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1、AVEA 对比,John GuoClinical Support ManagerCrtical Care,ChinaJ,靠什么去卖 AVEA,销售力量客户购买呼吸机的依据?可靠,质量,安全售后声誉送气,病人舒适度品牌忠诚度易用装机量840 sold 2600 units in US 2005,AVEA/Vela 售卖策略,捆绑销售一台呼吸机不可能满足所有需要满足所有临床需求 减少培训费用降低购置费用降低总成本,竞争优势,安全性灵活性易用性高性价比。,对Covidien 840,Delivering your highest standard of careSafe and reliableLo
2、nger battery functionCompressor operates on battery Preserve FIO2Longer emergency operationHigher Feature/Price Ratio Easier to useInternet upgrade capabilityAmerican Made,监测参数波形，(AVEA 多1条)控制参数,PB840的神话#1,双屏幕，提供双倍信息:,PB840的神话#1:双屏提供双倍信息,AVEA 多1个波形,所有基本设置参数,5 个监测参数(可选择)以及所有基本状态信息.840屏幕顶部为监测参数，不能选择。底部
3、屏幕仅仅是设置屏 设置屏及两屏之间均有大块的浪费区,Touch-Turn-Accept only.,$7000 replacement cost!,840 显示压力/容量环 显示环的屏幕不能马上返回到曲线屏没有流速/容量环。没有参考环，不能前后对比。,AVEA 具有所有这些功能，并可以进行打印.,PB840的神话#1:双屏提供双倍信息,AVEA 可以监测 15个可选择参数的监测屏。840 不能提供气管内和食管内压力资料。,PB840的神话#1:双屏提供双倍信息,Myth#2.PB-美国大公司的名牌呼吸机,840 在爱尔兰生产AVEA在美国棕榈泉生产Covidien不是以前的 PB Covidi
4、en中国只有1名临床支持。VIASYS 中国拥有两名顶尖临床支持。每年开1-2次培训班。Covidien是没有前途的公司Tyco/PB 最新的呼吸机是 Achieva，1999上市.VIASYS 近8年内上市：AVEA,Vela,3100-B；近2年又上市了Infant Flow SiPAP，和EnVey.,神话#3:840 是最好的婴儿呼吸机,840 没有近端传感器和监测.AVEA 具有精准的近端传感器，流速和容量测量更精确，触发灵敏度更高。可以选择加热丝或压差式传感器。840 的增氧功能启动时，氧浓度不可避免地升到100%，持续2分钟以内。AVEA的增氧浓度可以任意设置，持续2分钟以内。,
5、对于新生儿科来说，840的空压机太大、太吵电池不能启动.如果停电，病儿只能靠 100%O2 通气.AVEA的内置空压机小巧、安静，电池可支持30分。所设置的 FIO2 可以保持.,神话#3:840 是最好的婴儿呼吸机,840在新生儿模式下可以提供 PRVC 模式 但并非呼吸内压力调节,根据呼气潮气量调节压力不提供容量限制功能AVEA 提供TCPL是大家所熟知的新生儿模式.具有容量限制功能 容量保证通气，在呼吸内调节压力，保证每次呼吸的潮气量 为了安全和准确，应用吸气潮气量作为调节压力的依据。.840 具有 NCPAP必须使用低流量，以避免报警。AVEA 具有功能更完备的NCPAP.,神话#3:
6、840 是最好的婴儿呼吸机,Competitive ComparisonVIASYS AVEA vs.Tyco 840,仅能用 30 分钟的内置电池，且须用纯氧适用于转运吗？AVEA 配备标准 2-h内置电池，即使带动空压机也能坚持 30 分钟。配备外置电池可以用8小时。您是否愿意把经过比对的呼吸环打印下来，验证一下支气管舒张剂的效果呢?AVEA 提供具有前后对比功能的流速/容量环，最多可以储存4个环，还可以进行打印。,针对PB840埋雷,您想用氦氧治疗吗?您知道氦氧对机械通气的影响吗?AVEA 是 FDA 批准的唯一一款具有 Heliox 混氧和监测功能的机型 您想用气动雾化器进行雾化治疗吗
7、?作为标准参数，AVEA 提供气动雾化装置.在现代通气设备中，您不认为用小巧、安静、可由内置电池驱动的空压机应该成为现实吗？AVEA的内置空压机就具有这些特点，可依靠内置电池运行30分钟，外置电池可驱动2小时。,针对PB840埋雷,您希望您的呼吸机具有监测MIP 和 P100的功能吗?AVEA 具有专门的 MIP和P100监测功能您想在 APRV下，对高压相的自主呼吸轻松设定压力支持吗？AVEA 可以为APRV的双相压力提供相同的压力支持。您需要待机功能吗？AVEA 具有专门的待机功能。轻触返回键即可恢复通气。,*Note:840 cannot do true APRV because of
8、E-time variance.A bug in the software prevents locking in an E-time.Cannot use ARDS-net protocol.,针对PB840埋雷,对Maquet Servo-i,陈述AVEA的高标准安全可靠呼气端加热过滤系统长时间的内置电池在内置电池支持下运行的内置空压机 保持 FIO2的稳定紧急情况下的较长支持时间更高的性价比BicoreHeliox雾化器 易用应用成本低,神话#1:界面直观易操作,触摸、控制钮结合的光学编码界面,AVEA Simple Touch 操作.所有操作都是“触摸”加数据钮.无论想改变什么，触摸即
9、选择,神话#2:快速、简便的清洁程序,神话#2:快速、简便的清洁程序,未加热的呼气端过滤器,冷凝水积聚，增加呼气阻力,神话#3:应用成本低,神话#4:全面监测,ET CO2所有呼吸环,曲线,趋势,顺应性,阻力,P0.1(没有MIP),AVEA 全面监测包括呼吸功,研究显示，呼吸功正常时，机械通气的结果才最好监测呼吸功用于支持压力的滴定确定AutoPEEP 以设定合适的触发压力,Monitor WOB,adjust PSV,神话#5:Open Lung Tool会自动确定合适的 PEEP,由趋势数据和肺开放协议组成几乎没有人用的肺开放协议AVEA 的趋势数据可以编辑为类似格式AVEA 提供 PF
10、lex 自动确定内源性 PEEP 和过度扩张压力.,Competitive ComparisonVIASYS AVEA vs.Tyco 840,在传染性疾病越来越多的今天，是否需要具有加热功能的呼气端过滤器的呼吸机呢?AVEA 具有加热呼气端过滤器，既保护工作人员又保证病人的呼气阻力不增加。您是否愿意把经过比对的呼吸环打印下来，验证一下支气管舒张剂的效果呢?AVEA 提供具有前后对比功能的流速/容量环，最多可以储存4个环，还可以进行打印。您很关心购买成本，应用成本您计算了吗?给他看看过滤器的成本分析,针对Servo I 埋雷,对Drger XL 的比较,安全性和可靠性加热过滤器系统 保护工作人
11、员和机器易用性符合人类操作习惯的设计参数显示顺序合理先进性BicoreHeliox,神话#1:XL 的屏幕显示了所有信息,信息很多.增数量不应该牺牲质量.AVEA 减少培训时间，节省成本,XL 不是色彩编码曲线自主触发显示在屏幕的角落.,容量控制通气时显示吸气时间.必须通过高级设置改变基本参数，如峰流量既可设吸气时间又设峰流速，让人困惑.,AVEA 易于培训，减少培训时间和误操作.,神话#1:XL 的屏幕显示了所有信息,XL 不能提供气管内压和食道内压.XL 要想改变显示参数要进入专门的设置屏幕进行设置.AVEA 提供更多信息，显示更合理.安全性，减少培训时间,神话#1:XL 的屏幕显示了所有
