HEMODYNAMIC MANAGEMENT
up to the beat
THE
SERVING
MONITORING SYSTEM
YOUR THERAPEUTIC DECISION
MONITORING
Postoperative complications within 30 days occured for patients undergoing nonambulatory elective surgery1
Reduction of post operative morbidity with PCM technology2
A GOOD QUALITY SIGNAL IS ESSENTIAL
1/3 patients may suffer from underdamping/resonance of the arterial pressure waveform3
Underdamping/resonance phenomena has a substancial impact on CO measurements with pulse wave analysis4
Average worldwide cost of care for septic patient in ICU5
Most of these complications are paramount to hemodynamic troubles
ENHANCE YOUR THERAPEUTIC DECISION PROCESS, SECURE YOUR THERAPEUTIC IMPACT
Accurate arterial variables
Dynamic e-filter6,7,9 PRAM patented algorithm6 Supported by +70 studies8
Best quality/price ratio
No disposable Unlimited use Made in Europe
EASY 3-step process
Other unique features
Pedriatric use (>3kgs) Specific variables (e.g. CCE) HL7 compatible DO&CHECK function
After sales service
A COMPLEX REALITY…
IN A CHALLENGING ENVIRONMENT...
17% $37,000 54% > Check Connect Monitor >
THE DYNAMIC OPTIMISATION OF ARTERIAL PRESSURE SIGNAL QUALITY
The quality of the blood pressure waveform is key to ensure accurate MAP and CO monitoring
AnalysisofthearterialpressurewaveformbyPRAM:ontheleftthepoints of instability (POi) indicated as Z(t)8,on the right a representation of the dicrotic pressure detected and measured at a frequency of 1000 Hz
Dicrotic pressure
With PRAM dicrotic notch is well identified, the 1000hz frequency allows the identification of POi to estimate the right impedance & calculate precisely MAP, CO and SVR8
MostCareUp FILTER ACTIVATION
BEFORE AFTER
The dynamic filter of MostCareUp automatically reduces the resonance phenoma to optimize arterial waveform and optimize the accuracy of the pulse contour method.
Asys Asys Z (t) SV = t P 1000 Hz
Z1 Z2 Z3 SYS DIA Z4 mmHg Time 160 60 F F Not active F Standard F Advanced
*sp=standardprice **costofusecomparisonbetweenanondedicateddisposalandadedicated disposable
invasive monitoring system
VYGON
THE
FUNCTION
VYGON’S UNIQUE VALUES
• Specific variable CCE
Cardiac Cycle Efficiency (CCE) is an exclusive variable which describes hemodynamic performance in terms of energy expenditure in the patient being monitored.
Relationship between between CCE and left ventricular ejection fraction (LVEF). CCE was estimated by pulse wave analysis and LVEF by echocardiography.The correlation coefficient is 0.88 (95 % CI 0.81–0.92, P\0.001).Black dots represent LVEF < 40 %,white dots LVEF ≥ 40 %.
CCE estimated by PCM and LVEF by echocardiography: CCE predict LVEF, accordingly showing a direct correlation. Low CCE indicate poor cardiac function and is considered an indication for echo11
Physiological range of CCE -0.2 ÷ 0.3 [units]
CCE as a «wake-up call» for an echocardiography
CCE as a simple surrogate marker of Ea/Ees
CCE expresses the ability of the cardio-vascular system to maintain homeostasis at different energetic levels10
-0,2 0,3
DO&CHECK
The DO&CHECK function is specifically designed to help you with hemodynamic monitoring variations following specific treatments (fluid challenge & passive leg raising, drugs administration, etc.) Your therapeutic decision is now tracked and supported by the DO&CHECK function. MostCareUp is the best monitor in your daily routine. 45° PLR 12.2012.30 12.40 12.50 PR CO CCE PPV 105 PR 3.8 CO 12% PPV 0.07 CCE (+23%) 120 PR 3.1 CO 18% PPV -0.19 CCE
A MONITOR ADAPTED TO ITS ENVIRONMENT
Connection & data side
WIFI: wireless connection to Hospital Information System supporting HL7 protocol
USB Port: quick data download
HDMI port: screen duplication
HDMI port: screen duplication LAN port: connection to Hospital Information System supporting Health Level 7 (HL7) messaging standard
Patient side
ABP Input to connect MostCare Up to the arterial blood pressure transducer
CVP Input for direct connection to CVP transducer and for real time values of Systemic Vascular Resistance
External module input
Input/Output for analogue connection to the bedside monitor
1st version launched in 2004
Minimum 2 Years warranty
~2% technical problem reported***
After Sales Service
Europe
For more information visit www.hemodynamic-management.vygon.com or contact your Vygon’s representative or via monitoring@vygon.com
ABOUT MOSTCAREUP & VYGON
***InternalVygonHQdata2022
1. Chang W. D, et al. Rehospitalizations following sepsis: common and costly. Crit Care Med. 2015;2085-2093
2. Michard F, et al. Perioperative goal-directed therapy with uncalibrated pulse contour methods: impact on fluid management and postoperative outcome British Journal of Anaesthesia, 2017;119 (1): 22–30
3. Romagnoli S, et al. Accuracy of invasive arterial pressure monitoring in cardiovascular patients: an observational study Critical Care 2014;18:644
4. Foti L, et al. The impact of arterial pressure waveform underdamping and resonance filters on cardiac output measurements with pulse wave analysis BJA 2022;03 024
5. Martin G, et al. sepsis severe sepsis and septic shock change in incidence pathogens and outcomes 2012;10(6): 701–706
6. Scolletta S, et al: Comparison between Doppler-echocardiography and uncalibrated pulse contour method for cardiac output measurement: a multicenter observational study. Crit Care Med44 2016; 1370-1379
7. Greiwe G, et al. Cardiac output estimation by pulse wave analysis using the pressure recording analytical method and intermittent pulmonary artery thermodilution Eur J Anaesthesiol 2020;37: 920–925
8. Romagnoli S, et al. The Pressure Recording Analytical Method (PRAM): Technical Concepts and Literature Review JCVA 2016;Sep 14
9. Foti L, et al. The impact of arterial pressure waveform underdamping and resonance filters on cardiac output measurements with pulse wave Analysis BJA 2022;03 024
10. Romano M, et al. Cardiac cycle efficiency: A new parameter able to fully evaluate the dynamic interplay of the cardiovascular system. Int J Cardiol 2012;155(2): 326-7
11. Scolletta S, et al. Assessment of left ventricular function by pulse wave analysis in critically ill patients. Intensive Care Med 2013;39: 1025-33
FOR FURTHER INFORMATION, PLEASE CONTACT: questions@vygon.com
The specification shown in this leaflet are for information only and are not, under any circumstances, of a contractual nature.
VYGON – 5, RUE ADELINE - 95440 ECOUEN - FRANCE
RECEPTION: +33 (0)1 39 92 63 63
SERVICE CLIENTS FRANCE: +33 (0)1 39 92 63 81
EXPORT CUSTOMER SERVICE: +33 (0)1 39 92 64 15
www.vygon.com
09/22DBMOST22639EV1
