Study Shows Cheetah Medical’s BIOREACTANCE® Technology May Be a Valuable Tool in Early Detection of Sepsis in Patients Who Present to the Emergency Department with Fever

Results from the first study of Cheetah Medical’s early triage protocol for sepsis were presented Saturday, May 16th, at the 2009 Society for Academic Emergency Medicine Annual Meeting in New Orleans. Sepsis is a life-threatening blood infection condition of increasing incidence that ranked 6th out of the Top 20 most expensive conditions treated in U.S. hospitals and 3rd out of the Top 20 most expensive conditions billed to Medicare in 2006. With more than 18 million cases of severe sepsis reported worldwide each year, it is one of the major causes of morbidity and mortality. Mortality rates in severe sepsis are as high as 28%–50%, equaling the number of deaths caused by acute myocardial infarction.

In this study, the Cheetah Medical NICOM® Noninvasive Cardiac Output & Hemodynamic Monitoring System was able to distinguish septic patients from non-septic patients using a rapid 5-minute BIOREACTANCE®-based, fully noninvasive, triage protocol. The protocol utilizes a change in patient position and measures the response of specific hemodynamic variables. These hemodynamic responses were found to be significantly different in septic patients as compared to patients who did not go on to develop sepsis.

Rakesh Engineer, MD, FACEP, Discipline Leader, Emergency & Undifferentiated Care at the Cleveland Clinic Lerner College of Medicine and the study’s Primary Investigator, said: "Patients presenting to the Emergency Department with sepsis syndromes have a very high mortality, from 25-45%. Early, aggressive diagnosis and initiation of therapy has been shown to markedly reduce mortality. Our data suggest that patients presenting with concern for infection may quickly and accurately be assessed for the presence of sepsis using BIOREACTANCE noninvasive hemodynamic monitoring and an orthostatic protocol.”

Emergency departments (EDs) are the first point of medical contact for septic patients. The most important development in the treatment of sepsis and its outcome has been ‘‘early goal-directed therapy’’ (EGDT) which demonstrated a significant reduction in mortality of about 45%. Yet, in order to implement EGDT, early recognition and hemodynamic optimization of the septic patient is required. It is also important to determine who is not septic, thus obviating unnecessary invasive tests and costs.

Michael Pinsky, M.D., Professor of Critical Care Medicine, Bioengineering, Cardiovascular Disease and Anesthesiology at the University of Pittsburgh Medical Center comments about the results: “It is always difficult to determine which patients presenting to an ED are more likely to rapidly deteriorate, and which will recover quickly. The risk of under-resuscitation of the unstable patient is increased mortality, morbidity and cost, while the risk of aggressive instrumentation and treatment in the stable patient is increased complications of the (invasive) procedures which are known to increase morbidity and cost. The study by Engineer et al. used a simple hydrostatic challenge to clearly identify which patients were in “compensated shock” and thus needed aggressive resuscitation. The relevance of this study is that it is the first to show, in an ED population, that the use of a rapid and noninvasive monitoring device can accurately identify occult cardiovascular instability. The clinical implications of these findings are potentially far-reaching.”

About Cheetah Medical

Cheetah Medical delivers accurate noninvasive cardiac output (CO), noninvasive blood pressure (NIBP), stroke volume variation (SVV), thoracic fluid content (TFC) and other vital hemodynamic monitoring parameters to provide continuous, clinically actionable information for fluid and drug optimization in acute and ambulatory care settings, including intensive care, emergency, perioperative care, dialysis and outpatient cardiology. The NICOM® Noninvasive Cardiac Output & Hemodynamic Monitoring System uses Cheetah Medical’s proprietary BIOREACTANCE® Technology, which has validated performance accuracy and faster directional changes compared to invasive CO measurement methods, with less potential costs and risks. Cheetah Medical worldwide headquarters are located in Tel-Aviv, Israel and its United States headquarters are located in Portland, Oregon. For more information, visit our website at http://www.cheetah-medical.com.