwardsreg















Area of

pressure

curve

Shape of

pressure

curve


Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]

Area of

pressure

curve

Shape of

pressure

curve


Systole



Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]














phenylephrine


PiCCO Limites
























Vigileo

CAP






S = prod D2 4 ITV


Doppler Œsophagien



bull Peu invasif

bull Simple

bull 2 appareils



bull Approximation



Doppler Œsophagien



Principe

DC = SurfAo V(t)dt






Excess gain

Correct gain




























NICO limites




soit valide


















LIDCORAPID




with an arm cuff
































Area of

pressure

curve

Shape of

pressure

curve


Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]

Area of

pressure

curve

Shape of

pressure

curve


Systole



Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]














phenylephrine


PiCCO Limites
























Vigileo

CAP






S = prod D2 4 ITV


Doppler Œsophagien



bull Peu invasif

bull Simple

bull 2 appareils



bull Approximation



Doppler Œsophagien



Principe

DC = SurfAo V(t)dt






Excess gain

Correct gain




























NICO limites




soit valide


















LIDCORAPID




with an arm cuff





























Area of

pressure

curve

Shape of

pressure

curve


Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]

Area of

pressure

curve

Shape of

pressure

curve


Systole



Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]














phenylephrine


PiCCO Limites
























Vigileo

CAP






S = prod D2 4 ITV


Doppler Œsophagien



bull Peu invasif

bull Simple

bull 2 appareils



bull Approximation



Doppler Œsophagien



Principe

DC = SurfAo V(t)dt






Excess gain

Correct gain




























NICO limites




soit valide


















LIDCORAPID




with an arm cuff


























Area of

pressure

curve

Shape of

pressure

curve


Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]

Area of

pressure

curve

Shape of

pressure

curve


Systole



Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]














phenylephrine


PiCCO Limites
























Vigileo

CAP






S = prod D2 4 ITV


Doppler Œsophagien



bull Peu invasif

bull Simple

bull 2 appareils



bull Approximation



Doppler Œsophagien



Principe

DC = SurfAo V(t)dt






Excess gain

Correct gain




























NICO limites




soit valide


















LIDCORAPID




with an arm cuff
























Area of

pressure

curve

Shape of

pressure

curve


Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]

Area of

pressure

curve

Shape of

pressure

curve


Systole



Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]














phenylephrine


PiCCO Limites
























Vigileo

CAP






S = prod D2 4 ITV


Doppler Œsophagien



bull Peu invasif

bull Simple

bull 2 appareils



bull Approximation



Doppler Œsophagien



Principe

DC = SurfAo V(t)dt






Excess gain

Correct gain




























NICO limites




soit valide


















LIDCORAPID




with an arm cuff






















Area of

pressure

curve

Shape of

pressure

curve


Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]

Area of

pressure

curve

Shape of

pressure

curve


Systole



Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]














phenylephrine


PiCCO Limites
























Vigileo

CAP






S = prod D2 4 ITV


Doppler Œsophagien



bull Peu invasif

bull Simple

bull 2 appareils



bull Approximation



Doppler Œsophagien



Principe

DC = SurfAo V(t)dt






Excess gain

Correct gain




























NICO limites




soit valide


















LIDCORAPID




with an arm cuff




















Area of

pressure

curve

Shape of

pressure

curve


Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]

Area of

pressure

curve

Shape of

pressure

curve


Systole



Systole


dt( ) dt

ComplianceHeart

rate

Patient-specific

calibration factor

(determined with

thermodilution)

t [s]

P [mm Hg]














