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12 mainstream sidestream capnpgraphy


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  • 1. Mainstream and Sidestream CAPNOSTAT ® 3 Mainstream CO 2 Sensor LoFlo™Sidestream CO 2 Module
  • 2. Capnography
    • The standard-of-care
      • Capnography
        • Indicates a ventilatory event faster than any other type of monitoring
        • Provides a means for continuous, real-time monitoring of ventilation
        • Helps confirm ET tube placement
        • Enables you to provide the same level of care during procedural sedation as is required in the O.R.
  • 3.
    • Provides a time sensitive picture for the clinician as to the ongoing changes in a patient’s respiratory status during procedural sedation
      • Immediate and sensitive data regarding a patient’s respiratory status for assessing the safety of a repeat bolus of medicine in an inadequately sedated patient
  • 4.
    • Study comparing the CAPNOSTAT mainstream with Microstream ® sidestream
      • Study conducted in a neonatal NICU concluded that the CAPNOSTAT sensor is more accurate than Microstream at estimating PaCO 2 .
    Kathleen Deakins RRT-NPS Comparison of Microstream and Mainstream Capnography with Arterial CO2 in Neonates; University Hospitals of Cleveland, OH; FAARC 12-03 Clinical Studies
  • 5.
    • Procedural Sedation Study in the ED
      • When the criteria of an ETCO 2 >50 mmHg, an absolute change >10 mm Hg, or an absent waveform were applied, all respiratory distress was detected , not detected by pulse oximetry alone.
      • The CO 2 monitor represents an additional monitor that can add to the safety of procedural sedation by quickly detecting hypoventilation
    Miner JR, Heegaard W, Plummer D. End-tidal carbon dioxide monitoring during procedural sedation. Academy Emergency Medicine. 2002;9(4):275-80. Clinical Studies
  • 6.
    • Study comparing the CAPNOSTAT mainstream with Microstream sidestream in Emergency Medical Services
      • Environmental conditions, specifically changes in ambient temperature:
      • “ Under the conditions of low and changing ambient temperature (-20 degrees C, +22 degrees C), only the Tidal Wave (Respironics; mainstream) remained uninfluenced, whereas deviations of -12% and +15% were found with the NPB-75 (Microstream; sidestream)”.
    Biedler A, Wilhelm W, Mertzlufft F. [Portable capnographs in emergency care: a comparison of equipment] Anaesthesiol Reanim. 1999;24(3):71-8. Clinical Studies
  • 7. CAPNOSTAT Mainstream Sensor
    • Even under the harshest of airway conditions, the CAPNOSTAT sensor’s true single beam:
      • Successfully compensates for the presence of contaminates
      • Continues to operate
      • Provides accurate readings
    Jaffe, MB. Mainstream or sidestream capnography? Respironics-Novametrix White paper 1012102, August 2002.
  • 8. CAPNOSTAT Mainstream Sensor
    • Contaminate-free design
      • Disposable patient sampling cuvette ensures analyzer is not exposed to, or contaminated with patient secretions, moisture, etc.
      • Unaffected by patient secretions
        • Microstream sidestream systems are affected by patient secretions
      • Keeps defibrillator in service
      • Reduces maintenance costs
  • 9. CAPNOSTAT Mainstream Sensor
    • Family of Single Patient Use and Reusable Airway Adapters
      • Adult, pediatric and infant
    • CAPNO 2 mask™
        • For use on non-intubated patients
  • 10.
    • No sample gas is diverted from the patient
      • Typical sampling rates in sidestream systems run from 50cc to 250cc per minute
      • Because there is no sampling, the CAPNOSTAT sensor is free from sample line occlusion and waveform distortions
    • Heated sensor
      • The CAPNOSTAT sensor heats the sample cell windows keeping them dry, minimizing effects from airway moisture
    CAPNOSTAT Mainstream Sensor
  • 11. Benefits of Using the CAPNOSTAT Sensor
    • Superior solid state design for greater accuracy and robustness
    • Instantaneous analysis due to no delay time and 60ms rise time (other devices have greater than 2 second delay time with a rise time of 200-240ms)
      • Capnogram is displayed in 15 seconds, full specifications in 60 seconds
      • “ Crisp” waveform faithfully reflects airway ventilation
      • Better performance at higher respiratory rates
    • Relatively lightweight due to miniaturization and newer technologies
  • 12.
    • Low deadspace airway adapter is available for infants
    • Airway adapter serves as the sample cell and is disposable
    • Airway adapter is located in line with the patient
      • No gas sampling takes place
    • Analysis performed at the patient airway and under the same environmental conditions
    Benefits of Using the CAPNOSTAT Sensor
  • 13.
