The Acumen IQ sensor - part of the minimally invasive family of hemodynamic sensors - unlocks the Hypotension Prediction Index (HPI) software. Build on the foundation of the Edwards Arterial Pressure-Based Cardiac Output (APCO) algorithm.
The Acumen IQ sensor unlocks the ability to predict hypotensive events with the Acumen Hypotension Prediction Index (HPI) software. Acumen Hypotension Prediction Index software offers the only predictive monitoring parameter for hypotension commercially available. Developed in partnership with clinicians, this first-of-its-kind predictive decision support software detects the likelihood of 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.
*A hypotensive event is defined as MAP < 65 mmHg for a duration of at least one minute.
The Acumen IQ sensor attaches to any existing arterial line and automatically calculates key parameters every 20 seconds, reflecting rapid physiologic changes in moderate- to high-risk surgery.
- Stroke Volume (SV)
- Stroke Volume Variation (SVV)
- Mean Arterial Pressure (MAP)
- Contractility (dP/dt)
- Cardiac Index (CI)
- Systemic Vascular Resistance (SVR)
- Hypotension Prediction Index (HPI)
- Afterload: Dynamic arterial elastance (Eadyn)
The Acumen IQ sensor unlocks first-of-its-kind predictive decision support to manage intraoperative hypotension
Acumen Hypotension Prediction Index software offers the only predictive monitoring parameter for hypotension commercially available. Developed in partnership with clinicians, this first-of-its-kind predictive decision support software detects the likelihood of 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.
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 non cardiac 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 1 in 12 patients (8 million people globally) over 45 years old experience MINS each year.4,5,6
Manage the flow component of perfusion to guide individualized fluid management.
When managing perfusion, stroke volume can be optimized using the patient’s own Frank-Starling curve. The patient’s location on the curve can be determined by measuring changes in SV in response to change in preload using a bolus fluid challenge or passive leg raise (PLR). 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 and insufficient administration.7Additionally, stroke volume variation (SVV) has been proven to be a highly sensitive and specific indicator for preload responsiveness when managing volume. As a dynamic parameter, SVV has been shown to be an accurate predictor of fluid responsiveness in loading conditions induced by mechanical ventilation.8-10
Frank-Starling relationship between preload and stroke volume (SV)
The Hypotension Prediction Index Software is comprised of three key elements:
- The HPI parameter displays as a value ranging from 0 to 100, with higher values indicating higher likelihood of a hypotensive event.
- The HPI high alert popup alerts you when your patient is trending toward or experiencing a hypotensive event.
- The HPI secondary screen provides advanced hemodynamic pressure and flow parameters allowing you an opportunity to investigate and identify the root cause of potentially developing hypotensive events.
Manage the flow component of perfusion to guide individualized fluid management.
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:
- Hypotension duration
- Hypotension severity
- Protocol compliance
- Hypotension frequency
- Volume management variability
Hemodynamic education empowering clinical advancement
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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, dened 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.
- Khan, J., Alonso-Coello, P., Devereaux, P.J., Myocardial injury after noncardiac surgery, Curr Opin Cardiol, 2014, 29: 307-311.
- Sellers, D., Srinivas, C., Djaiani, G. (2018). Cardiovascular complications after non-cardiac surgery. Anaesthesia, 73 (Suppl. 1), 34 - 42.
- van Waes, J., Nathoe, H., Graa, 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.
- Berkenstadt, H., et al. (2001) Stroke Volume Variation as a Predictor of Fluid Responsiveness in Patients Undergoing Brain Surgery. Anesthesia & Analgesia, 92, 984-9.
- Cannesson, M. (2010) Arterial pressure variation and goal-directed fluid therapy. Journal of Cardiothoracic and Vascular Anesthesia, 24(3), 487-97.
- Peng, K., Li, J., Cheng, H., Ji, FH. (2014) Goal-directed fluid therapy based on stroke volume variations improves fluid management and gastrointestinal perfusion in patients undergoing major orthopedic surgery. Medical Principles and Practice, 23(5), 413-20.
- Richard, F., Mountford, W., Krukas, M., Ernst, F., Fogel, S. (2015) Potential return on investment for implementation of perioperative goal-directed fluid therapy in major surgery: a nationwide database study. Perioperative Medicine, 4,11.
For professional use
For a listing of indications, contraindications, precautions, warnings, and potential adverse events, please refer to the Instructions for Use (consult eifu.edwards.com where applicable).
Edwards Lifesciences devices placed on the European market meeting the essential requirements referred to in Article 3 of the Medical Device Directive 93/42/EEC bear the CE marking of conformity.
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