France ResMed
1. The characteristic (Figure ; Helia outward appearance photograph)
HELIA is the resuscitator for the home to be small for the adult and the infant who is made by the French SAIME.S.A Inc. and to be chic. Because it is highly efficient and multifunction hi-tech resuscitator of the turbine type of the pressure ventilation and quantity ventilation compatible, it is applicable with the critical care, too. 8-hour drive is made in the outside battery use. Oxygen can be added in a maximum of 15 LPM. In 2005, SAIME.S.A was bought by ResMed and changed to the France ResMed Inc.. In Japan, it is sold from Kimura medical department instrument Inc..
2. The performance
The mode .PSV¤PCV(+Vt Guaranteed)¤
The taking air quantity of ventilation .0-2.5 L
The intake gas flow rate .10-99 LPM
The maximum intake gas flow rate .200 Above LPM
Breathing number of times .OFF,6-40 BPM
The intake time .0.25-5 sec.
PEEP. .3-12 hPa
The weight .10 Kg
The power consumption .AC100v 100VA¤ DC 24-29v 5.5A max.
The battery operating time The 3.5 inner hours
It is about 8 hours in the outside use.
3. The outline of the mechanism (Figure ; Structure elucidation of Helia)
It is using permanent-magnet synchronous motor [ for the drive of the blower. The number of rotations of the turbine is controlled by the microprocessor. The entry pressure of the new Mattick block is measured with the pressure transducer and stabilizing with the servo control which controls the number of rotations of the turbine The intake valve receives the revision which is based on the actual measurement with a servo control by the microprocessor done through the new Mattick valve which is called an intake chamber. An intake gas flow rate is measured with the flow transducer of the delta-pressure type. A servo control is done by the microprocessor like the side of intake about the exhalation-valve, too. A gas flow rate is measured by the side of intake and the same mechanism about the expiration gas flow rate, too. As for the PEEP pressure, it is making a control pressure with special small compressor and it is making exhalation-valve drive gas with making PEEP regulator. At the equipment abnormality time, intake gas and expiration gas are released in the big worrying by the function of the one way valve, the exhalation-valve. It measures a gas flow rate with the high-precision delta-pressure type flow transducer which is intake and expiration together called "MERUSIYANITUKUSENSA-". It makes pressure with special small compressor and the PEEP pressure is driving an exhalation-valve in this.
4. The operation (Figure ; Operating panel of Helia)
1) The patient circuit
If the patient circuit has the proximal pressure monitor tube, the 2 branch usualtype and exhalation-valve built-in 1 branch type "NOIDURE", too, is usable. The backlight of the screen lights up when continuing to press on/a standby and is turned on. An automatic judgement is done by the type of the patient circuit.
2) The setting
Because operation is locked up the environment operating, to change setting, the lock must be canceled. It turns a rotary knob to the right while pushing the KEY button. It becomes a pending-lock automatically if the key operation is not 2 minutes. It is possible to be chosen by the mode when it presses a direct mode key. The PS pressure, PEEP, the air changes per hour, the taking air quantity of ventilation, Pmax/delta PIP, the trigger sensitivity are accessible with the direct key. After the setting of the other item and an alarm lets out a menu from the menu in the lower right of the operating panel, pushing the key of the parameter, the alarm, the measurement, it chooses an item by the select-button on either side and it enters value by the rotary knob.
3) The characteristic of breathing mode
A various mode is had but the SIMV mode is only A/C mode, not being. As for the ventilation help, it is possible to choose pressure ventilation, quantity ventilation, IPPB.
Quantity ventilation (Tidal Volume Guaranteed, Vt Guaranteed ) can be added by PSV, PCV, the Ps.Tv mode. It becomes VS(Volume Support) if adding by the PSV mode. It becomes PRVC if adding to the PCV mode. In these modes, based on the air quantity of ventilation which measured a ventilating-pressure in the past, it fixes the following ventilating-pressure. The goal taking air quantity of ventilation can be achieved when ventilating about three times. The Ps.Tv mode is the ventilation mode which does conglomerate operation which belongs to the quantity ventilation mode. If the pressure setting by the PS is less than 6, it operates as quantity ventilation (Volume Control) by the general dwindling wave. On the other hand, when making PS pressure equal to or more than 6, VAPS(Volume Assured Pressure Support) similarity is operated. At first, when operating as PSV but in case of taking air quantity of ventilation's not being able to be achieved, gradually the intake time extends (To Tmax). After that, the square wave of VCV increases gradually in the form that VCV weights PSV and it achieves a taking air quantity of ventilation.
The IPPB mode adds a mouthpiece by the chest-physical-therapy business and does. It is to make intake extend a conduct lung slowly. It provides a rather little intake gas flow rate by the square wave and intake ends by the pressure cycle or the time cycle.
