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1029 Lidco Rapid user manual

1. Enable Logging Contact LiDCO for a detailed interface specification Appendices a LI DCO Kapid User s Manual B Specifications General Specifications Monitor HM 81 01 User Interface Touchscreen External Connections Power Analog Blood Pressure Input File Download Operating Conditions 10 40 C 10 40 C 30 75 RH non condensing 30 75 RH non condensing 700 1060 hPa 700 1060 hPa Output Scaling Signal to noise better than 55dB Stability better than 0 5 Full Scale over 4 hours Equipment Classification Class 1 Not Protection Against warnes OOOO O Not forse in he Presence of Flammable Gases Fitted with a 3V 195mA lithium battery Only to be replaced by qualified service personnel Dispose of the old battery in a safe manner that complies with applicable laws www lidco com Version 1 04 45 LI DCO Kapid User s Manual Desktop Stand Li10533 Spacer for Desktop Stand Li10532 Li10532 Desktop Stand for POC 125 Monitor Platform Weight 1 0kg Power Supply Unit POC 125 PSU PCM80P524 Equipment Classification Class 1 IEC 601 LiDCOsmart Card Li10506 Microprocessor integrated chip Size WxLxT Nominal 86x54x0 76mm 7816 1 Appendices 46 LI DCO Kapid User s Manual C Electrical Safety Appendix 4 IEC 60601 1 2 2001 BS EN 60601 1 2 2002 Guidance and Manufacturer s Declaration The LiDCOrapid Hemodynamic Monitor System needs special precautions re
2. VGA USB ports Ethernet NOOR WD Appendices 50 User s Manual So lt Q O i E LiDCOrapid mounting options e Desk top stand and pole mount clamp DTP 1201 POC 125 Use 4 off M4x16mm screws Use 4 off M4x20mm screws e Pole mount clamp DTP 1201 POC 125 Use 4 off M4x10mm screws Use 4 off M4x12mm Screws Use 4 off 10 32 x 5 16 FHMS 5I Version 1 04 www lidco com User s Manual So lt Q O i LiDCO Blood Pressure Module Installation LiDCOrapid DTP 1201 LiDCOrapid POC 125 M4 Screw Lengths mm EE EE A EE EE O Lo A A o O o c o T og Ol 5 c o AIOS lt HO CE L Bor Ke TES TES di M4 x 12mm ai M4 x 25mm ill M4 x 16mm O wz x lt M4 x4 off M4 x4 off 52 Appendices LI DCO Kapid User s Manual F 1 10 11 12 References Pearse R Dawson D Fawcett J Rhodes A Grounds RM Bennett ED Early goal directed therapy after major surgery reduces complications and duration of hospital stay A randomised controlled trial 2005 Critical Care 9 R687 R693 DOI 10 1186 cc3887 Michard F Boussat S Chemla D Anguel N Mercat A Lecarpentier Y Richard C Pinsky M Teboul JL Relation between Respiratory Changes in Arterial Pulse Pressure and Fluid Responsiveness in Sep
3. 140 F THIS MAY DAMAGE THE EQUIPMENT The sound pressure level at the operator s position according to IEC 704 1 1982 is no more than 70dB A Although compliant with the applicable EMC requirements this equipment may still be affected by and may still affect other equipment If interference is occurring the user is encouraged to try to correct the interference by one of the following measures e Repositioning either equipment to reorient and or increase the separation between the equipments e Connect the equipment to a power outlet on a circuit different from that to which the other equipment is connected e Consult an experienced technician for help Safety and Maintenance Ill LI DCO Kapid User s Manual Table Of Contents 1 0 Introduction 1 1 1 Standard Hemodynamic Monitoring 2 1 2 Functional Hemodynamic monitoring 3 1 3 Quick Start 4 2 0 Indications Contraindications and Warnings 6 3 0 Operation of LiDCOrapid 8 3 1 Setup 8 3 1 1 Equipment Setup 8 3 1 2 Startup Screen 13 3 1 3 LiDCOsmart 14 3 1 4 Setup Screen 15 3 1 5 Beat Detector Threshold 20 3 1 6 Calibration via CO Entry 21 3 2 Operation 24 3 2 1 Overview of LiDCOrapid Screen 24 3 2 2 Hemodynamic Monitoring Display 21 3 2 3 Event Response Display 29 3 2 4 Dynamic Preload Responsiveness Display 30 3 2 5 Event marking 32 3 2 6 Configuration of LiDCOrapid Screen 33 3 2 Event List 34 3 2 8 History and Chart Screens 35 3 3 Safety Instructio
4. The preload responsiveness variables display provides either Stroke Volume Variation or Pulse Pressure Variation information as a long term trend and a short term trend of Delta SV or PP Both trends have a defined zone that indicates the currently accepted cut off for potential fluid responsiveness SVV tends to predict fluid responsiveness when the values are consistently above 10 PPV tends to predict fluid responsiveness when the values are consistently above 13 The long term trend is adjustable between 10 and 60 minutes and provides an easy to interpret picture of the value and general trend in these parameters As the values and trend go above the green zone it becomes more likely that the patient will respond to fluids The short term trend covers a 30s period and can be used in a similar manner As the amplitude of the wave increases beyond the green zone it becomes more likely that the patient will respond to fluids It is also possible to interpret the stability of the input data as well as confirm the respiratory rate using this display A numeric display is also provided for ease of data recording The combination of preload responsiveness variables and event response displays in combination with other clinical signs provides the opportunity to anticipate the necessary intervention and to observe the patients actual hemodynamic response www lidco com Version 1 04 3 LI DCO Kapid User s Manual 1 3 Quick St
5. DCO Kapid User s Manual 3 2 2 Hemodynamic Monitoring Display The LiDCOrapid provides standard hemodynamic parameters of blood pressure and heart rate in a unique trend display that allows both long term and short term views In addition using the PulseCO blood pressure waveform analysis algorithm the monitor also displays nominal stroke volume The long term display contains the entire case up to a maximum of 8 hours The time axis automatically adjusts scale to provide the highest resolution possible for the duration displayed This display provides a complete overview of the case with the ability to identify trends and also where targets were met A marker line can be placed on the lower trend screen to mark a baseline or set a target The short term or acute display shows data over a fixed 2 minute period This provides an easy way to observe immediate changes and give an early warning for more immediate response Touch the vertical axis to Touch inside the graph to display the display the control window target window for CO SV or SVR SV Graph The scale of both axes can be adjusted by The target line can be added by selecting the de selecting Auto scale and using the on box it can be adjusted by using the increase decrease buttons increase decrease buttons www lidco com Version 1 04 21 LI DCO Kapid User s Manual When events are marked they are displayed on both
6. Monitor to double trigger the heart rate The Beat Detector Threshold should be increased as above e Patients experiencing bigemini instability will on occasion cause the LiDCOrapid Hemodynamic Monitor to under estimate the heart rate Decrease the threshold to obtain the correct heart rate Press to reveal this information on the LiDCOrapid Hemodynamic Monitor Operation of LiDCOrapid 20 LI DCO Kapid User s Manual 3 1 6 Calibration via CO or CF Entry The LiDCOrapid can be calibrated by entering a known value for Cardiac Output CO or Calibration Factor CF It is important that calibration is carried out in a hemodynamically stable period with minimal variation in blood pressure or heart rate The entry of the cardiac output should be done in a timely manner to avoid introducing a bias due to a change in the patient s condition Pre calibration Check List The performance of the LiDCOrapid Hemodynamic Monitor may be compromised in the following patients e Patients with aortic valve regurgitation e Patients being treated with an intra aortic balloon pump IABP e Patients with highly damped peripheral arterial lines e Patients with peripheral arterial vasoconstriction WARNING Do not use the LiDCOrapid Hemodynamic Monitor with the patient types listed above the performance of the device may be significantly compromised in such patients Before use of the LiDCOrapid Hemodynamic Monitor familiarize yourself with
