Swan´s or PiCCO

Hi,

We use Swan`s and PiCCO system for haemodynamic monitoring in our ICU. I`m for Swan`s but my ICU friend is PiCCO fan. Our fight about that is endless. Help us! Are you for me or my friend?

:angryfire :angryfire

Sorry i'm for your friend. My favorit is PiCCO. Allthough invasive, it is less invasive than Swan Ganz. Also PiCCO is said to have some more reliable values (for some parameteres) than Swan Ganz, because it uses flow rather than pressure. But i am not sure about that.

In the nurse instructionmanual I have for PiCCO, it states that some values are aprox. 15 min delyed in Swan Ganz, but instant when using PiCCO.

Yes..... I am a PiCCO nurse.

Just too bad we don't use PiCCO here

Hi,

I agree with Vikingnurse. I too am a PiCCo fan ... less invasive and no chance of accidental wedging. The unit I presently work on is phasing out swan ganz. Along with giving more accurate readings, the doctors who haven't got much experience with inserting swanz catheters can easily insert a picco line. Thumps up for PiCCo.

We use dopplers and are in the process of introducing PiCCO.

I haven't used PiCCO much but I must admit I'm more inclined to use them than swans.

Hmm, 2:0 to my friend, not good for me.

Thank`s Vikingnurse and Baby G for comments. Everything you said is true, no doubt about that. My friend use these arguments too. But, my arguments for Swan`s are:

- PiCCO arterial catheter and especialy guidewire for Seldinger tehnique is very, very thin and fragile. If doctor can`t do it in first attempt, probably guidewire for art. catheter is useless.

- When Swan`s is used there is no such blood around patients. PiCCO method is "bloody method".

- femoral artery is the most common place for art. catheter placement. I think that area isn`t nice place for such invassive method.

- of course, using PiCCO method you must have central venous catheter also. So we have two "big" invassive lines ( INFECTION CONTROL ? )

- for transpulmonary thermodilution, saline themperature is under 8 degree Celsius ( 4 -6 ). When cold saline is injected throw central line and heart, bradicardia, arrhytmia and even cardiac arrest is possible. We have 3 - 4 CPR last year after transpulmonary thermodilution with PiCCO ( uh...brrr...I hate to remember ).

- PiCCO monitor doesn`t measure CVP. So CVP must be mesuread before thermodilution. ( extra transducer or manometer )

- Our two PiCCO monitor cables ( for CVC and artery ) is also fragile. We don´t know why.

Of course, for some patiens PiCCO is better method but... Again, I think Swan ganz is better for haemodynamics measurement.

It looks like you are already experienced in using PiCCO

would U be so kind to sent me some practical information or a guideline in using PiCCO. we will be starting soon with picco

I am a circulation practitioner on a dutch level 1 ICU

Sorry i'm for your friend. My favorit is PiCCO. Allthough invasive, it is less invasive than Swan Ganz. Also PiCCO is said to have some more reliable values (for some parameteres) than Swan Ganz, because it uses flow rather than pressure. But i am not sure about that.

In the nurse instructionmanual I have for PiCCO, it states that some values are aprox. 15 min delyed in Swan Ganz, but instant when using PiCCO.

Yes..... I am a PiCCO nurse.

Just too bad we don't use PiCCO here