SLE5000
Even if it says a newborn baby-an infant personal plane, in that there are many resuscitators with similar composition, breathing circuit of the Jackson lease type, and the unique valve less exhalation-valve, the combination of the latest microprocessor control are original.
The user interface, too, was strengthened and became GUI(Graphic User Interface) operation.
Moreover, HFO feature, too, is strengthened.
That the object had the maximum weight of 8 Kg in SLE200HFO + got to support in a maximum of 20 Kg.
It is PTV, PSV, TTV (PRVC and the same feature) compatible, the high efficiency of graphic display built-in, the resuscitator of advanced function.
Of the only equipment that the respiratory-care of all the premature babies, the newborn baby can be supported in one this however, it is.
2. The
performance
1) The mode that it is possible to use
The mode not to do a trigger to the spontaneous-respiration
CPAP
CMV
HFO Only
HFO+CMV
The mode to do a trigger to the spontaneous-respiration
PTV (= A/C)
PSV
SIMV + PSV
---------------------------------
+TTV (Targeting Tidal Volume =PRVC,VS)
+Apnea Backup (PCV or PRVC)
+PEEP
2) This proximal dater
The maximum intake gas
flow rate
The active-ventilation .60LPM
PSV.
.60LPM
The sampling time .2 msec.
The number of the maximum
active-ventilations .150
BPM
The maximum SIMV number of times
.150 BPM
The HFO frequency .3-20Hz
The HFO amplitude of vibration
.4-180mmHg
3. The explanation of the control
circuit, the controlling
mechanism
1) The outline of the controlling mechanism
It uses for linear Fluothane Sir information of the heat which was provided for the Y peace part and it makes a mode of the ventilation of PSV and TTV, PTV "NADO" possible.
At the control board, it is Controller CPU : Dallas DS80C390, 12 MHz, CPU instruction set, Monitor CPU : Dallas DS80C390, 12 MHz, CPU instruction set, User Interface CPU : iDragon mP6 IA, 250 MHz, ROM-DOS are used.
2) The characteristic of the mechanical mechanism
The composition which combined the exhalation-valve of the valve less with breathing circuit of the Jackson lease type is hereditary "RETEIRU" in SLE5000, too.
An ironhand mechanism is digitalized on it.
A blender for the oxygen concentration adjustment was a mechanical method in SLE2000 but in SLE5000, it was changed into the electronic type by the graduate-acting control valve.
The developmental-mechanics of HFO, too, was improved and SLE2000 was generating HFO by the mechanism to build in and for it to be mechanical in the exhalation-valve in the rotary nozzle, but SLE5000 switches the gas stream of the positive pressure occurrence nozzle and the negative pressure occurrence nozzle by high-speed Solenoid-controlled valve and is making HFO occur.
As for the control of the airway pressure by the exhalation-valve, in SLE2000, it changed the pressure of the mechanical regulator by Solenoid-controlled valve and it was controlling an airway pressure but in SLE5000, the gas flow rate of the positive pressure nozzle and the gas flow rate of the negative pressure nozzle, too, are doing an airway pressure electrically with the graduate-acting control valve by the direct-control.
3) The gas flow rate measurement
It adopts a heat ray type flow transducer about the Y peace.
4) The intake valve
The positive pressure nozzle and the negative pressure nozzle which is in the exhalation-valve do the function which is equivalent to this.
5) The expiration valve
The positive pressure nozzle and the negative pressure nozzle which is in the exhalation-valve do the function which is equivalent to this.
Oxygen, typing in compressed gases control an oxygen concentration with the graduate-acting control valve of SV1, SV2, SV3, SV4 after regulators PR1, PR2 decompress respectively and are more included in MIxing Chamber than the air plumbing.
Regulator PR5 decompresses this gas, and it controls a flow rate with flow control receptacle FR1 and becomes fresh gas Fresh Gas.
In case of the trouble of oxygen or the air, Solenoid-controlled valve SV7 releases the side of intake in the big worrying.
The control of the airway pressure is done with the gas stream of the exhaust nozzle of the expiration box.
PIP and PEEP pressure are generated with the gas stream of the opposite direction of 3rd Jet Nozzle.
