Acumen Hypotension Prediction Index software
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The Acumen Hypotension Prediction Index (HPI) software is a first-of-its-kind technology that provides you with information regarding the likelihood of a patient trending toward a hypotensive event*
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*A hypotensive event is defined as MAP <65 mmHg for a duration of at least one minute.
HemoSphere advanced monitoring platform
All-in-one monitoring for smart recovery
Staying ahead of hemodynamic instability is critical and challenging. Harnessing the power of machine learning and predictive algorithms, HemoSphere monitor helps you manage pressure and flow with intelligent decision support. As an all-in-one monitoring platform, HemoSphere monitor delivers advanced pressure, flow, and tissue oximetry insights from a single, comprehensive monitor. And with Viewfinder remote app, you can track patient progress from your smartphone.*
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.
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Hemodynamic monitoring matters
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CAUTION: Federal (United States) law restricts this device to sale by or on the order of a physician. See instructions for use for full prescribing information, including indications, contraindications, warnings, precautions, and adverse events.
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For critically ill and surgical patients, proactive monitoring can mean the difference between recovery and complications. When patient recovery is on the line, continuous access to advanced hemodynamic insights can help you stay ahead of critical moments.
200
million
Adults across the world will undergo noncardiac surgery annually, and this number continues to increase each year
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Patients over 45 years old — more than 1 in 12 patients — globally are estimated to suffer myocardial injury after noncardiac surgery per year.
1 12
in
Patients over 45 years old experience MINS each year after non-cardiac surgery
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.
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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.
Prolonged exposure (≥10 min) to mean arterial pressure (MAP) <80 mmHg and for shorter durations <70 mmHg was associated with mildly elevated risks of any overall organ injury.
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30-day mortality, 90-day mortality, perioperative acute myocardial infarction, acute kidney injury, continuous renal replacement therapy, sepsis/sepsis/systemic inflammatory response syndrome.
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The findings indicated an association between intraoperative hypotension in non-cardiac surgery and the three components of MACCE: death, myocardial infarction, and stroke. MACCE was associated with all three absolute MAP thresholds (≤75, ≤65, and ≤55 mmHg) and with the 40% under baseline relative MAP threshold (p<0.001). As absolute MAP thresholds decreased, association progressively increased between IOH and MACCE, 30-day mortality, and 90-day mortality. Due to its association with 30-day MACCE, IOH may be an avoidable risk.
Increased durations of MAP <65-60 mmHg or for any exposure <55-50 mmHg were associated with moderately or highly elevated risks of overall organ injury.
Advanced hemodynamic monitoring can help you identify physiologic changes that may lead to critical complications.
Manage hemodynamic instability
*When used in surgical patients who require intraoperative hemodynamic monitoring during non-cardiac surgery.
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Hypotension
Cerebral and tissue desaturations
Variation in fluid management
Shock
Evidence shows strong associations between intraoperative hypotension and increased risk of acute kidney injury (AKI), myocardial injury and mortality. Early detection of hypotension can reduce patient risk. Explore how Acumen Hypotension Prediction Index (HPI) software can help anticipate hypotensive events*.
Cerebral desaturations are serious and may lead to complications such as post-operative cognitive dysfunction, and even death. Having a comprehensive picture of oxygen delivery and consumption may allow you to reduce the clinical implications of prolonged desaturations. Learn how ForeSight tissue oximetry sensor helps monitor and detect potential desaturations.
Using advanced hemodynamic parameters for a shock patient can help you identify the type of shock and determine the most appropriate therapy. Appropriate treatment is based on an understanding of the underlying pathophysiological mechanisms. Studies show that individuals with suspected similar diseases (such as heart failure, sepsis and stroke) present with widely diverse hemodynamic profiles. Discover how Acumen IQ sensor can help you diagnose and treat shock early.
