Flotrac is a hemodynamic monitoring platform that continuously measures cardiac output and stroke volume using a patient's arterial pressure waveform, with parameters updated every 20 seconds. It is primarily used for critical care patients requiring assessments of cardiac function, fluid status, and vascular resistance, with both continuous and intermittent measurement options. This minimally invasive system provides dynamic insights into a patient's hemodynamics while requiring no manual calibration and is designed for mechanically ventilated patients.

1. Flo Trac
Presented by : Ms Garima
( MSc Nursing Ist year )

2. Introduction
 Flotrac is a monitoring platform that displays both intermittent and
continuous hemodynamic measurements related to the assessment of the
essential components of oxygen delivery as well as the balance of oxygen
delivery against consumption .
 The monitor uses the patient's arterial pressure waveform to continuously
measure cardiac output and stroke volume .
 Automatically updates advanced parameters every 20 seconds, reflecting
rapid physical changes in moderate to high-risk surgery.

3.  The continuous parametric measurements provided from an arterial
line via an Edwards CO sensor include cardiac output (CO), stroke
volume (SV), and stroke volume variation (SVV).
 The intermittent parametric measurements require use of a
VolumeView catheter in a femoral artery, a CVC (central venous
catheter) thermistor manifold, and a central venous pressure
measurement.
 The intermittent parameters include:
 cardiac output (iCO)
 stroke volume (iSV),
 systemic vascular resistance (iSVR)
 global end-diastolic volume (GEDV)
 extravascular lung water (EVLW)

4. Mechanism of work
 The monitor uses the patient’s arterial pressure waveform to continuously
measure cardiac output.
 With inputs of height, weight, age and gender, patient-specific vascular
compliance is determined .

5. Flo Trac sensor
 It is a sterile , single use kit that monitors pressures when attached to
pressure monitoring cathetars . it has a straight , flow through design
across the pressure sensors with an integral flush device .
 Easily setup and calibrated at the bedside using the familiar skills used in
pressure monitoring .
 It measures the variations of the arterial pressure which is proportional to
stroke volume.

6. Vent PortFlushing Device /
Snab Tab Device

7. Parts of flo trac
SCREEN
DATA BOX
FLO TRAC
SENSOR
TUBINGS

8. Physiology Screen

9.  The Physiology screen displays monitored parameters using a visual
representation of the heart, lungs and circulatory system and their
relevant measured volume .
 The lungs appear gray in continuous mode to indicate that no
information is available for extravascular lung water.
 In the Screen the image of the beating heart is a visual
representation of the pulse rate .

11. Big Numbers Screen
 The screen displays parameters in a larger size than the other screens. This makes it
easier for clinicians and other personnel to see the values from a distance .

12. Cockpit Screen
 This monitoring screen displays globes with the values of the parameter being monitored. They
graphically indicate target, out of range and target values with needle indicators to show where the
patient’s parameter falls .

13. Patients Data Entry Screen

14. Indications
 Use primarily for critical care patients in which the balance between cardiac
function, fluid status and vascular resistance needs continuous or
intermittent assessment
 Assess Extra Vascular Lung Water (EVLW) as an indicator of pulmonary
edema

15. The first image shows low pulmonary edema, the second
shows moderate pulmonary edema, and the third shows
severe pulmonary edema

16. FloTrac Continuous Parameters
 Cardiac output (CO) - Continuous assessment of the volume of blood
pumped by the heart measured in liters per minute.
 Cardiac Index (CI) Cardiac output relative to body surface area (BSA).
 Stroke Volume (SV) Volume of blood pumped with each heart beat.
 Stroke Volume Index (SVI) Stroke volume relative to body surface
area (BSA).

17.  Systemic Vascular Resistance (SVR) The resistance that the left
ventricle must overcome to eject stroke volume with each beat .
 Systemic Vascular Resistance Index (SVRI) SVR relative to body
surface area.
 Stroke Volume Variation (SVV) The percent difference between
SVmin, max and mean

18. Initial Startup
 Connect the primed FloTrac sensor to the Databox.
 Connect the primed FloTrac pressure tubing to the radial or femoral arterial catheter and
primed central venous pressure tubing to the CVC catheter if continuous SVR/ SVRI
monitoring is desired .
 Patient data can be entered by touching the Settings button.
 Touch Patient Data and then touch each field to enter or select the patient demographic
data.
 Touch the Home button. Touch the Monitor Screen Selection button and then select the
desired monitoring screen

19. Zeroing of FloTrac for continuous monitoring :
 Level the transducer and sensor to the patient’s phlebostatic axis.
 Touch the Clinical Actions button.

