Continuous monitoring of glucose and lactate at the patient bed-side: increasing patient safety and comfort while freeing up staff-time.
Truly continuous monitoring of blood glucose levels eliminates the risk for trend gaps and enables proactive glycemic control. Continuous lactate surveillance ensures visibility on lactate trends which apart from offering prognostic information will also aid the evaluation of ongoing therapy.
EIRUS, in summary:
- Monitors two analytes simultaneously—glucose and lactate.
- Samples are analyzed every second and data is updated onscreen (at least every minute), numerically and as a trend curve—ensuring no gaps in trends.
- Saves staff time compared to frequent intermittent sampling.
- Highly accurate in a wide concentration-range*
- Integrated alarms and continually updated glucose and lactate values onscreen provide peace of mind.
- EIRUS uses a specialized catheter that acts as a conventional CVC, but is also used for monitoring.
It can therefore be used in patients who need a CVC anyway.
- Microdialysis does not require blood draws for analyte sampling, which means no need for anti-coagulants.
- Compact, portable and quiet.
- Easy to learn and intuitive.
- Sets up quickly and easily.
EIRUS and EIRUS Central Venous Catheter are registered trademarks of MAQUET Critical Care AB.
Maquet has received EC-certificate (Conformité Européenne) in Europe for the EIRUS system. EIRUS may be pending regulatory approvals to be marketed in your country.
*For details, see Technical Data
Microdialysis, a well-established technology, offers the opportunity to sample blood analytes with high accuracy and without drawing any blood.
EIRUS is a monitoring platform consisting of a monitor (1), specialized multi-purpose central venous catheter (2) and a disposable biosensor (4).
Continuous metabolic monitoring is enabled through the insertion of a specialized microdialysis (MD) central venous catheter.
Saline is infused through the microdialysis inlet (yellow arrow).
The saline passes under the semi-permeable membrane (3).
Small metabolites (blue and green dots) like glucose and lactate are in equilibrium between the blood and now created dialysate.
The dialysate is pumped through the microdialysis outlet (green arrow) and flows into the biosensor.
The dialysate is measured enzymatically in the sensor (4) and collected as waste (blue arrow).
Continuous Glucose Monitoring
Hyperglycemia is prevalent in critical care and worsens outcomes. Also hypoglycemia and glucose variability are associated with increased morbidity and mortality.1-4
Although glucose management has become standard in ICU treatment, applying adequate glucose control remains a challenge. Intermittent assessment methods such as arterial blood gas analyzers and hand-held glucometers may fail to detect fluctuations or hypoglycemic episodes. In addition, frequent blood draws may be inconvenient for the patient and adds to the workload of nursing staff. 5-6
Truly continuous glucose monitoring with EIRUS, displays glucose levels automatically, every minute, without additional blood draws*, and alerts staff when out-of-range values are detected. This allows for assessment of the patient’s glycemic condition at a glance, while at the same time offering greater patient convenience.
Continuous Lactate Monitoring
Lactate levels act as a warning signal in patients at risk. Changes in lactate levels can help to aid evaluation of ongoing therapy and the need for additional diagnostics and potential therapeutic interventions.7-8 Elevated levels of blood lactate (hyperlactatemia) are common in critically ill patients, and irrespective of the exact underlying mechanisms, generally reflect increased morbidity and mortality. Clinical studies underscore the importance of monitoring lactate levels and confirm that lactate-directed resuscitation therapy is beneficial in critically ill patients.7 Changes in lactate levels over time can be used in the assessment of the patient’s overall condition and response to therapy. Continuous monitoring with EIRUS tracks this important clinical parameter at a glance.