A gas flow rate to 3rd Jet is adjusted with the nozzle by the opening and shutting control of graduate-acting control valve PR3.
Regulators PR3, PR4 are the graduate-acting control valve which controls amplitude of vibration in case of HFO.
HFO occurs with the nozzle Negative Pressure Nozzle for the negative pressure which was provided into the expiration block and nozzle Positive Pressure Nozzule for the positive pressure but the continuing intermittently of these gases is done by 4 ream high-speed Solenoid-controlled valve SV9, SV10, SV11, SV12.
SV6 is for the proofreading of an oxygen concentration sensor.
It is making the purge style of the proximal airway pressure tube with PR7, FR4.
5. The control
software
The explanation of the each function
In the flow trigger formula, the sensitivity is 0.2-10 It is possible to choose in the range of LPM.
The patient circuit which doesn't use Fluothane Sir, too, is possible and now, it becomes a pressure trigger formula.
The maximum sensitivity is 0.5 It is a mmHg.
2)CPAP
CPAP by the Jackson lease type patient circuit is made.
It puts on an anaerosis back-up (the pressure ventilation), too, in ON/OFF.
TTV, too, can be added to the anaerosis back-up ventilation.
It controls ventilating-pressure PIP automatically for the taking air quantity of ventilation to become a set value when adding TTV.
However, in case of TTV operation, it ends intake when a taking air quantity of ventilation is achieved when not reaching intake time Ti.
3)CMV
CMV is the active-ventilation mode (the pressure ventilation) which doesn't
synchronize with the spontaneous-respiration. TTV, too, can be added.
It controls ventilating-pressure PIP automatically for the taking air quantity of ventilation to become a set value when adding TTV.
However, in case of TTV operation, it ends intake when a taking air quantity of ventilation is achieved when not reaching intake time Ti.
4)PTV
In the SLE Inc., PTV and the mode to express are A/C and the mode to be expressed generally.
An active-ventilation by the pressure ventilation is provided to the trigger.
The inspiratory-pressure corrugation can choose a square wave or a climbing-pulse.
PCV pressure is done by the self-regulation to become PRVC and the mode to be expressed generally when adding TTV and to maintain a setting taking air quantity of ventilation.
In the TTV operation time, the set value of PIP becomes the upper limit (Max PIP) of the ventilating-pressure.
5)SIMV
It is a fixed time method but the trigger window time becomes in the SIMV cycle time-the CMV cycle time like the figure.
If 有意"NI"少 doesn't include the SIMV number of times from the respiratory-rhythm of the patient in the characteristic of this method
It is easy for the trigger window time to synchronize with the spontaneous-respiration of being long and becoming, but when the SIMV number of times and the air changes per hour of the patient are near, the trigger window time draws in extremely and the possibility that the spontaneous-respiration can not be synchronized with becomes high.
An active-ventilation is given by the pressure ventilation.
In the active-ventilation, PSV can be added to spontaneous-respiration 荘.
As for the PSV pressure, the optional % value can be set to the PIP pressure.
The standard is 100%.
TTV can be added, too.
TTV does active-ventilation pressure PIP in the self-regulation in the taking air quantity of ventilation to become a set value.
PSV pressure, too, is connected with the PIP pressure.
6)PSV
It sets PSV pressure in PIP.
End-of-suction end condition (Termination Sensitivity) can be set at the % value of the highest value for expiratory flow.
The upper limit in the PSV intake time, too, can be set in the range in 0.1-3.0 seconds.
It does PSV pressure in the self-regulation to operate as VS and for the taking air quantity of ventilation to become a set value when adding TTV.
Now, the set value of PIP becomes the upper limit (Max PIP) of the ventilating-pressure.
When the taking air quantity of ventilation can be achieved even if the intake flow doesn't decline in TTV addition, the intake of PSV ends.
7)HFO
3-20-Hz frequency 4-180 of SLE5000 HFO's being powerful It is possible to create the pressure of mBar.
PTV compatible infant personal plane however, recently, there is much equipment which can add HFO but there is not the more independent HFO is , and it is possible to ventilate with it power more.
It forms in the HFO independence and CMV+HFO.
