One Monitor, One Disposable

Designed to support your clinical decision making

  • 3 in 1 hemodynamic monitor;
  • Non-invasive, minimally invasive and calibrated with BIS™ option;
  • PulseCO™ software & CNAP™;
  • ER and peri-operative settings.

 

The LiDCOunity monitor is a single platform which combines both the LiDCOplus and LiDCOrapid functions. This provides a single solution to monitoring needs throughout the hospital.

The clinician can choose which mode is most appropriate to the clinical situation. The LiDCOunity can be used non-invasively, minimally invasively with a radial arterial line and can be calibrated with the lithium dilution technique.

It is the only technology available that can be calibrated with a standard radial arterial line and without the need for a central line.

The LiDCOunity uses the PulseCO™ algorithm which converts blood pressure to its constituent parts of flow (CO, SV) and resistance (SVR).  The PulseCO™ algorithm is scaled to each patient with either the lithium dilution technique or the nomogram using age, height and weight.

LiDCOunity offers

  • 3 in 1 platform for monitoring in any clinical situation;
  • Non- invasive monitoring, minimally invasive monitoring via the radial arterial line, calibrated values
  • Very easy to set up and use;
  • Designed to be used to allow for early and prompt monitoring in sepsis;
  • The clinician can see why the blood pressure has changed which helps with important clinical decisions;
  • The LiDCOunity also provides parameters which help to decide when to start and stop giving fluid;
  • One disposable for both arterial line and non-invasive which is cost effective;
  • Depth of anesthesia monitoring with BIS™.

Refer to the screen guide tab for further insights into how the flexibility of the displays can help meet your needs

Application of LiDCO-Rapid in peri-operative fluid therapy for aged patients total hip replacement

Application of LiDCO-Rapid in peri-operative fluid therapy for aged patients total hip replacement

Patient Population
Total hip replacement.

LiDCO Monitor
LiDCOrapid fluid optimisation.

Trial Design
Randomised LiDCOrapid fluid optimisation vs conventional fluid management.

Outcome Impact
Lactate levels were significantly lower than seen in the conventionally managed subjects vasopressor requirements and complications were also significantly lower in the LiDCOrapid fluid optimized group.

OBJECTIVE
To explore a good strategy for fluid therapy, we observed the effect of application of LiDCOrapid on peri-operative hypotension and complications in aged patients undergoing total hip replacement, performed under combined spinal-epidural anesthesia (CSEA).

METHODS
Forty patients were randomly divided into normal fluid therapy group (group N) and LiDCOrapid guiding fluid therapy group (group L). For group N, anytime mean arterial pressure (MAP) was less than 65 mmHg, a rapid intravenous infusion of 150 ml hydroxyethyl starch solution (HES,130/0.4, 6%) was given. For group L, whenever stroke volume variation (SVV) was more than 10%, HES (130/0.4,6%) was also given to patients until SVV returned to normal limits. After administration of HES, MAP still less than 65 mmHg called for 25-50 μg of phenylephrine to be given to maintain normal MAP in both groups. Heart rate (HR), MAP and lactate level of arterial blood (LAC) was compared between the two groups as prior to anesthesia (T0); instantly (T1), 15 min (T2), 30 min (T3), 60 min (T4), 90 min (T5) after spinal anesthesia; and at the end of surgery (T6).

RESULTS
MAP and HR were significantly higher in group L than in group N at T4 to T6 (all P<0.05). LAC was significantly lower in group L than in group N at T5 and T6 (all P<0.05). Phenylephrine requirements and incidences of peri-operative complications were also significantly lower in group L than in group N (all P<0.05).

CONCLUSION
LiDCOrapid may be used in fluid therapy for aged patients undergoing total hip replacement.

Han G, Liu K, Xue H, Zhao P. Application of LiDCO-Rapid in peri-operative fluid therapy for aged patients undergoing total hip replacement. Int J Clin Exp Med 2016;9(2):4473-4478, www.ijcem.com /ISSN:1940-5901/IJCEM0010819

Lactate levels were significantly lower than seen in the conventionally managed subjects vasopressor requirements and complications were also significantly lower in the LiDCOrapid fluid optimized group.

RCT effect of peri-operative GDHT on cardiac surgery outcomes

RCT effect of peri-operative GDHT on cardiac surgery outcomes

Patient Population
Cardiac surgery.

LiDCO Monitor
LiDCOrapid goal-directed therapy (GDT) targeted cardiac index (CI).

Trial Design
Randomised GDT targeted cardiac index vs standard care.

Outcome Impact
Composite endpoint 30-day mortality and major postoperative complications reduced in the goal-directed therapy group (27.4% vs 45.3%) and GDT patients had less infections (12.9% vs 29.7%), a lower incidence of low cardiac output syndrome (6.5% vs 26.6%), reduced ICU (3 vs 5 days) and hospital stay (9 vs 12 days).

OBJECTIVES
To evaluate the effects of goal-directed therapy on outcomes in high-risk patients undergoing cardiac surgery.