12、信息,SmartCare,根据现有知识做成的撤机协议根据呼吸频率、潮气量、和呼气末CO2滴定PSV 水平适应症体重 15 kg，血流动力学稳定的病人.有自主呼吸，氧和状态稳定采用主动湿化的插管病人COPD不适用在应用 SmartCare 时，AAC 不起作用ETCO2 监测面对着冷凝水和分泌物的挑战可能会延长那些本可以轻易脱机的术后病人的脱机时间需要硬件和软件升级,ETCO2 需要花费大约$7000.只有Bicore 被证实可以缩短 COPD 病人的脱机时间.,感染性疾病盛行的今天，没有有效的呼气端过滤器很可怕！AVEA 有加热过滤器.您想用 Heliox吗?您知道某些呼吸机对 Heliox
13、的兼容性吗?AVEA 是 FDA批准的唯一可以提供先进Heliox气体混合并进行监测的呼吸机。,针对 Evita XL埋雷,内置电池，内置安静的小空压机?AVEA 内置电池带动内置空压机 30 分钟，不带空压机可运行 2 小时.您想测定气管内压吗？您想测定有自主呼吸的病人的 AutoPEEP?Bicore 技术 AVEA独有.把尽可能多的信息显示在同一个屏幕上实用吗?AVEAs 主屏清晰，显示必要的信息.其他屏幕易进入.,针对 Evita XL埋雷,Drger Babylog Competitive Positioning,AVEA PositionTechnologically advanc
14、edSafer to useHeated expiratory filter systemEasier to useWider range of applicationsBabylog has 30 Lpm max flow,Babylog PSV and VG,Competitive positioning,Starting PSV on the Babylog:Step 1-Select PSV as a mode.,Comments:Note PSV is a separate mode of ventilation and cannot be used in conjunction w
15、ith any other mode,such as SIMV.AVEA offers the use of PSV with Volume or Pressure SIMV,TCPL SIMV or CPAP.,Step 2-Set the sensitivity and activate PSV,Comments:Some operators find this screen confusing.PSV button was pressed to display this screen.The+and appear be the controls for increasing or dec
16、reasing pressure support since the ON button to engage PSV is adjacent to them.The+and affect the sensitivity,called Trigger,but there is no indication that you are setting pressure or flow.We assume it is flow because without the proximal flow sensor there is no flow measurement.Also,PSV is initiat
17、ed by pressing the On button without having set a pressure.Since control knobs must now take on multiple functions,the initial pressure support will be inspiratory pressure currently used in IMV or SIMV ventilation.AVEA has dedicated primary control buttons labeled specifically for each function.AVE
18、A allows the preset and review of all of the primary controls before initiating PS.,Step 3-Set the flow rate,Comment:The operator is now instructed to set a flow rate based on a graphical interpretation of one breath.This is not easy to do with the small waveform.As the depth and breadth of infant s
19、pontaneous breathing changes,the flow rate will need additional manual adjustments.AVEA varies,breath by breath,the flow rate based on the babys compliance,resistance and spontaneous effort.,TI,Under PSV the set TI operates as a TImax,which cannot be exceeded.The set TI should be 30-50%longer than T
20、Ispo to allow the baby to sigh.,Step 4-Set the maximum inspiratory time,Comment:The operator is now instructed to rotate the Inspiratory Time Control Knob,TI,to a setting that is 30-50%longer than the displayed TIspo to act as a Maximum Time Limit.(Note that during this demonstration period there is
21、 no TIspo display to reference.)Because PSV is an add-on to a limited upgradeable platform,knobs that once were controls must now be used as limits without any change in the indicator.AVEA has an automatic default of maximum I-time,based on user preference testing,and separate dedicated controls to
22、fine tune the setting if needed.Babylog termination criteria is set at 15%of peak flow.(?too long for infants)AVEA has adjustable flow termination.,Step 5-Set the PSV pressure,Comment:PSV pressure is set,using the same Pinsp Control Knob that sets the Peak Pressure in IPPV or SIMV ventilation.Again,
