Rating of the best anesthesia and respiratory devices for 2020

The coronavirus pandemic has made its own adjustments to everyday life, changing it radically: issues that previously received little attention have come to the fore.

One of these issues is the level of equipment of healthcare institutions. Despite the fact that the post-Soviet health care system has many positive aspects, compared to the European one, for a long time it experienced a shortage of modern equipment, new technologies in treatment and comfortable conditions for patients. The complex of these problems led to the fact that many institutions were not ready for a new threat called "coronavirus", since in a pandemic, an extremely important factor in the recovery of the population is the presence of a large number of beds and resuscitation equipment. The main component of the second criterion is the presence of anesthetic and respiratory devices that help a person with pneumonia to saturate the lungs with oxygen, and in the case of a coma, they completely take over the respiratory function.

In this article, we will consider the most popular models of ventilation devices, get acquainted with the criteria for their selection, form a rating of the best ones based on feedback from real users, and also find out what to look for in order not to make mistakes when choosing.

What is anesthesia and respiratory apparatus for?

An anesthetic and respiratory apparatus (NDA) in medicine is called a device that delivers a mixture of gaseous anesthetics into the lungs of a person, while it forms a single complex with a ventilator and a monitor that displays the patient's vital signs.

The principle of operation of the device is to supply, together with air, a gaseous anesthetic mixture to the lungs of a person, which has optimal temperature and humidity indicators. The mechanism is designed in such a way as to remove the air mixture from the lungs with minimal human effort.

Each device of this type consists of a gas supply system and a mixing and diverting tank. Most often, three types of gases are used in anesthesia machines - air, pure oxygen and nitrous oxide. In order to prevent personnel from accidentally confusing the supply hoses, an international labeling system has been created, according to which oxygen corresponds to green, air to blue, nitrous oxide to yellow. All connecting elements also have the corresponding colors and different connectors, which makes it impossible to mistakenly connect the wrong hose. When buying a Russian-made unit, it should be borne in mind that their hoses for oxygen and air are reversely marked (air - green, oxygen - blue).

What you need to consider when buying NDA

Most of the devices sold, both Russian and foreign, have the following characteristics:

• almost all of them are equipped with a fuse with a function to turn off the supply of nitrous oxide in case of detection that the mixture contains less than 30% oxygen during inhalation;
• Most modern devices have a button that instantly replaces the supplied mixture with pure oxygen - a function used in emergency situations.

Criteria for choosing anesthesia and respiratory apparatus:

• The ability to adjust the breathing volume. The parameter includes the minute volume of respiration and its frequency. The best devices allow you to adjust characteristics such as: the duration of the inspiratory phase, changing the ratio between the phases of inspiration and expiration, adjusting the expiratory curve, etc.
• Ability to work in spontaneous breathing mode. Such a function is necessary in cases where the patient has spontaneous breathing (for example, during elective operations). It is sometimes used for manual ventilation.
• Availability of an autonomous backup power source. The function is needed for emergency use during problems with the power supply.
• Positive airway or end-inspiratory pressure monitoring systems. This function allows you to maintain respiratory function during anesthesia, which is especially important for patients with pneumonia, including those caused by coronavirus.

The principle of operation of the device is simple: from the cylinders, the gas mixture is supplied through the hoses to the breathing circuit. It can be of two types: direct and reversible. In the second case, a mixture of gases returns from the respiratory tract and mixes with a fresh mixture, then re-entering the lungs. In such devices, an adsorber must be installed, which removes carbon dioxide from the air mixture.

Depending on what method the anesthetic composition is supplied through the device, the following types of respiratory circuits are distinguished:

• Open - in recent years, it is practically not used, since such mechanisms do not have the ability to adjust the level of anesthesia, as well as its depth. This type of NDA does not have an evaporator and mixing tank.
• Semi-open type. The principle of operation is designed in such a way that only fresh composition enters the patient's lungs, the exhaled air is returned directly to the atmosphere.
• Semi-closed type. In such a circuit, reverse is partially used. The volume of the mixture that is recirculated is inversely proportional to the volume of the supplied gas-air mixture. Excess gases are released into the atmosphere. With this technology, an adsorbent is necessarily used that absorbs carbon dioxide in order to avoid its toxic effects on the human body.
• Closed type. In such a circuit, complete tightness is created, an adsorbent is necessarily used, and the anesthetic composition does not come into contact with the surrounding atmosphere.

Recently, modular devices have been on sale. The popularity of models of this type is due to the ability to modify the anesthesia-respiratory apparatus for the specific needs of a medical institution, wide functionality and scope.

