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As a UK company, we are proud that Deltex Medical was awarded a NICE recommendation for the CardioQ-EDM. The UK National Institute for Health and Care Excellence (NICE) published guidance on CardioQ-EDM in 2011 that considered extensive clinical and economic evidence. The guidance showed that EDM guided fluid management can reduce postoperative complications and reduce the length and costs of hospital stays. This recommendation was exclusively for the use of the EDM to guide fluid optimization during surgery.

NICE recommended that “CardioQ-EDM should be considered for use in patients undergoing major or high-risk surgery or other surgical patients for whom a clinician would consider using invasive cardiovascular monitoring” and concluded that “the case for adopting CardioQ-EDM in the NHS,is supported by the evidence.” As a result of reducing complications and length of stay, NICE estimated savings of £1,100 ($1,750) per patient.

NICE states that ‘The “Case for Adoption” is based on the claimed advantages for introducing the specific technology compared with the current management of the condition… the technology has been found to offer advantages to patients and the NHS’. The evidence based used to form the conclusion of the NICE guidelines was based on randomized controlled trials in surgical procedures including: colorectal, cardiac and orthopedics.

The CardioQ-EDM is the only technology with a sufficient evidence base to support such extensive recommendation and guidance.

Recommendations:

  • 1.1  The case for adopting the CardioQ-ODM in the NHS, when used as described in 1.2, is supported by the evidence. There is a reduction in post-operative complications, use of central venous catheters and in-hospital stay (with no increase in the rate of re-admission or repeat surgery) compared with conventional clinical assessment with or without invasive cardiovascular monitoring. The cost saving per patient, when the CardioQ-ODM is used instead of a central venous catheter in the peri-operative period, is about £1100 based on a 7.5-day hospital stay.
  • 1.2  The CardioQ-ODM should be considered for use in patients undergoing major or high-risk surgery or other surgical patients in whom a clinician would consider using invasive cardiovascular monitoring.

Clinical Evidence:

  • 3.1 Clinical outcomes relevant to the use of the CardioQ-ODM are mortality, peri-operative complications, reductions in the use of central venous catheters, length of critical care and in-hospital stay and re-admission rates. Full details of all clinical outcomes considered by the Committee are available in the assessment report at http://guidance.nice.org.uk/MT/80

Conclusions:

  • 6.1   The Committee concluded that the available data support a clinical benefit and a cost saving when the CardioQ-ODM is used in patients undergoing major or high-risk surgery or other surgical patients in whom a clinician would consider using invasive cardiac monitoring.

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