Competition Heats Up in Consciousness Monitoring

by James Cavuoto editor

The market for depth-of-anesthesia monitoring systems, currently dominated by Aspect Medical Systems Inc. with its BIS technology, is heating up. At least two new competitors have entered the market recently, potentially creating a new competitive landscape in the brain state analysis segment of the neurosensing market.

Cleveland Medical Devices Inc. recently introduced its WAVCNS index, based on the company’s NeuroSense monitor. Like BIS, WAV is based on analysis of EEG signals recorded from surgical patients and a 0 to 100 scale. In a pair of papers presented at the annual meeting of the American Society of Anesthesiologists, CleveMed investigators reported that WAVCNS outperformed BIS. The researchers attributed the performance difference to a 15-second time delay during induction that exists with BIS but not WAVCNS. BIS also uses unilateral monitoring, which CleveMed says hampers the intra-patient reproducibility.

WAV, which stands for wavelet-based anesthetic value, has been clinically tested in 300 patients. CleveMed says that its index correlates well with BIS when the patient’s state is stable or evolving slowly over time.

Everest Biomedical Instruments, the Chesterfield, MO engineering firm, markets a system called SNAP II to help assess level of consciousness. The SNAP index uses both high and low frequency EEG evaluated in real time. The SNAP II device supplements hemodynamic monitoring and clinical observations with the SNAP Index to facilitate patient management.

Meanwhile, Aspect Medical has not been standing still in the depth of anesthesia market. The company recently introduced BIS VIEW, Aspect’s newest stand-alone monitor. The monitor offers a color screen display with a soft-touch keypad and more compact design and simplified operation for clinical environments with limited room for monitoring equipment. Aspect also introduced BIS EPIC (Education Programs for Improved Care). BIS EPIC offers anesthesia providers access to learning resources that help optimize user education to achieve desired anesthesia goals and to maximize the value of BIS technology.

Earlier this month, Aspect announced it has entered into a multi-year licensing agreement with Shenzhen Mindray Bio-Medical Electronics Co., Ltd., a subsidiary of Mindray Medical International Ltd. to integrate Aspect’s BIS technology into Mindray’s patient monitoring systems sold globally. Mindray is a provider of patient monitoring systems in China and has a growing presence throughout Asia and Europe. BIS technology is available on Mindray’s Beneview T8 high end modular systems that were recently introduced to the market.

“We believe that this agreement with Mindray will be valuable as the market in China and other countries in the Far East continue to develop,” said Nassib Chamoun, president and CEO of Aspect Medical Systems. “This is an important step in strengthening our leadership position in brain monitoring and supports our commitment to expand the reach of the safety and quality benefits of BIS monitoring through alliances with leading original equipment manufacturers across the globe.”

According to Minghe Cheng, executive vice president of Mindray, the need to incorporate BIS technology into patient monitors was driven by demand from customers. “We believe that BIS is becoming widely recognized around the world as a standard component of anesthesia practice. We will be pleased to offer BIS to our customers though an integrated BISx solution with our BeneView T8 monitoring system,” said Cheng.