Bird Products Corp.
V.I.P BIRD (Gold, Sterling)
1. The characteristic (Figure ; Outward appearance photograph of V.I.P BirdGold) (Figure ; Outward appearance photograph of V.I.P BirdSterling)
V. I.P is Bird in the abbreviation of Ventilator Infant Pediatric It is the infant personal plane to have supposed that is 8400STi. It deals with the newborn baby, the infant, the infant. At the resuscitator for the newborn baby, it is equipped with the mode of the ventilation of the method of the demand of the more boiling toward the elder child in addition to the regular TCPL mode to make an inspiratory-pressure by relieving a continuous flow in the pressure by the exhalation-valve, too. There is a maximum intake gas flow rate in 120LPM and the taking air quantity of ventilation is the performance that the business of the adult to support in 995 ml, and so on, too, doesn't include an inferior. At first, there was not PTV feature when not using air quantity of ventilation monitor Partner IIi. It was improved by 2 models of becoming Gold (5,500,000 yen of price) and Sterling (4,600,000 yen of price) in 2000, and the air quantity of ventilation monitor was had and became PTV compatible, being average. A taking air quantity of ventilation was extended to 1,200 ml. Moreover, the mode of PCV, VCV like the servo ventilator and moreover VAPS in addition to the TCPL mode, too, became available. Way, Gold means money and Sterling means silver. Gold is equipped with the PCV, VAPS mode, the Rise Time control but it is not in Sterling. Fluothane Sir has two kinds of infant and pediatric. The latter is elder child turning in the baby turning in the former.
2. The performance
1) The mode that it is possible to use
The TCPL mode
The demand mode
2) This proximal dater
The maximum intake gas flow rate
The active-ventilation .120LPM
PSV. .120LPM
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
MPU is used for the control circuit and as for the information, all digital processing is done. It is composed of the printed circuit board of Main, Display, Power/Driver, Volume Monitor.
2) The characteristic of the mechanical mechanism
A new Mattick circuit is composed by the tubeless die-cast (Bird same as 8400STi). Also, the quickness of the trigger response, too, is mentioned specially. The driver reaction time of the float rigger is short with 25 +/-3 ms. (The driver reaction time of the intake valve is 0.2 ms.)
3) The gas flow rate measurement
a) The side of intake
It calculates a flow rate from the position of the servo valve and the pressure of back and forth.
b) The part of the peace of or Y of the side of the expiration
As for Fluothane Sir, two kinds for the newborn baby and the infant are prepared. Proofreading information is recorded about being "DURE", too, and is read by the equipment when connecting a sensor. The tube and the connector need note so as not to replace the other sensor. For the newborn baby, it is a heat ray type. It is possible to measure in the range of 0.2-30LPM. It installs between the Y peace and the tracheal tube. Fluothane Sir for the infant is the delta-pressure type which measures a flow rate at the inclination with the back and forth pressure of the film type sensor. It is possible to measure in the range of 1.0-120LPM. It installs between the exhalation-valve and the patient circuit and it measures.
4) The intake valve
It is a stepper motor drive type. There is a resolution of 0.1LPM in the improvement type in the one of conventional Bird.
5) The expiration valve
The exhalation-valve body is Bird It is 8400ST and similarity but an expiration suction mechanism is laid down. TCPL applies a jet style to the venturi part of the exhalation-valve and is attraction in expiration gas in jet Venturi effect. This is Auto-PEEP vs. a plan.
4. The new Mattick circuit (Figure ; New Mattick schematic of V.I.P Bird)
As for the Gold, Sterling model, the improvement of several places is accomplished for the accuracy improvement to old model.
Via the filter, the one of the oxygen plumbing inputs to the direct blender and entry gas from the air plumbing adjusts an oxygen concentration. This is Bird 3800 It is the one which is the same as microblender. "Blender bleed system" which slips gas partially in the storage tank eve to keep the precision of the blender in the area with few flow rates, too, is provided. This place doesn't become extinct and the dense fog of 6LPM is abandoned. Also, respectively, the pressure relief valve of 100psig is preparatory to protect a machine. The gas which adjusted an oxygen concentration is a 1.1-liter storage tank, and it gathers and prepares for the peak rate of flow. The regulator decompresses to 25psig and it enters an intake valve via the pulse damper. A current-adjustment is done with the intake valve and intake gas is formed. In the previous model, High Frenquecy Drive Solenoid for HFV was prepared with the option but after acting as Gold, Sterling model, there is not option setting. Relief valve (Safety solenoid) and the excessive pressure opening valve (Over Pressure Relief Valve) which can be manually on the panel surface adjusted are prepared for the intake gas output as the double security apparatus.
