Flow family anesthesia
machines
- competitor comparison
Focus on ventilation, vaporizers, AGC and RM
Flow-i/e vs
• Dräger Perseus A500
• Dräger Zeus
• GE Aisys CS2
• Mindray A9
MX-8620 - Competitor comparison - AGC & RM launch for Flow -c and-e - Version 00.9
Comparables
Flow-i/Flow-e
Dräger Perseus A500
GE Aisys CS2
Dräger Zeus
Mindray A9
GENERAL
PATIENT TYPE
Adult, pediatric, neo
Adult, pediatric, neo
Adult, pediatric, neo
Adult, pediatric, neo
Adult, pediatric, neo
CONFIGURATION
Mobile, ceiling
Mobile, ceiling
Mobile, ceiling
Mobile, ceiling
Mobile, ceiling
Flow-e: central brake (four
wheels)
Flow-i: individual brakes
Central brake (two wheels)
Central brake (two wheels)
Central brake (two wheels)
Central brake (two wheels)
WEIGHT OF
ANESTHESIA
MACHINE (KG)
C20: 138
C30: 138
C:40 138
Flow-e: 164
168
160
180
161
CONTROL SCREEN
15 inches
15 inches
15 inches
20 inches
18,5 inches
BATTERY BACKUP
90 min
30 min minimum with monitor
30 min minimum with monitor
At least 30 minutes; up to 90 minutes,
depending on the ventilation parameters.
90 min
MX-8620 - Competitor comparison - AGC & RM launch for Flow -c and-e - Version 00.9
3
Comparables
Flow-i/Flow-e
Dräger Perseus A500
GE Aisys CS2
Dräger Zeus
Mindray A9
VENTILATOR
VENTILATOR TYPE
Servo gas modules with
volume reflector
Digitally controlled gas modules in
combination with ascending bellows (bag-inbottle)
Turbine (Turbovent 2) with manual bag as
gas reservoir
Turbine (Turbovent 2) with manual bag as
gas reservoir
Gas modules with volume exchanger
SYSTEM VOLUME (L)
2.8 incl absorber
3,5 incl absorber and bag
4,7 (auto) 4,4 (man)
2
3.35 mechanical ventilation
3.45 manual ventilation
(including 1.5 l CO2 absorber)
VENTILATION MODES
Manual/spontaneous, AFGO,
VCV, PCV, SIMV-VC, SIMV-PC, PSVPro, PCV- Manual/spontaneous with optional adjustable
VCV, PCV, PRVC, SIMV, apnea VG, CPAP/PSV, SIMV PCV-VG
CPAP, pressure control (CMV, SMV+/PS),
mute, heart lung mode/cardiac
volume control (CMV, CMV/AF/PS); optional
bypass mode, inspiratory/
pressure support (CPAP/pressure support),
expiratory hold, PSV
pressure control (APRV), external fresh gas
outlet (electronic gas mixer only)
Manual/spontaneous with adjustable CPAP, Manual/Spontaneous, Bypass, VCV with PLV
pressure control (CMV, SIMV+, SIMV+/PS), function; PCV, PCV-VG, CPAP, PS with
volume control (CMV, CMV/AF, SIMV/AF,
backup, SIMV-VC, SIMV-PC, APRV, AMV,
SIMV/AF/PS), pressure support consisting of High flow nasal cannula
CPAP/pressure support; optional external
fresh gas outlet; Smart Ventilation Control
FRESH GAS FLOW
0.1-20 l/min
0.2-15 l/min
0.2-15 l/min
TIDAL VALUME
RANGE (ML)
20–2000, 5 ml in PC
20–1500, 5 ml in PC
20–2000
20-1500
10-1500 (5 ml in PC)
PRESSSURE (CMH2O)
PEEP RANGE (CMH2O)
0-120
0–50
12-100
Off, 4–30
7-80
Off, 2–35
8-70
Off, 3–35
5-90
0-50
ACTIVE INSPIRED
HYPOXIC GUARD
O2Guard®
Nothing similar
Nothing similar
Nothing similar
Nothing similar
APL TYPE & VALVE
RANGE (CMH2O)
Electronically controlled, SP80
Mechanical
Mechanical
Mechanical
Mechanical
NON-CONSUMABLE
FLOW SENSORS
Yes, Ultrasonic
No, Variable orifice
No, Hot-wire
No, Hot-wire
No, Variable orifice
4
0, 0,2-20 l/min
MX-8620 - Competitor comparison - AGC & RM launch for Flow -c and-e Version 00.9
Comparables
Flow-i/Flow-e
GE Aisys CS2
Dräger Perseus A500
Dräger Zeus
Mindray A9
VAPORIZER
TYPE
Electronic injector
Electronic vaporizer – Aladin2 cassette
Mechanical flow over with optical reading,
Vapor 2000 & 3000
DIVA – direct injection of volatile agents
module
Electronic injector – Mindray specific
NUMBER OF ACTIVE
SLOTS
2
1
2-3
2
2
VAPORIZER WEIGHT
KG
3,2 full
2,8
7-9 kg
5 kg empty
3,5
POSSIBILITY TO FILL
DURING USE
Yes
No, must be undocked
Yes
Yes, but it needs to be flushed before.