20.  Touch Zero & Waveform

21.  Zero each transducer by touching -0- next to the pressure or -0- All
to zero both.
 Open transducers so they are “ON” to the patient and confirm
appropriate waveforms
 Touch the Home button to begin monitoring

22. https://youtu.be/Fie8wrf7csM

23. Volume View Intermittent TPTD Monitoring
 Trans pulmonary thermodilution (TPTD) measures parameters related to
blood flow, fluid volume, and organ function .
 It is measured when an indicator solution of known temperature and volume
is injected into the central venous circulation.
 It then passes through the pulmonary vascular system, the left heart, and
finally into the arterial system .

24. Volume View Intermittent TPTD Parameters
 Cardiac Function Index (CFI) is provided by transpulmonary thermodilution and serves
as an indicator of left ventricular systolic function .
 Cardiac output (iCO) Intermittent assessment through thermodilution of the volume of
blood pumped by the heart measured in liters per minute .
 Extravascular Lung Water (EVLW) Extravascular water content of the lung tissue.
 Extravascular Lung Water Index (ELWI) Extravascular water content of the lung tissue
relative to predicted body weight (PBW) .
 Global Ejection Fraction (GEF) Estimated ejection fraction using GEDV.

25. Cont.….
 Global End-Diastolic Volume (GEDV) Estimated combined volume of the RAEDV,
RVEDV, LAEDV, and LVEDV.
 Global End-Diastolic Volume Index (GEDI) Estimated combined volume of the RAEDV,
RVEDV, LAEDV, and LVEDV relative to body surface Area .
 Intrathoracic Blood Volume (ITBV) Estimated combined volume of the heart and the
pulmonary blood volume (PBV).
 Pulmonary Vascular Permeability Index (PVPI) Ratio of the extravascular lung water
and the estimated volume of pulmonary blood .

28. Articles required
A Tray containing :
 Flo trac and tubings
 Sterile gloves
 20 cc syringe
 Cold saline
 Pressure Bag
 Volume View femoral artery catheter
 Volume View sensor
 Central Venous catheter
 Volume View Manifold
 TruWave disposable pressure transducer (CVP transducer)

29. Procedure
 Insert the VolumeView femoral arterial catheter and Insert a CVC).
 Ensure the TruWave central venous pressure transducer and VolumeView sensor are primed and
then connected to the EV1000 databox.
 Ensure the sensor and transducer are level to patient’s phlebostatic axis and zero transducers on
monitor using Clinical Actions button.
 Connect the VolumeView sensor to the VolumeView femoral arterial catheter and confirm the
appropriate waveforms and pressures are displayed .
 Connect the databox thermistor cable to the VolumeView femoral arterial thermistor and confirm
appropriate temperature on the EV1000 monitor.

30. Procedure
 Connect a pre-chilled syringe with normal saline to the VolumeView
manifold valve/port connection
 Touch the Clinical Actions button

31.  Touch Thermodilution
 Touch the button next to Injectate Volume and touch the desired
injectate volume (up to 20 mL) on the drop-down menu

32.  Touch Start Set. Wait is highlighted. When the thermal baseline is
established you will see the Inject screen .
 When Inject appears on the screen, use a rapid, smooth, continuous
method to inject the cold solution with the volume amount previously
selected .

33.  If more measurements are required, replace with another pre-chilled
primed syringe

34. https://youtu.be/Qjx06vrcsjY

35. Advantages
 Continuously computes stroke volume from the patient’s arterial pressure
signal .
 Displays key hemodynamic parameters on a continuous basis (every 20
sec)
 Requires NO manual calibration
 The user simply enters patient age, gender, height and weight to initiate
monitoring
 Advanced waveform analysis compensates for .
 Patient-to-patient differences in vasculature
 Real time changes in vascular tone
 Differing arterial sites

36. Disadvantages
 No absolute contraindications but has limitations that must be taken into
account.
 The monitoring system is only recommended for patients that are 100%
mechanically ventilated and not spontaneously breathing.

37. Summary

38. Conclusion
 FloTrac system - a minimally invasive solution system that provides
dynamic and flow-based hemodynamic parameters.
 Uses Patients arterial waveform for analysis .
 Automatically provides results every 20 secs .