An airway pressure is monitored in three places of the side of intake, the side of the expiration and the proximal pressure. A purge style is provided for the proximal pressure sensor tube. Solenoid-controlled valve Inspiratory/Expiratory Hold-Inspiratory Pause Slenoid which stops so as not for the purge style to flow into the patient circuit in case of expiration fold's intake fold's there being and accepting an intake pose in the Gold, Sterling model was added. This blocks that the gas of the patient circuit at the time of the pose flows backward at the same time to gas for the system drive, too. Moreover, Solenoid-controlled valve for the zero point proofreading is added to the Gold, Sterling model for the accuracy improvement of the pressure transducer.
The exhalation-valve is an electromagnetic driven type, but respectively, the jet venturi mechanism is laid down and is attraction in expiration gas. JET SOLENOID supplies jet gas.
In the Gold, Sterling model, an expiration air quantity of ventilation monitor feature was had. It measures the pressure gap of the place around the sensor of the delta-pressure type with the pressure transducer and it measures an air quantity of ventilation.
5. The control software
The explanation of the each function
1) The trigger formula
In old model, the basics were a pressure trigger formula and PTV by the float rigger was possible only in Partner equipment with the option, but in the Gold, Sterling model, the flow trigger formula is basic and to be general is PTV. When connecting Fluothane Sir for the newborn baby, the bias style becomes 3LPM and detects a flow in the Y peace part of the patient circuit. The sensitivity can be set in 0.2-3.0LPM. When connecting Fluothane Sir for the infant, the bias style becomes 5LPM. It puts this sensor between the exhalation-valve and the patient circuit. This is to decrease an influence with pressure inclination by Fluothane Sir's resistance. The sensitivity can be set to the range of 1.0-5.0LPM. The bias style can be chosen about off setting, too, only when connecting Fluothane Sir for the infant. Now, it becomes a pressure trigger formula.
TCPL is the mode name which is peculiar to Bird Inc. in the abbreviation of Time Cycle Pressure Limited. This is the pressure ventilation mode to create an inspiratory-pressure, closing a continuous flow by the pressure relieving type exhalation-valve in case of intake which is a general method at the resuscitator for the newborn baby. Even if there is not a trigger, there are that isn't done few having of it and few breathing work volumes compared with the demand method because the patient puts on a continuous flow freely with intake. Specifically, it is little, that breathing work volume that the patient becomes able to breathe in intake gas after there is a trigger is overwhelming.
An active-ventilation is an exhalation-valve in the continuous flow and is done by the pressure relieving (CFPR, Constant Flow Pressure Relief) method to open and shut. Until the airway pressure becomes a set value in the inspiratory-phase, an exhalation-valve is closed. As a result, the continuous flow flows in to the lung of the patient and becomes intake gas. When the airway pressure reaches the airway pressure upper limit (High Pressure Limit), a continuous flow is relieved from the exhalation-valve. Relieving quantity in the exhalation-valve is controlled with the servo control to maintain a set-pressure during the intake time. However, in the expiratory-phase, it is possible to breathe freely because the continuous flow is flowing at the time of the mystery gar. It sets continuous flow quantity with the control of the flow. So as not to hinder the expiration of the patient by the expiratory-phase in the setting of an intake flow rate(=continuous flow quantity) above 15LPM, the continuous flow quantity falls to 15LPM. In the setting below 15LPM, the continuous flow quantity doesn't change. When the intake flow is lacking and is, a demand flow is supplied in a maximum of 120 LPM.
There is a trigger window in the Assist/Control mode only in the time of the 60-second/setting air changes per hour. The active-ventilation of Assist is sent when detecting intake among the trigger windows. When not detecting intake among the trigger windows, the active-ventilation of Control is sent to the end of the trigger window. A trigger window is reset and the new trigger window for the following ventilation begins every time for a that active-ventilation it is sent in that Control in Assist. To secure least expiration time, a 250-mS refractory period is provided for the expiratory-phase and even if it detects a trigger in this period, an active-ventilation isn't sent.
The active-ventilation can choose TCPL, quantity ventilation VCV, pressure ventilation PCV (only the Gold model), VAPS (only the Gold model).
The trigger window is a variable-time method. It becomes CPAP/PSV when setting the SIMV number of times to 0 revolutions per minute. Now, off can not be chosen to the trigger sensitivity. In the TCPL mode, an active-ventilation and PSV, CPAP are done by the TCPL(CFPR) method by the continuous flow. In the demand mode, as for being general, it uses PSV. The active-ventilation of SIMV can choose TCPL, VCV, PCV (only the Gold model), VAPS (only the Gold model). When the intake flow is lacking and is, a demand flow is supplied in a maximum of 120 LPM.
The pressure trigger begins the intake of PSV and it ends in the flow cycle. As for the acceleration with flow rate in start-up of PSV, an overshoot is self-adjusted as it is not. The Gold model can set the speed of the standing-up by the Rise Time control. The end-of-suction end recognition condition changes as follows according to the supplied air quantity of ventilation. When the flow doesn't decline, it ends by the time cycle. In the alarm condition, it ends in the pressure cycle.