DESIGN:
A prospective randomised controlled trial and an updated meta-analysis of randomised trials published from inception up to May 1, 2015.

SETTING
Surgical ICU within a tertiary referral university-affiliated teaching hospital.

PATIENTS
One hundred twenty-six high-risk patients undergoing coronary artery bypass surgery or valve repair.

INTERVENTIONS
Patients were randomized to a cardiac output-guided hemodynamic therapy algorithm (goal-directed therapy group, n = 62) or to usual care (n = 64). In the goal-directed therapy arm, a cardiac index of greater than 3 L/min/m was targeted with IV fluids, inotropes, and RBC transfusion starting from cardiopulmonary bypass and ending 8 hours after arrival to the ICU.

MEASUREMENTS AND MAIN RESULTS
The primary outcome was a composite endpoint of 30-day mortality and major postoperative complications. Patients from the goal-directed therapy group received a greater median (interquartile range) volume of IV fluids than the usual care group (1,000 [625-1,500] vs 500 [500-1,000] mL; p < 0.001], with no differences in the administration of either inotropes or RBC transfusions. The primary outcome was reduced in the goal-directed therapy group (27.4% vs 45.3%; p = 0.037). The goal-directed therapy group had a lower occurrence rate of infection (12.9% vs 29.7%; p = 0.002) and low cardiac output syndrome (6.5% vs 26.6%; p = 0.002). We also observed lower ICU cumulative dosage of dobutamine (12 vs 19 mg/kg; p = 0.003) and a shorter ICU (3 [3-4] vs 5 [4-7] d; p < 0.001) and hospital length of stay (9 [8-16] vs 12 [9-22] d; p = 0.049) in the goal-directed therapy compared with the usual care group. There were no differences in 30-day mortality rates (4.8% vs 9.4%, respectively; p = 0.492). The metaanalysis identified six trials and showed that, when compared with standard treatment, goal-directed therapy reduced the overall rate of complications (goal-directed therapy, 47/410 [11%] vs usual care, 92/415 [22%]; odds ratio, 0.40 [95% CI, 0.26-0.63]; p < 0.0001) and decreased the hospital length of stay (mean difference, -5.44 d; 95% CI, -9.28 to -1.60; p = 0.006) with no difference in post-operative mortality: 9 of 410 (2.2%) versus 15 of 415 (3.6%), odds ratio, 0.61 (95% CI, 0.26-1.47), and p = 0.27.

CONCLUSIONS
Goal-directed therapy using fluids, inotropes, and blood transfusion reduced 30-day major complications in high-risk patients undergoing cardiac surgery.

Osawa EA, Rhodes A, Landoni G, Galas FR, et al. Effect of Perioperative Goal-Directed Hemodynamic Resuscitation Therapy on Outcomes Following Cardiac Surgery: A Randomized Clinical Trial and Systematic Review. Crit Care Med. 2016;44(4):724-33. doi: 10.1097/CCM.0000000000001479.

Study showed composite endpoint 30-day mortality and major post-operative complications reduced in the goal-directed therapy group (27.4% vs 45.3%) and GDT patients had less infections (12.9% vs 29.7%), a lower incidence of low cardiac output syndrome (6.5% vs 26.6%), reduced ICU (3 vs 5 days) and hospital stay (9 vs 12 days).

Haemodynamic optimisation in lower limb arterial surgery: Room for improvement?

Haemodynamic optimisation in lower limb arterial surgery: Room for improvement?

Patient Population
High-risk peripheral vascular surgery.

LiDCO Monitor
LiDCOplus oxygen delivery (DO2) GDT target.

Trial Design
Randomised GDT vs standard care.

Outcome Impact
Significantly less fluid or adjusted all complications in the IGFT group.

BACKGROUND
Goal-directed therapy has been proposed to improve outcome in high-risk surgery patients. The aim of this study was to investigate whether individualised goal-directed therapy targeting stroke volume and oxygen delivery could reduce the number of patients with post-operative complications and shorten hospital length of stay after open elective lower limb arterial surgery.

METHODS
Forty patients scheduled for open elective lower limb arterial surgery were prospectively randomised. The LiDCOplus system was used for hemodynamic monitoring. In the intervention group, stroke volume index was optimised by administering 250 ml aliquots of colloid intra-operatively and during the first 6 h post-operatively. Following surgery, fluid optimisation was supplemented with dobutamine, if necessary, targeting an oxygen delivery index level ≥ 600 ml/min(/) m(2) in the intervention group. Central hemodynamic data were blinded in control patients. Patients were followed up after 30 days.

RESULTS
In the intervention group, stroke volume index, and cardiac index were higher throughout the treatment period (45 ± 10 vs. 41 ± 10 ml/m(2), P < 0.001, and 3.19 ± 0.73 vs. 2.77 ± 0.76 l/min(/) m(2), P < 0.001, respectively) as well as post-operative oxygen delivery index (527 ± 120 vs. 431 ± 130 ml/min(/) m(2), P < 0.001). In the same group, 5/20 patients had one or more complications vs. 11/20 in the control group (P = 0.05). After adjusting for pre-operative and intraoperative differences, the odds ratio for ≥ 1 complications was 0.18 (0.04-0.85) in the intervention group (P = 0.03). The median length of hospital stay did not differ between groups.

