9.1 Attachment 1: Comments on particular modes of operation
- Volume Control and VC-AutoFlow: In most ICU ventilators the upper airway pressure alarm
limit “Paw-high” is not only used for generating the airway pressure high alarm but also for
limiting the maximum pressure generated by the therapy device. In Dräger anesthesia devices,
the alarm limit is only used for generating the alarm but does not limit the pressure. For the
pressure limitation, the Pmax setting is used, which also has to be set specific to the patient and
the clinical situation.
- Pressure Support: When the patient triggers breaths with a lower frequency than the set
minimum frequency (RRmin), the anesthesia device remains in the Pressure Support mode and
non-triggered breaths are given in addition to the spontaneously triggered breaths to achieve
the set minimum frequency. In addition, the alarm “Apnea Ventilation” is generated. In many of
the Dräger anesthesia devices, the alarm can be configured to low or medium priority. As in
long-term ventilation, the user might not be permanently in front of the device, so the medium
alarm priority is recommended. Dräger anesthesia devices have no dedicated apnea-time and
apnea back-up ventilation mode as it is available in most ICU ventilators. As minute volume in
this case will decrease the operator has to react and choose an appropriate ventilation mode or
adapt ventilation settings (e.g. higher RRmin).
- Inspiratory Flow and Slope: In Pressure Control and Pressure Support on Fabius family
devices, users can adjust the insp. flow to impact the speed at which the pressure curve rises.
On Perseus and Apollo, the “slope” setting is used to define the time for the pressure rise in
Pressure Control, Pressure Support, VC-AutoFlow and APRV (only available in Perseus).
Therefore, to achieve a ventilation pressure quicker, the user can set a high inspiratory flow
(Fabius) or a short Slope (Apollo, Perseus).
- Non-Invasive Ventilation (NIV): Dräger anesthesia devices do not offer a dedicated NIV-mode.
Therefore, the user has to pay particular attention to leakages when doing mask ventilation.
- Nasal High Flow Therapy: Dräger anesthesia devices do not offer Nasal High Flow Therapy.
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