Webinar: Turbine Versus Central Gas Supply Pros & Cons SBF Respiratory Care, Sept 5th 2012, Erwin Broos

Turbine vs. Central Gas Supply Pros & Cons Introduction Basics Turbine in ICU Ventilation Turbine in Non Invasive Ventilation Turbine in Emergency Transport Turbine in Anaesthesia Ventilation Bench Tests Webinar Turbine vs. Central Gas Supply, Pros & Cons | Sept 5th 2012

Turbine vs. Central Gas Supply Pros & Cons Dräger Products Using Turbines Savina Carina Savina 300 Patient ventilation Evita Infinity V500 / Babylog VN500 Perseus A500 Zeus IE Webinar Turbine vs. Central Gas Supply, Pros & Cons | Sept 5th 2012

Non Invasive Ventilation Turbine vs. Central Gas Supply Pros & Cons Fields of Application for Patient Ventilation ICU Ventilation NICU Ventilation Non Invasive Ventilation Home Care Ventilation Emergency & Transport Ventilation Ventilation in Remote Areas Anaesthesia Ventilation Webinar Turbine vs. Central Gas Supply, Pros & Cons | Sept 5th 2012

Turbine vs. Central Gas Supply Pros & Cons Customer Requirements Related to Gas Delivery Good quality of ventilation stationary and during transport Provide ventilation in different environments Patient comfort in spontaneous breathing Patient comfort silent environment Low cost of ownership Energy efficiency of the equipment Need for a backup in case of central gas supply (CGS) or power failure Need for an alternative gas source in case a CGS is not available Need for High Frequency in NICU ventilation Perform special maneuvres High flow demand Webinar Turbine vs. Central Gas Supply, Pros & Cons | Sept 5th 2012

Turbine vs. Central Gas Supply Pros & Cons Introduction Basics Turbine in ICU Ventilation Turbine in Non Invasive Ventilation Turbine in Emergency Transport Turbine in Anaesthesia Ventilation Bench Tests Webinar Turbine vs. Central Gas Supply, Pros & Cons | Sept 5th 2012

Turbine vs. Central Gas Supply Pros & Cons Gas Delivery Technology Using high pressure gas sources Using low pressure gas sources High pressure valves High & medium pressure valves Turbines Pistons Webinar Turbine vs. Central Gas Supply, Pros & Cons | Sept 5th 2012

Turbine vs. Central Gas Supply Pros & Cons Gas Delivery Technology The difference of high & medium pressure valves to turbine technology High & medium pressure valves are so called proportional flow valves these valves need high pressure and O2 e.g. from a central gas system ( CGS ) the valve generates a constant flow proportional to the degree of which the valve opens A turbine is based on a rotating wheel turbines use breathing gas from ambient air or from a low pressure 02 source (e.g. Oxygen compressors) turbines generate a gas pressure by compressing the gas What is the difference between HPSV technology and turbine technology ? Webinar Turbine vs. Central Gas Supply, Pros & Cons | Sept 5th 2012

Turbine vs. Central Gas Supply Pros & Cons Different Turbine Technologies Savina 300 turbine (side stream blower): Right side with the turbine wheel and the driving electric motor. Left side with turbine housing half and the side stream channel. Pressure and flow is controlled by a an additional inspiratory valve Carina turbine in comparison (radial blower): Through fast revolution of the wheel the breathing gas is propelled. The pressure and flow is controlled by the revolution speed. Can you give me some technical insights to Savina 300 turbine technology? Webinar Turbine vs. Central Gas Supply, Pros & Cons | Sept 5th 2012

Turbine vs. Central Gas Supply Pros & Cons Pneumatic Mode of Operation – Evita 4 / XL HP − AIR HPSV Mixer O2 P HP − O2 Patient P Flow Valve HP - AIR = high pressure air inlet (2,7-6bar) HP – O2 = high pressure oxygen inlet (2,7-6bar) Sensors = all sensors are colored blue HPSV Mixer = high pressure servo valve mixer Webinar Turbine vs. Central Gas Supply, Pros & Cons | Sept 5th 2012

Turbine vs. Central Gas Supply Pros & Cons Pneumatic Mode of Operation – Savina / Savina 300 LP Mixing Chamber Turbine Valve Filter LP − AIR Flow O2 Valve Bench HP − O2 O2 P Patient P Flow Valve LP - AIR = low pressure (ambient) air inlet HP – O2 = high pressure oxygen inlet (2,7-6bar) Sensors = all sensors are colored blue LP Mixing Chamber = low pressure (ambient) mixing chamber Webinar Turbine vs. Central Gas Supply, Pros & Cons | Sept 5th 2012