Flush time for sevo appr 1 min
Yes
FILLING VOLUME (ML)
300 (more than a regular 250
ml bottle)
200 ml for sevoflurane and isoflurane
240 ml for desflurane
300
315
320
HEATING TIME FOR
DESFLURANE
None
None
5–6 minutes for D-Vapor
2 minutes heating for all vaporizers
None
MX-8620 - Competitor comparison - AGC & RM launch for Flow -c and-e - Version 00.9
5
Comparables
Flow-i/Flow-e
GE Aisys CS2
AUTOMATIC
GAS
DELIVERY
MODE
AGC (automatic gas control)
Et Control (end tidal control)
TARGET VALUES
The control is made by setting
FIO2 and EtAA. Setting the FIO2 is
the gold standard.
PRE-SETTING
Dräger Perseus A500
Mindray A9
TCA (target controlled anesthesia)
ACA (automatic controlled anesthesia)
The control is made by setting EtO2 and
EtAA thus the user has no real control of
what the FDO2 is.
The control is made by setting FIO2 and
EtAA.
The control is made by setting FIO2 and
EtAA.
Possible to preset AGC values in
advance thus you can easily
activate it when patient is ready
for AGC.
Not possible to preset agent or FIO2 values
Not possible to preset agent or FIO2
values
Not possible to preset agent or FIO2
values
SETTING OF SPEED
Different speeds during induction
and emergence can be set.
Reduces risk for hemodynamic
instability.
Not possible. Not having the option of speed
settings could cause adverse events eg.
hemodynamic instability in some patient
groups
Not possible. Not having the option of
speed settings could cause adverse
events eg. hemodynamic instability in
some patient groups
Not possible. Not having the option of
speed settings could cause adverse
events eg. hemodynamic instability in
some patient groups
PREDICTION
Predicts the time to reach set
target value. Useful function when
planning the anesthesia.
Not possible to predict the time to reach the
target. You must rely on your own knowledge
about time to reach target.
Not possible to predict the time to reach
the target. You must rely on your own
knowledge about time to reach target
Not possible to predict the time to reach
the target. You must rely on your own
knowledge about time to reach target
AGENT SWITCHING
WITH ACTIVE
VAPORIZERS
Yes, possible.
Not possible, need to deactivate the
vaporizer before switching to another agent.
Previous vapor needs to be washed out
before next can be introduced which is costly
and time consuming. The manufacturer
recommends exiting End-tidal Control mode
before changing the anesthetic.
Not possible. If you happen to mix gases
the user must switch to fresh gas mode
until the second gas is washed out. Do not
switch to TCA mode for at least 15
minutes.
Yes, possile but warning for mixed agent
FRESH GAS FLOW
Lowest possible is 0,1 L/min which
is important for the overall agent
consumption.
Lowest possible is 0,5 L/min.
0 l/min
0.2 l/min
CONSUMABLES
No
No
No
Yes, galvanic O2-cell
MX-8620 - Competitor comparison - AGC & RM launch for Flow -c and-e - Version 00.9
6
NOT EXISTING
Dräger Zeus
Comparables
Flow-i/Flow-e
LUNG
RECRUITMENT
Auto RM (Recruitment Maneuver)
Vital Capacity
One-step recruitment
One-step recruitment
One-step recruitment
•
Automatic stepwise RM: a
configurable pressure step is
applied for a time period
•
The Vital Capacity procedure automates
the manual bag ‘squeeze and hold’.
•
Automates the manual bag ‘squeeze
and hold’.
•
Automates the manual bag ‘squeeze
and hold’.
