NPi-200 for pupillary light reflex in critical care patients

The technology described in this briefing is NPi-200. It is used to measure pupillary light reflex and pupil diameter in patients in critical care.

The innovative aspects are that the neurological pupil index, a proprietary index developed from more than 600,000 normative data sets, allows pupil reactivity and other parameters to be trended over time, like other vital signs.

The intended place in therapy would be as an alternative to manually checking pupillary response using a pen torch in critical care units.

The main points from the evidence summarised in this briefing are from 6 observational studies including a total of 1,217 people in critical care units. They show that NPi-200 can measure additional parameters compared with standard care and predict poor outcomes in people who are critically ill.

Key uncertainties around the evidence or technology are that only 1 comparative observational study was included, which did not report on patient outcomes and none of the studies were conducted in the UK.

The cost of NPi-200 is £17.50 per patient, per 7-day stay in a critical care unit, with hourly observations (excluding VAT). The resource impact would be greater than standard care, which is around £1.50 for a pen torch.