7. USB 5VDC 500mA max e Not protected against water ingress e type CF applied part F type isolated floating patient part providing a high degree of protection against shock and is suitable for use during defibrillation Defibrillation recovery lt 5 seconds e Rx ONLY Federal law USA restricts the sale of this device by or on the order of a physician e CE Complies with the requirements of the Directive 93 42 EEC as amended concerning medical devices e The BPM is not Category AP or Category APG and should not be used in the vicinity of a flammable anaesthetic mixture with air or oxygen or nitrous oxide Operation of LiDCOrapid 10 LI DCO Kapid User s Manual LiDCO BPM Installation amp Cleaning Cleaning 1 Clean the cable amp module with a soft cloth moistened with water 2 Wipe off excess water and allow to air dry Cautions Never immerse or soak the cable or module Disinfection 1 Disinfect the cable amp module with a soft cloth moistened with 75 ethanol or 70 isopropanol or 2 glutarldehyde 2 Wipe off excess liquid and allow to air dry The BP Module is mounted to the VESA plate on the back of the LiIDCO Monitor e LiDCOrapid can be mounted on a Stand and or a Pole Clamp e LiDCOp us can be mounted on a Rollstand Disconnect the Monitor from the voltage supply before cleaning disinfecting LiDCOrapid LiDCOrapid M4 Screw Lengths mm POC 125 DTP 1201 Pole Clamp Stand amp Pole Cl
8. for 25 cycles lt 5 Ur gt 95 dip in Ur for 5 secs Compliance level 6 kV contact 8 kV air 2kV for power supply lines 1kV for input output lines 1kV differential mode 2kV common mode lt 5 Ur gt 95 dip in Ur for 0 5 cycle 40 Ur 60 dip in Ur for 5 cycles 70 Ur 30 dip in Ur for 25 cycles lt 5 Ur gt 95 dip in Ur for 5 secs NOTE Ur is the a c mains voltage prior to application of the test level Appendices Electromagnetic environment guidance Floors should be wood concrete or ceramic tile If floors are covered with synthetic material the relative humidity should be less than 30 Mains power quality should be that of a typical commercial or hospital environment Mains power quality should be that of a typical commercial or hospital environment Mains power quality should be that of a typical commercial or hospital environment If the user of the LiDCOrapid Hemodynamic Monitor System requires continued operation during power mains interruptions it is recommended that the LiDCOrapid Hemodynamic Monitor System be powered from an uninterruptable power supply Power frequency magnetic fields should be at levels characteristic of a typical location in a typical commercial or hospital environment 48 LI DCO Kapid User s Manual Electrical Safety Testing The LiDCOrapid POC 125 monitor is a SELV Safety Extra Low Voltage devi
9. p101 15 Jonas M Mills E Wolff C O Brien T 2010 Effect of cardiac arrhythmias on PulseCO calibration and performance Poster presentation ISICEM Brussels Critical Care 14 1 p102 16 Green D Paklet L 2010 Latest developments in peri operative monitoring of the high risk major surgery patient International Journal of Surgery 8 90 99 17 Abdel Galil K Craske D McCaul J 2010 Optimisation of intraoperative haemodynamics early experience of its use in major head and neck surgery Brit Journal of Oral and Maxillofacial Surgery 48 3 189 191 18 Purushothaman B O Brian T Green D 2010 The hemodynamic effects of anaesthetic induction and their correlation with changes in depth of anaesthesia Proceedings of the 2010 Annual Meeting of the ASA 19 Koff M Richard K Novak M Canneson M Dodds T 2010 Elevated PPV predict an increased length of stay and morbidity during high risk abdominal surgery Proceedings of the 2010 Annual Meeting of the ASA 20 Hadian M Severyn D Pinsky M 2010 The effects of vasoactive drugs on pulse pressure and stroke volume variation in postoperative ventilated patients Critical Care In press 21 Linton N Linton R 2003 Haemodynamic response to a small intravenous bolus injection of epinephrine in cardiac surgical patients European Journal of Anaesthesiology 20 298 304 22 Dyer RA Piercy JL Reed AR Lombard CJ Schoeman LK James MF 2008 Hemodynamic changes associated with spinal anesth
10. the short and long term trend displays of MAP and HR The display of numeric data to the right can be averaged over periods of 10 20 or 30 seconds This is can be adjusted in the configuration screen 3 2 6 To change the trend display press the button parameters Press the CO button trend of SV to change to a trend of CO Press the SV button to change to a Indexed or absolute numeric values can be quickly displayed by pressing inside the number display Press the CO SV SVR numeric display to display CI SVI SVRI The alternate value is shown in reversed colours for 10 seconds Operation of LiDCOrapid 28 LI DCO Kapid User s Manual 3 2 3 Event Response Display The Event Response Display is used to track changes in a hemodynamic parameter as a result of a therapeutic intervention Simply press the green play button to start and the display will show the relative change in the parameter both graphically and numerically at regular intervals over a period of up to 40 minutes Press the red stop button when complete To reset the start simply press the green restart button and the display will clear and start over again Fyent Response The default parameter for display is Stroke Volume and the display averaging interval is 10 seconds adjustable to 20 30 secs or off These can be changed by using the configuration screen see section 3 2 6 Alternately press the parameter name to swit
11. using the increase decrease buttons increase decrease buttons www lidco com Version 1 04 35 LI DCO Kapid User s Manual Press this button to enter the chart screen The Chart Screen allows for numeric data display to assist in recording values for routine clinical charts as well as general review The Chart screen displays all the LiDCOrapid hemodynamic parameters including absolute and index values in six 6 columns Data are available for up to the past 24hours The Earliest data is the Patient The Latest data is the most oldest data available Information recent data available Patient ID Test003 RCO1 Height 1 80 m Age 66 years 00 months Weight 65 0 kg BSA 1 83 10 50 10 55 11 00 107 107 108 109 60 60 60 61 78 78 79 80 16 46 46 46 55 i 55 30 2362 4317 dyn s mem Data Navigation fice the period between each displayed time point The interval Press to move choices are 5 default 15 and 30 minutes or 1 2 and 4 hours For example hourly data intervals will display data at the start of each clock hour starting when the first full hour has passed the time period for data averaging at each time point The data can be averaged for periods of 10 default 30 or 60 seconds Operation of LiDCOrapid 36 LI DCO Kapid User s Manual 3 3 Safety Instructions Maintenance and Cleaning Safety Instructions see also inside front cover e Always refer to the LiDCOrapid Hemody
12. 9481 P Brass E Mills J Latza J Peters E Berendes Comparison of cardiac index LiDCOrapid and PlCCOplus in the ICU ISICEM 2011 doi 10 1186 cc9482 P D Santis C Marano F Cavallor A Della Anna P DE Santis C Bonarrigo C Falcone C Sandroni Prediction of fluid responsiveness with the LIDCO System Journal List 2011 doi 10 1186 cc9484 C Willars A Dada D Green Functional haemodynamic monitoring the relative merits of SVV SPV and PPV as measured by the LiDCOrapid in predicting fluid responsiveness in high risk surgical patients Poster presentation 2011 doi 10 1186 cc9486 S Lobo L Ronchi N Oliveira P Brandao A Froes G Cunrath K Mishiyama J Netinho F Lobo Restrictive strategy of intra operative fluid maintenance during optimization of oxygen delivery decreases major complications after high risk surgery Crit Care 2011 Sep 23 15 5 R226 www lidco com Version 1 04 55 2274 User s Manual LiDCOrapid English Li10680 LiIDCO Rapid Registered office R amp D and Production LiDCO Limited 16 Orsman Road London N1 5QJ UK Telephone 44 0 20 7749 1500 Fax 44 0 20 7749 1501 Sales and Marketing LiDCO Limited Unit M South Cambridge Business Park Babraham Road Sawston Cambridge CB22 3JH UK Telephone 44 0 1223 830666 Fax 44 0 1223 837241 0120 For your local Distributor see www lidco com HM 81 01 UM 044 5 060110 520411 gt Cardiac Sensor Systems LiDCO
13. C 61000 3 2 Class A those connected S the public MOSS power supply network that supplies buildings used for domestic purposes Harmonic emissions Voltage fluctuations Complies flicker emissions IEC 61000 3 3 The LiDCOrapid Hemodynamic Monitor System should not be used adjacent to or stacked with any other equipment and that if adjacent or stacked use is necessary the LiDCOrapid Hemodynamic Monitor System should be observed to verify normal operation in the configuration in which it will be used www lidco com Version 1 04 47 LiIDCO Rapid Guidance and manufacturer s declaration electromagnetic immunity User s Manual The LiDCOrapid Hemodynamic Monitor System is intended for use in the electromagnetic environment specified below The customer or the user of the LiDCOrapid Hemodynamic Monitor System should ensure that it is used in such an environment Immunity test Electrostatic discharge ESD IEC 61000 4 2 Electrical fast transient burst IEC 61000 4 4 Surge IEC 61000 4 5 Voltage dips short interruptions and voltage variations on power supply input lines IEC 61000 4 11 Power frequency 50 60 Hz magnetic field IEC 61000 4 8 IEC 60601 test level 6 kV contact 8 kV air 2kV for power supply lines 1kV for input output lines 1kV differential mode 2kV common mode lt 5 Ur gt 95 dip in Ur for 0 5 cycle 40 Ur 60 dip in Ur for 5 cycles 70 Ur 30 dip in Ur
