Clinical Nutrition. Solution - Catalogue. Gold Standard Solutions for Indirect Calorimetry and Body Composition in research and clinical applications

Transcription

1 Clinical Nutrition Solution - Catalogue Gold Standard Solutions for Indirect Calorimetry and Body Composition in research and clinical applications

2 Company Profile Founded in 1980, COSMED is a privately owned company manufacturing Cardio Pulmonary and Metabolic Diagnostic Equipment. new grounds with metabolic measurements and rapidly became the best selling oxygen measurement device in Education, Sports Science and Research. Since its foundation, COSMED primary goal has always been to improve the quality of its products and services through innovation and superior customer service. COSMED manufactures a full range of Spirometers, Pulmonary Function, Cardio Pulmonary Exercise & Nutritional Assessment diagnostic equipment. In 2011, COSMED further enhanced its already extensive offerings with the acquisition of Life Measurement, Inc. (LMI), a leading US provider of body composition assessment equipment in infants, children and adults. COSMED started in 1980 designing and manufacturing spirometers. In the late 80s, COSMED introduced a portable electronic desktop-sized spirometer named Pony, which was immediately successful in the European and Far East markets with more than 20,000 units sold globally. In the mid 90s COSMED designed the first portable metabolic analyzer, the K4. This truly innovative device broke GERMANY AUSTRALIA CHINA UNITED KINGDOM COSMED Asia Pacific Pty Ltd China Representative Office UK Representative Office Sydney Guangzhou +86 (20) /26 London anz@cosmed.com china@cosmed.com uk@cosmed.com COSMED srl COSMED USA Inc. COSMED Deutschland GmbH (Toll Free US only) Fridolfing Concord CA +1 (925) deutschland@cosmed.com Chicago IL +1 (773) info@cosmed.com 2 info@cosmedusa.com COSMED distribution network includes more than 80 countries. COSMED is investing today in order to improve technology for tomorrow. UNITED STATES Milan +39 (02) COSMED is a world-wide organization with subsidiaries in the United States and representative offices in Germany, UK, China and Australia, employing approximately a total of 120 full-time employees. All COSMED products are designed to meet the latest recommendations and guidelines from the leading scientific organizations, including American Thoracic Society (ATS), ITALY (Headquarters) Rome +39 (06) the European Respiratory Society (ERS), the American Heart Association (AHA) and the American College of Sport Medicine (ACSM). All of our products meet CE mark, IEC /EN and FDA 510(K) and other various international certifications.

3 Indirect Calorimetry Solutions O 2 CO 2 Overview The determination of energy needs is a basic component of nutritional assessment because the balance between energy intake and expenditure may have important health implications. The benefits of providing optimal nutrition for recovery from illness and chronic health management are also well documented. The exact measurement of Resting Metabolic Rate can offer a scientifically-based approach to customize nutrients delivery and to maximize the benefits of nutrition therapy, avoiding not-appropriate nutritional support and reducing the incidence of overfeeding and underfeeding. References AARC Clinical Practice Guideline Metabolic Measurement Using Indirect Calorimetry During Mechanical Ventilation 2004 Revision & Update Respiratory Care September 2004 Vol 49 No 9 Academy of Nutrition and Dietetics The accurate measurement of energy expenditure is generally accomplished by indirect calorimetry (IC), which is considered the Gold Standard for determining caloric needs in confined-to-bed patients and is indispensable for Nutrition Support Teams providing nutrition care to patients in different departments of the hospital. COSMED boasts the most extensive range of indirect calorimetry solutions in the market ranging from the fully configured metabolic cart to the portable desktop device. COSMED calorimeters can satisfy the specific needs of heterogeneous different application fields: from Intensive Care Units to Nutrition Support Teams (NST), from Enteral/Parenteral nutrition, up to metabolic syndrome counselling and commercial weight management. COSMED technology has been validated by several prestigious research centres and it has been adopted by major clinical nutrition department all around the world (to know more: 3

