Comment by IanN Commented Feb 26, 2014

Impact factor: 20

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Deltex have produced a new device- the ODM+.
This combines pulse pressure waveform analysis with traditional ODM signalling.
The PPWA element is slaved from whatever system one currently uses, and displays concurrently with the ODM trace.

Both can be used together to help with clinical decision making, or the ODM element can be used while anaesthetised, and the PPWA element after extubation if the patient cannot tolerate the ODM probe.

This device is interesting since it displays both PPWA and ODM concurrently, and shows the often contradictory (or at least confusing) relationships between stroke volume, stroke volume variation, and PPV with changes in patient position, tidal volume, fluid state etc. Previously, these relationships would only have been revealed if one used two separate monitoring technologies.

Whether this device simply adds \"more numbers\" to monitoring without \"better numbers\" is unclear to me at present, but it should give cause for thought that not all fluid monitoring devices (or PPWA algorithms) should be regarded as equal: it would be perfectly possible to arrive at completely different treatments using values derived from SVV or values derived from PPWA.

As yet, there is no published evidence for clinical benefit from combined ODM/PPWA guided management, but in the wake of the OPTIMISE study, I would expect similar trials to be carried out in due course.

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