Acumen intelligent decision support suite
Proactively manage pressure and flow with first-of-its-kind predictive technology
Harnessing the power of machine learning, Acumen suite delivers predictive decision support to help you detect hemodynamic instability and optimize fluid administration. With advanced hemodynamic monitoring that provides continuous pressure and flow parameters, you will get valuable insight into the adequacy of perfusion – to stay ahead of critical moments.
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Managing pressure and flow
Acumen HPI software
Sensors and platform
Acumen AFM software
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Retrospective analytics and more
Edwards, Edwards Lifesciences, the stylized E logo, Acumen, Acumen AFM, Acumen HPI, Acumen IQ, AFM, HemoSphere, HPI, and Hypotension Prediction Index are trademarks of Edwards Lifesciences Corporation or its affiliates. All other trademarks are the property of their respective owners. © 2023 Edwards Lifesciences Corporation. All rights reserved. PP--US-7642 v2.0 Edwards Lifesciences • One Edwards Way, Irvine CA 92614 USA • edwards.com
Edwards, Edwards Lifesciences, the stylized E logo, Acumen, Acumen AFM, Acumen HPI, Acumen IQ, AFM, HemoSphere, HPI, and Hypotension Prediction Index are trademarks of Edwards Lifesciences Corporation or its affiliates. All other trademarks are the property of their respective owners. © 2023 Edwards Lifesciences Corporation. All rights reserved. PP--US-7642 v1.0 Edwards Lifesciences • edwards.com One Edwards Way, Irvine CA 92614 USA
Adequate perfusion requires sufficient arterial pressure and cardiac output. With access to continuous pressure and flow parameters, advanced hemodynamic monitoring provides valuable insight into patient perfusion, detects hemodynamic instability and helps you optimize fluid administration.
Managing pressure and flow is key to hemodynamic stability
Intraoperative hypotension (IOH) is common and may elevate risk across all age groups – but it can be reduced.
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 high alert popup
The advanced hemodynamic pressure and flow parameters provided on the HPI secondary screen allow you to investigate and identify the root cause of potentially developing hypotensive events.
HPI secondary screen
The HPI parameter value is updated every 20 seconds, providing continuous predictive insights into developing hypotensive events.*
Educational resources
Case study: Clinical utility of dP/dt
The advanced hemodynamic parameters on the secondary screen are arranged visually by:
Preload Contractility Afterload
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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 It may be used as an indicator of fluid responsiveness.
Contractility
Systolic slope (dP/dt) Maximum upslope of the arterial pressure waveform from a peripheral artery. It measures the maximum rate of the arterial pressure rise during left ventricular contraction Changes from baseline or trend values of arterial dP/dt are more useful than absolute values, and may be an indicator of increasing or decreasing contractility
Afterload
Dynamic arterial elastance (Ea ) The ratio of pulse pressure variation to stroke volume variation It may be used as a predictor to determine when a preload responsive patient may also be pressure responsive. Ea greater than 1.0 may suggest that preload responsive patients will increase their mean arterial pressure in response to a fluid bolus
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Learn more
Ea explained
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Shah NJ, Mentz G, Kheterpal S. The incidence of intraoperative hypotension in moderate to high risk patients undergoing non-cardiac surgery: A retrospective multicenter observational analysis. J Clin Anest. 2020;66:109961. Gregory A, Stapelfeldt WH, Khanna AK, Smischney NJ, Boero IJ, Chen Q, et al. Intraoperative hypotension is associated with adverse clinical outcomes after noncardiac surgery. Anesth Analg. 2021 Jun 1;132(6):1654-1665. 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. Martin GS, Kaufman DA, Marik PE, Shapiro NI, Levett DZH, Whittle J, et al. Perioperative Quality Initiative (POQI) consensus statement on fundamental concepts in perioperative fluid management: fluid responsiveness and venous capacitance. Perioper Med (Lond). 