Large patient-to-patient variability in fluid administration exists between clinicians and within surgical procedures. Too much or too little fluid administration can lead to complications including mortality, AKI and gastrointestinal and respiratory problems – as well as increased length of stay, which leads to higher hospital costs. See how Acumen Assisted Fluid Management (AFM) software is effective in optimizing fluid administration.
1. Salmasi V, Maheshwari K, Yang G, Mascha EJ, Singh A, Sessler DI, et al. Relationship between intraoperative hypotension, defined by either reduction from baseline or absolute thresholds, and acute kidney injury and myocardial injury. Anesthesiology. 2017;126:47-65. 2. Lilot M, Ehrenfeld JM, Harrington B, Cannesson M, Rinehart J. Variability in practice and factors predictive of total crystalloid administration during abdominal surgery: retrospective two-centre analysis. Br J Anaesth. 2015 May;114:767-76. Epub 2015 Jan 13. 3. Thacker JKM, Mountford WK, Ernst FR, Krukas MR, Mythen MMG. Perioperative fluid utilization variability and association with outcomes: considerations for enhanced recovery esample US surgical populations. Ann Surg. 2016;263:502-10. 4. Shin CH, Long DR, McLean D, Grabitz SD, Ladha K, Timm FP, et al. Effects of intraoperative fluid management on postoperative outcomes: a hospital registry study. Ann Surg. 2018;267:1084-1092. 5. Miller TE, Mythen M, Shaw AD, et al. Association between perioperative fluid management and patient outcomes: a multicentre retrospective study. Br J Anaesth. 2021;126:720-729. 6. Vincent & De Backer. Circulatory Shock. New England Journal of Medicine. 2013. 1726-1734. 7. Nowak, RM ea al. Noninvasive hemodynamic monitoring in emergency patients with suspected heart failure, sepsis and stroke: the premium registry. West J Emerg Med 2014, 786-794.
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With expanded software, insights, and capabilities, HemoSphere monitor is now smarter than ever. Experience intelligent decision support that can help you detect and treat hemodynamic instability, as well as a mobile app that lets you view insights from anywhere.*
Get premier access to the latest smart monitoring innovations when you upgrade to HemoSphere 360 software and service program.
Explore the Acumen suite
Your expertise + smart hemodynamic monitoring
Insights from anywhere with Viewfinder remote app
Access your patients’ hemodynamic insights, trends, alerts and more directly from your smartphone. • Track patient progress on your phone • View multiple patients simultaneously • Access patient insights from anywhere
Acumen HPI software is effective in detecting hemodynamic instability and substantially reducing the duration of intraoperative hypotension.*
Manage pressure and flow
Right and left heart monitoring on a single screen
Educational resources
Case study: Clinical utility of dP/dt
Ea explained
dyn
Watch video
You can access both right heart and left heart patient monitoring from a single screen. See important indicators of preload, afterload, and contractility on the invasive screen when Swan-Ganz catheter is used along with Acumen IQ sensor.*
Acumen Assisted Fluid Management (AFM) software is a first-of-its-kind machine learning solution. It provides decision support that enables you to deliver adaptable, individualized fluid management and to optimize fluid administration.
Insights from anywhere with Viewfinder remote app*
* Compared to a retrospective historical control group, in noncardiac surgical patients requiring arterial line monitoring
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Designed to guide optimal fluid administration
Acumen IQ sensor parameters that can be viewed on the invasive screen include SVV, Ea , dP/dt, HPI and MAP only.
Trending ΔctHb on ForeSight sensor
ΔctHb shows the relative change in total tissue hemoglobin and helps you identify the potential cause of StO changes. When trended together, these parameters provide additional insights into the suitability and impact of potential interventions.
Trending ΔctHb with ForeSight sensor
Learn more about HemoSphere 360 program
Discover Viewfinder remote app
Harnessing the power of machine learning, Acumen software suite has first-of-its-kind solutions designed to help you optimize fluid administration, detect hemodynamic instability, and predict the likelihood of hypotension.