23、available control knobs must now take on a new function without any change in indication.AVEA has separate controls for all functions and only displays the controls specific to the current mode or type of ventilation.,Step 6:Set the Back up ventilation,By the TE knob a Backup Frequency can be set.In
24、 case of apnea or depressed respiratory drive,controlled ventilation starts,as in A/C.,Comment:This not true apnea back-up ventilation,like on the AVEA,whereby an apnea interval is reached and back-up ventilation is started at preset parameters.If the babys spontaneous rate falls below the“back-up”r
25、ate,a breath is delivered.If the flow sensor becomes inoperative,the baby is switched to IMV at the TI set as a maximum limit.,Find this screenTurn here,butLook here,Important points to remember about Babylog PSV,PSV was an add-on to a ventilator with a limited upgrade capacity.Some of the control k
26、nobs,such as TI and TE,now become limits or back-ups without any indication change.You cannot use PSV with SIMVFlow is a manually set control based on a subjective interpretation of a small,one-breath pressure waveform.Back-up ventilation is actually a rate that the baby must run ahead of,or be give
27、n a mechanical breath.If the flow sensor becomes inoperative,all of the controls set as limits revert back to primary settings.The baby is ventilated in IMV at the I-time set as a maximum limit and the rate set as a minimum.,Volume Guarantee(VG),Step 1&2-Select VG screen and enter target VT,Comment:
28、Lack of consistency.The+and buttons did not set pressure in PSV,but they set the volume target in VG.For safety and ease of use,AVEA employs consistency in setting parameters and activation of modes.,Pinsp,Set the maximum pressure,which shall be allowed to give to the patient.Pinsp is the upper boun
29、dary for theVG regulator(see doted line).,Comment:The same Pinsp control knob that was used to set the Inspiratory Pressures in IMV,SIMV and PSV is now changed to a High Pressure Limit without any change in indication.Important Point!If the proximal flow sensor becomes inoperative due to water,secre
30、tions,surfactant or burn out,the Babylog will begin ventilating in IMV at the current setting for the Pinsp control(set as a HIP).,Set the pressure limit,Insp.Flow,Set Inspiratory Flow,so that pressure plateau is reached withinfirst third of inspiratory time,Comment:The flow rate is not variable,but
31、 manually set based on a subjective interpretation of the displayed waveform.Some may want to compare this to PRVC or Autoflow.Not true.As changes in the babys compliance,resistance and effort change,the flow rate will need to be manually adjusted.,Step 4-Set the flow rate,Step 4-Set respiratory rat
32、e,Once the desired TI is set,rotate the TE control to a time that will give the desired respiratory rate.For assistance,select the monitoring screen“Set 1”to display the calculated I:E ratio and fset.,Comment:Find this screen,Turn here,butLook here,Volume Guarantee Alarms,TI,PEEP/CPAP,0,6,10,25 mbar
33、,Vent.Mode,Vent.Option,0.4,0.2,0.6,0.8,1.0,2,5,15,30 s,3,15,3,1,5,7,5,10,20,30 L/min,mbar,10,5,20,30,60,70,80,50,40,25,21,30,40,50,60,70,80,90,100,0.2,0.1,0.3,0.4,0.6,0.8,1.0,1.5,2 s,O2-Vol%,TI,Insp.Flow V,Pinsp.,Pressure Limit Pinsp has been reached,Not enough flow to reachset VT within set TI,Not
