The modern requirements imposed to the equipment for the artificial ventilation of the lungs used in intensive care units and resuscitation are rather extensive. They usually include existence of the adaptive modes, comfort for the patient, convenience in management and disinfection, safety in respect of transfer of an intrahospital infection. Often ventilators incorporate the monitor module which allows to use it during the work with the patient and to refuse third-party devices.
If to address history, then it becomes clear that the modern equipment for carrying out IVL even if it goes not from eminent producers, many times over exceeds the similar equipment which is issued in the 70-80th years of last century. Quite recently carrying out qualitative IVL was absolutely impossible without deep sedation and the patient's relaxation, that is full switching off at the last for respiratory function. From the modes only the mode with control on the volume to which as an option positive pressure at the end of an exhalation was used was available. The electromechanical motor setting fur or the piston in motion was the basic driving element in the fan. Monitoring was used extremely limited and usually included peak pressure on a breath and a pulsoksimetriya. It is no wonder that the percent of survival of patients after similar IVL was rather low.
The situation essentially changed with development of the concept of the active valve when the IVL mode began to represent a control algorithm of a stream in a rebreathing system, and the equipment for the operating room (narcotic devices) and intensive care units (respirators) began to differ essentially. Thus, not the electric motor, but the electromagnetic device operating a continuous stream of kislorodo-air mixture began to be responsible for forming of an artificial breath. Use of the solenoid valve allowed to make the equipment more sensitive to respiratory attempts of the patient that considerably facilitated implementation of the concept of synchronization with a respirator and made possible development of the auxiliary modes.
Now in the world there are several producers of respirators which are considered as reference for the others. These are the companies "Drager", "Puritan Bennet", "Hamilton Medical", "GE Healthcare", "Maquet". These firms have extensive experience of production of the respiratory equipment that allows them to specialize in development of the most advanced modes of ventilation, first of all auxiliary and intellectual. It is necessary to notice that the products of these companies are most preferable to use at patients with heavy pulmonary pathology when for carrying out IVL weeks and months are required, it especially concerns patients of infantile and children's age.
However this fact does not mean at all that the products of other, younger producers cannot be used in an intensive care. In those situations when this is not about ventilation of the patient with difficult restrictive pulmonary pathology (and it meets rather seldom and the vast majority of patients of intensive care unit have no it), use of the high-quality equipment of less famous producers yields just the same results of treatment. Besides, the equipment of producers of the second echelon has one indisputable advantage — it significantly cheaper than that which is made by leaders of the market that allows to staff with them intensive care units without considerable financial expenses. A number of intensive care units owing to specifics of work in general practically does not meet in the practice crushing restrictive damages of lungs that that does existence on their equipment of the respiratory equipment of an expert class senseless and unreasoned in terms of economic feasibility.
The equipment of producers of the second echelon, as a rule, has all necessary options for carrying out artificial ventilation of the lungs in the majority of clinical situations. These are the compulsory, compulsory and auxiliary and auxiliary modes, the mode of spontaneous breath with support by pressure and volume, the adaptive and intellectual modes of ventilation. Such equipment is equipped with all necessary respiratory monitoring, to it the various range of expendables is issued.
As an example of the qualitative respirator intended for equipment of intensive care units of the general profile it is possible to consider a respirator of Lufter 3 ("Kranz").
This medical ventilator is intended for use at children and adults. It has the touch color screen that creates considerable comfort at management of a respirator and carrying out monitoring. All respiratory parameters are displayed in real time. Settings of ventilation are exposed by means of touch buttons. In general it is possible to tell that the screen on usability is similar to models of higher price range.
The device is assembled on the functional rack convenient for movement to which also the humidifier and a basket for accessories fasten. Such design allows to move easily and quickly a respirator to the right place of chamber of an intensive care.
The device Lufter 3 allows to realize the following modes of ventilation: ventilation with control on pressure (PCV), ventilation with control on the volume (VCV) the alternating compulsory synchronized ventilation with control on pressure or on the volume (P-SIMV and V-SIMV), the ventilation mode with two levels of positive pressure, the mode of spontaneous breath with support by pressure, the interesting mode of the ventilation regulated on pressure with management on volume, the mode of noninvasive ventilation with positive pressure. Besides function of apnoyny ventilation in the absence of respiratory activity at the patient who is in the mode of spontaneous breath is provided.
Rebreathing system of a respirator standard also includes actually the patient's contour, a humidifier, the moisture collection and the Y-shaped block. The most various can be used, disposable and reusable rebreathing systems of various producers suitable according to the destination. The respirator allows to conduct graphic and digital monitoring of process of IVL which indicators are displayed on the display, and it is possible to choose the necessary mode of display and those parameters which are necessary for the doctor.
Thus, this respirator perfectly is suitable for ventilation of the patients who do not have serious primary pulmonary pathology. These are the patients after operative measures needing ventilating support, patients with disturbance of neuromuscular conductivity and demanding respiratory support owing to a craniocereberal trauma, patients with an acute left ventricular failure, patients with pneumonia without development acute respiratory a distress syndrome and other categories of patients.
Thus, it is possible to draw a conclusion that the modern equipment of producers of the second row is capable to compete with models of eminent producers, especially, if not there is a speech about ventilation of patients with heavy pulmonary pathology or use of the intellectual modes. These devices are very functional, convenient, practical, demand considerably smaller costs of service and differ in reasonable cost.