(1595) Noninvasive Hemodynamic Monitoring Devices for Patients With Sepsis Across Michigan Hospitals

Introduction: Novel technologies can non-invasively measure hemodynamic parameters, facilitating cardiac output monitoring and dynamic assessments of fluid-responsiveness in patients with sepsis. There are several clinically validated non-invasive hemodynamic monitors available, but their uptake in clinical practice is unknown.

Methods: We conduct biyearly surveys of 69 hospitals participating in the Michigan Hospital Medicine Safety Consortium (HMS) Sepsis Initiative, a collaborative quality initiative sponsored by the Blue Cross Blue Shield of Michigan. Surveys are completed by each hospital’s HMS representative. The spring 2024 survey asked hospitals if they use non-invasive monitoring devices for managing patients with sepsis in their Emergency Department (ED) and/or Intensive Care Units (ICUs). A similar question was asked in spring 2023. Only non-invasive devices were included. Devices that require central venous or arterial catheters (e.g., Hemosphere, FloTrac) were excluded. Hospital urbanicity was determined using Rural-Urban Continuum Codes.

Results: 69/69 (100%) hospitals completed the HMS spring 2024 survey. Of these, 17 (24.6%) reported using at least one non-invasive monitor, with 2/17 (11.7%) reporting using >1 device. The most common device was vascular unloading or volume clamp finger cuff, with 10/69 (14.5%) hospitals reporting use. Other devices included: bioreactance (4, 5.8%), pulse wave transit time (3, 4.3%), and radial artery applanation tonometry (2, 2.9%). No hospitals reported using bioimpedence or wearable doppler. Most (16/17, 94.1%) hospitals reporting use of a non-invasive monitor were urban. In 2023, 18 / 69 (27.5%) hospitals reported using any non-invasive monitor.

Conclusions: One quarter of Michigan hospitals use non-invasive monitoring in patients with sepsis, and type of device varies across hospital. While such devices facilitate non-invasive hemodynamic monitoring, the low overall uptake and use of differing devices likely reflect the novelty of these technologies and limited data on their impact. More research is needed to understand how use of non-invasive hemodynamic monitoring affects patient outcomes.