Table of Contents

1. OVERVIEW OF CRITICAL CARE……………………………………………………… 1-1
1.1 Critical Care Staff …………………………………………………………………… 1-3
1.1.1 Intensivists………………………………………………………………. 1-3
1.1.2 Hospitalists……………………………………………………………… 1-4
1.1.3 Nurses……………………………………………………………………. 1-5
1.2 Critical Care Units…………………………………………………………………… 1-5
1.3 Emergency Departments…………………………………………………………. 1-8
1.4 Products and Equipment …………………………………………………………. 1-8
1.4.1 Invasive ………………………………………………………………….. 1-9
1.4.2 Noninvasive…………………………………………………………….. 1-9
1.4.3 Transport………………………………………………………………. 1-10
1.4.4 Medical Equipment Malfunctions………………………………. 1-10
1.5 Procedures Performed in the Intensive Care Unit ……………………… 1-12
1.6 Critical Access Hospital Designation ……………………………………….. 1-12
1.7 The Leapfrog Group ……………………………………………………………… 1-13
1.8 Healthcare Economics…………………………………………………………… 1-13
1.9 Demographics ……………………………………………………………………… 1-14
1.10 Managed Care……………………………………………………………………… 1-14
1.11 Mergers and Acquisitions ………………………………………………………. 1-18
1.12 Healthcare Worker Shortage ………………………………………………….. 1-18
1.12.1 Physician Shortage ………………………………………………… 1-19
1.12.2 Nursing Shortage …………………………………………………… 1-19
1.13 Group Purchasing Organizations ……………………………………………. 1-20
Exhibit 1-1: Critical Care Nursing Responsibilities………………………………………… 1-6
Exhibit 1-2: Community Hospitals in the United States, 2002-2012 ………………… 1-7
Exhibit 1-3: 2011, Personal Healthcare Service and Supply Expenditures
in the United States, by Category……………………………………………. 1-15
Exhibit 1-4: Population Forecast, by Age, 2010, 2020, and 2030………………….. 1-16
2. NEUROLOGIC MONITORING SYSTEMS MARKET ……………………………. 2-1
2.1 Clinical Overview……………………………………………………………………. 2-1
2.1.1 Traumatic Brain Injury ………………………………………………. 2-1
2.1.2 Stroke…………………………………………………………………….. 2-2
2.1.3 Cerebral Aneurysm ………………………………………………….. 2-3
2.1.4 Brain Tumors…………………………………………………………… 2-4
2.2 Intracranial Pressure Monitoring……………………………………………….. 2-5
2.2.1 Products and Technologies……………………………………….. 2-6
2.2.2 Market Analysis ……………………………………………………….. 2-8
2.2.3 Competitive Analysis ………………………………………………… 2-9
2.3 Cerebral Oximetry ………………………………………………………………….. 2-9
2.3.1 Products and Technologies……………………………………… 2-12
2.3.2 Market Analysis ……………………………………………………… 2-15
2.3.3 Competitive Analysis ………………………………………………. 2-17
2.4 Combined Market Analysis…………………………………………………….. 2-19
Exhibit 2-1: 2013, Selected Intracranial Pressure Monitoring Systems ……………. 2-7
Exhibit 2-2: Intracranial Pressure Monitoring Products, Market Forecast,
2012-2017 …………………………………………………………………………… 2-10
Exhibit 2-3: 2012, Intracranial Pressure Monitoring Products Market,
Share by Supplier…………………………………………………………………. 2-11
Exhibit 2-4: 2013, Selected Noninvasive Cerebral Oximetry Products…………… 2-16
Exhibit 2-5: Noninvasive Cerebral Oximetry Monitoring Products,
Market Forecast, 2012-2017 ………………………………………………….. 2-18
Exhibit 2-6: 2012, Noninvasive Cerebral Oximetry Products Market,
Share by Supplier…………………………………………………………………. 2-20
Exhibit 2-7: Neurologic Monitoring Systems, Combined Market Forecast,
2012-2017 …………………………………………………………………………… 2-21
3. BRAIN FUNCTION MONITORING PRODUCTS MARKET ……………………. 3-1
3.1 Intraoperative Awareness………………………………………………………… 3-1
3.2 Anesthesia Monitoring…………………………………………………………….. 3-3
3.3 Sedation Management ……………………………………………………………. 3-4
3.4 Cerebral Ischemia Monitoring…………………………………………………… 3-5
3.5 Costs ……………………………………………………………………………………. 3-5
3.6 Products and Technologies ……………………………………………………… 3-6
3.6.1 Covidien …………………………………………………………………. 3-6
3.6.2 Danmeter/Goalwick Holdings …………………………………….. 3-8
3.6.3 GE Healthcare/General Electric …………………………………. 3-8
