HealthManagement, Volume 19 - Issue 6, 2019

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Summary: Noninvasive, continuous haemodynamic assessment in clinically proven quality made easy.

Easy-to-use and reliable methods for a clinically valuable cardiovascular assessment have become inevitable at a time when cardiovascular disease (CVD) is the number one cause of death1 and postoperative complications causing long hospital stays are not the only facts placing significant economic burden on healthcare services worldwide.

Noninvasive, continuous arterial blood pressure monitoring (CNAP®) – as offered by CNSystems – has fulfilled this claim for over 20 years for closing the cycle of prevention, early detection, continuous monitoring and efficient treatment. More than 900 studies in many different application fields reflect the reliability and versatile usability of this market-leading technology, which not only enhanced standard intermittent methods with continuous information, but also revolutionised cardiovascular monitoring by providing full haemodynamics from simple finger sensors.2,3

The method is, for instance, very much appreciated in the field of hypertension prevention in order to closely investigate its influencing factors with the goal to early detect, predict and ideally prevent this widespread disease. Studies with our technology not only underlined that physical exercise has a positive impact on the CV system,4,5 but also confirmed that prompt antihypertensive treatment may contribute to a stabilised cardiovascular state and reversed health effects.6

Haemodynamic and autonomic assessment also plays an important role in the diagnosis and management of Syncope, which is still a challenging task in medical practice7 requiring noninvasive, continuous and easy-to-use equipment for efficient haemodynamic and autonomic monitoring. Numerous study groups have used our technology during head-up tilt-tests to provoke unconsciousness and get a detailed insight in the physiological mechanisms during syncopal events.8,9

CNAP® has even convinced with its reliability and the potential to improve patient outcome and save cost in the very sensitive field of perioperative medicine. Noninvasive solutions are not only associated with less risks, but also with fewer complications for the patient than invasive methods. Benes et al. (2015) showed that Goal Directed Therapy based on pulse pressure variation from CNAP® applied in intermediate risk patients undergoing hip or knee replacement, reduced postoperative wound infection, the number one complication and essential cost driver in surgical patients,10 by 61%.11



The range of applications for our noninvasive technology is wide. CNAP® can be used wherever there is the need for continuous monitoring but no indication for invasive solutions. It is easy to use, practically without any risks and clinically proven with the same accuracy as invasive reference methods.

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References:

1. Lin WH (2013) Investigation on Cardiovascular Risk Prediction Using Physiological Parameters. Computational and Mathematical Methods in Medicine, 1–21.

2  Ilies C (2012) Detection of hypotension during Caesarean section with continuous non-invasive arterial pressure device or intermittent oscillometric arterial pressure measurement. British Journal of Anaesthesia, 3–9. 

3 Wagner JY (2017) A comparison of volume clamp method-based continuous noninvasive cardiac output (CNCO) measurement versus intermittent pulmonary artery thermodilution in postoperative cardiothoracic surgery patients. Journal of Clinical Monitoring and Computing, 1–10. 

4 Taylor KA (2017) Continuous Cardiac Autonomic and Haemodynamic Responses to Isometric Exercise. Med Sci Sport Exerc. Available from ncbi.nlm.nih.gov/pubmed/28350715

5  O’Driscoll JM (2018) Cardiac autonomic and left ventricular mechanics following high intensity interval training: A randomised cross-over controlled study. J Appl Physiol.  Available from ncbi.nlm.nih.gov/pubmed/29952247

6 Czuriga‐Kovács (2019) Hypertension‐induced subclinical vascular and cognitive changes are reversible—An observational cohort study. The Journal of Clinical Hypertension, 21(5):658–667. 

7 Wu TC (2018) Carotid Sinus Massage in Syncope Evaluation: A Nonspecific and Dubious Diagnostic Method. Arquivos Brasileiros de Cardiologia.

8  Makowiec D (2017) Multistructure index characterization of heart rate and systolic blood pressure reveals precursory signs of syncope. Scientific Reports, 7(1):419. 

9 Buszko K (2018) The complexity of hemodynamic response to the tilt test with and without nitroglycerine provocation in patients with vasovagal syncope. Scientific Reports, 8(1):14554. 

10 Manecke et al. (2014) Tackling the economic burden of postsurgical complications: would perioperative goal-directed fluid therapy help? Critical Care,18(5):566.

11 Benes et al. (2015) Fluid management guided by a continuous non-invasive arterial pressure device is associated with decreased postoperative morbidity after total knee and hip replacement. BMC Anesthesiology,15(1),148.