•
Automates the manual bag ‘squeeze
and hold’.
•
PEEP can be programmed at the
end of the procedure.
•
PEEP can be programmed at the
end of the procedure.
•
PEEP can be programmed at the
end of the procedure to help
sustain an open lung.
PEEP can be programmed at the end of
the procedure.
•
•
PEEP can be programmed at the
end of the procedure.
•
Not a recommended procedure by
experts - leads to more hemodynamic
compromise and microscopic and
biochemical signs of lung injury due to
over-distension.
•
Switches back to the previously set
ventilation.
•
Switches back to the previously set
ventilation.
•
Not a recommended procedure by
experts.
•
Not a recommended procedure by
experts.
•
Not a recommended procedure by
experts.
•
•
•
SAFE due to stepwise increase
in pressure
- Less hemodynamic
compromise for the patient.
VISUALISATION - a real time
monitoring of ongoing RM and
"Time to target" (the time taken
by the recruitment maneuver)
helps the workflow in the ORthe user can plan the anesthesia
in an efficient manner.
EASY - The user can start RM
with just one touch.
RM trends
•
•
7
Real-time monitoring that will
allow the user to follow the
changes in lung mechanics
during lung recruitment
procedures.
EFFECTIVE - graphical breathby-breath presentation of EIP
(End Expiratory Pressure), PEEP
and Cdyn.
- the user can easily assess
compliance changes in relation
to PEEP changes.
•
Breath count function - helps the
user perform RM manually
•
Possible to save monitored
parameters during a RM (EIP,
PEEP, Cdyn) with a time stamp
GE Aisys CS2
Perseus A500
Dräger Zeus
Cycling
•
•
•
Programmable steps allow for increasing
and decreasing PEEP levels during
mechanical ventilation.
Doesn’t show the ongoing RM
graphically and compliance
measurements in relation to PEEP and
PEAK pressures.
Not user friendly - it is confusing and it
takes long time to configure a RM since
it demands a lot of interaction from the
user
Compliance trending
• Provides compliance measurements, but
doesn't show the corresponding PEEP and
PEAK pressures. Therefore it is difficult to
assess compliance changes in relation to
PEEP changes.
Multi-step recruitment
Multi-step recruitment
•
Programmable steps allow for
increasing and decreasing PEEP
levels during mechanical ventilation.
•
•
Max inspiratory pressure and max
PEEP are set
•
Max inspiratory pressure and max
PEEP are set
•
Automatic decremental phase
•
Automatic decremental phase
•
Reminder: time since last RM
•
Reminder: time since last RM
Programmable steps allow for
increasing and decreasing PEEP
levels during mechanical ventilation.
Compliance trending
Compliance trending
• Provides compliance trending
graphically and with arrows
• Provides compliance trending
graphically and with arrows
• Arrows shows direction of pressure
and PEEP
• Arrows shows direction of pressure
and PEEP
Mindray A9
Multi-step recruitment
•
Programmable steps allow for
increasing and decreasing PEEP
levels during mechanical ventilation.
•
Delta pressure, PEEP, Breaths,
I:E,rate and PEEP on exit are set
Compliance trending
• Provides compliance trending
graphically
• Has no breath count function - the user
has to count breaths in every step if RM is
performed manually.
• Not possible to save monitored parameters
(EIP, PEEP, Cdyn) during a RM with a
time stamp.
MX-8620 - Competitor comparison - AGC & RM launch for Flow -c and-e Version 00.9
Flow-c vs
• GE CS 650
• GE CS 750
• Dräger Atlan
• Mindray A7
MX-8620 - Competitor comparison - AGC & RM launch for Flow -c and-e - Version 00.9
Comparables
Flow-c
GE CS650
GE CS750
Dräger Atlan
Mindray A7
GENERAL
PATIENT TYPE
Adult, pediatric, neo
Adult, pediatric, neo
Adult, pediatric, neo
Adult, pediatric, neo
Adult, pediatric, neo
CONFIGURATION
Mobile, ceiling
Mobile, ceiling, wall
Mobile, ceiling, wall
Mobile, ceiling, wall
Mobile, ceiling
Central brake (four wheels)
Central brake (two wheels)
Central brake (two wheels)
Central brake (two wheels)
Central brake (two wheels)
WEIGHT OF
ANESTHESIA
MACHINE (KG)
134
145
145
147 (without vaporizers)
118 (wall mount version)
160
CONTROL SCREEN
15 inches
12 inches
15 inches
15 inches, fixed
15 inches, fixed
BATTERY BACKUP
90 min
30 min minimum with monitor
30 min minimum with monitor
At least 30 minutes; up to 90 minutes,
depending on the ventilation parameters.
