M. Geisen MD, F. Caliandro MD, M.E. Edsell MD, H. Meeran MD, M. Cecconi MD, S.N. Fletcher MD

St. George's Healthcare NHS Trust, University of London   

(click to read poster)

Excerpts:

    

Continuous hemodynamic monitoring with evaluation and constant re-evaluation by the ICU team is essential for optimal care of critically ill patients, in particular, patients after cardiac surgery. Determining changing cardiac performance, either after surgery or as a result of severe systemic insults such as sepsis (including intrinsic contractility and loading conditions), underlies the majority of treatment decisions in these patients. Older methodology, such as CVP or PAC monitoring, is fraught with inaccuracy and misinterpretation, and mounting evidence has shown echocardiography to be a superior method of evaluation. Consequently, transesophageal echocardiography (TEE) has become standard of monitoring care in complicated operative cases.

While TEE can provide the clinician with a direct visualization of cardiac performance, traditional TEE probes are large, cannot be left in place for long periods (re-evaluations require re-insertion and higher risk of oral trauma), are non-disposable requiring cleaning and processing, and are extraordinarily expensive with limited supply (hence, limited availability for use in the ICU). These aspects make traditional TEE suboptimal for use in the ICU. The Imacor TEE system has been developed specifically for hemodynamic TEE monitoring in the ICU to overcome the limitations of traditional TEE. It is the only FDA approved device that has disposable TEE probes that can remain in place in the patient for continuous evaluation for up to 72 hours, enabling clinicians to obtain information on cardiac performance and alter clinical management as needed.   

As a result of its distinct advantages for hemodynamic monitoring in the ICU, the ImaCor hTEE has become an essential tool in the intensivists' armamentarium at Vanderbilt University Medical Center and numerous other academic and VA hospitals nationwide. Consequently, our attending critical care physicians, fellows, and residents have completed training and already possess valuable experience with the ImaCor hTEE system and it's protocols. We have already seen its benefit in improving patient outcomes and lowering overall care costs.         

Harold Hastings PhD, Co-Founder and CTO

(Excerpted, please click to read full article) 

... the miniaturized, disposable ImaCor hTEE probe has been designed and cleared to remain indwelling for 72 hours and used successfully by intensivists in thousands of ICU patients - its use as a functional hemodynamic monitoring device has been reported in a November 2012 editorial by Philippe Vignon MD in Anesthesia and Analgesia:

"Recently, a miniaturized single-use monoplane TEE probe with limited imaging capability has been designed for a 72-hour esophageal insertion. This true functional hemodynamic monitoring device allows a serial qualitative assessment of central hemodynamics, which results in frequent therapeutic changes (Vieillard-Baron et al., unpublished results)." Vignon, P.   Anesthesia and Analgesia 2012; 115:999-1003.

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As the end of the year approaches, we look back on some ImaCor milestones: over 2,500 hTEE exams performed to date, a growing body of clinical cases, several emerging multicenter studies, and the installation of hTEE technology at numerous best-in-class academic institutions such as The Mayo Clinic, UPMC and Stanford. In addition to several new sites in the US, hTEE is now being used in hospitals abroad, including sites in Switzerland, the United Kingdom, Finland, and Germany. As it has gained traction with its simple three-view learning methodology, our hTEE approach has become an essential tool in the intensivist's armamentarium. 

Moreover, the clinical benefit and financial benefit of hTEE have become intertwined. Clinicians and administrators now see hTEE's impact on hemodynamic management, specifically improving care in the 20% of critically ill patients who consume over 80% of the ICU's resources. Christopher Hughes MD Vanderbilt University Medical Center agrees, "We have already seen its (hTEE) benefit in improving patient outcomes and lowering overall care costs."  To that end, we encourage our hospitals to undergo a rigorous new technology review in order to realize the financial benefit of implementing hTEE into ICU workflow. Through active support of their technology assessment programs, we are able to track how hTEE impacts patient care, clinical outcomes, and ICU cost savings.

We made significant investments in education in 2012, sharing best practices and physician training guidelines, offering a series of hTEE courses in the spring, and releasing the online ultrasound reading room tutorial. The culmination of these efforts was the inaugural hTEE symposium in Lisbon where eleven leading critical care physicians shared exceptional hTEE clinical evidence, including case series and multicenter studies.

Our engineering team made great strides in 2012, releasing progressive software updates that further simplified system usability and debuting ImaCor's next generation ultrasound platform, the Zura EVO. The EVO, with its touchscreen interface, represents a breakthrough achievement, continuing ImaCor's growing impact on patient care in the ICU.

Our 2012 accomplishments are the foundation of even greater advances that we will bring to you in 2013, including ICU workflow efficiencies, improvements in patient care, and reduction in department costs.

With warm regards,

Peter Pellerito

President & CEO

Nov 2012 Newsletter     

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