Edwards Lifesciences
Vigilance VGSV and CEDV Monitor Troubleshooting Guide
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Edwards Vigilance VGSV or CEDV Monitor Continuous Cardiac Output (CCO), Mixed Venous Oxygen Saturation (SvO2) and Continuous End Diastolic Volume (CEDV) CCOmbo V Catheter
CCOmbo V VIP Catheter
Model: 774F75, 774HF75 Length: 110 cm Size: 7.5F Recommended Introducer Size: 8.5F – 9.0F
Model: 777F8, 777HF8 Length: 110 cm Size: 8F Recommended Introducer Size: 9.0F PA Distal Port
Balloon Inflation Volume
• Transduce distal lumen – proper waveform is PA
• Appropriate inflation volume is 1.25 – 1.5 cc
VIP Port 777F8, 777HF8 • 30 cm from tip • Located in RA/SVC
Thermistor
Proximal Injectate Port
• 4 cm from tip • In main body of PA
• 26 cm from tip • Located in RA or SVC • If incorrectly positioned in introducer sheath, Bolus CO measurement will be erroneously high due to reflux of injectate within introducer • Transduce Proximal Injectate Lumen – proper waveform is RA or SVC
Thermal Filament • 14 – 25 cm from tip • Rests between RA and RV • Should be free floating and avoid endocardial surface • Erroneous CCO measurements may result if beyond pulmonic valve Note: Assess patient physiology. Atypical physiology and heart size may require special handling.
Computation Constants required for Bolus Cardiac Output only For use with bath temperature probes CATHETER MODELS INJECTATE TEMP
0 – 5º C 19 – 22º C 23 – 25º C
774F75, 774HF75
777F8, 777HF8
INJECTATE VOLUME (ML)
COMPUTATION CONSTANT (CC)
10 5 10 5 10 5
0.564 0.257 0.582 0.277 0.594 0.283
0.550 0.256 0.585 0.282 0.600 0.292
0.574 0.287 0.595 0.298
0.559 0.263 0.602 0.295
Computation Constants for CO-Set+ Delivery System 6 – 12º C 8 – 16º C 18 – 25º C
10 5 10 5
Troubleshooting for Edwards Vigilance VGSV or CEDV Monitor PROBLEM OR DISPLAYED MESSAGE
POSSIBLE CAUSE
SUGGESTED ACTION
“Alert CEDV: Signal Adapting – Continuing" message
• Patient’s respiratory pattern may have changed • Use of some types of Sequential Compression Devices (SCDs)
• Allow more time for the monitor to measure and display EDV • Turn SCD cooling system off temporarily
“Alert CEDV: Heart Rate Signal Loss” message
• Average patient’s heart rate is out-of• Wait until average heart rate is within range range (HR < 40 bpm or HR > 170 bpm • Verify slave cable connections between Vigilance [or 150 bpm for software ver. 6.0]) monitor and bedside monitor • No Heart rate detected • Loose slave cable connection
“Alert CEDV: Exceeding HR Threshold Limit” message (software ver. ≥ 6.2)
• Patient’s time-averaged heart rate is greater than 150 bpm but less than or equal to 170 bpm
• Verify average HR values • Follow standard hospital protocol for reducing patient’s HR below 150 bpm
“Alert CEDV: Irregular ECG Pattern” message (Software ver. ≥ 6.2)
• Physiologic change in patient’s status • Unsecured leads / connections of the ECG Signal • Double sensing due to atrial or atrial-ventricular (AV) pacing
• Follow standard hospital protocol • Re-position leads or reconnect ECG slave cable if necessary • Re-position reference lead to minimize atrial spike sensing. • Select appropriate lead configuration to maximize HR triggers and minimize atrial spike sensing • Assess appropriateness of milliamperage (mA) pacing levels
No CEDV value with Heart Rate (HR) slaved and CCO displayed
• Non-CEDV catheter being used • Incorrect ECG slave cable
• Verify Edwards CEDV catheter is being used • Verify correct ECG slave cable is being used
Vigilance Monitor Heart Rate (HR) does not match bedside monitor
• Heart rate is averaged when CCO is on
• Temporarily turn off CCO, wait a minimum of 10 seconds and verify HR correlates with bedside monitor
CEDV not trending on graph
• CEDV graph not enabled
• Enable CEDV on graph: - Press TREND - Press SELECT GRAPH - Press Graph 1, 2 or 3 to turn on EDV
EF, EDV, EDVI, ESV and ESVI on Patient Data screen are blank when CALC is pressed
• Manual heart rate data entry overrides auto calculation (denoted by asterisk next to HR on Patient Data screen)
• Clear manual heart rate data: - Press EDIT - CURSOR to asterisked Heart Rate data - Press CLEAR - Press CALC
If problem persists, call Edwards Technical Support at 1.800.822.9837 (US and Canada) or 949.250.2222
See instructions for use for full prescribing information. Caution: Federal (USA) law restricts this device to sale by or on the order of a physician. Edwards Lifesciences, Edwards, the stylized E logo, CO-Set, CCOmbo V and VIP are trademarks of Edwards Lifesciences Corporation. Vigilance is a trademark of Edwards Lifesciences Corporation and is registered in the U.S. Patent and Trademark Office. © Copyright 2002 Edwards Lifesciences LLC. All rights reserved. 3168-12/01-CC
Edwards Lifesciences LLC · Irvine, CA 92614 USA · 949.250.2500 · www.edwards.com Edwards Lifesciences (Canada) Inc. · Mississauga, Ontario · Canada L5C 4R3 · 905.566.4220 Edwards Lifesciences S.A. · Ch. du Glapin 6 · Switzerland · 41.21.823.4300 Edwards Lifesciences Japan · Chiyoda-ku, Tokyo 102-0085 · Japan · 81.3.5213.5700