NDAs are produced in various versions: wall-mounted, floor-mounted, portable (portable). The former are used in ambulances, the latter are used in hospitals, and the third is used by emergency services in emergency situations.

Rating of high-quality anesthesia and respiratory devices

Most often, stationary models are used for large medical institutions, which have a number of advantages - a wide scope of use, design features allow you to configure the device depending on the needs of the clinic, can be used for inhalation anesthesia, artificial ventilation, general anesthesia.

Stationary models

Dräger Perseus A500

This German-made device is an anesthesia station and combines the latest developments in medical science and technology. The device is designed in such a way as to provide high-quality ventilation of the lungs in such a way that, with partial safety of the respiratory function, it will allow a person to breathe himself.

The proprietary ventilation technology is designed in such a way as to quickly respond to changes in the concentration of the gas-air mixture in the respiratory tract.

Another feature of the Dräger Perseus station is the presence of a comfortable and spacious workplace, which includes an area for processing medical records, a locker for storing consumables, and an ergonomic arrangement of medical equipment control levers (brake pedal, buttons and switches). The design of the device is organized in such a way that its washing and disinfection does not require the use of special tools and devices.

In order to make it easier for the user to interact with the unit, it is equipped with a number of additional functions. Among them, we can highlight the presence of self-diagnostics, the presence of a backup power source, which ensures the continuous operation of the device even in case of power outages. All shelves and consoles have universal fixings, with which they can be positioned in such a way as to provide easy access. The control system is equipped with a rotary knob, so it is easy to learn how to operate it.

The built-in safety system provides control of the concentration of the gas-air composition in the respiratory tract, constantly assessing its parameters. There is a predictive function that allows you to focus not only on the doctor's experience, but also on the data of the control system when setting the characteristics, which together ensures the effective operation of the device.

Built-in intelligence promptly warns of incorrect hose connections, as well as informs about the timing of their replacement. The main screen of the device contains the following information: patient category and basic data about him, date, time, station name, information about its operating status, messages to the user, information about disabled alarms, and monitoring of patient status parameters are also displayed here.

The unit has 2 additional screens that display various information, including gas composition and breathing volume, pressure in the mixture supply system. All monitors have good viewing angles. The device is equipped with a self-timer function. All wires and hoses are positioned to prevent tangling and to protect them from dust and other contamination. The central brake and easily rotating casters allow the unit to be moved anywhere and secured with just one push of the lever. The average price of the unit is 5,100,000 rubles.

• convenient access to all modules, it is possible to modify and customize the equipment for specific conditions;
• an ergonomic workspace with lighting, a large number of shelves and cabinets for storing consumables;
• a large number of adjustments and settings for equipment operation;
• many positive user reviews;
• German quality of materials and components.

• large dimensions;
• in Russia, a small number of specialists know how to set up and maintain the unit.

Dräger Fabius Plus

Another representative of one of the best German manufacturers, Dräger, is distinguished by high ventilation efficiency, simple operation, reliability and durability, and the possibility of configuration in various ways.

For its intended purpose, the anesthesia-respiratory apparatus is a device for artificial ventilation of the lungs, which does not require an external supply of liquefied gas. According to the manufacturer's data, the increased accuracy of the gas-air mixture supply makes it possible to use the device not only for adults, but also for children. Suitable for low flow anesthesia.

The mechanism can be additionally equipped with two evaporators. The modular design allows you to purchase and additionally install the required attachments, modifying the unit for the needs of a particular clinic.In addition to additional monitors, various sensors and controllers can be connected to the device, and the operating system allows the device to be integrated into the electronic system of the entire hospital without installing additional programs.

Upon request, the customer, upon purchase, can choose options (for an additional fee) that are not included in the basic package. These options include: a fresh gas flow cut-off, backup ventilation, quick start (does not require power supply when ventilation is started), backup power supply, etc.

The unit is designed in such a way that it can be placed not only on the floor, but also hung on the wall, or installed on a mobile cart.

The screen can be either black and white or color (optional). Data on the patient's condition can be displayed both on monitors and in a general information system for their systematization, control and analysis. The average price is 1,944,000 rubles.

• additional modules can be installed depending on the needs of the clinic;
• can be used for children and adults;
• universal mounts allow placing the device not only on the floor, but also on walls, mobile carts;
• the unit is inexpensive in its segment;
• a large set of programmable characteristics.

• a little-functional device as standard.

Philips / Dameca Siesta I TS

The American-made unit is well known among professional medical anesthesiologists. Its feature is the ability to use not only for adults, but also for children, including babies. NDA can be used as a ventilator, as well as for patients who have spontaneous breathing. The mechanism provides not only high-quality ventilation, but also displays the main indicators of a person's vital activity, allowing you to control his condition at the current moment.

