VolumeView System

Transpulmonary Thermodilution Technology

(TPTD)
Edwards Lifesciences
…starting and advancing with you.

2000 1993
Vantex Catheter Swan-Ganz
SvO2/CCOmbo
Catheter

2003
PreSep 1989
Oximetry
Swan-Ganz
Catheter
2005 Volumetric
FloTrac Sensor Catheter
1984
2007 Swan-Ganz
PediaSat Oximetry Oximetry Catheter
Catheter
1980
Edwards Lung Water
Computer
1971
2010 Swan-Ganz Thermodilution
VolumeView Set Catheter
1970
Swan-Ganz Pulmonary
Artery Catheter
..........
VolumeView System
Transpulmonary Thermodilution Technology

Concepts to measure and derive key elements of

Oxygen Delivery:
• Cardiac Output
• Volumetric Calculations:
• Preload
• Afterload
• Contractility
• Lung Water Assessments
VolumeView System
Transpulmonary Thermodilution Technology

Critically ill patients often deal with

imbalances of oxygen delivery and
consumption which leads to organ
dysfunction or possibly death.

The clinician is faced with evaluating:

• physical assessment
• laboratory analysis
• non-invasive monitoring
• invasive monitoring

Determining if an imbalance exists and

how to best treat it.
VolumeView System
Transpulmonary Thermodilution Technology

c (l)

Time (t)
VolumeView System
Transpulmonary Thermodilution Technology

Injection

c (l)

Time (t)
VolumeView System
Transpulmonary Thermodilution Technology

• Intermittent TPTD Cardiac Output (VV-ICO)

• Calibrated Continuous Cardiac Output (VV-CCO)
• Intermittent or continuous assessment of
Systemic Vascular Resistance (SVR)
• Global End Diastolic Volume (GEDV)
– Global Ejection Fraction (GEF)
– Cardiac Function Index (CFI)
• Extravascular Lung Water (EVLW)
– Pulmonary Vascular Permeability Index
 Cardiac Output Calculation with the
VolumeView System
Intermittent Cardiac Output Measurements (VV-CCO)
VolumeView System
Cardiac Output Calculation

Finding the root cause and

choosing the correct
intervention at the right
magnitude is critical in
prevention of complications
associated with over- or
under-resuscitation of the
patient.
VolumeView System
Cardiac Output Calculation
VolumeView System
Cardiac Output Calculation

Stewart-Hamilton Equation
Injectate Temp
Injectate Volume
Blood Temp

( Tb – Ti ) x Vi x K
CO =
∞ Computation

∫ ∆T dt
Constant

Cardiac Output b

{
Areas Under the Curve
VolumeView System
Cardiac Output Calculation

Injection

c (l)

Time (t)

( Tb – Ti ) x Vi x K
CO =
∞
∫ ∆T dt
b

0
VolumeView System
Cardiac Output Calculation

Injection

c (l)

Time (t)
Blood Temp

( Tb – Ti ) x Vi x K
CO =
∞
∫ ∆T dt
b

0
VolumeView System
Cardiac Output Calculation

Injection

c (l)

Time (t)
Injectate Temp

( Tb – Ti ) x Vi x K
CO =
∞
∫ ∆T dt
b

0
VolumeView System
Cardiac Output Calculation

Injection

c (l)

Time (t)
Injectate Volume

( Tb – Ti ) x Vi x K
CO =
∞
∫ ∆T dt
b

0
VolumeView System
Cardiac Output Calculation

Injection

c (l)

Time (t)
Area under curve

( Tb – Ti ) x Vi x K
CO =
∞
∫ ∆T dt
b

0
VolumeView System
Cardiac Output Calculation

Injection

c (l)

Time (t)
VolumeView System
Cardiac Output Calculation
VolumeView System
Cardiac Output Calculation
Calculating GEDV
Global End Diastolic Volume
Calculating GEDV
Global End Diastolic Volume

Slope
Function * ITTV = GEDV
Calculating GEDV
Global End Diastolic Volume

PTV
Calculating GEDV
Global End Diastolic Volume

Injection ITTV = CO * MTt

c (l)

Time (t)
Calculating GEDV
Global End Diastolic Volume

Slope Function

S1 S2

Slope
Function * ITTV = GEDV
 Slope
Function * ITTV = GEDV

Slope
GEDV = Function * ITTV
Calculating GEDV
Global End Diastolic Volume
Calculating GEDV
Global End Diastolic Volume
Calculating GEDV
Global End Diastolic Volume
Calculating GEDV
Global End Diastolic Volume
 GEF
Global Ejection Fraction
GEF
Global Ejection Fraction

Cardiac Output / Pulse Rate = Stroke Volume

GEF
Global Ejection Fraction

Cardiac Output / Pulse Rate = Stroke Volume

Stroke Volume 4 / GEDV = Global Ejection Fraction

*
GEF
Global Ejection Fraction

Cardiac Output / Pulse Rate = Stroke Volume

Stroke Volume 4 / GEDV = Global Ejection Fraction

*
Global Ejection Fraction normal range is between 25-35%
GEF
Global Ejection Fraction
 CFI
Cardiac Function Index
CFI
Cardiac Function Index

CFI = CO / GEDV
GEF
Global Ejection Fraction

Cardiac Output:
• Global End Diastolic Volume
• Global Ejection Fraction
• Extravascular Lung Water
 EVLW
Extra Vascular Lung Water
EVLW
Extra Vascular Lung Water

VolumeView system can

calculate the amount of
extra vascular lung water
or EVLW, which is an
assessment of pulmonary
edema
EVLW
Extra Vascular Lung Water
EVLW
Extra Vascular Lung Water

̶ =
PTV PBV EVLW
PTV
Pulmonary Thermal Volume

PTV = CO * DSt
Injection

c (l)

PTV
Time (t)
PBV
Pulmonary Blood Volume

PBV = 0.25 * GEDV

PBV
EVLW
Extra Vascular Lung Water

̶ =
PTV PBV EVLW
EVLW
Extra Vascular Lung Water
EVLW
Extra Vascular Lung Water
EVLW
Extra Vascular Lung Water
EVLW
Extra Vascular Lung Water
 PVPI
Pulmonary Vascular Permeability Index
PVPI
Pulmonary Vascular Permeability Index

/ = PVPI
EVLW PBV
0.25
* GEDV
PVPI
Pulmonary Vascular Permeability Index
Edwards Lifesciences
…starting and advancing with you.

2000 1993
Vantex Catheter Swan-Ganz
SvO2/CCOmbo
Catheter

2003
PreSep 1989
Oximetry
Swan-Ganz
Catheter
2005 Volumetric
FloTrac Sensor Catheter
1984
2007 Swan-Ganz
PediaSat Oximetry Oximetry Catheter
Catheter
1980
Edwards Lung Water
Computer
1971
2010 Swan-Ganz Thermodilution
VolumeView Set Catheter
1970
Swan-Ganz Pulmonary
Artery Catheter
..........
For Professional Use. CAUTION: Federal (United States) law restricts this device to sale by or on the order
of a physician. See instructions for use for full prescribing information, including indications,
contraindications, warnings, precautions and adverse events.
Edwards, Edwards Lifesciences, the stylized E logo, CCombo, FloTrac, PediaSat, PreSep, Swan-Ganz, Vantex, and VolumeView are trademarks of
Edwards Lifesciences Corporation.

© 2011 Edwards Lifesciences Corporation. All rights reserved. AR06453