Homecare Pneumology NEONATOLOGY ANAESTHESIA INTENSIVE CARE VENTILATION Step beyond the future

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Alexina Leonard
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1 Homecare Pneumology NEONATOLOGY ANAESTHESIA INTENSIVE CARE VENTILATION Step beyond the future Sleep Diagnostics Service Patient Support

2 The future starts now! For over 30 years, Heinen + Löwenstein has been researching and developing medical devices to benefit patients and continuously improve ergonomics for users. All of our developments are driven solely by a desire to benefit people. Paradigm shift in anaesthesia and ventilation The vitaq is revolutionising our present approach to, and understanding of anaesthesia and ventilation. The vitaq closed platform is a global leader in cutting-edge technology. It enables comprehensive control, superior ventilation, and provides the user with insight into the patient s physiology and metabolism. Quantitative anaesthesia and ventilation In daily clinical practice, inhalation anaesthesia is currently generally performed as minimal flow and low flow anaesthesia. The level of fresh gas supply to the respiratory system is key. The flow of fresh gas is significantly lower than the patient s respiratory minute volume. The anaesthetic gases in the exhaled air are returned to the patient via the rebreathing system. The CO 2 is chemically bound by carbon dioxide absorbers. As a rule, the lower the flow of fresh gas, the higher the level of rebreathed gas, and the lower the amount of excess gas. The time constant is typically much longer in the system; i.e. adaptations of the gas composition take longer the lower the flow of fresh gas. Xenon can now be used as the sole anaesthetic agent. The programmable Qapps, which further optimizes the processes of managing anaesthesia and ventilation, also opens up a range of new possibilities and underscores the uniqueness of the vitaq system. Xenon - simply the best In clinical applications, the safe and easy use of xenon as an anaesthetic has been conclusively demonstrated. Since 2005, xenon has been approved for use as an anaesthetic gas and is considered to be an ideal anaesthetic. This inert gas is not metabolized by the body and therefore significantly improves the waking experience as well as providing previously unattainable haemodynamic stability and organ protection, in particular neuroprotection. However, due to a lack of suitable anaesthesia ventilators - and the resultant high consumption levels and high costs - xenon has not been used as a routine anaesthetic. The vitaq is the first closed respirator that enables the use of xenon. New treatment strategies are now feasible in the ICU as well. Combined with the Xe-Qapp, it ensures that the speed is maximized at which xenon is respirated with minimum loss. GOOD TO KNOW! The vitaq is the first completely closed system using conventional volatile anaesthetics such as desflurane, sevoflurane and isoflurane. When there are changes in concentration, excess volatile gas is absorbed by a specially developed charcoal filter. The electronic (closed loop) control mechanisms ensure that the inspired or expired gas concentrations set by the anaesthesiologist are automatically maintained. The ingenious overall design of the vitaq, with its surprisingly quiet high-performance turbine and valve-free circulatory system, enables time constants within the range of seconds. This practically eliminates any restriction on options for ventilation. The amount of gas supplied is precisely the amount actually used. This is termed QUAM. GOOD TO KNOW! With quantitative anaesthesia in a closed system, the composition and volume of the supplied fresh gas always corresponds to the amount of oxygen, nitrogen oxide and inhaled anaesthetic that the patient is currently being administered. Patient safety, cost efficiency and superior control are combined. QUAM stands for quantitative universal administration method and is the next stage in quantitative anaesthesia. In addition to QUAM, the vitaq can also operate in conventional modes such as semi-closed and open. Given its specific properties, xenon is an almost perfect anaesthetic. It enables constant blood pressure regulation and short induction and waking phases. Furthermore, this inert gas is associated with fewer side effects, such as postoperative nausea and vomiting, and does not contribute to the greenhouse effect.

No borders - one for all In intensive care, volatile anaesthesia has previously been carried out in a semi-open system with additional components and conventional ICU respirators.

