Respironics Inc.
BiPAP model S/T 30, S/T-D 30
BiPAP which the Respironics Inc. proposes is the ventilation help law to do the patient who has a spontaneous-respiration by presupposing a leak under the mask and also of the registered trademark of the equipment however, there is it.
Bi of BiPAP is the equipment which helps in the ventilation in "the positive pressure in case of intake" and "the positive pressure in case of the expiration" in the meaning of IPAP(Inspiratory Positive Airway Pressure) and EPAP(Expiratory Positive Airway Pressure), two PAP.
The point which is the pressure ventilation type resuscitator which presupposed the leak of breathing circuit is original, of the circuit leak pressure ventilation (Pressure Ventilation) permits and this is utilizing the characteristic to be excellent about the synchronism with the spontaneous-respiration.
Therefore, the patient who needs a controlled-respiration becomes the outside of the adaptation.
The acute-exacerbation and the sleep apnea of the chronic-respiratory-failure patient and so on become good adaptation.
Recently, the low invasiveness and the handiness of BiPAP are evaluated and clinical application is being expanded.
(Note ; The term resembles but BIPAP of the Drager Inc. is another concept.)
BiPAP is S, S/T, S/T 30, S/T-D A model was developed in order with 30, Vision, Esprit, Harmony, Synchrony.
S/T 30 and S/T-D 30 is the same performance basically but is S/T-D Removability remote Control Panel (DCP30) can be attached to 30.
DCP30 makes telemechanics and a pressure display feature, an interface (outputting the signal of the pressure, the air quantity of ventilation, the flow outside the outside) possible.
The alarm function can be added if attaching the airway pressure monitor (APM ; Airway Pressure Monitor) of the option.
2. The
performance
The mode S(Sontaneous), S/T(Spontaneous/Timed), T(Timed),CPAP
Maximal flow 150LPM (The S/T model is 120LPM).
The
inspiratory-pressure
.4-30pH2O
PEEP. .4-30pH2O
Breathing number of
times .4-30BPM
The power consumption .115V
AC 1.4A
S/T 30, S/T-D 30 is composed by the control system by the 送気 equipment by the blower, and PVA (the valve type which adjusts gas pressure in IPAP, EPAP which is called Pressure Valve Assembly), the airflow meter (Fluothane Sir), the accurately composed analog computer.
It needs an advanced technology but the design and the manufacture of the analog computer have the possibility to surpass a digital circuit.
However, the details are a black box.
S/T 30, S/T-D The point which is breathing ancillary equipment by the D pressure ventilation by the rebreathing type 30 pieces of originality have the C part which doesn't use the B exhalation-valve which presupposed a A leak under the @ mask.
There is a gas leak mechanism which is called "UISUPA-SUIBERU" in the mask.
An intake gas circuit and an expiration gas circuit are separated and the general resuscitator doesn't mix.
The existence of the leak at the patient circuit is in the condition which isn't rather desirable.
On the other hand, gas in the patient circuit is replaced by the intentional amount of leak which depends on "UISUPA-SUIBERU" and the amount of leak not to intend which depends on doing the fit bad of the mask by BiPAP.
In other words, by the ventilation law by the rebreathing type circuit, in one tube of the patient circuit, "SEYO"吸 feeling gas and expiration gas are reciprocating partially (Expiration gas is exchanged for the fresher gas about most gas at the) it does 15p(, flowing backward degree in the tube in the worst condition).
It is a ventilation law by "the reverse idea" which presupposed that the leak exists that the loss quantity of patient circuit gas by the leak becomes fresh gas.
of of course, there had been a leak which is certain degree of about intake gas, too, but it was necessary so
It is providing the mechanism which is simple with the 送気 equipment with the high flow rate not to make a problem and the delicate gas control technology and moreover is excellent about the synchronism with the patient.
However, it is CO.2Because the amount of leak sometimes becomes a problem in the decreasing setting (in other words, are "NADO") with (the short expiration time where there are many taking air quantity of ventilation where there are few ventilating-pressures), too, the rebreathing which is needs enough consideration.
4. Breathing mode
The unique term of the Respironics Inc. includes IPAP and EPAP.
IPAP means the pressure of the inspiratory-phase and EPAP means the pressure of the expiratory-phase.
The setting of IPAP is equivalent to the setting of PSV level and PCV level and EPAP is equivalent to PEEP.
The S mode means PSV+PEEP, it sets PSV level in IPAP and sets PEEP level in EPAP.
When the intake gas flow rate exceeds a trigger to IPAP more than an estimated leak flow rate than with EPAP CMPCP, it is when reaching the intake quantity of 5-9 ml.
In the IPAP time, it continues for doing 300 ms of minimum.
The change of EPAP is done from IPAP when the IPAP time reaches 3 seconds when the time and the patient when the intake gas flow rate became below the standard value do expiration actively.
It explains that the intake gas flow rate and the time change a standard value but the details are unclear.
For the 300 first ms which switched over to EPAP, the trigger sensitivity becomes low intentionally and prevents a mystery gar.
There are not S mode and a difference if the S/T mode is the mode to have added Time cycle feature to the S mode and detects a trigger within time (60sec/BPM) which is prescribed at setting breathing number of times but IPAP begins in Time cycle if not being.
In other words, it is the mode about the Assist/Control mode that PSV is begun instead of the active-ventilation.
The switchover to EPAP is the same as the S mode more than IPAP.
In the IPAP time, it continues for doing 200 ms of minimum.
The T mode is setting breathing number of times and %IPAP time and the intake time and the expiration time are the PCV similarity mode to be provided, but are different from PCV and the trigger mechanism doesn't operate.
All switchover from EPAP from IPAP to EPAP the switchover from it to it and to IPAP, too, is done in time cycle.
Because a flow is controlled to maintain the pressure of IPAP・EPAP even if there is a spontaneous-respiration, the T mode is approximation in BIPAP with the meaning having to do with rather an original text.
There is not a display of CPAP but to choose CPAP mode, it chooses IPAP or EPAP as the mode selection switch.
In the position of IPAP, CPAP level is set in the set value of IPAP.
In the position of EPAP, it is established in the set value of EPAP.
Next, it sets the value of IPAP or EPAP.
In the S mode, it needs only to set IPAP, EPAP.
In the S/T mode, it sets breathing number of times more.
In the T mode, it sets more in the %IPAP time, too.
S/T 30, S/T-D There is not an alarm function and at 30 simple substances, it supports an alarm function in Airway Pressure Monitor of the option.
In this case, the airway pressure upper limit, the airway pressure minimum, the delay time (that the airway pressure minimum alarm operates) can be set.
7. The maintenance
Appropriately, it checks and it exchanges a filter if necessary.
It receives regular inspection in 1 every year.
It says that it has a blower and a valve assay for equal to or more than 20,000 hours but in the low place of the aerial cleanliness, the lifetime draws in.