I agree, Maquet did come up with those things, but unforunately the competition perfected them. The Maquet technology is antiquated. And reading your comments I can only assume you still take a horse and buggy to work.....keep smiling
no, I am an RT also. I work in a big hospital in NY. We use a few types of vents and i personally love the 300 and the servo i. Its ok to not like them but i would hardly say they are antiquated.
I'm also an RT. To stir the pot I'll ask both the Servo and Evita advocates a couple questions.
How can you like the Servo 300A when it's PS flow termination is fixed at 5%? There was an article in the Respiratory Care Journal showing how that can needlessly increase air trapping and dyspnea. Curious that they designed it that way after the PB 7200 was being slammed and criticized for having it's flow termination criteria be an absolute 5L/M (patient on Servo 300 would have to have a spontaneous flow of 100L/M to get the same PS termination criteria!).
For the Evita advocates....tell me the advantages of having the Autoflow (PRVC or VC+ PC/VC hybrid) adjust the PC Pi level based on the amount of measured volume returning to the circuit. VC+ on 840 and PRVC on Servo base their subsequent Pi levels on the measured volume leaving the ventilator. What if the patient has a big chest tube leak?
I haven't used the Servo-i and from what I understand it's solved my objections.
Personally I don't think even the Servo300A PS flow termination matters at all. To "wean" our patients all we need is to have them on PRVC with the Ti adjusted and then switch to straight up CPAP with no PS for the spontaneous breathing trial.
I see no role in "weaning" for either Automode or MMV. The new consensus guidelines would justify not using either mode (for MMV though, in neuro patient with wildly varying RR and drive--turn off Autoflow, turn on MMV and alternate between getting out of his way and returning with support).
Posts: 171 | Location: Palo Alto, CA USA | Registered: November 14, 2002
You are able to turn off the leak compensation feature on all Evita vents. This should be done when ventilating with a patient with a large chest tube leak or the vent can "chase" the leak and aggrivate the problem.
Unfortunately, this option (leak comp. on/off) is buried in the configuration and not as readily accessable as it should be, imho. It can, however, be changed during ventilation. Look in the configuration for ventilation defaults.
Well, here is my spin on the ventilator scene. Siemens recently sold the servo vent line to maquet and receiving adequate and timely service could be an issue. The Evita is a fine ventilator and also about ten thousand dollars more then the Avea. The Avea has a fine stable of vent modes and the aprv can compete with anyone. We are going to buy "NICO"s to monitor our co2 volume and not just co2 in mmhg. I work at OHSU in Portland.
Here is my spin on the Ventilator scene, I have worked with several ventilators in my PICU career. I agree with Jeff about the Servo 300 and the PS termination criteria. However in looking over all that I have worked with and talking with others I really only like two ventilators out there. The Evita's from draeger and the Galileo from Hamilton. These two company's have always listened to issues from customers and are always on the cutting edge of technology. Currently they are the only two companies with closed loop ventilation modalities which work much better than Automode or MMV.