14. User s Manual LiIDCO Rapid Fluid management just got easier Cardiac Sensor Systems LIDCO LiDCO Version 1 04 LI DCO Kapid User s Manual Manufactured by LiDCO Ltd 16 Orsman Road London N1 5QJ UK LiDCOrapid User s Manual Software V1 04 This device is covered by one or more of the following patents US Pat 006071244 WO9724982 other patents applied for This device bears the mark in accordance with the provisions of the Directive 93 42 EEC of June 14 1993 concerning medical devices CE 0120 Caution USA Federal Law restricts this device to sale by or on the order of a physician All LiDCO devices are intended for use by qualified medical personnel only Carefully read all manuals that are provided with your device before use Printed in the Untied Kingdom Copyright Notice LiDCO LiDCOrapid and PulseCO are trade marks of LIDCO Ltd This document is copyrighted 2007 2011 by LiDCO Ltd All rights are reserved LiDCO Ltd reserves the right to alter the products described in this manual at any time without notice No part of this manual may be reproduced copied translated or transmitted in any form or by any means without the prior written permission of LiIDCO Information provided in this manual is intended to be accurate and reliable However LIDCO assumes no responsibility for use of this manual nor for any infringements upon the rights of third partie
15. amp LE stana Refer to page 52 for illustrations of BP Module installation www lidco com Version 1 04 11 LI DCO Kapid User s Manual Starting the Monitor Switch on the power using the ON OFF switch located near to the power cable The power switch is not latching and will return to the original position The monitor will complete it s startup routine and display the Startup Screen Switch off the power by pressing the ON OFF switch Option 1 Direct analogue signal input into LiDCOrapid via Channel 3 ON OFF Power Input Signal From Monitor 1 Volt 100mmHg Option 2 Analogue input via BP Module into Channel 2 Option 3 Direct BP input via the BP module into Channel 1 Operation of LiDCOrapid 12 LI DCO Kapid User s Manual 3 1 2 Startup Screen The Startup Screen is the entry point to initiate patient monitoring with the LiDCOrapid gt cu LiDCOsmart is inserted into the card reader to begin Please insert a valid LiDCOsmart Card Press Start to begin monitoring This will display the Setup Press Start button to begin If the LiDCOsmart has been used previously on this patient and hasn t expired then the Startup Screen will indicate that the LiDCOsmart has been previously used If the same The patient ID on the card is See patient is being monitored then press the Resume but
16. any liquid into an opening This may cause fire or electrical shock The openings on the enclosure are for air convection Protect the equipment from overheating DO NOT COVER THE OPENINGS Put this monitor on a reliable surface during installation Dropping it or letting it fall may cause damage The monitor should be mounted on the LiDCO desktop stand or a dedicated roll stand or an engineered support to provide stability during use Follow the instructions supplied with the mounting arrangement to ensure correct fitting If the equipment is not used for a long time disconnect the monitor and the power supply unit from the power source to avoid damage by transient over voltage Never open the equipment For safety reasons the equipment should be opened only by qualified service personnel If one of the following situations arises get the equipment checked by service personnel a The power cord or power supply unit or other cable is damaged b Liquid has penetrated into the equipment c The equipment has been exposed to moisture d The system does not work well or you cannot get it to work according to the User s Manual e The equipment has been dropped and damaged f The equipment has obvious signs of breakage Safety and Maintenance Version 1 04 I LI DCO Kapid User s Manual 16 DO NOT LEAVE THIS EQUIPMENT IN AN UNCONTROLLED ENVIRONMENT WHERE THE STORAGE TEMPERATURE IS BELOW 20 C 4 F OR ABOVE 60 C
17. apid User s Manual Channel 1 Connection IBP Transducer Input 1 Connect BPM cable to BPM 2 Connect BPM cable to Patient Monitor cable 3 Connect BPM cable to IBP Transducer cable 4 Connect the USB cable to LIDCO Monitor and BPM Channel 2 Connection Alternate Analog Input 4 Connect the USB cable to LIDCO Monitor and BPM 5 Connect analog output cable from patient monitor to BPM LiDCO BPM Troubleshooting No BP Waveform is observed on any channel Check all cable connections For Channel 2 zero the Patient Monitor IBP waveform No values are displayed for Channel 1 Channel 1 must be zero ed before values will display Zero Fail Signal Varying Confirm Patient Monitor and Transducer are in Zero Zero Fail Offset too large position No BP waveform or values are displayed for Channel 2 Zero Fail Signal VaryingCheck cable connections Contact your LiDCO representative to obtain a cable No cable for Channel 2 Specify the Make Model of your Patient Monitor The BPM is compliant with the applicable EMC Reposition to reorient and or increase the separation requirements It may still be affected by and or affect between the equipment Connect the equipment to a other equipment If interference occurs power outlet on a different circuit LiIDCO BPM Specifications amp Symbols e Compatible transducers sensitivity 5uV Ve mmHg e Analog waveform 1V 100mmHg 0 2 5VDC OV offset e Accuracy 3 of full scale e Power
18. ar disease extremes of vasopressor drug administration or patients treated with deep hypothermia In such circumstances if accurate arterial blood pressure is required for patient management then a femoral or more central aortic catheter maybe required Warnings WARNING Do not use the LiDCOrapid Hemodynamic Monitor with the patients types listed above the performance of the device may be significantly compromised in such patients Before use of the LiDCOrapid Hemodynamic Monitor familiarize yourself with the full list of indications contraindications and warnings WARNING Product Instructions and Training Before use of the LiDCOrapid Monitor System please ensure that you have been trained in the use of the system and familiarize yourself with the Contraindications amp Warnings Operating Instructions Section 3 Ax Warnings LiDCOrapid Hemodynamic Monitor Initial Checks of Patient Pathology and Peripheral Artery Condition e Before use check the patient notes for the presence of aortic valve regurgitation The LiDCOrapid Hemodynamic Monitor may be inaccurate in such patients e Severe peripheral arterial vasoconstriction vasospasm may negatively affect the arterial pressure waveform and therefore the accuracy of the LiDCOrapid Hemodynamic Monitor such events may occur in severe peripheral vascular disease extremes of vasopressor drug administration and hypothermic patients Indications Contraindications and Warni
19. art Step 1 Connect Cables and Switch ON Figure 1 1 Connect the power cable to the monitor and an appropriate power socket 2 Switch on the monitor via the power switch on the bottom 3 Connect the appropriate blood pressure cable to the LiDCOrapid monitor and to the primary monitor ON OFF Power Input Signal From Monitor 1 Volt 100mmHg Figure 1 Step 2 Insert the LiDCOsmart Card Figure 2 1 These instructions are on the monitor and the LiDCOsmart as well 2 Obtain a new LiDCOsmart when starting a new patient 3 Orient the LiIDCOsmart so that LiDCOrapid can be read and the arrow points to the monitor 4 Insert the card into the reader the gold chip should be facing you 5 When complete the Startup Screen will indicate Start 6 Press Start to begin The Setup Screen will be displayed next LiIDCOSmart amp IE ER 212 hours M08s0028 www lidco com See Section 3 1 1 for alternate signal Figure 2 sources via the BP Module Introduction 4 LI DCO Kapid User s Manual Step 3 Setup Screen data entry 1 Enter the Patient s identification age height and weight 2 Observe the blood pressure waveform matches the primary monitor 3 Check the values for Systolic Mean Diastolic Blood Pressure and Heart Rate are within 5 of the primary monitor s displayed values Step 4 Start LiDCOrapid 1 Press the Navigate button to display a submenu 2 Select the Main Screen b
