Deltex Medical Share Discussion Threads

[nobbygnome] 13/4/2020 11:29

LOL I think we all know who is talking libellous b@llocks here...and it's not schloo!

[myosite] 12/4/2020 22:01

Schloo
You talk complete b@llocks

[schloo] 11/4/2020 10:17

Myosite is, of course and as ever, lying when he says ODM is not an ICU monitor

It is indeed an ICU monitor as well as a surgical one and has an unrivalled safety record in both settings. The BBC feature on the UCL ICU shows world leading doctors using this world leading technology on the front line to help CoVid patients. It will be interesting to compare their outcomes with those that choose not to use ODM after the dust settles

The insinuations about safety are, naturally, preposterous and precisely the sort of reason why the GMC would strike Myosite off if only they knew his real identity

Good to see that he has highlighted ODM's particular strength: ODM measures central blood flow. This is why ODM keeps getting the positive evidence in both surgery and ICU.

LID products do not measure central blood flow and keep on failing to get the evidence. This does not mean they have no value: if nothing else, they may tell doctors when to raise their games and deploy the ODM

Schloo

[nobbygnome] 11/4/2020 07:36

That's simple

1. ODM has been shown in multiple RCTs to be effective in surgery.
2. The DEMG monitor can make 3 different readings (ODM, PPW, HDIC) which to my knowledge is not true of any other monitor. It is therefore, a far more flexible bit of kit than any other monitor. For example the LID monitor only measures PPW.

[divmad] 10/4/2020 18:41

Nobby, what are the key USPs for Demg??

[nobbygnome] 10/4/2020 09:31

So just that everyone knows what sort of character buywell is, please see my post below copied from one of the LID threads. Truly shocking

'I have just seen further up the thread (post 170) where buywell changed his post to make my next post seem completely inappropriate and then quoted that post in his post! He made exactly the same post on the other thread (5607) and edited that one too. What a thoroughly despicable person he is and really sums up what sort of character he is. Even me as an old hack of posting on BBs is shocked at how low buywell will stoop. Absolutely disgraceful......'

[nobbygnome] 10/4/2020 08:38

It must be tough for LID shareholders to take that LID's monitor is a far inferior bit of kit, which is not really required at all!

[nobbygnome] 10/4/2020 08:33

But the DEMG monitor can be used for the same measurement as the Lidco monitor (link below). ODM is the correct solution in some cases but not all. However, no matter because then operatives can just switch to another method using the same monitor; the bottom line it is just a much more flexible bit of kit. There really is no need for a Lidco monitor at all as it doesn't add anything. And as for use in surgery, there are no RCTs which shows it works at all.......

[buywell3] 10/4/2020 04:21

Quite correct myosite which is why intra-aorta probes are a contraindication on Deltex website , perhaps others have not taken the need to read the list

It is quite long


buywell would say somewhat dangerous IMO rather than scary

However there could be another answer other than using old mechanical ventilators

04 APR 2020

RESPIRATORY HELMETS CAN DECREASE NEED FOR INTUBATION AND SPREAD OF COVID-19 VIRUS



Not many folks realize but going on a mechanical ventilator can cause VAP ventilator Acquired Pneumonia after around 48 hrs , a good job Boris did not have to go on one

Many die from VAP as a result

This full head helmet idea might gain traction




Perhaps someone from medical research.com can enlighten us


Check out that ODM damaged nose nasal polyps contraindication also guys

all IMO dyor

[myosite] 09/4/2020 22:28

The problem for ODM with IABPs is that they sit in the aorta where ODM measures central blood flow. They are however 1960s technology .......so is the ODM!!

Worth pointing out that the ODM is not an ICU monitor but a theatre based device which currently is a little scary to use with Covid in the upper airway

[schloo] 09/4/2020 08:56

I would respond to Buywell's latest post point by point except I can not see that he has any point

So, what about Intra-aortic balloon pumps (IABP) and the stream of drivel he has been sliming over the boards since being (yet again) shown for an ignorant fool?

The problem for ODM with IABPs is that they sit in the aorta where ODM measures central blood flow. They are however 1960s technology and barely used any more

Below is from the American Heart Journal in 2014

Temporal trends in the use of intra-aortic balloon pump associated with percutaneous coronary intervention in the United States, 1998–2008

Background

With conflicting evidence regarding the usefulness of intra-aortic balloon pump (IABP), reports of IABP use in the United States (US) have been inconsistent. Our objective was to examine trends in IABP usage in percutaneous coronary intervention (PCI) in the US, and to evaluate the association of IABP use with mortality.

Methods

Retrospective, observational study using patient data obtained from the Nationwide Inpatient Sample (NIS) database from 1998 to 2008. Patients undergoing any PCI (1,552,602 procedures) for a primary diagnosis of symptomatic coronary artery disease (CAD) and acute coronary syndrome (ACS), including non-ST elevation MI (NSTEMI) and ST elevation MI (STEMI), were evaluated.