0-50ml. .5% of Peak Flow
50-200ml. .5-20% of Peak Flow(liniar)
200ml over. .25% of Peak Flow
In the maximum intake time of PSV, it is limited to 3 seconds, or twice of being "DURE" in the CMV cycle time or the shorter time. Also, PS/VAPS Time Limit can be set to the optional value by setting it in the maximum intake time, too. It drops an intake flow rate on 40LPM when 1.5 liters urged by the intake of the taking and intake gas is supplied until a maximum of 3 seconds.
6) Flow Termination ("HURO-TA-MINE-SIYON") (Figure ; Explanation of "HURO-TA-MINE-SIYON")
It is valid only in the TCPL mode. The float rigger begins intake and it ends by the time cycle but ends when the intake gas flow rate falls to the % flow rate to the peak rate of flow when setting Termination Sensitivity Control (the termination). It is possible to set in 5-25% of ranges. When the flow rate doesn't decline, it ends by the time cycle. However, there is an advantage to prevent Fighting, securing necessary expiration time in this when the breathing rate increases. Also, there is an effect which lowers an average airway pressure, too. In the alarm condition, it ends in the pressure cycle.
It is available only in the Gold model. It is general PCV. It maintains the inspiratory-pressure which was set by the inspiratory-phase. Intake ends in Time Cycle. In this mode, "HURO-TA-MINE-SIYON" (Flow Termination) doesn't work.
8) VAPS (Diagram of VAPS)
It is available only in the Gold model. VAPS is the mode that PSV and VCV (the quantity ventilation, the volume control) begin at the same time if expressing easily by the abbreviation of Volume Assured Pressure Support. As for the intake gas flow rate, PSV or VCV being "DURE" or the more ones are provided. Generally, the predominance of it is done but VCV does to do the becoming of to be predominant at the beginning of intake in PSV when becoming the end of intake. It is change "WARIRU" when the measurement intake gas flow rate falls to the setting intake gas flow rate (the intake flow) of VCV. The advantage of both of PSV and VCV ventilation is the mode to have been fayed.
9)Leak Compensation (The leak revision)
It becomes valid when making a bias flow off in Fluothane Sir use for the infant and choosing a pressure trigger formula. Value (=0.5cmH with "Machine pressure-Proximal airway pressure" of which this is the Leal make-up feature and the similarity of the Bear Inc. and it is constant in case of intake2O) If becoming above, it increases an intake flow rate in the range of 0-10LPM to revise this. Also, if the baseline pressure(=the PEEP/CPAP pressure) decline in case of the expiration, it adjusts an intake valve to make this up. These revise the leak of the patient circuit, being general. It is to prevent from the maintenance of the PEEP/CPAP pressure and an auto cycle about the pressure trigger formula. However, the simmering, these patients that the adaptation of PSV is expanded into the patient with equal to or less than 10-Kg weight can make a leak revision feature to be off for such a special condition because there are few leaks and also the leak revision feature sometimes causes the decline of the pressure trigger sensitivity. Now, it uses the Select button and it makes leak revision off but for the details, it refers to the manual.
10) The demand flow feature
When the PEEP/CPAP pressure can not maintain an airway pressure only by the function of the exhalation-valve, the flow rate of the servo valve on the side of intake increases by the within-the-limits to 120LPM.
11) The suction of expiration gas
In the setting of a flow, above 5LPM, the setting of PEEP pressure becomes an attraction mechanism in expiration gas with the jet pump which was incorporated into the exhalation-valve to prevent from the occurrence of Auto-PEEP at the time below 5cmH2O.
10) The PEEP revision
Few changes of the PEEP/CPAP pressure occur even if the expiration gas flow rate changes because the opening and shutting of an exhalation-valve is adjustable with the servo control by the pressure.
11) The back-up feature
There is not an anaerosis back-up feature.
12) Battery drive
It consumes it is possible to operate, now by a maximum of 5 A in DC12v.
13) The dater output
RS The various dater can be output at 232. Also, it is possible to link with Partner IIi with the optical fiber.
14) The self test
" There is Power On Self Test" feature and an error code is displayed in the error occurrence time.
6. The operation system (Figure ; Operating panel, figure of Gold ; The operating panel of Sterling)
1) The operation method
It sets with the control which supported respectively every setting item. Value is displayed respectively about the set value, too.
