OREANDA-NEWS. LiDCO (AIM: LID), the hemodynamic monitoring company, welcomes the recent publication of four studies that provide further evidence of the improved outcome benefits derived from the use of LiDCOrapid in high volume general and cardiac surgery. 

The Society of Critical Care Medicine journal has published a study evaluating the effects of goal directed therapy using LiDCOrapid in high-risk patients undergoing cardiac surgery. The randomised controlled trial involved 126 patients undergoing coronary artery bypass surgery or valve repair. The authors concluded that using LiDCOrapid in these high-risk patients for implementing a goal-directed hemodynamic therapy decreased major complications and also reduced ICU and hospital length of stay. The incidence of infection was reduced by 57% and the frequency of low cardiac output syndrome was reduced by 76%. This group stayed in hospital on average three days less than the standard treatment group. This is an important study, high-risk cardiac patients require hemodynamic and fluid management both in surgery and also post operatively in the ICU. Historically this has only been possible through using a highly invasive pulmonary artery catheter. The LiDCOrapid's minimal and non-invasive nature provides advanced monitoring while avoiding additional invasive catheter insertion.

The World Journal of Surgery recently published a large study examining the influence of an enhanced recovery programme using LiDCOrapid for the fluid management element on the outcomes of upper gastrointestinal cancer surgery in 252 patients. Oesophageal cancer surgery is frequently performed in malnourished patients who go on to have a higher incidence of surgical complications that impede recovery.  Both overall length of hospital stay and critical care length of stay were significantly shorter. Patients in the enhanced recovery group, where LiDCO technology was used, left hospital on average three days earlier.

Presented at the 11th Annual Academic Surgical Congress in the USA early this year and now having been peer-reviewed and published, a 394 patient study from a major hospital in the USA showed that implementing an enhanced recovery programme for elective abdominal surgery using intraoperative fluid management guided by LiDCOrapid resulted in a statistically significant decrease of two days in mean length of stay. In addition, the enhanced recovery group had a zero mortality rate compared to a 2.6% mortality rate in the standard care group. The authors also noted that the cost of surgery was less in the enhanced recovery group.

Finally in another of our key growth markets, China, a randomised control trial has been published assessing the application of LiDCOrapid for peri-operative fluid therapy for elderly patients undergoing total hip replacement under combined spinal-epidural anesthesia. Hemodynamic changes are relatively severe in these patients and usu-ally include incidences of low blood pressure and reduced organ perfusion that causes ischemia and complications. Clearly an optimal fluid management protocol is crucial for these patients in order to decrease the incidence of hypotension. Use of the LiDCOrapid to implement a simple fluid management protocol reduced the number of times pharmaceutical interventions were required while maintaining improved blood pressure, with the result that complications were significantly lower in the LiDCOrapid fluid managed group.

Commenting, Matt Sassone, Chief Executive Officer of LiDCO, said: "We continue to see a wealth of clinical evidence demonstrating the benefit of using LiDCO technology in multiple different high-risk surgery procedures from around the world. Having peer-reviewed journal published data substantiating the clinical effectiveness of LiDCOrapid in an expanding number of large volume surgical indications will help us as we seek to further commercialise the business."

Papers Referenced:

Eduardo A. Osawa; Andrew Rhodes; Giovanni Landoni; Filomena R. B. G. Galas; Julia T. Fukushima, 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 Apr; 44(4):724-33. doi: 10.1097/CCM.0000000000001479

A. Karran, J. Wheat, D. Chan, P. Blake, R. Barlow, W. G. Lewis. Propensity Score Analysis of an Enhanced Recovery Programme in Upper Gastrointestinal Cancer Surgery. World J Surg (2016) 40:1645-1654. DOI 10.1007/s00268-016-3473-6

Fitzgerald T, Mosquera C, Koutlas N, Vohra N, Lee K, Zervos E. Enhanced recovery after surgery in a single high-volume surgical oncology unit: Details matter. Surgery Research and Practice Volume 2016 (2016), Article ID 6830260

Guang Han, Kun Liu, Hang Xue, Ping Zhao. 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

About LiDCO Group Plc

LiDCO is a supplier of non-invasive and minimally invasive hemodynamic equipment to hospitals used to monitor the amount of blood flowing around the body and ensure that vital organs are adequately oxygenated. LiDCO's products facilitate the application of hemodynamic optimisation protocols for high risk patients in both critical care units and in the operating theatre. 

Increasingly clinical studies are showing that the optimisation of patients' hemodynamic status in high risk patients produces better outcomes and reduced hospital stay.  LiDCO's computer-based technology, developed at St Thomas' Hospital in London, has been shown to significantly reduce morbidity and complications, length of stay and overall costs associated with major surgery.

Key Products:

LiDCOunity: a hemodynamic monitor that combines the full suite of LiDCO technology (non-invasive, minimally invasive and calibrated technologies) into one platform. Designed to have the flexibility to adapt to a patient's changing acuity, the product enables clinicians to seamlessly transition between non-invasive, minimally invasive and calibrated hemodynamic monitoring.

LiDCOplus: a computer-based platform monitor used in the Intensive Care Unit for real-time continuous display of hemodynamic parameters including cardiac output, oxygen delivery and fluid-volume responsiveness (PPV% and SVV%).

LiDCOrapid: a cardiac output monitor designed specifically for use in the operating theatre for fluid and drug management. The monitor enables anaesthetists to receive accurate and immediate feedback on the patient's fluid and hemodynamic status - a key measure of overall well-being before, during and after surgery.  The LiDCOrapid provides:

·     early and rapid warning of hemodynamic change to aid choice of therapeutic route: fluid or drug

·     quantification of hemodynamic response guidance on effective delivery of fluids to ensure the right amount at the right time

The software incorporated into LiDCOrapid allows the LiDCOrapid monitor to co-display Medtronic's level of consciousness parameter ('BISTM')* and add the convenience of CNSystem's continuous non-invasive blood pressure monitoring ('CNAP')**. This addresses a growing requirement for non-invasive monitoring solutions that are more comprehensive and can effectively replace multiple single parameter monitors. 

LiDCOview: an easy-to-use graphical display of historical LiDCOplus and LiDCOrapid hemodynamic data.

*BISTM and Bispectral Index are trademarks of Medtronic registered in the US and foreign countries.

**CNAPTM is a trademark of CNSystems Medizintechnik AG.