Acumen Hypotension Prediction Index (HPI) software is a first-of-its-kind technology that detects the likelihood of a patient trending towards hypotension.
Multiple studies have shown Acumen HPI software:
Achieves statistically significant reduction of hypotension when combined with a treatment protocol in noncardiac surgery vs. standard of care.1,2
Demonstrates accuracy to predict the likelihood of hypotension.4
Demonstrates superior predictive abilities for hypotension over common hemodynamic parameters such as cardiac output (CO), stroke volume (SV), and changes in mean arterial pressure (MAP).3
Key elements of the Acumen HPI software
The HPI parameter displays as a value ranging from 0 to 100, with higher values indicating higher likelihood of a hypotensive event.*
The HPI parameter value is updated every 20 seconds, providing continuous predictive insights into developing hypotension.
HPI high alert popup
The HPI high alert popup alerts you when your patient is trending towards or experiencing a hypotensive event.*
If the HPI parameter value exceeds 85 for two consecutive 20-second updates or reaches 100 at any time, the HPI high alert popup window will appear, prompting you to review the patient hemodynamics using the HPI secondary screen.
HPI Secondary Screen
The secondary screen provides you insights into the cause of hypotension, and hemodynamic parameters are arranged visually by preload, afterload and contractility.
It provides a complete hemodynamic picture of your patient. Parameters displayed include MAP, CO, CI, SVR, PR, SV and SVV/PPV, as well as HPI, dP/dt, and Eadyn.
Stroke volume variation (SVV) or pulse pressure variation (PPV)
The percent difference between minimum and maximum stroke volume (SV) or pulse pressure (PP) during a respiratory cycle.
Systolic slope (dP/dt)
Maximal upslope of the arterial pressure waveform from a peripheral artery.
Dynamic arterial elastance (Eadyn)
The ratio of pulse pressure variation to stroke volume variation.
Publication in JAMA: “Effect of a Machine Learning–Derived Early Warning System for Intraoperative Hypotension vs Standard Care on Depth and Duration of Intraoperative Hypotension During Elective Noncardiac Surgery: The HYPE Randomized Clinical Trial."
This clinical trial included 68 noncardiac surgery patients and studied the time-weighted average of hypotension for those randomized to the early warning system with Acumen HPI software vs those receiving standard care. The 34 patients monitored with Acumen HPI had a cumulative median time of hypotension of 8 minutes compared to 32.7 minutes in the control group.
The median time-weighted average of hypotension showed a difference of 0.38 mmHg between the interventional and control group.1
Publication in the Journal of Clinical Monitoring and Computing: "Hypotension Prediction Index based protocolized haemodynamic management reduces the incidence and duration of intraoperative hypotension in primary total hip arthroplasty: a single centre feasibility randomised blinded prospective interventional trial."
In this single center feasibility study, Acumen HPI software combined with protocolized treatment was shown to reduce the relative and absolute duration of hypotension in 99 total hip arthroplasty patients, in comparison to a historical and prospective control group.2
Publication in Anesthesia and Analgesia: "Ability of an Arterial Waveform Analysis–Derived Hypotension Prediction Index to Predict Future Hypotensive Events in Surgical Patients"
In this 255 patient, 2-center retrospective analysis study, when compared with hemodynamic parameters such as SV, CO, SVV, and MAP, Acumen HPI software showed a higher predictive performance at 5 and 10 minutes before hypotension.3
Publication in Anesthesiology: "Machine-learning Algorithm to Predict Hypotension Based on High-fidelity Arterial Pressure Waveform Analysis".
Acumen HPI software demonstrated high accuracy in predicting hypotension.
At 10 minutes before an event, Acumen HPI software predicted hypotension with a specificity and sensitivity of 89% and 90% respectively, and with an AUC of 0.95 in this study. A database of 1,538 patient records was used for training and external validation of the software's algorithm.4
Risk of hypotension
Research findings have revealed strong associations between intraoperative hypotension (IOH) and elevated risk of both acute kidney injury (AKI) and mycardial injury after noncardiac surgery (MINS).6,9,10
Acumen HPI software is effective in detecting hemodynamic instability and substantially reducing the amount of intraoperative hypotension when used in surgical patients who require hemodynamic monitoring during noncardiac surgery.8
Acumen intelligent decision support suite
The Acumen intelligent decision support suite offers both predictive and retrospective decision support for the management of hypotension.
Acumen IQ sensor**
HemoSphere advanced monitoring platform
Acumen Analytics software
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- Wijnberge, M., Geerts, B., Hol, L., Lemmers, N., Mulder, M., Berge, P., Schenk, J., Terwindt, L., Hollman, M., Vlaar, A., Veelo, D. (2020) Effect of a Machine Learning-Derived Early Warning System for Intraoperative Hypotension vs Standard Care on Depth and Duration of Intraoperative Hypotension During Elective Noncardiac Surgery: The HYPE Randomized Clinical Trial. JAMA Online, February 17, 2020.
- Schneck, E., Schulte, D., Habig, L., Ruhrmann, S., Edinger, F., Markmann, M., Habicher, M., Rickert, M., Koch, C., Sander, M. (2019) Hypotension Prediction Index based protocolized haemodynamic management reduces the incidence and duration of intraoperative hypotension in primary total hip arthroplasty: a single centre feasibility randomized blinded prospective interventional trial. Journal of Clinical Monitoring and Computing online, November 29, 2019.
- Davies SJ, Vistisen ST, Jian Z, et al. Ability of an arterial waveform analysis-derived hypotension prediction index to predict future hypotensive events in surgical patients. Anesth Analg 2019.
- Hatib, F., Zhongping, J., Buddi, S., Lee, C., Settels, J., Sibert, K., Rinehart, J., Cannesson, M. (2018). Machine-learning Algorithm to Predict Hypotension Based on High-fidelity Arterial Pressure Waveform Analysis. Anesthesiology 129, 663-74.
- Shah, N., Mentz, G., Kheterpal, S. The incidence of intraoperative hypotension in moderate to high risk patients undergoing non-cardiac surgery: A retrospective multicenter observational analysis. Journal of Clinical Anesthesia. 2020: 66; 1-12.
- Salmasi, V., Maheshwari, K., Yang, G., Mascha, E.J., Singh, A., Sessler, D.I., & Kurz, A. (2017). Relationship between intraoperative hypotension, defined by either reduction from baseline or absolute thresholds, and acute kidney injury and myocardial injury. Anesthesiology, 126(1), 47-65.
- Wesselink EM, et al. Intraoperative hypotension and the risk of postoperative adverse outcomes: a systematic review. Br J Anaesth. 2018;121(4):706-721. 42 studies’ noncardiac surgery patient number ranged from 40 to 152,445, with a median of 1,523 patients (inter-quartile range 261-17,739).
- U.S. Food and Drug Administration. 2021. K203224 510k Summary, Acumen Hypotension Prediction Index, viewed August 24, 2021. https://www.accessdata.fda.gov/ cdrh_docs/pdf20/K203224.pdf.
- Sun, L.Y., Wijeysundera, D.N., Tait, G.A., & Beattie, W.S. (2015). Association of Intraoperative Hypotension with Acute Kidney Injury after Elective non-cardiac Surgery. Anesthesiology, 123(3), 515-523.
- Walsh, M., Devereaux, P.J., Garg, A.X., Kurz, A., Turan, A., Rodseth, R.N., Cywinski, J., Thabane, L., & Sessler, D.I. (2013). Relationship between Intraoperative Mean Arterial Pressure and Clinical Outcomes after non-cardiac Surgery. Anesthesiology, 119(3), 507-515.
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