1. Haemodynamic Monitoring Theory and Practice

2. 2 Haemodynamic Monitoring A.Physiological Background B.Monitoring C.Optimising the Cardiac Output D.Measuring Preload E.Introduction to PiCCO technology F.Practical Approach G.Fields of Application H.Limitations

3. Applications in intensive care (early use) Indications for PiCCO Technology Applications - Severe sepsis - Septic shock/SIRS reaction - ARDS - Cardiogenic shock (myocardial infarction / ischaemia, decompensated heart failure) - Heart failure (e.g. due to cardiomyopathy) - Pancreatitis - Poly-trauma including haemorrhagic shock - Sub-arachnoid haemorrhage - Decompensated liver cirrhosis / hepatorenal syndrome - Severe burns Perioperative Applications - Cardiac surgery - High risk surgery and high risk patients - Transplantation

4. The use of PiCCO technology is indicated in all patients with haemodynamic instability and for those with complex cardiocirculatory conditions. By early use, PiCCO-directed therapy optimisation can prevent complications. Recommendation: Indications for PiCCO Technology Applications

5. Summary and Key Points Application PiCCO technology is able to be used in a wide group of patients, both in Intensive Care Medicine and peri-operatively The use should always be taken into consideration in haemodynamically unstable patients as well as in those with complex cardiocirculatory conditions As well as directing therapy, the PiCCO parameters can also provide important diagnostic information PiCCO technology supports decision making in unstable patients