GE Healthcare's new product is the Engstrom Carestation, developed by Datex-Ohmeda, now part of GE HEalthcare. It is a full featured critical care ventilator that has been in use in Europe and Australia since May. It received FDA clearance for the U.S. in October and will be formally launched at the AARC meeting in New Orleans next week.
In my opinion, it is the Servo i hands down. Its ability to respond to the pts needs as well as the open lung tool and its ease of use place the servo i ahead of the others.
I disagree with smd44, it would be the Drager Evita XL, hands down. It now has the open lung tool that you can set to measure this procedure in a low flow state which is more accurate then the Servo i. It also has the ATC option that works during inspiration, expiration, and now if you would like only during the spont. breath. Drager has a clinical and educational group (ICON) available 24 hours a day. ICON is run by Dr. Habashi who developed APRV. Everyone copies his method of using APRV including Servo i.
I certainly respect your opinion and I guess it comes down to personal preferance but from what I understand about the low flow manuever on the drager, is that it is for only one breath. How can you accurately determine open and closing pressures if you are not recruiting the whole lung? Also, with atc, they only measure diameter of the tube. in order to calculate resistance you need both length and diameter. The servo i measures and adjusts pressures breath by breath taking into account the ETT therefore atc is not needed. Also, you can not accurately determine how much pressure is added via atc. From what I heard of ICON, it is a nice feature. Again, I guess it comes down to personal preferance. I prefer the Servoi but what I suggest if you are looking at purchasing ventilators is to look at whats out there and what you need and decide from there.
APRV was 1st described by Stock & Downs in 1987 & the Servo 300 had it as an option in Europe years ago ( called Bi-pap ). We prefer the Servo-i. The ECRI journal Health Devices is a good place for info.
I must ammend myself to EQ@LGH; you are correct, Dr. John Downs developed APRV in 1986. Dr Nader Habashi perfected it around 1996. Some people refer to Downs APRV or Habashi APRV and it has been my experience that most hospitals facilities are utilizing the Habashi version (just my opinion).
Now as for the Servo-i, here are some things I don't like:
1. Poor/limited neonatal ventilation performance; there is No proximal flow sensor. 2. In neonates there is No automatic leakage adaptation with trigger compensation. 3. If you compare inspiratory volumes, and expiratory volumes in neonatal circuits, they are always wrong (Even stated in the user manual by Maquet)! 2. No Automatic Tube Compensation 3. No leakage compensation 4. No P0.1-measurement; no NIF-measurement 5. Spontaneous breathing capability in PRVC is poor – Inspiration yes but no expiration at the upper level – there is no "Room to breathe" PRVC – cannot be used with leakages 6. Limited weaning parameters 7. Their expiratory cassette is very expensive 8. The Pressure Support concept above the set Phigh on Bi-level is dangerous; deliverying pressure above the ventilating pressure....who thinks that is a good idea?
Whilst the eVent Inspiration has only recently arrived here in Australia (A near 100% NPB 840 - Drager Evita market) it has gained wide acceptance across SEA across numerous clinical sites.
Well worth a look. The clinical principles are certainly sound and the company demonstrates its in-house experience through this. As the company states they are offering a high performance, cost effective, low maintenance ventilation solutions.
For 90% of the global ventilation community that more than meets their needs.
