ClearSight system

A noninvasive solution that enables clinical decision support to help optimize patient perfusion

The ClearSight system provides continuous blood pressure and advanced hemodynamic parameters from a noninvasive finger cuff.

Continuous data offered by the ClearSight system enables you to proactively optimize perfusion through hemodynamic management.

Advanced hemodynamic monitoring, simplified

Proactive decision support for individualized patient care

Noninvasive hemodynamic monitoring offered by the ClearSight system provides information to enable you to make proactive clinical decisions across the continuum of care, including moderate- to high-risk surgery patients, and can be utilized to manage your patients’ changing clinical situations in the hospital environment.

Continuous noninvasive monitoring

Continuous noninvasive blood pressure (BP) from a noninvasive finger cuff in addition to key advanced hemodynamic parameters:

Cardiac Output (CO)
Stroke Volume (SV)
Stroke Volume Variation (SVV)
Systemic Vascular Resistance (SVR)
Mean Arterial Pressure (MAP)

Extend the benefits of hemodynamic monitoring

The ClearSight system gives you noninvasive access to automatically calculated, beat-to-beat hemodynamic information for a broader patient population, including patients in whom an arterial line would not be typically be placed.¹

Graphical Trend screen on
HemoSphere advanced monitor

A versatile approach to continuous monitoring

The ClearSight system connects to your patient’s finger. Upon starting a measurement, the finger cuff can be used and re-applied for up to 72 hours on one patient. After 8 hours of continuous monitoring on a single finger, the finger cuff should be re-applied to another finger. To increase comfort, two ClearSight finger cuffs may be connected simultaneously to alternate the measurement between two fingers. This allows uninterrupted continuous monitoring up to 72 hours.

Now available on HemoSphere advanced monitoring platform

HemoSphere advanced monitoring platform provides a comprehensive view of hemodynamics and tissue oximetry, giving you confidence in knowing continuous oxygen saturation and perfusion for your patient. Full-range compatibility with noninvasive, minimally-invasive and catheter solutions allow you to pair a single monitor with the right device for your patient across different clinical settings and diverse patient profiles.

Model numbers

Model	Description
ClearSight Finger Cuff Small (multi pack, 5)	CSCS
ClearSight Finger Cuff Medium (multi pack, 5)	CSCM
ClearSight Finger Cuff Large (multi pack, 5)	CSCL
HemoSphere ClearSight upgrade kit	HEMCSMUPG
HemoSphere smart recovery non-cardiac with ClearSight, Acumen IQ sensor, FloTrac, and tissue oximetry module	HEMAQSR2
HemoSphere ClearSight module	HEMCSM10

ClearSight brochure

1. Truijen, J et al. Noninvasive Continuous Hemodynamic Monitoring. Journal of Clinical Monitoring and Computing 2012;26(4):267–268.

Clinical application

The ClearSight system offers continuous clinical decision support to enable proactive clinical decisions for your moderate- to high-risk surgical patients and patients at risk for complications.

Hypotension management

Studies show associations between intraoperative hypotension and:

Increased risk of Acute Kidney Injury (AKI)
Cardiac & Non-Cardiac Surgery¹

Myocardial Injury MINS
Leading cause of post-operative mortality within 30 days after surgery¹

Cleveland Clinic researchers discovered that:²

Continuous noninvasive monitoring reduced the amount of IOH by nearly half when compared to intermittent blood pressure monitoring.
Early detection of hypotension by continuous hemodynamic monitoring allows for timely remedial actions, thereby reducing IOH.

Clarity through advanced hemodynamic parameters CO, SV, SVV, and SVR can help you determine if the cause of IOH is preload, afterload, or contractility.

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
Maheshwari, K et al. A Randomized Trial of Continuous Noninvasive Blood Pressure Monitoring During Noncardiac Surgery. Anesthesia & Analgesia, 2018 Aug; 127(2)424-431.

Cockpit screen on HemoSphere advanced monitor

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
Maheshwari, K et al. A Randomized Trial of Continuous Noninvasive Blood Pressure Monitoring During Noncardiac Surgery. Anesthesia & Analgesia, 2018 Aug; 127(2)424-431.