3.6.4 Masimo…………………………………………………………………… 3-9
3.6.5 Medical Device Management …………………………………….. 3-9
3.6.6 Stryker……………………………………………………………………. 3-9
3.7 Market Analysis ……………………………………………………………………. 3-10
3.7.1 Market Drivers ……………………………………………………….. 3-10
3.7.2 Market Limiters………………………………………………………. 3-14
3.7.3 Market Forecast …………………………………………………….. 3-16
3.7.4 Competitive Analysis ………………………………………………. 3-16
Exhibit 3-1: 2013, Selected Brain Function Monitors and Sensors………………… 3-11
Exhibit 3-2: 2013, Healthcare Settings and Clinical Applications for
Brain Function Monitoring Products…………………………………………. 3-15
Exhibit 3-3: Brain Function Monitoring Products, Market Forecast,
2012-2017 …………………………………………………………………………… 3-17
Exhibit 3-4: 2012, Brain Function Monitoring Systems Market,
Share by Supplier…………………………………………………………………. 3-18
4. HEMODYNAMIC MONITORING PRODUCTS MARKET ………………………. 4-1
4.1 Pulmonary Artery Catheters …………………………………………………….. 4-1
4.1.1 Indications for Use……………………………………………………. 4-3
4.1.2 Utilization Debate …………………………………………………….. 4-4
4.1.3 Products and Technology………………………………………….. 4-5
4.1.3.1 Argon Medical Devices/
RoundTable Healthcare Partners…………………. 4-6
4.1.3.2 Arrow International/Teleflex…………………………. 4-6
4.1.3.3 Biosensors International……………………………… 4-6
4.1.3.4 Edwards Lifesciences…………………………………. 4-6
4.1.3.5 ICU Medical………………………………………………. 4-7
4.1.4 Market Analysis ……………………………………………………….. 4-7
4.1.5 Competitive Analysis ………………………………………………. 4-11
4.2 Noninvasive and Minimally Invasive Cardiac Output Monitoring ….. 4-11
4.2.1 Bioimpedance………………………………………………………… 4-11
4.2.2 Doppler Ultrasound ………………………………………………… 4-14
4.2.3 Fick Partial Rebreathing ………………………………………….. 4-16
4.2.4 Arterial Waveform Analysis ……………………………………… 4-16
4.2.5 Products and Technology………………………………………… 4-16
4.2.5.1 Cardiotronic/Osypka Medical……………………… 4-16
4.2.5.2 Cheetah Medical ……………………………………… 4-17
4.2.5.3 Deltex Medical…………………………………………. 4-17
4.2.5.4 Edwards Lifesciences……………………………….. 4-18
4.2.5.5 Fujifilm SonoSite/Fujifilm Holdings ……………… 4-18
4.2.5.6 Hemo Sapiens…………………………………………. 4-18
4.2.5.7 Innovision ……………………………………………….. 4-19
4.2.5.8 LiDCO ……………………………………………………. 4-19
4.2.5.9 Noninvasive Medical Technologies …………….. 4-19
4.2.5.10 Philips Healthcare/Royal Philips…………………. 4-20
4.2.5.11 Pulsion Medical Systems ………………………….. 4-20
4.2.5.12 Uscom ……………………………………………………. 4-20
4.2.6 Market Analysis ……………………………………………………… 4-24
4.2.7 Competitive Analysis ………………………………………………. 4-25
4.3 Combined Market Analysis…………………………………………………….. 4-25
Exhibit 4-1: 2013, Selected Pulmonary Artery Catheters ………………………………. 4-8
Exhibit 4-2: Pulmonary Artery Catheters, Market Forecast, 2012-2017 …………. 4-12
Exhibit 4-3: 2012, Pulmonary Artery Catheters Market, Share by Supplier…….. 4-13
Exhibit 4-4: How Impedance Cardiography Works……………………………………… 4-15
Exhibit 4-5: 2013, Selected Noninvasive and Minimally Invasive
Cardiac Output Monitoring Systems………………………………………… 4-21
Exhibit 4-6: Noninvasive and Minimally Invasive Cardiac Output
Monitoring Systems, Market Forecast, 2012-2017 …………………….. 4-26
Exhibit 4-7: 2012, Noninvasive and Minimally Invasive Cardiac Output
Monitoring Systems Market, Share by Supplier…………………………. 4-27
Exhibit 4-8: Hemodynamic Monitoring Products, Combined Market Forecast,
2012-2017 …………………………………………………………………………… 4-29
5. VITAL SIGNS MONITORING PRODUCTS MARKET …………………………… 5-1
5.1 Information Integration…………………………………………………………….. 5-2
5.2 Variable Acuity/Universal Beds ………………………………………………… 5-3
5.3 Connectivity…………………………………………………………………………… 5-4
5.4 Electronic Medical Records ……………………………………………………… 5-4
