[PiCCO monitoring of 4 critically ill patients]

The PiCCO physiological monitor (Pulsion Medical Systems, Munich, Germany) was used for hemodynamic diagnosis and monitoring of 4 patients: a polytraumatized female patient with septic shock and ventilator-associated pneumonia; a man with congestive heart failure and cor pulmonale who developed acute heart failure while recovering from anterior resection of the rectum; a man with severe head injury and acute respiratory distress syndrome; and a polytraumatized male patient with a myocardial contusion. All were in a life-threatening situation, either immediately as in the case of the patient with myocardial contusion or eventually as in the patient with septic shock. The PiCCO monitor recorded hemodynamic parameters satisfactorily, facilitating adjustments to optimize treatment. The risks and complications of the usual method of monitoring by Swan-Ganz catheter are well-known. New less invasive monitoring systems designed to record parameters similar to those detected by the Swan-Ganz catheter but with fewer complications and risks have become available. One example, the PiCCO monitor, combines arterial thermodilution with analysis of the pulse waveform, providing a series of hemodynamic parameters useful for managing the critically ill patient.