90 min
MX-8620 - Competitor comparison - AGC & RM launch for Flow -c and-e - Version 00.9
9
Comparables
Flow-c
GE CS650
GE CS750
Dräger Atlan
Mindray A7
VENTILATOR
VENTILATOR TYPE
Servo gas modules with
volume reflector
Digitally controlled gas modules in
combination with ascending bellows (bag-inbottle)
Digitally controlled gas modules in
combination with ascending bellows (bag-inbottle)
Piston
Digitally controlled gas modules in
combination with ascending bellows (bagin-bottle)
SYSTEM VOLUME (L)
2.8 incl absorber
3,5 incl absorber and bag
3,5 incl absorber and bag
4,7 (auto) 4,4 (man)
2,85 (auto) 1,8 (man)
VENTILATION MODES
VC, PC, PS, PRVC,
SIMV(PC), SIMV(VC),
Manual/Spontaneous, AFGO
VC, PC, PCV-VG, SIMV PCV-VG, PSV,
CPAP+PSV, Manual/Spontaneous
VC, PC, PCV-VG, SIMV PCV-VG, PSV,
CPAP+PSV, Manual/Spontaneous
FRESH GAS FLOW
0.1 -20 l/min
0.1-15 l/min
0.1-15 l/min
0.2-15 l/min
0.2-15 l/min
TIDAL VOLUME
RANGE (ML)
20–2000, 5 ml in PC
20–2000, 5 ml in PC
20–2000, 5 ml in PC
5-1500
20-1500
PEEP RANGE (CMH2O)
0–50
Off, 4–30
Off, 4–30
Off, 2–35
Off, 3–30
ACTIVE INSPIRED
HYPOXIC GUARD
O2Guard®
Nothing similar
Nothing similar
Nothing similar
Nothing similar
APL TYPE & VALVE
RANGE (CMH2O)
Electronically controlled, SP80
Mechanical
Mechanical
Mechanical
Mechanical
NON-CONSUMABLE
FLOW SENSORS
Yes, Ultrasonic
No, Variable orifice
No, Variable orifice
No, hot wire
No, Variable orifice
10
Manual/Spontaneous (Man/Spon); volume
control (VC-CMV); pressure control (PCCMV)
Manual/spontaneous, VCV, PCV, PVC-VG,
SIMV-VC, SIMV-PC, PS; SIMV-VG,
CPAP/PS; APRV
MX-8620 - Competitor comparison - AGC & RM launch for Flow -c and-e Version 00.9
Comparables
Flow-c
GE CS650
GE CS750
Dräger Atlan
Mindray A7
VAPORIZER
TYPE
Electronic injector
Mechanical variable bypass, Tec 6 Plus
and/or Tec 7
Mechanical bypass, Tec 6 Plus and/or Tec 7
Mechanical variable bypass with optical
reading, Vapor 2000 & 3000
Mechanical variable bypass, V60
NUMBER OF ACTIVE
SLOTS
1
2
2
1-3
2
VAPORIZER WEIGHT
KG
3,2 full
7-10
7-10
7-9
8
POSSIBILITY TO FILL
DURING USE
Yes
Yes
Yes
Yes
Yes
FILLING VOLUME (ML)
300 (more than a regular 250
ml bottle)
300 ml but only 225 ml when refilling due to
that 75 ml is reatined by the wick system
300 ml but only 225 ml when refilling due to
that 75 ml is reatined by the wick system
300
360
HEATING TIME FOR
DESFLURANE
None
Yes
Yes
5–6 minutes for D-Vapor
Yes
MX-8620 - Competitor comparison - AGC & RM launch for Flow -c and-e - Version 00.9
11
Comparables
Flow-c
AUTOMATIC
GAS
DELIVERY
MODE
AGC (automatic gas control)
TARGET VALUES
The control is made by setting
FIO2 and EtAA. Setting the FIO2 is
the gold standard.
PRE-SETTING
Possible to preset AGC values in
advance thus you can easily
activate it when patient is ready
for AGC.
SETTING OF SPEED
Different speeds during induction
and emergence can be set.
