Acumen Hypotension Prediction Index software

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The Critical Care product group is now part of BD (Becton, Dickinson and Company). Edwards Lifesciences is the manufacturer of the products.

Acumen Hypotension Prediction Index (HPI) software is a first-of-its-kind technology that detects and helps clinicians treat hemodynamic instability. The use of Acumen HPI software has shown a low incidence, duration, and severity of hypotension.¹

A multicenter study demonstrated that patients monitored with Acumen HPI software experienced:

Low incidence of hypotension

41% of patients avoided hypotension when monitored with Acumen HPI software, compared to 12% of patients in another large multicenter study where Acumen HPI software was not used.^*1,2

Brief duration of hypotension

Patients in this study experienced approximately 2 minutes of hypotension, or 1% of surgery time, compared with 28 minutes in another large multicenter study where Acumen HPI software was not used.^{* 1,2}

Low severity of hypotension

Patients monitored with Acumen HPI software experienced a very low TWA MAP <65 mmHg, at 0.03. The TWA MAP <60 mmHg was 0.^*1

*Multicenter, prospective, observational study of over 700 noncardiac surgery patients across 5 countries monitored with Acumen IQ arterial line sensor. Hypotension defined as >1 min below MAP 65 mmHg.

Key elements of the Acumen HPI software

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HPI Parameter

The HPI parameter displays as a value ranging from 0 to 100, with higher values indicating higher likelihood of a hypotensive event.**

The HPI parameter value is updated every 20 seconds, providing continuous predictive insights into developing hypotension.

Smart Alerts and Smart Trend screen

The smart alerts popup alerts you when your patient may be trending toward a hypotensive event.**

Smart alerts and trends provide you with a focused view of the potential targets for intervention such as preload, afterload and contractility - so you can prevent or treat hypotension upon review of the patient's complete hemodynamic state.

HPI high alert popup

Relationship View screen

The relationship view screen provides you insights into the cause of hypotension, and hemodynamic parameters are arranged visually by preload, afterload and contractility.

It provides hemodynamic information associated with hypotension, including several key parameters such as MAP, CO, SVR, PR, and SV, as well as HPI, dP/dt, and Ea_dyn

Relationship View screen

Preload

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.

Contractility

Systolic slope (dP/dt)

Maximum upslope of the arterial pressure waveform from a peripheral artery.

Case study: Clinical utility of dP/dt

Afterload

Dynamic arterial elastance (Ea_dyn)

The ratio of pulse pressure variation to stroke volume variation.

System vascular resistance (SVR)

Derived measure of impedance of blood flow from the left ventricle

Watch Ea_dynexplained

HPI high alert popup

Relationship View screen

HPI Parameter

The HPI parameter displays as a value ranging from 0 to 100, with higher values indicating higher likelihood of a hypotensive event.**

The HPI parameter value is updated every 20 seconds, providing continuous predictive insights into developing hypotension.

Smart Alerts and Smart Trend screen

The smart alerts popup alerts you when your patient may be trending toward a hypotensive event.**

Smart alerts and trends provide you with a focused view of the potential targets for intervention such as preload, afterload and contractility - so you can prevent or treat hypotension upon review of the patient's complete hemodynamic state.

Relationship View screen

The relationship view screen provides you insights into the cause of hypotension, and hemodynamic parameters are arranged visually by preload, afterload and contractility.

It provides hemodynamic information associated with hypotension, including several key parameters such as MAP, CO, SVR, PR, and SV, as well as HPI, dP/dt, and Ea_dyn

Preload

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.

Contractility

Systolic slope (dP/dt)

Maximum upslope of the arterial pressure waveform from a peripheral artery.

Case study: Clinical utility of dP/dt

Afterload

Dynamic arterial elastance (Ea_dyn)

The ratio of pulse pressure variation to stroke volume variation.

