Dear fellow 99nicu members, A warm Hello !

Having been used to the settings on the 3100A, I was wondering how do you set the HFOV in the fabian acutronics?

In the 3100A sensormedics, we were setting Bias Flow at 20 L/min, I:E at 1:2 ( 33%). However the fabian HFOV can work from 8 till 20 L/min of Bias flow. What is your usual starting Bias flow and where is your comfort zone ? Also since the Fabian can accommodate I:E of 1:1, 1:2 and 1:3 , what do you usually start with?

 

Warm hello to you as well!

We don't have that accutronic machine but have almost invariably (with Sensormedics) had the ratio IE set to 1:1

We use I:E of 1:1 with the Fabian (we also used 1:2 ratio with Sensormedics). The company suggests to use 8 lpm of bias flow for HFO.

Thanks for the information.

Just out of curiosity, will it be sub-optimal or even harmful to run the fabian at flows of 20 like the sensormedics3011A. And if the I:E ratios were set at 1:3 or 1:2 instead of 1:1 would it affect ventilator performance with effect on patient respiratory function?

BTW, a nice comparison:

http://www.prhoinsa.com/images/pdf/sle/bibliografia/Harcourt_Comparison_8_HFO_ventilators_2014.pdf

 

Harcourt, E.R., John, J., Dargaville, P.A., Zannin, E., Davis, P.G., Tingay, D.G., 2014. Pressure and flow waveform characteristics of eight high-frequency oscillators. Pediatr Crit Care Med 15, e234–240. doi:10.1097/PCC.0000000000000111

There is a study in rabbits comparing different flows with HFO which did not find any difference in effect with different bias flows (cant find the citation at the moment).

In a course on HFOV they mentioned that there is no evidence to say which ratio would be more efficient for ventilating patients (Van Kaam).

Thanks for the link!

Hi Jack. We usually set the flow between 8 and 12 depending on the baby. We have found it to be amazing. I did not think that anything would be as good as the Sensormedics but we have a fleet of 18 Fabians and have not needed to use the Sensormedics since. We do find that you need to use a much lower Hz down to 6 at times for the critically ill baby who is impossible to oxygenate. If you need more technical advice definitely worth contacting your local distributor or head office direct. They are extremely skilled and very helpful. Good luck!

We usually set I:E to 1:2!