20. can be entered as well A full list of events is available for review at any time and past event information can be edited see section 3 2 7 to mark an event Characteristics L Fluid Challeng J None C Inotrope L Vasoactive Drug Choose an Event Type and Characteristic Press the white box to add additional information Press the green tick when complete which will add the flag or the red X to cancel Note The event flag is located to the nearest beat at the time the button is pressed Operation of LiDCOrapid 32 LI DCO Kapid User s Manual 3 2 6 Configuration of LiDCOrapid Screen The LiDCOrapid Screen can be configured to display different parameters at different averaging intervals or with different targets than the defaults to make changes to the display Press the configuration button Hemodynamic Trend Parameters can be displayed as either absolute or indexed to body surface area The averaging period for numeric display can be chosen from No Average 10 20 default or 30 seconds CO SV default or CO SVR or SV SVR can be displayed Event Response Stroke Volume default can be replaced with CO MAP HR or SVR The frequency of data update can be chosen from 10 default 20 or 30 seconds Dynamic Preload Responsiveness Parameters SVV default or PPV SVV target zone limit 10 default PPV target zone limit 13 default F Stroke Volume metres k
21. ce powered using a Class 1 power supply There are no patient applied parts or protective earth connection Electrical safety is achieved through the monitor being a SELV device and through the construction of the Class 1 power supply The system has been tested and complies with all relevant clauses of IEC 60601 1 standard Electrical Safety Testing 1 Test the system as a Class 1 Type B IEC 60601 1 device Refer to your Electrical Safety Analyser user manual 2 The protective earth resistance test is not a requirement for the POC 125 LiDCOrapid monitor Either omit the test manually or ignore the test result if it is part of an automatic test sequence 3 All tests must pass the IEC 60601 1 test limits with the exception of the protective earth resistance test Note The stud on the rear of the monitor is an equipotentiality connection only This should not be confused with a protective earth connection The LiDCOrapid DTP1201 is a Class 1 device The system has been tested and complies with all relevant clauses of IEC 60601 1 standard www lidco com Version 1 04 49 LI DCO Kapid User s Manual D Monitor Connectors Layout POC 125 127 Bottom view of monitor L Power cable input On off switch 3 BP signal input to ADC card NO RS232 VGA USB ports Ethernet NO O1 f 0 a Hoe EX ojo 0 Go EE O Power cable input On off switch BP signal input to ADC card RS232
22. ch between Cardiac Output Mean Arterial Pressure Heart Rate or Systemic Vascular Resistance When an event is started restarted or stopped an event flag is automatically set If not required this flag can be cancelled by selecting the red X The event information is entered as normal to keep a record of the intervention Other events can still be entered when the event response is running see 3 2 5 The Event Response will become a trend when the Event Response display reaches 40 minutes of data Each new data point will appear on the right and the earliest point will disappear on the left Press to switch between the Blood Pressure waveform display and the Event Response display www lidco com Version 1 04 29 LI DCO Kapid User s Manual 3 2 4 Dynamic Preload Responsiveness Display The Dynamic Preload Responsiveness Display is used to assess the likely response of a patient to a fluid challenge Data is displayed both graphically and numerically on this screen for ease of use WARNING Dynamic Preload response variables e g SVV or PPV are only valid in patients with closed chests on full mode control ventilation WARNING Dynamic Preload response variables e g SVV or PPV are unreliable in patients with significant arrhythmia The LiDCOrapid will alert when heart rate variation exceeds 10 The display is made up of two independent graphical trends The first is a trend of either the Stroke Volume Variat
23. e For Channel 2 zero the Patient Monitor IBP waveform No values are displayed for Channel 1 Check all cable connections Zero Fail Signal Varying Channel 1 must be zero ed before values will display Zero Fail Offset too large No BP waveform or values are displayed Check cable connections for Channel 2 No cable for Channel 2 Contact your LIDCO representative to obtain a cable Specify the Make Model of your Patient Monitor The BPM is compliant with the Reposition to reorient and or increase the applicable EMC requirements It may separation between the equipment Connect the still be affected by and or affect other equipment to a power outlet on a different circuit equipment If interference occurs Appendices 38 LI DCO Kapid User s Manual Description Possible Causes and Corrective Measures 3 LiDCOSmart Card Smartcard is not recognised or e Wrong card or inserted incorrectly Invalid Smartcard Check card is a LiIDCOsmart and is oriented facing the user with the chip end entering the monitor first see section 3 1 3 Smartcard is expired e Card has expired and can no longer be used Replace card with a new LiDCOsmart 4 Data Download Buttons Not Active e USB device is not attached Download does not complete e USB device is full e USB device is not compatible Check USB device is attached Try a different USB device 5 Serial Data Interface Data does not appear on Philips Monitor Vuelink Enabled not
24. ecise as an independent calibration of the PulseCO algorithm with a well performed indicator dilution measurement e The estimate used has boundary conditions similar to any device using a nomogram based approach to estimate physical characteristics Individual patient history may include a variety of potentially confounding conditions such as chronic hypertension arteriosclerosis and or diabetes which may alter aortic capacitance e Care should be taken when using the LiDCOrapid in patients with severe peripheral vasoconstriction due to pre existing disease or as a result of vasoactive drug treatment In these cases the radial artery pressure may be substantially different to the central aortic pressure e The scaling factor estimate is derived from in vivo radial artery data and may be less accurate in patients with femoral arterial catheters e Always shut down the monitor before using it on a different patient This is in order to avoid the possibility that incorrect set up parameters and or calibration factors are used in the calculation of the new patient s hemodynamics e The central venous right atrial pressure is manually entered on the Configuration Screen always check that the correct venous filling pressure is being used for the calculation of the systemic vascular resistance index e LiIDCOrapid Hemodynamic Monitor is not required to be directly connected to the patient applied part pressure transducer The data processed is the i
25. es the default for future use Channel selection is required again only if the cable input channel is changed e Press to display the channel selection window e Choose the channel that matches the cable connection A waveform will display in the associated window that is connect to the IBP e Channel 1 IBP Transducer BP Module e Channel 2 Analog BP Waveform BP Module e Channel 3 Analog BP Waveform LiDCO Monitor e Confirm the Pressure and Heart Rate match the Patient Monitor e Note Channel 1 must be zero ed before pressure and heart rate values will display e Press to zero the pressure on Channel 1 when the Patient Monitor is zero ed e Press Z when finished to return to the previous screen oo Zero Channel Button Selected OSTATE Beat Cable Detector ee Threshold Connection Exit Button www lidco com Version 1 04 19 LI DCO Kapid User s Manual 3 1 5 Beat Detector Threshold Heart rate display adjustment procedures Press to display the beat detector Threshold adjustment window If heart rate displayed on primary monitor is lower than that displayed on the LiDCOrapid Press to raise threshold until displayed heart rate matches If heart rate displayed on primary monitor is higher than that displayed on the LiDCOrapid Press to lower threshold until displayed heart rate matches Note e Patients with a pronounced diastolic pressure bounce can cause the LiDCOrapid Hemodynamic
