Uscom - Model 1A - Non-Invasive Doppler monitoring Device with Advanced Hemodynamics

The USCOM 1A non-invasive Doppler monitor with advanced hemodynamics provides rapid, reliable and repeatable serial hemodynamic monitoring for personalized management of fluid, sepsis, heart failure and hypertension. The USCOM 1A is validated from 0.12 l/min to 17 l/min and from 26 weeks gestational age to 110 years.

Primary Applications

Preload - Fluid management, fluid responsiveness and fluid optimization; when to start and when to stop fluid.

Sepsis - Hemodynamic status, including DO₂, Stroke Volume (SV) and Cardiac Output (CO) optimization.

Shock - Shock differentiation with identification of underlying hemodynamic derangements.

Cardiac Function - Assessment of systolic function, heart failure and cardiopulmonary exercise testing.

Hypotension - Differentiate and identify SVR and CO/SV derangement.

Hypertension - Differentiate and identify SVR and CO/SV derangement.

Primary Markets

Pediatrics - Identifies distinct patterns of shock and monitors therapy. USCOM 1A is applicable for fluid, sepsis and shock management and systolic function assessment of cardio toxic oncology patients. More info

Critical Care Medicine - Less than 50% of ICU patients given fluid boluses are volume responsive. USCOM 1A provides non-invasive Stroke Volume monitoring to increase sensitivity and specificity in excess of 90%. USCOM 1A is applicable for hemodynamic and ventilation management in the Medical and Surgical ICU, the stepdown unit and outreach. More info

Emergency Medicine - USCOM 1A provides front line hemodynamic assessment and detection of hypotension, shock differentiation, early sepsis management, triage and retrieval. More info

Perioperative Medicine - Normal Cardiac Output pre-anesthesia improves anesthetic outcome. Perioperative fluid and hemodynamic optimization improves recovery time and patient outcomes and reduces cost. USCOM 1A is used for pre-operative assessment, perioperative management and post-surgical monitoring. More info

Maternal Medicine - Pre-eclampsia occurs in 3-5% of all pregnancies which results in poor maternal and fetal outcomes and is responsible for 15-20% of all maternal deaths. USCOM 1A detects early pre-eclampsia and is used in Maternal-Fetal and IVF clinics and the Maternal ICU for gestational hypertension, intrauterine growth retardation. More info

Neonatology - Neonatal sepsis is a leading cause of infant death. The quicker an infant receives treatment, the better the outcome. Serial measurement of SVI, CI and SVRI monitors hemodynamic changes and identifies optimal therapeutic response. More info

Additional Markets

Liver Transplantation - Massive fluid shifts of intravascular volume and high blood loss characterise liver transplantation surgery and require monitoring of Stroke Volume and Cardiac Output.

Outpatient Clinic - Non-invasive, rapid and reproducible assessment of hemodynamics in the Hypertension, Heart Transplantation, Heart Failure and Maternal-Fetal clinic.

Drug Trials - Implantation of a device or administration of drugs requires CO monitoring.

Veterinary Practice and Animal Research - The non-invasive USCOM 1A is an ethical alternative for measuring circulation in animals from mice to gorillas.

Benefits

USCOM 1A is an advanced non-invasive, specialized Doppler ultrasound device designed specifically for rapid, reliable and reproducible optimization of the circulation, in the most cost effective way.

ACCURATE

• Sector leading validation
• When to start and when to stop fluid
• Confident SV guided fluid management
• Appropriate inotrope and vasoactive management by SV monitoring
• Confidence to change the way you see and manage hemodynamics

NON-INVASIVE

• Reduced risk of infection with safe and accurate Doppler ultrasound
• For neonates, children, pregnant women and the elderly
• For healthy subjects and awake or anesthetized patients
• Measures right and left sided CO

PORTABLE

• Advanced hemodynamics available at every bedside
• Move to the Emergency department, ICU, general ward or clinic
• Training and operation by physicians, nurses or paramedics
• Rapid assessment and differentiation of hemodynamics
• Rapid and targeted intervention

COST

• Multiple measurements as often as required
• Cost doesn`t compromise clinical decision
• Reduced costs - reduced stay and no disposables

USCOM 1A compared with Echocardiography

• Uscom sensitivity of 5% for measurement of SV change
• LVOT algorithm reduces Echo LVOT diameter variability and exam time
• Uscom FlowTracer reduces operator variability and reduces exam time
• Multi-beat averaging increases accuracy compared with single beat measurement
• Excellent intra-operator reproducibility correlation (r=0.911)
• Integrated and advanced hemodynamic parameters of preload, inotropy and afterload
• Rapid acquisition time with instantaneous calculation of oxygen delivery parameters

USCOM 1A is a non-invasive, transcutaneous Doppler ultrasound device designed to simplify acquisition and storage of high-fidelity measurement and trending information of cardiovascular performance. It uses state-of-the art electronics, high fidelity ultrasonics and advanced signal processing to deliver accurate and simple measurements of Cardiac Output. Advanced trend analysis and reporting are provided using the proprietary Uscom Reporter software. The USCOM 1A monitor provides an intuitive touch screen user interface allowing for instant access to both live and recorded information. The USCOM 1A monitor can store tens-of-thousands of patient files and weighs just 6 kilograms. The USCOM 1A is available with its own custom roll stand, making it highly portable and ideal for transfer from patient-to-patient or ward-to-ward.

Transducer

USCOM 1A uses high fidelity continuous wave Doppler to accurately measure cardiac blood flow. Continuous wave Doppler is the most accurate and reproducible ultrasound modality with a sensitivity to hemodynamic change in the order of 2-3%. Unlike pulsed wave Doppler, it is easy to use and more reproducible and doesn`t depend on accurate sample volume placement. Echocardiography is primarily focused on 2-D imaging, and has been validated to monitor cardiac morphology but not hemodynamics.

