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

2. 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

3. 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

4. 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

5. 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

6. 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

7. 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

8. 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

9. 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

10. 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

11. Turbine vs. Central Gas Supply Pros & Cons Pneumatic Mode of Operation – Savina / Savina 300LP
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

12. Turbine vs. Central Gas Supply Pros & Cons Pneumatic Mode of Operation – Evita V500 / Babylog VN500MP
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

13. 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

14. 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

15. 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

16. 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

17. 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

18. 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

19. 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

20. 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

21. 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

22. 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

23. 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

24. 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

25. 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

26. 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

27. 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

28. 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

29. Thank you for your attention.
Thanks for your attention!