Acumen IQ cuff

Smart, noninvasive hemodynamic monitoring

This first-of-its-kind noninvasive solution unlocks Acumen Hypotension Prediction Index (HPI) software. It also provides continuous blood pressure measurements and advanced hemodynamic parameters, giving you insight to your patients' hemodynamic status.

Unlocks Acumen HPI software

Acumen IQ cuff unlocks the first-of-its-kind technology designed to help predict future hypotensive events*.

*A hypotensive event is defined as MAP <65 mmHg for a duration of at least one minute.

Offers noninvasive monitoring

Accurately measures continuous blood pressure and hemodynamic parameters for patients who don't need, or can't have, an arterial line.¹

Enables individualized patient care

An advanced hemodynamic monitoring solution that helps guide individualized treatment decisions.

Features of Acumen IQ cuff

Acumen IQ cuff is available on the HemoSphere advanced monitoring platform. This noninvasive finger cuff unlocks Acumen HPI software and enables you to proactively optimize perfusion using continuous blood pressure and advanced hemodynamic parameters. The finger cuff provides automatically calculated, beat-to-beat hemodynamic information and offers you access to advanced hemodynamic parameters for patients who don’t need, or can’t have, an arterial line.

Advanced hemodynamic parameters

Hypotension prediction index (HPI)
Maximum slope of the arterial pressure upstroke (dP/dt)
Dynamic arterial elastance (Ea_dyn)
Stroke volume (SV)
Stroke volume variation (SVV)
Mean arterial pressure (MAP)
Cardiac index (CI)
Systemic vascular resistance (SVR)

Model numbers	Description	Unit of Measure
AIQCS	Acumen IQ cuff - small	EA
AIQCM	Acumen IQ cuff - medium	EA
AIQCL	Acumen IQ cuff - large	EA

The easy application and snug fit of the Acumen IQ finger cuff self-coiling design eliminates placement errors on a patient to improve consistency.

Clinical application

Manage perfusion, noninvasively

Acumen IQ cuff is available on the HemoSphere advanced monitoring platform

Maintaining necessary peripheral perfusion requires adequate peripheral blood pressure and adequate cardiac output. Acumen IQ cuff offers advanced hemodynamic parameters and continuous blood pressure to help you monitor perfusion, and access to the Acumen HPI software provides you insight to determine the root cause of instability.

Risk of hypotension

Research findings have revealed strong associations between intraoperative hypotension (IOH) and elevated risk of both acute kidney injury (AKI) and myocardial injury after noncardiac surgery (MINS).^2,3,4

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.

IOH is common⁶

88% of patients continuously monitored with an arterial line still experienced hypotension, defined as MAP <65 mmHg for 1 minute.⁵

IOH has elevated risks

Prolonged exposures below MAP thresholds of 65 mmHg are associated with increased risk of mortality, myocardial injury and AKI after noncardiac surgery.^2,6

IOH can be reduced

Acumen HPI software has demonstrated a reduction* in the duration of IOH by 57%.⁷

* Single arm, multicenter, prospective-to-historical control where patients received arterial line monitoring.

Learn more about the risks of IOH

Managing volume

Dynamic and flow-based parameters are more informative than conventional parameters in determining fluid responsiveness and may help guide individualized volume administration in patients and avoid excessive or insufficient administration.⁸

Continuous access to pressure and flow parameters allows you to evaluate hemodynamic instability and guide appropriate treatment. When managing perfusion, stroke volume can be optimized using the patient’s own Frank-Starling curve.

Avoidance of hypotension and strategies to optimize fluid management in surgical patients are two modifiable factors that may contribute to improved patient outcomes.

Technical overview

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Easy-to-use finger cuff

The Acumen IQ finger cuff design reduces variability in application. The easy-to-use self-coiling mechanism within the interior of the cuff wraps around the patient’s finger and offers consistent snugness and usability.

