Ventilation: innovation and technology

To achieve patient-ventilator synchronisation, you can customise the beginning and end of each inspiration with ResMed's trigger and cycle technology.

• Recognising that each patient is different, ResMed provides five levels of trigger and cycle sensitivity to help you tailor and fine-tune triggering and cycling values to different respiratory conditions and patient needs.
• The trigger sensitivity determines how easy or difficult it is for your patient to initiate a breath. The cycle sensitivity determines exactly when your patient starts to expire. The technology can  be customised to each patient's unique respiratory needs so that patient-ventilator synchrony is maintained and work of breathing is reduced.
• The more sensitive trigger and cycle settings ('High' and 'Very High') provide flexibility for high resistance which is especially suited to paediatrics and those patients with obstructive lung diseases.
• Less sensitive settings ('Low' and 'Very Low') provide flexibility if your patient is prone to auto-triggering, caused by restrictive lung diseases and cardiogenic artefact.
• Trigger and cycle sensitivities work with a technology called Vsync to accurately measure unintentional leak. Together, these technologies provide optimal synchronisation.
• To further enhance the existing trigger settings our ventilators also feature ResMed’s NIV+ trigger sensitivity which helps to compensate for leak and improves sensitivity.

Exclusive to ResMed, iVAPS is a volume assured therapy mode that targets alveolar ventilation by automatically adjusting pressure support. Easy to set up, iVAPS with iBR helps to accommodate changes in your patient’s respiratory rate to consistently meet the required ventilation target.

• Combining the comfort and synchrony of pressure support with the assurance of target volume iVAPS maintains appropriate alveolar ventilation even when the patients’ respiratory needs change such as  during different stages of sleep.
• Responding to your changing needs, iVAPS provides rapid, yet gentle automatic pressure support that is maintained yet smooth to avoid sleep disruption.
• Using the Learn Targets feature, iVAPS assess each individual patient's spontaneous respiratory rate and uses this rate as an input for the iBR helping to minimise the disruption in blood gasses.
• If there are pauses in your patient's breathing (for instance if they cough or sigh), the iBR technology uses the data learned to determine whether to deliver ventilation. This helps to ensure that your patients will not be over-ventilated, and helps to encourage spontaneous breathing.
• The Learn Targets feature runs automatically determining each patient's iBR while ventilating.  No manual set  up is required, helping you to save time and providing more confidence that your patient is receiving ventilation that suits their particular respiratory needs.

iVAPs technology is available in Lumis 150 ST and Lumis 150 ST-A devices.

Learn Circuit

Learn circuit is an important feature as it evaluates and compensates for resistance in the circuit to optimise ventilation and is designed to deliver the correct mask pressure.

ResMed's therapy solutions are designed to overcome resistance in various ways, depending on the ventilator, either through automatic tests such as Learn Circuit, or manual selection of circuit options through the ventilator menu.

• At the push of a button and in less than a minute, Learn Circuit automatically runs a test through the ventilator to evaluate any impedance in the circuit.
• If there is an impedance problem, the device will use this information to compensate to deliver the set pressure. 

Vsync and TiControl

Vsync is a leak management algorithm and the product of ResMed’s extensive experience in NIV. Vsync monitors and compensates for unintentional mask leak, so that patients receive their prescribed therapy pressure. Working in sync with TiControl, Vsync ensures reliable breath detection even in conditions of high leak.

When Vsync detects a sudden and large change in flow, the usual 10 second window in which the device scans for leak, is rapidly reduced to a 2 second window. This allows for rapid resynchronisation of ventilator flow to help compensate.

Once the ventilator has adjusted and once again synchronised with the patient’s respiratory demand, the window period is quickly moved back to its default 10 second value.

Without Vsync, the outcome would be different. The increased flow from a leak can be misinterpreted as patient inhalation, causing the ventilator to mistrigger from EPAP to IPAP, and fall out of sync with the patient's actual effort. It can also diminish the ventilator's ability to cycle the breath.

Vsync works closely with the TiControl feature to further maintain patient synchronisation, even during instances of large leak. TiControl allows you to manage your patient's inspiratory time limit according to their pathology. For challenging respiratory conditions, TiControl allows you to manage spontaneous flow, letting you set your patient's ideal levels.

With its Ti Min and Max settings, you can be assured that TiControl helps to ensure your patient is breathing at the desired pace.

Even if your patient's cycle of breath becomes spontaneous and out of its registered inspiration phase, the device will respond, providing timely intervention if required.

Together, the Vsync and TiControl features help to offer extra assurance and control over your patient's inspiratory time, promoting reliable device controlled synchrony.

Setting your patient up on a ventilator with ResMed's Pathology Defaults feature is fast, easy and streamlined.

You can choose from a list of pre-set values that are grouped together according to specific disease states and lung mechanics, such as:

• chronic obstructive lung disease
• chronic restrictive lung disease
• normal lung mechanics
• obstructive lung mechanics
• obesity hypoventilation.

Choosing from pre-set values helps you quickly set up the ventilator with clinically acceptable parameters for your patient's disease state, and then allows you to fine-tune the pressure settings required for each individual patient.