GE Healthcare is exhibiting new methods in ventilation monitoring to help enhance critical patient care and to further expand the performance of its Engstrom Carestation ventilator. Developed with Professor Ola Stenqvist, M.D., Ph.D., intensivist and anesthesiologist at Sahlgrenska University Hospital in Gothenburg, Sweden, the breakthrough options of SpiroDynamics and FRC INview (Functional Residual Capacity) are based on validated algorithms and measurements. The Engstrom Carestation ventilator is being showcased Dec. 11-14 in GE Healthcare's booth, #210, at the 52nd Annual Convention and Exhibition of the American Association for Respiratory Care (AARC) in Las Vegas.
"Doctors and world leaders in mechanical ventilation are telling GE this is the most important step forward in respiratory care in 20 years, because our ventilator and monitor are working in concert," said Paul Baumgart, general manager of GE Healthcare's Respiratory Care business. "There has been a challenge in treating patients on mechanical ventilation because no device measured what was happening inside the patient's lungs. Clinicians needed to take a variety of measurements outside the body to establish the course of respiratory care. This indirect method has meant there was no easy way to precisely determine how a ventilator is affecting a patient."
"Now GE INview gives clinicians a clear window to the lungs to see what's happening and determine a personalized course of therapy," said Baumgart.
The Engstrom Carestation, released in 2004, was the first critical care respiratory carestation to offer integration throughout the care process. The ventilator enables clinicians to integrate ventilation with monitoring modules capable of measuring advanced parameters.
"Although respiratory mechanics has been researched for many years, there has been a lack of measurement technology that allows clinical assessment of the tracheal and alveolar pressures in ventilated patients," said Dr. Stenqvist. "The SpiroDynamics and FRC INview extend the performance of the Engstrom Carestation by providing clinicians with pressure and volume measurements directly from the patient's lungs, plus the ability to measure their Functional Residual Capacity."
FRC INview, a GE breakthrough technology, adds a new dimension to pulmonary monitoring by providing measurement of FRC without interrupting ventilation. It provides the ability to directly measure the end expiratory lung volume by slightly altering the delivered FiO2 level for short periods of time. Using the volumetric O2 and CO2 measurement capability of the Compact Airway module, the Engstrom Carestation displays the patient's FRC level through numeric values as well as a graphic curve.
By providing a direct measurement of end expiratory lung volume on mechanically ventilated patients, FRC INview enables cycled, automatic measurement of FRC with no additional gas source required. Calculations are based on real-time lung function, without interruption of ventilation therapy and allows for a better assessment of the effectiveness of lung recruitment maneuvers.
"Therapists haven't had a simple, concise method to quantify lung volume," said Baumgart. "The method has involved stopping ventilation to measure the volume. Additionally, the measurement involved a simplistic formula using a patient's height, weight and gender."
"Every breath counts. Patients have to be ventilated properly from the first breath. GE INview provides unique information to help enable therapists and physicians determine what therapy to give a patient from his or her first breath on mechanical ventilation."
With SpiroDynamics, critical care clinicians can now monitor tracheal pressure regardless of the ventilator setting. The breakthrough method facilitates compliance measurement at the beginning, middle and end of a breath for better assessment of overdistention, providing a dynostatic curve that better estimates Alveolar pressure. This further enhances detection of Intrinsic PEEP and inflection points. SpiroDynamics is similar to Spirometry by creating a P/V loop that is analyzed by the user. As a component to the INview suite, SpiroDynamics provides a simple, reliable method to gather more accurate information on lung mechanics.
"Approximately 70 percent of the resistance between a ventilator and the patient's lungs arise from the endotracheal tube," said Baumgart. "Other products take measurements of lung pressure from outside this tube, thereby encountering this resistance."
"SpiroDynamics combines the ventilator with the monitor and measures at the trachea, beyond the ET tube, providing a more accurate reading of a patient's lung pressure."