New Study in CHEST Validates the Cheetah Medical Inc. NICOM® 100% Non-Invasive Method for Addressing One of the Most Difficult Assessment Issues in Critical Care Medicine
Published: Sep 05, 2012
VANCOUVER, Wash., Sept. 4, 2012 /PRNewswire/ -- A new study led by Dr. Paul Marik, Professor and Division Chief of Pulmonary Critical Care at Eastern Virginia Medical School in Norfolk, VA was published this week in CHEST, the journal of the American College of Chest Physicians. The study confirmed the high accuracy of using the non-invasive NICOM technology to assess fluid status, one of the most prevalent and frequent challenges in critical care and emergency medicine.
Intravenous (IV) fluid administration has long been a cornerstone of treating patients in shock. In fact, early, guided fluid administration has been shown to lead to dramatic improvements in outcomes and survival of various conditions including sepsis, major surgery and trauma. However, multiple studies have shown that only approximately 50% of critical care patients are responsive to additional fluid. That is, in about half of patients, increased fluid will significantly improve their cardiac function (as measured by stroke volume); whereas in the other half, it will not. Furthermore, accumulating evidence suggests that both inadequate and excessive fluids are associated with poor outcomes. A method to determine volume responsiveness and dosing of fluid is important in the critical care setting; but historically many methods have been invasive, associated with catheter-line blood stream infections or bleeding, costly, and/or had unacceptable accuracy.
In this study, Dr. Marik and team confirmed the accuracy and effectiveness of Cheetah Medical's NICOM system, a 100% non-invasive hemodynamic monitoring system, to address the challenge of fluid management. Critical care patients suffering from sepsis, shock and other life-threatening conditions were monitored with the NICOM monitor and a passive leg raise (PLR) maneuver was performed. PLR induces a gravitational transfer of blood from the lower limbs towards the heart. If the NICOM monitor recorded a change in stroke volume index (SVI) of greater than 10%, the patient was considered fluid responsive. The results from the PLR with NICOM were then compared to results from an IV fluid bolus and carotid Doppler flow measurements. The PLR maneuver with NICOM monitoring had a sensitivity of 94% and a specificity of 100% for predicting volume responsiveness.
The conclusion of the study is, "Monitoring the hemodynamic response to a PLR maneuver using the NICOM provides an accurate method of assessing volume responsiveness in critically ill patients."
"As critical care physicians we understand that determining a patient's fluid status is essential to our ability to provide safe and effective treatments to our patients. Fluid optimization is the cornerstone of medical management in many of our patients, most notably those suffering from sepsis, trauma, acute kidney injury and those recovering from major surgical interventions," said Dr. Jordan Bonomo, Director, Division of Critical Care, Department of Emergency Medicine, University of Cincinnati College of Medicine. "This research further validates my experience in using NICOM monitoring, along with the PLR maneuver, in the management of critically ill patients."
"We are pleased with the study findings, which further validate our technology and complement previous studies that have come to similar conclusions," said Yoav Avidor, MD, CEO of Cheetah Medical. "We hope this study will encourage use of Cheetah's NICOM system in the management of critical care, emergency medicine and surgical patients. We believe that NICOM may enable hospitals to advance the quality of care for a large number of patients that are not benefiting from advanced hemodynamic monitoring and fluid optimization today."
About Cheetah Medical
Cheetah Medical's NICOM® Noninvasive Cardiac Output and Hemodynamic Monitoring System uses the company's proprietary BIOREACTANCE® Technology to deliver continuous, accurate, noninvasive cardiac output (CO) and other vital hemodynamic monitoring parameters, useful for fluid management and drug titration. The system is FDA-cleared and CE Marked, and since its commercial launch in 2008 has been adopted by a growing number of clinicians worldwide. Cheetah Medical headquarters is located in Tel-Aviv, Israel and its United States headquarters is located in Vancouver, Washington. For more information, visit our website at http://www.cheetah-medical.com.
Reference: Marik PE, Levitov A, Young A, et al. The use of NICOM (Bioreactance) and Carotid Doppler to determine volume responsiveness and blood flow redistribution following passive leg raising in hemodynamically unstable patients. Chest. 2012. [Epub ahead of print]
Dr. Jordan Bonomo was not an investigator in this study and has no relevant financial interests to disclose.
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SOURCE Cheetah Medical