2) The contradicting setting
When choosing a contradicting set value, the figure which is displayed in the item of there blinks and prompts for the correction. 3) The setting of Fluothane Sir's reference mark
a) Fluothane Sir for the infant
When connecting Fluothane Sir for the infant, it does the reference mark of the flow measurement in the automatic setting when pushing the button of Flow Display/Compensation. It displays flow revision quantity in the display for 3 seconds. Because there is possibility that it isn't possible to set correctly when many, the air changes per hour of the patient sets a reference mark to the case, blockading a Y adapter, unbuckling from the patient.
b) Fluothane Sir for the newborn baby
When connecting Fluothane Sir for the newborn baby, it displays a flow value in the sensor only and as for the trigger sensitivity, there is not self-regulation. When pushing the button of SELECT which is in the display, it displays the measured value of the gas flow rate to the direction of intake and the direction of the expiration. The indicated-value when making the display of intake and the patient isn't doing intake yet corresponds to the amount of leak. It sets trigger sensitivity to the value which added a measured amount of leak.
It is 30 in the air changes per hour When establishing above BPM, it sets a termination and it prevents from auto-PEEP and Fighting. In the intake time, this changes in the 0.2-0.4-s range. The same inspiratory-pressure however, PTV is careful because the taking air quantity of ventilation increases compared with IMV. The tracheal tube diameter isn't suitable for PTV's being able to ignore the resistance of the sensor and the patient below 4.5mm I.D for passing away.
The following original value is general as the reference value of the setting. Air changes per hour 30-60BPM, intake flow 5-8LPM, the intake time of 0.35-0.40 s, sensitivity 0.2LPM, 25% of terminations The trigger sensitivity inflicts an amount of leak on 0.2LPM. Way, the intake flow value of the sensor of the patient in the intake beginning eve is an amount of leak. It pushes and it measures the button of Flow Display/Compensation. It isn't auto-cyclinging or it observes and it revises more if necessary. The termination decreases 5% more than 25% and adjusts them for the intake time to be able to be secured for equal to or more than 0.20-0.25 s. At the newborn baby, to become 5% or 10% is general. Incidentally, in the intake time, it extends when the intake time is short at 25% of values and makes a value little. The display of the termination sensitivity blinks when the termination operates but this condition is normal.
7. The monitor, the alarm function
The hypernoea, the airway pressure upper limit, the airway pressure minimum, the taking air quantity of ventilation upper limit, the expired volume per minute minimum, the low PEEP/CPAP pressure, the anaerosis There are a distributed-gas pressure malfunction, that the equipment is mal-function, sensor abnormality, an equal "NO" item.
8. The display feature
1) The display of the set value
It supports in the control boiling for each setting and a figure by the LED is displayed.
2) The display of the actual measurement
Using the display window which is provided for the upper right of the operating panel It chooses a taking air quantity of ventilation, a measurement breathing rate, an expired volume per minute, a breathing rate, intake time, I:E ratio, peak pressure (P.I.P), average airway pressure (M.I.P), the actual measurement, "NADO" of the flow who measured by Fluothane Sir at the button of SELECT and it puts on them by the digit-present.
9. The patient circuit composition, the humidifier (Figure ; Patient circuit of V.I.P Bird : Illustrating a circuit for the infant)
1) The patient circuit
There are two kinds of the newborn baby circuits and the circuits for the infant. That the proximal pressure monitor tube is necessary is complicated. However, there is a sense of security that the airway pressure can be correctly monitored even if there is a blockade of the patient circuit.
2) The humidifier
The standard is HPD of the Transmed Inc. It is 3000. This humidifier is more usable to the adult than to the newborn baby. The humidification efficiency is high and there is little resistance than F&P.
3) The structure of the exhalation-valve is simple and the maintenance is easy.
10. The maintenance
The component set of Fluothane Sir is careful so as not to mix with the parts for the other exchange. The precision falls when doing a catachresis. This can be used for about 6 months. The one which was passed in the manufacturing Goichi year cancels even if it is unused. The sensor sterilizes a wash, liquid medicine within 24 hours and does a rinse with the purified water. The autoclave does in the condition to have been decided. The exhalation-valve, too, does a wash, sterilization, a rinse in the same way. The filter does an autoclave every patient.
11. The regular inspection
1) The daily life
It checks a filter, the check of the tube kind, an exhalation-valve, equipment. The exchange of the necessary part
2) It is "TO" in 1,000 hours.
The check of the air, the trap and the filter of the oxygen entry It exchanges if necessary. The proofreading of a pressure transducer
3) It is "TO" in 5,000 hours.
It receives maintenance by the dealer.
4) It is "TO" in 20,000 hours.
It receives an overhaul.
5) 2 every years
It overhauls the blender of the oxygen concentration.
12. The fault
1) It is poor in the display feature. Therefore, the trigger sensitivity setting in Fluothane Sir use for the newborn baby isn't simple. Standard equipment with the graphic monitor is wanted.
2) HFO isn't made.
3) Wishing to be equipped with the PRVC mode because not to do needing such as VAPS