The Acumen Hypotension Prediction Index (HPI) software is a
first-of-its-kind technology that provides you with information regarding the likelihood of a patient trending toward a hypotensive event.*
Edwards Lifesciences has a heritage of partnering with clinicians to advance patient care. That heritage is at the core of the Acumen Hypotension Prediction Index software. Developed in partnership with clinicians across the world and the first in a new category of products, Acumen Hypotension Prediction Index software offers the only predictive monitoring parameter for hypotension that is commercially available in the United States.
This first-of-its-kind predictive decision support software detects the likelihood of a patient trending towards a hypotensive event before the event occurs, and provides you with insights to understand the root cause and inform a potential course of action for your patient.
Part of the Acumen intelligent decision support suite, the Acumen Hypotension Prediction Index software is unlocked with the Acumen IQ sensor.
Three key elements of the Acumen Hypotension Prediction Index software
The HPI parameter displays as a value ranging from 0 to 100, with higher values indicating higher likelihood of a hypotensive event.
The proprietary algorithm - developed with machine learning, and using data from almost 59,000 hypotensive events and over 144,000 non-hypotensive events - detects potential of hypotensive trending of a patient's mean arterial pressure (MAP). The HPI parameter value is updated every 20 seconds, providing continuous predictive insights into developing hypotensive events.
The higher the value of the HPI parameter, the greater the likelihood a hypotensive event will occur.
The diagnostic performance of the HPI parameter was assessed through clinical validation studies:
The full table of Results of Clinical Validation studies may be found in the Operator's Manual.
- Specificity: ratio of true negatives to total number of non-events (negatives) with a negative defined as a data point that is at least 20 minutes away from any hypotensive event
- Sensitivity: ratio of true positives to total number of events (positives) with positive defined as data point that is at most 5 minutes prior to a hypotensive event.
HPI high alert popup
The HPI high alert popup alerts you when your patient is trending toward 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
If your patient is trending toward a hypotensive event, or is experiencing a hypotensive event, you can investigate the root cause and proactively inform a potential course of action. The advanced hemodynamic pressure and flow parameters provided on the HPI secondary screen allow you an opportunity to investigate and identify the root cause of potentially developing hypotensive events.
The HPI secondary screen is accessed through the HPI high alert popup, by touching the HPI Information Bar (when enabled); by pressing the button on the HPI Key Parameter, or at any time through the Clinical Actions menu on the monitor. Acumen Hypotension Prediction Index software secondary screen displays consolidated values for patient parameters of MAP, CO, SVR, PR, SV, and SVV/PPV as well as two additional indicators of contractility and afterload to provide a complete hemodynamic profile of the patient. The advanced hemodynamic parameters on the secondary screen are arranged visually by preload, contractility, and afterload.
Using these advanced hemodynamic parameters can provide you potential insights into the cause of a hypotensive event.
Stroke volume variation (SVV)
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 (PPV/SVV).
In noncardiac surgery patients, research findings have revealed strong associations between intraoperative hypotension and elevated risk of both acute kidney injury (AKI) and myocardial injury after noncardiac surgery (MINS).1,2,3
MINS — the most common cardiovascular complication that occurs after noncardiac surgery — is the leading cause of mortality within one month following surgery.1,4 It is a substantial public health issue.4
More than 200 million adults across the world will undergo noncardiac surgery annually, and this number continues to increase each year.5,6 Globally, an estimated 8 million patients over 45 years old — more than 1 in 12 patients — suffer myocardial injury after noncardiac surgery per year.4,6,7
Once a patient’s mean arterial pressure (MAP) reaches 65 mmHg, it only takes 10 minutes of exposure to see higher associations between intraoperative hypotension and MINS.1
Additionally, if a patient's MAP reaches 50 mmHg, it only takes one minute of exposure to see a significant escalation in risk of MINS making early identification of a hypotensive event critical.1
Acumen Hypotension Prediction Index software is the first predictive technology that provides you with information regarding the likelihood of a patient trending toward a hypotensive event* and assists you in understanding the root cause of deteriorating cardiovascular stability.
The Acumen IQ sensor — part of the minimally invasive family of hemodynamic sensors — unlocks the Acumen Hypotension Prediction Index software. The minimally invasive Acumen IQ sensor connects to any existing radial arterial line. The Acumen IQ system automatically updates advanced parameters every 20 seconds, reflecting rapid physiological changes in moderate-to high-risk surgery. Advanced hemodynamic parameters provided by the Acumen IQ sensor offer you continuous insight into your patient’s hemodynamic status.
Acumen Analytics software
Acumen Analytics software enables you to analyze the data retrospectively, providing insights into hemodynamic management of individual patients as well as groups of patients. The view of specific pressure and flow parameters allows you to analyze:
Available on the platform of the future
HemoSphere advanced monitoring platform offers advanced hemodynamic parameters that can help guide you with proactive decision support in a range of clinical situations and settings so you can maintain optimal patient perfusion.
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.
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 – Call 800-822-9837 anytime, day or night
- Product information and orders – Call 800-424-3278 to speak to a customer service representative
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- 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.
- Kahn, Alonso-Coello and Devereaux, Myocardial injury after non-cardiac surgery, Curr Opin Cardiol, 2014, 29:307-311
- Devereaux and Sessler, Cardiac complications in patients undergoing major non-cardiac surgery, N Engl J Med, 2015, 373(23):2258-2269.
- Sellers, D., Srinivas, C., Djaiani, G. (2018). Cardiovascular complications after non-cardiac surgery. Anaesthesia, 73 (Suppl. 1), 34 - 42.
- van Waes, J., Nathoe, H., Graaff, J., Kemperman, H., de Borst, G., Peelen, L., van Klei, W. (2013). Myocardial Injury After Noncardiac Surgery and its Association With Short-Term Mortality. Circulation, 127, 2264 - 2271.