34、long enoughinsp.time toreach set VT,Comment:VT low alarms may require multiple adjustments to manual controls for TI,PInsp and/or Insp Flow.Pinsp,now the pressure limiting alarm,is usually increased to reduce the amount of nuisance alarms.All alarms sound the same.,VG+PSV,A Volume Support type modeS
35、et a target tidal volumeAll breaths are patient triggeredPressure will not exceed Pinsp control settingIn PSV,this is a settingIn PSV+VG this is a limitIndicator does not changeTE sets maximum expiratory timeIndirectly sets back-up rateMachine breath will be delivered if spontaneous breath not taken
36、If flow sensor fails,IMV initiated at:Pressure set by Pinsp,which was a pressure limit.I-time set by TI,which was an I-time limitRate indirectly determined by TE,which was a back-up rate.,VG was an add-on mode to a ventilator with a limited upgrade capacity and no microprocessor control over flow.Co
37、ntrol knobs that had been dedicated settings are now employed as limits without denoting the new function.The Inspiratory Pressure control knob,used to set ventilating pressure in IMV or PSV,is now a Pressure Limit control.Babys with conditions affecting large swings in compliance and resistance rea
38、ch this limit frequently.There is a tendency to gradually increase this limit to reduce the occurrence of nuisance alarms.If the proximal flow sensor becomes inoperative,the Babylog starts ventilating in unsynchronized IMV at the Pinsp pressure setting.The flow sensor element is very sensitive to wa
39、ter,secretions,surfactant and in-line treatments.Some hospitals use a new one($40)with every baby.If surfactant fouls the flow sensor,the baby could potentially be given a higher pressure that would generate a higher tidal volume with no way of monitoring a tidal volume increase.,VG Important points
40、 to remember,VG Important points to remember,Volume is only guaranteed up to the pressure limit set by the Pinsp control.Babies with dramatic changes in compliance and resistance will only have minimal changes to their delivered volume before the limit is reached.They will still desaturate,only now
41、the ventilator will be alarming constantly as well.Volume is measured on Expiratory VolumeLeaks occurring after the breath is delivered will cause the next breath to be delivered at a higher pressure.Multiple alarms for TI,Flow and Pinsp require manual settings adjustments,Volume ventilation is avai
42、lable in Standard SIMV and A/CSet tidal volume,rate and flowRate is set directlyTitrate Set Volume to desired Exhaled VolumePressure limiting(like VG)Pressure Control Ventilation with Machine volume and Volume LimitAutomatic flow regulationCircuit volume guarantee and limit Programmable Increase O2
43、ButtonThis is a HUGE benefit in the NICU,AVEA is better and safer,True Apnea Back-up Ventilation Simple controls of Apnea interval,rate,volume or pressure.Simple Pressure Support Set-upPressure is set with a dedicated control.Flow is variable,calculated for every breath.Termination criteria has default valuesFine tune adjustments if needed,AVEA Is Better and Safer,Babylog Screen,Unless you pay extra for thisYou get this,
