These results would prompt one to use hourly recalibration. buy inhibitor Regarding our results, time elapsed from preceding calibration did not determine the level of agreement, as individually good agreement was observed up to 24 hours and individually poor agreement occurred within a period of 2 hours after calibration. Moreover, we found acceptable agreement in patients who were administered a high NE dosage, and thus had higher arterial stiffness, who had mean calibration periods of 7 hours.This study also examined the clinical use of calibrations by using PiCCO technology. Our institutional guidelines recommend a recalibration of the PiCCO system every 8 hours (three times daily), as well as before and after any major change in therapy. We found that in only 54% of recordings were institutional guidelines of recalibration met.

We did not observe a correlation of calibration frequency with APACHE II score or NE dosage, indicating that calibration of PCCO may not be dependent on the severity of critical illness. These findings are surprising, since recalibration may increase agreement between methods [13]. However, our results indicate that the time interval between calibrations may not to be the most important factor in determining PCCO accuracy; moreover, therapy during calibrations seems to be important.There are some limitations to our study. To avoid additional risk due to a more invasive methodology of CO measurement, we used the PiCCO integrated transcardiopulmonary thermodilution instead of the pulmonary artery thermodilution method as a reference technique for PCCO as previously described [13,14].

The calibration interval was not strictly standardized to measure the effect of NE dosage on calibration frequency on our ICU.ConclusionsThis study demonstrates further limitations Entinostat of the PCCO method for the determination of continuous CO. Only during high NE dosage (��0.1 ��g/kg/min) was PCCO interchangeable with COTCP. Therefore, the accuracy of PCCO measurement relies on important clinical circumstances.Key messages? During clinical conditions, PCCO and COTCP measurements cannot be used interchangeably in patients who are either not on vasopressor treatment or on a low dose of vasopressors.? Acceptable agreement between the methods was observed only during an increased dose of norepinephrine, representing the minority of measurements. Even then the limits of agreement were rather large.? The time interval between calibrations of PCCO does not improve the reliability of PCCO within a period of 24 hours.