Thursday, September 8th, 2011
Septic shock is a leading cause of death in intensive care units. Survival depends on rapid diagnosis and aggressive therapy. The early recognition and support of blood circulation is a crucial intervention, which is well supported by a new hemodynamic monitoring solution, NavigatorTM from Applied Physiology. This assists clinicians to quickly diagnose and treat septic shock. View the clinical case study simulation to see how Navigator simplifies the management of septic shock.

Navigator™ is a hemodynamic monitoring package that simplifies the management of critically ill patients. A bedside clinical decision support system, NavigatorTM performs the complex calculations required to evaluate a patient’s circulatory state. The system provides continuously updated calculations of circulation volume, blood vessel muscle control and heart function, in patients who have lost circulatory control.

According to a study published July 2010 in the Archives of Surgery, sepsis and septic shock may be more common than heart attacks in patients who have undergone general surgery. The authors reported a death rate from septic shock of 34% within 30 days of surgery.

Diagnosis and early treatment of septic shock are challenging as the signs are subtle, and deterioration is often rapid. By providing continuous monitoring against circulatory targets, the Navigator system helps clinicians to spot the early signs of sepsis, leading to an early and definitive response to this threat.

A key strategy in managing septic shock is resuscitation with aggressive circulation volume replacement. Rapid and safe restoration of fluid volume is key in improving blood pressure and vital organ blood flow. Navigator provides immediate and continuous feedback on the patient’s response to treatments. Real-time, graphical feedback about the patient's status helps doctors and critical care nurses to interpret the effect of interventions and so, minimise the risks of both under or over treatment.

A clinical case study demonstrates by simulation how Navigator™ simplifies the care of septic shock. A 57-year-old woman presents at the Emergency Department with a 3-day history of increasing right loin pain and severe general malaise over 4 hours. When her low blood pressure does not respond to fluid infusion, hemodynamic monitoring is commenced and the monitors connected to the Navigator system. Soon the clinician has a clearer picture of the patient’s status and subsequent progress, and is able to start dealing methodically with the various issues until he is confident that the patient’s circulation is optimally supported.

The simulation shows how Navigator™ displays an insightful immediate picture of the patient’s circulatory status. The graphical interface supported the diagnosis of septic shock by displaying precise, real time assessments of cardiovascular status.

“When critically ill patients are connected to medical equipment to monitor breathing, blood pressure, heart rate and other functions, a lot of raw data is produced - this poses a major interpretative challenge for clinicians”, says Dr Mark Leaning, Applied Physiology founder and director. “We developed the Navigator system to assist clinicians in analysing key data, so that they can spot the early and subtle signs that a patient is developing complications and then, to understand how the patient is responding to treatment.”

Navigator™ is an example of a new generation of clinical decision support devices that simplify and enhance critical care delivery. The system, from Sydney based Applied Physiology, provides volumetric, peripheral circulatory and cardiac function information, which it automatically compares with clinician defined targets, so clarifying the picture of the patient’s progress and response to interventions.


Contact Profile

Applied Physiology

Applied Physiology Pty Ltd is an Australian owned, Sydney based clinical decision support software company. The company’s flagship product is Navigator™, a patented and innovative cardiovascular clinical decision support system designed to help intensive care unit (ICU) and operating theatre teams improve patient outcomes, increase safety and better manage costs in the critical care patient environment.

The efficacy and safety of Navigator™ were assessed in a multi-centre randomised trial in 112 patients recovering from open-heart surgery in seven leading Australian tertiary intensive care units (ICU). Results of the trial were published in the Anaesthesiology and Intensive Care Journal in March 2011, “Computer based haemodynamic
guidance system is effective and safe in management of postoperative cardiac
surgery patients

Navigator™ is currently available as a standalone device. A version suitable for embedding into the new generation of advanced bedside patient monitors is now being piloted with Philips Healthcare. These monitors connect to the hospital information system, improve clinical information access and simplify the physical critical care environment.

Navigator™ will be on display in the Applied Physiology and Philips Healthcare booth at the upcoming European Society of Intensive Care Medicine (ESICM) congress in Berlin, 1-5 October 2011.
Delia Dent
P: +61 410 575 123


Cardiovascular clinical decision support, hemodynamic monitoring, septic shock, critical care, intensive care unit, Navigatorâ„¢, Applied Physiology



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