NI 60 Non-invasive ventilation without compromise Homecare Pneumology Neonatology Anaesthesia INTENSIVE CARE VENTILATION Sleep Diagnostics Service Patient Support
NI 60 Non-invasive ventilation without compromise Evidence Cardiogenic pulmonary edema CPAP therapy should be the primary treatment for patients with hypoxemic ARF due to cardiogenic pulmonary edema after initial nasal administration of oxygen. Mechanical Ventilation in Acute Respiratory Failure. Hanover 2008, p.27 ARF Non-invasive ventilation should be used to treat ARF whenever possible to avoid the complications of invasive ventilation. German Respiratory Society, Clinical Practice Guideline Non-invasive Mechanical Ventilation in Acute Respiratory Failure. Hanover 2008, p.10 Areas of application NON-INVASIVE VENTILATION Use the full therapeutic spectrum of non-invasive ventilation. HELMET VENTILATION Continuation of NIV therapy in spite of mask-related complications as a supplementary therapy option. Application areas Emergency room ICU
COPD COPD patients who are invasively ventilated and capable of NIV should be extubated as early as possible and switched to NIV. Mechanical Ventilation in Acute Respiratory Failure. Hanover 2008, p.10 AECOPD Minor to moderate AECOPD with ph levels of 7.30-7.35 is a clear indication for NIV at an early stage. Mechanical Ventilation in Acute Respiratory Failure. Hanover 2008, p.10 NASAL CPAP Nasal CPAP as a low-complication transition from prolonged weaning to respiratory therapy. DYNAMIC BILEVEL Combines the advantages of pressure-controlled and volume-controlled ventilation. Significant reduction of the user s workload based on virtually full automation. IMC Shock room
NI 60 Non-invasive ventilation without compromise Triple compensation for measured leakage Approved for mask, helmet, and nasal CPAP therapy Integrated drug nebulizer No compromise in compressed air quality and triggering Sufficient flow reserves for up to 180 L/min Optional products 1. Aircon respiratory gas humidifier 2. NI 60 cart 3. NI 60 support arm 4. Drug nebulizer 5. Nasal CPAP mask strap 6. Water trap with integrated swirl valve and exchangeable filter unit
In the presence of leakages, pressure cannot be held constant. Mechanical Ventilation in Acute Respiratory Failure. Hanover 2008, p.31 Non-invasive ventilation should be used to treat ARF whenever possible to avoid the complications of invasive ventilation. German Respiratory Society, Clinical Practice Guideline Non-invasive Mechanical Ventilation in Acute Respiratory Failure. Hanover 2008, p.10 Comprehensive leakage compensation Technology instead of compromise The effective compensation of leakage caused by masks and tubes represents a major challenge for medical devices. Even short-term pressure drops of just 0.2 seconds may lead to the collapse of alveolar areas, which means they must be avoided as effectively as possible. The dual hose system of the NI 60 continuously measures, indicates, and adjusts mask-related leakage. Furthermore, the display provides precise data about the leakage status. Because of the active valve control of expiration, the device can rely on high-speed control algorithms, which prevents the risk of rebreathing CO 2. In contrast to single hose systems, no additional flush flow is required to compensate the tube stricture. Compact NIV therapy even outside of the intensive care unit Respiratory therapy with CPAP or NIV is considered the standard treatment for cardiac pulmonary edema. It may be expedient to start the treatment right in the emergency room or the cardiac cath lab to avoid unnecessary delays of pharmacotherapy or cardiological intervention. The compact NI 60 ventilator is ideally suited for this purpose because of its easy handling and extensive leakage compensation. This also facilitates the prompt start of therapy outside of intensive care units. Thanks to technical advancements in conventional BiLevel ventilation, non-invasive applications now allow for the easy combination of pressure-controlled ventilation with the benefits of volumecontrolled ventilation. Dynamic BiLevel ensures CO 2 washout while significantly reducing the operating time. 1. Aircon respiratory gas humidifier The Aircon respiratory gas humidifier combines modern technology and innovative design in a high performance unit. Thus, it fulfills the medical requirements and the economic expectations of the market. The result is optimal physiologically conditioned respiratory gas, which protects the mucous membranes of the ventilated patient from drying out and prevents interference with the mucocilliary clearance. 2. NI 60 cart The matching movable cart accommodates the NI 60 device, a support arm for tubes, and an inspired gas conditioner for mobile use in the clinic. Optional add-on boxes can store filters or masks.
