Infant Ventilator

TO TREAT INFANT RESPIRATORY DISTRESS SYNDROME

Treatment
Treatment
  • PREVENTION
  • DIAGNOSTIC
  • TREATMENT
  • OVERVIEW
  • TECHNOLOGY Characteristics
  • Infant Ventilator
    Representative Product

    DEATHS ASSOCIATED WITH PREMATURITY

    DEATHS ASSOCIATED WITH RESPIRATORY DISTRESS SYNDROME

    Condition

    Mechanical ventilation is used to assist breathing for neonates who are unable to breathe sufficiently on their own. In the neonatal intensive care unit (NICU) setting, mechanical ventilation is often a major driver of both cost and duration of care.


    Mechanism of Action

    There are three main types of mechanical ventilation. Pressure ventilators are the most common, and deliver air to a pre-set peak inspiratory pressure. Volume ventilators deliver air to a pre-set tidal volume (around 5-7mL/kg in a 1.2kg infant). High frequency ventilators operate at 180-900 breaths per minute with extremely small tidal volumes, allowing ventilation when conventional means have failed. Complex, modern ventilators can trigger and adjust flow based on the patient’s spontaneous breath. These features may offer advantages to some patients but have not been shown to decrease mortality. In all cases, ventilation is designed to support the infant to the point that she matures enough to breathe on her own. In many cases, prolonged use can cause lung injury.

     

    Current Use in High-Resource Settings

    Although intubation is not always necessary, the majority of patients who require ventilation get an endotracheal tube which connects to the ventilation apparatus. Depending on their condition, neonates can remain on ventilators for days to weeks.


    Application in Low-Resource Settings
    The high cost of ventilators and the high level of skill required to operate, maintain, and repair the ventilators mean that ventilators are used almost exclusively in well equipped neonatal intensive care units. Low-resource health care providers in developing settings have less training and experience with mechanical ventilation, thus causing increased morbidity through pneumothorax and other lung injury.

     

    Related Technologies in Development
    BU/MIT Ventilator, Morrison Pneumatic Ventilator, Onebreath Ventilator, Seattle Children's Hansen Ventilator

    REPRESENTATIVE DEVICES

    MAKE
    MODEL
    PRICE*
    Condition
    STATUS
    NOTES

    Draeger

    Babylog 8000
    $10,000
    Refurbished
    Marketed
    Advanced triggering capability

    Siemens

    Servo 300
    $4,000
    Refurbished
    Marketed
    Advanced triggering capability

    Bird

    VIP
    $3,000
    Refurbished
    Marketed
    Pressure, time, manual triggers

    * Prices are approximated. Actual pricing can, and will vary by marketplace and market conditions.

  • CHARACTERISTICS OF REPRESENTATIVE PRODUCT

    TECHNOLOGY CHARACTERISTICS

    OPERATIONAL PARAMETERS

    POTENTIAL OPPORTUNITIES FOR IMPROVEMENT

    SKILLS

    REQUIRED

    Intended end user
    Training required
    Time required per use
    Physician, nurse
    Hours
    Days-Weeks

    Considerable skill is required to successfully operate a ventilator. In this case, some engineering ability is also required to assemble the device on site.

    ENVIRONMENT/ INFRASTRUCTURE

    Power required
    Waste collection
    Complementary technologies required
    Temperature and storage
    Maintenance
    Battery power, provided pressurized gas
    Treating patient facing parts as disposable reduces the chance of hospital acquired infection.
    Endotracheal tube, pressurized gas, oxygen, clean water
    Requires regular maintenance by trained personnel.

    COST

    Device Cost (Approx)
    Cost/course (Approx)
    $1000 ā€“ $3000
    <$1

    The low cost of this device is related, in part, to its self-assembly requirements

    OTHER

    Portability
    Regulatory
    Efficacy
    Not appropriate for use outside hospitals
    Potentially lifesaving in cases of respiratory failure and complementary with surfactant therapy.

    Additional devices required for impact: infant warmer, surfactant, vital signs monitoring, pulse oximetry

Sources: WHO Technology Summary - GMDN #42411 Intensive-care ventilator, adult/infant, UMDNS #17429 Ventilators, Intensive Care. Greenough et al. Neonatal ventilation techniquesā€“ which is best for prematurely born infants? Arch Med Schi 2008: 116-12. Cheifetz, Ira. Invasive and noninvasive pediatric mechanical ventilation. Respiratory Care. 2003: 442-58. Henderson-Smart DJ, De Paoli AG, Clark RH, Bhuta T. High frequency oscillatory ventilation versus conventional ventilation for infants with severe pulmonary dysfunction born at or near term. Cochrane Database of Systematic Reviews 2009, Issue 3. Art. No.: CD002974. DOI: 10.1002/14651858.CD002974.pub2.