CONCLUSION
Peri-operative individualised goal-directed therapy may reduce post-operative complications in open elective lower limb arterial surgery.

Sepsis | Reduced mortality with noninvasive hemodynamic monitoring of shock

Sepsis | Reduced mortality with noninvasive hemodynamic monitoring of shock

Patient Population
ICU shock patients.

LiDCO Monitor
LiDCOplus.

Trial Design
Observational study comparing no hemodynamic monitoring vs pulmonary artery vs LiDCOplus managed shock patients.

Outcome Impact
Treatment of patients using the LiDCOplus monitor significantly reduced the observed mortality rate to 13% against 32% and 20% in the invasively monitored and 37% in the unmonitored patient groups.

PURPOSE
This study compared clinical outcomes associated with exposure to pulmonary artery catheters (PACs), central venous catheters (CVCs), arterial pressure waveform analysis for cardiac output (APCO), or no central monitoring (NCM) in patients with shock.

MATERIALS AND METHODS
We assessed 6,929 consecutive patients from 2003 to 2006 within a surgical intensive care unit of a university hospital, identifying 237 mechanically ventilated patients with shock.

RESULTS
Adjusted for severity of illness, use of APCO monitoring, compared with other options, was associated with reduced intensive care unit mortality (odds ratio [OR], 0.37; 95% confidence interval [CI], 0.18-0.77) and 28-day mortality (OR, 0.43; 95% CI, 0.22-0.85). Other monitors were not associated with changes of 28-day mortality (CVC: OR, 0.63; 95% CI, 0.34-1.17; PAC: OR, 0.78; 95% CI, 0.36-1.69) or were associated with increased risk (NCM: OR, 2.29; 95% CI, 1.14-4.61). There were significant differences in the fluid and vasoactive drug prescriptions among the groups.

CONCLUSIONS
This study supports an association between the use of APCO monitoring and reduction in mortality in shock compared with traditional methods of monitoring. Although it is impossible to exclude the role of unrecognized/unrecorded differences among the groups, these findings may result from differences in supportive care, directed by monitor technology.

Hata J, Stotts C, Shelsky C, Bayman E, Frazier A, Wang J, Nickel E. Reduced mortality with noninvasive hemodynamic monitoring of shock. J Crit Care. 2011;26(2):224.E1-8.

Treatment of patients using the LiDCOplus monitor significantly reduced the observed mortality rate to 13% against 32% and 20% in the invasively monitored and 37% in the unmonitored patient groups

The LiDCOrapid with continuous non-invasive arterial pressure (CNAP™) module provides continuous cardiac output non-invasively, without the requirement for an arterial line. The CNAP™ dual finger cuffs will provide a continuous, non-invasive pressure which is then analysed by the validated PulseCO™ algorithm to derive beat to beat hemodynamic data.

• LiDCOrapid with CNAP™ is safe and easy to use, allowing for effective hemodynamic management of all surgery types;

• The device allows for monitoring prior to induction as well as throughout surgery. This enables immediate fluid and drug management and the setting of hemodynamic baselines;

•CNAP™ is used with the PulseCO™ ‘pulse power’ algorithm which reliably tracks hemodynamic change in the presence of inotropes and vasoactive drugs.

• The CNAP™ dual finger cuff system is scaled to the brachial artery with an arm cuff to provide a reliable continuous absolute value for blood pressure.

• SVV, PPV, HR and change in SV will be comparable to those derived from an invasive arterial line.


CNAP™, How it works…

The CNAP™ uses a vascular unloading technique dates back to the Czech physiologist Jan Peňáz in the 1970s. It is the basic principle for detecting blood volume changes in the finger and transforming plethysmographic signals into continuous blood pressure information.

The dual finger cuff inflates and deflates to maintain a constant blood volume which produces a non-invasive pressure waveform. This is then individually scaled to the patient using a brachial arm cuff measurement.

For cardiac output monitoring, the continuous, non-invasive blood pressure waveform is analysed by the
validated PulseCO™ algorithm.

  • An infrared light source and sensor measure continuous blood volume in the finger;
  • The finger pressure cuff inflates and deflates to maintain a constant blood volume;
  • This counter pressure produces a continuous BP waveform;
  • An absolute BP via the brachial arm cuff is then used to scale this waveform to the brachial artery pressure;
  • The validated PulseCO™ algorithm derives SV, CO, SVR and SVV from the non-invasive waveform.

continuous non-invasive pressure, CNAP

LiDCO Calibration Guide – How to set up the disposables

View Video >
LiDCO Calibration Guide – How to set up venous access

View Video >
LiDCO Calibration Guide – Useful information

View Video >