4 Indirect Calorimetry Quark RMR - Indirect Calorimetry Lab The New Standard for measuring Energy Expenditure at Rest in Research and Clinical Practice O 2 CO 2 The Quark RMR is a compact bedside indirect calorimetry solution designed to allow accurate and instantaneous estimation of Resting Energy Expenditure (REE) and respiratory ratio (R), in a non-invasive way, through the measurement of oxygen consumption (VO 2 ) and carbon dioxide production (VCO 2 ) together with other ventilatory parameters. Quark RMR allows also to identify metabolism substrate utilization (%FATm %PRO, %CHO) enabling thus improved nutrition support and accurate planning of nutritional therapies. Energy requirements are monitored accurately and instantaneously either with a flow-dilution canopy hood on spontaneously breathing subjects or (optionally) to mechanically- assisted patients by inserting directly at the patient s circuit a disposable flowmeter (Flow-REE). Quark RMR accuracy and reliability have been validated against reference techniques. Accurate, compact, bedside indirect calorimetry solution Measurement of Resting Energy Expenditure (REE) & Substrates Provided with flow-based-dilution canopy Optional kit for measuring REE in mechanically assisted patients (ICU) Suitable for subjects from 15kg and above Validated against the Gold Standard Validation articles Ashcraft C.M. et al. A Test of Validity of a New Open-Circuit Indirect Calorimeter. J Parenter Enteral Nutr Mar 10 Sundström M et al. Indirect calorimetry in mechanically ventilated patients. A systematic comparison of three instruments. J. Clin Nutr Feb;32(1): Blond E. et al. A new indirect calorimeter is accurate and reliable for measuring basal energy expenditure, thermic effect of food and substrate oxidation in obese and health e-spen e- Journal of Clinical Nutrition and Metabolism 6 (2011) e7ee15 more scientific studies on ICU Kit The optional ICU module for Quark RMR allows measurement of REE in patients undergoing mechanically assisted ventilation. Face Mask Mode In addition to canopy hood, REE testing can be performed with COSMED reusable face masks available in 5 different sizes (adult and pediatric). OMNIA Software Innovative and user-friendly software interface including latest features and trends. Compatibility with Windows 8 and touch-screen ready interface.

5 Gold Standard Technical Specifications Product Description REF Quark RMR Indirect Calorimetry Laboratory C Standard packaging Quark RMR unit, Canopy hood (with veil), Flowmeter Resting (2 pcs.) w/ sampling line, antibacterial filters, OMNIA PC software, calibration syringe, HR monitor (receiver and transmitter), power supply cable, USB cable, user manual Standard Tests Nutritional Assessment Resting Energy Expenditure (REE, RMR), Indirect Calorimetry w/ Canopy Hood or w/ Face Mask or w/ mouthpiecesantibacterial filter, Respiratory Quotient (RQ), Substrates Analysis (%FAT, %PRO, %CHO) Flowmeter Turbine Ø-18mm (Canopy/Mask) Flow-REE (ICU) - Optional Type Bidirectional Digital Turbine Disposable PNT (Lilly) Flow Range 0-8 l/s 0-1,7 l/s Accuracy ± 2% or 20 ml/s (flow) ± 2% or 100 ml/min (ventil.) ± 2 % Resistance <0.7 cmh 2 O 3l/s <0.3 cmh 2 0/l/s up to l/s Visualization resolution 4 ml/s 1 ml/s Gas Analyzers O 2 CO 2 Type Paramagnetic NDIR Range 0-25% (Standard Range 0-30% - ICU Range 0-60% - Elevated 0-10% FiO 2 Testing: User defined) Accuracy ± 0.02 % ± 0.02 % Response time 120 ms 100 ms Hardware Dimensions & Weight Unit: 17 x 30 x 45 cm/8 Kg Canopy: 32 x 50 x 30 cm/0.6 Kg Interface ports USB A-B, RS-232, HR-TTL, SpO 2 Electrical requirements V ± 10% 50/60 Hz Internal emergency battery 12V; 1,2 Ah Environmental conditions Temperature 0-50 C ( F); Barometer mmhg; Humidity 0-100% Software OMNIA Available languages Italian, English, Spanish, French, German, Portuguese, Greek, Dutch, Turkish, Russian, Chinese, Korean, Romanian, Czech PC Configuration 1.4 GHz or faster processor speed. Compatible with Vista (32/64), Windows 7 (32/64), Windows 8 (32/64). RAM 4GB (8GB recommended). 500 MB of free disk space Modules Description REF ICU kit for vent Patients Allowing Quark RMR measurement of REE in patients undergoing mechanically assisted C ventilation. Mixing Chamber 7 liters Mixing Chamber (physical) C Accessories & Options Description REF Gas Calibration Kit Gas cyclinder required for O 2 /CO 2 calibration (16% O 2, 5% CO 2, N 2 bal) and a pressure regulator A (Gas) A (Regulator) Pulse Oximetry Oximeter (Xpod) requires probe Oximeter ipod (w/ finger probe) C C Ethanol Burning Kit Kit consists of a glass ampoule for the verification of respiratory quotient readings. Routine calibration performed by burning a known quantity of Ethanol C Medical Cart Medical-graded with isolation transformer (according to MDD directive). Designed to hold the whole equipment during bedside applications. Safety & Quality Standards MDD (93/42 EEC); FDA 510(k); EN (safety) / EN (EMC) C (230 VAC) C (120 VAC) 5