Helmet CPAP is the alternative for treating hypoxemic ARF, especially in case of mask complications. Mechanical Ventilation in Acute Respiratory Failure. Hanover 2008, p. 68 NIV in spite of mask-related complications Nasal CPAP can improve oxygenation and lung mechanics. Mechanical Ventilation in Acute Respiratory Failure. Hanover 2008, p.48 Nasal NIV Mask-related complications often force the termination of noninvasive ventilation, making it necessary to switch to conventional ventilation therapy. In such cases, a ventilation helmet can be an option for continuing the non-invasive ventilation that helps avoid intubation and reduces lethality. The fact that mask-related complications are completely ruled out is another reason why helmets are usually tolerated better and for a longer time. The NI 60 features a special helmet mode to ensure optimal triggering in spite of the dead space. Setting the expiratory flush flow guarantees CO2 washout and prevents any unwanted CO2 rebreathing. Nasal CPAP with settings of 9-10 cm H2O leads to a rise in the oxygenation index without hemodynamic effects. This is a significant advantage over CPAP therapy with low PEEP settings. Nasal CPAP with the corresponding PEEP setting is therefore an interesting therapy option in many cases. It has also been documented to reduce the length of patient stays in intensive care and clinical settings. Furthermore, nasal CPAP allows for prolonged application within the scope of weaning and post-operative respiratory therapy. The NI 60 features this option in addition to mask and helmet applications. 3. NI 60 support arm 4. Drug nebulizer Our flexible tube support arm features two joints for individual attachment of ventilation tubes and thus provides reliable strain relief for the mask. The high-quality nebulizer can be filled with ready-to-use drug solution during ongoing therapy. The integrated safety valve prevents potential pressure loss and therefore rules out reflex alveolar collapse. The clear drug chamber enables early detection of possible incompatibilities.
The images contains optional accessories which can be ordered in addition. (Please inquire further information.) CPAP therapy should be the primary treatment for patients with hypoxemic ARF due to cardiogenic pulmonary edema after initial nasal administration of oxygen. Mechanical Ventilation in Acute Respiratory Failure. Hanover 2008, p.26 In the post-extubation phase after prolonged invasive ventilation (> 48 h), patients with hypercapnic ARF and risk factors for extubation failure should receive prophylactic treatment with NIV. Mechanical Ventilation in Acute Respiratory Failure. Hanover 2008, p.38 Compact NIV therapy outside of the intensive care unit Respiratory therapy with CPAP or NIV is considered the standard treatment for cardiac pulmonary edema. It may be expedient to start the treatment right in the emergency room or the cardiac cath lab to avoid unnecessary delays of pharmacotherapy or cardiological intervention. The compact NI 60 ventilator is ideally suited for this purpose because of its easy handling and extensive leakage compensation. This also facilitates the prompt start of therapy outside of intensive care units. Respiratory therapy and NIV in the post-extubation phase Once a patient has been successfully extubated, there can be many factors that may lead to additional work of breathing, which turn increases the risk of renewed acute respiratory failure. In such patients, preventive non-invasive ventilation can lower the risk of re-intubation due to acute ARI in the post-extubation phase. This measure is easy to perform in IMC and recovery units, using a combination of NIV ventilation and respiratory therapy. 5. Nasal CPAP mask strap The CPAP mask strap was specifically developed for long-term nasal therapy. The various sizes ( 2 / 3 / 4 ) allow for precise anatomical adjustment and ensure high wearing comfort. The design of the CPAP mask strap prevents mechanical trauma to the nasal mucous membranes and is compatible with all conventional heated tube systems. 6. Water trap with integrated swirl valve and exchangeable filter unit The water trap with integrated gas filter protects patients and the ventilation device from dirt particles, rust and condensation from the centralized gas supply unit, thereby supporting the low-maintenance operation of intensive care ventilators.
Heinen + Löwenstein Arzbacher Straße 80 D - 56130 Bad Ems Phone: +49 26 03/96 00 0 Fax: +49 26 03/96 00 50 www.hul.de p-ni60-e Stand: 05/2014