Maquet SERVO I Ventilator

[zdravka pironova]

Hello colleagues, I need your help!

We just received a new type of ventilator - Maquet Servo I Ventilator. However, so far we have used Babylog 800 Plus. I read in the manual but still don't fully understand the different ventilation modes. So far in our NICU, we have been working with SIPPV and SIMV. 

Could you please suggest some reading/articles that could help us? We are also taking care of ELBW. We recently had a newborn weighing 650 grams and 2 pairs of twins born in 28 weeks gestation. We are situated far from any university hospitals and need to fend for ourselves. Thank you in advance for any help or advice you can provide us.

 

[piatkat]

Do you have NAVA module there? If you do (most likely!) and you have Edi catheters to monitor signal of the diaphragm, then you're good to start with Neurally Adjusted Ventilatory Assist (invasive and non-invasive).

You can find useful resources on Getinge pages:

https://www.getinge.com/za/product-catalog/nava/#block-708975

https://www.getinge.com/dam/hospital/documents/marketing-sales/case-studies-and-abstracts/english/clinical_literature_for_nava_and_edi__neonatal_and_pediatric-en-non_us.pdf

We do most of our invasive ventilation for premature infants in NAVA mode in our unit, also for the smallest ones

[tjuren]

If you need something what is most simmilar to SIPPV on Babylog than chose PRVC together with volume guarantie. If something simmilar to PSV than you go for PRVS= VS. Anyway you should have some representative in your country from Getinge. Get in contact with him/her. I know manual is very unfriendly written.  Yes, NAVA is also of choice, but if you are without any lecture how to do that , it might be very difficult. Hope this help

 

Regards Tom

[rehman_naveed]

Hi

only difference is PEEP is added to PIP while in others PEEP is separate. Meaning the PIP which baby get includes PEEP. Rest of concepts are same. 

[Sutirtha Roy]

@tjurenDon't you think instead of SIPPV; SIMV with VG in Drager Babylog 8000 plus could be more analogues to Maquet PRVC?

[rehman_naveed]

Yes there is no VG, instead use PRVC for volume control ventilation 

[tjuren]

To Sutirtha. Yes you'r right PRVC is more like SIMV  than SIPPV.  Fixed support.

[zdravka pironova]

Thank you all for your help and support ! Your input has been incredibly useful !

[Francesco Cardona]

The list we received from the company is as follows:

 

SIPPV -> PC

SIPPVVG -> PRVC

SIMV -> SIMV(PC)+PS

SIMVVG -> SIMV(PRVC)+PS

PSV -> PS/CPAP, it additionally uses backup with PC in contrast to the babylog

 

From our experience: we mainly use PRVC or PC mode with preterms. You will need an external flow-sensor if you want to use it reliably in preterms esp. below 1,5kg. The internal flow sensor is not sensitive enough. Our impression is also that registered Tidalvolumes (VT) are not necessarily comparable to other machines we have used in this population. The Servo often measures higher VTs. If you dont have external flow sensors it might be wise to use PC and watch TV closely (i.e. have close alarm ranges), so you are alarmed if compliance changes.

Hope this helps.

[piatkat]

26 minutes ago, Francesco Cardona said:

The list we received from the company is as follows:

 

SIPPV -> PC

SIPPVVG -> PRVC

SIMV -> SIMV(PC)+PS

SIMVVG -> SIMV(PRVC)+PS

PSV -> PS/CPAP, it additionally uses backup with PC in contrast to the babylog

 

From our experience: we mainly use PRVC or PC mode with preterms. You will need an external flow-sensor if you want to use it reliably in preterms esp. below 1,5kg. The internal flow sensor is not sensitive enough. Our impression is also that registered Tidalvolumes (VT) are not necessarily comparable to other machines we have used in this population. The Servo often measures higher VTs. If you dont have external flow sensors it might be wise to use PC and watch TV closely (i.e. have close alarm ranges), so you are alarmed if compliance changes.

Hope this helps.

That's Servo N, right? The question is about Servo I, do they have the same modes available? For sure the interface is much much different 😕

[Francesco Cardona]

7 hours ago, cathfriday said:

That's Servo N, right? The question is about Servo I, do they have the same modes available? For sure the interface is much much different 😕

The servo-i has the same modes as far as I know. At least with the new servo-i the modes are the same (we use this machine in our PICU). Older machines have slight aberrations of the names, but its possible to figure out.

https://highlandcriticalcare.files.wordpress.com/2020/03/servoi-pocket-guide.pdf