The table : The setting item by each mode, the feature which can be set, the feature which can not be chosen
Trigger OFF ~ › It is › at the time of PS:OFF. ~
Vt Guaranteed › › › ~
E.Trig › ~ › ~
Tmax/Ti ~ Ti Tmax Tmax
Slope › › @ @
dPIP/Pmax d PIP dPIP Pmax @
Freq ~ › › ~
Flow @ @ @ ›
The PS › › Doing ›/OFF can ›
The single circuit › › ~ ›
NIPPV › › ~ ›
Selectable or it is impossible for N.B. › to choose a setting item, ~.
The entry means that it is impossible to set or a non-setting item.
4) The trigger
The patient circuit does a 1 branch type or a 2 branch type in the automatic judgement at the time of power on. It becomes a pressure trigger if being the former. If being latter, it becomes a float rigger by Flow-by which secured 10LPM in the expiration flow rate. The sensitivity can be chosen at the 1-10 value. Sensitivity 1 is 0.25hPa or 0.5LPM. The sensitivity declines about 0.25hPa or 0.5LPM as figures are given. In the PCV, ACV (becoming Volume Control when making a PS off in PsTv) mode, it is possible to make a trigger mechanism to be off. Generally, the pressure trigger is for NIPPV which has a circuit leak and the float rigger is for the patient that a leak was done by the cannulation which is not.
Generally, by the feature which is called Flow Cycle, in HELIA, it is called an expiration trigger. It ends an inspiratory-phase when the intake gas flow rate falls to the % value to have set to the peak intake flow rate in case of pressure ventilation. 5-90% or one's own “® can be chosen. Like the case (figure ; decision procedure of E.trigger) to have made automatic (E.Trig=AUT) It pulled to the point which reached a peak intake flow rate from coordinates (0,0). The end-of-suction end condition of the straight line T1 which pulled x‹ is an intake gas flow rate and an intersecting point at the x axis using the angle x‹ which is the same as straight line T0, the Y axis and angle alpha to accomplish. In this case, ventilation with the more necessary time it does, the more early the end-of-suction end ends to reach a peak rate of flow.
The meaning of the minimum air changes per hour in A/C The ventilation help, too, stops if the spontaneous-respiration passes away when making off.
rising time can choose three of Slope0, Slope1, Slope2. Slope0 becomes a setting inspiratory-pressure within 200 ms. Slope1 reaches within 200 ms in the setting inspiratory-pressure-2hPa. Slope2 reaches - 4hPa within 200 ms.
8) The others
The value of the inspiratory-pressure that the goal taking air quantity of ventilation, delta PIP are permissible at the machine by PsTv to achieve a goal taking air quantity of ventilation The ventilating-pressure does HELIA in the self-regulation to the pressure which applied delta PIP pressure to the PS pressure to maintain a taking air quantity of ventilation. The inspiratory-phase ends and Tmax changes to the expiratory-phase when the intake time becomes this value at the maximum intake time.
5. The monitor, the alarm
It is equipped with the main power, the battery consumption, the low airway pressure, the high airway pressure, the external energizer voltage malfunction, the patient circuit leak, the taking air quantity of ventilation minimum, the taking air quantity of ventilation upper limit, the air changes per hour upper limit, the turbine abnormality, the equipment abnormality, the "NADONO" alarm. The alarm of the oxygen concentration is prepared with the option. The bargraph of the airway pressure, and setting and an alarm item are made liquid crystal in the character representation at 2 lines as the monitor feature. When connecting the Windows PC which installed the Heliascope software of the option with the serial connector, the graphic corrugation, the loop corrugation, the set value, the actual measurement, the trend and so on can be displayed with multi- window on the PC screen.
6. The patient circuit
Two of the singles and the doubles can be used. It is possible to use by the use, too.
7. The maintenance
It does a feature check, battery charging, a service regularly.
8. The fault
1) The display feature
To be independent is poor in the monitor feature and the display feature and it is difficult to see the confirmation of the setting contents and an operation monitor. If attempting to make home business surely, such a feature returns and unnecessary but however, the setting is complicated for it. HELIASCOPE is necessary to use in the hospital.
The possibility that the thing itself who has SIMV mode was very easy for HELIA It is made because it is the wise decision that is saving SIMV mode Š¸"ETE" easily and is familiar with breathing mode. However, that the intelligibility of the standard user in the Japanese market can follow this level real is question.
3) The mode name
Because the mode name and the mode concept don't agree with the general mode name about Japan because it is made in France, there is a point which it is difficult to understand, to be few. It is easy that to hold at the rather commonplace mode and the feature beforehand is accepted in the Japanese market. Extremely by also, that understand, being multifunction too much To prevent misunderstanding, it had better narrow down a feature more. If wanting to maintain multifunction absolutely, the level which it is possible to use according to the level of the user in the initial condition must be limited.
4) The external energizer
It is difficult to use to be DC24v, to be few.