NIMBUS i-Care - Intraoperative neuromonitoring
Thanks to the NIMBUS i-Care, your surgical team will be able to stimulate the central and peripheral nervous system while monitoring the patient’s neurophysiological responses.
Our users have trusted and proven the effectiveness of the NIMBUS range of products for over 22 years, and its applications in intraoperative neuromonitoring for over 15 years. Many scientific publications cite their use in the operating room and demonstrate their safety.
Intraoperative neuromonitoring – To secure surgical results
The use of intraoperative neuromonitoring on a daily basis contributes to securing surgical and postoperative results, particularly in neurotology, otolaryngology, and spine surgery.
The preconfigured parameters of the NIMBUS i-Care intraoperative neuromonitoring facilitate safe use and improve the operability of the surgical team. They were chosen based on scientific literature and user experience, in order to help:
- locate the functional areas of the cortex and subcortex by direct electrical stimulation;
- locate and check the integrity of the cranial nerves;
- locate the nerve fibers to be cut or preserved (peripheral nerves, spinal roots).
To meet these different needs, NIMBUS i-Care intraoperative neuromonitoring offers to work on three main surgical area with a total of five preconfigured configurations:
- Neurosurgery (CNS), with “Cerebral cortex” parameter;
- Neurosurgery (PNS), with “Peripheral nerves” and “Spinal roots (dorsal D / ventral V)” parameters;
- Neurotology and ENT surgery, with “Recurrent laryngeal nerves” and “Cranial nerves” parameters.”
The surgical team visually and audibly follows the transmission of stimulation and the muscle response in real time. The sound response intensifies as it approaches a nerve with the associated muscle response. The electromyographic response is visible on the monitor screen and freezes when a predefined threshold is exceeded, allowing the curve reading time to be increased. The user also follows, in real time, the latency and amplitude measurements of each channel.
Intraoperative neuromonitoring with the NIMBUS i-Care guarantees high-quality results by preserving false negatives and positives through continuous impedance monitoring. The patient interface constantly monitors the positioning of the muscle collection needles and alerts the user when signal is lost. Automatic detection and removal of stimulation artifacts helps prevent false positives.
The surgeon can record up to 150 hours of muscular responses during the surgical procedure and extract them immediately using the device’s USB port to add to the patient’s file.
NIMBUS i-Care – Combines robustness with flexibility for cost optimization and day-to-day efficiency
Thanks to its ability to perform direct electrical stimulation and intraoperative neuromonitoring, the NIMBUS i-Care can be used in many different surgical specialties, which greatly boosts the value associated with purchasing this equipment. Its security, simplicity, and flexibility is amplified further by its guaranteed lifetime of 10 years of service.
It is complicated to plan the movement and planning of operating room services according to the surgical program. With this in mind, the ease-of-transport of the NIMBUS i-Care can be a great asset. Operating room planning is simplified further thanks to its flexibility of use in several disciplines, such as neurosurgery, otolaryngology, and otology.
Customizable settings can be created for more expert teams to help improve the usability of the NIMBUS i-Care. Quick access to the main menu allows users to immediately select the desired mode and speed up installation. The simplicity of the user interface and the limited number of menus makes it easy for surgical teams to learn quickly.
Total flexibility is offered thanks to the choice of stimulation mode, the characterization of the type of emitted signal, and the parameters of use. A diverse range of monopolar, bipolar, and tripolar stimulation probes, both straight and angled, complete the flexibility of the NIMBUS i-Care and offer many choices to surgeons. Thus, surgeons can adapt the selectivity of the stimulation probe according to her/his needs and the patient’s anatomy.
INNOPSYS support and NIMBUS network – For experience sharing
INNOPSYS’s experienced staff trains medical teams in the optimal use of the NIMBUS i-Care, neurostimulators, and intraoperative neuromonitoring. These face-to-face trainings promote the sharing of experiences. Remote refreshment sessions can also be scheduled.
The INNOPSYS team also supports your staff remotely for all help and instant diagnostic requests related to the use of the NIMBUS i-Care.
The network of renowned users of the i-Care range offers opportunities to share experiences and information, and to improve cooperation between international services. Visits to the operating room for advanced surgeries can also be arranged.
1. Chiesa-Estomba CM, Larruscain-Sarasola E, Lechien JR, Mouawad F, Calvo-Henriquez C, Diom ES, Ramirez A, Ayad T. Correction to: Facial nerve monitoring during parotid gland surgery: a systematic review and meta-analysis. Eur Arch Otorhinolaryngol. 2021 Apr;278(4):945-949. doi: 10.1007/s00405-020-06235-w. Erratum for: Eur Arch Otorhinolaryngol. 2021 Apr;278(4):933-943. PMID: 32789640.
2. Bai B, Chen W. Protective Effects of Intraoperative Nerve Monitoring (IONM) for Recurrent Laryngeal Nerve Injury in Thyroidectomy: Meta-analysis. Sci Rep. 2018 May 17;8(1):7761. doi: 10.1038/s41598-018-26219-5. PMID: 29773852; PMCID: PMC5958090.
3. Charalampidis A, Jiang F, Wilson JRF, Badhiwala JH, Brodke DS, Fehlings MG. The Use of Intraoperative Neurophysiological Monitoring in Spine Surgery. Global Spine J. 2020 Jan;10(1 Suppl):104S-114S. doi: 10.1177/2192568219859314. Epub 2020 Jan 6. PMID: 31934514; PMCID: PMC6947672.
NIMBUS i-Care specifications
CLASSIFICATION AND STANDARDS
|CERTIFICATION||NF EN ISO 13485:2016|
(MDD 93/42/CEE, ANNEXE IX)
|NOTIFIED BODY||GMED CE 0459|
|TENSION||220 V - 230 V AC ±10%||120 V AC ±10%|
|ACCESSORIES||Remote control, stimulation extension lead, patient interface, carrying case and main lead|
|PATIENT INTERFACE||8 muscle signal collection|
|STIMULATION PARAMETERS (±10% of the setpoint)|
|PULSE WIDTH||60-16000 µs|
|CURRENT INTENSITY||0-32 mA|
|DIMENSIONS AND WEIGHT (LxHxD)|
|NEUROMONITORING||365 x 280 x 270 mm - 10,5 kg|
Before using the device, please carefully read the instructions from the Nimbus i-Care user manual. Medical devices are health products which have, due to the European regulation, the CE 0459 marking.