Webinar: Turbine Versus Central Gas Supply
Pros & Cons
SBF Respiratory Care, Sept 5th 2012, Erwin Broos
Turbine vs. Central Gas Supply Pros & Cons
1. Introduction
2. Basics
3. Turbine in ICU Ventilation
4. Turbine in Non Invasive Ventilation
5. Turbine in Emergency Transport
6. Turbine in Anaesthesia Ventilation
7. Bench Tests
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Webinar Turbine vs. Central Gas Supply, Pros & Cons | Sept 5th 2012
Turbine vs. Central Gas Supply Pros & Cons
Dräger Products Using Turbines
Savina
Carina
Savina 300
Patient ventilation
Evita Infinity V500 /
Babylog VN500
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Webinar Turbine vs. Central Gas Supply, Pros & Cons | Sept 5th 2012
Perseus A500
Zeus IE
Turbine vs. Central Gas Supply Pros & Cons
Fields of Application for Patient Ventilation
ICU Ventilation
NICU Ventilation
Non Invasive Ventilation
Home Care Ventilation
Emergency & Transport Ventilation
Ventilation in Remote Areas
Anaesthesia Ventilation
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Webinar Turbine vs. Central Gas Supply, Pros & Cons | Sept 5th 2012
Turbine vs. Central Gas Supply Pros & Cons
Customer Requirements Related to Gas Delivery
• Good quality of ventilation stationary and during
transport
• Provide ventilation in different environments
• Patient comfort in spontaneous breathing
• Patient comfort silent environment
• Low cost of ownership
• Energy efficiency of the equipment
• Need for a backup in case of central gas supply
(CGS) or power failure
• Need for an alternative gas source in case a
CGS is not available
• Need for High Frequency in NICU ventilation
• Perform special maneuvres
• High flow demand
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Webinar Turbine vs. Central Gas Supply, Pros & Cons | Sept 5th 2012
Turbine vs. Central Gas Supply Pros & Cons
1. Introduction
2. Basics
3. Turbine in ICU Ventilation
4. Turbine in Non Invasive Ventilation
5. Turbine in Emergency Transport
6. Turbine in Anaesthesia Ventilation
7. Bench Tests
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Webinar Turbine vs. Central Gas Supply, Pros & Cons | Sept 5th 2012
Turbine vs. Central Gas Supply Pros & Cons
Gas Delivery Technology
Gas delivery technology
Using high pressure gas sources
High pressure
valves
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High & medium
pressure valves
Webinar Turbine vs. Central Gas Supply, Pros & Cons | Sept 5th 2012
Using low pressure gas sources
Turbines
Pistons
Turbine vs. Central Gas Supply Pros & Cons
Gas Delivery Technology
The difference of high & medium pressure valves to turbine technology
1. High & medium pressure valves are so called proportional flow valves
 these valves need high pressure and O2 e.g. from a central gas system
( CGS )
 the valve generates a constant flow proportional to the degree of which the
valve opens
2. A turbine is based on a rotating wheel
 turbines use breathing gas from ambient air or from a low pressure 02
source (e.g. Oxygen compressors)
 turbines generate a gas pressure by compressing the gas
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Webinar Turbine vs. Central Gas Supply, Pros & Cons | Sept 5th 2012
Turbine vs. Central Gas Supply Pros & Cons
Different Turbine Technologies
Savina 300 turbine (side stream blower):
- Right side with the turbine wheel and
the driving electric motor.
- Left side with turbine housing half
and the side stream channel.
- Pressure and flow is controlled by a
an additional inspiratory valve
Carina turbine in comparison (radial blower):
- Through fast revolution of the wheel
the breathing gas is propelled.
- The pressure and flow is controlled by
the revolution speed.
