1. The characteristic (Figure ; Outward appearance photograph of BEAR CUB750)
Bear Cub deals with the infant of -30 Kg of 500g with the resuscitator of the CFPR(Constant Flow Pressure Relief) mechanism to make an inspiratory-pressure occur to in relieving a continuous flow in the pressure by the exhalation-valve. Way, the VIASYS Inc. is expressing the mode which is composed of CFPR mechanism with TCPL(Time Cycle Pressure Limit). In the Bear Cub II system of the ex-model, it realized PTV in the aggregate of Bear Cub, CEM, NVM-1. However, each development time was different, the unification of the operability lacked for its purpose and the arrangement of the switch and the sharing of roles became apart. It integrated these and it is BearCub750VS that it gathered to one machine. On the mechanism, special spirit of innovation isn't seen, but it combines a that the experiencing which was cultivated for many years is done new Mattick technology and an established electronic technology and is built into the product with high percentage of completion. With the option 3 corrugation graphic display, the grasping of the respiratory condition of the patient is easy. In 2001, it was improved and PSV mode was added to becoming 750PSV. 750PSV is 3,200,000 yen of price.
2. The performance
1) The mode that it is possible to use (It is TCPL mode completely).
750VS 750PSV
Flow Cycle SIMV
Flow Cycle A/C
+ The Volume limit mechanism
2) This proximal dater
The si stem operation interval time .2.5ms
The maximum intake gas flow rate
The active-ventilation .30LPM
The number of the maximum active-ventilations .150 BPM
The maximum SIMV number of times .150 BPM
3. The control circuit, the controlling mechanism
1) The outline of the controlling mechanism
It depends on the new Mattick mechanism in the gas control and it depends on MPU in the timing-control. Having to do with a previous era in to be few, "GA" but this is pressure corrugated "YA". The flow rate corrugation has the smoothness which is peculiar to the analog mechanism and there is not unnaturalness which is peculiar to the digital servo. MPU is Motorola 68HC11 is used for Controller and the Monitor mechanism respectively.
2) The characteristic of the mechanical mechanism
It is the CFPR(Constant Flow Pressure Relief) mechanism which gets an inspiratory-pressure by relieving a continuous flow in the pressure by the exhalation-valve. For the separate continuous flow quantity to be able to be set to the business and the business in case of the expiration in case of intake, it has two continuous flow adjustment mechanisms.
3) The gas flow rate measurement
An air quantity of ventilation monitor is a heat ray type and is installed between the Y peace and the tracheal tube. There are two heat rays in the sensor. It distinguishes between the direction of intake and the expiration with each temperature difference. It is scalableness in the range of 40LPM from 0.2. It is possible to use without proofreading because it is recording a calibration dater to the inner ROM.
4) The intake valve
The intake valve is a needle valve. There are two of the business (the intake gas flow rate control) in case of business (Base Flow) and intake in case of the expiration and they are changed by Solenoid-controlled valve by these. In each, it is connected with rheostat (potentiometer) and the gear, and it is and it tells the position of the control to MPU.
5) The expiration valve
A mechanical servomechanism by the new Mattick method is used for an exhalation-valve. It changes two standard pressure developmental-mechanicses (the PIP pressure of the business and the PEEP pressure of the business in case of the expiration in case of intake) by Solenoid-controlled valve, it controls the aperture of the exhalation-valve and it controls an inspiratory-pressure. It least-izes the influence of the intake and the expiration of the patient and it stabilizes PIP/PEEP pressure.
4. The new Mattick circuit (Figure ; New Mattick circuit of BearCub750PSV)
The O2/ The filter (filter), the non-return valve (check valve), the regulator (O to be of the gas which entered from the Air entry in each2/ The blender (O to be OBJ DO and to be decompressed in Air regulator) and to stabilize2/ It is in Air blender) in the entry. Accommodated with gas by two non-return valves (check valve) when becoming one gas with the abnormality of the plumbing The O2/ Air entry gas pressure is monitored with the pressure transducer.
It adjusts to the oxygen concentration for the purpose by the blender but bleed valve (bleed valve) is provided to maintain this precision to +/-30% in the range of 3-30LPM.
