Webinar: Turbine Versus Central Gas Supply Pros & Cons SBF Respiratory Care, Sept 5th 2012, Erwin...

Webinar: Turbine Versus Central Gas SupplyPros & Cons

SBF Respiratory Care, Sept 5th 2012, Erwin Broos

1. Introduction

2. Basics

3. Turbine in ICU Ventilation

4. Turbine in Non Invasive Ventilation

5. Turbine in Emergency Transport

6. Turbine in Anaesthesia Ventilation

7. Bench Tests

Webinar Turbine vs. Central Gas Supply, Pros & Cons | Sept 5th 20122 | 28

Turbine vs. Central Gas Supply Pros & Cons

Turbine vs. Central Gas Supply Pros & ConsDräger Products Using Turbines

Savina Savina 300 Carina

Perseus A500 Zeus IEEvita Infinity V500 /

Babylog VN500

Patient ventilation


Webinar Turbine vs. Central Gas Supply, Pros & Cons | Sept 5th 2012

Turbine vs. Central Gas Supply Pros & ConsFields of Application for Patient Ventilation

ICU Ventilation NICU Ventilation

Emergency & Transport Ventilation

Anaesthesia Ventilation

Home Care Ventilation

Non Invasive Ventilation

Ventilation in Remote Areas

4 | 28


Turbine vs. Central Gas Supply Pros & ConsCustomer Requirements Related to Gas Delivery

• Good quality of ventilation stationary and during transport

• Provide ventilation in different environments• Patient comfort in spontaneous breathing• Patient comfort silent environment• Low cost of ownership• Energy efficiency of the equipment

• Need for a backup in case of central gas supply (CGS) or power failure

• Need for an alternative gas source in case a CGS is not available

• Need for High Frequency in NICU ventilation• Perform special maneuvres• High flow demand

5 | 28

1. Introduction

2. Basics





7. Bench Tests



6 | 28


Turbine vs. Central Gas Supply Pros & ConsGas Delivery Technology

Gas delivery technology

Using high pressure gas sources Using low pressure gas sources

High pressure valves

High & medium pressure valves

Turbines Pistons

7 | 28

The difference of high & medium pressure valves to turbine technology

1. High & medium pressure valves are so called proportional flow valves

these valves need high pressure and O2 e.g. from a central gas system ( CGS )

the valve generates a constant flow proportional to the degree of which the valve opens

2. A turbine is based on a rotating wheel

turbines use breathing gas from ambient air or from a low pressure 02 source (e.g. Oxygen compressors)

turbines generate a gas pressure by compressing the gas

Turbine vs. Central Gas Supply Pros & ConsGas Delivery Technology


Savina 300 turbine (side stream blower):

- Right side with the turbine wheel and the driving electric motor.

- Left side with turbine housing half and the side stream channel.

- Pressure and flow is controlled by a an additional inspiratory valve

Carina turbine in comparison (radial blower):

- Through fast revolution of the wheel the breathing gas is propelled.

- The pressure and flow is controlled by the revolution speed.

Turbine vs. Central Gas Supply Pros & ConsDifferent Turbine Technologies


Pa

tien

t

Valve

P

Flow

PO2

HPSVMixer

HP − AIR

HP − O2


Turbine vs. Central Gas Supply Pros & ConsPneumatic Mode of Operation – Evita 4 / XL

HP - AIR = high pressure air inlet (2,7-6bar)

HP – O2 = high pressure oxygen inlet (2,7-6bar)

Sensors = all sensors are colored blue HPSV Mixer = high pressure servo valve mixer

10 | 28

Pa

tien

t

Valve

P

Flow

PO2


Turbine vs. Central Gas Supply Pros & ConsPneumatic Mode of Operation – Savina / Savina 300

LPMixing

Chamber

Turbine

Valve

FilterLP − AIR

Flow

O2 Valve Bench

HP − O2

LP - AIR = low pressure (ambient) air inlet


Sensors = all sensors are colored blue LP Mixing Chamber = low pressure (ambient) mixing chamber

11 | 28

Pa

tien

t

Valve

P

Flow

PO2

MPMixingTank Valve

HP − AIR

HP − O2

Valve

Valve


Turbine vs. Central Gas Supply Pros & ConsPneumatic Mode of Operation – Evita V500 / Babylog VN500

Turbine Unit

FilterLP − AIR

GS 500

MP Mixing Tank = medium pressure mixing tank (0,2-0,3bar)

LP - AIR = low pressure (ambient) air inlet

HP - AIR = high pressure air inlet (2,7-6bar)


Sensors = all sensors are colored blue

12 | 28

1. Introduction

2. Basics





7. Bench Tests




Turbine vs. Central Gas Supply Pros & ConsICU Ventilation

Turbine pros & cons Customer requirements CGS pros & cons

Clinically no difference Good quality of ventilation in stationary use

Patient comfort in spontaneous breathing

Clinically no difference

Predestined fortransport. Compact devicesand light weight (depends on the ventilator)

Good quality of ventilation during transport Not intended fortransort. Possible only with gascylinders. Great disadvantage in handling the transport.

