Respironics
BiPAP Vision
1. The characteristic (Figure ; Outward appearance photograph of BiPAP Vision)
BiPAP Vision was sold in 1997 as the most host computer. The big screen liquid crystal display can be displayed in the graphic presentation and the various information, the equipment setting information, "WO" of 3 corrugations (the flow, the volume, the pressure) in the characteristic as in the name of Vision. Moreover, a max-flow and pressure, too, were strengthened and oxygen concentration setting and an alarm function, too, were had. A highly efficient PAV(Proportional Assist Ventilation) mode, too, is had.
2. The performance
The mode .S/T,CPAP,PAV
Maximal flow 240 LPM
The inspiratory-pressure .2-40‡pH2O
PEEP. .2-20‡pH2O
Breathing number of times .4-80BPM
rise time. .0.05-0.4sec
The display The .3 corrugated simultaneous display, the dater display
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3. The outline of the mechanism
1) The composition (Figure ; Structure of BiPAP Vision)
The air to have introduced from fresh air is pressurized by the blower. According to the IPAP pressure, the number of rotations of the blower changes into 3 steps. PVA controls IPAP/EPAP pressure in IPAP and EPAP in two valve groups, slipping unnecessary pressure. It estimates that the intake gas flow rate is Fluothane Sir by the leak revision mechanism but it calculates from decreasing the gas flow rate *of* where an expiration gas flow rate is needed to compensate for the leak by the existence of the expiration gas flow rate.
2) The improvement
In BiPAP Vision, the following improvement is added. ‡@ It changes a blower in the thing boiling by the high capacity. ‡A The valve assay, too, is S/T At 30, it is one, but it adds another valve to adjust rise time and it becomes a 2 ream type. Two valves aren't connected. ‡B To improve a maximal flow, these parts are directly arranged. ‡C It is preparing a graphic display. A digital circuit is introduced into the part for its purpose. However, the basic part is S/T 30, S/T-D It is composed of analog computer in 30 and the similarity.
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4. The trigger condition
The circuit leak can not catch a trigger correctly in the ventilation law of the presupposition like BiPAP when the leak revision isn't sound. It is preventing a malfunction using the more peculiar trigger condition. These are named as follows.
1) Expiratory Flow Rate Adjustment (Figure ; BiPAP Vision, EFA diagram)
If the EPAP time becomes equal to or more than 5 seconds, the expiration gas of the patient should not exist. It assumes that the gas flow rate at this point is a circuit leak at the time of EPAP and it readjusts a baseline (the flow) in Breath by Breath. This way is sure but the frequency that the EPAP time is equal to or more than 5 seconds can not look forward to it too much in some cases. Therefore, it uses the following way, too.
2) Tidal Volume Adjustment (Figure ; BiPAP Vision, TVA diagram)
If there is not a circuit leak, the intake capacity and the volume-of-expired-gas are the possibility to be the same. In other words, because it is possible to assume that the difference between the intake capacity and the volume-of-expired-gas is a circuit leak, it readjusts a baseline (the flow) as the difference of both passes away.
3)Volume Trigger
IPAP starts when the quantity of the intake gas which exceeds a baseline gas flow rate (revising above-mentioned amount of leak) reaches 6 ml (The spontaneous-respiration by the S/T mode).
4) Shape Signal (Figure ; BiPAP Vision, SS diagram)
By the unique trigger formula of the Respironics Inc., it participates in the switchover to IPAP-EPAP, EPAP-IPAP with Shape Signal. It sets the flow corrugation (the assessed value which excluded an estimated circuit amount of leak from the actual measurement) of the patient 15LPM off and a 150 mS delayed corrugation is called Shape Signal. It compares the flow corrugation and the Shape Signal corrugation of the patient and it ends the IPAP, EPAP aspect when these lines intersect. It thinks that the essence of this concept is detecting the remarkable time of the change in the measured value.
5)Maximam IPAP Time
It becomes EPAP when limiting IPAP to a maximum of 3 seconds at the time of the spontaneous-respiration and exceeding this.
6) Spontaneous Expiratory Threshold (Figure ; BiPAP Vision, SET diagram)
It makes a switching flow rate condition (called terminal flow, too,) to EPAP rise with the passage of time from IPAP with the elapse in the IPAP time. The longer the IPAP time becomes in this case, for the switchover from IPAP to EPAP to happen the more it becomes easy.
5. The operation (Figure ; Operating panel of BiPAP Vision)
1) The general operation
The function key to have supported a display is laid down, and it pushes a key according to the menu and chooses it. It picks and it enters value.
2) The setting
Before attachment of the equipment, first, the amount of leak inside the entering, the expiration port and in the mask must be measured in the expiration port test mode. Next, it chooses entering breathing mode in the operation mode. The meaning of the S/T mode is S/T 30, S/T-D 30 is rather different with that. The S/T mode is PSV+PEEP and a mode of the ventilation of the similarity basically, but IPAP begins in time cycle if the number of the spontaneous-respirations decreases below the set air changes per hour and IPAP ends in time cycle. In other words, it becomes PCV+PEEP similarity if there is not a trigger in the constant time which is decided by the set value of the air changes per hour (The BIPAP similarity?). The inspiratory-pressure start-up time can be set when setting IPAP Rise Time. Moreover, when doing an oxygen concentration, alarm setting, the setting operation completes.
3) Breathing circuit
Nasal-mask circuit (non invasive) and circuit (invasive) for the tracheal-intubation can be used. It always attaches a bacterial filter to the patient circuit.
6. The monitor, the alarm function
1) The monitor (Figure ; Graphic presentation example of BiPAP Vision) (Figure ; Bargraph display example of BiPAP Vision)
It puts on 3 corrugations of the flow, the volume, the pressure with the graphic presentation. It puts on set values and actual measurements such as the air quantity of ventilation and the air changes per hour, the amount of leak by the numeral display. It is possible to do a bargraph display, too.
There is an item of the one of the following. Doing the bad of the miss of the airway pressure upper limit, the airway pressure minimum, the anaerosis, the low expired volume per minute, the breathing number of times upper limit, the breathing number of times minimum, the inner battery voltage decline, the equipment worse, the pressure line, the ironhand worse, the oxyecoia-supply
7. The maintenance
It checks and it exchanges a back panel filter, an oxygen module filter appropriately. It receives regular inspection in 1 every year.