Results

The overall use of IABP significantly decreased during the study period from 0.99% in 1998 to 0.36% in 2008 (univariate and multivariate p for trend <.0001). Patients who received IABP had substantially higher rates of shock compared to those who did not receive IABP (38.09% vs. 0.70%, p<.0001), which was associated with markedly higher in-hospital mortality rates (20.31% vs. 0.72%, p<.0001). However, IABP use significantly decreased in patients with shock (36.5% to 13.4%) and AMI (2.23% to 0.84%) (univariate and multivariate p for trend for both <.0001). A temporal reduction in all-cause PCI-associated mortality from 1.1% in 1998 to 0.86% in 2008 (univariate and multivariate p for trend <.0001) was also observed.

Conclusions

The utilization of IABP associated with PCI significantly decreased between 1998 and 2008 in the US, even amongst patients with acute myocardial infarction and shock



Just to put that in context: an average of 155,000 PCI patients a year and by 2008, the number of IABPs used had fallen from 1,500 a year to around 550. Extrapolating the trend suggests that approximately zero are used today

So to summarise the idiot's argument: no CoVid patients have IABPs, but if they did, the ICUs would struggle to use ODM on the DEMG boxes and would have to use the arterial line or impedance cardiography alternatives. Er, that's it

[nobbygnome] 09/4/2020 08:51

Price on the move. I feel a surge coming on.....or it could be my enlarged prostate!

[buywell3] 08/4/2020 22:45

Torreskid and Maxk

You won't get an answer on the other thread, perhaps you can share this with the rest on the other thread

buywell would be grateful to you


Noninvasive systems are presently not recommended for the hemodynamic monitoring of critically ill patients in the ICU. Such systems should be reserved for etc



See lower in the article in english



It does say they are OK for general ward use though, under the heading

Continuous hemodynamic monitoring. When and with what? ( just over half way through the article)



"Noninvasive systems could be used in the hospital ward or emergency service to confirm a preliminary diagnosis, to assess the course in lesser risk patients, or for monitoring prior to admission to the ICU. For the time being, the use of such systems is not recommended in application to more critically ill patients. In general, the greater the severity and complexity of the disease condition, the greater the need for intensive treatments and increased precision in the measures obtained–and such conditions are currently associated with increased invasiveness of the systems used.21"

21 is

J. Alhashemi, M. Cecconi, C.H. Hofer.
Cardiac output monitoring: an integrative perspective.
Crit Care, 15 (2011), pp. 214
| Medline

see




Also please note this supporting link which says :

''Conclusions

When it comes to blood pressure monitoring, arterial cannulation and PAC are the gold standards in acute and critical care settings. These are invasive procedures that provide accurate hemodynamic monitoring when compared to the non-invasive means.''

and

''Non-invasive methods are a great and safe alternative for hemodynamic monitoring in patients who are in critical or non-critical state. These are invasive procedures that provide accurate hemodynamic monitoring when compared to the non-invasive means.
These devices can serve as a great alternative to invasive monitoring of blood pressure in patients who are out of the critical stage or undergoing elective procedures.''

and this

''The interchangeability of TEDP and PAC methods for hemodynamic monitoring of cardiac surgery patients cannot be ascertained by data obtained in this study.''



1. Remember PAC is invasive and the Gold standard for ICU and Operating Room use

TEDP is Trans Esophageal Doppler Probe , ODM is considered to be minimally invasive , plus a new non invasive system was launched in 2017 after NICE said this:




'' It is now proposed that MTG3 is transferred to the static list until it is updated as part of a clinical
guideline. ''



May 4, 2017 - Deltex Medical Group plc (LON:DEMG) has launched a non-invasive High Definition Impedance Cardiography (HD-ICG) module in the UK

''"Noninvasive systems could be used in the hospital ward or emergency service to confirm a preliminary diagnosis, to assess the course in lesser risk patients, or for monitoring prior to admission to the ICU. For the time being, the use of such systems is not recommended in application to more critically ill patients. In general, the greater the severity and complexity of the disease condition, the greater the need for intensive treatments and increased precision in the measures obtained–and such conditions are currently associated with increased invasiveness of the systems used.''


all IMO etc

dyor and so on

[nobbygnome] 08/4/2020 21:31

LOL you can run but you can't hide buywell. Please see the very simple question on the LID thread. I am sure as a well researched LID investor you will have the answer at your fingertips...

TIA

[buywell3] 08/4/2020 21:23

Torreskid

You won't get an answer on the other thread, perhaps you can share this with the rest on the other thread

buywell would be grateful to you


Hemodynamic monitoring in the critically patient ...www.medintensiva.org › es-hemodynamic-monitoring-in-critically-pa...

Noninvasive systems are presently not recommended for the hemodynamic monitoring of critically ill patients in the ICU. Such systems should be reserved for ...



