NICaS Solution

NICaS Solution is Suitable For

View our services +

Heart Failure

Providing caretakers with accurate information on patient hemodynamic status

Challenges

  • Determining the different causes of acute or chronic hemodynamic instability.
  • Over-or under-prescribing diuretics for the HF patient.
  • Viewing trends in hemodynamic status throughout the patient’s treatment period in the community setting or in the hospital.

    • Solutions

  • Trends in a hemodynamic profile are viewed on a specially designed screen that is easy to understand.
  • Decisions on which medication to administer are facilitated.
  • Our clients report a 95% decrease in readmission.

    • Hypertension

    Isolate the exact cause of hypertension based on each patient’s hemodynamic parameters

    Challenges

  • Only 1 in 4 adults (24%) with hypertension have their condition under control.
  • Current statistically based protocols are only partially successful in controlling hypertension (54%).
  • Very difficult to determine the underlying cause of HTN without a complete hemodynamic profile of the patient.

    • Solutions

  • Recent studies and customer experience show an improvement in hypertension control to above 90%.
  • Personalized treatment according to individual hemodynamic profiles.
  • Physicians can be more effective in prescribing the proper medication for hypertension.

    • Gestational Hypertension

    Determine the exact cause of hypertension for Preeclampsia management

    Challenges

  • Preeclampsia and eclampsia significantly increase the risks of maternal and perinatal adverse outcomes. These may include placental abruption, preterm birth, and low birthweight.
  • Preeclampsia management focuses primarily on maternal hypertension therapy. This can reduce the risk of severe hypertensive episodes and safely prolong gestation.
  • There is no accepted standard for the management of preeclampsia.

    • Solutions

  • With NICaS, physicians can more effectively prescribe the proper medication for the right cause of hypertension.
  • Enabling personalized treatment suited to the individual hemodynamic profile.
  • NICaS data can assist in eliminating hypertension as a risk factor that can cause complications during pregnancy: preeclampsia, etc.

    • Dialysis

    Determine patient’s body composition and the cause of intradialytic hypertension

    Challenges

  • Determining the patient’s dry weight level: How much fluid do you need to remove during the dialysis session.
  • Understanding the cause of intradialytic hypotension or hypertension events.
  • Determining what medication to prescribe in order to keep blood pressure stable during and after the treatment.

    • Solutions

  • Accurate dry weight – no guessing.
  • Easy to determine which medication to prescribe.
  • Significant decrease in intradialytic hypotension/hypertension events.

    • ICU/ICCU

    Determining the cause of hypertension or hypotension by each patient’s objective hemodynamic

    Challenges

  • Assess fluid status and fluid responsiveness.
  • Monitor and treat hypotensive/hypertensive patients.
  • Evaluate drug response and drug titration online.

    • Solutions

  • NICaS helps reduce the length of hospital stay and/or patient mortality.
  • Personalized treatment according to individual hemodynamic profiles: Stop guessing what medication to administer.
  • View trends of the hemodynamic profile on a specially designed screen that is easy to operate and understand.

    • Reducing Readmission & Hospitalization Rates for Heart Failure Patients

    Providing caretakers with accurate information on patient hemodynamic status

    How NICaS Helps Reduce Hospitalization and Readmission Rates:

    Utilizing NICaS technology, provided by NI-Medical, can effectively reduce hospitalization and readmission rates for heart failure, including reversions from outpatient settings back to the hospital.

    NICaS is accurate, and more importantly, it is consistent. This allows assessment of a patient’s clinical response to medication adjustments over time. NICaS enables medication titration not previously seen in these CHF patients.

    NICaS takes the guesswork out of managing difficult patients with heart failure. It facilitates expeditious optimization of these patients.

    NICaS helps to identify patients with impending heart failure before they reach the stage of decompensation, allowing the time to make the necessary adjustments that prevent deterioration.

    Using NICaS for the management of HF patients reduces Hospital Readmission Rate by over 90%.


    Heart Failure Hospitalizations In Numbers

    Heart failure is responsible for 11 million physician visits each year, and leads to more hospitalizations than all forms of cancer combined.

    The majority of hospital admissions for heart failure are, in fact, readmissions.

    Approximately 24% of the people discharged from the hospital with heart failure will be readmitted within 30 days. More than half of them will be readmitted within 6 months.

    Heart failure is the number one discharge diagnosis seen by Medicare. The direct and indirect costs of heart failure add up to about $40 billion annually.

    Infectious Disease

    Accurate and continuous info helps reduce risk of infection

    Challenges

  • Current protocols advise against mechanical ventilation. This makes managing severe patients extremely challenging due to missing tissue oxygenation parameters.
  • Limited knowledge about the virus requires closer patient surveillance.
  • Risk of medical team contamination.