System vascular resistance (SVR)

Derived measure of impedance of blood flow from the left ventricle

Watch Ea_dynexplained

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

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Clinical evidence

Review clinical evidence and validation studies for Acumen HPI software

See the evidence

Risk of hypotension

Though intraoperative hypotension (IOH) is common in surgical patients, numerous studies indicate that it is strongly associated with risk of myocardial injury (MI), acute kidney injury (AKI), and mortality.^3,4,7

Acumen HPI software is effective in detecting hemodynamic instability and substantially reducing the duration of IOH during noncardiac surgery.^8*

*Compared to a retrospective historical control group, in noncardiac surgical patients requiring arterial line monitoring¹

IOH is common³

88% of patients continuously monitored with an arterial line still experienced hypotension, defined as MAP <65 mmHg for 1 minute.²

IOH has elevated risks^4-7

Prolonged exposures below MAP thresholds of 65 mmHg are associated with increased risk of mortality, myocardial injury and AKI after noncardiac surgery.^3,9

IOH can be reduced

Studies show: Use of Acumen HPI software significantly reduced hypotension.⁸

^*Prospective, single-arm multicenter study in noncardiac surgical patients requiring arterial line monitoring compared to a historical control

Learn more about the risks of IOH

Unlock Acumen HPI software noninvasively or minimally-invasively

Acumen IQ cuff (noninvasive)

Acumen IQ cuff (noninvasive)

Acumen IQ cuff unlocks Acumen HPI software* and provides continuous blood pressure and advanced hemodynamic parameters from a noninvasive finger cuff.

* Acumen HPI parameter is indicated for surgical patients only when using an Acumen IQ cuff

Acumen IQ sensor (minimally-invasive)

Acumen IQ sensor (minimally-invasive)

Acumen IQ sensor unlocks Acumen HPI and Acumen Assisted Fluid Management (AFM) software. The sensor connects to any existing radial arterial line and offers you patients’ hemodynamic status.

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.

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Pocket card: Normal hemodynamic parameters

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References

Kouz K, Garcia MIM, Cerutti E, Lisanti I, Draisci G, Frassanito L, et al. Intraoperative hypotension when using hypotension prediction index software during major noncardiac surgery: a European multicentre prospective observational registry. (EU HYPROTECT). BJA Open. 2023 May 4;6:100140.
Shah, N., Mentz, G., Kheterpal, S. The incidence of intraoperative hypotension in moderate to high risk patients undergoing non-cardiac surgery: A retrospective multicenter observational analysis. Journal of Clinical Anesthesia. 2020: 66; 1-12.
Salmasi V, et al. Relationship between Intraoperative Hypotension, Defined by Either Reduction from Baseline or Absolute Thresholds, and Acute Kidney and Myocardial Injury after Noncardiac Surgery: A Retrospective Cohort Analysis. Anesthesiology. 2017 Jan;126(1):47-65.
Mascha EJ, et al. Intraoperative Mean Arterial Pressure Variability and 30-day Mortality in Patients Having Noncardiac Surgery. Anesthesiology. 2015 Jul;123(1):79-91.Walsh M, et al. Relationship between intraoperative mean arterial pressure and clinical outcomes after noncardiac surgery: toward an empirical definition of hypotension. Anesthesiology. 2013 Sep;119(3):507-15.
Walsh M et al. Relationship between intraoperative mean arterial pressure and clinical outcomes after noncardiac surgery: toward an empirical definition of hypotension. Anesthesiology. 2013 Sept;119(3):507-15.
Sun LY, et al. Association of intraoperative hypotension with acute kidney injury after elective noncardiac surgery. Anesthesiology. 2015 Sep;123(3):515-23.
Wijnberge M, et al. Association of intraoperative hypotension with postoperative morbidity and mortality: systematic review and meta-analysis. BJS Open. 2021 Jan 8;5(1):zraa018.
U.S. Food and Drug Administration. 2021. K203224 510k Summary, Acumen Hypotension Prediction Index.
Wesselink E., et al Intraoperative hypotension and the risk of postoperative adverse outcomes: a systematic review. British Journal of Anaesthesia. 2018

Important safety information

Important safety information

CAUTION: Federal (United States) law restricts this device to sale by or on the order of a physician.
See Instructions For Use (IFU) / Directions For Use (DFU) for full prescribing information, including indications, contraindications, warnings, precautions and adverse events.