1. The Crossvent 2i+ option The Crossvent 2i+ is available in 2 different configurations: Model 2200JC Built-in model for retrofitting incubators that currently use the MVP-10 Model 2200KCB Stand Alone Shown with optional 2016 dual flow meters

2. Features of the Crossvent 2i+ More gas efficient. Full complement of patient alarms built in. Flow triggering for Assist/Control or SIMV Mode with Pressure Support also (still has the old standard of constant flow CMV, if needed). Accurate tidal volume measurement down to 2 ml (and fairly accurate below that). Mean airway pressure reading. Approved for use with nitric oxide delivery systems.

3. Arguments for the CV-2i+ over the MVP-10 The CV-2i+ will provide patient-triggered breaths, making it quicker and easier to stabilize the patient. The CV-2i+ will allow the team to match whatever mode they may find the patient on (except high frequency of course), thus eliminating the need to “start from scratch.” The CV-2i+ has built-in patient alarms. The CV-2i+’s exhaled tidal volume measurement provides one more piece of information to evaluate the effectiveness of the vent settings.

4. One Final Comparison Everyone should agree that if patients could be ventilated with a lower peak inspiratory pressure yet achieve the same effectiveness, we’d be better off and be less likely to suffer further complications. In the following comparison, I assumed that a patient’s measured minute ventilation would be indicative of the PaCO2 of their blood gas. So, if the PaCO2 is at an acceptable level for a patient on certain settings on the MVP-10, then it stands to reason that achieving the same minute ventilation on the CV-2i+ would result in a similar PaCO2.

5. PREMISE I assumed a spontaneously breathing patient at a rate of 50 breaths per minute had a normal PaCO2 reading on an MVP-10, with the following vent settings: Rate=30, PIP=20 cm, Ti=0.35, PEEP=4 cm. While the vent was attached to a flow analyzer, I activated the test lung to simulate a total patient breath rate of 50 breaths per minute and noted the minute ventilation achieved…then dialed in the same settings on A/C mode on the CV-2i+. MVP-10 CV-2i+ Constant Flow CMV Mode Set rate=30 (patient rate =50) Ti=0.35 PIP=20 cm PEEP=4 Flow=6 lpm Measured Min. Ventilation=470 ml/min Assist Control Mode using flow sensor Set rate=30 (patient rate =50) Ti=0.35 sec PIP=20 cm PEEP=4 Flow=6 lpm Measured Min. Ventilation=600 ml/min In order to achieve the same Min. Volume as on the MVP-10 the PIP had to be lowered to 16 cm

6. Summary Aside from all the other obvious benefits of the CV-2i+ over the MVP-10, the ability to ventilate a patient on lower settings and achieve the same minute volume is a huge advantage. A patient will always be more comfortable on a ventilator that is able to be in sync with their efforts. Being able to synchronize with the patient may allow for transporting more patients on conventional ventilation instead of automatically assuming they need high frequency. If the transport team is using an MVP-10 to transport newborns, and they seem to be staying longer at the referral hospital in order to get the patient stable for transport…maybe it’s because they have to start from scratch in the ventilatory process and not just due to a “sicker than normal” patient.

7. Bio-Med Devices, Inc. For more information please contact Michael MacGregor Voice Mail: 800-224-6633 x243 Office: 317-297-2050 Cell: 317-513-2050 E-mail: m.macgregor@biomeddevices.comm.macgregor@biomeddevices.com www.biomeddevices.com