phenylephrine


PiCCO Limites
























Vigileo

CAP






S = prod D2 4 ITV


Doppler Œsophagien



bull Peu invasif

bull Simple

bull 2 appareils



bull Approximation



Doppler Œsophagien



Principe

DC = SurfAo V(t)dt






Excess gain

Correct gain




























NICO limites




soit valide


















LIDCORAPID




with an arm cuff































phenylephrine


PiCCO Limites
























Vigileo

CAP






S = prod D2 4 ITV


Doppler Œsophagien



bull Peu invasif

bull Simple

bull 2 appareils



bull Approximation



Doppler Œsophagien



Principe

DC = SurfAo V(t)dt






Excess gain

Correct gain




























NICO limites




soit valide


















LIDCORAPID




with an arm cuff




























phenylephrine


PiCCO Limites
























Vigileo

CAP






S = prod D2 4 ITV


Doppler Œsophagien



bull Peu invasif

bull Simple

bull 2 appareils



bull Approximation



Doppler Œsophagien



Principe

DC = SurfAo V(t)dt






Excess gain

Correct gain




























NICO limites




soit valide


















LIDCORAPID




with an arm cuff

























phenylephrine


PiCCO Limites
























Vigileo

CAP






S = prod D2 4 ITV


Doppler Œsophagien



bull Peu invasif

bull Simple

bull 2 appareils



bull Approximation



Doppler Œsophagien



Principe

DC = SurfAo V(t)dt






Excess gain

Correct gain




























NICO limites




soit valide


















LIDCORAPID




with an arm cuff



















PiCCO Limites
























Vigileo

CAP






S = prod D2 4 ITV


Doppler Œsophagien



bull Peu invasif

bull Simple

bull 2 appareils



bull Approximation



Doppler Œsophagien



Principe

DC = SurfAo V(t)dt






Excess gain

Correct gain




























NICO limites




soit valide


















LIDCORAPID




with an arm cuff

































Vigileo

CAP






S = prod D2 4 ITV


Doppler Œsophagien



bull Peu invasif

bull Simple

bull 2 appareils



bull Approximation



Doppler Œsophagien



Principe

DC = SurfAo V(t)dt






Excess gain

Correct gain




























NICO limites




soit valide


















LIDCORAPID




with an arm cuff


























Vigileo

CAP






S = prod D2 4 ITV


Doppler Œsophagien



bull Peu invasif

bull Simple

bull 2 appareils



bull Approximation



Doppler Œsophagien



Principe

DC = SurfAo V(t)dt






Excess gain

Correct gain




























NICO limites




soit valide


















LIDCORAPID




with an arm cuff
























Vigileo

CAP






S = prod D2 4 ITV


Doppler Œsophagien



bull Peu invasif

bull Simple

bull 2 appareils



bull Approximation



Doppler Œsophagien



Principe

DC = SurfAo V(t)dt






Excess gain

Correct gain




























NICO limites




soit valide


















LIDCORAPID




with an arm cuff





















Vigileo

CAP






S = prod D2 4 ITV


Doppler Œsophagien



bull Peu invasif

bull Simple

bull 2 appareils



bull Approximation



Doppler Œsophagien



Principe

DC = SurfAo V(t)dt






Excess gain

Correct gain




























NICO limites




soit valide


















LIDCORAPID




with an arm cuff























S = prod D2 4 ITV


Doppler Œsophagien



bull Peu invasif

bull Simple

bull 2 appareils



bull Approximation



Doppler Œsophagien



Principe

DC = SurfAo V(t)dt






Excess gain

Correct gain




























NICO limites




soit valide


















LIDCORAPID




with an arm cuff






















S = prod D2 4 ITV


Doppler Œsophagien



bull Peu invasif

bull Simple

bull 2 appareils



bull Approximation



Doppler Œsophagien



Principe

DC = SurfAo V(t)dt






Excess gain

Correct gain




























NICO limites




soit valide


















LIDCORAPID




with an arm cuff




















S = prod D2 4 ITV


Doppler Œsophagien



bull Peu invasif

bull Simple

bull 2 appareils



bull Approximation



Doppler Œsophagien



Principe

DC = SurfAo V(t)dt






Excess gain

Correct gain




























NICO limites




soit valide


















LIDCORAPID




with an arm cuff



















Doppler Œsophagien



bull Peu invasif

bull Simple

bull 2 appareils



bull Approximation



Doppler Œsophagien



Principe

DC = SurfAo V(t)dt






Excess gain

Correct gain




























NICO limites




soit valide


















LIDCORAPID




with an arm cuff



















Doppler Œsophagien



Principe

DC = SurfAo V(t)dt






Excess gain

Correct gain




























NICO limites




soit valide


















LIDCORAPID




with an arm cuff




















Principe

DC = SurfAo V(t)dt






Excess gain

Correct gain




























NICO limites




soit valide


















LIDCORAPID




with an arm cuff



















Principe

DC = SurfAo V(t)dt






Excess gain

Correct gain




























NICO limites




soit valide


















LIDCORAPID




with an arm cuff























Excess gain

Correct gain




























NICO limites




soit valide


















LIDCORAPID




with an arm cuff



















Excess gain

Correct gain




























NICO limites




soit valide


















LIDCORAPID




with an arm cuff













































NICO limites




soit valide


















LIDCORAPID




with an arm cuff












































NICO limites




soit valide


















LIDCORAPID




with an arm cuff





































NICO limites




soit valide


















LIDCORAPID




with an arm cuff



























NICO limites




soit valide


















LIDCORAPID




with an arm cuff

























NICO limites




soit valide


















LIDCORAPID




with an arm cuff





















NICO limites




soit valide


















LIDCORAPID




with an arm cuff



















NICO limites




soit valide


















LIDCORAPID




with an arm cuff

































LIDCORAPID




with an arm cuff































LIDCORAPID




with an arm cuff

























LIDCORAPID




with an arm cuff























LIDCORAPID




with an arm cuff






















LIDCORAPID




with an arm cuff





















LIDCORAPID




with an arm cuff




















LIDCORAPID




with an arm cuff



















LIDCORAPID




with an arm cuff

























































Documents

Déterminants et Techniques de Mesure du Débit Cardiaque · Cardiology Institute [email protected] Déterminants et Techniques de Mesure du Débit Cardiaque Alain Combes, MD,