A critical care mechanical ventilator (Servo-U, Maquet, Baden-Württemberg, Germany) incorporating a dual limb circuit (RT200, Fisher & Paykel, Auckland New Zealand) was used in combination with a humidifier (MR850, Fisher & Paykel, Auckland New Zealand). The VMN was placed at the dry side of the humidifier. A lung protective, low tidal volume ventilation strategy of 8 mL/Kg for a 69 Kg adult was adopted (Vt 550 mL, RR 13 BPM, and I:E Ratio 1:2) [64 (link)]. The capture filter was placed between the endotracheal tube (ETT) (Flexicare, 8.00 mm, UK) and a test lung (IMT Medical, Bachs Switzerland). See Figure 8 .
Servo u
Manufactured by Getinge
Sourced in Sweden
The Servo-U is a ventilator designed for intensive care and emergency settings. It provides advanced ventilation modes and features to support patient respiratory needs.
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Lab products found in correlation
5 protocols using servo u
1
Mechanical Ventilation with Lung-Protective Strategy
2
Comparative Usability of ICU Ventilators
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Three ICU ventilators, which are commonly used in the ICU department of our local medical institutions, were selected and made available for our usability study: Evita 4 (Draeger, Lubeck, Germany; software version: 04.24 07/12/11), Servo I (Maquet, Solna, Sweden; software version: v5.00.00), and Boaray 5000D (Probe, Shenzhen, China; software version: 0A_006_V06.10.02_151119). New generation ventilators, such as the V500 (Draeger) and Servo U (Maquet), have been developed by the manufacturers. However, these new generation ventilators are rarely used in our local medical institutions, making them unavailable for our test. The Boaray 5000D is a similar product as Evita 4 and Servo I, which has been used in nearly a thousand hospitals in China and has been exported to more than 50 foreign countries and regions. Therefore, the test ventilators in our study represent current ventilator in our local region, and available for our usability study. In the study, each ventilator was equipped with a standard double limb circuit and connected to a test lung (Venti.Plus™, GaleMed, Taipei, Taiwan, China).
3
Comparative Evaluation of ICU Ventilators
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Six ICU ventilators were evaluated in a dedicated bench test. All ventilators were provided free of charge by manufacturers: (1) Dräger V500 (Lubeck, Germany); (2) Covidien PB980 (Mansfield, MA, USA); (3) Philips V680 (Murrysville, PA, USA); (4) Hamilton S1 (Bonaduz, Switzerland); (5) General Electrics R860 (Fairfield, CT, USA); and (6) Maquet Servo-U (Göteborg, Sweden). General characteristics of the devices are provided in the online repository (Additional file 1 : Table S1).
4
Mechanical Power Calculation in Ventilation
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WOBv is the amount of energy spent to ventilate one liter of gas and is expressed as J/L (16, 17). In this study, WOBv values were obtained from mechanical ventilators (Maquet Servo-U, Sweden), which is calculated as described Cabello and Mancebo (16) using following quation:
Then, WOBv values were dived by the tidal volume (17), which is calculated by mechanical ventilator, expressed as J/L.
To calculate mechanical power (MPdyn), we multiplied the minute volume (MVe) by the WOBv values (3), assuming expiratory valve is inactive.
With the contribution of PEEP, (0.098 × RR x TVe x PEEP) (2) the equation is formulated as follows: MVe is the expiratory minute volume (L/min), WOBv is the Work of Breathing ventilator (J/L), PEEP is the Positive End Expiratory Pressure (cmH2O), and 0.098 is the transformation factor.
Then, WOBv values were dived by the tidal volume (17), which is calculated by mechanical ventilator, expressed as J/L.
To calculate mechanical power (MPdyn), we multiplied the minute volume (MVe) by the WOBv values (3), assuming expiratory valve is inactive.
With the contribution of PEEP, (0.098 × RR x TVe x PEEP) (2) the equation is formulated as follows: MVe is the expiratory minute volume (L/min), WOBv is the Work of Breathing ventilator (J/L), PEEP is the Positive End Expiratory Pressure (cmH2O), and 0.098 is the transformation factor.
5
Comparison of Five Ventilator Devices
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We compared 5 ventilators: the Puritan Bennet 980 (Covidien, Boulder, Colorado), Servo-u (Maquet, Rastatt, Germany), Evita Infinity V500 (Dra ¨ger Medical, Lu ¨beck, Germany), Hamilton G5 (Hamilton Medical, Rha ¨zu ¨ns, Switzerland), and Avea (CareFusion, San Diego, California). The study was performed at the Department of Anesthesiology and Intensive Care Medicine, Osaka University Graduate School of Medicine in Osaka, Japan.
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