IRVINE, CA -- (Marketwired) -- 07/11/13 -- Masimo (NASDAQ: MASI) announced today that the French Society for Anaesthesia and Intensive Care (SFAR) has added Masimo PVI® -- a noninvasive and continuous parameter to help clinicians assess fluid responsiveness and improve fluid management -- to guidelines for optimal hemodynamic management during surgery.(1)
During surgery, the optimal administration of fluid has been shown to reduce post-operative mortality, length of hospital stay, and the recovery period of patients who have undergone gastrointestinal surgery. However, SFAR noted some traditional management approaches to guide fluid administration are unreliable, and that central venous pressure (CVP) monitoring -- a common invasive parameter -- "constitutes a notoriously invasive and insufficient approach." SFAR added, "Particularly in high risk surgery, the classic monitoring of hemodynamic variables does not ensure adequate systemic perfusion (risk of occult 'hypovolemia') and may lead to inadequate treatment decisions."
Instead of so-called "static" parameters such as CVP, SFAR recommends the use of "dynamic" parameters that measure variations over the respiratory cycle. Multiple dynamic parameters have been shown to help clinicians predict fluid responsiveness and improve fluid management. However, most dynamic parameters require invasive and/or complex methods. In contrast, PVI is noninvasive and easily obtained with any Masimo SET® or rainbow® sensor. In recommending the use of dynamic parameters, SFAR noted, "PVI, whose reliability has been proven,(2,3) is available today, and could allow the spread of preload dependence monitoring for patients under general anaesthesia and controlled ventilation in minor and moderate surgery."
SFAR said dynamic indices such as PVI contribute "to the detection of the 'low probability of response to filling' as long as the value remains low ( < 9%), eliminating the need to test the response to filling in a regular systemic manner," and that compared to traditional "empirical administration of fluids," which can either be insufficient or excessive, a dynamic indicator such as PVI "allows an improvement in the patient's prognosis."
SFAR also observed that, "If the main effect of the vascular filling (VF) is to increase venous return and thus cardiac output, it is surprising that cardiac output is only rarely monitored in current practice by anaesthetists." In alluding to PVI, SFAR stated: "Only rapid implementation, surgeon-independent strategies which are either noninvasive or minimally invasive and of low cost will be able to spread in practice."
The new SFAR Formalized Experts' Recommendations add to the growing catalog of clinical evidence in support of Masimo's breakthrough, noninvasive and continuous monitoring technologies, such as PVI. Just last year, the United Kingdom's National Health Service included PVI in its Intra Operative Fluid Management pack, which serves as a guide for hospitals wishing to implement fluid responsiveness monitoring to improve patient outcomes.(4)
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