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Webinar Turbine vs. Central Gas Supply, Pros & Cons | Sept 5th 2012
Turbine vs. Central Gas Supply Pros & Cons
Pneumatic Mode of Operation – Evita 4 / XL
O2
HP − AIR
P
HPSV
Mixer
Patient
HP − O2
P
Flow
Valve
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HP - AIR
=
high pressure air inlet (2,7-6bar)
HP – O2
=
high pressure oxygen inlet (2,7-6bar)
Sensors
=
all sensors are colored blue
Webinar Turbine vs. Central Gas Supply, Pros & Cons | Sept 5th 2012
HPSV Mixer =
high pressure servo valve mixer
Turbine vs. Central Gas Supply Pros & Cons
Pneumatic Mode of Operation – Savina / Savina 300
LP − AIR
Turbine
Filter
O2
LP
Mixing
Chamber
P
Patient
Flow
Valve
HP − O2
P
O2 Valve Bench
Flow
Valve
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LP - AIR
=
low pressure (ambient) air inlet
HP – O2
=
high pressure oxygen inlet (2,7-6bar)
Sensors
=
all sensors are colored blue
Webinar Turbine vs. Central Gas Supply, Pros & Cons | Sept 5th 2012
LP Mixing Chamber = low pressure (ambient) mixing chamber
Turbine vs. Central Gas Supply Pros & Cons
Pneumatic Mode of Operation – Evita V500 / Babylog VN500
O2
HP − AIR
Valve
MP
Mixing
Tank
P
Valve
HP − O2
LP − AIR
Patient
Valve
Filter
P
Turbine Unit
Flow
Valve
GS 500
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HP - AIR
=
high pressure air inlet (2,7-6bar)
HP – O2
=
high pressure oxygen inlet (2,7-6bar)
MP Mixing Tank
= medium pressure mixing tank (0,2-0,3bar)
Sensors
=
all sensors are colored blue
LP - AIR
low pressure (ambient) air inlet
Webinar Turbine vs. Central Gas Supply, Pros & Cons | Sept 5th 2012
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Turbine vs. Central Gas Supply Pros & Cons
1. Introduction
2. Basics
3. Turbine in ICU Ventilation
4. Turbine in Non Invasive Ventilation
5. Turbine in Emergency Transport
6. Turbine in Anaesthesia Ventilation
7. Bench Tests
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Webinar Turbine vs. Central Gas Supply, Pros & Cons | Sept 5th 2012
Turbine vs. Central Gas Supply Pros & Cons
ICU Ventilation
Turbine pros & cons
Clinically no difference
Customer requirements
 Good quality of ventilation in stationary use
CGS pros & cons
Clinically no difference
 Patient comfort in spontaneous breathing
Predestined for
transport. Compact devices
and light weight (depends on the
ventilator)
 Good quality of ventilation during transport
Not intended for
transort. Possible only with gas
cylinders. Great disadvantage in
handling the transport.
Depends on the ventilator
 Patient comfort with regards to a silent
environment
Relatively low noise level
Typically turbine based
ventilators are energy efficient
due to its mobile use abilities
 Energy efficiency of the equipment
Depends on the specific
ventilator
No specific difference
 Low cost of ownership
No specific difference
No compressor needed.
 Need for a backup for CGS or power
Need for compressors.
 Need alternative if CGS is not available
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Need for a HP-Air
 Need for HF in NICU ventilation
No specific disadvantage
With some drawbacks
 Perform a number of special maneuvres
No limitations
Turbines can exceed CGS
in max. flow
 High flow demand
Covered by CGS
Webinar Turbine vs. Central Gas Supply, Pros & Cons | Sept 5th 2012
Turbine vs. Central Gas Supply Pros & Cons
Turbine vs. external compressors
Typical external compressor
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-
Limited flow delivery:
typical 30 l/min average flow
-
Limited lifetime:
about 50% of a ventilator lifetime
-
High maintenance cost
-
Bulky: big and heavy
-
Very loud
-
Adds additional investment costs
-
Mask ventilation almost not possible:
A compressor will “run out of gas”
when trying to compensate for a
large leak
Webinar Turbine vs. Central Gas Supply, Pros & Cons | Sept 5th 2012
Turbines
The Savina turbine has none of the
disadvantages of an external
compressor !
Turbine vs. Central Gas Supply Pros & Cons
Evita Infinity V500 / Babylog VN500 – A Hybrid System
The hybrid system is unifying the advantages of
central gas supply & turbine technology into one
setup
• Same ventilation performance with or without
the GS 500
• The GS 500 eliminates the disadvantages of
external compressors
• No high pressure filter needed for the AIR inlet
• Three turbines generates the „mid pressure“ for
the mixing tank.