Acumen intelligent decision support suite
Decision support powered by machine learning
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.*
Hypotension Prediction Index (HPI) Parameter
Manage pressure and flow with intelligent decision support
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
Explore ForeSight tissue oximetry sensor
Stay ahead of hemodynamic instability
Acumen software
Acumen sensors
Acumen Assisted Fluid Management (AFM) software
Acumen Hypotension Prediction Index (HPI) software
Acumen IQ cuff unlocks Acumen HPI software and provides continuous blood pressure and advanced hemodynamic parameters from a noninvasive finger cuff.* Parameters: HPI | dP/dt | Ea | CO/CI | SV/SVI | SVR/SVRI | SVV | PPV | MAP
Acumen IQ cuff
Acumen IQ sensor
Acumen IQ sensor enables continuous monitoring, connects to any existing arterial line, and unlocks Acumen HPI and Acumen AFM software. Parameters: HPI | dP/dt | Ea | CO/CI | SV/SVI | SVR/SVRI | SVV | PPV | MAP
Unlock the power of Acumen software with these smart monitoring devices*
Manage pressure and flow with intelligent decision support with Acumen HPI software
Noninvasive monitoring with Acumen IQ cuff
Minimally-invasive, arterial line monitoring with Acumen IQ sensor
Predict fluid responsiveness with Acumen AFM software
Unlocked by Acumen IQ cuff** or Acumen IQ sensor, Acumen HPI software is a first-of-its-kind technology that detects hemodynamic instability. Gain insight from a focused view of the potential targets for intervention - so that you can prevent or treat hypotension upon review of the patient's complete hemodynamic state.
* Surgical patient use only
Acumen AFM software is a first-of-its-kind machine-learning solution which provides decision support to enable you to deliver individualized fluid management, and optimize fluid administration. Acumen AFM software is unlocked by Acumen IQ sensor.
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Acumen HPI software is unlocked by Acumen IQ cuff or Acumen IQ sensor. Acumen AFM software is unlocked by Acumen IQ sensor only.
Acumen HPI parameter is indicated for surgical patients only when using an Acumen IQ cuff.
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ForeSight sensor delivers absolute StO values that – when used in combination with the full hemodynamic insights delivered by HemoSphere advanced monitoring platform – enable you to confidently recognize and reverse cerebral desaturations.
ForeSight tissue oximetry sensor
Features
Model Numbers
Advanced hemodynamic parameters provided by the Acumen IQ sensor offer you continuous insight into your patient’s hemodynamic status.
Unlocks the Acumen Hypotension Prediction Index software. Connects to any existing radial arterial line. Automatically updates advanced parameters every 20 seconds, reflecting rapid physiological changes in moderate- to high-risk surgery.
AIQS8
84 in / 213 cm
Model
Description
Length
Unit of measure
Acumen IQ sensor standalone
Acumen IQ sensor standalone (5-pack)
60 in / 152 cm
EA
Acumen Analytics software
Acumen Analytics software enables you to analyze parameters from the EV1000 and HemoSphere monitoring platforms retrospectively, providing insights into hemodynamic management of individual patients, as well as groups of patients. The view of specific pressure and flow parameters allow you to analyze:
Hypotension frequency Hypotension duration Hypotension prevalence
More on HemoSphere advanced monitoring platform
HemoSphere advanced monitoring platform offers advanced hemodynamic parameters that can help guide you with proactive decision support in a range of clinical situations and settings so you can maintain optimal patient perfusion.
AIQS85
AIQS6
AIQS65
AIQS8C503
Acumen IQ sensor with TruWave disposable pressure transducer
AIQS6AZ
Acumen IQ sensor with VAMP adult system
AIQS6AZ5
AIQS6C502
Acumen IQ sensor with TruWave disposable pressure transducer with VAMP adult system
Acumen IQ cuff unlocks Acumen HPI software and provides continuous blood pressure and advanced hemodynamic parameters from a noninvasive finger cuff. Continuous data offered by the Acumen IQ cuff enables you to proactively optimize perfusion through hemodynamic management and provides more accurate systolic, diastolic and MAP values than a brachial cuff.