6 Indirect Calorimetry Fitmate GS - Desktop Indirect Calorimetry The world s only portable desktop indirect calorimeter for clinical testing and research O 2 CO 2 The Fitmate GS is the first portable desktop indirect calorimeter using the dilution technique for accurate measurements of Resting Metabolic Rate (RMR) in a clinical setting. The use of a ventilated hood makes the test highly comfortable allowing patients to breathe freely. The ventilated hood can also be used for long periods of time with minimal discomfort and no air leaks from the system. Fitmate GS allows reliable, accurate, easy and quick measurement without the need of consumables and complicated calibration procedures with gas cylinders. Fitmate accuracy has been validated against the gold standard Douglas Bag. Resting Energy Expenditure (REE, RMR) by oxygen consumption Provided with flow-based-dilution canopy (Fitmate GS only) Simple and effective monitoring of patient s energy requirements Affordable, portable, compact, easy to use with built-in printer Automatic calibration and no need of consumables Validated vs. Gold Standard technique Validation articles Optional measurement with face mask or mouthpiece Vandarakis D, et al. A comparison of COSMED metabolic systems for the determination of RMR. Res Sports Med 2013;21(2):187 Lee J et al. Validation Of The Cosmed Fitmate For Predicting Maximal Oxygen Consumption MSSE: May Vol 41 5 Nieman DC, et al. Validation of Cosmed s FitMate in measuring exercise metabolism. Res Sports Med (1):67-75 Nieman DC, et al. Validation of Cosmed s FitMate in measuring oxygen consumption and estimating resting metabolic rate. Res Sports Med (2):89-96 more scientific studies on Simple to Use Main measured parameters can be viewed in real time on the LCD screen. Warning alerts are prompted in case levels of ventilation or oxygen concentration are out of range. Silicone Face Masks Available in 5 different sizes (adult and pediatric), COSMED reusable masks allow REE testing with maximum patient comfort. Standard on Fitmate or optional with Fitmate GS Mouthpiece & Antibacterial Filter An affordable alternative to the use of face masks, it keeps the same level of accuracy and prevents leakages with some type of patientsand eliminates possible user s mistake.

