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Neonatal ventilators: Whats good, what could beter?


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Hello,

I am a student and I have to make a comparison of neonatal ventilators. So I like to know your experiences with ventilators, such like:

- Avea from Cardinal health

- Babylog 8000 plus

- Bear Cup 750 and Bird VIP

- Carestation from GE

- E100, E150 and E500 form Newport

- Inter 3 and Inter Neo from Intermed

- IV100 and Millenium from Sechrist

- Leoni & Leoni plus

- Servo-I Infant

- SLE 2000 HFO and SLE 5000

- Stephanie

I am looking forward to read your experiences!

---

Rick Meerkerk

Student Rotterdam University

Health Technology

The Netherlands

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I have worked with quite a few ventilators. Though some have more features than others, what I have learned is that the outcome of the patient is more dependent on the familiarity and experience of the team handling the ventilator than the functions in the ventilator.

If my team is experienced with Babylog ventilator, and we are given a newer ventilator with more functions, the patient outcome will be worse of with the newer ventilator than the older one. So be careful in drawing conclusions regarding which is better than the other.

It is good to learn to use a few models of ventilator and become an expert in those models. It really makes a difference to patient outcome.

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Guest drsivjir

Our unit in AIMS,Cochin,Kerala,India,have Babylog ventilators as well as SLE 2000 HFO Plus.

We are very much comfortable with Dragger Babylog machine especially regarding ventilation of preterm and babies who are <1500 grams.The volume Garenteed support mode is especially good to assess how much is the lung improvement and how much the baby is able to generate the volume by itself, so it is considered as a better weaning mode.

SLE ventilator is able to handle babies >3kg may be up to 10-12kg, so we are using it preferably for the term babies and those who require HFOV.

Every ventilator can be familiarized only by routine use of it.Without using commenting about the other ventilators are not possible

The newer generation of SLE and Stephanie are having soft screen touch modes and give beautiful graphics of the pulmonary functions

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  • 2 weeks later...

I completely agree with JACKs first post, that the driver is more important than the machine.

I remember Martin Keszler speaking on HFOV long ago. Experimental data on HFOV was very promising in terms of clinical outcomes, but results from clinical trials was not that convincing. One of his comment of this discrepancy was that HFOV, being a very powerful tool, was put in hands of people at the beginning of the HFOV learning curve.

My personal experience is limited to Stephanie, Leoni PLus and Drager Babylog. Given that fact that (tidal) volume matters more than pressure when it comes to lung injury, some kind of volume control is needed. Through various ways, this can be achieved with all those three machines.

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Guest Dukstar

We have a unit where we train many junior residents. Babylog 8000, with its easy-to-use knobs is really easy to manage.But, in pulmonary graphs, it is quite poor, but how many of us rely on pulmonary graphics?

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Yes,I agree that Drager babylog 8000 has got poor graphics.But we can fix an additional monitor on top of that paying extra money,we really follow the graphics and make adjustment accordingly.The Maquet servo i comes with good monitor ,we dont really need to pay any extra for that.but its good only for term babies........................

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  • 2 weeks later...

I understand after reading and asking in some Dutch hospitals that the babylog is not strong enough to breathe babies above 1.2 kilogram. So I want to know why you just are using the babylog. Are there no alternatives?

Thank you for your reactions!

So far I aim me especially at the

- Babylog from Dräger

- Leoni plus from Heinen & Löwenstein

- Servo-i Infant from Maquet

- SLE 5000 from SLE

- Stephanie from Stephan

These are not bad, but some do have better functions which what?

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  • 2 weeks later...

The babylog is fine for babies above 1.2kg. Our PICU uses them up to 2 months for bronchiolitis.

The problem is that HFV module is inadequate above 1.5kg-2.0kg, but it works fine in conventional ventilation.

We are currently using a Leoni Plus on trial, and so far I have been satisfied with it. In conventional ventilation, it does as well as the babylog, and uses a continuous flow mode. In HFOV it is supposed to be more powerful than the Babylog, but I haven't had the chance to try that mode yet.

The mian criticism I have of the Babylog and the Leoni is the inability to combine SIMV with pressure support, which some of the other ventilators can do (Viasys Avea, Draeger Evita XL).

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The biggest advantage of Draeger Babylog is its supporting system for all physiological modes like SIMV,SIPPV,PSV and its beauty in handling volume gurantee.If you carefully go over it there is a screen which shows physiological parametere like compliance and resistance and if you could use them in the right direction it makes up for not having good pulmonary graphics

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Guest Johannes

If I may add my 5c worth of wisdom...

Having experience mainly with the Dräger BabyLog and Stephanie (and to a much lesser degree of a few others) I can say that the Dräger works fine for the majority of cases, although it shows that it has now come into the years. The Stephanie is a much more modern machine, which shows in its functions and ergonomics. As pointed out, the Dräger has not enough capacities for bigger infants, which may be of concern in some cases.

Of all the fancy functions modern ventilators provide, we should remember that the mainstream of use is in either SIPPV, SIMV and, to a lesser extend, HFV mode.

But, even at the risk of stating the obvious, I agree with what has been said above, the most important factor is familiarity of the user with the ventilator used.

Hope this helps!

Cheers

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