Take a look a the new viasys vent. I has some software problems that are being worked out. It is like the E4 but more user friendly. The apnea backups you set. Therefore you don't have the same problem with Peds as with servo.

Jeff N. To decide on what ventilator to get I think key issues are not the type of ventilator but related factors. After all, money is no object, right?

What size facility are you in? Where is it located? Is your staff bright and eager to learn new things? How many patients do you ventilate non-invasively? Do you need transport vents for in house? Do you see a lot of trauma with subsequent ARDS that needs high end care?

Thanks for letting me participate.

You have to decide what ventilator would best fit your needs and pt population. Why spend money on something you dont need? You could get them to spend the money on other things also needed by your pts.
I have worked with the Evita4....its nice. I have worked with the Servo300........its nice. I have worked with the 840......its nice. I have worked with lots of nice ventilators. You have to think what you want control of as well. You have diff insp time, flow controls, trigger controls etc on diff vents. The range importance will depend on your pt population and pt acuity(Sp?)
(i'm not a good speller...lol)
Everyone has their opinion on which vent is their fave, but lets face it.......they all vent...:)

To quote our famous Dr. MacIntyre, "The best ventilator is the one that being managed by someone who knows what they are doing." (apologies to Dr. Mac if I got the wording not quite right!"

No profound thoughts, but simple observations after a 4 month vent trial. Ventilators truly have become more hierarchical/complicated than most (not all) RCP's can grip in light of the RCP shortage and turnover. If your department has an attrition less than 20% God Bless You all.

That's not to say progress in method of ventilating is inappropriate viewed in the same light. Progress at what cost? What evidence?

I know somewhere out there is a Neil McIntyre fan. Nice guy. But one voice of many. APRV, PAV, BI-Level, PRVC, Autoflow/mode...

I manage RT at a very large Mid-Atlantic (1500 bed center) that gets it all. After a 4 month vent eval (still in progress), none of them are overly impressive to my staff because they all do pretty much the same thing.

Some are purple, some are blue, some are too heirarchical, some service reps are quite nice while others should be operating a carnival ride instead. Reliability!!!

What it is coming down to is reliability. It truly doesn't matter what one vendor calls APRV if 1) the RCP's don't know how to apply/adapt it to their patient's condition, or if the damn thing goes down every week. We can adapt just about any ventilator to a patient, but not if it's in the shop all the time.

Out of the 5 vents we have reviewed, kicked the tires, spat on the windshield...4 have had major hardware/software problems. That's pathetic in today's market. Imagine 4 of the 5 cars you drove (at $35,000.00 a pop) broke down on testing, or better yet the rep said..."We'll get that gas gauge fixed before you actually buy it".

I need it now...ready to go, in perpetuity (considering usual wear and tear).

Liability my friends...think safety and liability!

Happy Holidays!

We use Evita 2 now but used to be a servo house, we found that both vents were very good but the Evita could be upgraded with any additional functions without having to buy another box.

We saw the new XL WOW unbelievable you at least should take a look. The rep said we could easily upgrade and compared to buying a new box could do it at half the price.

a mechanical ventilation genuis

What additional functionality does th XL offer. It was my understanding that it just lets you configure the user interface. Does it add another mode or anything like that? To add 50% of the cost of the older Evita ventilator just to add on a larger screen seems to be pricey. What clinical benefits are there?

all i know is what the rep told us and what limited time i had to play with it. If you like graphics it is awesome if your a number cruncher it would make more sense to go woth the cheaper model..

He said it was about 1500$ more than the E4

which again is pointed toward a graphics package

a mechanical ventilation genuis

Terry, Terry, Terry shame on you!! The only common ground that PRVC and AUTOFLOW have is that they work of the same algorthm. Both recalculate compliance with each breath, and the next breath reflects any change in compliance. As the patient's lung compliance changes, the pressure will adjust up or down in increments of no more than 3 cms H20 per breath. After that Autoflow offers so much more including lowering peak airway pressures and allowing the patient to exhale, cough or sigh during the inspiratory period. Something PRVC does not allow. AutoFlow responds like a Continuous Positive Airway Pressure (CPAP) system with CPAP level set at Pinsp. Whenever the patient tries to inhale, the demand valve will deliver more flow. Whenever the patient wants to exhale, the expiration valve will allow expiratory flow while the pressure/positive end expiratory pressure (PEEP) level is kept constant. Autoflow is a mode enhancement that can be added to any volume mode; PRVC is mode that does not respond to spontaneous efforts. The siemens manual itself recommends that the patient be sedated/paralyzed for PRVC to be effective. Autoflow takes advantages of the patient's spontaneous efforts, and reduces the needs for sedation and paralyitics.

As it looks like nobody of you ever heard about the "Inspiration" ventilator from Ireland.Just read that they have 510k now for US. This is a absolute sexy Unit with Bipap autoflow and some extra features really help in the Daily work.
Programmable Pressure Sigh, Programmable Neb, Ethernetconnetion and a great SW-Tool!!!
I saw it in Orlando at the AARC and it looks great. Nobody talked about Pricing but this could be something to renew this discussion.Just know the Webadress event-medical.com
enjoy