    • Solutions

  • Closes the information gap to enable better treatment strategy.
  • Provides information remotely without risk to medical teams.

    • Skilled Nursing Facilities

    Determining the different causes of acute or chronic hemodynamic instability

    Challenges

  • Determining the different causes of acute or chronic hemodynamic instability.
  • Reducing the high readmission rates that cause revenue losses and star rating decreases.
  • Viewing trends in the hemodynamic status throughout the patient’s treatment.

    • Solutions

  • Better patient treatment: portable, safe, accurate and accessible hemodynamic monitoring.
  • Remote management: Cloud based central management platform allowing connection to EMR and remote analysis by specialists.
  • Our clients report a 60.5% cut in all cause related readmissions and 98% for CHF.

    • Pharma Clinical Trials

    NICaS helps speed up the drug development process

    NICaS Can Help You To:

  • Assess inclusion criteria
  • Obtain real-time dose titration information
  • Monitor cardiac safety in both cardiovascular and non-cardiovascular trials
  • Evaluate drug efficacy and safety
  • Support single- or multi-site clinical trials
  • Document desired and adverse effects of candidate compounds
  • Reduce total trial time by facilitating patient recruitment
  • Decrease time-to-market of successful compounds

    • NICaS unique technology:

  • Allows easy application with only two sensors
  • Secures the data transfer to the core lab
  • Accurately assesses the smallest hemodynamic changes

    • Special Request

    Let us know how NICaS can help you

    Our Team Is Here To Help

    We are here to provide you with more information, answer any questions you may have and create an effective solution for your NICaS needs. Just fill out the form below and we will get back to you soon.

    Treatment Protocol

    GOAL: Goal BP is ≤ 140/90 mmHg for patients without CKD or ≤ 130/80 mmHg for patients with DM or CKD. Goal Hemodynamics is the normal range shown in the hemodynamics status map (see Appendix B). A summary of the protocol for use by clinicians is also included (see Appendix C). Only Baystate Health approved providers will be involved in the BP treatment.

    Determination of hypertension etiology

    Based on the NICaS output, the definition of hemodynamic status is as follows (see Appendix B): Vasoconstricted: if Hypertensive and CPI<0.85 and TPRI>3000 and CI<2.85 Hyperdynamic: if Hypertensive and CPI>0.85 and TPRI<3000 and CI>3.6 Mixed Hemodynamic: if hypertensive and not vasoconstricted and not hyperdynamic as defined above

    Recommended action based on hypertension etiology

    If the patient's hemodynamic status is identified as Vasoconstricted:

    • Vasodilators: add/increase angiotensin-converting enzyme inhibitor (ACEI), angiotensin receptor blocker (ARB), alpha-blocker, or calcium channel blocker (CCB) without a negative inotropic effect. Consider direct vasodilators in resistant cases or HTN crisis.
    • Diuretics: reduce/stop if Hypovolemic
    • Beta-blockers: reduce/stop

    Definition of fluid status:

    • Hypovolemic: if SI<30 and (total body weight (TBW) low or TBW normal+pulmonary edema)
    • Hypervolemic: If SI>30 and TBW high

    Definition of cardiac function zones:

    • Zone A: SI>0.48*HR+13
    • Zone B: SI ≤0.48*HR+13

    If the patient's hemodynamics status is identified as Hyperdynamic:

    • Vasodilators: reduce/stop
    • CCB with negative inotropic effect: add/increase if in Cardiac Function Zone A
    • Beta-blockers: add/increase if in Cardiac Function Zone B
    • Diuretics: add/increase if Hypervolemic

    If the patient's hemodynamic status is identified as Mixed Hemodynamics:

    • Vasodilators: add/increase ACEI, ARB, alpha-blockers, or CCB without negative inotropic function. Consider direct vasodilators in HTN crisis.
    • CCB with negative inotropic effect: add/increase if in Cardiac Function Zone A
    • Diuretics: add/increase if Hypervolemic and reduce/stop if Hypovolemic
    • Beta-blockers: add/increase if in Cardiac Function Zone B

    General Recommendations

    • Titrate medications only after a new NICaS measurement
    • First treat hemodynamics category with the most severe state
    • Add only one medication at a time
    • RAASi is used if CKD and/or albuminuria
    • Patients could shift between hemodynamic categories following a change in medications

    Diuretics Recommendations

    • Thiazide is added if Hypervolemic or edema
    • Spironolactone is added if BP resistant (and potassium < 5)
    • Loop diuretics if CKD 3-5 or resistant edmea