• HF ventilaton can not be provided when
operating with GS 500
Unique and unreached hybrid concept in the
market unifying CGS and Turbine benefits
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Webinar Turbine vs. Central Gas Supply, Pros & Cons | Sept 5th 2012
Turbine vs. Central Gas Supply Pros & Cons
1. Introduction
2. Basics
3. Turbine in ICU Ventilation
4. Turbine in Non Invasive Ventilation
5. Turbine in Emergency Transport
6. Turbine in Anaesthesia Ventilation
7. Bench Tests
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Webinar Turbine vs. Central Gas Supply, Pros & Cons | Sept 5th 2012
Turbine vs. Central Gas Supply Pros & Cons
Non Invasive Ventilation
• NIV devices initially has established in home
care for conscious, spontaneous breathing
patients
• It was a must that those devices comes with
excellent breathing comfort
• NIV ventilators provides the best leack
compensation based on single hose systems
with a leak valve
Carina
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Webinar Turbine vs. Central Gas Supply, Pros & Cons | Sept 5th 2012
Turbine benefits:
• Independent and mobile
• Smooth gas delivery (Anti Fump)
Turbine vs. Central Gas Supply Pros & Cons
1. Introduction
2. Basics
3. Turbine in ICU Ventilation
4. Turbine in Non Invasive Ventilation
5. Turbine in Emergency Transport
6. Turbine in Anaesthesia Ventilation
7. Bench Tests
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Webinar Turbine vs. Central Gas Supply, Pros & Cons | Sept 5th 2012
Turbine vs. Central Gas Supply Pros & Cons
Emergency & Transport
A brief assessment
• Most compact ventilators in this field
• Turbines adds size by itself and by additionally
needed batteries
Oxylog 1000
Oxylog 3000 plus
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Webinar Turbine vs. Central Gas Supply, Pros & Cons | Sept 5th 2012
• Turbines ensures excellent ventilation
capabilities and whould eliminate some of the
current drawbacks (e.g. limited flow or
ventilation with low O2 concentration)
• Currently not established but in future turbines
will find its way in certain areas of Emergency
and Transport ventilation
Turbine vs. Central Gas Supply Pros & Cons
1. Introduction
2. Basics
3. Turbine in ICU Ventilation
4. Turbine in Non Invasive Ventilation
5. Turbine in Emergency Transport
6. Turbine in Anaesthesia Ventilation
7. Bench Tests
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Webinar Turbine vs. Central Gas Supply, Pros & Cons | Sept 5th 2012
Turbine vs. Central Gas Supply Pros & Cons
Anaesthesia Ventilation
Perseus A500
• Classic anaesthesia devices like Fabius and
Primus Family systems commonly use piston
driven ventilation
• Strongest driver for Turbines in anaesthesia
ventilation:
o introduce ICU quality ventilation for top
class systems
o ensure independency from CGS
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Webinar Turbine vs. Central Gas Supply, Pros & Cons | Sept 5th 2012
Turbine vs. Central Gas Supply Pros & Cons
Path-Breaking Ventilation Technology TurboVent® 2
 Ventilation quality like an intensive
care ventilator:
 Spontaneous breathing at any time.
 Nearly unlimited inspiration flow.
 No compromises with regards to
ventilation performance:
 Equipped with all modern types of
ventilation modes.
 Vol. ctrl. AutoFlow
 Active PEEP and real CPAP.
 Intelligent hygienic concept
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Webinar Turbine vs. Central Gas Supply, Pros & Cons | Sept 5th 2012
Turbine vs. Central Gas Supply Pros & Cons
Anesthesia Ventilation
2009:
Zeus IE with TurboVent 2
the world’s smallest and most
powerful anesthesia ventilator.
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Webinar Turbine vs. Central Gas Supply, Pros & Cons | Sept 5th 2012
Turbine vs. Central Gas Supply Pros & Cons
1. Introduction
2. Basics
3. Turbine in ICU Ventilation
4. Turbine in Non Invasive Ventilation
5. Turbine in Emergency Transport
6. Turbine in Anaesthesia Ventilation
7. Bench Tests
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Webinar Turbine vs. Central Gas Supply, Pros & Cons | Sept 5th 2012
Turbine vs. Central Gas Supply Pros & Cons
Benchstudy on turbine based ICU ventilators, 2009
Savina is among the best
performing ventilators out of a
total number of 13 ICU ventilators
which were tested.
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Webinar Turbine vs. Central Gas Supply, Pros & Cons | Sept 5th 2012
Turbine vs. Central Gas Supply Pros & Cons
ERS Buyers Guide about Savina and turbine based ventilators
ERS Buyers Guide about Savina and turbine based ICU ventilators
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Webinar Turbine vs. Central Gas Supply, Pros & Cons | Sept 5th 2012
Turbine vs. Central Gas Supply Pros & Cons
Turbine related benefits beyond independence from CGS
 Excellent spontaneous breathing capabilities (proven !)
 Equals the performance of high pressure source ventilators (proven !)
 Excellent NIV (turbines are established in NIV devices)
– At large leaks and high flow demands the Savina turbine is not limited to the
capacity of central gas supplies:
In some hospital settings the medical gas pipeline system may have by some
reasons limited gas delivery capacity (which may be the case temporarily or even
permanent)
 Goodbye compressor!
The turbine is not just an alternative, it should be the preferred solution!
– Supports a compact design when comparing to systems with compressor
– Reduces investment cost: compressor is obsolete
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Webinar Turbine vs. Central Gas Supply, Pros & Cons | Sept 5th 2012
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