7 Best Price Technical Specifications Products Fitmate GS Fitmate Description Desktop indirect calorimetry with canopy hood Desktop indirect calorimetry Part Number C C Standard packaging Fitmate GS unit, AC/DC Adapter, USB cable, Fitmate PC Software (CD-Rom), Body meter, Oxygen sensor, Canopy hood, Canopy blower, control board, Fitmate case, Thermal paper Gas Analyzers Oxygen (O 2 ) Type GFC Range 0-25% Response time t ms Fitmate unit, RMR - Flowmeter, Silicone Mask, AC/DC Adapter, USB cable, Fitmate PC Software (CD-Rom), Body meter, Oxygen Sensor, Fitmate case, Thermal paper, Antibacterial filters Accuracy ±2% (REE) ±0.02% (O 2 ) Warm-up time 10 seconds Flowmeter Fitmate GS Fitmate Type Bidirectional digital turbine (Ø 28mm) Bidirectional Digital Turbine (Ø 18 mm) Flow range 0-16 l/s 0-8 l/s Accuracy ± 2% or 20 ml/s (flow) ± 2% or 100 ml/min (ventilation) ± 2% or 20 ml/s (flow) ± 2% or 100 ml/min (ventilation) Resistance <0.6 14l/s <0.7 cmh 2 3l/s Ventilation range 0-50 l/min Canopy Hood Dimensions & Volume 46.8x32x22 cm / 18,7 l Flow rate range l/min Blower internal battery 4 AA Hardware Dimensions & weight 24 x 20 x 8 cm / 1.5kg Interface ports USB A-B, RS-232, HR-TTL, Flowmeter Display Color LCD 320 x 240 pixel Printer High speed thermal printer 12 cm (4,7 in) Battery Rechargeable Li-ion batteries (autonomy 6h; charging time 2h10) Firmware Available languages Italian, English, Spanish, French, German, Portuguese, Greek, Dutch, Turkish, Chinese, Korean, Japanese, Finnish, Polish, Russian, Slovenian Software Fitmate Suite Available languages Italian, English, Spanish, French, German, Portuguese, Greek, Dutch, Chinese, Finnish, Russian, Slovenian Required PC configuration Pentium or faster, Windows XP, VISTA (32/64 bit), Windows 7 (32/64 bit) 128 Mb RAM or more, USB, CD-Rom reader, 80 Mb on HD space available. Accessories & Options Description REF Fitmate cart Fits Fitmate unit, printer, masks, printouts, carrying case C Calibration syringe 3L syringe for accuracy check of flow volume measurements C O 2 sensor replacement kit Includes GFC sensor, sampling line and mounting key C Activity Monitor Fitmate Lifecorder PLUS Integrated one-axial, solid state accelerometer. Records up to 60 days of data, steps, distance, energy expenditure, and classify Physical Activity Levels according to METs (sedentary, light, moderate, heavy) C

8 Indirect Calorimetry Product Comparison Quark RMR Fitmate GS Fitmate Gas Sensors Technology Oxygen (O 2 ) l l l Carbon Dioxide (CO 2 ) l Gas Sampling Technology Breath by breath (BBB) l m l Dilution (Canopy Hood) l l m Nutrition Assessment Resting Energy Expenditure (REE, RMR) l l l Substrates Analysis (RQ, %FAT, %PRO, %CHO) l Indirect Calorimetry w/ ventilated patients (ICU) m Indirect Calorimetry w/ Canopy Hood l l m Indirect Calorimetry w/ Face Mask m m l Indirect Calorimetry w/ mouthpiece-antibacterial filter m l l Weight Management Program (Energy Balance) l l Physical Activity Monitoring (PAL classification) w/ Lifecorder w/ Lifecorder Diet Planner l l Fitness Assessment Standardized Measurements (WHR, BP, RHR, etc) l l Body composition by Skinfold (Formulas) l l Other Tests Pulse Oximetry (SpO 2 ) m 8

9 Body Composition Solutions 2-Compartment Model Overview Researchers widely recognize that the accurate assessment and tracking of body composition can provide key information in both clinical and research settings. Body Composition is the single best way to get the whole picture of what s really going on in the body. Body composition information can also be used to help monitor and evaluate infant growth patterns, optimize nutritional interventions, obtain important feedback during drug treatments, and optimize release criteria. COSMED patented technology, the whole-body Air Displacement Plethysmography (ADP), is a recognized and scientifically validated densitometric method to measure human body composition. ADP is based on the same principles as the Gold Standard method of Hydrostatic weighing, but through a densitometric technique that uses air displacement rather than water immersion. Air-displacement plethysmography offers several advantages over established reference methods, including a quick, comfortable, automated, noninvasive, and safe measurement process, and accommodates various subject types (e.g., infants, children, obese, elderly, and disabled persons). COSMED ADP body composition assessment systems have been validated against main body composition assessment techniques and are extensively used in research and clinical settings all around the world (to know more: 9