Reduces risk for hemodynamic
instability.
PREDICTION
Predicts the time to reach set
target value. Useful function when
planning the anesthesia.
AGENT SWITCHING
WITH ACTIVE
VAPORIZERS
Yes, possible.
FRESH GAS FLOW
Lowest possible is 0,1 L/min which
is important for the overall agent
consumption.
GE CS650
NOT EXISTING
MX-8620 - Competitor comparison - AGC & RM launch for Flow -c and-e - Version 00.9
12
GE CS750
NOT EXISTING
Dräger Atlan
NOT EXISTING
Mindray A7
NOT EXISTING
Comparables
Flow-c
LUNG
RECRUITMENT
Auto RM (Recruitment Maneuver)
Vital Capacity
Vital Capacity
•
Automatic stepwise RM: a
configurable pressure step is
applied for a time period
•
The Vital Capacity procedure automates
the manual bag ‘squeeze and hold’.
•
•
•
PEEP can be programmed at the
end of the procedure to help
sustain an open lung.
PEEP can be programmed at the end of
the procedure.
The Vital Capacity procedure
automates the manual bag ‘squeeze
and hold’.
•
PEEP can be programmed at the
end of the procedure.
•
Not a recommended procedure by
experts - leads to more
hemodynamic compromise and
microscopic and biochemical signs
of lung injury due to over-distension.
•
•
•
SAFE due to stepwise increase
in pressure
- Less hemodynamic
compromise for the patient.
VISUALISATION - a real time
monitoring of ongoing RM and
"Time to target" (the time taken
by the recruitment maneuver)
helps the workflow in the ORthe user can plan the anesthesia
in an efficient manner.
EASY - The user can start RM
with just one touch.
RM trends
•
•
13
Real-time monitoring that will
allow the user to follow the
changes in lung mechanics
during lung recruitment
procedures.
EFFECTIVE - graphical breathby-breath presentation of EIP
(End Expiratory Pressure), PEEP
and Cdyn.
- the user can easily assess
compliance changes in relation
to PEEP changes.
•
Breath count function - helps the
user perform RM manually
•
Possible to save monitored
parameters during a RM (EIP,
PEEP, Cdyn) with a time stamp
GE CS650
•
Not a recommended procedure by
experts - leads to more hemodynamic
compromise and microscopic and
biochemical signs of lung injury due to
over-distension.
GE CS750
Cycling
•
•
•
Programmable steps allow for increasing
and decreasing PEEP levels during
mechanical ventilation.
Doesn’t show the ongoing RM
graphically and compliance
measurements in relation to PEEP and
PEAK pressures.
Not user friendly - it is confusing and it
takes long time to configure a RM since
it demands a lot of interaction from the
user
Compliance trending
• Provides compliance measurements, but
doesn't show the corresponding PEEP and
PEAK pressures. Therefore it is difficult to
assess compliance changes in relation to
PEEP changes.
• Has no breath count function - the user
has to count breaths in every step if RM is
performed manually.
• Not possible to save monitored parameters
(EIP, PEEP, Cdyn) during a RM with a
time stamp.
•
•
NOT EXISTING
Mindray A7
One-step recruitment
•
Automates the manual bag ‘squeeze
and hold’.
•
PEEP can be programmed at the
end of the procedure.
•
Not a recommended procedure by
experts.
Multi-step recruitment
•
Programmable steps allow for
increasing and decreasing PEEP
levels during mechanical ventilation.
Programmable steps allow for
increasing and decreasing PEEP
levels during mechanical ventilation.
•
Delta pressure, PEEP, Breaths,
I:E,rate and PEEP on exit are set
Doesn’t show the ongoing RM
graphically and compliance
measurements in relation to PEEP
and PEAK pressures.
Compliance trending
Cycling
•
Dräger Atlan
Not user friendly - it is confusing and
it takes long time to configure a RM
since it demands a lot of interaction
from the user
• Provides compliance trending
graphically
Compliance trending
• Provides compliance measurements,
but doesn't show the corresponding
PEEP and PEAK pressures. Therefore
it is difficult to assess compliance
changes in relation to PEEP changes.
• Has no breath count function - the user
has to count breaths in every step if
RM is performed manually.
• Not possible to save monitored
parameters (EIP, PEEP, Cdyn) during
a RM with a time stamp.
MX-8620 - Competitor comparison - AGC & RM launch for Flow -c and-e Version 00.9