26. esia for cesarean delivery in preeclampsia Anesthesiology Vol 108 No 5 802 811 23 Jonas M Fennell J Brudney CS 2008 Haemodynamic optimsation of the surgical patient revisited Anaesthesia International Spring 2008 Vol 2 No1 24 Archer T Knape K Liles D Wheeler A Carter B 2008 The hemodynamics of oxytocin and other vasoactive agents during neuraxial anesthesia for cesarean delivery findings in six cases Int J Obstetric Anesthesia Vol 17 3 247 254 25 Kim H Hadian M Severyn D Pinsky M 2009 Cross comparison of the trending accuracy of continuous cardiac output measurement devices in postoperation patients Poster presentation ISICEM Brussels Critical Care 13 Suppl 1 P209doi 10 1186 cc7373 26 Dyer R Reed A van Dyk D Arcache M Hodges O Lombard C Greenwood J James M 2009 Hemodynamic Effects of Ephedrine Phenylephrine and the Coadministration of Phenylephrine with Oxytocin during Spinal Anesthesia for Elective Cesarean Delivery Anesthesiology 111 753 65 27 Cecconi M Monti G Dawson D Vamadan S Hamilton M Della Rocca G Grounds RM Rhodes A 2009 Dynamic Indices by PulseCO in post surgical intensive care patients Proceedings of the 2009 Annual Meeting of the ESICM References 54 LI DCO Kapid User s Manual 28 29 30 31 32 P Brass E Mills J Latza J Peters E Berendes LiDCOrapid and PICCOplus preload response parameter validation study ISICEM 2011 doi 10 1186 cc
27. f significant changes in the displayed parameters so that appropriate action can be taken The full procedure trend is shown to the left of the acute change This window will display all data and automatically rescale the time axis as more data is collected maximum window size is 8hrs The full procedure trend provides a complete picture of changes and is useful in examining long term increases or decreases as well as change from start for the hemodynamic parameters MAP amp HR mm Hy amp b ym E MAP amp nia min Hemodynamic Introduction 2 LI DCO Kapid User s Manual 1 2 Functional Hemodynamic monitoring The LiDCOrapid is a combination of both standard and functional hemodynamic monitoring The functional monitoring portion is comprised of two different sets of display See Figure that provide both a predictive indication of fluid responsiveness and the ability to assess changes in hemodynamic parameters as a result of interventions such as fluid boluses vasoactive drugs or inotropes All the data are derived via continuous beat to beat Pulse Pressure and Stroke Volume analysis The event response display is used to monitor the change in a hemodynamic parameter after an intervention e g fluid challenge or change in drug therapy The display is designed to calculate a change from baseline and display a graphical trend This allows for a clear understanding of the actual hemodynamic response to the intervention
28. garding EMC and needs to be installed and put into service according to the EMC information provided below Portable and mobile RF communications equipment can affect the LiDCOrapid Hemodynamic Monitor System To assure compliance the LiDCOrapid Hemodynamic Monitor System should only be used with the following cables supplied by LiDCO Description Maximum length AC Power Cord DC Power Cord PulseCO LiDCOrapid to Patient Blood Pressure Monitor BPM Interface Cable Use of accessories and cables with the LiDCOrapid Hemodynamic Monitor System other than those supplied by LiIDCO may result in increased emissions or reduced immunity of the LiDCOrapid Hemodynamic Monitor System Guidance and manufacturer s declaration electromagnetic emissions The LiDCOrapid Hemodynamic Monitor System is intended for use in the electromagnetic environment specified below The customer or the user of the LiDCOrapid Hemodynamic Monitor System should ensure that it is used in such an environment Emissions test Compliance Electromagnetic environment guidance RF emissions Group 1 The LiDCOrapid Hemodynamic Monitor System uses RF CISPR 11 energy only for its internal function Therefore its RF emissions are very low and are not likely to cause any interference in nearby electronic equipment RF emissions Class B The LiDCOrapid Hemodynamic Monitor System is suitable for use CISPR 11 in all establishments including domestic establishments and IE
29. he patient ID field The patient s name is not included in any of the data files The download screen allows easy navigation of the available data by collecting all files with the associated patient ID folder These folders can be sorted by Patient ID Start Stop or Duration In the lower window all the associated files are displayed To download data 1 Attach a USB device and ensure it is acceptable 2 Select the Patient ID 3 Press the LiDCOview button to download the entire data set LVU or 4 Select the specific file in the lower window and press the Green File Download button Note Some USB devices may not work with LiDCOrapid www lidco com Version 1 04 43 LI DCO Kapid User s Manual Data Communications Press this button to enter Data Communications Connect 9 pin D type cable to COM1 port Data Output CO CI SV SVI SVR SVRI PPV SVV HRV Philips VueLink Press Serial Enabled and Vuelink Enabled Requires Vuelink Module Aux Plus M1032A A05 And Interface Cable M1032 61699 K6C Dis taterees 80 sus 30 sec Averaging Interval is set by Philips Enable Logging Averaging can be set to No 10 20 or 30 Lai Mac 00D0CA 473317 seconds at EN alee ole Other RS 232 Connections Press Serial Enabled and LiDCOSerial Enabled Interval can be selected from beat data to 4 hourly X Obtain DHCP address Averaging can be set to 10 20 30 or 60 L DHCP seconds
30. ilogrammes J sr www lidco com Version 1 04 33 LI DCO Kapid User s Manual 3 2 Event List Press this button to display a list of events as shown below _ inotrope INoradrenaline Nore 10 31 38 Ventilator Setting Volume Control 10 32 25 Vasoactive Drug Metaraminol 10 32 31 Surgical Vascular Clamp 10 32 38 Other None To select an event press these buttons to scroll through the events or simply touch the event information line Press this button to edit event information such as Event Characteristic or Additional Information Note The timing of the event cannot be changed R dnional inormation Infusion Operation of LiDCOrapid 34 LI DCO Kapid User s Manual 3 2 8 History and Chart Screens Press this button to access the History Screen The History screen can be used to look back over up to 24hrs of hemodynamic data including preload response parameters SVV PPV and HRV Absolute or index values are displayed based on the configuration screen settings 3 2 6 Press here to alternate this graph between SVV PPV and SVR aay rrrrrrrrrerrr c Touch the vertical axis to Touch inside the graph to display the display the control window target window for CO SV or SVR SV Graph The scale of both axes can be adjusted by The target line can be added by selecting the de selecting Auto scale and using the on box it can be adjusted by
31. ion SVV or the Pulse Pressure Variation PPV over an adjustable 10 60 minute period Adjust time period or scale by pressing the increase decrease buttons in the control window Operation of LiDCOrapid 30 LI DCO Kapid User s Manual The second Delta SV or PP is a fixed 30 second trend of the change in stroke volume or pulse pressure normalised to the current mean stroke volume or pulse pressure This results in a percentage value that oscillates around a baseline of 0 This display gives a clear graphical indication of the respiratory cycle and signal quality The more sinusoidal the signal the better the quality Each wave reflects a respiratory cycle as reflected by change in SV or PP The numeric value of SVV or PPV is displayed along with the heart rate variation When the HRV exceeds 10 the SVV or PPV is considered unreliable The background of the HRV display will change to yellow and the Trend of the dynamic preload responsiveness display will indicate unreliable data by using a yellow line for each affected data point Press this button to switch the display to PPV www lidco com Version 1 04 31 LI DCO Kapid User s Manual 3 2 5 Event marking Events can be marked at any time during the use of the LiDCOrapid A flag is placed on the hemodynamic monitoring display with the event number Each event can be individually annotated Standard event types are listed and additional information