Depends on the ventilator Patient comfort with regards to a silent environment

Relatively low noise level

Typically turbine basedventilators are energy efficientdue to its mobile use abilities

Energy efficiency of the equipment Depends on the specificventilator

No specific difference Low cost of ownership No specific difference

No compressor needed. Need for a backup for CGS or power

Need alternative if CGS is not available

Need for compressors.

Need for a HP-Air Need for HF in NICU ventilation No specific disadvantage

With some drawbacks Perform a number of special maneuvres No limitations

Turbines can exceed CGSin max. flow

High flow demand Covered by CGS

14 | 28

Typical external compressor

- Limited flow delivery:typical 30 l/min average flow

- Limited lifetime:about 50% of a ventilator lifetime

- High maintenance cost

- Bulky: big and heavy

- Very loud

- Adds additional investment costs

- Mask ventilation almost not possible:A compressor will “run out of gas” when trying to compensate for a large leak

Turbines

The Savina turbine has none of the disadvantages of an external

compressor !

Turbine vs. Central Gas Supply Pros & ConsTurbine vs. external compressors

15 | 28 Webinar Turbine vs. Central Gas Supply, Pros & Cons | Sept 5th 2012

Turbine vs. Central Gas Supply Pros & ConsEvita Infinity V500 / Babylog VN500 – A Hybrid System

The hybrid system is unifying the advantages of central gas supply & turbine technology into one setup

•Same ventilation performance with or without the GS 500•The GS 500 eliminates the disadvantages of external compressors•No high pressure filter needed for the AIR inlet•Three turbines generates the „mid pressure“ for the mixing tank.•HF ventilaton can not be provided when operating with GS 500

Unique and unreached hybrid concept in the market unifying CGS and Turbine benefits


1. Introduction

2. Basics





7. Bench Tests



Turbine vs. Central Gas Supply Pros & ConsNon Invasive Ventilation

• NIV devices initially has established in home care for conscious, spontaneous breathing patients

• It was a must that those devices comes with excellent breathing comfort

• NIV ventilators provides the best leack compensation based on single hose systems with a leak valve

Turbine benefits:• Independent and mobile• Smooth gas delivery (Anti Fump)

Carina


1. Introduction

2. Basics





7. Bench Tests



Turbine vs. Central Gas Supply Pros & ConsEmergency & Transport

A brief assessment

•Most compact ventilators in this field

•Turbines adds size by itself and by additionally needed batteries

•Turbines ensures excellent ventilation capabilities and whould eliminate some of the current drawbacks (e.g. limited flow or ventilation with low O2 concentration)

•Currently not established but in future turbines will find its way in certain areas of Emergency and Transport ventilation

Oxylog 1000

Oxylog 3000 plus


1. Introduction

2. Basics





7. Bench Tests



Turbine vs. Central Gas Supply Pros & ConsAnaesthesia Ventilation

• Classic anaesthesia devices like Fabius and Primus Family systems commonly use piston driven ventilation

• Strongest driver for Turbines in anaesthesia ventilation:o introduce ICU quality ventilation for top

class systemso ensure independency from CGS

Perseus A500


Turbine vs. Central Gas Supply Pros & ConsPath-Breaking Ventilation Technology TurboVent® 2

Ventilation quality like an intensive care ventilator:

Spontaneous breathing at any time. Nearly unlimited inspiration flow.

No compromises with regards to ventilation performance:

Equipped with all modern types of ventilation modes. Vol. ctrl. AutoFlow

Active PEEP and real CPAP.

Intelligent hygienic concept


Turbine vs. Central Gas Supply Pros & ConsAnesthesia Ventilation

2009:

Zeus IE with TurboVent 2

the world’s smallest and most powerful anesthesia ventilator.


1. Introduction

2. Basics





7. Bench Tests



Savina is among the best performing ventilators out of a total number of 13 ICU ventilators which were tested.

Turbine vs. Central Gas Supply Pros & ConsBenchstudy on turbine based ICU ventilators, 2009


ERS Buyers Guide about Savina and turbine based ICU ventilators


Turbine vs. Central Gas Supply Pros & ConsERS Buyers Guide about Savina and turbine based ventilators

Excellent spontaneous breathing capabilities (proven !)

Equals the performance of high pressure source ventilators (proven !)

Excellent NIV (turbines are established in NIV devices)

– At large leaks and high flow demands the Savina turbine is not limited to the capacity of central gas supplies:In some hospital settings the medical gas pipeline system may have by some reasons limited gas delivery capacity (which may be the case temporarily or even permanent)

Goodbye compressor!The turbine is not just an alternative, it should be the preferred solution!

– Supports a compact design when comparing to systems with compressor

– Reduces investment cost: compressor is obsolete


Turbine vs. Central Gas Supply Pros & ConsTurbine related benefits beyond independence from CGS

Thank youfor your attention.

Thanks for your attention!

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