From the May 2015 issue of HealthCare Business News magazine


Shift to two types of ventilators
Infant-to-adult ventilators are attractive because they offer one user interface for staff to become familiar with, and also make maintenance easier, says Kathey Leibold, an analyst with MD Buyline. But one-size machines definitely do not fit all. A machine must deliver volume and pressure specifically for the micro-preemie, and must also compensate for leaks, since the endotracheal tubes used on the infants don’t have cuffs, in an effort to prevent damage to the airway. Monitoring, alarms, and settings must also be designed for the smallest of patients. Respiratory therapists have found that even machines with neonatal or infant software aren’t always the best choice, Leibold says.

“You really need a dedicated ventilator that is designed specifically and only for those really tiny patients,” Leibold says. “A tiny preemie is not the same as an adult.” Staff in neonatal units have also historically preferred to keep their machines inside the NICU, to avoid potentially spreading infection to some of the most vulnerable patients.
There are a number of exciting options now on the market, as a number of makers now have neonatal-only machines. Draeger introduced the Babylog VN500, a neonatal/pediatric specific ventilator, in 2010. It offered “easy-to-read data and graphics, alarm messages, and parameter screens,” says Coombs, adding that these “were paramount features for the neonatology group.”

Data management was also a key issue for hospital IT departments, and with the VN500, a comprehensive set of patient values, alarms, settings, and waveforms can be exported to a variety of information systems and physiologic monitors.

One plus was its interface. The VN500 has much in common with Draeger’s infant-to-adult V500 ventilator, including a similar user interface and hardware components, though there are some differences. The VN500 has infant-specific features, including an optional control for leakage compensation, while the V500 has specific adult applications, such as automated weaning protocol.

There may be additional changes to the neonatal machine to allow it to be even more specifically tailored for the youngest patients. “As technology and market clearance for infant-specific features of the VN500 move forward over time, there will be more differentiation between the two models,” Coombs says.

Another developing trend in neonatal ventilation is the use of volume guarantee ventilation, Coombs says. Studies have shown that infants who receive volume ventilation versus conventional pressure ventilation tend to have less variation in C02 values, potentially less intraventricular hemorrhage, and a lower incidence of bronchopulmonary dysplasia and other lung-related injuries. “To be successful in using this mode of ventilation, proper monitoring of tidal volumes and airway leakage is essential,” Coombs says.

May 2015 Magazine

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