However Uscom has developed a custom application of continuous wave Doppler ultrasound, using unique divergent beam acoustics technology. This utilises a broad rather than focused ultrasound beam, making the USCOM 1A device easier to use and less user-dependent than previous Doppler devices. Uscom`s divergent beam transducer operates at a frequency of 2.2.MHz.

OXYCOM

OXYCOM provides real time, non-invasive, simple and safe oxygen delivery (DO₂) measurements. When circulation really matters, OXYCOM provides the answers. By measuring DO₂ with OXYCOM, it’s possible to target real circulatory optimization goals using fluid, inotropes and vasotherapies.

DO₂ is the goal of circulatory optimization, and this involves optimizing the underlying components of DO₂. OXYCOM allows rational and safe measurement and optimization of DO₂ and its components.

OXYCOM is useful in any environment in which normal circulation is critical or in disease where DO₂ may be deranged such as sepsis, heart failure, hypertension, trauma, anaesthesia, post-surgery etc.

Parameters

USCOM directly and accurately measures cardiac flow, either from the suprasternal notch, where aortic flow is measured, or parasternally, where pulmonary flow is measured. By adjusting the location and angle of the USCOM 1A transducer, the operator optimizes the signal following visual cues from the USCOM 1A display.

Vpk: Peak Velocity of flow
vti: Velocity Time Integral
HR: Heart Rate
MD: Minute Distance
ET%: Ejection Time Percent
SV: Stroke Volume
SVI: Stroke Volume Index
SVV: Stroke Volume Variability
CO: Cardiac Output
CI: Cardiac Index
SVR: Systemic Vascular Resistance
SVRI: Systemic Vascular Resistance Index
Pmn: Mean Pressure Gradient
FT: Flow Time
FTc: Flow Time Corrected
SW: Stroke Work
CPO: Cardiac Power
SMII: Inotropy Index
PKR: Potential Kinetic Ratio
CVP: Central Venous Pressure
MAP: Mean Blood Pressure
SYS: Systolic Blood Pressure
DIA: Diastolic Blood Pressure
Height: Patient’s height in cm or inches
Weight: Patient’s weight in kgms or pounds
BSA: Body Surface Area
OTD: Outflow Tract Diameter

With the addition of the OXYCOM product the following additional parameters are available:

SpO2: Oxygen Saturation
DO2: Oxygen Delivery
SVS: Stroke Volume Saturation
Hb: Hemoglobin

Measures can be saved individually or grouped and averaged over a 3, 7 or 14s period. The parameters are displayed as the value (v), the difference to the previously saved value (Δ) and the average of all values within the examination (avg).

The trend tab displays graphical information, that provides a simply assessed monitor of serial cardiac function.

The USCOM 1A displays 31 parameters of cardiovascular performance.

Seven are user entered values - Central Venous Pressure (CVP), Diastolic Blood Pressure, Systolic Blood Pressure, Oxygen Saturation (SpO₂), Hemoglobin (Hb), Height and Weight.

Oxygen Delivery (DO₂), Stroke Volume Saturation (SVS), SpO₂ and Hb are displayed and/or calculated when the OXYCOM option is enabled.

CPU

x86 compatible
Low Power
Fanless

ULTRASONICS

2.2MHz Transducer
< 100mW/cm² output
Digital signal processing with FFT
Custom IIR filters
Audio output

OPERATING SYSTEM

Microsoft CE
Uscom custom platform

BATTERY

Rechargeable Smart Battery (Li-lon)
Internal charger and removable
High capacity - over two hours, 8700mAh
Status monitoring
Industrial quality

DISPLAY

LCD TFT Flatscreen
12.1" active screen size
800 x 600 pixels
256k colours
LED backlight

TRANSDUCERS

Divergent beam profile
Reliable long term targeting
Ergonomic grip and handle
Reusable

COMMUNICATIONS

Ethernet - Network printing
USB - Local printing
USB - Flash drive export

POWER SUPPLY

Universal input voltage 100-240VAC
65W 15V output
Medically isolated and approved
Short circuit protection
Over voltage protection

TOUCHSCREEN

AccuTouch - 5 wire resistive
4096 x 4096 resolution

DATA STORAGE

More than 500,00 exams
Solid State Disk

DIMENSIONS

Height - 310mm
Width - 350mm
Depth - 180mm
Weight - 5.4kg

OPTIONS

Digital Connectivity - HL7
Printer
Roll stand
Pole mounting attachments

Fluid remains one of the most challenging clinical interventions and inappropriate administration has dire outcomes.

Sepsis is a medical emergency characterized by altered circulation, with death caused ultimately by circulatory failure.

Heart failure is the leading cause of death worldwide and early detection allows optimal management.

Hypertension damages the heart, vessels, brain and kidneys resulting in, at best, poor quality of life, while early detection and management of underlying hemodynamic derangements is crucial to improving therapy and outcomes.

USCOM 1A accurately measures blood flow, Stroke Volume and Cardiac Output, across the aortic or pulmonary valve. Regardless of whether the patient is in sinus rhythm, atrial fibrillation, on vasopressors, on and off ventilation or experiencing active autonomic regulatory changes such as in sepsis, USCOM 1A is reliable. This distinguishes USCOM 1A from blood pressure devices which display surrogates of flow derived from blood pressure measures.

USCOM 1A is improving management and saving lives in the neonatal, pediatric, critical care, emergency, perioperative, oncological, maternal and perinatal populations. Appropriate use of the USCOM 1A reduces mortality in septic shock patients.

Over 500 publications confirm the clinical utility of the USCOM 1A and demonstrate its outstanding reliability and reproducibility and role in clinical medicine - and it’s non-invasive.