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Masimo (MASI) Reports SedLine's Psi & DSA Parameter Findings

Masimo Corporation MASI recently announced the findings of a prospective study published in Frontiers in Neurology. The study evaluated whether general anesthesia guided by Masimo SedLine Brain Function Monitoring parameters on Root could reduce the incidence of postoperative delirium (POD) in patients undergoing carotid endarterectomy (CEA).

The researchers found a significantly reduced risk of postoperative delirium, using a combination of SedLine’s Patient State Index (PSi) and Density Spectral Array (DSA) to guide anesthesia during the procedure, and concluded that patients "may benefit from the monitoring of multiple EEG parameters during surgery.” Notably, Psi is an index based on processed electroencephalogram (EEG), while the Density Spectral Array (DSA) represents the power of the EEG on both sides of the brain.

Study Objective

Per the study's authors, cerebral blood supply may be "severely disrupted" during CEA, and cerebral function is "highly vulnerable" to even brief changes in oxygen and blood supply, as well as to cerebral vascular diseases like carotid stenosis. POD is a "common yet serious" type of geriatric neurological dysfunction associated with poor short- and long-term prognosis and greater healthcare costs.

The duration of EEG suppression during surgery is associated with the incidence of POD. Noting this, researchers sought to investigate whether monitoring multiple processed EEG parameters simultaneously to guide anesthesia during CEA could positively impact the incidence of POD when compared to using a single parameter alone.

Study in Detail

The study authors enrolled 255 patients scheduled for CEA and randomly divided them into an intervention group (n=127, mean age 62) and a standard group (n=128, mean age 63). General anesthesia in the intervention group was managed using a combination of Masimo SedLine PSi and DSA monitoring (designed to reduce the risk of intraoperative EEG burst suppression); whereas in the standard group, PSi without DSA monitoring was used. Patients in both groups were monitored with continuous transcranial Doppler ultrasound and near-infrared spectroscopy. The primary outcome of the study was the incidence of POD during the first three days after surgery, measured using the Confusion Assessment Method. The postoperative hospital length of stay (LOS) and other neurologic complications were secondary outcomes. The EEG data obtained by SedLine to calculate the cumulative duration of burst suppression for each patient was independently reviewed by a team of neurophysiologists.

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The researchers discovered that the intervention group had a significantly lower incidence of POD than the standard group. In addition, patients in the intervention group spent significantly less overall time with EEG suppression and there was no significant difference in the incidence of other neurologic complications.

The study also found that patients, especially those exhibiting hemodynamic fluctuations or receiving surgical procedures that disrupt cerebral perfusion, may benefit from monitoring multiple EEG parameters during surgery.

Industry Prospects

Per a report published in Persistence Market Research, the global electroencephalography devices market is expected to see a CAGR of nearly 7% from 2020 to 2030. Factors such as the growing adoption of EEG devices in surgery centers, increase in the patient population of neurological disorders and several technological advancements in the field of EEG equipment are expected to fuel market growth.

Per company data, POD affects up to 60% of patients after major surgery, most common in the elderly and in up to 91% of the critically ill. POD prevention has been designated as a public health priority by numerous medical bodies, including the American Society of Anesthesiologists (ASA). The incidence of POD has been linked to both preoperative vulnerabilities and the cumulative duration of intraoperative EEG burst suppression. Hence, processed EEG monitoring during surgery, as found in the current study and others, may lower the rate of POD by assisting clinicians in minimizing the duration of burst suppression.

Given the market prospects, the recent findings on Masimo SedLine Brain Function Monitoring parameters seem strategic.

Other Notable Study Findings

In October 2021, Masimo announced the findings of an abstract presented at ANESTHESIOLOGY 2021 in San Diego. The study evaluated the use of Masimo PVi as part of goal-directed fluid therapy to guide intraoperative fluid administration during major oncosurgery, where lung ultrasonography is used to diagnose extravascular lung water (EVLW). The findings of the study demonstrated that the use of PVi as a dynamic, continuous method of managing fluid administration led to patients receiving less fluid and having fewer B-lines (a measure of EVLW), with no significant decrease in postoperative perfusion or oxygenation when compared to a central venous pressure-guided fluid administration protocol.

In September 2021, Masimo revealed the findings of a study published in the European Journal of Pediatrics that evaluated the feasibility of using Masimo EMMA Capnography on mechanically ventilated preterm infants (neonates). The study's findings demonstrated that the Masimo EMMA Portable Capnograph “may be considered an effective monitoring device” for mechanically ventilated neonates. However, EMMA does not have FDA clearance for neonates.

Share Price Performance

The stock has outperformed its industry over the past year. It has grown 21.8% compared with the industry’s 15.9% growth.

Zacks Rank and Key Picks

Currently, Masimo carries a Zacks Rank #3 (Hold).

A few better-ranked stocks in the broader medical space are GlaxoSmithKline plc GSK, Chemed Corporation CHE and BellRing Brands, Inc. BRBR, each carrying a Zacks Rank #2 (Buy). You can see the complete list of today’s Zacks #1 Rank (Strong Buy) stocks here.

GlaxoSmithKline has a long-term earnings growth rate of 5.8%. The company surpassed earnings estimates in three of the trailing four quarters and missed in one, delivering an average surprise of 15.3%.

GlaxoSmithKline has underperformed its industry over the past year. GSK has gained 14.6% compared with the industry’s 19.9% rise.

Chemed has a long-term earnings growth rate of 7.7%. The company surpassed earnings estimates in three of the trailing four quarters and missed in one, delivering a surprise of 5.6%, on average.

Chemed has outperformed its industry over the past year. CHE has gained 5.2% against the 35.9% industry decline.

BellRing Brands has a long-term earnings growth rate of 29.1%. The company surpassed earnings estimates in the trailing four quarters, delivering an average surprise of 23.2%.

BellRing Brands has outperformed the industry it belongs to in the past year. BRBR has gained 29.1% versus the industry’s 0.3% growth.

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