Turbine vs. Central Gas Supply Pros & Cons Pneumatic Mode of Operation – Evita V500 / Babylog VN500 MP Mixing Tank Valve HP − AIR HP − O2 O2 P Patient Turbine Unit Filter LP − AIR GS 500 P Flow Valve HP - AIR = high pressure air inlet (2,7-6bar) HP – O2 = high pressure oxygen inlet (2,7-6bar) Sensors = all sensors are colored blue MP Mixing Tank = medium pressure mixing tank (0,2-0,3bar) LP - AIR = low pressure (ambient) air inlet Webinar Turbine vs. Central Gas Supply, Pros & Cons | Sept 5th 2012

Turbine vs. Central Gas Supply Pros & Cons Introduction Basics Turbine in ICU Ventilation Turbine in Non Invasive Ventilation Turbine in Emergency Transport Turbine in Anaesthesia Ventilation Bench Tests Webinar Turbine vs. Central Gas Supply, Pros & Cons | Sept 5th 2012

Turbine vs. Central Gas Supply Pros & Cons ICU Ventilation Turbine pros & cons Customer requirements CGS pros & cons Clinically no difference Good quality of ventilation in stationary use Patient comfort in spontaneous breathing Predestined for transport. Compact devices and light weight (depends on the ventilator) Good quality of ventilation during transport Not intended for transort. Possible only with gas cylinders. Great disadvantage in handling the transport. Depends on the ventilator Patient comfort with regards to a silent environment Relatively low noise level Typically turbine based ventilators are energy efficient due to its mobile use abilities Energy efficiency of the equipment Depends on the specific ventilator No specific difference Low cost of ownership No compressor needed. Need for a backup for CGS or power Need alternative if CGS is not available Need for compressors. Need for a HP-Air Need for HF in NICU ventilation No specific disadvantage With some drawbacks Perform a number of special maneuvres No limitations Turbines can exceed CGS in max. flow High flow demand Covered by CGS Webinar Turbine vs. Central Gas Supply, Pros & Cons | Sept 5th 2012

Turbine vs. Central Gas Supply Pros & Cons Turbine vs Turbine vs. Central Gas Supply Pros & Cons Turbine vs. external compressors Typical external compressor Limited flow delivery: typical 30 l/min average flow Limited lifetime: about 50% of a ventilator lifetime High maintenance cost Bulky: big and heavy Very loud Adds additional investment costs Mask ventilation almost not possible: A compressor will “run out of gas” when trying to compensate for a large leak Turbines The Savina turbine has none of the disadvantages of an external compressor ! Webinar Turbine vs. Central Gas Supply, Pros & Cons | Sept 5th 2012

Turbine vs. Central Gas Supply Pros & Cons Evita Infinity V500 / Babylog VN500 – A Hybrid System The hybrid system is unifying the advantages of central gas supply & turbine technology into one setup Same ventilation performance with or without the GS 500 The GS 500 eliminates the disadvantages of external compressors No high pressure filter needed for the AIR inlet Three turbines generates the „mid pressure“ for the mixing tank. HF ventilaton can not be provided when operating with GS 500 Unique and unreached hybrid concept in the market unifying CGS and Turbine benefits Webinar Turbine vs. Central Gas Supply, Pros & Cons | Sept 5th 2012

Turbine vs. Central Gas Supply Pros & Cons Introduction Basics Turbine in ICU Ventilation Turbine in Non Invasive Ventilation Turbine in Emergency Transport Turbine in Anaesthesia Ventilation Bench Tests Webinar Turbine vs. Central Gas Supply, Pros & Cons | Sept 5th 2012

Turbine vs. Central Gas Supply Pros & Cons Non Invasive Ventilation NIV devices initially has established in home care for conscious, spontaneous breathing patients It was a must that those devices comes with excellent breathing comfort NIV ventilators provides the best leack compensation based on single hose systems with a leak valve Turbine benefits: Independent and mobile Smooth gas delivery (Anti Fump) Carina Webinar Turbine vs. Central Gas Supply, Pros & Cons | Sept 5th 2012

