Flotrac

uses and limitation of flotrac - way to monitor cardiac output

1. FLOTRAC BY DR.VIJAYANAND PALANISAMY

2. The Vigileo ™/ FloTrac ™ system utilizes an existing radial or femoral arterial line that is attached to its monitoring unit.

3. The key findings that emerged from many literature reviews indicated that the Vigileo ™/ FloTrac ™ system's specific values for CO and CI may not correlate exactly with PAC with 100% accuracy. However, the trends of these Vigileo ™/ FloTrac ™ system derived values are useful to estimate hemodynamic status. Additionally, the SVV values are reliable for gauging vascular fluid status and the adequacy of need for additional intravascular fluid volume.

4. How to asses volume responsiveness?

5. Advantages Requires No Manual Calibration for CO Calculation. User enters Patient ( Pt ) Specific Data. ( age, gender, height, weight to initiate the monitoring .) Non invasiveness Works through an already existing arterial line catheter Continuous CO monitoring No CVL is required Advanced Arterial Waveform Analysis ( PRAM) by FloTrac Sensor. Pt to pt differences in vasculature. Real time changes in vascular tone. Different arterial sites are acceptable .

6. Disadvantages Good Arterial Signal Quality is critical for accurate CO calculation . Elevated levels of PEEP can erroneously increase SVV and warrant for fluid resuscitation per the monitor but may not actually be needed for the patient. Finally, large changes in vascular tone or vasodilation may also correlate with an increased SVV does not account for differences in the pulse pressure readings recorded from different arterial cannulation sites.

7. Moreover, increases in the pulse pressure may not always reflect an increase in stroke volume . In fact, to the contrary, it may actually reflect an underlying decrease in the stroke volume–as can be seen with utilization of vasopressors . These phenomena have been inaccurately delineated per the Flotrac ™/ Vigileo ™ as Meng et al. , demonstrated through the comparison of phenylephrine and ephedrine administration with total body tilting using the Esophageal Doppler as the reference method.

8. Still Not Reliable during Arrhythmias For Hemodynamically Unstable Patients Intra Aortic Balloon Pump in use. Ventricular Assist Devices in use.

9. contraindications No absolute contraindications but has limitations that must be taken into account. Currently, the monitoring system is only recommended for patients that are 100% mechanically ventilated and not spontaneously breathing

10. Cost effectiveness should be a consideration when determining which hemodynamic system to use However, clinical judgment cannot be substituted for data obtained from the system.

11. THANK YOU