Gives you noninvasive access to automatically calculate beat-to-beat hemodynamic information for a broad patient population, including patients in who an arterial line would not be typically placed. The easy to use self-coiling mechanism within the interior of the cuff wraps snugly around the patient’s finger and offers improved cuff placement, consistent snugness, and usability.
AIQCM
Medium
AIQCS
Small
Pack size
AIQCL
Large
Absolute measures, comprehensive insights
All-in-one monitoring
Tissue oximetry measures are only one part of a patient’s hemodynamic profile. That’s why ForeSight sensor integrates with HemoSphere monitor – making it the only system that allows you to see a comprehensive view of patient perfusion (including pressure, flow, and tissue oximetry) on the same monitor. ForeSight sensor enables you to trend ΔctHb with StO , which can provide additional insights into the suitability and impact of potential interventions. By using ForeSight sensor with Acumen HPI software, you can access predictive insights that may help to prevent or mitigate cerebral desaturations caused by hypotension.
Viewfinder remote app
Access your patients’ complete physiologic insights, trends, alerts, and more – directly from your smartphone.
Viewfinder remote app brings HemoSphere monitor insights wherever you are. From your smartphone, you can track patient progress, view multiple patients simultaneously, manage in-app alarms, and more.
Stay informed remotely
Stay connected to your patients’ progress in the moment with the power to remotely view multiple patients simultaneously.
Multi-patient view
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
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
CTRL
hCTRL
0
640
660
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
Bring comprehensive insights beyond the bedside
Hypotension was defined as a MAP <65 mmHg for at least 1 minute.
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Stay informed of critical moments – from anywhere
Discover Viewfinderremote app
HemoSphere monitor was expertly designed to deliver a unique visual monitoring experience defined by enhanced screen clarity, intuitive navigation and responsive touch – for intelligent decision support you can count on during rapidly changing situations.
Monitor with clarity, manage with confidence
HemoSphere advanced monitoring platform allows you to customize and easily move between screens for the most meaningful data. Viewfinder remote app makes insights from your HemoSphere monitors accessible from anywhere.
The right view – for the right insights
Discover more resources
Physio-relationship
Animated physiology
Depicts real-time changes occurring in your patient by delivering visual diagrams and numeric parameters.
Allows you to select, place and track interventions over time while providing key trending data. Percent change displays current status and history of monitored parameters.
Graphical trend
Depicts the balance between oxygen delivery and consumption, helping you to identify any root causes for irregularities and appropriate interventions.
Cockpit
Combines large, easy-to-read numbers with specific color target ranges, parameters and alarms to clearly indicate patient status and monitoring needs.
You can access both right heart and left heart patient monitoring from a single screen. See important indicators of preload, afterload and contractility on the invasive screen when Swan-Ganz catheter is used along with Acumen IQ sensor.*
Right and left heart monitoring on one screen
Two-in-one monitoring
HemoSphere 360 software and service program
Protect your HemoSphere advanced monitoring platform with HemoSphere 360 program, a comprehensive service program that provides premier access to new updates to your system software and warrants your monitor against damages and downtime.
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Minimally-invasive
Invasive
Noninvasive
Noninvasively unlocks Acumen Hypotension Prediction Index (HPI) software and provides continuous blood pressure and flow measurements.*
Acumen IQ sensor enables continuous monitoring, connects to any existing arterial line and unlocks Acumen HPI and Acumen AFM software.
Swan-Ganz pulmonary artery catheters offer continuous parameters on three major integrated elements – flow, pressure and oxygen delivery and consumption – for a comprehensive hemodynamic profile.
Swan-Ganz pulmonary artery catheter
Explore the full range of HemoSphere compatible devices on our website
*For surgical patients only.
ForeSight sensor delivers absolute StO values that – when used in combination with the full hemodynamic insights delivered by HemoSphere monitor – enable you to confidently recognize and address cerebral desaturations.
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