Ecological Special software controls the injection of the volatile anaesthetic, addition of anaesthetic gas, maintenance of the end-tidal value, the capturing of the volatile anaesthetic in the

3 No borders - one for all In intensive care, volatile anaesthesia has previously been carried out in a semi-open system with additional components and conventional ICU respirators. There is now a new approach for volatile anaesthesia: Fully enclosed with no additional components, low-loss and fewer contaminants. Ecological Special software controls the injection of the volatile anaesthetic, addition of anaesthetic gas, maintenance of the end-tidal value, the capturing of the volatile anaesthetic in the charcoal filter and the closed circulatory system reduce the usage of the gases to an absolute minimum. This saves costs and protects the patient, user and environment. Monitoring the metabolism Several important parameters have been added to classic ventilation monitoring: The monitoring of the patient s oxygen uptake VO 2 and carbon dioxide output VCO 2. The respiratory quotient RQ is calculated and displayed. Optimal respiratory gas conditioning The higher the flow of fresh gas, the greater the loss of heat and moisture through the lungs. The closed system of the vitaq and absorption of excess volatile anaesthetic by a carbon charcoal filter obviate the need for purging with cold air. This special feature ensures the optimal conditioning of respiratory gas in the system. Hygiene and preparation The vitaq, the easy and safe disinfection of surfaces was prioritized. High-quality materials and a new design inner circulatory system enable easy hygienic preparation and accordingly prevent crosscontamination with nosocomial pathogens. The charcoal filter, CO 2 absorber, membrane chamber and circulatory system can be accessed quickly, easily and without tools.

The future starts now! Circulatory system The autoclavable circulatory system consists of light-weight plastic and does not have any metal conductive parts such as valves.

Volumes are precisely applied and monitored with membrane and laser systems. This even makes it possible to treat neonates.

The geometry of the granules is specially configured. This enables maximum CO 2 absorption and prevents channel formation.

Vapour-free Qtainer Qtainers are available to provide desflurane, isoflurane and sevoflurane and can be quickly and easily filled.

Of course, the integrated hot-swappable, interruption-free power supply comes as standard. The O 2 concentration is automatically controlled and maintained according to user settings.

4 The future starts now! Circulatory system The autoclavable circulatory system consists of light-weight plastic and does not have any metal conductive parts such as valves. The circulatory part has only three components so it can be easily removed and disassembled without any tools. Precision The precision of the vitaq is exemplary. Volumes are precisely applied and monitored with membrane and laser systems. This even makes it possible to treat neonates. Small ecological footprint with Qsorb and charcoal filter Disposable absorbers are used for CO 2 absorption. The Qsorb was developed specially for the vitaq TM. The geometry of the granules is specially configured. This enables maximum CO 2 absorption and prevents channel formation. The Qactivecarbon active charcoal filter for absorbing the volatile anaesthetic is also disposable. This saves costs and is environmentally friendly. Vapour-free Qtainer Qtainers are available to provide desflurane, isoflurane and sevoflurane and can be quickly and easily filled. Safety Safety means more than integrated monitoring and ease-of-use. Redundant high-performance processors continuously monitor the functioning of the vitaq. Of course, the integrated hot-swappable, interruption-free power supply comes as standard. The O 2 concentration is automatically controlled and maintained according to user settings. This excludes the risk of hypoxia from insufficient O 2 within the system. The end-tidal concentration in the anaesthetic gas is reliably maintained according to the user setting. This significantly reduces the risk of overdosing and awareness. GOOD TO KNOW! Disposable absorbers are easy and quick to install. Since they are immediately discarded, there is no processing cost or dust accumulation, which minimizes the risk of dust contamination and gas flow resistance during this period.

Advantages of vitaq TM at a glance: xenon -

control of anaesthesia and ventilation awareness of

from premature infants to adults minimum gas use

5 Advantages of vitaq TM at a glance: xenon - anaesthetic and organ protector (optional) complete control of anaesthesia and ventilation awareness of the patient s physiology and metabolism flexible use from premature infants to adults minimum gas use comprehensive safety approach easy and quick hygienic preparation

Heinen + Löwenstein worldwide p-vitaq-e/2 as

KG Arzbacher Strasse 80 D - 56130 Bad Ems www.

6 Heinen + Löwenstein worldwide p-vitaq-e/2 as of: 11/2016 All rights retained; we reserve the right to modify technical data. Heinen + Löwenstein GmbH & Co. KG Arzbacher Strasse 80 D Bad Ems Telephone: / Fax: / info@hul.de

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