5.5 Patient Tagging ……………………………………………………………………… 5-5
5.6 Meaningful Use ……………………………………………………………………… 5-6
5.7 Health Level Seven Conformance…………………………………………….. 5-7
5.8 Wireless Medical Telemetry Service………………………………………….. 5-7
5.9 Mobile and Wireless Applications……………………………………………… 5-8
5.10 False Alarms ……………………………………………………………………….. 5-11
5.11 Vital Signs Monitoring Products, Market Analysis ……………………… 5-11
5.11.1 Modular Monitoring Systems……………………………………. 5-11
5.11.1.1 Products and Technology………………………….. 5-12
5.11.1.2 Market Forecast ………………………………………. 5-17
5.11.1.3 Competitive Analysis ………………………………… 5-22
5.11.2 Portable Monitoring Systems……………………………………. 5-24
5.11.2.1 Products and Technology………………………….. 5-27
5.11.2.2 Market Forecast ………………………………………. 5-36
5.11.2.3 Competitive Analysis ………………………………… 5-36
5.11.3 Telemetry Monitoring Systems …………………………………. 5-38
5.11.3.1 Products and Technology………………………….. 5-38
5.11.3.2 Market Forecast ………………………………………. 5-44
5.11.3.3 Competitive Analysis ………………………………… 5-47
5.11.4 Combined Market Analysis………………………………………. 5-49
Exhibit 5-1: Wireless Medical Telemetry Service and Related Bands ……………… 5-9
Exhibit 5-2: Selected Characteristics and Performance Requirements for
Adult Modular Vital Signs Monitoring Systems ………………………….. 5-13
Exhibit 5-3: Selected Characteristics and Performance Requirements for
Neonatal and Pediatric Modular Vital Signs Monitoring Systems …. 5-16
Exhibit 5-4: 2013, Selected Modular Vital Signs Monitoring Systems ……………. 5-18
Exhibit 5-5: Modular Vital Signs Monitoring Systems, Market Forecast,
2012-2017 …………………………………………………………………………… 5-23
Exhibit 5-6: 2012, Modular Vital Signs Monitoring Systems Market,
Share by Supplier…………………………………………………………………. 5-25
Exhibit 5-7: End-User Needs Supporting the Emergence of
Portable Vital Signs Monitoring Systems………………………………….. 5-26
Exhibit 5-8: Selected Characteristics and Performance Requirements for
Portable Vital Signs Monitoring Systems………………………………….. 5-28
Exhibit 5-9: 2013, Selected Portable Vital Signs Monitoring Systems……………. 5-30
Exhibit 5-10: Portable Vital Signs Monitoring Systems, Market Forecast,
2012-2017 …………………………………………………………………………… 5-37
Exhibit 5-11: 2012, Portable Vital Signs Monitoring Systems Market,
Share by Supplier…………………………………………………………………. 5-39
Exhibit 5-12: Selected Characteristics and Performance Requirements for
Telemetry Vital Signs Monitoring Systems ……………………………….. 5-40
Exhibit 5-13: 2013, Selected Telemetry Vital Signs Monitoring Systems …………. 5-45
Exhibit 5-14: Telemetry Vital Signs Monitoring Systems, Market Forecast,
2012-2017 …………………………………………………………………………… 5-48
Exhibit 5-15: 2012, Telemetry Vital Signs Monitoring Systems Market,
Share by Supplier…………………………………………………………………. 5-50
Exhibit 5-16: Vital Signs Monitoring Products, Combined Market Forecast,
2012-2017 …………………………………………………………………………… 5-51
6. COMPANY PROFILES…………………………………………………………………….. 6-1
6.1 CAS Medical Systems, Inc. ……………………………………………………… 6-1
6.2 Covidien LTD…………………………………………………………………………. 6-2
6.3 Dräger Medical, Inc./Drägerwerk AG & Co. KG…………………………… 6-5
6.4 Edwards Lifesciences Corporation ……………………………………………. 6-7
6.5 GE Healthcare/General Electric Company …………………………………. 6-8
6.6 ICU Medical, Inc. ……………………………………………………………………. 6-9
6.7 Integra LifeSciences Corporation ……………………………………………… 6-9
6.8 Johnson & Johnson………………………………………………………………. 6-10
6.9 Mindray Medical International LTD………………………………………….. 6-10
6.10 Philips Healthcare, Inc./Royal Philips NV …………………………………. 6-11
6.11 Spacelabs Healthcare/OSI Systems, Inc………………………………….. 6-13
6.12 Welch Allyn, Inc……………………………………………………………………. 6-14
APPENDIX: COMPANY LISTING……………………………………………………………… A-1