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The report generated by the B4C System has five sections that organize all information acquired and processed for a monitoring session. Refer to 12 technical documentation for further details regarding the analytical software.

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Report Header

The first report section, Figure 6.7-2, is a summary of the monitoring session information including patient identification, monitoring session identification, sensor and patient information, observations, and patient clinical context.

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Patient Identification:

this sub-section, Figure 6.7-3, contains all information to uniquely identify a patient.

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Info

ATTENTION - The appointment (ID) field title and meaning can be customized according to the organization you are working for (corporate account). Please consult your clinical engineering team if you have any questions.

Monitoring observations:

Figure 6.7-4 indicates how many observations were included in the monitoring session.

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Monitoring session information:

this sub-section, Figure 6.7-5, contains information that identifies the monitoring session.

  • UMI: monitoring session unique ID;

  • Beginning: start date and time of session;

  • Duration: how long the monitoring session took.

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Sensor unique identifier (UDI);

Figure 6.7-6 contains sensor and patient information

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The available options for patient position are in Figure 6.7-8

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Patient clinical context:

information entered by the health professional at the beginning of the monitoring session, Figure 6.7-9.

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Security watermark:

Figure 6.7-10 shows the safety feature printed throughout the report that indicates who, when and from which corporate account the report was generated from. This inhibits any unauthorized report replication.

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Report Footer

This report section, Figure 6.7-11, is included in every report page with relevant disclaimer plus

  • support email contact

  • support telephone

  • support web address

  • hospital name

  • UMI: report unique identifier

  • report page number

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Surrogate ICP waveform report

The second report section, Figure 6.7-12, is a summary of the monitoring session pulse morphology and relevant disclaimers.

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Estimated P2/P1 ratio variation in time:

This graph, Figure 6.7-13, is a summary of the surrogate waveform estimated P2/P1 peaks ratio for each minute of the monitoring period. Each blue line represents a minute of the monitoring session and the value of each in the graph scale, i.e., the estimated calculated ratio for that minute. Each lighter blue rectangle behind each blue line indicates the 95% confidence interval for that P2/P1 ratio estimation.

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Warning

WARNING - The B4C System does not replace a comprehensive clinical evaluation. The waveform output should always be evaluated by the clinician in conjunction with other clinical parameters or analyses

Minutes with observations

The purple box, Figure 6.7-14, in the summary graph is a visual representation for the minutes that the sensor operator included observations in them. The purple balloon indicates the minute nr. in which the observations were included.

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Duration of monitoring session

The total time of a monitoring session, Figure 6.7-15, is divided into four segments, Each time stamp is represented in an hour, minute and second format. In addition to this, in parentheses on the right side of the time stamp, the day that the timestamp is for. D0 represents the same day the monitoring session started. D1, and so on, are for the days after the monitoring session began. This is useful for multi-day monitoring sessions or sessions that start on one day and end on another day.

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Estimated P2/P1 ranges

On the right side of the graph, Figure 6.7-16, there is a visual aid that identifies minutes of the monitoring session for which the calculated P2/P1 ratio was above 1.2, between 1.2 and 0.8, and below 0.8.

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Disclaimers

Figure 6.7-17 contains important information and disclaimers that should be read by the clinician.

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Monitoring observations

The third report section, Figure 6.7-18, appears only for monitoring sessions that have had an observation included, will show the observation details for each minute that has an observation. It can be one to several pages depending on how many observations were made.

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b4c signal over time

Figure 6.7-19 shows the overall minute of surrogate ICP waveform pulses and the moments an observation was included.

Info

ATTENTION - A minute can have a maximum of six observations.

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Pulse morphology for the minute with observation(s)

Figure 6.7-20 shows the calculated average waveform of the minute with observation and respective parameters such as:

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Minute’s observations (Figure 6.7-21): this box contains the actual observations included for that minute. There can be a maximum of 6 observations. Each observation is numbered and includes the sensor and patient position informed by the operator at the moment of observation.

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Monitoring session results

The fourth report section, Figure 6.7-22, will show a minute by minute average surrogate waveform calculation for the whole monitoring session. Each subsection will have two swim-lanes for each 4 minutes of monitorization. It could be one to many pages depending on how many minutes the monitoring session lasted.

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b4c signal over time

The pulse by pulse swim lane will, Figure 6.7-23, show the actual pulse by pulse visual representation in a four minute timeline. The minutes with a purple box are the ones that have an observation and the grey circle depict the exact moment the observation happened. You will also have a view of any relevant trends as well as the timestamp for each minute.

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Pulse morphology - average per minute:

This minute by minute swim lane, Figure 6.7-24, will show, for each minute, the calculated average pulse morphology with associated waveform parameters, which from top to bottom are:

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Info

ATTENTION - you may see following messages will appear in place of the average pulse waveform and associated parameters

  • No Data - when no data for that minute was injected into the database

  • Insufficient signal quality - when less than half of the six 10 second blocks of that minute did not pass the SNR (signal-to-noise) filter

  • Insufficient sample size - at least half of expected pulses, based on derived BPM, were considered artifacts

  • Difference between P2/P1 statistically non-significant - WHEN the smallest of P2 or P1 confidence intervals is bigger than 20% of pulse’s max amplitude OR the smallest of P2 or P1 max amplitudes MINUS max between P2 or P1 min amplitudes is greater than 30% of smallest of P2 or P1 confidence intervals

  • Time to peak out of physiological limits - none of surrogate ICP pulses in that minute had a nTTP between 0 and 0.5

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Additional information

The fifth report section, Figure 6.7-25, which appears in the last page, contains more technical information for the entire monitoring session. It contains five graphs as explained below. This is typically used in researches or customer support context.

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b4c signal over time

Figure 6.7-26 shows the sensor’s pin deflection, in micrometers, for each waveform pulse during the total monitoring session.

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Derived heart rate graph

Figure 6.7-27 shows for each minute (each blue horizontal line) the calculated heart derived from the sensor waveform. The histogram on the right side shows the distribution of minute counts for each heartbeat range.

A blue rectangle behind each blue line indicates the confidence interval for each minute. The grey dotted line in the middle is the average derived heart rate for the whole monitoring session and the top and bottom red dotted lines represent two standard deviations from the average.

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Normalized time to peak graph

Figure 6.7-28 shows for each minute (each blue horizontal line) the calculated average normalized time to peak. The histogram on the right side shows the distribution of minutes count for each time to peak range.

A blue rectangle behind each blue line indicates the confidence interval for that minute. The grey dotted line in the middle is the average calculated normalized time to peak for the whole monitoring session and the top and bottom red dotted lines represent two standard deviations from the average.

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Monitoring session derived useful minutes graph

Figure 6.7-29 shows for each minute (each blue horizontal line) the quantity of useful pulses utilized for calculation of waveform associated parameters. The histogram on the right side shows the distribution of minute counts for each useful minutes count range. A red line represents a minute with insufficient useful pulses for any statistically representative calculation.

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Pulse amplitude graph

Figure 6.7-30 shows for each minute (each blue horizontal line) the calculated average pulse amplitude. The histogram on the right side shows the distribution of minute counts for each amplitude range.

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