32. mic monitoring In this way the user can see both long term and short term trends in key parameters such as BP HR and SV Dynamic preload responsiveness parameters SVV or PPV give predicted fluid responsiveness assessment Functional hemodynamic change in parameters such as SV or CO via Event Response provides immediate feedback on interventions MAP amp HR 2 min Hemodynamic l Ly 126 95 7 JLTHR ia J nSV 2 min Event Response TT Change Preload Response Press the CO button trend of SV to change to a trend of CO Press the SV button to change to a to display Cl SVI SVRI for 10 seconds Press the CO SV SVR numeric display Operation of LiDCOrapid 22 LI DCO Kapid User s Manual Press to switch between the Event Response display and the BP waveform Press to Change the parameter displayed in the Event Response window Press to reveal a submenu Press to return to the Setup Screen 3 1 4 Press to return to the Configuration Screen 3 2 6 Press to enter an event 3 2 5 www lidco com Version 1 04 25 LI DCO Kapid User s Manual Press to capture the screen as a JPG file Press to shutdown the monitor Press the CO button to enter a CO Value directly and calibrate the monitor See section 3 1 6 Press to display the Chart screen 3 2 8 Press to display the History screen 3 2 8 Operation of LiDCOrapid 26 LI
33. namic Monitor User s Manual e Check the power supply voltage is suitable for use with the LiDCOrapid Hemodynamic Monitor before connecting the equipment to the power outlet e Disconnect the LiDCOrapid Hemodynamic Monitor and the power supply unit from the voltage supply when not being used e Disconnect this equipment from any AC outlet before cleaning Use a damp cloth and do not use liquids or spray detergents for cleaning e The BPM is not Category AP or Category APG and should not be used in the vicinity of a flammable anaesthetic mixture with air or oxygen or nitrous oxide e When disconnecting a cable pull on the connector not the cable itself e Do not attempt to remove the back cover of the LiDCOrapid Hemodynamic Monitor or open the power supply unit as you will be exposed to an electric shock hazard This operation should only be performed by LiDCO Ltd certified service personnel e To avoid the risk of electric shock or permanent damage to the product do not expose any of the LiDCOrapid Hemodynamic Monitor or power supply unit components to rain liquids or excessive moisture e Consult qualified service personnel if the LiDCOrapid Hemodynamic Monitor does not operate normally the power supply unit or power cord is damaged or moisture liquid has penetrated the product Maintenance The following maintenance is required for the LiDCOrapid Hemodynamic Monitor 1 Annual electrical safety check in accordance with hospital
34. ngs 6 LI DCO Kapid User s Manual Other Warnings e On set up and during use of the LiDCOrapid Hemodynamic Monitor always cross check to the pressure parameters and heart rate displayed by host monitor The following parameters heart rate systolic diastolic and mean pressures should all be within 5 of the values displayed by the host primary monitor Pay attention to the heart rate and if necessary adjust the threshold for detecting the beat in order to adjust the rate see section 3 1 5 e Dynamic Preload response variables e g SVV or PPV are only valid in patients with closed chests on full mode control ventilation e Dynamic Preload response variables e g SVV or PPV are unreliable in patients with significant arrhythmia The LiDCOrapid will alert when heart rate variation exceeds 10 e Always use the correct LiDCOrapid Hemodynamic Monitor cable assembly for connection to the primary monitor or the LIDCO BP Module LiDCO Ltd has a list of compatible monitor cable assemblies e The BP Module allows the arterial blood pressure waveform to be accessed directly via a standard invasive blood pressure transducer when connected to a patient monitor e The BP Module is used when it is difficult or not possible to access the arterial blood pressure waveform via a standard analog output from the patient monitor e The BP Module will accept a standard analog output from the patient monitor e The scaling factor estimate cannot be as pr
35. ns Maintenance and Cleaning 37 3 4 Troubleshooting the LiDCOrapid 38 4 0 Appendices A0 Engineering Screen 40 B Specifications 45 C Electrical Safety Testing 47 D Monitor Connectors Layout 50 E LiDCOrapid Mounting Options 51 F References 53 www lidco com Version 1 04 IV LI DCO Kapid User s Manual www lidco com V LI DCO Kapid User s Manual 1 0 Introduction The LiDCOrapid is a minimally invasive hemodyamic monitor that derives nominal stroke volume and heart rate from the patient s existing arterial pressure waveform using the PulseCO algorithm The display is designed into a single screen for ease of viewing and decision making The LiDCOrapid helps to optimally deliver goal directed management GDM strategies using its patented and clinically validated PulseCO algorithm It was developed for the acute care physician to get immediate feedback on a patient s fluid and hemodynamic status e The LiDCOrapid monitor is designed to be simple to interpret quick to set up and an effective way of managing the hemodynamics of surgical or any hemodynamically unstable patient requiring fluid and drug support e The LiDCOrapid is designed to be used by a physician or nurse to detect potentially deleterious changes in the hemodynamic status of the patient and then helps the user choose use and monitor the response of the patient to the therapeutic intervention e The LiDCOrapid is the first hemodynamic monitor s
36. nt If resuming a previous patient these boxes will be automatically filled in and cannot be altered Patient Details BP Waveform Systolic MAP Diastolic The blood pressure waveform will appear when the signal cable or BP module is connected The values for pressure and heart rate will appear within a few seconds The LiDCOrapid reports values for stoke volume SV and cardiac output CO that are based on the PulseCO algorithm scaled to the patient s specific characteristics The PulseCO scaling factor reflects the patient specific maximum aortic capacitance and will generally remain constant over short periods of time The PulseCO algorithm has been demonstrated to trend without the need for recalibration in numerous studies for up to to 24 hours9 19 12 Version 1 04 15 Patient Details BP Waveform The LiDCOrapid uses a nomogram based estimate of the patient specific scaling factor This was developed using in vivo calibration data from post surgical patients with radial arterial blood pressure waveform data The nomogram estimate was then validated in an independent cohort of medical ICU patients giving a good correlation 0 77 no bias and acceptable limits of agreement 26 when compared with indicator dilution based calibration Ay Warnings The scaling factor estimate cannot be as precise as an independent calibration of the PulseCO algorithm with a well performed indicator dilution mea
37. pecifically designed for use in the highly demanding conditions encountered in the operative room The product s continuously available beat to beat hemodynamic data will facilitate the use of enhanced fluid and drug based surgical optimization programs in a substantial number of the patients undergoing moderate and high risk surgical procedures This form of advanced care has been previously demonstrated to reduce complications and hospital length of stay Introduction Version 1 04 1 LI DCO Kapid User s Manual 1 1 Standard Hemodynamic Monitoring The LiDCOrapid is a combination of both standard and functional hemodynamic monitoring The standard monitoring portion is comprised of two trend display periods and associated numeric values of hemodynamic parameters The parameters are combined in a natural grouping to facilitate ease of interpretation The upper trend shows the Blood Pressure Systolic Mean and Diastolic with the Heart Rate The lower trend is normally set to display Stroke Volume This can be configured to display Cardiac Output or Systemic Vascular Resistance instead The values displayed in the lower trend are nominal unless the monitor is calibrated with a known value for Cardiac Output The two display periods are designed to show both an acute change and the full procedure The acute change portion is shown to the left of the numeric display and is set to a fixed scale of 2 minutes This provides an early warning o
