BBI Contributing Editor

SAN FRANCISCO, California – The consolidation of equipment vendors was noticeable at this year's American Society of Anesthesiologists (ASA; Park Ridge, Illinois) meeting, with fewer booths and new devices being shown than in past years. We found some new technology on the Moscone Convention Center exhibit floor, some enhancement and refinement of previously announced technologies to make them more marketable and much development of web-enable personal devices that host medical applications.

This is becoming a market in which those companies with novel products in unsaturated markets are doing substantially better than the larger firms with broad product lines in mature markets. Telemetry, resuscitation, oximetry, EEG-index (BIS) monitoring and a few other segments will buck the trends, but most other segments will have difficulty until the market gets through its current slowdown.

Optical Sensors (Eden Prairie, Minnesota) was showing its works in progress, a series of three new oximeters that, like those from sector leaders Nellcor (Pleasanton, California) and Masimo (Irvine, California), are claimed to be motion-tolerant and sensitive enough to use in low-perfusion situations. One is a module that fits into a Compaq (Houston, Texas) Windows CE personal digital assistant that converts it into a pulse oximeter. This plug-in, when approved, is likely to cost less than $600 and be a hit with anesthesiology residents. OSI also was showing a new, small, hand-held oximeter and a portable, desktop unit about the size of Nellcor's new N-395.

Nonin (Plymouth, Minnesota) was showing its new PalmSat 2500 and FDA-approved, hand-held oximeter that run on either four AA alkaline batteries (for 100 hours) or a NiMH pack for up to 40 hours. This device runs less than $700 and has a fairly robust sensor that was motion tolerant during some heavy tapping we performed at their booth. Nonin includes an A/D converter in the sensor and, by digitizing at that point, eliminates the cable component of noise for the red and infrared signals sent back to the PalmSat 2500 oximeter. This device is clearly targeted at the "spot check" market more than the ambulatory monitoring or general ward application. Nonin also showed its 9840 series of oximeters with non-invasive BP and CO₂ detectors. These are clearly aimed at the pre-hospital, EMS market but were in the booth at ASA anyway.

Nellcor, however, is targeting some of its new oximeters at the ambulatory segment by including its Intouch system, a pager link that uses Data Critical's (DC; Seattle, Washington) pager technology with its oximeters, so that nurses carrying around a DC pager can be informed when a patient experiences either a desaturation or a false alarm. The combination of oximetry and paging ups the ante for the ambulatory segment of the hospital market, which is not already using telemetry systems that include oximeters. For now, nurse alarm notification gives Nellcor an application advantage in this segment, as long as the number of false alarms is low enough not to be objectionable.

Rounding out the new oximeters was the recently FDA-cleared cerebral oximetry unit by Somanetics (Troy, Michigan). This new unit adds pediatric application to the previously approved adult application. However, a price of about $20,000 limits the market that can purchase it, and it is not helped by having relatively costly sensors.

In terms of anesthesia computerized patient records (A-CPR), Agilent Technologies (Andover, Massachusetts) has exercised its option and acquired outright the Dr. Philip's Anesthesia Recording computer-based, interoperative charting system. Agilent also was showing new modules for modular bedside monitors that implement Aspect Medical's (Newton, Massachusetts) BIS monitoring. These were two significant enhancements to its perioperative product offerings. Agilent also showed the new OEM Pulsion less-invasive continuous CO module, and new A1 and A3 bedside monitors. The A1 and A3 join the current M3 and M4 portable monitors as part of a new family of products that will replace Agilent's aging modular products. Agilent had entered into an agreement with Deltex Medical earlier in 2000 for its trans-esophageal echo cardiac output technology, giving the company one of the most comprehensive offerings of invasive CO available from any competitor.

Another newcomer to the A-CPR market was Dynamic Healthcare Technologies' (Lake Mary, Florida) SurgiPlus product. The company was showing the first piece – the automated, interoperative record piece – of what it is planning to make a complete solution. Apart from the relative strengths or weaknesses of this first component, the lack of complementary pieces (which are not due until at least later this year) will limit most serious interest in the product, making it more of an early revelation of a work in progress than a viable product for those seeking to automate now.