Patient monitoring  

Ultrasound blood flow monitor improves recovery time after surgery

18 September 2006

The CardioQ blood-flow monitor from Deltex Medical allows clinical teams to better manage patients during surgery and reduce complications. This shortens the time patients spend in hospital and results in large savings in the costs of patient care.

The monitor uses disposable ultrasound probes inserted into the oesophagus to determine the amount of blood being pumped around the body. It allows doctors to optimise blood flow with fluid and drugs and maintain oxygen supplies to the organs and tissues.

In a recent study published in the British Journal of Surgery, a hospital in England reduced by one third the recovery time taken by patients following major surgery. The patients at the Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust suffered fewer complications and were fit for discharge three days sooner than other patients.

The double-blind prospective randomised controlled trial followed 108 patients undergoing colorectal surgery. Patients using the CardioQ monitor were, on average, fit for discharge after six days and actually discharged after seven days.

Patients not using CardioQ were, on average, fit for discharge after nine days, three days longer. They were actually discharged after nine days, two days longer.

If all patients were healthy enough to leave hospital two days sooner, the UK National Health Service (NHS) could save up to £400 million per year. In addition, this figure does not include the additional costs of treating the significantly higher rate of clinical complications and unplanned use of critical care experienced by patients in the study’s control group not using CardioQ.

Comparison between this study and recent data released by the NHS Institute show that the average length of stay for patients using the CardioQ is almost half that of NHS averages; 8 days compared with 15 days.

A day in an NHS general or surgical ward costs up to £400 a day, depending on additional care required; in an intensive care unit it costs £1,200 or more. The potential productivity gains and financial savings to the NHS from reducing the length of hospital stay are huge.

The study’s main findings showed that patients using CardioQ:

  • were fit for discharge three days sooner (6 days versus 9 days)
  • were actually discharged from hospital two days sooner (7 days versus 9 days)
  • suffered significantly fewer post-operative complications (2% of patients using CardioQ versus 15% of patients in the control group)
  • did not require unplanned admission into the hospital’s critical care unit following surgery, versus 11% of patients in the control group (0% patients versus 11%)
  • tolerated food significantly earlier (2 days versus 4 days after surgery), which itself can speed up recovery

In addition to use of the CardioQ, the team at The Freeman Hospital has implemented an Enhanced Surgical Recovery Programme which also contributes to faster recovery times. 80% of patients undergoing colorectal procedures have keyhole surgery, compared to a national NHS average of just 5%, and 80% of its patients undergoing major colorectal resections are admitted on the day of surgery.

The monitor has been proven to reduce length of hospital stay in numerous different surgical specialities including orthopaedic, colorectal, cardiac and general surgery. It is estimated that it could benefit one million NHS patients a year.

CardioQ has shown both clinical and economic benefit in each of seven clinical trials published in leading peer-reviewed medical journals. The monitor costs £7,000 and the probes used in the trial cost £55 each. Savings from reduced length of stay mean each monitor pays for itself in days.

Mr Alan Horgan, Consultant Colorectal Surgeon at the Freeman Hospital, leader of the study said:“These results are remarkable. Everyone involved in surgery and NHS management should read this study.

“Fluid-balance during and after surgery is incredibly important to patient wellbeing. Being able to monitor and maintain balance more accurately with CardioQ has allowed us to take days off patient recovery time. We have proven that it is possible to save the NHS
both time and money, while also enhancing patient care.”
In January, the National Institute for Health and Clinical Excellence (NICE) declared the use of oesophageal Doppler monitors to be “standard clinical practice” yet this technology is currently used in only 2% of cases where patients and taxpayers could benefit.
The first NHS Trust to implement widescale use of the CardioQ during surgery, the Medway Maritime NHS Trust in Kent, undertook a comprehensive audit of the impact and delivered savings of over £1 million a year. It reduced length of stay by over three days per patient undergoing a broad range of surgical procedures — a saving of £800 per patient.

Ewan Phillips, Managing Director of Deltex Medical said: “CardioQ has now been proven to work in seven independent trials. This study has
shown once again that it benefits patients and can deliver dramatic improvements to hospital productivity and financial efficiency.
“In the current climate of financial deficits, embracing this technology should be a 'no brainer' for the NHS. There are two reasons why NHS Trusts should buy technology: to save money and improve patient care; CardioQ does both. If NHS Trusts are serious about enhancing patient care and significantly reducing their costs, they should prioritise adopting our technology.”

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