Angelie EIS System. Electrical Impedance Segmentography. When the smallest thing matters

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Gerald Lawrence
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1 Angelie EIS System Electrical Impedance Segmentography When the smallest thing matters

Easy-to-Use Accurate and Quick Electrical Impedance Segmentography (EIS) is a painless, low cost, noninvasive and radiation-free method to continuously record distribution of air in parts of the

Data is continuously displayed in the form of images, waveforms and parameters. In other words, the Angelie EIS lets you visualise the distribution of ventilation.

2 Easy-to-Use Accurate and Quick Electrical Impedance Segmentography (EIS) is a painless, low cost, noninvasive and radiation-free method to continuously record distribution of air in parts of the human body. The Angelie EIS is an Electrical Impedance Segmentography System which has been specially designed for clinical use. Data is continuously displayed in the form of images, waveforms and parameters. In other words, the Angelie EIS lets you visualise the distribution of ventilation. The system works on both spontaneously breathing and ventilated patients. Continuous Monitoring Noninvasively The Angelie EIS System monitors the impedance across four quadrants of the lung. This is representative of the equivalent ventilation and shows changes in volume for each of these quadrants. Regional changes of lung ventilation, such as alveolar collapse and atelectasis, pneumothorax, misplacement of tracheal tubes the effects of surfactant administration can be diagnosed by X-ray, but cannot be monitored continuously in NICUs at present. Therefore methods to monitor regional ventilation of spontaneously breathing infants and especially of mechanically ventilated infants at bedside are required. See changes as they happen A great research tool Heterogeneous distribution of air and ventilation between right and left lung as well as within each lung remains a major problem in neonatal intensive care. It constitutes a therapeutic dilemma, since increasing ventilatory support also increases the heterogeneity and gas exchange disturbances. Alveolar collapse or overdistension of the lungs is associated with ventilation/perfusion mismatch.

Recruitment See changes in lung volume as they happen Medical staff use X-Rays on a regular basis to assess the regional distribution of ventilation, which largely affects the capability of the lung

3 Recruitment See changes in lung volume as they happen Medical staff use X-Rays on a regular basis to assess the regional distribution of ventilation, which largely affects the capability of the lung to exchange gases. For many therapeutic measures, such as adjustments of ventilator settings, recruitment manoeuvres, patient positioning, lung suction, and pneumothoraces, it is highly beneficial to get immediate feedback on a breath-by-breath basis to assess the efficiency of the measure. The Angelie EIS images, real-time impedance curves and derived parameters allow this feedback immediately and in real-time. Mechanical Monitor ventilation across all four quadrants Infants and premature neonates, have incomplete respiratory systems. This makes the intubation of an infant a more complicated procedure than the intubation of an adult. Possible complications of infant intubation include damage to the pharyngeal structures; intubation of the oesophagus and inefficient oxygenation. Endotracheal tubes may become obstructed by secretions or become misplaced due to being uncuffed tubes. Clinicians are then able to use the Angelie EIS System to access and confirm continued correct placement to the ET tube; patency of the ET tube and effective distribution of gas to all four quadrants. The Angelie EIS System visually monitors the four quadrants of the lung, enabling the clinician to see areas of concern immediately. The user may be able to remedy the issue quicker, and therefore able to prevent escalation to a more serious situation. Pneumothorax Get prior warnings Due to the incomplete development of the respiratory systems of infants and premature neonates, they are very susceptible to Chronic Lung Disease. Pneumothoraces are one of the complications associated with mechanical ventilation, especially in premature infants and infants with Meconium Aspiration Syndrome. Asynchronous ventilation and volutrauma are also contributing factors. A pneumothorax occurs when there is rupture of the alveoli, leaking air into the space between the lung and the chest wall. The Angelie EIS System can be used as an Early Warning System monitoring the normal and abnormal distribution of gas within the infant s lungs. By continuously monitoring this gas distribution the clinician is able to detect the possible occurrence of a pneumothorax much more quickly and initiate treatment more quickly, preventing more serious situation developing. Immediate information

Easy to Apply Three Examination Modes Allow the user to change the way gas distribution data is displayed.

Check Electrode contact Unit alarms when an electrode is disconnected or there is a poor connection.

Fixation The Angelie EIS is noninvasive and has no known hazards or adverse effects associated with it.

4 Easy to Apply Three Examination Modes Allow the user to change the way gas distribution data is displayed. Touch Screen controls Touch screen controls change depending upon the function required and allow quick access to all the Angelie s features. User Definable Scales When recording and reviewing an examination allow easy visibility. Check Electrode contact Unit alarms when an electrode is disconnected or there is a poor connection. Archive Patient Data To the Angelie or external USB, allows transfer and storage of data for later review. Fixation The Angelie EIS is noninvasive and has no known hazards or adverse effects associated with it. This combination makes the Angelie EIS well-suited for continuous respiratory monitoring of neonatal intensive care patients right at the bedside. Using only ten small electrodes the system can be applied quickly and easily to any patient.

Screen Display The bright, high-resolution screen display allows easy determination of the impedance changes

Digital information shows percentage changes from a zero point that highlight improvements and reductions in each

Additional graphic displays in the top half of the screen show instantaneous views of each quadrant.