38. protocol Cleaning Ax WARNING To avoid potentially life threatening patient cross infection always follow your hospital s recommended microbiological decontamination procedure for cleaning the LiDCOrapid System Recommended cleaning materials and methods are shown below To clean Wipe with a cloth moistened with a soap solution To disinfect Wipe with a gauze moistened with a dilute alcohol or glutaraldehyde based disinfectant Dry thoroughly with a lint free cloth www lidco com Version 1 04 3 LI DCO Kapid User s Manual 3 4 Troubleshooting the LiDCOrapid Description Possible Causes and Corrective Measures 1 Setup Screen e Data must be filled into the fields Patient s ID Height Weight and Age before accessing the LiDCOrapid Screen Enter data in yellow boxes Press Start button Cannot access the LiDCOrapid Screen 2 Set Up Procedure Difference of greater than 5 between e BP Cable not connected to primary monitor parameters displayed on primary and or at the LiDCOrapid ADC connection monitor and those shown on the BP Check connections Window of the LiDCOrapid e Primary Monitor analogue output is not to the LiDCOrapid Hemodynamic Monitor ADC Specification of 100 mmHg 1 volt Check analogue pressure output specification of Monitor or Module used e LiDCOrapid ADC faulty Confirm with PulseCO simulator or another Primary Monitor No BP Waveform is observed on any e Check all cable connections channel
39. re LIDCO or authorised representative Data Download www lidco com Version 1 04 41 LI DCO Kapid User s Manual Demonstration Demonstration mode allows the user to playback one of several waveforms into the LiDCOrapid Note that the monitor will display a periodic message when a demonstration waveform is being displayed In this mode the normal blood pressure signal input is ignored The following waveforms are available in demonstration mode _ Inotrope _ High Heart Rate Stable _ Fluid Challenge _ Post Fluid Challenge _ Fluid Response LIVE DATA Inotrope High Heart Rate Stable Fluid Challenge Post Fluid Challenge Fluid Responsive Appendices de view Data Download 2008 03 25 20 28 2008 03 25 21 58 2008 03 25 19 27 2008 03 15 20 20 2008 03 08 10 39 2008 03 15 12 08 2008 03 25 19 57 2008 03 13 06 56 2008 03 09 08 21 LiIDCO Kapid 2008 03 25 20 39 2008 03 25 22 23 2008 03 25 19 56 2008 03 15 21 24 2008 03 08 12 13 2008 03 15 20 19 2008 03 25 20 09 2008 03 13 08 48 2008 03 09 11 53 User s Manual PulseCO Data The LiDCOrapid stores patient data for 6 months The data download feature allows patient files to be downloaded either as LiDCOview files LVU or for the specific files to be downloaded separately All data is downloaded to USB drives which must be inserted before a download can occur The files are organised according to t
40. s cardiac output monitoring with pulse contour analysis A comparison with lithium indicator dilution cardiac output measurement Critical Care Medicine 33 2015 2021 Hamilton T T Huber L M Jessen M E 2002 PulseCO a less invasive method to monitor cardiac output from arterial pressure after cardiac surgery Ann Thoracic Surgery 74 51408 12 Smith J Kirwan C Lei K Beale R 2005 Cardiac Output measured by lithium dilution and transpulmonary thermodilution in adult intensive care patients Critical Care Medicine 33 1 2 Suppl 207 S A56 Smith J Kirwan C Lei K Beale R 2007 Comparison between un calibrated cardiac output using the femoral and radial arterial pressure waveform in critically ill patients ISECM A779 Marquez J McCurry K Severyn D Pinsky M 2008 Ability of pulse power esophageal Doppler and arterial pulse pressure to estimate rapid changes in stroke volume in humans Critical Care Medicine 36 11 3001 7 www lidco com Version 1 04 53 LI DCO Kapid User s Manual 13 Kemps H Thijssen E Schep G Sleutjes B De Vries W Hoogeveen A Wijn P Doevendans P 2008 Evaluation of two methods for continuous cardiac output assessment during exercise in chronic heart failure patients Journal of Applied Physiology 105 1822 1829 14 Mills E Jonas M Wolff C O Brien T 2010 PulseCO consistency variation in calibration factor over 24 and 48 hours Poster presentation ISICEM Brussels Critical Care 14 1
41. s which may result from such use All brand and product names mentioned herein are trademarks or registered trademarks of their respective holders This device is subject to the EU Directive 2002 96 EC WEEE It is not registered for use in private households and may not be disposed of at municipal collection points for waste electrical and electronic equipment LiDCO Ltd has authorized a firm to dispose of this device in the proper manner For more detailed information please contact your local LiDCO Ltd organization Version 1 04 LI DCO Kapid User s Manual Safety and Maintenance gt N O1 Read these safety instructions carefully Keep this User s Manual for later reference All cautions and warnings on the equipment should be noted Make sure the voltage of the power source is correct before connecting the equipment to the power outlet Use only the power supply unit supplied with the equipment 6 Use only the correct adapter for the power supply unit to suit the power source 7 The power outlet socket must be located near the monitor and must be easily accessible 12 13 14 15 Position the power cord so that people cannot step on it Do not place anything over the power cord Disconnect this equipment from any AC outlet before cleaning Use a damp cloth Do not use liquid or spray detergents for cleaning Keep this equipment away from humidity 10 11 Never pour
42. selected for Serial Link Data does not appear on Interfacing Select Vuelink in Engineering Screen Data Monitor Communications then restart monitor e LiDCOserial Enabled not selected Serial Link Select LiDCOserial in Engineering Screen Data Communications then restart monitor www lidco com Version 1 04 39 LI DCO Kapid User s Manual 4 0 Appendices A Engineering Screen The LiDCOrapid has an Engineering Screen which allows for configuration of the monitor downloading of data files and a demonstration mode The Engineering Screen is accessed from the Startup Screen by pressing the Engineering Screen button The Engineering Screen has three main purposes Demonstration Data Download Engineering Functions Appendices 40 LI DCO Kapid User s Manual Engineering Functions The following is a brief description of the Engineering functions Where noted these functions should be performed by LiDCO personnel authorised representatives or suitably trained staff Engineering Logs monitor functional details and error capture LIDCO or authorised representative Serial Interface turn RS232 Demonstration interface on off and configure frequency of data transfer Calibrate Touchscreen LiIDCO or authorised representative only Configure TCP IP set ethernet communications details iDCOsmart card LiDCO or authorised representative only Update Software used to upgrade softwa
43. solated pressure analog output from an approved patient monitor e The LiDCOrapid Hemodynamic Monitor should not be connected to any electrical equipment that is not compliant with EN 60601 1 1 and EN 60601 1 2 or equivalent electrical safety and EMC standards Make sure the LiDCOrapid monitor is securely mounted and that all cords and accessory cables are appropriately arranged to minimize the risk of injury to patients users or the equipment Do not expose the LiDCOrapid monitor to extreme temperatures Do not obstruct the LiDCOrapid monitor ventilation openings www lidco com Version 1 04 r LI DCO Kapid User s Manual 3 0 Operation of LiDCOrapid 3 1 Setup 3 1 1 Equipment Setup Mounting Recommendations Securely mount the LiDCOrapid Hemodynamic Monitor according to your institution s practices Optional mounting accessories can be purchased from approved medical equipment suppliers Contact your local LiDCO representative for recommendations on alternative mounting options Set Up Procedure Connecting the Power supply After the monitor is securely mounted attach the DC power cord supplied with the monitor at the back and connect it to a hospital grade power outlet The LiDCOrapid power supply automatically adjusts for power voltages from 100 to 240 VAC and converts the input voltage to 24VDC for supply to the monitor POC model only WARNING Do not use extension cords or multiple socket devices to connect po
44. surement The estimate used has boundary conditions similar to any device using a nomogram based approach to estimate physical characteristics Individual patient history may include a variety of potentially confounding conditions such as chronic hypertension arteriosclerosis and or diabetes which may alter aortic capacitance e Care should be taken when using the LiDCOrapid in patients with severe peripheral vasoconstriction due to pre existing disease or as a result of vasoactive drug treatment In these cases the radial artery pressure may be substantially different to the central aortic pressure The scaling factor estimate is derived from in vivo radial artery data and may be less accurate in patients with femoral arterial catheters Press the Navigate button ww lidco com Version 1 04 17 LI DCO Kapid User s Manual Press this button to go to the main monitoring Screen See Section 3 2 1 Press the CO button to enter a CO Value directly and calibrate the monitor see section 3 1 6 Press the Beat Detector Threshold to adjust for incorrect HR display See Section 3 1 5 Press the Configuration button to change the LiDCOrapid screen See Section 3 2 6 Press the Exit button to shutdown the LiDCOrapid Operation of LiDCOrapid 18 LI DCO Kapid User s Manual LiDCO BPM Channel Selection Channel Selection is required on first use of the BP Module The selected channel becom
