Exploring the Volume Exchanger Breathing System for Anesthesia

10-26-2022

The need for ICU-level ventilation has become a global trend within the healthcare industry as more patients are entering the operating room (OR). With patient types ranging from preexisting comorbidities to elective procedures that require specialized care, the need to address specific ventilation requirements in the OR with more precise anesthesia technology is a growing concern for practitioners. From obese patients to pediatric/NICU patients, clinicians in the US are seeking anesthesia machines that can handle ICU-level ventilation with more precision, increased reliability, enhanced patient safety, streamlined workflow, and maximized uptime. To help combat these issues, many clinicians are looking to explore the latest advancements in anesthesia care and the advantages of a volume exchanger breathing system from both a clinician and patient standpoint.

Advances in Anesthesia Ventilators

A critical part of all anesthesia machines, the ventilator, is essentially a set of external lungs. It breathes for deeply anesthetized patients, maintaining the patient’s regular respiratory rates and blood chemistry. When anesthesia machines were first introduced, their ventilators were very simple with just a few ventilation modes. Over time, ventilators became more sophisticated with many advanced ventilation modes, having either a double circuit, bellows design, turbine design, or a single circuit piston configuration.

As the medical needs of patients continue to evolve, ventilator technology has also changed and adapted to meet the growing demands of the clinical landscape. The latest technology coming into the market is the volume exchanger (VE), an innovative rebreathing circuit system that delivers precise and reliable ventilation to patients. Replacing traditional bellows, VE offers less risk of malfunction with no moving components, increases reliability, and may offer a longer service life.

Bellows on a traditional anesthesia machine

Volume Exchanger breathing system on an anesthesia machine

Volume Exchanger Benefits

VE is an innovative breathing system that delivers precise and reliable ventilation to optimize patient safety during anesthesia. The VE separates the drive and patient gas rather than using physical separation with a bellows. The VE delivers ICU-level ventilation, enabling accurate tidal volumes down to 5 ml and providing more exact ventilation capabilities. Additional benefits include:

Streamline Workflow: Small system volume allows for quick wash-in and wash-out time. With no moving components, the VE can help reduce malfunction risk, support increased reliability, and maximize uptime.

Precise Ventilation: Capable of delivering a wide range of tidal volumes and peak flow for all patient types. Lower system compliance leads to less volume loss in the breathing system to ensure precise volume delivery for small patients with extremely low tidal volume (as low as 5mL), allowing for more precise ventilation for all patients, particularly for neonates and pediatrics.

Patient Safety: Maintains normal ventilation during excessive leaks by driving gas to maintain normal ventilation. VE provides clinicians with a visual VE indicator and a graphical alarm noting the leak on the system administrator screen to clearly illustrate the breathing system ventilation state.

More Usability: Offering smaller volumes, compared to the bellows system, VE unlocks more possibilities to provide optimal care with smaller and tighter volumes for pediatric and neonate patients.

A8/A9 Innovative Breathing System for ICU-level Ventilation

FAQs

What is a Volume Exchanger?

The A8/A9 contains an innovative rebreathing circuit called the Volume Exchanger that replaces traditional bellows in an anesthesia machine. The VE does not have a physical medium to separate drive and patient gas like a bellows.

How Does the VE Work?

There is minimal diffusion of the drive gas and patient gas due to the VE’s long double-layered coiled tube. In addition, there is a low gas contact area due to the tube’s small diameter. Like other anesthesia machines, the flow of drive gas, which is made up of 100% oxygen, is regulated by a proportional valve.

What Happens During the Inspiratory and Expiratory Phases (Auto Mode)?

During the inspiratory phase, the drive gas pushes both patient gas and fresh gas into the breathing system to create inspiration. During expiration, exhaled and fresh gas enter the volume exchanger, where gas is scavenged. In Manual mode, the VE is not part of the circuit.

Explore Mindray’s VE Anesthesia Platforms

At Mindray, we believe in a better future for our clinicians and patients. Our newest A8 and A9 anesthesia platform embodies this philosophy by retaining traditional features while introducing disruptive technology (including VE) to maximize patient safety, help improve patient outcomes, complement the way clinicians work best, and increase efficiency in the perioperative environment.