Intelligent Ventilation solutions
Since 1983, Hamilton Medical has been developing intelligent ventilation solutions that provide safer care for critically ill patients and make life easier for the people who care for them.
Solutions that support clinicians
Critical care today is confronted with a widening gap between demand and supply (Angus 2000). In addition, patient safety has become a global priority in the past decade (Chan 2012). As a result, many clinicians are under pressure to provide a higher quality of care to an increasing number of complex patients with limited resources.
Hamilton Medical aims to support clinicians by providing Intelligent Ventilation solutions that:
- Improve patient safety and comfort
- Are easy to use
- Increase efficiency of care
The common Ventilation Cockpit user interface
The Ventilation Cockpit user interface on all Hamilton Medical ventilators is operated in the same way – independent of the device and its use in the ICU, in the MR suite, or during transport. Complex data is integrated into intuitive visualizations.
Intelligent ventilation modes
Hamilton Medical's intelligent ventilation modes Adaptive Support Ventilation (ASV) and INTELLiVENT-ASV adapt ventilation breath by breath, 24 hours a day, from intubation to extubation, and for active and passive patients. They automatically employ lung-protective strategies to minimize complications such as AutoPEEP and volutrauma/barotrauma. Within the rules of this lung-protective strategy, they encourage the patient to breathe spontaneously.
ASV adjusts respiratory rate, tidal volume, and inspiratory time continuously depending on the patient’s lung mechanics and effort.
INTELLiVENT-ASV is a next-generation intelligent ventilation mode that automatically controls ventilation and oxygenation based on the targets set by the clinician and on physiologic input from the patient.
Keeping an eye on patient-ventilator synchrony with IntelliSync+
The well-trained eye of a ventilation expert is capable of detecting asynchronies by analyzing the waveform shapes of either the flow or the pressure waveforms. However, the expert cannot always be at the bedside, and the patient condition can change from breath to breath.
That is where IntelliSync+ takes over. This new technology mimics the expert‘s eye to identify signs of patient effort (trigger) or relaxation (cycling), thus replacing conventional trigger settings for inspiration and expiration.
Lung-protective ventilation tools
Studies have demonstrated that survival is higher with protective ventilation than conventional ventilation (Amato 1998). Hamilton Medical provides specific tools to further support your protective ventilation strategy:
The Protective Ventilation Tool (P/V Tool) provides a respiratory mechanics maneuver that records a quasi-static pressure/volume curve. It allows easy assessment of recruitability in ARDS patients. In addition, it provides a simple and safe way to perform lung-recruitment maneuvers.
The transpulmonary pressure measurement can be used to set PEEP, tidal volume, and inspiratory pressure for ARDS patients. In combination with the P/V Tool, it is useful to assess recruitability and recruitment maneuvers.
Integrated continuous cuff pressure control
Recent clinical studies show that continuous cuff pressure control can decrease microaspiration and VAP (Lorente 2014, Nsei 2011). IntelliCuff® is an integrated cuff pressure control module that ensures optimal cuff pressure.
The CO2 measurement is performed using a CAPNOSTAT® 5 mainstream CO2 sensor at the patient‘s airway opening. The CAPNOSTAT 5 sensor provides technologically advanced measurement of end-tidal carbon dioxide (PetCO2), respiratory rate, in addition to a clear, accurate capnogram at all respiratory rates up to 150 breaths per minute.
The integration of SpO2 pulse oximetry enhances the ventilation support options for Hamilton Medical ventilators (not available for HAMILTON-C2/MR1) and is an important parameter for closed-loop ventilation with INTELLiVENT-ASV.
Amato MB, Barbas CS, Medeiros DM, Magaldi RB, Schettino GP, Lorenzi-Filho G, Kairalla RA, Deheinzelin D, Munoz C, Oliveira R, Takagaki TY, Carvalho CR. Effect of a protective-ventilation strategy on mortality in the acute respiratory distress syndrome. N Engl J Med. 1998 Feb 5;338(6):347-54.
Angus DC, Kelley MA, Schmitz RJ, White A, Popovich J Jr; Committee on Manpower for Pulmonary and Critical Care Societies (COMPACCS). Caring for the critically ill patient. Current and projected workforce requirements for care of the critically ill and patients with pulmonary disease: can we meet the requirements of an aging population? JAMA. 2000 Dec 6;284(21):2762-70.
Chan M. World Health Organization (WHO) [Internet]. Geneva: WHO; 2012 Oct 22 [cited 2014 Oct 28]. Available from: http://www.who.int/dg/speeches/2012/patient_safety_20121022/en/
Lorente L, Lecuona M, Jiménez A, Lorenzo L, Roca I, Cabrera J, Llanos C, Mora ML. Continuous endotracheal tube cuff pressure control system protects against ventilator-associated pneumonia. Crit Care. 2014 Apr 21;18(2):R77.
Nseir S, Zerimech F, Fournier C, Lubret R, Ramon P, Durocher A, Balduyck M. Continuous control of tracheal cuff pressure and microaspiration of gastric contents in critically ill patients. Am J Respir Crit Care Med. 2011 Nov 1;184(9):1041-7.