Volume clamp method

The essence of the volume clamp method involves clamping the artery to a constant volume by dynamically providing equal pressure on either side of the arterial wall. The volume is measured by a photo-plethysmograph built into the cuff. The counter pressure is applied by an inflatable bladder inside the cuff and is adjusted 1,000 times per second to keep the arterial volume constant. Continuous recording of the cuff pressure results in real-time finger pressure waveform.¹

The Physiocal method - Physiological Calibration

Physiocal is the real-time method for determining the proper arterial ‘unloaded’ volume, i.e., the volume without a pressure gradient across the arterial wall. Physiocal analyzes the curvature and sharpness of the plethysmogram during short episodes of constant pressure levels. It then automatically and periodically recalibrates the system allowing accurate tracking of physiologic changes, e.g., in vasomotor tone. Calibration interval starts at 10 beats, but it increases to every 70 beats as stability increases. Physiocal interval >30 beats is considered reliable.⁹

Brachial pressure reconstruction

Clinical standard for noninvasive BP is brachial level. Acumen IQ cuff reconstructs the brachial arterial pressure waveform from the finger arterial pressure waveform. The reconstruction algorithm is based on a vast clinical database.¹⁰

Cardiac output calculation

Stroke volume is calculated by an algorithm based on an improved pulse contour method. Cardiac output results from stroke volume times heart rate, and is updated every beat.¹¹

Product implementation

Acumen IQ cuff setup guide

Edwards clinical education

Hemodynamic education empowering clinical advancement

With a long-term commitment to improving the quality of care for surgical and critical care patients through education, Edwards clinical education meets you no matter where you are in the learning process — with a continuum of resources and tools that continuously support you as you solve the clinical challenges facing you today, and in the future.

Noteworthy

FAQ's Acumen HPI software

Acumen intelligent decision support suite

The Acumen intelligent decision support suite offers predictive decision support for the management of hypotension.

Acumen IQ sensor** (minimally-invasive)

Acumen IQ sensor unlocks the Acumen HPI software and automatically updates advanced parameters every 20 seconds, reflecting rapid physiological changes in patients.

** Surgical and nonsurgical patient use

Acumen HPI software

Acumen HPI software provides you with information regarding the likelihood of a patient trending towards a hypotensive event, and provides you with insights to understand the root cause and inform a potential course of action.

Acumen Analytics software

Acumen Analytics software enables you to retrospectively view and analyze hemodynamic parameters, including mean arterial pressure, providing you insights into the frequency, duration and prevalence of intraoperative hypotension in your practice.

The Edwards Advantage

We are committed to providing your institution, clinicians and staff with the highest levels of customer service and support to ensure seamless product implementation and ongoing use, including:

24/7 Technical support

(+1).800.822.9837

For product information and orders

(+1).800.424.3278

Let us help you

References

Peñáz J. Photoelectric measurement of blood pressure, volume and flow in the finger. Digest of the 10th Conference on Medical and Biological Engineering. Dresden, Germany; 1973:104.
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.
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.
Shah, N., Mentz, G., Kheterpal, S. (2020). The incidence of intraoperative hypotension in moderate to high risk patients undergoing3. non-cardiac surgery: A retrospective multicenter observational analysis. Journal of Clinical Anesthesia. 2020; 66:1-12.
Wesselink EM, Kappen TH, Torn HM, Slooter AJC, van Klei WA. Intraoperative hypotension and the risk of postoperative adverse outcomes: a systematic review. Br J Anaesth. 2018;121(4):706-721.
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.
Cannesson, M. (2010) Arterial pressure variation and goal-directed fluid therapy. Journal of Cardiothoracic and Vascular Anesthesia, 24(3), 487-97.
Wesseling KH, et al. Physiocal, calibrating finger vascular physiology for Finapres. Homeost Health Dis. 1995;36(2-3):67-82.
Gizdulich P, et al. Models of brachial to finger pulse wave distortion and pressure decrement. Cardiovasc Res. 1997;33(3):698-705. doi: 10.1016/S0008-6363(97)00003-5.
Truijen J, van Lieshout JJ, Wesselink WA, Westerhof BE. Noninvasive continuous hemodynamic monitoring. J Clin Monit Comput. 2012;26(4):267-78. doi: 10.1007/s10877-012-9375-8