Download Q2 Plus Tip Booklet

The Advanced OptiQ™ CCO/SvO2
Monitoring System with the
Enhanced Q2Plus™ Computer
Q2Plus™
Setup
>>
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Power On
Connect cables to monitor (allow optical module to warm at least 15 minutes) and catheter
Enter patient height and weight for indexing (minimum 20 kg or 44.4 lbs.)
Perform pre-insertion calibration
Flush ports
Place catheter in patient
Perform light intensity baseline
Press Start/Stop CCO
Symbols
Monitoring Screen
? Help Menu
For Transport: Disconnect Optical Module at
monitor to maintain calibration
1
Setup
Submenu
Guided Patient Setup
(guides through initial setup)
Enter Patient Information
(Patient ID#, Height, Weight)
SO2 (O2 saturation) Setup Pre-Insertion Calibration
Light Intensity Baseline
InVivo Calibration
Alarm Limits Setup SO2 Display Parameters
Restart SO2 Module
CCO Setup
CCO Display Parameters
Alarm Limits Setup
Bolus CO-Td Setup
Catheter Selection
Prep for CO-Td Series
Previous CO-Td Series
Mark Events: Drug Titration, Suctioning,
Nursing Maneuvers, etc.
Patient History
View Current Patient History Data
View Previous Patient History Data
Clear Previous Patient History Data
Clear Previous Bolus CO-Td Series
OpMod Data
Calculate Values
Hemodynamic Calculator
Drug Dose Calculator
System Configuration
Date/Time Functions
System Settings
Communication Setup
Service Mode
Tertiary Menu
Low # High #
SO2 Mode: Venous or Arterial
Light Intensity Trend: Displayed/Not Displayed
Mode: CCO or CCI
Ave. Mode: Normal, Fast Filtered, Fast, Urgent
QSI Trend: Displayed/Not Displayed
Low # High #
Catheter: OptiQ/TDQ
Injectate Volume 10 mL
Probe Type: None
Comp. Constant:
Save Data to OPMOD
Display Data from OPMOD
Time and Date
Time Format: 12 to 24 Hour Clock
Time Scale: 1, 2, 4, 8, 16 Hours
PA Temperature Units: Fahrenheit/Celsius
Alarm Volume: Low, Medium, High
Light Intensity Trend: Displayed/Not Displayed
Code Required
Code Required
Code Required: 2 vs. 4 Averaging Modes
2
SO2 Setup
Light Intensity Baseline
Current Light Intensity
Optimal Examples
LH
Acceptable Examples
Unacceptable Examples
Light Intensity is a graphic display that tells the user the quality of the reflected light
signal obtained from the catheter.
3
SvO2
Diagram
Alveolus
PvO2 40 mmHg
SvO2 60-80%
Hgb 13-15 gm/dL
PaO2
105 mmHg
PaCO2
38 mmHg
PaO2 100 mmHg
SaO2 95-98%
PvCO2 40-50 mmHg
PaCO2 40 mmHg
Venous
Arterial
VO2
225-275 mL/min.
110-130 mL/min./m2
PvO2 40 mmHg
O2
Reserve
525-975 mL/min.
420-540 mL/min./m2
Cells
O2 Demand
DO2
Skin, etc.
PvCO2 40-50 mmHg
The Delicate Balance
PaO2 90-95 mmHg
Vital Organs
800-1200 mL/min.
550-650 mL/min./m2
CO
4-8 L/min.
3-5 L/min./m2
PaCO2 35-45 mmHg
CO
VO2
Oxygen
Consumption
Hgb
SvO2
SaO2
+ –
­
Oxygen Delivery
4
Approximate Response Times
Response time is defined as the time required to recognize 90% of any change in cardiac output.
Response time is reflective of the Q2+ monitor’s adaptive averaging algorithm. During periods when the monitor detects higher
levels of thermal noise or artifact, the monitor adapts by increasing the number of data points evaluated for inclusion in the cardiac
output calculation. Thermal noise or artifact is any change in pulmonary artery temperature that is not caused by the intermittent
heating of the TriOx™ catheter’s thermal filament.
The Q2+ monitor’s exclusive QSI bar provides, at a glance, a graphic depiction of the level of thermal noise that is being experienced
in the patient’s pulmonary artery.
QSI Bars Displayed
Response Time
< 3 QSI Bars
3 QSI Bars
4 QSI Bars
5 QSI Bars
~ 15 min
10 - 15 Min
5 - 10 Min
3 - 5 Min
Common causes of thermal noise or artifact in the pulmonary artery:
>>
Infusions of Banked Blood
>> Spontaneous respiration, coughing, increased work of breathing
>>
Rapid infusions of:
>> Patient movement
>>
Medications
>> Electrocautery
>>
Fluid for volume replacement
>> Pneumatic compression devices (SCD’s)
>> Post by-pass re-warming
5
>> Hypovolemia
QSI
is a graphic display that tells the user how strong the thermal cardiac output signal is in relation to the thermal background noise.
Thermal Background Noise
c an arise from a number of sources. Some common examples include: patient rewarming post-bypass, fluid infusion, spontaneous
respiration, patient movement, pneumatic compression leg cuffs.
Averaging Time
r efers to the “window” of time during which data is averaged. During periods of increased thermal noise, the Q2Plus will adapt the
averaging time to provide greater artifact rejection.
Preassembled Bridge Add-On Kit for Confirming Proper Coil Placement
Normal PA Distal Monitoring
DTPP
PA
DTPP Monitoring to Confirm Coil Placement
DTPP
PA
6
Setup
PA Distal Port
>> PA waveform verifies
the location
Balloon Inflation Volume
Distal Thermal Coil
Positioning Port (DTPP™)
>> Appropriate inflation volume
is 1.25 - 1.5cc
>> RV waveform verifies the
location of the thermal coil
>> If less than 1.25cc,
reposition the catheter
For more information, contact your ICU Medical Product Specialist Representative at 1-800-824-7890 or visit www.icumed.com
©2012 ICU Medical, Inc.
M1-1234 Rev 02
800.824.7890 | www.icumed.com