Hemodynamic Monitoring is essential for Stroke Patients to Improve Outcome

Medical Need:

The WHO reports 15 million patients worldwide per year who are affected by stroke. 33% of them die and another 33% remain permanently disabled. 80% of all acute strokes are associated with an elevated blood pressure.^[1]

The treatment therapy within the first 24 hours onset after acute ischemic stroke is essential for the outcome: “Acute blood pressure variability within early hours of presentation to the emergency department is associated with an increased risk of death at 90 days.”^[1] Both high and low blood pressure are predictors for poor outcome and increase risk for early (14 days) and late death (6 months) by 3.6% and 3.8% respectively, for every 10 mmHg of systolic blood pressure below or above 150 mmHg.^[2]

Decreasing blood pressure in the acute phase of ischemic stroke results in poor neurological outcome.^[3] Also, remaining high systolic pressure during endovascular therapy under general anesthesia after acute stroke is a strong outcome predictor for the neurological results.^[4]

These facts make close-meshed, favourably continuous blood pressure monitoring, indispensable to increase outcome and decrease the mortality risk.

In many stroke patients, especially in severe cases, standard invasive continuous blood pressure monitoring by means of an arterial catheter is not indicated due to the donation of blood dilutive medication which makes noninvasive alternatives preferable.

 

Solution:

CNAP^® HD allows for completely noninvasive and continuous hemodynamic monitoring for patients after stroke and during endovascular therapy under general anesthesia.

The unique combination of continuous CNAP^® blood pressure, cardiac output and a dynamic fluid parameters (CNAP^® PPV/SVV) is a risk-free and cost effective tool to better manage patients’ hemodynamics after stroke.

 

Medical Benefit:

The noninvasive CNAP^® HD technology ...

• provides continuous monitoring, completely noninvasive in order to observe what happens in between two NIBP measurements and to obtain a trend view
• increases medical outcome
• reduces mortality risk

 

Economic Aspects:

• Better outcome decreases treatment and hospitalization cost
• CNAP^® HD saves time and cost as setup can be carried out by any healthcare professional, continuous values available only shortly after startup

• CNAP^® HD delivers more accurate and close-meshed information which helps reducing complications
• CNAP^® HD requires minimal training
• CNAP^® HD is cost saving through reusable sensors, causes no disposable cost

 

Devices designed for monitoring stroke patients:

• CNAP^® Monitor 500
• CNAP^® Partner Solutions

 

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See also:

• CNAP^® technology
• The power of continuity
• Bloodpressure today
• Clinical Information
• Clinical Relevance

 

Selected CNAP^® Applications:

• Anesthesia
• Fluid management
• Cesarean section
• Laparoscopic surgery

• Orthopedic surgery
• Vascular surgery

• Cardiological interventions
• Emergency medicine
• Pediatric surgery

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References:

[1] Stead L.G., et al. The impact of blood pressure hemodynamics in acute ischemic stroke: a prospective cohort study. International Journal of Emergency Medicine, 5:3 (2012).

[2] Leonardi-Bee, J. Blood Pressure and Clinical Outcomes in the International Stroke Trial. Journal of the American Heart Association. 33:1315.1320. Retrieved from View abstract here.. doi:10.1161/01.STR.0000014509.11540.66 (2002).

[3] Castillo, J., Leira, R., García, M. M., Serena, J., Blanco, M., & Dávalos, A. Blood pressure decrease during the acute phase of ischemic stroke is associated with brain injury and poor stroke outcome. Stroke; a journal of cerebral circulation, 35(2), 520–6. doi:10.1161/01.STR.0000109769.22917.B0 (2004).

[4] Davis, M.J. Anesthetic Management and Outcome in Patients during Endovascular Therapy for Acute Stroke. Anesthesiology, 116:396-405 (2012).