Hayek HRTX

The Hayek HRTX

  • works using a unique Biphasic Cuirass Ventilation (BCV) technique.
  • is primarily used in the home-care setting. Treatment can be administered either in hospital or the home.
  • is a user-friendly, fully computerized device, which has eleven sizes of cuirass enabling treatment of both adult and pediatric patients.
  • Compact and lightweight, the Hayek HRTX Ventilator is ideally suited to ventilate a patient for up to 24 hours on one charge, making the HRTX an extremely portable and reliable device.

The Hayek HRTX Ventilator provides an efficient and effective method of non-invasive external ventilation and can be a real alternative to traditional forms of ventilation, including non-compliant Bilevel Positive Airway Pressure users. It actively controls the inspiratory and expiratory phases of respiration (using BCV), making the device work physiologically and successfully, while increasing the patient’s cardiac output.

Using the various trigger modes, the Hayek HRTX Ventilator may be synchronized to the patient’s own respiratory or cardiac cycles. During treatment while using the Hayek HRTX, a negative pressure is generated within the chest cuirass, for inspiration or continuous inspiratory assistance, and applies a positive pressure within the cuirass inducing expiration. This positive expiratory pressure means that expiration is an active phase in the respiratory cycle this makes the Hayek HRTX particularly efficient at CO2 clearance. The pressure applied within the cuirass acts uniformly over the thorax. Subsequently, lung expansion is also uniform ventilating all areas of the lungs. In positive pressure ventilation (PPV) the gas pushed into the lungs naturally follows the path of least resistance therefore ventilating the already well ventilated areas.

Increase in pressures/volumes to aid ventilation of all areas of the lungs leads to barotrauma, volutrauma and possible development of a pnuemothorax. These complications, along with those of ventilator associated pneumonia, are of no relevance with BCV.

Features and Benefits

  • The Hayek HRTX in many cases offers a REAL non-invasive alternative to Positive Pressure Ventilation (PPV) as it can provide complete ventilation, unlike other non-invasive ventilators.
  • The only ventilator that automatically expels secretions, clearing the lungs.
  • The only ventilator that is fully physiological, increasing the patient’s cardiac output.
  • Treatment can be administered either in the home or on the go with the generous battery.
  • Improved patient care: The Hayek HRTX has been shown to reduce mortality rates, increase patient comfort, and avoid many harmful side-effects associated with existing respiratory techniques.
  • Significant Cost-savings: Unique operating method reduces readmissions. Ease-of-use reduces dependency on highly specialized staff in the home as well. Family and other non-clinical personnel can easily be trained.

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Modes of Operation

Continuous Negative Pressure (CNEP)

This mode of support uses CNEP which is applied to the thorax to expand lungs evenly for ventilation. This mode can be easily adjusted/manipulated to suit the individual patient’s requirements. The level is then adjusted until the work of breathing decreases. This will be noted with decreased retractions, use of expiratory muscles, metabolic acidosis, stable or falling CO2 and improved oxygenation.

Indications for CNEP Use:

  • Recruitment of alveoli and small airways
  • Conditions of increased WOB
  • Small airways disease
  • Can prevent intubation or support post extubation for patients who tire easily
  • Relief of pulmonary vascular congestion
  • Can be used with PPV for lung protection and increased ventilation with lower vent pressures
  • Oxygenation
  • RV function
  • Majority respond

Control (Mandatory Controlled Ventilation)

In control mode, positive and negative pressures are applied, along with a controlled I:E ratio, to actively control inhalation and exhalation. This allows for the provision of full ventilator support. A mandatory respiratory rate is set and delivered. The patients synchronize with the mandatory breaths, as BCV utilizes the patient’s own thorax to effect respiration. This is a unique function that only BCV has; The Control Mode mimics physiological respiration.

Indications for Control Mode:

  • CO2 retention refractory to CNEP
  • Low or absent drive
  • Fatigued pulmonary musculature
  • May also be combined with PPV to improve CO2 clearance
  • Neg to pos pressure swings mimic natural respiration and intrathoracic pressures

There are 2 modes triggered by the patient’ s respiratory effort. These modes can be used as pressure support modes and an aid to weaning.

Respiratory Triggered

  • Provides triggered ventilation with the respiratory cycle triggered by the patient’ s actual respiratory requirements
  • The frequency is determined by either the patients rate or the minimum frequency set by the physician
  • The I:E ratio is determined and set by the physician
  • The trigger can either be through the cuirass or through the airway tube placed at or near the patients airway e.g. by the patients nose or mouth. Cuirass trigger will pick up more vigorous spontaneous breathing, whereas airway mode can be triggered by smaller, shallower respiratory effort.
  • As the respiratory cycle is triggered by the patient’s own respiration, this allows better adjustment to the patients actual requirements. The respirator will wait for a period for the trigger; this is dependent on the trigger sensitivity set. If no trigger is detected during this period then the respirator will begin another cycle. In the event of apnea the Hayek HRTX will deliver the set back up rate.
  • Trigger % should be 80-85% if higher you may need to adjust sensitivity, this is to ensure false triggers are prevented
  • Minimum backup rate is 6 per minute i.e. 1 every 10 seconds
  • Maximum backup rate is 60 per minute i.e.1 per second

Respiratory Synchronized

  • This mode is fully synchronized with the patient’s own respiration, automatically adjusting the arte and shape of breathing in sympathy with the natural breathing adjustments being made by the patient themselves.
  • The patient’ s inspiratory effort creates an initial trigger, followed by a further trigger by the initial effort of expiration. The trigger can be either through the cuirass or airway.
  • Difference between this mode at respiratory triggered is that on this mode the support is timed with patients own respiratory pattern, so no I:E ratio is set by the physician
  • The I:E ration will be calculated and displayed
  • This mode will allow the patient to breathe both at their own rate and determine their own shape.
  • In the event of apnea the Hayek HRTX will deliver the set back up rate delivering fully controlled ventilation at the pressures set

Secretion Clearance

  • Secretion Clearance mode is composed of 2 separate modalities; the Vibration Mode and Cough Assist Mode
  • Vibration Mode (High Frequency Chest Wall Oscillation)
    • Using frequencies of 240-1200 Cycles Per Minute, positive and negative pressures are applied to effectively expand and truly oscillate the chest wall and lungs to facilitate mobilization of secretions.
  • Cough Assist Mode

To finish the secretion clearance phase, a cough assist mode mimics a huff cough to force up secretions. Using an I:E Ratio with an extended inspiration and sharp expiration (inverse I:E ratio), BCV facilitates mobilization and removal of pulmonary secretions.

Patient Groups

  • Neuromuscular
(E.g. SMA, Duchene’s etc)
  • Cystic Fibrosis (CF) and those who require chest physiotherapy
  • Asthma
  • Chronic Obstructive Pulmonary Disease (COPD)
  • Head and Spinal Injuries
  • Aids Related Lung Disease
  • And Many more….
  • Other patients problems that will potentially respond to
    • Need for ongoing recruitment of alveoli and small airways
    • Conditions requiring non-invasive support for relief of increased WOB
    • Small airways disease
    • Need to improve oxygenation
    • Need to decrease RV workload and improve function
    • CO2 retention
    • Low or absent drive
    • Fatigued weak or poorly inervated pulmonary musculature
    • Anomalous cardiac flow situations
    • Restrictive processes
    • Obstructive processes
    • Mixed obstructive and restrictive
    • Muco-proliferative lungs
    • Reoccurring atelectasis/pneumonias
    • Reoccurring pneumothoraces
    • Other means of support have not worked or is not desired i.e. BiPAP due to skin issues, or desire to avoid trach and PPV