2020 Apr 21;9:12. Thacker JKM, Mountford WK, Ernst FR, Krukas MR, Mythen MMG. Perioperative fluid utilization variability and association with outcomes: considerations for enhanced recovery e orts in sample US surgical populations. Ann Surg. 2016;263:502-10. Miller TE, Mythen M, Shaw AD, Hwang S, Shenoy AV, Bershad M, et al. Association between perioperative fluid management and patient outcomes: a multicentre retrospective study. Br J Anaesth. 2021;126:720-729. Malbrain MLNG, Langer T, Annane D, Gattinoni L, Elbers P, Hahn RG, et al. Intravenous fluid therapy in the perioperative and critical care setting: Executive summary of the International Fluid Academy (IFA). Ann Intensive Care. 2020 May 24;10(1):64. Futier E, Lefrant JY, Guinot PG, Godet T, Lorne E, Cuvillon P, et al. Effect of Individualized vs Standard Blood Pressure Management Strategies on Postoperative Organ Dysfunction Among High-Risk Patients Undergoing Major Surgery: A Randomized Clinical Trial. JAMA. 2017 Oct 10;318(14):1346-1357. French WB, Scott ML. Fluid and hemodynamics. Anesthesiol Clin. 2022;40(1):59–71. Ariyarathna D, Bhonsle A, Nim J, Huang CKL, Wong GH, Sim N, et al. Intraoperative vasopressor use and early postoperative acute kidney injury in elderly patients undergoing elective noncardiac surgery. Ren Fail. 2022 Dec;44(1):648-659. Joosten A, Hafiane R, Pustetto M, Van Obbergh L, Quackels T, et al. Practical impact of a decision support for goal-directed fluid therapy on protocol adherence: a clinical implementation study in patients undergoing major abdominal surgery. J Clin Monit Comput. 2019 Feb;33(1):15-24. Fellahi JL, Futier E, Vaisse C, Collange O, Huet O, Loriau J, et al. Perioperative hemodynamic optimization: from guidelines to implementation-an experts’ opinion paper. Ann Intensive Care. 2021 Apr 14;11(1):58.
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A recent study reported at least one hypotensive event* in 88% of noncardiac cases, with a mean cumulative duration of 28.2 minutes.
For all age groups, IOH has an important – and avoidable –association with major adverse cardiac or cerebrovascular events within 30 days after surgery.
A recent multicenter, prospective, observational study of more than 700 patients demonstrated that the use of Acumen HPI software resulted in a low incidence, short duration, and low severity of intraoperative hypotension.**
Physiological variability between patients increases the complexity of fluid management.
* A hypotensive event is defined as MAP<65 mmHg for at least 1 minute. ** Multicenter, prospective, observational study of patients across 5 EU countries monitored with Acumen IQ arterial line sensor. Hypotension defined as >1 min below MAP 65 mmHg.
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Understand the risks of hypotension
Variability in fluid administration and responsiveness can lead to complications – but optimal fluid management is attainable.
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Excessive or insufficient fluid administration results in poor patient outcomes, which range from edema to major organ damage, most notably in the kidneys.
Goal-directed hemodynamic therapy (GDHT) can positively impact postoperative outcomes.
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Discover hypotension prediction software
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Edwards, Edwards Lifesciences, the stylized E logo, Acumen, Acumen AFM, Acumen HPI, Acumen IQ, AFM, HemoSphere, HPI, and Hypotension Prediction Index are trademarks of Edwards Lifesciences Corporation or its affiliates. All other trademarks are the property of their respective owners. © 2023 Edwards Lifesciences Corporation. All rights reserved. PP--US-7642 v1.0 Edwards Lifesciences • One Edwards Way, Irvine CA 92614 USA • edwards.com
Acumen Hypotension Prediction Index (HPI) software is designed to detect hemodynamic instability. Acumen HPI software provides insights to help identify the potential root cause of hemodynamic instability to enable you to treat the cause.
Detect hemodynamic instability with predictive technology
Key features of Acumen HPI software
Smart Alerts and Smart Trends
The smart alerts popup notifies you when your patient may be trending toward a hypotensive event.** Smart alerts and smart trends provide you with a focused view of the potential targets for intervention such as preload, afterload and contractility - so you can treat the root cause.
The relationship view screen provides insights into the cause of potential hypotension. Hemodynamic parameters are arranged visually by preload, afterload and contractility. It provides insights into hemodynamic instability, including several key parameters such as MAP, CO, SVR, PR, PPV, and SVV, as well as HPI, dP/dt, and Ea .