    • Immediate response for emergency situations
      • No delay in measurement
    • Variety of airway adapters allows use on intubated or nonintubated neonatal, pediatric, and adult patients
    • Heated sensor keeps sample cell windows dry
    Benefits of Using the CAPNOSTAT Sensor
  • 14.
    • Uses the same proven analyzer and electronic technology as the CAPNOSTAT 3 Mainstream CO 2 sensor
    • Users can seamlessly switch between the LoFlo Sidestream CO 2 Module or CAPNOSTAT 3 Mainstream CO 2 Sensor, to allow selection of the technology most suited for the application
    LoFlo Sidestream Module - Features
  • 15.
    • Innovative disposable patent pending sample cell and filter
      • Eliminates the possibility of contamination of the analyzer, thereby protecting your investment
    • Sampling rate of 50ml/minute
    LoFlo Sidestream Module - Features
  • 16.
    • Complete family of:
      • Adult, pediatric, and infant nasal cannula kits
      • Oral/nasal cannula kits
      • Sampling kits with oxygen delivery
      • Adult/pediatric and infant/neonatal on airway adapter kits for intubated patients
      • Patents pending
    LoFlo Sidestream Module - Features
  • 17.
    • Innovative, patents pending, low deadspace neonatal on-airway adapter with less than 1 ml deadspace
    LoFlo Sidestream Module - Features
  • 18.
    • Sample pump rated for 24,000 hours of continuous use
      • No routine changing of the sample pump
      • Typical sidestream systems sample pump rated at 7,000 hours or less
    • Patent pending CAPflow™, Respironics capillary based flow control system permits tight control of flow, independent of barometric pressure
    • Pump is activated automatically when the disposable sample cell is connected and turns off automatically when sample cell is removed
    LoFlo Sidestream Module - Features
  • 19.
    • Measurement of End Tidal Carbon Dioxide (ETCO 2 ) and respiration rate
    • Delivers a crisp, accurate capnogram at all respiratory rates up to 150 breaths per minute
    • Waveforms and ETCO 2 readings in 15 seconds, warm up in less than 80 seconds,
    • Full accuracy in 3 minutes
    • Routine gas calibration is not required
    LoFlo Sidestream Module - Features
  • 20.
    • 50 ml/min flowrate
    • Ideal for non-intubated and intubated patients
    • Interchangeable with the CAPNOSTAT 3 Mainstream CO 2 Sensor
    • No calibration required
    LoFlo Sidestream Module - Features
  • 21.
    • LoFlo Module plugs into the M Series and is interchangeable (and backward compatible) with the CAPNOSTAT sensor
    • Care giver has the choice of using the CAPNOSTAT sensor or the LoFlo module
    • Superior solid state design for accuracy and robustness
    • Immediate response for emergency situations
    • Integrated filter keeps sample cell windows dry
    Benefits of Using the LoFlo Sidestream Module
  • 22.
    • Analyzer CANNOT be contaminated due to our Removable Sample Cell
    • Family of adult, pediatric and infant sampling cannulas and on-airway adapter kits allows LoFlo to be used on intubated or non-intubated patients
    • 24,000 hour rated sample pump @ 50 ml/min sample rate
    • No routine service is required
    Benefits of Using the LoFlo Sidestream Module
  • 23. Product Summary
    • ZOLL offers you the choice of using mainstream or sidestream ETCO 2 that best fits your applications -
    • “ Plug and play”
    • Both technologies are robust, proven solid state
    • Lifetime warranty
    • Analyzer in both systems CANNOT be contaminated by patient secretions or water
    • The CAPNOSTAT sensor and LoFlo module are for use in all clinical areas where ETCO 2 monitoring is required
    • No routine calibration
  • 24. Clinical Summary
    • Of equal importance to the ETCO 2 value is the waveform which faithfully reflects what’s occurring.
      • Subtle changes in waveforms can indicate actual or impending problems with setup, airway mechanics, respiratory drive, cardiovascular systems, and other important conditions.
      • The shape and trends of the CO 2 waveforms contain valuable information that is not available from any other source.
  • 25. Clinical Summary
    • Capnography affords the clinician breath by breath trending of ETCO 2 and thus a noninvasive look at ventilation
      • Trending provides information on changes in ventilation and perfusion
  • 26.
    • Thank you for visiting the ZOLL web site. If you
    • have any questions or need additional information,
    • please call 1 (800) 348-9011 or (978) 421-9655
    • ZOLL Medical Corporation
    • 269 Mill Road
    • Chelmsford, MA 01824
    This material is presented with the consent of Respironics Inc. Wallingford CT. CAPNOSTAT is a registered trademark and LoFlo is a trademark of Respironics, Inc. Microstream is a registered trademark of Oridion