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New ventilator
Originally posted by CCAT-RT:
To get us at least back on the subject of Vents and not the fight about APRV vs I would like to say this...
There are a ton of vents out on the market that do a lot of great things. Every vent that is produced is marketed to be the next best thing. Personally I'm a fan of Drager and just about every product they produce. In saying that there are problems with the technology that they deploy. The only problem so far, and I'm sure others would agree is there flow sensor technology. If you would like to know how to fix those problems I can give you an easy answer. But now is neither the time nor the place. Email me with your questions.
Getting back to our subject at hand, new vents can be great to get into your facility and mix things up. Examples would be the LTV's and there line up. LTV makes a great vent if you're only using it for home use on long-term patients or as a transport ventilator (I would limit this to pediatric and adults, not neo's). However, I am not a fan of using this vent in house on critical patient for extended periods of time. Most people fail to realize that LTV has a screen for their vents that nicely mounts to the top of the machine. Wilford Hall Medical Center in San Antonio was using this vent on a trial basis in the Trauma center and strictly on transports services. We found that the vent performed well for our use. They make a great "backpack" for the vent and also some hooks so that you can attach the vent to the bed instead of lying it IN the bed between the patient's legs.
GE Healthcare has recently come out with a brand new vent. Currently I am starting up a research project of that mode of ventilation that everyone either love or hates to talk about, APRV. Only my study will be targeting the pediatric and neonate population. Anyway, about the GE, this seems to be a really nice package especially with the 2.2 Software. If any of you have used this in your facility or seen it at a product fair you have probably said to yourself; "Wow the alarms sound like the INO vent that we use for nitric". Well you would be correct. INO and there nitric products are produced for them by GE Healthcare. I am told that by late 2006 to early 2007 the INO nitric delivery system will be available on the GE. So there will be no need to have two different machines in the same room taking up space. Pretty smart if you ask me. The spiro abilities on the GE are pretty cool to work with if you care to dabble into that sort of thing on your patient.
Servo has come out with their updates for the Servo-i. New software that takes 15 seconds to set up the vent when you're in the room instead of the eternity (2 min 45 seconds) it use to take. New proximal airway sensors for neonatal use although if I understand without the proxy the ventilator still is accurate within 5 cc.
Viasis makes the Avea and another "transport" type ventilator. Myself, personally, I would say stay away for it. I've used it and I'm not found of it. The rep that took care of us was great when we wanted to get the Avea into the facility and let us have it for as long as we wanted. Maybe the dragers have spoiled me, or maybe I just hate troubleshooting vents, but it took myself and three other therapist to fix a leak problem we where having. The leaks originated on the exhalation side of the machine and this is the huge downfall of this vent. When we contacted the rep about the problems we where simply told it was an "education issue" and that we did not have the proper training. So we had him come in, needless to say I guess he wasn't very educated either. It took him an hour to fix the same problem. To finish my rant on this vent (again email me if you have questions I would be glad to answer them) equipment techs hate them... 50% of the RT's I talk to feel the same way. Great color by the way, and like the rep says... "You know they use this vent on Gray's Anatomy?"
Now with everything I just said remember this when looking at a new ventilator. Old habits die hard, and Doc's usually have their comfort zones, which are hard to penetrate with new and fresh ideas. I'm sure Dr Habashi and Dr Derdak would say different and I expect this from them. They are great Doc's with a lot of experience. This can be seen with people who continue to try and disprove APRV and it's benefits. No this is not a mode of ventilation that should be used on all patients, but with it comes to IRDS, ARDS, ALI, and other conditions I really don't have time to discuss, I would say it's right up there with HFOV as being the best. (Once again the email thing if you want more info) When looking at the vents ask yourself what you will be using it for. If you not looking to run Heliox, or your facility doesn't use Nitric or even APRV, don't let the reps even talk to you about it. Some people will say, "with our vent you can monitor 350,000 different things", that's great but you will never use it. Most facilities will be lucky to venture out of Volume control and into Pressure mode. I know your not going to use a mode like APRV, ILV, or PRVC+.

is there a bias aginst the event insprration i have seen it and its a neat thing with all modes in built nebuliser, programmable sighs, automode, weblink, hiliox,nox(upgrade), ncpap for neonates ,robust and rugged pnenmatic which is maintainence free hence they are now offering a 5y warrenty what do u guys feel about it. feel like hiding!!!
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This message has been edited. Last edited by: GaryMefford,
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Obviously you need to learn how to read. What makes you think I haven't used a modern vent - I didn't say that. I have no nostalgia for the 7200. And if you think the 7200 is still a better vent than the LTV 1000, I hope neither me nor my family members ever need you "expert" services. Obviously you work for the competition! I have no ties what so ever to PB and I never have. I have used the LTV extensively in a different facility than where I am now, and I hate having to use the 7200 - but that is what we have here! And yes, I STILL GET THEM WEANED (although I must admit, it takes longer than it should).
Originally posted by PCMStexas:
You know... Neil McEntyre, MD (not sure about the spelling) said a few years ago at an AARC conference that, all of the new features that come out on these ventilators work as designed; the only problem is, they fail to make a difference in patient outcome.

Other than pressure control, pressure support, continuous flow, flow triggering, and maybe adjustable Rise Time and Flow Termination, most of the newer features haven't impacted patient outcome very much (at least not according to published research).

So, I believe, what this really comes down to is one RT's preference over another's AND how well they like their sales rep. I seriously doubt that any of us RT's have personally used all of the vents on the market - in a clinical situation on a real patient. We have used maybe 1 or 2; they worked, so we feel they are great vents (and because we like the sales rep). I am still using the PB7200 (certainly not by choice) and I get patients weaned off the vent. It is old and outdated technology, and I would love to have more up to date technology, but I am stuck with what I have - which by the way was considered state of the art in the early 1980's.

If I were buying new vents, I'd get the LTV 1000 (Pulmonetic Systems). It is small and lightweight, can be used in the ICU or as a transport, has many of the newer modes and features as the other vents you are talking about, and is quite a bit less expensive than the vents you are talking about. And, no I don't particularly like my sales rep!
Posts: 6 | Registered: July 14, 2003Reply With QuoteReport This Post
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Drager is a big problem if you need serves from them. Servoi is cool vent. Avea is pretty good, too. I'll never buy another drager
Posts: 1 | Registered: November 16, 2007Reply With QuoteReport This Post
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