It adjusts a continuous flow in case of intake with flow control valve (inspiratory flow control valve). It adjusts a continuous flow in case of the expiration by base flow valve (base flow control valve). These are Solenoid-controlled valve (flow control solenoid) and switch over. When MPU senses, it releases compulsorily in the intake gas big worrying by Solenoid-controlled valve (dump solenoid) and saying the expiration pleuropodium of the patient circuit was blockaded, it does an airway pressure below 5‡pH2O. Pressure relief valve (adjustable over pressure relief valve) with the mechanical method which it is possible for the user to adjust to the mechanical back in 15-75‡pH2O is provided as further security measures. The fresh air can be breathed under the negative pressure of - 3‡pH2O than this valve, too.
The inspiratory-pressure is an exhalation-valve in the continuous flow and makes with blocking off. It relieves pressure above being constant by the exhalation-valve which is PEEP valve. Exhalation-valve (exhalation valve) works as the servo control mechanism with PIP pressure and PEEP/CPAP pressure. Standard pressure is inputted to the chamber of the expiration valve in the left side and an actual airway pressure is inputted to the chamber in the right. The degree of the opening and shutting of an exhalation-valve is corrected based on these pressure errors (the inclination) (= The new Mattick servo). It changes standard pressure to the PIP pressure standard pressure or the PEEP/CPAP pressure standard pressure by 3 direction Solenoid-controlled valve (exhalation solenoid) and it makes PIP pressure and PEEP/CPAP pressure occur to the patient circuit. As for the PIP pressure, PEEP/CPAP pressure is made with PEEP valve by inspiratory pressure valve. This is the principle which controls pressure, adjusting the back pressure of jet venture Lee. compliance volume is connected to absorb the vibration of the pressure by the change.
An expiration gas suction mechanism by jet venture Lee is prepared by the exhalation-valve.
Purge regulator (purge orfice) supplies proximal pressure sensor tube (proximal airway pressure tube) with the purge style. This tube is connected with pressure gage (proximal airway pressure gauge) and pressure transducer (proximal pressure transducer).
5. The control software
The explanation of the each function
1) The trigger formula
PTV of the flow trigger formula is possible. It is possible to set sensitivity in the range of 0.2-5.0LPM.
2)A/C (Assist/Control)
TCPL (the continuous flow + pressure relieving) ventilation is given every time it detects a trigger. When not detecting a trigger, an active-ventilation is given by the set air changes per hour. The continuous flow can be separately set by the inspiratory-phase and the expiratory-phase. It switches over to the expiratory-phase when reaching a set value when setting a volume limit. The alarm of the sound and the LED of the case sounds. 750PSV became able to make this alarm to be becoming off.
SIMV is a variable-time method. The active-ventilation is the same as A/C in the TCPL ventilation. There is not a demand flow feature. The spontaneous-respiration aspect is CPAP. Volume Limit can be added.
It is CPAP by the continuous flow. An alarm warns when detecting an anaerosis and is included in the back-up ventilation.
An active-ventilation is helped in TCPL and a spontaneous-respiration is helped in PSV. Volume Limit can be added to the ventilation, too, in time. It becomes quantity ventilation Volume Cycle to the case.
It is PSV which is made with CFPR mechanism. The difference with the active-ventilation of A/C of the TCPL method is the point which intake doesn't begin with if there is not a trigger, the point that the intake peak rate of flow fell to the 10% in the ending of intake. Volume Limit can be added. At the time of the anaerosis, an alarm sounds and is included in the back-up ventilation.
7)Flow Cycle A/C
Basically, it is the ventilation which is the same as PSV, but the ventilation doesn't begin in PSV if there is not a spontaneous-respiration in it whereas a spontaneous-respiration is ventilated by the setting air changes per hour by Flow Cycle A/C even if it is not.
8)Flow Cycle SIMV
As for the difference with SIMV/IMV, an active-ventilation is done by the ventilation of PSV. In the spontaneous-respiration aspect, it is CPAP.
9)Volume Limit
Of the ventilation of the active-ventilation, which type of PSV however, intake aborts to prevent a pulmonary over-expansion when the taking air quantity of ventilation reaches a set value by the feature which can be added. It is pressure ventilation and quantity ventilation however, it is when this feature operates. When this feature is operated, it is possible to make not sound and not sound an alarm.
