Vigileo monitors

[IheartICUnursing]

Who out there is using Vigileo monitors? In which patients do you find them most useful?

Also, I know SVV is inaccurate in A fib/ other arrhythmias. Is the same true for the other parameters? CO/CI, SV/SVI? I couldn't find a definitive answer on the Edwards website.

One last thing- Overall, what is your opinion of the Vigileo monitor? Are you using the numbers to guide patient care in your unit?

My unit just started using them (late, I know....)

[ICUPrincessNurse]

We use vigileos often. It's part of our sepsis protocol to insert a presept catheter and monitor ScVO2 on them. Usually they end up with an a-line and we flo-trac that right on into our vigileo.

We also use them on a lot of our sick traumas, sick patients in general and any trauma in the elderly who end up with an a-line (no a-line elderly traumas get the Bio-Z for non-invasive CO monitoring).

It is my understanding that the SVV is the only parameter affected by arrhythmias. For what it's worth...your SVV is also really most reliable if your patient is passive on the vent and on a high tidal volume positive pressure ventilation. One of our attendings will have us give a patient some one time doses of fentanyl, versed and vex (vented patients only, obvi) and then come to the bedside with the whole MICU team and do teaching on fluid responsiveness as far as passive leg raise (watch your CO and SV there) as well as SVV and it's uses. Super interesting to watch. So your buddy that is a POD#1 exutbated CABG that you're about to go walk....don't put all of your fluid responsiveness eggs in your SVV basket. Look at the other parameters as well.

I've seen physicians give orders to bolus until the SVV is

With a good waveform and within the parameters of a passive on the vent, high Vt PPV, sinus rhythm...it can be VERY useful. But they're fairly restrictive guidelines.