See lower in the article in english



It does say they are OK for general ward use though, under the heading

Continuous hemodynamic monitoring. When and with what? ( just over half way through the article)



"Noninvasive systems could be used in the hospital ward or emergency service to confirm a preliminary diagnosis, to assess the course in lesser risk patients, or for monitoring prior to admission to the ICU. For the time being, the use of such systems is not recommended in application to more critically ill patients. In general, the greater the severity and complexity of the disease condition, the greater the need for intensive treatments and increased precision in the measures obtained–and such conditions are currently associated with increased invasiveness of the systems used.21"

21 is

J. Alhashemi, M. Cecconi, C.H. Hofer.
Cardiac output monitoring: an integrative perspective.
Crit Care, 15 (2011), pp. 214
| Medline

see






dyor

[torreskid] 08/4/2020 14:54

Where is this quote
"Noninvasive systems are presently not recommended for " from???

utter non-sense.....when reliable as Invasive monitoring, then 10 out of 10 intensivists will prefer non-invasive monitoring (as I previously mentioned, the risks of serious hospital acquired infections outweighs the small advantage of direct invasive monitoring)

The minute a patient is admitted to ICU, then the odds are stacked against them (<40% survival rates)

Plus ODM is a useful alternative for many high risk operations

[nobbygnome] 08/4/2020 07:25

Yes buywell is embarrassing himself and committing libel on a regular basis. I will try my upmost to ensure he gets his comeuppance!

He is a troll of the very worst sort....

[buywell3] 08/4/2020 02:54

buywell just watched the latest BBC News program about Covid-19 ICU treatment

In it a CPAP ventilator was shown with a FULL FACE MASK covering nose and mouth

Regarding mechanical ventilation a FULL FACE MASK was also shown

A nurse was also shown conscious and talking whilst on oxygen wearing a FULL FACE MASK covering her nose and mouth

Question:

How do you insert a ODM probe down the throat of a patient (via the nose or mouth usual routes) when they are on oxygen or a ventilator wearing a FULL FACE MASK as these patients were on the latest BBC News ?

[maxk] 07/4/2020 21:13

buywell37 Apr '20 - 17:07 - 5570 of 5571
0 0 1

But not forgotten by the Heath Care Services around the world at this point in time.

It is becoming evident that many ICU patients with Covid-19 are suffering heart damage

Other organ damage has also been noted in China, Italy and countries that have suffered many deaths from this disease.

The case for Hemodynamic Monitoring in ICU's for Covid-19 patients is proven and orders for monitors are flooding in .

Invasive Hemodynamic Monitoring is the prefered method for ICU patients , particularly those on ventilators .


"Noninvasive systems are presently not recommended for the hemodynamic monitoring of critically ill patients in the ICU. Such systems should be reserved for patients with less serious conditions and/or for patients admitted to the hospital ward or emergency service. "

ODM types are classed as minimally invasive here


So those are more suited to non ICU use IMO

LiDCO makes invasive monitors which were developed in St Thomas' Hospital were Boris is now in the ICU

get well
Boris

dyo



Comment:

mrC2u7 Apr '20 - 19:09 - 5571 of 5572
0 1 0

Lidcorapid makes most of the money and is non-invasive and LID pumps LidcoPlus as minimally invasive and has done for 20 or more years

So you have shot yourself in the foot yet again you ridiculous, pumped up idiotic buffoon

Probably a lot easier target than your brain

SHUT UP

MrC

[mrc2u] 07/4/2020 19:02

Look at the BBC news clip you ridiculous, stupid, idiotic, pumped up buffoonYou made stuff upYou got rumbledAgainNow SHUT UPMrC

[nobbygnome] 07/4/2020 15:36

Yes DEMG is clearly undervalued.......whilst LID is clearly overvalued!

[buywell3] 07/4/2020 15:36

buywell awaits a video clip showing how an ODM probe from any manufacturer that use these can be used when a full face mask ie covering nose and mouth , is used for ventilation purposes.

For buywell this ventilation issue is going to prove pivotal re Covid-19

buywell is of the opinion that because ODM probes can't be inserted through a standard full face mask, then other Hemodynamic monitors from other manufacturers will have to be be used.

Then there is the issue of Covid-19 virus ODM probe contamination

It has started

ICU Health care professionals are now dying from Covid-19 after acquiring it whilst bravely working in ICU's saving patients lives.

It will happen more and more because Covid-19 is such a contagious disease within the stressed and hectic ICU environment .

EVERYTHING must be done to reduce virus exposure to ICU staff

buywell is of the opinion that in a ICU an ODM probe from any manufacturer ,(there are now several), when being withdrawn from a Covid-19 patient or indeed one who might be Covid-19 but has not been tested as such because they did not show symptoms (people may be sick with the virus for 1 to 14 days before developing symptoms), such Covid-19 contaminated probe becomes a danger to all ICU staff in that ICU area.

All IMO

dyor

[euclid5] 07/4/2020 15:32

NobbyG - surprised the market hasn't bought into Demg yet and market cap is low - £7m