[Hemodynamic monitoring: PiCCO system].

Cardiac output (CO) is monitored in critically ill patients to maintain and improve cardiac function with the primary goal of adequate tissue perfusion. For a long time, this monitoring has been done using the pulmonary arterial catheter, which has been provoking increasing controversy. For some years, monitoring of CO has been evolving with the appearance of new invasive and non-invasive monitoring systems. In this chapter we review some aspects of CO monitoring with the PiCCO system based on transpulmonary thermodilution. This system is based on the injection of a cold fluid bolus centrally in the vein. A thermistor located in the tip of the arterial catheter, usually femoral, is used to measure blood temperature changes. A thermodilution curve is created and the hemodynamic parameters obtained after its analysis.