Choose the right monitoring for each patient. Unlock Acumen HPI software with either Acumen IQ cuff† (noninvasive) or Acumen IQ sensor (minimally invasive).
Relationship View
Unlock with Acumen IQ cuff or sensor
Smart Alerts and Smart Trends screen
Relationship View screen
† Acumen HPI parameter is indicated for surgical patients only when using an Acumen IQ cuff.
Acumen Assisted Fluid Management (AFM) software feature not included on Viewfinder remote app. Viewfinder remote app is intended as a visual support aid, not as a monitoring device.
Multi-patient view
Individual patient view
Predictive insights
* Multicenter, prospective, observational study of patients across 5 EU countries monitored with Acumen IQ arterial line sensor. Hypotension defined as >1 min below MAP 65 mmHg.
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.
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A recent study demonstrated that the use of Acumen HPI software resulted in a low incidence, short duration and low severity of intraoperative hypotension.*¹ Read more clinical evidence
Individualize fluid management
See how Acumen HPI software works
** A hypotensive event is defined as MAP <65 mmHg for a duration of at least one minute.
Relationship view
Keep your surgical patients in the optimal fluid range
Acumen AFM software uses machine learning to make predictions on a patient’s fluid responsiveness based on hemodynamic data and past fluid responsiveness.
Acumen Assisted Fluid Management (AFM) software offers predictive decision support and individualized fluid recommendations to help you deliver optimized fluid administration.
Predictive fluid decision support
Publication in JAMA: “Effect of a Machine Learning–Derived Early Warning System for Intraoperative Hypotension vs Standard Care on Depth and Duration of Intraoperative Hypotension During Elective Noncardiac Surgery: The HYPE Randomized Clinical Trial”
HYPE trial results published in JAMA
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Elective, noncardiac surgery patients monitored with Acumen HPI software had a median time of hypotension per patient of 8 minutes compared to 32.7 minutes in the control group. Time-weighted average of hypotension combines the duration and the severity of hypotension corrected for the total duration of the procedure. With Acumen HPI software, the study showed a median .38 mmHg difference between the interventional and control group. The Acumen HPI software secondary screen provided insight into the potential root cause of that hypotension, enabling clinicians to identify the appropriate treatment course.
Publication in the Journal of Clinical Monitoring and Computing: “Hypotension Prediction Index based protocolized haemodynamic management reduces the incidence and duration of intraoperative hypotension in primary total hip arthroplasty: a single centre feasibility randomised blinded prospective interventional trial”
Results from Acumen HPI implementation in total hip arthroplasty prospective trial
Number of hypotensive events per hour (n/hr) Absolute IOH time (sec) Relative IOH time (IOH time as % of total anesthesia time)
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Acumen Hypotension Prediction Index software combined with protocolized treatment was shown to reduce the relative and absolute duration of hypotensive events in total hip arthroplasty patients, in comparison to a historical and prospective control group.
HPI
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HPI=Hypotension Prediction Index software; CTRL=routine anaesthetic care cohort; hCTRL=historic control group HPI group, n=25; CTRL, n=24; hCTRL, n=50. Total n=99
Prediction of hypotension at 5 minutes before an event
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Publication in Anesthesia and Analgesia: “Ability of an Arterial Waveform Analysis–Derived Hypotension Prediction Index to Predict Future Hypotensive Events in Surgical Patients” When compared with hemodynamic parameters such as SV, CO, SVV, and MAP, Acumen HPI software showed a higher predictive performance at 5 and 10 minutes before hypotension in this study.
Acumen HPI software had superior ability to predict hypotensive events than common hemodynamic parameters
Receiver operating characteristic curves for HPI, CO, SV, MAP, PP, HR, SVV, and shock index for prediction hypotension 5 and 10 min before the event.
Publication in Anesthesiology: “Machine-learning Algorithm to Predict Hypotension Based on High-fidelity Arterial Pressure Waveform Analysis”
Acumen HPI software demonstrated high accuracy in predicting hypotension
Predictive algorithms can be assessed via a ROC curve, with the AUC showing the predictive power of the algorithm for a specific dataset. At 10 minutes before an event, Acumen HPI software predicted hypotension with a specificity and sensitivity of 89% and 90% respectively, and with an AUC of 0.95 in this study.