Turbine vs. Central Gas Supply Pros & Cons Introduction Basics Turbine in ICU Ventilation Turbine in Non Invasive Ventilation Turbine in Emergency Transport Turbine in Anaesthesia Ventilation Bench Tests Webinar Turbine vs. Central Gas Supply, Pros & Cons | Sept 5th 2012

Turbine vs. Central Gas Supply Pros & Cons Emergency & Transport A brief assessment Most compact ventilators in this field Turbines adds size by itself and by additionally needed batteries Turbines ensures excellent ventilation capabilities and whould eliminate some of the current drawbacks (e.g. limited flow or ventilation with low O2 concentration) Currently not established but in future turbines will find its way in certain areas of Emergency and Transport ventilation Oxylog 1000 Oxylog 3000 plus Webinar Turbine vs. Central Gas Supply, Pros & Cons | Sept 5th 2012

Turbine vs. Central Gas Supply Pros & Cons Introduction Basics Turbine in ICU Ventilation Turbine in Non Invasive Ventilation Turbine in Emergency Transport Turbine in Anaesthesia Ventilation Bench Tests Webinar Turbine vs. Central Gas Supply, Pros & Cons | Sept 5th 2012

Turbine vs. Central Gas Supply Pros & Cons Anaesthesia Ventilation Classic anaesthesia devices like Fabius and Primus Family systems commonly use piston driven ventilation Strongest driver for Turbines in anaesthesia ventilation: introduce ICU quality ventilation for top class systems ensure independency from CGS Perseus A500 Webinar Turbine vs. Central Gas Supply, Pros & Cons | Sept 5th 2012

Turbine vs. Central Gas Supply Pros & Cons Path-Breaking Ventilation Technology TurboVent® 2 Ventilation quality like an intensive care ventilator: Spontaneous breathing at any time. Nearly unlimited inspiration flow. No compromises with regards to ventilation performance: Equipped with all modern types of ventilation modes.  Vol. ctrl. AutoFlow Active PEEP and real CPAP. Intelligent hygienic concept Webinar Turbine vs. Central Gas Supply, Pros & Cons | Sept 5th 2012

Turbine vs. Central Gas Supply Pros & Cons Anesthesia Ventilation 2009: Zeus IE with TurboVent 2 the world’s smallest and most powerful anesthesia ventilator. When we designed the circle system for TCA, we took the idea from the physioflex to use a blwer for circulating the gas in the circuit for rapid wash in and constant concentration control. We soon realized that this little blower also had the capacity to deliver effcient flows to use it for ventilation at the same time. It turned out to be the most powerful anesthesia ventilator ever. Webinar Turbine vs. Central Gas Supply, Pros & Cons | Sept 5th 2012

Turbine vs. Central Gas Supply Pros & Cons Introduction Basics Turbine in ICU Ventilation Turbine in Non Invasive Ventilation Turbine in Emergency Transport Turbine in Anaesthesia Ventilation Bench Tests Webinar Turbine vs. Central Gas Supply, Pros & Cons | Sept 5th 2012

Turbine vs. Central Gas Supply Pros & Cons Benchstudy on turbine based ICU ventilators, 2009 Savina is among the best performing ventilators out of a total number of 13 ICU ventilators which were tested. Webinar Turbine vs. Central Gas Supply, Pros & Cons | Sept 5th 2012

ERS Buyers Guide about Savina and turbine based ICU ventilators Turbine vs. Central Gas Supply Pros & Cons ERS Buyers Guide about Savina and turbine based ventilators ERS Buyers Guide about Savina and turbine based ICU ventilators Webinar Turbine vs. Central Gas Supply, Pros & Cons | Sept 5th 2012

Turbine vs. Central Gas Supply Pros & Cons Turbine related benefits beyond independence from CGS Excellent spontaneous breathing capabilities (proven !) Equals the performance of high pressure source ventilators (proven !) Excellent NIV (turbines are established in NIV devices) At large leaks and high flow demands the Savina turbine is not limited to the capacity of central gas supplies: In some hospital settings the medical gas pipeline system may have by some reasons limited gas delivery capacity (which may be the case temporarily or even permanent) Goodbye compressor! The turbine is not just an alternative, it should be the preferred solution! Supports a compact design when comparing to systems with compressor Reduces investment cost: compressor is obsolete Webinar Turbine vs. Central Gas Supply, Pros & Cons | Sept 5th 2012

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