Hemodynamic instability

Critically ill patients are often hemodynamically unstable owing to hypovolemia, cardiac dysfunction, and alterations in vasomotor function.¹ These conditions may lead to deterioration into multi-organ failure, and eventually death.

Continuous access to pressure and flow parameters allow you to evaluate hemodynamic instability and guide appropriate treatment including individualized fluid management.

The ClearSight system offers a noninvasive approach to monitoring the following key hemodynamic parameters:

Cardiac Output (CO)
Stroke Volume (SV)
Stroke Volume Variation (SVV)
Systemic Vascular Resistance (SVR)
Mean Arterial Pressure (MAP)

When managing perfusion, stroke volume (SV) can be optimized using the patient’s own Frank-Starling curve.

The patient’s response to a fluid challenge may be assessed by changes in SV, as indicated by location on the curve. Dynamic and flow-based parameters provide a comprehensive hemodynamic assessment and may help guide individualized fluid administration to avoid over and under resuscitation.²

Huygh, J., Peeters, Y., Bernards, J., Malbrain, M. (2016). Hemodynamic monitoring in the critically ill: an overview of current cardiac output monitoring methods.
Cannesson, M. (2010) Arterial pressure variation and goal-directed fluid therapy. Journal of Cardiothoracic and Vascular Anesthesia, 24(3), 487-97.

Enabling you to proactively manage intraoperative hypotension

Frank-Starling relationship between preload and stroke volume (SV)

Huygh, J., Peeters, Y., Bernards, J., Malbrain, M. (2016). Hemodynamic monitoring in the critically ill: an overview of current cardiac output monitoring methods.
Cannesson, M. (2010) Arterial pressure variation and goal-directed fluid therapy. Journal of Cardiothoracic and Vascular Anesthesia, 24(3), 487-97.

Sepsis management

Severe sepsis and septic shock are leading causes of morbidity and mortality in patients admitted to the intensive care unit

Access to CO and SV enables early detection and management of sepsis which is critical to improving survival rates and reducing the economic burden of sepsis.

The noninvasive ClearSight system allows continuous assessment of your patient’s physiological needs and helps you recognize hemodynamic instability from sepsis.¹

Marik, et al: Hemodynamic parameters to guide fluid therapy. Annals of Intensive Care 2011 1:1

Marik, et al: Hemodynamic parameters to guide fluid therapy. Annals of Intensive Care 2011 1:1

Technology overview

How does it work?

ClearSight system technology is based on two methods: the volume clamp method to continuously measure blood pressure (BP) and the Physiocal method for initial and frequent calibration.

Volume clamp method

The Physiocal method - Physiological Calibration

The Physiocal method

Brachial pressure reconstruction

Cardiac output calculation

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 1000 times per second to keep the arterial volume constant.

Continuous recording of the cuff pressure results in real-time finger pressure waveform.¹

1. Peñáz J. Photoelectric measurement of blood pressure, volume and flow in the finger. 1973; Dresden 1973. p. 104

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.¹

1. Wesseling KH, Wit B, Hoeven GMA, Goudoever J, Settels JJ. Physiocal, calibrating finger vascular physiology for Finapres. Homeostasis. 1995;36:67-82.

Clinical standard for noninvasive BP is brachial level. The ClearSight system reconstructs the brachial arterial pressure waveform from the finger arterial pressure waveform. The reconstruction algorithm is based on a vast clinical database¹

1. Gizdulich P, Prentza A, Wesseling KH. Models of brachial to finger pulse wave distortion and pressure decrement. Cardiovasc Res. 1997;33:698-705. doi: 10.1016/S0008-6363(97)00003-5

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 beat¹

1. Truijen J, van Lieshout JJ, Wesselink WA, Westerhof BE. Noninvasive continuous hemodynamic monitoring. J Clin Monit.Comput. 2012 Jun 14.

For blood pressure and cardiac output validation studies, download the ClearSight technology overview here.

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.

For more educational information

Product implementation

ClearSight system is available on the HemoSphere advanced monitoring platform. Continuous access to your choice of paramaters on the HemoSphere advanced monitoring platform, when used with the noninvasive ClearSight system, enables you to ensure adequate perfusion and proactively manage fluid administration.

Review how to setup and operate the ClearSight system on HemoSphere advanced monitor.

ClearSight system setup guide

HemoSphere advanced monitoring platform operator's manual

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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.