How to setup the LiDCO hemodynamic monitor for non invasive monitoring in ten simple steps. Read below or watch the YouTube video.
• Connect the power supply (optional)
• Power on using the button underneath the monitor
* when A/C power is not available, the monitors battery can offer 3hrs of operation when fully charged.
• Select “R” for the LiDCOrapid trend of Hemodynamics, and
• Select “C” for CNAP (Continuous Non-Invasive Arterial Pressure) from the finger
• The wedge will turn from blue to green when selected.
• Press the white check mark in the center of the wheel to confirm and move
forward
• Enter Pt. ID number, age, height, weight, gender and patient type
• Press the green forward arrow* to enter monitoring mode
*If the arrow isn’t green, go back to complete all details
1) Select “External NIBP” in CNAP settings if you will calibrate with the hospital BP arm cuff. Apply it to either arm.
2) Un-Select “External NIBP” if you will calibrate with the arm cuff attached to the LiDCO. Attach the black airhose from the LiDCO to the appropriate size cuff, and apply the cuff to either arm.
Step 5: Attach CNAP to patient
• Place the patient’s index finger onto the sizing gauge on top of the cuff controller to determine the correct cuff size (S/M/L).
*the cuffs should slide easily over the knuckles without resistance
• Position the finger cuffs at the base of the pointer, middle and ring finger
• Connect finger cuffs to cuff controller (black) & cuff controller to monitor cable (orange)
• Fasten cuff controller to forearm with strap provided
*if the arm will be tucked during surgery, ensure the pt is padded to avoid any potential compression injuries.
• If possible, assure the Cuff controller is at the level of the Right Atrium
• Press the green button in the Blood Pressure Channel to start the CNAP signal acquisition
*if the arrow remains grey, check all connections, and observe the area at the top of the screen for troubleshooting messages.
If setup for external NIBP, enter values for systolic and diastolic for NIBP when prompted
If setup for LiDCO NIBP cuff, this step is automated
• This indicates the relative strength of perfusion in the finger. You need at least one green box for the measurement to proceed.
• The further to the right the green box is, the stronger the pulse signal.
• One finger cuff will inflate and deflate several times as the monitor senses the patients pulse. Observe as the red line on the pressure graph moves slowly up and down as the finger cuff inflates and deflates.
• Next, the finger cuff will begin to counter-pulse and display an arterial waveform (~90 seconds total)
• The CNAP has successfully detected the blood pulsatility in the finger.
• Observe NIBP arm cuff measurement used for calibrating the LiDCO finger sensors appears in parenthesis below the current finger cuff pressure measurement
• Observe continuous trending of all measured parameters: CO, CI, SV, SVR, SVV, PPV, & Event response % Change.
Roughly 17% of patients receiving elective surgery suffer postoperative complications within 30 days of their procedure [1] and this figure represents the third leading cause of death globally [2].
This blog is intended to quickly shore up what you already know about hemodynamic monitoring in critical care, highlight some pitfalls of volume assessment in COVID-19 patients and provide
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