Clinicians

What if you could ventilate…

ventilate-withoutmask Without a BiPAP® mask

ventilate-nosedation Without sedation

ventilate-nobarotrauma Without the risk of barotrauma

ventilate-noinfection Without the risk of infection

And at the same time…

  • Increase cardiac output
  • Facilitate secretion clearance
  • Provide an active expiratory phase
  • Exercise musculature, promoting strengthening

Introducing Biphasic Cuirass Ventilation (BCV)

Overview

The United Hayek ventilators work using a unique Biphasic Cuirass Ventilation (BCV) technique. 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 RTX particularly efficient at CO2 clearance.

With over 300 publications to date, BCV is a very well proven method of ventilation.

Provides an efficient and effective method of non-invasive external ventilation and is a real alternative to traditional forms of ventilation.

  • Mimics the natural physiology of spontaneous ventilation.
  • Active expiratory phase.
  • Full support with no risk with no risk of VAP, barotrauma or infection.
  • Eat, drink and talk while fully supported.
  • BCV can be used in place of BiPAP, CPAP (where underlying OSA if not a factor), vest and cough assist type devices, and in many cases, invasive positive pressure ventilation.

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Simple Application

BCV works using a clear plastic shell called a Cuirass. The cuirass is lightweight and has a foam seal that maintain an airtight fit around the patient. It is very comfortable to wear. It is available in 12 different sizes, ranging from babies to adults.

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Broad Applications

BCV can be used in both the hospital setting or at home. BCV is ideally suited for use in both acute and chronic, intubated or non-intubated patients.

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Comfort Factor

BCV doesn’t just ventilate fantastically, it is really comfortable too. The seal is made of super soft foam, the cuirass is very light and it is designed to fit light a glove. United Hayek units automagically compensate for leaks, therefore the cuirass doesn’t need to be applied tightly.

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Clean & Hygenic

The seal is hypoallergenic and it’s disposable too. This mean it’s hygenic, which helps to avoid infection, and, of course, it’s latex free.

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Superb Technology

United Hayek units are really advanced. Devices like the Hayek RTX are crammed with the latest technology. It incorporates many modes of ventilation.

Biphasic Cuirass Ventilation

  • BCV offers complete non-invasive ventilation, high frequency chest wall oscillation, and assisted cough device.
  • BCV delivers all 4 modes of ventilation without changing the patient interface.
  • BCV can be used with positive pressure ventilation to improve clinical outcomes.
  • BCV is the only means of cardio-pulmonary support that functions in a truly physiologic way, increasing cardiac output.

clinicians-advantages

BCV has been successfully used on patients with:

  • Acute Respiratory Failure
  • Neuromuscular (E.g. SMA,Duchene’s etc)
  • Problems with Weaning from PPV
  • Cystic Fibrosis (CF) and those who require chest physiotherapy
  • Asthma
  • Chronic Obstructive Pulmonary Disease (COPD)
  • Head and Spinal Injuries
  • Ventilation during anesthesia in Ear Nose and Throat (ENT) Procedures
  • Aids Related Lung Disease
  • Ventilation Post-­‐Operation (E.g. post-­‐coronary bypass, Fontan, Fallot, post-­‐pneumonectomy)
  • Other patients problems that will potentially respond to BCV:
    • 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 innervated 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
  • Many more…

Case Studies

Chest X-ray films of an 88-year-old man with Adams-Stokes syndrome and pulmonary congestion. (Left) Extensive left-sided atelectasis. (Right) Atelectasis was resolved after treatment with the Hayek RTX.

