Background
The management of blood pressure using vasopressor therapy is a fairly routine practice in the critical care setting. Most current bedside physiologic monitoring systems rely on audible alarms which are triggered when the patient’s blood pressure drops above or below the alarm thresholds, often resulting in undesirable fluctuations in blood pressure. Horizon Trends and ST Map were developed to provide meaningful and intuitive displays of actual clinical status to desired goals (Horizon Trends) and to make it easier to see any changes in the patient's ST segments.
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Purpose
The purpose of this study was twofold:
- Assess whether or not the presence of an innovative display on the bedside monitor called “Horizon Trends” can improve the clinical management of patients on vasoactive blood pressure support.
- Quantify the incidence of ST segment elevation or depression for critically ill patients on vasoactive blood pressure support.
Method
A total of 74 critically ill patients receiving titratable vasoactive medications for blood pressure support were used as study participants. Group 1 (N=30) used audible alarms for blood pressure management. Group 2 (N=21) used Horizon Trends in addition to the audible alarms. Group 3 (N=23) used both Horizon Trends and ST Map on the resting display. Information provided by this display was used to manage both the blood pressure and any ST segment changes in conjunction with the standard display. |  |
Results
Subjects in both the Horizon Trends group (Group 2) and the Horizon Trends/ST Map group (Group 3) had higher mean arterial blood pressures and spent more time within their target blood pressure ranges as compared to Group 1.
Conclusion
Horizon Trends displays data that can be useful for blood pressure management using vasoactive medications in a way that appears to improve clinical practice.
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