Ok, sounds like a deal, I'll await the change

I had to change the spelling in my profile.

All is well with the world.

a mechanical ventilation genius

Yes, the 840 and ServoI learn and compensate for the circuit compliance; however, I doubt anyone is performing the circuit compliance measurement AFTER the circuit is brought up to operating temperature. I would expect that the compliance would increase....enough to be a potential concern with micropreemies. Draeger typicall recommends a VT of 4-6 ml/kg for neonates....I believe users of other vents will attest to larger volumes being often required due to the inaccuracy of volume delivery.

As far as concerns of the ventilator relying on information from the sensor which could fail...if doing volume ventilation with an Evita and the flowsensor fails the ventilator will automatically use the average applied pressure (I belive avg. of last 3 breaths?). With the Babylog and volume ventilation, the PIP setting will be the max. applied pressure if the sensor fails and should be set at an appropiate level (5cm or so above actual PIP, maybe less if higher PIPs are used). If pressure ventilating, of course, the PIP will be at set level. The Germans have designed in a pretty safe system if the sensor fails.

Hi,
I have 10 of the PB 840s in our NICU,and they are working well, and sorry Pual we are running the SST after the 840 is up to temp.
P.S. It is not as much what vent you are using, but how you are using it.

I Wish to thank the entire RC Community For the valuable input on this Topic . I guess this means we can all just (get Along),,,,Cpap

I havent had any experience with the 840 on neonates, but I have used the Bird VIP and the Drager Baby Log.

Both seem to work well, the Drager works especially well with micro premies.

I have experienced software problems with the Drager, and the flowsensors often go bad on the Birds.

Mike

quote:

Originally posted by robert johnson:
Hi,
I have 10 of the PB 840s in our NICU,and they are working well, and sorry Pual we are running the SST after the 840 is up to temp.
P.S. It is not as much what vent you are using, but how you are using it.

how long are you waiting for temp on 840 before doing sst?

I live in NJ. In general, the northeast is (was) a pretty big PB area but I do not know of anyone using the 840 on neonates. We are using the Servo-i and we compensate for compressible volume loss. We trialed the new flow sensor they offer as an option but found that the volumes were accurate with or without it (We also compared volumes with the use of the VentCheck flow sensor) We just had an upgrade (not sure the software version)but it allows us to perform a seperate 10 second circuit test to get the most up-to-date compressible volume measurement (without having to go through another pre-use test). Pretty good stuff.

The best way to find out who is doing this is to contact your PB rep and/or the AARCs speciality section chair for Peds/Neonates and get their help and a list of users.

A flow sensor at the wye is probably more accurate than the 840 or Servo I if the flow sensor has just been calibrated, is clean, dry and brand new. As soon as they get wet, they drift. No question. As they age and are reprocessed, they drift sooner. I believe that ALL must be taken out of line when delivering surfactant, which is when it is most important to monitor, so where is the value there? Flow sensors are realatively heavy on the tube, add deadspace, and can get lost, broken, and can be expensive.

Pros and cons to both approaches.