Download Case Studies

Why BCV?

improvement in gas exchange, reduced work of breathing, no risk of infection or barotrauma, cardiac output improved, maintain respiratory muscles, provide even ventilation, reduces end tidal PC02, Actively controls both phases of respiratory cycle

  • Non-Invasive
  • Complete Ventilation
  • Cost Effective
  • Physiological & Natural
  • Decreased Mortality
  • No Risk of VAP

BCV & Cardiac Benefits

  • Average > 60% increase in CO (Cardiac Output) has been documented with use in low CO states. Some individual studies > 100%
  • Improves venous return when used with PPV
  • Lower PA pressures and alveolar perfusion pressures
  • Can unload R heart
  • Improvement with acute cardiogenic pulmonary edema

BCV and Weaning

  • Decreased WOB allowed by BCV enhances weaning efforts, shortening time on vent and in ICU.
  • Application of BCV post-extubation decreases reintubation rate.
  • Often patients with even chronic vent needs will thrive without invasive interface ultimately using BCV

BCV Usage

Continuous negative pressure (CNEP)

Used in conditions with increased work of breathing, small airways disease, V/Q mismatching and those infants who may tire easily post extubation. This mode of support can be easily adjusted/manipulated to suit the individual patients – requirements. Start your CNEP roughly 2cms H2O more than you would CPAP. This level is then adjusted until the increase work of breathing decreases. This will be noted with decreased recession, use of expiratory muscles, metabolic acidosis, stable or falling CO2 and improved oxygenation. The air within the cuirass can cause the infants to be at risk of temperature loss. It is advisable to dress them in pyjamas or warm clothes, without buttons as these can affect the seal on the cuirass. Or place them under a radiant heater Once a suitable level of CNEP is found and the patient is n the recovery phase of their illness weaning from CNEP can be initiated by bringing down the level of CNEP and then once at an expectable level taking the patient off for controlled periods. These are gradual lengthened to suit the patient. CNEP helps improve right ventricular function, especially when used in conjunction to PPV. References: 10, 11, 12, 13, 15.

Ventilation Modes

There are 3 different Ventilation modes available on the Hayek RTX. There are 2 modes which are triggered by the patient’s respiratory effort, whare are “Respiratory Triggered” and “Respiratory Synchronized”. These modes can be used as pressure support modes and an aid to weaning.

Control Mode

This mode provides full control over the patient’s respiration

  • Mandatory respiratory rate is set and delivered; patients do not fight against the mandatory breaths as the Hayek RTX uses their own respiratory muscles to breath. This is a unique function of the Hayek RTX as it mimics physiological respiration.
  • Controls both inspiratory and expiratory phases and you have control over the I:E ratio
  • Commence rate at 2 above their own current spontaneous rate, then can slowly decrease the rate as patients breathing controlled by Hayek RTX
  • If PaCO2 increases alter I:E ratio to 1:1.2 – 1:1.5
  • At frequency’ s over 60 the inspiratory pressure and the expiratory pressures should set at the same figures i.e. -15 and +15
  • At frequencies of 240-1200cpm you can only preset frequency and inspiratory pressure parameters
  • It is in this mode that you are able to oscillate the patient from 1-20Hz with pressures up to +/- 50 cmH2O

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 patients own respiration, this allows better adjustment to the patients actual requirements. The respirator will wait for a period for the trigger; this is dependant on the trigger sensitivity set. If no trigger is detected during this period then the respirator will begin another cycle. In the event of apnoea the Hayek RTX 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 Synchronised

  • This mode is fully synchronised with the patients 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 which is 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 apnoea the Hayek RTX will deliver the set back up rate delivering fully controlled ventilation at the pressures set.

Download Full Information Brochure

The Truth

Positive pressure ventilation techniques, as well as invasive mechanical ventilation, have a lengthy list of adverse effects, which BCV does not. Some potential adverse physiologic effects of positive pressure ventilation (PPV) are:

  • Decreased cardiac output
  • Unintended respiratory alkalosis
  • Increased intracranial pressure
  • Gastric distension
  • Impairment of hepatic and renal function

Perhaps the most feared complications occurring during mechanical ventilation include:

  • Pneumothorax
  • Bronchopleural fistula
  • Development of nosocomial pneumonia

The use of positive pressure ventilation can lead to barotrauma, volutrama and possible development of a pneumothorax. These complications can be entirely avoided with the use of BCV.

BCV: The Truth

BCV offers effective, even and natural ventilation without risk to the patient and can be applied by virtually anyone with minimal training. BCV will also facilitate the clearance of secretions in contrasts to PPV, which compounds secretions. BCV provides the only real solution to the complexities encountered in delivering life saving ventilation in such events.