1. Taylor JH, Bellman GJ: Hyperglycemia in the intensive care unit: no longer just a marker of illness severity. Surg. Infect. 2005 (6): 233-245
2. Egi et al.: Hypoglycemia and outcome in critically ill patients. Mayo Clin Prox 2010, 85: 217-224
3. Egi et al.: Variability of blood glucose concentration and short-term mortality in critically ill patients. Anesthesiology 2006, 105: 244-252
4. Krinsley JS: Glycemic control in the critically ill – 3 domains and diabetic status means one size does not fit all! Critical Care 2013, 17:131.
5. Finfer S, Werneman J, Preiser J-C et al. : Clinical review: Consensus recommendations on measurement of blood glucose and reporting glycemic control in critically ill adults. Critical Care 2013, 17: 229
6. Aragon, D: Evaluation of nursing work effort and perceptions about blood glucose testing in tight glycemic control. Am J Crit Care. 2006 Jul;15(4):370-377
7. Bakker J et al. Clinical use of lactate monitoring in critically ill patients. Annals of Intensive Care 2013; 3:12
8. Schierenbeck F. Nijsten, M.W.N, Franco-Cereceda A, Liska J. Introducing intravascular microdialysis for continuous lactate monitoring in patients undergoing cardiac surgery: a prospective observational study. Crit Care 2014; 18(2): R56
|Monitor Unit:||Dimensions: 205 × 91 × 233 mm
Weight: 3.5 kg
IV pole mount capacity
|Adjustable audio alarms:||Glucose: below the hypoglycemia limit, below target, above target
Lactate: above target.
|Battery backup:||3 hours|
|Sensor:||maximum 4 days use|
|EIRUS Central Venous Catheter:||7 Fr. Effective length is 16 and 20 cm, maximum 30 day use. It has 3 lumens that can be used as a conventional CVC, and two lumens (inlet and outlet) and a semi permeable membrane for microdialysis sampling.|
|Analyzed samples:||Microdialysate (perfusion solution: saline)|
|Measuring principle:||Electrochemical biosensor with glucose oxidase and lactate oxidase|
|Measuring frequency:||Every second|
|Assay range glucose:||1-25 mmol/L, 18-450 mg/dL|
|Assay range lactate:||0.5-10 mmol/L, 4.5-90mg/dL|
|Accuracy glucose:||According to ISO15197-2003, Clarke Error Grid Analysis; 97.7%-99% in area A, 100% in area A+B1,2,4. Patients: 994 and 607 paired samples.1,2 Pigs: 213 paired samples, incl. 126 at glucose concentrations below 4.1 mmol/L.4|
|Accuracy lactate:||1609 paired samples were obtained in patients. Correlation coefficient was 91%, Bland-Altman: 0.02 mmol/L3.|
Supports External Communication
9-pin RS232 serial port. USB port.
EIRUS System Components and Order Numbers
|EIRUS monitor with built-in syringe compartment:||66 95 400|
|EIRUS sensor reader kit:||66 95 420|
|EIRUS sensor (5 pcs):||66 95 440|
|EIRUS central venous catheter (5 pcs):|
|16 cm||66 95 450|
|20 cm||66 95 452|
For professional use. Please read instructions for use.
1. Schierenbeck F, Franco-Cereceda A, Liska J. Evaluation of a continuous blood glucose monitoring system using central venous micro dialysis. J Diabetes Sci Technol. 2012 Nov 1;6(6):1365-1671.
2. Schierenbeck F, Öwall A, Franco-Cereceda A, Liska J. Evaluation of a continuous blood glucose monitoring system using a central venous catheter with an integrated micro dialysis function. Diabetes Technol There. 2013 Jan;15(1):26-31.
3. Schierenbeck F. Nijsten, M.W.N, Franco-Cereceda A, Liska J. Introducing intravascular microdialysis for continuous lactate monitoring in patients undergoing cardiac surgery: a prospective observational study. Crit Care 2014; 18(2): R56
4. Schierenbeck F. et al J Evaluation of Intravascular Microdialysis for Continuous Blood Glucose Monitoring in Hypoglycemia: An Animal Model. Diabetes Sci Technol 2014 July; 8: 839-844
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