Find the Optimal Ventilator for Your Critical Care Patients

Gary Milne

Changing your patient’s ventilator as their care progresses may provide better outcomes.

Choosing the right intensive care ventilator can help you give patients the best possible care. This can be challenging when patients suffer from unpredictable infectious ailments or diseases. But monitoring your patient’s disease progression can help you choose the ventilator that meets their needs. And understanding the various tools and functionality helps you improve patient outcomes.

Ventilators can vary widely and determining best use cases requires proper assessment of your patient. While high-acuity units are commonly used for critical patients, low-acuity ventilators can be ideal for post-acute weaning.

For example, more advanced ventilators should be used for patients with an infectious disease who show signs of acute respiratory distress syndrome (ARDS). These units provide enhanced monitoring capabilities — which can improve improve your ability to treat ARDS patients.

How do you determine ICU ventilator use for your patient?

Enhanced monitoring capabilities may mean the difference between using the Puritan Bennett™ 980 (PB980) ventilator and the Puritan Bennett™ 560 (PB560) ventilator. The PB980 ventilator’s monitoring capabilities may help determine the best clinical approach to care depending on the course or duration of your patient’s stay.

In general, the PB980 ventilator and the Puritan Bennett™ 840 (PB840) ventilator are high-acuity ventilators, while the Newport^TM HT70 plus ventilator and PB560 ventilator are better for low-acuity use. Portable ventilators — like the PB560 ventilator — are typically less complicated for easier user operations.

Another difference in high- and low-acuity ventilators is the oxygen setting. For example, a patient on 50 to 60 percent oxygen shouldn’t be placed on the PB560 ventilator if they require levels of about 50 percent for interventions (e.g. suctioning).

As patients begin to improve in the ICU, your approach to treat them may change. Several factors can help determine if it may be time to switch your patient to the PB560 ventilator for the wean or recovery phase, including:

Returning lung function
Decreased ventilator-supported oxygen dependency
Other ventilator support improvements

Intensive care ventilators are a mature technology. Even so, advanced modes and features are continually added that may help with lung assessment and recruitment, patient weaning, patient monitoring, and patient-ventilator synchrony. It’s best to always refresh your understanding of various ventilator benefits for appropriate patient use.

DISCLAIMER:

The PB560 ventilator system has not been FDA cleared. The PB560 ventilator system has been authorized by FDA under an emergency use authorization (EUA). The PB560 ventilator system is authorized only for the duration of the declaration that circumstances exist justifying the authorization of emergency use of this ventilator system under section 564(b)(1) of the Act, 21 U.S.C. § 360bbb-3(b)(1), unless the authorization is terminated or revoked sooner.

Understand the benefits of the PB560 ventilator

A sub-acute and portable ventilator — like the PB560 ventilator — can be effective and allows increased mobility. While not intended for long-term ICU implementation, this tool’s original design catered toward the portable or homecare ventilator management system.

Lightweight and compact, the PB560 ventilator is a clinician-trusted ventilation system that’s flexible enough for use in the critical care environment. Use among critically-ill patients in the ICU for treatment of infectious diseases should be considered a temporary supportive measure.

Features supporting this include the assist control, synchronized intermittent mandatory ventilation (SIMV), and continuous positive airway pressure (CPAP) modes. The PB560 ventilator also supports multiple breath types — including volume control, pressure control, and pressure support. While the PB560 ventilator does measure well in the critical care environment, clinicians should assess patients frequently for their ever-changing care needs.

Additional features of the PB560 ventilator include:

Two waveforms displayed
Up to 50 percent oxygen
Up to a 1:1 ratio
PEEP settings up to 20
Exhaled monitoring
Long batter life

The PB560 ventilator can be used for continuous or intermittent support of patients weighing at least five kilograms but should be limited to more stabilized patient scenarios.

PB980 ventilator features

For critically-ill patients, key parameters of your ventilator management strategy should include:

Advanced monitoring
Filtration/containment
High settings of pressure and oxygen level

In addition to a 100 percent oxygen setting, the PB980 ventilator features include:

PEEP setting of 45
Greater than 4:1 inverse ratio
Built-in integrated expiratory filter requiring change every 15 days
Robust graphic displays including screen capture

The PB980 ventilator helps patients breathe more naturally^† through some of the most innovative breath delivery technology.

Improving patient outcomes with the right ventilator

It’s important to note that the PB560 is only authorized for use in the United States during the COVID-19 public emergency. While the PB560 ventilator features multiple modes and breath types, it lacks some advanced features typically associated with monitoring and managing critical patients. This makes it a great option for the recovery phase as a temporary solution rather than long-term ICU deployment. The PB980 ventilator includes advanced monitoring and features that may be integral to supporting your patient when it matters most.

References
† Compared to conventional mechanical ventilation (VC,VC+,PC,PS).
1. Milne G. Puritan Bennett™ 560 Ventilator vs. the Puritan Bennet™ 980 ventilator. Medtronic. https://www.medtronic.com/covidien/en-us/products/mechanical-ventilation.html. March 2020.

TOPICS: Puritan Bennett™ Ventilators, Intensive Care Unit