Published Articles

The Next Big Thing: The Trend Toward a Universal Design

by Mario Carvajal

24x7 Magazine, February 2004

See the original 24x7 article here

A growing trend in patient ventilation products over the past several years is the move to a universal ventilation system: one ventilator that can safely and accurately ventilate all patients—from the smallest neonates to children to adults.

Everyone started out with one ventilator system, and, while fringe products may have provided pressure ventilation, that was not the norm—until we learned that was a very viable way to ventilate adults and children.

For neonates, however, these early ventilators were not suitable, due to the difficulties caused by the need for very wide operating ranges for both volumes and pressures. Neonates, who are at the lowest end of the scale, require delivered-breath accuracy and resolution that is difficult to achieve. To properly ventilate neonates, more sophisticated drive systems and software control come into play.

Generally speaking, the mode of ventilation for neonates today is pressure control, while for children and adults it can be either pressure or volume control, depending on the situation.

Recently, however, there has been a big push for a universal ventilator that can be used with neonates, children, and adults. Essentially, this is a convergence of two separate product lines, made possible by advances in technology. Modern microprocessor-controlled pneumatic systems coupled with sophisticated software now offer options of pressure and volume suitable for a wide range of patient sizes, without sacrificing accuracy, resolution and safety all on the same machine.

The new universal ventilators are explicitly designed to address the very different requirements of adult, pediatric, and neonatal patients with one instrument. That means that preset ranges for all relevant flow and volume parameters can be automatically adjusted with a patient-range selection knob, and the practitioner can safely and flexibly customize preferred treatment parameters. This ability to ventilate any patient with a comprehensive range of features means that there is no longer a need for separate, specific ventilators operating in specific ICU environments—the user can move the ventilator to wherever it is most needed.

The benefit from a facility perspective is that hospitals can now make one purchasing decision that will meet the needs of all their patients.

From a sales perspective, however, selling one product to both the NICU and the ICU can be a challenge. The NICU staff traditionally has not wanted to take its ventilator out of the department because to accidentally hook a ventilator that has adult or pediatric settings to a neonate would be a catastrophe.

To address this concern, the latest designs have implemented safeguards to detect patients automatically. That way even if patients are hooked up prior to the ventilator being appropriately set, they will not be injured.

What all this means from the biomedical department’s perspective is that there are fewer products it needs to service, and, if it has to supply parts, there is a cost savings as well.

In terms of training, the universal ventilator represents a significant cost savings also. If the hospital is purchasing only one ventilator, then the biomedical technicians will need to take only one class. That offers a sharper learning curve and productivity in a shorter amount of time.

In the clinical field, one hears a lot about standardization, which allows clinicians to go from one bed to another, and, although the patient is different, the technology is the same. That translates into ease and efficiency in terms of how devices are being applied to various patients, most notably during emergencies

There is a lot to be said for that from a biomedical department standpoint as well. Switching from one type of ventilator to another in the shop takes time. The biomed needs to change gears, so to speak. In addition, because each ventilator requires countless testing accessories, supplies, and tools, a savings can be realized. In short, standardization means increased productivity and savings on training, test equipment, and parts.

For patients, the facility, and the biomedical technicians, the universal ventilator may truly be the next big thing.

See the original 24x7 article here