AUC=area under curve; ROC=receiver operating characteristic.
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Highlights from 2020 Wijnberge, et al.
Highlights from 2019 Schneck, et al.
Highlights from 2019 Davies, et al.
Highlights from Hatib, et al
Prediction of hypotension at 10 minutes before an event
ROC closest to the y-axis approaches a perfect model, with fewer false-positive and false-negative values
Key features of Acumen AFM software
Hypotension was defined as a MAP <65 mmHg for at least 1 minute.
Acumen IQ sensor attaches to any existing radial arterial line and unlocks both Acumen AFM and HPI software. With access to two predictive algorithms to help you manage pressure and flow, you can enhance patient care and stay ahead of hemodynamic instability.
Acumen IQ sensor
Throughout a procedure, Acumen AFM software adapts to each patient. As it learns from the patient’s response to each analyzed fluid bolus, the software optimizes its future recommendations.
Individualized fluid administration
Acumen IQ fluid meter automatically tracks volume administration and flow rate in real time when used with Acumen AFM cable.
Automatic volume tracking
Unlock Acumen solutions
See how Acumen AFM software works
Throughout a procedure, Acumen AFM software adapts to each patient. As it learns from the patient’sresponse to each analyzed fluid bolus, the software optimizes its future recommendations.
Acumen IQ fluid meter automatically tracks volume administration and flow rate in real time when used with Acumen AFM cable
Unlock the power of Acumen software solutions with monitoring devices that deliver advanced insights for individualized hemodynamic management – all on HemoSphere monitor.
Manage pressure and flow with all-in-one monitoring
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.
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.
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.
Discover HemoSphere monitor
Acumen IQ cuff
HemoSphere monitor
Acumen IQ cuff unlocks Acumen HPI software.* It delivers noninvasive, continuous blood pressure measurements and advanced hemodynamic parameters with accuracy comparable to a radial arterial line.
Keep track of rapid physiological changes with Acumen IQ sensor. By connecting to any existing radial arterial line, the sensor unlocks Acumen HPI and AFM software** and offers you continuous insights into your patient’s hemodynamic status.
Harnessing the power of machine learning and predictive algorithms, HemoSphere monitor helps you manage pressure and flow with intelligent decision support. HemoSphere monitor delivers advanced pressure, flow and tissue oximetry insights from a single, comprehensive monitor. Offering full-range cuff, sensor and catheter capability, HemoSphere monitor enables individualized care for each patient’s unique needs. And with Viewfinder remote app, you can even view your patients’ hemodynamic insights directly from your smartphone.†
* Acumen HPI parameter is indicated for surgical patients only when using an Acumen IQ cuff.
Discover Acumen IQ cuff
** AFM software is indicated for surgical patients only ≥ 18 years of age.
Discover Acumen IQ sensor
† Viewfinder remote app is not a monitoring device and AFM feature is not available with Viewfinder remote app
Expand your insights
Expand your insights with restrospective analysis and ongoing clinical education
Acumen Analytics software
Clinical education
Acumen Analytics software enables you to retrospectively view and analyze hemodynamic parameters, including mean arterial pressure, providing you insights into the frequency, duration and prevalence of intraoperative hypotension in your practice.
Edwards Lifesciences clinical education meets you no matter where you are in the learning process. With a long-term commitment to improving the quality of care for surgical and critical care patients, the Edwards continuum of educational resources and tools supports you as you solve clinical challenges today and in the future.
Edwards, Edwards Lifesciences, the stylized E logo, Acumen, Acumen HPI, Acumen IQ, ForeSight, HemoSphere, HPI, Hypotension Prediction Index, Swan, Swan-Ganz, and Viewfinder are trademarks of Edwards Lifesciences Corporation or its affiliates. All other trademarks are the property of their respective owners. © 2022 Edwards Lifesciences Corporation. All rights reserved. PP--US-7626 v1.0 Edwards Lifesciences • edwards.com One Edwards Way, Irvine CA 92614 USA
