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mostcare

MostCareUp is the only monitor able to follow, in real time and from beat to beat, even the slightest haemodynamic variations in the patient.

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MostCareUp

The patented algorithm based on the PRAM method (Pressure Recording Analytical Method) evaluates the cardiac output and many other haemodynamic parameters without any prior calibration. An immediate, customisable interface can display a broad set of information regarding the preload, afterload, cardiac contractility and efficiency, which have become vitally important elements in optimising the treatment of high-risk patients and in defining the best haemodynamic settings for patients with alterations in their cardiovascular systems.

Discover PRAM method

Advantages

MostCareUp is a reliable and efficient system that adapts to a wide range of patient types and clinical conditions.
Thanks to its rapid set-up, information can be obtained in real time and saved, reviewed and transferred for subsequent analysis.

simple

No calibration needed.
Intuitive, customisable interface.
No change in protocols in use.

quick

Constant monitoring with immediate results.
Rapid connection and set up.

versatile

Any peripheral or femoral artery.
Applicable to the widest range of patients.
Easily transferred from one patient to another.

innovative

Exclusive variables (CCE, dicrotic pressure, Ea).
Patented dynamic filter to guarantee the quality of the pressure signal.
Modern connectivity and data transfer systems.

reliable

Patented and validated algorithm.
Immediate response to even the smallest haemodynamic variations.
A wide range of clinical papers available.

convenient

Can be used on numerous patients without disposable nor added elements.
On Demand system adaptable to all uses.

PRAM method

A patented algorithm

pram2

PRAM (Pressure Recording Analytical Method) is an innovative method to analyse the pressure wave used in MostCareUp. It allows for constant and sensitive monitoring in real time of the slightest haemodynamic variations because it is based, heart beat by heart beat, only on the morphology of the arterial pressure wave. pram1

Each patient is unique and his haemodynamic condition can evolve rapidly. The shape of the arterial pressure wave is the result of a complex balance which depends on both the pairing of the cardiac function with the vascular system and their interaction with the respiratory system. The precise analysis of the shape of the wave obviates the need for calibration and preestimated data about the patient. It also identifies the dicrotic pressure and the Z(t) impedance of the cardiovascular system, even in cases of unusual pressure wave forms.

pram1

Haemodynamic variables

  • pressure
    Systolic, diastolic, mean and pulse pressure (PP) are measured with every heartbeat.
  • dicrotic pressure
    The value of the dicrotic pressure, gauged with precision at 1000Hz, provides information about the vascular condition and the ventricle-arterial pairing.
  • cardiac output
    The stroke volume (SV) is measured beat-by-beat and allows for the cardiac output (CO) to be calculated.
  • derived variables
    Systemic vascular resistance (SVR), cardiac power output (CPO) and oxygen delivery (DO2) are examples of the derived variables provided by MostCareUp.
  • CCE
    Cardiac cycle efficiency (CCE) is an exclusive variable which describes haemodynamic performance in terms of energy expenditure in the patient being monitored.
  • dP/dt max
    The maximum pressure variation compared to time (dP/dt max) is linked to the heart's contractility and also to the condition of the vascular system.
  • dynamic variables
    Pulse pressure variation (PPV) and stroke volume variation (SVV) during the respiratory cycle can be viewed simultaneously.
  • dynamic filter
    The shape of the pressure curve can be affected by resonance phenomena. The exclusive, dynamic filter in MostCareUp has been designed to automatically optimise the quality of the wave and to reduce these phenomena.

Markers and Trends

markertrend2

MostCareUp can display trends for many haemodynamic variables simultaneously. It is also possible to insert personalised markers during specific events (e.g. start treatment).

The do&check function was designed specifically to help the clinic when monitoring haemodynamic variations following specific treatments (e.g. fluid challenge).