In order to avoid the likelihood of harm to human health, there is a built-in function to maintain the level of pure oxygen in the gas-air mixture at least 25%. The mixture is removed from the respiratory tract using an active evacuation mechanism. A proprietary absorber is used to absorb carbon dioxide, which can be disposable or reusable. The element can be replaced while the unit is running without interrupting the ventilation process. The unit can be used with low gases.

Electronic display with a diagonal of 15 ", shows the following parameters: data of the rotameter (flow and percentage of oxygen), ventilation and respiration indicators, airway pressure graphs, alarms, etc. An optional gas monitor is installed, which makes it possible to monitor the percentage of oxygen and anesthetic substance, etc.

The tidal volume ranges from 20 ml to 1500 ml. Respiratory rate - 4 to 80 times per minute.

• suitable for children and adults;
• large informative display;
• a large number of additional settings and adjustments;
• high-quality materials and components.

• not budgetary cost;
• rarely found on sale, it is not always possible to order online in an online store.

Chirana venar omega

The device made in Slovakia has shown itself well in the field of anesthesiology. When making a choice of which device is better to buy from which company, many professionals stop at this brand, since it combines an acceptable price and a high-quality set of characteristics.

The device is a working anesthesia station. A monitoring unit is integrated into it, the main tasks of which are tracking the supply of gases to the respiratory tract (rotameter function), as well as controlling their functions. The unit is equipped with protection against electrical noise generated by medical devices.To make it convenient for the user to operate the station, a 15-inch monitor is built into it, which displays all the main parameters of the patient's health. The manufacturer offers to separately purchase a syringe dispenser station if necessary.

The tidal volume of the station ranges from 5 ml to 1,500 ml, and mounts for two vaporizers are provided. There are eight ventilation modes, among the main ones - CMV, PCV, PS, MAN, SPONT, etc.

NDA monitors the following parameters: mechanical indicators of lung ventilation, graphical display of the current state of the airways, control of the volume of the consumed air-gas mixture, quick adjustment of ventilation parameters.

Features of the device:

• the presence of a three-level alarm system, incl. indication by light and sound;
• in order to start the basic mode - ventilation by volume - it is enough to enter only the patient's weight;
• an intelligent control system excludes the possibility of supplying a hypoxic air mixture;
• if for some reason the oxygen supply is interrupted, the unit automatically begins to supply air from the environment to the lungs;
• there is a built-in uninterruptible power supply with a working life of at least 2 hours.

Silent operation and high accuracy of setting the delivery of the medicinal composition makes it easier for the patient to be on the device. This is also facilitated by the electronic withdrawal of the exhaled composition, the control of the oxygen percentage, etc.

• wide functionality;
• built-in uninterruptible power supply;
• a large number of settings.

• small capacity of the built-in battery;
• according to buyers, the device does not differ in durability and reliability.

General Electric Aespire 100/7100

The Russian-made product is not as widely represented on the market as its counterparts, since it is a novelty. Nevertheless, over the period of operation, the equipment of this manufacturer has shown itself well, which allows us to recommend it for purchase.

Despite the compact size of the device, it has a large work surface on which medical documents can be placed. Below the table there are two drawers in which you can store consumables and accessories. There is a built-in dual illumination, all controls are located so that the doctor can access them from a standing or sitting position.

The station comes with only one built-in monitor, but, if necessary, you can purchase and install an additional external screen that will display the main parameters of a person's condition.

Users note the ergonomic cable management, so that they do not interfere with patient access and cleaning the room. All connecting joints are made in such a way as to exclude accidental erroneous connection of cables to another socket. The station control system is designed in such a way as to automatically change the amount of gas in the mixture, depending on its supply.

The interface is completely understandable even for an inexperienced user, there is an alarm system, monitoring the oxygen content in the patient's airways. Due to the special design of the bellows, the process of their inflation is visible to the user, and makes it possible to visually control the operation of the mechanism. The tidal volume of the device is 45 to 1,500 milliliters, the respiratory rate is 4 to 65 breaths per minute.

• since this is a Russian-made unit, the buyer does not have any difficulties with where to buy it and watch it "live";
• the delivery set contains an instruction with a detailed description of the NDA functionality, features of its use, tips and tricks for care and maintenance;
• ergonomic workplace;
• high-quality plastic, resistant to chemicals;
• good functionality;
• budget price.

• not suitable for children.

Penlon Prima 450/460

A British-made unit is rarely seen on the free market, but it also deserves attention. Compared to its competitors, the 450 has a compact footprint that allows it to fit into small offices, treatment rooms and operating theaters. The 460th model has standard dimensions, it is possible to attach an additional third evaporator. Since both modifications have similar characteristics, we will consider them together.