10) The anaerosis back-up
It is valid in the CPAP, PSV mode. The alarm shifts to the sounding back-up ventilation mode when detecting anaerosis time (choosing with switch of 5, 10, 20, 30 seconds, the rear-panel). Pressure is ventilated by the set air changes per hour (the set value is 6BPM at the time below 6BPM). When detecting a spontaneous-respiration, it deadens the sound but the LED of the caution becomes as it lit up.
11) The battery
It is possible to operate for about 30 minutes by built-in battery.
6. The operation system (Figure ; Operating panel of BearCub750PSV)
1) The panel layout
It becomes a monitor display, alarm setting, ventilation setting from the finial.
2) The setting of a ventilation condition
It does PIP pressure and PEEP/CPAP pressure by the analog mechanism of the new Mattick type while confirming a value by the manometer (the airway-pressure-meter).
The base flow is a digital display with the intake flow but this is not the meaning which is set by merely connecting the control of the analog mechanism to the potentiometer and being doing a digital display only digital-ly. Precision isn't high but of the part where precision is originally required however, there is not it.
It is possible to be set in the digital by intake time, and expiration time, an air changes per hour, a volume limit because they, are electrically processed while seeing a numeral display.
3) The trigger sensitivity
The circuit for the infant where there are many leaks must readjust trigger sensitivity according to the change of the change-of-position and the respiratory condition. It is difficult to understand optimal value, being sensuous in the general digital setting but in 750VS, an intake flow rate is displayed by the bargraph (The value isn't over). Because it sets analog-ly while seeing the move of the bar, it is easy to adjust to the optimum level.
7. The monitor, the alarm function
1) The monitor item
It changes and it puts on an air changes per hour, intake time, expiration time, I:E ratio, a peak inspiratory-pressure, an average airway pressure, air plumbing pressure, oxygen plumbing pressure, an expired volume per minute, a taking air quantity of ventilation, leak percentage (% tube leak) by the numeral display.
2) The alarm setting
The low PEEP/CPAP pressure, the hypernoea, the low inspiratory-pressure, the inspiratory-pressure upper limit, the expired volume per minute minimum, "NADOWO" can be set. The back panel the setting of anaerosis time has a setting switch.
3) The alarm item
The anaerosis, the battery voltage decline, the plumbing gas pressure malfunction, the equipment abnormality, the patient circuit abnormality, the setting to extend an inspiratory-pressure with and to contradict it, Fluothane Sir's abnormality, equal "GAARU"
8. The display feature
In the independence of the main unit, it is possible to do only a numeral display with monitor item but with the graphic display (the product which is common with Bear-1000) of the option, the flow, the pressure, 3 corrugations and the mechanics, breathing loop with volume can be displayed.
9. The patient circuit composition, the humidifier (Figure ; Patient circuit of BearCub750PSV)
It was shown in the figure.
10. The daily maintenance
1) Fluothane Sir
After wash, it sterilizes in "DEISUO-PA" or EOG. To a maximum of 50 times It doesn't guess a compressed gases style at the sensor. The proofreading is unnecessary.
2) The exhalation-valve (Figure ; Structural drawing of exhalation-valve of BearCub750PSV : Assembling an exhalation-valve body and a muffler as shown in the figure)
It does resolution, a wash, sterilization every patient. The exhalation-valve diaphragm exchanges when it admits damage.
3) Built-in battery
However, mom who connected to the power electric outlet is desirable when not using to do a battery in the auxiliary charge. The exclusive-goods and the exchange are necessary if the lifetime comes.
11. The regular inspection
1) Every month
It does OVP(Operational Vertification Procedure). (It refers to the manual).
2) 6 months
The check by the authorization serviceman
3) Once for every 5,000 hours or per year
It does preventing maintenance.
4) It takes in 10,000 hours or in 3.
It overhauls.
12. The fault
1) An exhalation-valve and the design of the exhalation-valve muffler (the silencer) which is aren't polished. The a little more simple structure is desirable.
2) There is not originality of the technical novelty and new breathing mode and so on.