Advice

The technology

The technology

The Kendall DL is a single-patient-use electrocardiogram (ECG) cable and lead wire system. It is used to assess and monitor cardiac health for people having cardiac surgery. The Kendall DL comprises:

  • disposable 3-, 5-, 6- and 10‑lead wires that connect directly to electrodes

  • a cable that connects the leads to an ECG monitor

  • a universal adaptor for compatibility with different models of ECG monitoring equipment.

The disposable design of the technology minimises the risk of cross-contamination between people, especially those having cardiac surgery with large incisions, or those at high risk of infection. The system's push button reduces the risk of false alarms. Kendall DL has 2 connection options that allow patients to move between bedside and telemetry monitoring.

If Kendall DL was adopted, it could replace reusable ECG cable and lead wires.

Innovations

Kendall DL provides both disposable ECG lead wires and cables, whereas other similar technologies provide only disposable ECG lead wires. The company claims that Kendall DL is the only single-patient-use ECG cable and lead wire set that can be used throughout a patient's hospital stay. The system uses a patented push button technology to secure the lead wire to the electrode.

Current care pathway

NICE's guideline on routine preoperative tests for elective surgery recommends that ECG is considered for people with cardiovascular, renal or diabetes comorbidities before their surgery. However, there are no recommendations on standards of ECG cable and lead wire. Clinical guidelines on recording a standard 12-lead ECG from the Society for Cardiological Science and Technology recommend equipment specification for ECG including the need for disposable electrodes. There is currently no national standard of care for cleaning ECG cable and lead wires in the NHS. There may be cleaning protocols at an individual hospital level.

Population, setting and intended user

Kendall DL is for people who need ECG monitoring, with a focus on those having cardiac surgery and those at risk of healthcare-associated infection. The company claims the technology would be used in preoperative assessment, during the operation, and in recovery in an intensive care unit.

Costs

Technology costs

Table 1 Cost of the Kendall DL Cable and Lead Wire System

Description

Cost (inclusive of VAT)

3-lead Kendall DL

£11.10 per unit

5-lead Kendall DL

£12.68 per unit

Costs of standard care

The company estimates the cost of reusable ECG leads to be £5.49 for an average lifetime of 30 to 40 uses.

Resource consequences

The technology is currently used in 15 hospitals in England. It could reduce cross-contaminations between patients who are at high risk of developing healthcare-associated infection.

A US budget impact analysis (Saunders and Lankiewicz, 2018a) showed that yearly costs for patients who had coronary artery bypass grafting were $12.2 million. This included 605 days in intensive care unit and 9 readmissions because of surgical site infections. The use of disposable leads resulted in savings of $16,780. Savings included 3.2 days shorter stay in intensive care and 2.4 fewer readmissions.

A recent conference abstract reported a budget impact analysis for the NHS. This suggested that a single-use ECG system reduced the cost of care for patients having coronary artery bypass grafting by £73 (1%), mainly because of a decrease in surgical site infections. Savings included 3.7 days shorter stay in intensive care and 1.5 fewer readmissions per 100 patients (Saunders and Lankiewicz, 2018b).

There would be no other resource or infrastructure changes needed to use the technology.