Applications

The PRAM method requires no external calibration or anthropometric normalisation. MostCareUp can therefore be easily used on any patient who requires constant or occasional haemodynamic monitoring. More specifically, during haemodynamic instability or in the presence of acute clinical variations in high risk patients.

circleperioperative

Optimising the flow of fluids in high risk surgery patients has significantly reduced postoperative complications, recovery time and improved the outcome of the patients, thus resulting in substantially lower costs.

  • 4 Pearse R et al., Crit Care, 2005
  • 5 Lopes MR et al., Crit Care, 2007
  • 6 Vincent JL et al., Crit Care, 2015

circleintensive care and critical patients

Thanks to beat-by-beat analysis, the PRAM method is able to reliably recognise and monitor the haemodynamic changes resulting from the administration of vasoactive drugs and fluids, in real time and even in septic or traumatised patients.

  • 7 Vincent JL et al., Crit Care, 2011
  • 8 Franchi F et al., BJA, 2011
  • 9 Guarracino F et al., Crit Care, 2014
  • 19 Donati A et al., J Crit Care, 2014

circlecritical patient

The echocardiography is a gold standard technique to evaluate ventricular function. Some of the variables provided by MostCareUp (dP/dt max and CCE) supply a constant stream of information about the cardiac function in the critical patient.

  • 11 Scolletta S et al., Intensive Care Med, 2013

circlecardiac insufficiency

The beat-by-beat monitoring of haemodynamic variables like dicrotic pressure, dP/dt max and CCE guarantees a rapid and immediate evaluation of any clinical variations in the patient so that immediate action can be taken.

  • 12 Giglioli C et al., Eur J Heart Fail, 2011
  • 13 Pavoni V et al., J Anesth Clin Res, 2012/li>
  • 14 Barile L et al., J. Cardiothorac Vasc Anesth, 2013

Specific applications

Paediatric patient

  • 15 Calamandrei M et al., Pediatr Crit Care Med, 2008
  • 16 Ricci Z et al., Crit Care, 2014
  • 17 Garisto C et al., Paediatr Anaest, 2014

Aortic counterpulsation

  • 20 Zangrillo A et al., J Cardiothorac Vasc Anesth, 20101
  • 21 Gelsomino S et al., Eur J Cardiothorac Surg, 2012
  • 22 Onorati F et al., J Thorac Cardiovasc Surg, 2012

Ventilation

  • 18 McBride WT et al., J Cardiothorac Vasc Anesth, 2012

Interventional cardiology

  • 23 Romagnoli S et al., J Cardiothorac Vasc Anesth, 2010
  • 24 Giglioli C et al., World J Cardiovasc Dis, 2013

Obese patient

  • 19 Balderi T et al., Obes Surg, 2008

Hypothermia therapy

  • 25 Lazzeri C et al., Acute Card Care, 2014

Connectivity and data management

connettivita

MostCareUp supports the most advanced communication and data transmission standards. The patient’s parameters and freezer-frames can be saved to the machine’s memory or exported via the USB port. The data can also be transferred to the hospital’s platform using the HL7 protocol. The image on the display can be shared for monitoring or educational purposes via HDMI.

MostCareUp guarantees the maximum flexibility and cost efficiency thanks to the various ways in which it can be used. The On Demand version of the monitor can be activated for a single use or for periods of time to meet specific application needs. The Endless version allows an unlimited use of the system without additional cost.

Vytech

loghi

Vytech was founded in 2008 by Vygon Italia, in order to distribute worldwide the innovative Cardiac Output haemodynamic monitor MostCare, based on P.R.A.M. patented algorithm. MostCare is the result of a complex work of research and experimentation conducted in some of the most important national and international research establishments.

Primary application healthcare areas include: Anaesthesia, ICU, Paediatrics, Cardiothoracic and Vascular Departments, the Operating Room and critical applications as Sepsis and Resuscitation.

Vytech provides worldwide distribution, consultancy and training for a better use of the product, after sales service, education and clinical practice and expertise.

Contacts

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