45. the BPM cable and Blood Pressure e Weight 300g module before use Module TEN a HxWxD 10x207x4mm Do not use in the event of damage BPM Interface Cable i Cable Length 3m When connecting cables do specific to not try to force instead align transducer type them and gently connect Insert and remove cables USB Cable BED EE eT Cable Length 20cm using the connector Use the A to B USB cable mark to align connectors LiDCO BPM Channel Selection Channel Selection is required on first use of the BP Module The selected channel becomes the default for future use Channel selection is required again only if the cable input channel is changed e Press to display the channel selection window See below e Choose the channel that matches the cable connection A waveform will display in the associated window that is connect to the e Channel 1 IBP Transducer BP Module 7 e Channel 2 Analog BP Waveform BP Module e Channel 3 Analog BP Waveform LiDCO Monitor e Confirm the Pressure and Heart Rate match the Patient Monitor e Note Channel 1 must be zero ed before pressure and heart rate values will display e Press LJ to zero the pressure on Channel 1 when the Patient Monitor is zero ed e Press Z when finished to return to the previous screen BP Waveform Channel 1 pm Zero Channel Buton Selected EETA Beat Cable Detector l Threshold Connection Exit Button www lidco com Version 1 04 9 LI DCO K
46. the full list of indications contraindications and warnings The calibration is performed on the Setup or main Screens Press the Navigate button to display the submenu When the LiDCOrapid is calibrated by either method the n is removed from the variables SV CO and SVR A yellow flag is placed on the SV and CO trends www lidco com Version 1 04 21 LiIDCO Rapid Current Cal Factor Cal Factor Uncal 450 Equalize New Cal Factor Cal Factor N T 0 2 il i X j y ere a Operation of LiDCOrapid Measured CO User s Manual Enter the value for CO in the Measured CO box and press the Equalize Button to generate a calibration factor Press the Green tick to accept the calibration or press the Red X to cancel 22 LI DCO Kapid User s Manual Current Cal Factor New Cal Factor Enter the value for CF in the Ce Measured CF box Touch the white box to enter a new calibration factor Touch the green tick button to apply it Current Cal Factor 1 060 New Cal Factor Press the Green tick to accept the calibration or press the Red X to cancel www lidco com Version 1 04 23 LI DCO Kapid User s Manual 3 2 Operation 3 2 1 Overview of LiDCOrapid Screen The main monitoring screen is a single heads up display that combines both standard and functional hemodyna
47. tic Patients with Acute Circulatory Failure Am J Respir Crit Care Med 2000 162 134 138 Berkenstadt H Margalit N Hadaani M Friedman Z Segal E Villa Y Perel A Stroke volume variation as a predictor of fluid responsiveness in patients undergoing brain surgery Anesth analg 2001 92 984 9 Belloni et al Assessment of fluid responsiveness parameters for off pump coronary artery bypass surgery A comparison among LiDCO Transesophageal Echocardiography and Pulmonary Artery Catheter 2007 Journal of Cardiothoracic and Vascular Anesthesia J Cardiothorac Vasc Anesth 2008 Apr 22 2 243 8 Wilde R B P Schreuder J J van den Berg P C M Jansen J R C 2007 An evaluation of cardiac output by five arterial pulse contour techniques during cardiac surgery Anaesthesia 62 760 68 Costa G C Della Rocca G Chiarandini P Mattelig S Pompei L Barriga M S Reynolds T Cecconi M Pietropaoli P 2007 Continuous and intermittent cardiac output measurement in hyperdynamic conditions pulmonary artery catheter vs lithium dilution technique Intensive Care Medicine doi 10 1007 s00134 007 0878 6 Missant C Rex S Wouters PF 2007 Accuracy of cardiac output measurements with pulse contour analysis PulseCOTM and Doppler echocardiography during off pump coronary artery bypass grafting European Journal of Anaesthesiology 1 6 doi 10 101 7 S0265021507002979 Pittman J Bar Yosef S SumPing J Sherwood M Mark J 2005 Continuou
48. ton snes gga been located on This will display the Setup Screen All the patient details will Press Roue button ts cantines be automatically entered If the LiDCOsmart has expired then the Startup Screen will ESS indicate this and a new LiDCOsmart will be required Please insert a valid LiDCOsmart Card www lidco com Version 1 04 13 LI DCO Kapid User s Manual WARNING The LiDCOsmart must be fully inserted into the card reader If the card is not recognised remove and reinsert Please remove the card Re insert when No card in the reader displays 3 1 3 LiDCOsmart The LiDCOsmart card is used to access the LiIDCOrapid Hemodynamic Monitor The LiDCOsmart is a single patient use card When a valid LiDCOsmart is inserted the Startup Screen will indicate Press Start New Patient to begin If the LiDCOsmart was used previously the Startup Screen will indicated Press Resume Previous Patient The LiDCOsmart has a predefined period of use that is printed on the card The start is recorded when monitoring begins Once the period has elapsed the card becomes expired If this happens while in use monitoring will continue Once the card is removed from the monitor or the monitor is shutdown that LiDCOsmart can no longer be used How to insert the Card Avoid heat scratching moisture or bending Operation of LiDCOrapid iS Enter Patient Information in the yellow highlighted boxes for a new patie
49. utton www lidco com Version 1 04 5 LI DCO Kapid User s Manual 2 0 Indications Contraindications and Warnings Indications for Use of the LiDCOrapid Hemodynamic Monitor System Intended Use The LiDCOrapid Hemodynamic Monitor System is intended for use as a diagnostic aid for the measurement of blood pressure cardiac output and associated hemodynamic parameters in adult patients Suitable Patients Patients who have had arterial catheters inserted and require monitoring Locations of use Medical amp Surgical ICU s Operating Suites Step Down High Dependency Units Trauma A amp E ER Departments Coronary Intensive Care Units Cardiac Catheter Laboratories Contraindications The following patients are contraindicated for use with the LiDCOrapid Hemodynamic Monitor e Patients with aortic valve regurgitation e Patients being treated with an intra aortic balloon pump IABP e Patients with highly under or over damped peripheral arterial lines due to blood clots kinks or air bubbles in the line e Patients with severe peripheral arterial vasoconstriction vasospasm Severe peripheral arterial vasoconstriction vasospasm may negatively affect peripheral arterial blood flow and therefore the accuracy of the arterial blood pressure measurements themselves and hence any arterial waveform derived cardiac output reading will also be affected This is a rare event and may be associated with severe peripheral vascul
50. wer to the monitor Do not use any other detachable power cords other than the power cord provided Connecting the LiDCOrapid to Primary Patient Monitor Option 1 Direct Analog Input The LiDCOrapid Hemodynamic Monitor is designed to interface with standard patient monitors that provide an analog arterial pressure waveform output LIDCO Ltd or your local distributor can provide a list of compatible patient monitors modules together with the appropriate cable assembly to connect to the patient monitor analog pressure out Option 2 3 LiDCO BP Module e The BP Module allows the arterial blood pressure waveform to be accessed directly via a standard invasive blood pressure transducer when connected to a patient monitor e The BP Module is used when it is difficult or not possible to access the arterial blood pressure waveform via a standard analog output from the patient monitor e The BP Module will accept a standard analog output from the patient monitor WARNING It is important that the primary blood pressure monitor is correctly calibrated Check that the pressure display on the monitor is the same as the pressure displayed on the LiDCOrapid screen Note The LiDCOrapid Hemodynamic Monitor does not have a mouse or keyboard All user interactions are mediated through the touch sensitive screen Operation of LiDCOrapid 8 LI DCO Kapid User s Manual Contraindications None LiIDCO BPM Components Precautions Check

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