10 Body Composition by Air Displacement Plethysmography Best Seller BOD POD GS - Gold Standard Body Composition Air displacement technique for accurate fat and fat-free mass analysis in adults and children The BOD POD Gold Standard Body Composition Tracking System is an air displacement plethysmograph which uses whole-body densitometry to determine body composition (fat and fat-free mass) in adults and children. A full test requires only about 5 minutes, and provides highly accurate, safe, comfortable, and fast test results. The accuracy of the BOD POD has been shown to be very high against reference techniques in a number of research publications. It is also completely non-invasive, making it especially suitable for frequent, longitudinal tracking of body composition and metabolic changes over time. Each BOD POD Gold Standard is a complete turnkey system with a dedicated computer system, the ability to measure thoracic gas volume (TGV), and data management capabilities. Gold Standard accuracy using wholebody densitometric principles Excellent test-to-test repeatability Fat and fat-free measurements Fast test time (2 minutes inside BOD POD and about 5 minutes total test time) Safe, non-invasive, and ideally suited for frequent testing Flexibility in testing special populations, including young children (Pediatric Option) Validation articles Fields DA, et al. ADP pediatric option in 2-6 years old using the f4cm as a criterion method. Obesity 2012 Aug;20(8): Ball SD, et al. Interdevice variability in percent fat estimates using the BOD POD. Eur J Clin Nutr Sep;59(9): Fields DA, et al. Body-composition assessment via ADP in adults and children: a review. Am J Clin Nutr (3): McCrory MA, et al. Evaluation of a new ADP for measuring human body composition. MSSE 1995 Dec;27(12): more scientific studies on Technical Specifications Product Description REF BOD POD Gold Standard Gold Standard body composition tracking system A Standard packaging BOD POD unit; Calibration cylinder; Electronic scale; Kiosk; Power supply; 10 Kg. calibration weights (2 pcs.); Nose clip; Window cleaner; Window cleaning cloths (5 pcs.); Quick reference guide; Body composition posters (1 tube); Transformer assembly; Printer; Printer cable (3 meters); BOD POD Operator s manual. Hardware POD Digital Scale Dimensions 165x84x132 cm 6.4x34x32 cm Weight 141 Kg 11.3 Kg Maximum patient weight 250 kg Software BOD POD Suite Available languages English PC Configuration (included) Windows XP Pro (32 bit) or Windows 7 (32 bit); 256 MB RAM (XP Pro), 2 GB RAM (Windows 7) Accessories & Options Description REF Pediatric option for subjects between 2 and 6 years of age (as small as 12 kg) A

11 Gold Standard PEA POD - Infant Body Composition Air displacement technique for fat and fat-free mass analysis in neonatal applications The PEA POD is an Air Displacement Plethysmography (ADP) system using whole body densitometry to determine body composition (fat and fat-free mass) in infants weighing between 1 and 8 kg. Researchers widely recognize that the accurate assessment and tracking of body composition in the critical period immediately following birth and throughout early life can provide key information in both clinical and research settings. The PEA POD is extremely simple to operate, with software prompts guiding the operator through each step of the process. From start to finish, a PEA POD test takes about 7 minutes. The accuracy of the PEA POD has been shown to be very high against reference techniques in a number of research pubblications. Gold Standard accuracy using wholebody densitometry Testing pre-term and term infants (1 to 8 kg ) Fat and Fat-Free Mass measurements Accomodates most infant behaviors (crying, movement, etc.) Safe, non-invasive, and ideally suited for frequent testing Excellent test-to-test repeatability Validation articles Roggero P et al Evaluation of ADP for body composition assessment in preterm infants. Pediatr Res. 2012;72(3): Ellis KJ, et al Body-composition assessment in infancy: ADP compared with a reference 4-compartment model. Am J Clin Nutr Jan;85(1):90-5. Ma G, et al Validation of a new pediatric ADP for assessing body composition in infants.. Am J Clin Nutr Apr;79(4): more scientific studies on Fast test time (only 2 minutes inside the chamber) Technical Specifications Product Description REF PEA POD Infant body composition tracking system A Standard packaging PEA POD unit; Computer/monitor; Software Disk; Volume panthom; 2 Kg. calibration weight; Chamber tray allen key; Door strap (placed on PEAD POD door); Subject cup (10 pcs.); Window cleaner; Window cleaning cloths (5 pcs.); Keyboard membrane; Printer; Air intake pre-filter (4 pcs.); Operator s manual. Hardware POD Dimensions 156x80x122 cm Weight 141 Kg Software PEA POD Suite Available languages English PC Configuration (included) Windows XP Pro (32 bit) or Windows 7 (32 bit); 256 MB RAM (XP Pro), 2 GB RAM (Windows 7) 11

12 COSMED Srl Via dei Piani di Monte Savello 37 Albano Laziale - Rome 00041, Italy +39 (06) Phone +39 (06) Fax info@cosmed.com cosmed.com 2014/08 COSMED E & OE. Subject to alterations without prior notice. REF C COSMED and its product names and logos are owned by COSMED and may be registered.