5 Screen Display The bright, high-resolution screen display allows easy determination of the impedance changes within each quadrant of the baby s lungs. A central overview panel shows the operator changes in volume with time. Digital information shows percentage changes from a zero point that highlight improvements and reductions in each quadrant s capacity. Additional graphic displays in the top half of the screen show instantaneous views of each quadrant. The lower half of the screen displays two graphs that show trend information from each quadrant and allow the user to see both longer term and short term changes. Touch screen controls allow easy adjustment to each graph.

Additional Safety Enhanced Monitoring Continuous information about regional distribution of ventilation, displayed as images, waveforms and parameters Trend display of changes in segment impedance

Regional Lung Ventilation in Infants. Judith C Weinknecht. June 2009 PhD Dissertation 2. Continuous Noninvasive Monitoring of Tidal Volumes by Measurement of Tidal Impedance in Neonatal Piglets.

6 Additional Safety Enhanced Monitoring Continuous information about regional distribution of ventilation, displayed as images, waveforms and parameters Trend display of changes in segment impedance representing regional distribution of ventilation Trend display of changes in segment impedance representing changes in end-expiratory lung volume References: 1. Electrical Impedance Segmentography. Regional Lung Ventilation in Infants. Judith C Weinknecht. June 2009 PhD Dissertation 2. Continuous Noninvasive Monitoring of Tidal Volumes by Measurement of Tidal Impedance in Neonatal Piglets. Kurth et al. PLoS ONE June 2011.v Continuous Noninvasive Monitoring of Lung Recruitment during High Frequency Oscillatory Ventilation by Electrical Impedance Measurement. An Animal Study. Burkhardt et al. Neonatology. May 2012

7 EIS System Amplifier Number of channels 4 (optional 8) Electrode input 4 Bipolar Input impedance >800 MOhm CMRR >110 db Noise Less than 0.5 µv (RMS) Calibration Integrated sine wave generator Sensitivity 0.01 µv/cm to 10 mv/ cm (in 19 steps) LFF 100 Hz HFF 10 khz ADC 16 bit Notch filter 50/60 Hz Isolation Type BF System power 5 V (via USB connection) Max USB cable length 1.2 m (Longer cable lengths can cause interruption/corruption) Angelie Touchscreen PC Hardware Processor System memory Intel Sandy Bridge CPU DDR3 up to 8 GB, 1066/1333 MHz Graphic memory Intel Graphic 2000/3000, integrated on CPU, freq 850 MHz LCD touch screen 15.6 LED LCD Brightness 220 cd/m 2 Resolution 1366 x 768 Touch screen True flat resistive touch External I/O USB ports Serial port Parallel port LAN Audio jack Electrical DC input Power supply Power on Thermal management Audio speakers EMC 4 type A 4 RJ45 COM ports 1 D-sub 25F 1 RJ45 1 mic in, 1 line out 19 V / 6.32 A 65 W/19 V On switch 1 internal cooling fan 2 x 2 W speakers FCC class A/CE mark/ EN Other Peripherals Wi-fi 2M webcam b/g/n WLAN card Environment Operating temperature 0ºC ~ 35ºC Storage temperature -20ºC ~ 60ºC Humidity 20% ~ 85% RH noncondensing IPX rating IP65 Dimensions 396 x 48 x 245 mm Weight Mounting 4.5 kg 75 x 75 mm standard VESA/Panel mount Operating Systems supported OS Windows XP, POS Ready, XP embedded, XP professional for embedded, Linux, Windows 7, POSReady7 Touchscreen PC PSU Input specifications Input voltage VAC Input frequency Hz Input current 1.60 A (RMS) for 115 VAC 0.80 A (RMS) for 230 VAC Earth leakage current 180 µa 264 VAC, 63 Hz Touch current 100 µa 264 VAC, 63 Hz Output specifications Output voltage 19 V Min current 0 A Max current 6.32 A Tolerance +/-5% Ripple and noise 190 mv Max power 120 W Average active efficiency (typical) 115 VAC 87% 230 VAC 86% Cables PSU mains cable USB cable (from touchscreen to Angelie)

8 SLE is a world leader in the design and manufacture of neonatal ventilators. Years of ventilation experience have given the company an understanding of the challenges facing nurses and clinicians when caring for the tiniest and most critical babies. From being pioneers of neonatal Patient Triggered Ventilation (PTV) in the 1980 s, to the introduction of combined HFO (High Frequency Oscillation) in the 1990 s, SLE has maintained a position of strength in neonatal ventilation. The knowledge and experience gained during years of development is evident in all of SLE s products: the result of our ongoing commitments to innovation, competency and care. SLE Limited. Twin Bridges Business Park, 232 Selsdon Road, South Croydon Surrey CR2 6PL UK Telephone:+44 (0) Fax: +44 (0) sales@sle.co.uk Web: Subject to Change G0118/0UK/001 08/13

SLE5000 Infant Ventilator with HFO

SLE5000 Infant Ventilator with HFO When the smallest thing matters SLE5000 - The Total Solution for Infant Ventilation Shown on optional roll stand. Ventilator may be mounted either way round on stand.