Both modifications are made according to the latest standards in the field of world medicine, they can work with low and ultra-low gas flows. As in other high-quality devices of this type, there is a protection against the ingress of a hypoxic mixture into the patient's lungs. Both devices have six ventilation modes, there is a working area with built-in electrical outlets (equipped with lighting and a pull-out document table). The 460 model can accommodate up to three evaporators and up to 4 gas cylinders. Both models also have built-in large storage boxes for medical supplies.

The station has a built-in backup battery with a duration of 30 minutes. The touch screen displays all the information you need and allows you to adjust functions as well as adjust parameters in one move. There is a special support for spontaneous inhalation and exhalation, which contributes to the rapid release of a person to spontaneous breathing. Several individual user settings can be saved.

• a large set of built-in functions;
• ergonomic work area;
• model 450 has a compact size, which allows it to be placed in rooms with a small area, such as are found in many Russian hospitals;
• suitable for adults and children.

• users complain about how much the station costs compared to the competition.

Portable models

VEGA-2-mini

Portable NDA of the Russian plant FactorMedTechnika LLC is widely used in ambulances, easy to carry due to its compact size and low weight (only 2.5 kilograms). It can also be used to assist victims at the scene of an emergency, transport them to the hospital, or when moving between clinic departments.

There are three main functions - forced and auxiliary ventilation of the patient's lungs, spontaneous breathing. It is possible to adjust the ventilation mode by volume and pressure. Nitrous oxide can be supplied in all three modes.

The device can be used by adults and children aged 1 year and older. There is a foldable wall mount (most often used in ambulances).

Built-in memory allows you to save up to three custom ventilation modes, which are subsequently activated by pressing one button. The battery lasts for 2 hours of battery life. The interface in Russian is designed in such a way as to simplify the user interaction with the device - there are a large number of prompts, alarms, etc. If necessary, you can purchase a module that allows you to connect the NDA with the resuscitator.

• light weight;
• budget price;
• a clear interface allows even a non-specialist to figure out how to select the desired mode, and what it is for;
• in comparison with analogues made in China, it has a longer service life and better quality of components.

• small functionality.

AINpSP-01/15-Medprom

Another Russian-made unit, which is mainly intended for use in ambulances and in emergency situations. Can be used for adults and children aged 6 and over.

NDA carries out an automatic supply of an oxygen-air composition or a mixture of oxygen and nitrous oxide. Ventilation with pure oxygen is also possible. Compact dimensions and low weight (3 kg) allow the device to be used for rescue operations. When the nitrous oxide supply is turned off, the oxygen injection is automatically stopped.The device can operate from its own cylinders with gas-air mixtures and nitrous oxide, or through an external connection.

• compact size and light weight;
• automatic pressure maintenance.

• can only be used for children over 6 years old;
• small capacity of the built-in battery.

AN-R10

This model is the “simplest” of all those considered. It is intended for short-term pain relief and anesthesia, or as a manual ventilator. To supply oxygen or nitrous oxide, use their own cylinders with a capacity of 1 liter, or stationary pneumatic systems located in reanimobiles or hospitals.

Despite the presence of manual pressure regulation, there is an automatic control of its maintenance at a given level. Mechanical pressure gauges are used to control the pressure in the cylinders. When the nitrogen supply is cut off, the oxygen supply is automatically shut off. There are two main modes - inhalation and anesthesia. The feed rate of the mixture of nitrous oxide and oxygen varies from 5 to 22 liters per minute.

• light weight and small overall dimensions;
• there are two built-in gas cylinders;
• there is an automatic pressure maintenance function.

• Mechanical ventilation requires manual control;
• short battery life.

Conclusion

It is not superfluous to mention that the selection and purchase of anesthesia and respiratory devices should be handled by a person who has a good idea of ​​what it is, what are the features of its use in a given situation, and also what are the significant differences between the models of well-known world manufacturers.

Due to the fact that the market for such equipment is specific and the choice of devices is small, most often you have to choose from models of several well-known manufacturers. Unfortunately, such an approach can only be afforded by a private clinic, since the state one is forced to be guided by the laws on public procurement, holding competitions, the main criteria for choosing a winner in which is the lowest cost. In this case, most often a Russian or Chinese manufacturer with equipment of not the best quality wins.

Currently, in the context of a pandemic, there are certain difficulties with the supply of anesthetic equipment from abroad, which is why the choice is narrowed only to Russian devices, and not all the needs of clinics can be met. Probably, over time, supplies of NDA to Russia will be established, but, perhaps, by this time the urgent need for them may decrease.

We hope that our article will help you make the right choice!