The new Puritan Bennett™ 980 ventilator was designed with the challenges of safe and effective ventilation in mind. Automatically detecting and compensating for fluctuating leak sizes, Puritan Bennett™ Leak Sync software helps clinicians manage patients’ work of breathing.
Breathing circuit leaks can cause a ventilator to erroneously detect patient inspiratory efforts (called autotriggering) or delay exhalation in pressure support. Patient interfaces, such as masks and uncuffed endotracheal tubes, are particularly prone to significant leaks. Inaccurately declaring inspiration or exhalation can result in patient-ventilator asynchrony and increased work of breathing.
Leak Sync software accurately quantifies instantaneous leak rates in adults, pediatric and neonatal patients during invasive or noninvasive ventilation. It compensates for leaks up to 65 L/min in adults, 40 L/min in pediatric patients, 30 L/min in neonates (NIV) and 15 L/min in neonates (IMV).
The Puritan Bennett™ Leak Sync software is similar to the Leak Compensation software on the Puritan Bennett™ 840 ventilator, but has been expanded to be used with VC+ and VS. Leak compensation software has been proven to synchronize faster than other leading ventilators to increasing and decreasing leaks.([FOOTNOTE=Leak Sync software is an enhancement to the Leak Compensation software found in: Oto J, Chenelle CT, Marchese AD, Kacmarek RM. A comparison of leak compensation during pediatric non-invasive positive pressure ventilation; a lung model study.Respir Care. 2013;58(12):2027-2037.],[ANCHOR=],[LINK=])
Clinicians strive to support healthy gas exchange and maintain clinical stability in NICU babies, while also protecting them from lung injury.([FOOTNOTE=Mahmoud RA, Proquitté H, Fawzy N, Bührer C, Schmalisch G. Tracheal tube airleak in clinical practice and impact on tidal volume measurement in ventilated neonates. Pediatr Crit Care Med. 2011;12(2):197-202.],[ANCHOR=],[LINK=]),([FOOTNOTE=Habre W. Neonatal ventilation. Best Pract Res Clin Anaesthesiol. 2010;24(3):353-364.],[ANCHOR=],[LINK=]) Gas leaks around the endotracheal or tracheostomy tube can make this a challenge. Considerable leaks around the airway interface are common in newborns with the use of uncuffed endotracheal and tracheostomy tubes and airway masks.([FOOTNOTE=Finholt DA, Henry DB, Raphaely RC. Factors affecting leak around tracheal tubes in children. Can Anaesth Soc J. 1985;32(4):326-329.],[ANCHOR=],[LINK=])
When breathing circuit leaks are not managed effectively, they can lead to([FOOTNOTE=Main E, Castle R, Stocks J, James I, Hatch D. The influence of endotracheal tube leak on the assessment of respiratory function in ventilated children. Intensive Care Med. 2001;27(11):1788-1797.],[ANCHOR=],[LINK=]),([FOOTNOTE=Bougatef A. Neonatal mechanical ventilation. In: Gullo A. Anaesthesia Pain Intensive Care and Emergency Medicine. Milan, Italy: Springer. 2005:73-81.],[ANCHOR=],[LINK=])
Detecting and responding to leaks is an important initiative that can improve treatment and reduce the infant’s work of breathing.([FOOTNOTE=Oto J, Chenelle CT, Marchese AD, Kacmarek RM. A comparison of leak compensation during pediatric non-invasive positive pressure ventilation; a lung model study. Respir Care. 2013;58(12):2027-2037.],[ANCHOR=],[LINK=])
The Puritan Bennett™ 980 neonatal ventilator was designed to help protect your most vulnerable patients from leak-related complications. Puritan Bennett™ Leak Sync software is available to automatically detect and compensate for fluctuating leak sizes, resulting in more accurate delivered tidal volumes. The software adjusts the effective trigger sensitivity in the presence of leaks, helping to reduce the incidence of auto-triggering and manage the baby’s inspiratory work of breathing.
By effectively managing airleaks during both invasive and noninvasive ventilation, the Puritan Bennett™ 980 neonatal ventilator can help clinicians provide the right ventilation, supporting the effort to keep babies safe and comfortable.([FOOTNOTE=Grossbach I, Chlan L, Trach MF. Ventilatory support and management of patient- and ventilator-related responses. Crit Care Nurse. 2011; 31(3):30-44.],[ANCHOR=],[LINK=])
People display normal variability in their breathing patterns even at rest. In contrast, although a necessary medical intervention, mechanical ventilation uses some sort of fixed parameter in almost all currently available modes. If the mechanical breath is delivered in a fashion that the patient doesn’t want or expect (too short, not enough flow, too long, etc.), asynchrony between the ventilator and the patient, discomfort, anxiety, and fatigue can result.([FOOTNOTE=De Wit M. Monitoring of patient ventilator interaction at the bedside. Respiratory Care. 2011;56(1):61-68.],[ANCHOR=],[LINK=])
Different types of asynchrony occur at different rates and may elicit different patient effects.([FOOTNOTE=Epstein SK. How often does patient-ventilator asynchrony occur and what are the consequences? Respiratory care. 2011;56(1):25-38.],[ANCHOR=],[LINK=]) Studies evaluating the overall frequency of asynchronies found that 12-43% of patients exhibit asynchrony in greater than 10% of total breaths.([FOOTNOTE=Blanch L, Villagra A, Sales B, et al. Asynchronies during mechanical ventilation are associated with mortality. Intensive care medicine. 2015;41(4):633-641.],[ANCHOR=],[LINK=]),([FOOTNOTE=Vignaux L, Vargas F, Roeseler J, et al. Patient-ventilator asynchrony during non-invasive ventilation for acute respiratory failure: a multicenter study. Intensive care medicine. 2009;35(5):840-846.],[ANCHOR=],[LINK=]) In these patients, improving patient-ventilator synchrony may potentially result in less anxiety and need for sedation.1
In patients undergoing pressure-support ventilation (PSV), a high number of asynchronous breaths is associated with an almost fivefold increase in ICU mortality,([FOOTNOTE=Blanch L, Villagra A, Sales B, et al. Asynchronies during mechanical ventilation are associated with mortality. Intensive care medicine. 2015;41(4):633-641.],[ANCHOR=],[LINK=]) a greater than threefold increase in median duration of mechanical ventilation, and a greater than twofold increase in median hospital length of stay.([FOOTNOTE=de Wit M, Miller KB, Green DA, Ostman HE, Gennings C, Epstein SK. Ineffective triggering predicts increased duration of mechanical ventilation. Crit Care Med. 2009;37(10):2740-2745.],[ANCHOR=],[LINK=]) Prolonged mechanical ventilation (≥ 21 days) has been shown to be associated with a 23% increase in daily average cost per patient and a 3.3 times higher hospital cost, while also accounting for a disproportionate consumption of healthcare resources.([FOOTNOTE=Loss SH, De Oliveira RP, Maccari JG, Savi A, Boniatti MM, Hetzel MP, et al. The reality of patients requiring prolonged mechanical ventilation: a multicenter study. Rev Bras Ter Intensiv. 2015;27:26–35.],[ANCHOR=],[LINK=])