Now, only the (1) expiratory-phase can choose the addition of HFO in the (2) inspiratory-phase + expiratory-phase, "WO".
7) Battery drive
The setting but in case of the power failure, it is possible to operate for 45-60 minutes.
8) The interface
The various information can be output from the RS232 port.
It sets while following the display of the screen in the electrochromatic display touchpanel.
Only necessary setting is displayed every mode.
Because an explanatory note is displayed with the graphic in the screen-display even if it doesn't read a manual, it is wonderful that it is possible to understand by the glance.
Because the arrow appears when touching the item to want to set, it presses the arrow of the looking up and the declining and it enters desired value.
(
Figure ; Input method of parameter)
In the line that an alarm level, too, is displayed in the graphic, it touches and it chooses an item and it sets value by the arrow.
(
Figure ; Alarm setting screen)
At first, in the condition (called Preview mode) which doesn't connect with the patient, it sets a mode, an air changes per hour, intake time Ti, PEEP, PIP, FiO2.
When pressing "confirm", the resuscitator starts.
It sets a back-up air changes per hour, an airway pressure alarm (high-pressure, the low pressure), an expired volume per minute decline alarm, trigger level (Breath Detection), "NADOWO".
It connects with the patient after this and it sets Termination Sensitivity "NADO" of PSV.
The operation which doesn't use Fluothane Sir, too, is possible but now, it becomes a pressure trigger formula.
The setting of a pressure trigger does after it connects to the patient.
Of course, the ventilation parameter except the airway pressure can be monitored and passes away.
The graphic, too, displays only pressure.
It sets this surely because Cycle Fail Alarm to confirm operation appears.
7. The monitor, the alarm
function
It is equipped with the various necessary alarms such as abnormality of the high pressure, the cycle malfunction, the low base pressure, the low taking air quantity of ventilation, the low expired volume per minute, the high expired volume per minute, the tachypn ea detection time, the monitor worse, the equipment, "HURO-SENSA" difference's being usual.
In the HFO mode, a pressure alarm is done by the self-regulation.
(
Figure ; Alarm setting about HFO mode)
It is "MO-DOYA" at the electrochromatic display.
The setting, the alarm, "GURAHUITUKUMO"
"NITA-" is easy to see and is displayed.
3 corrugations of the pressure, the flow, the air quantity of ventilation are displayed in the standard condition.
The loop corrugation of F/V, F/P, V/P, too, can be displayed.
Also, the trend of the expired volume per minute, the peak airway pressure, the average airway pressure, FiO2, setting air changes per hour (BPM) and so on can be displayed.
The F&P type is come equipped with.
It uses "DEISUPO" with the proximal pressure monitor tube or the patient circuit of the re-application type.
The option which adds NO, too, is prepared.
10. The daily maintenance
1) The expiration block
The expiration block seems to open a main unit left side cover.
It becomes the condition by which it is possible for a block to be unbuckled when turning a clamp 90 degrees and making level.
It comes when pulling an expiration block and a silencer kindly.
After pickling in alcohol and so on, it washes in Shimizu.
After that, it does an autoclave.
2) The patient circuit
It follows a guideline at the hospital.
11. The regular
inspection
It receives a prevention check every 6 months. It overhauls every 10,000 hours, or 2 months, 20,000 hours or
48 months.
12. The fault
1) There may are not misunderstanding in the PTV mode generally more in A/C which can be able to be used and the displayed one.
2) The percentage of completion of the limit of doing finding difficulty being is high in the fault as well as that the exhaust sound with much consumption of gas is rather big.
3) It is expensive. However, when thinking of the patient circuit of the consumables to be highly efficient
and moreover to be little, only for this to be simple, 8,000,000 yen of price are an inexpensive duck.
4) In the description of the manual, the concept of the mode has the disorder of the term and it is difficult a little.
The meaning of - limited and - cycled is different as the example.
The former is a general meaning but the latter means the condition to stop intake exceptionally at the extraordinary time.
Also, the meaning of pressure supported and PSV is different.
The former is the form of the ventilation help about the time of the intake of PSV and SIMV "NADO" and the latter is the meaning of general PSV.