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For further information about the HAMILTON-G5, Neonatal Ventilation please contact:

Support neonates non-invasively over nasal CPAP The breathing pattern of very premature infant are frequent- ly erratic and inadequate.The use of nasal CPAP with the HAMILTON-G5 effectively supports the breathing of preterm in- fants. It results in a decreased work of breathing, stabilized chest wall, improved asynchornous motion between chest and abdo- men and improves tidal volumen and minute ventilation. nCPAP- PS mode enables you to perform CPAP and NIPPV, known for its positive effects on recruitment and airway stabilization .

Volume Targeted Ventilation Inflammation caused by overdistension (volutrauma) is thought to be important in the pathogenesis of bronchopulmo- nary dysplasia (BPD). Preterm infants with variable lung compli- ance are particularly at risk. The HAMILTON-G5 with Volume tar- geted ventilation delivers consistent, appropriate tidal volumes as low as 2 ml with the goal of reducing lung damage. This lung pro- tective type of ventilation can provide an effective, safer means of ventilating the neonatal patient.

Proximal Flow Sensor and CO2 The HAMILTON-G5 with its proximal flow sensor provides respon- sive and accurate airway flow triggering and volume monitoring. Flow triggering at the proximal airway offers the sensitivity and HAMILTON MEDICAL AG response time that is required for tiny premature infants with Via Crusch 8 rapid respiratory rates. This enhances -patient synchrony CH-7402 Bonaduz and reduces work of breathing in neonates. Also, continuous Switzerland

noninvasive monitoring of end-tidal and volumetric CO2 reduces (+41) 81 660 60 10

the need for arterial sampling. The sidestream CO2 monito- (+41) 81 660 60 20 ring option is especially helpfull for neonates. www.hamilton-medical.com

Heliox Helium Oxygen gas mixtures facilitate ventilation with obstructive

diseases. through the HAMILTON-G5 can decrease work © HAMILTON MEDICAL 2008. AG All rights reserved. Printed in Switzerland. Special thanks to the Kantonsspital Chur, Switzerland. of breathing (WOB) in tiny premature infants with such as BPD and reactive airway disease. Reducing the neonate’s WOB can decrease calorie expenditure which is impor- 689286/01 Specifications are subject to change without notice. ASV and DuoPAP are trademarks of HAMILTON MEDICAL. tant in our tiny patients. Heliox has been demonstrated to Neonatal Ventilation reduce respiratory distress scores, reduce and 5 The HAMILTON-G5 facilitate CO2 removal. accurately achieves volumes as small as 2 ml in order to support the smallest patients. Safe and Intuitive Neonatal Ventilation

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Clinical benefi ts for infants Technical Specifi cations

The neonatal option expands your ventilator’s patient range down Controls Ventilation Cockpit to the tiniest infants and premature babies. The HAMILTON-G5 Ventilation modes nCPAP-PS, SPONT, APVcmv, APVsimv, Numeric monitoring 50 monitoring parameters can be displayed (see monitoring parameters) proximal flow sensing meets the needs of your smallest patients P-SIMV, DuoPAP, APRV, P-CMV Real-time waveforms Simultaneous display of up to 8 waveforms or up to 4 loops by providing precise volume and leak monitoring with accurate Special functions Manual breath, O2 enrichment standby, sigh, and loops based on: volume, flow, airway pressure, auxiliary pressure, CO2 or responsive triggering with IntelliTrig. The excellent nCPAP qualities apnea backup ventilation, fully reference loops compensated heliox application in all modes Trending Simultaneous display of up to 17 parameter trends, selected from all and sidestream capnography of this ventilator provides you with APVcmv and P-CMV rate 1 to 150 b/min 50 monitoring parameters for 1, 12, or 24 hours a very wide range of diagnostic and therapeutic options for APVsimv, P-SIMV, DuoPAP rate 1 to 80 b/min Others Graphic freeze and cursor function, inspiratory/expiratory hold user treating your most sensitive patients. The integrated Heliox option Target 2 to 200 ml configurable default graphics layout

allows Heliox-Therapie with accurate monitoring of tidal volumes. PEEP/CPAP (P low) 0 to 25 cmH2O (DuoPAP and APRV) Oxygen 21 to 100% Monitoring parameters Improve patient outcome Inspiratory time (Ti) 0.1 to 10s (10 to 80% of cycle time) Pressure Airway pressure (Paw)*, auxilary pressure (Paux)*, peak airway pressure Use of protective tidal volumes, 4 – 6 ml/kg in preterm infants, has T low (APRV) 0.1 to 30 s (cmH2O / mbar) (Ppeak), mean airway pressure (Pmean), minimum airway pressure been shown to reduce ventilator length of stay, incidence of BPD T high (DuoPAP and APRV) 0.1 to 30 s (Pminimum), plateau airway pressure (Pplateau) PEEP/CPAP Pressure trigger 0.1 to 10 cmH O below PEEP/CPAP Flow (l/min) Real time inspiratory flow*, inspiratory peak flow (Insp Flow), expiratory and pneumothorax.1,2 Stability of tidal volume is especially impor- 2 Flow trigger 0.1 to 5 l/min peak flow (Exp Flow) tant in avoiding hypocarbia and volutrauma asso ciated with rapid Time I:E Volume (ml) Real time tidal volume*, expiratory tidal volume / spont. VTE changes in compliance due to clearing of lung fluid and surfactant Automatic base flow 4 to 10 l/min, depending on flow trigger (VTE / VTEspont), expiratory minute volume / spont. minute vol. 3 administration. All monitored data and waveforms on the Pressure control 3 to 100 cmH2O, added to PEEP/CPAP (ExpMinVol / MVspont), leakage volume at the airway (Vleak) 3 HAMILTON-G5 are based on proximal airway measurements. Pressure support 0 to 100 cmH2O, added to PEEP/CPAP Time I:E ratio, total breathing frequency (fTotal), spontaneous breathing Work of breathing (WOB) and synchrony are enhanced with flow P high (DuoPAP and APRV) 0 to 50 cmH2O frequency (fSpont), inspiratory time (TI), expiratory time (TE), Pressure ramp 25 to 200 ms Lung mechanics Static compliance (Cstat), airway occlusion pressure (P0.1) intrinsic PEEP and pressure trigger sensitivity reduced to 0.1 lpm / 0.1 cm H2O Expiratory trigger sensitivity (ETS) 5 to 70 % of inspiratory peak flow (AutoPEEP), pressure time product (PTP), expiratory time constant (RCexp), respectively. Endtidal and volumetric CO2 measurements not only inspiratory time constant (RCinsp), expiratory flow resistance (Rexp), reduce blood gas frequency, but provide measurement of dead Alarms inspiratory flow resistance (Rinsp), rapid shallow breathing index (RSB), space and CO2 elimination. Precise spirometric displays of volu- Operator-adjustable Low/high minute volume, low/high pressure, Imposed work of breathing (WOB) 4 metric capnograms are provided. low/high tidal volume, low/high rate, apnea Oxygen Airway oxygen concentration (FiO2)

time, low/high PetCO2, %leak CO2 (option) Real time CO2 measurement (FCO2 / PCO2), end-tidal CO2 (PetCO2 / Reduce complexity in your hospital Special alarms Oxygen concentration, disconnection, loss FetCO2), V/Q status of the lung (slopeCO2), alveolar tidal ventilation The HAMILTON-G5 provides ergonomically advanced features of PEEP, obstruction, check (Vtalv), alveolar minute ventilation (V’alv), CO2 elimination (V’CO2) to help the clinician assess complex situations into easy to under- settings, Flow Sensor alarms,APV, CO2, airway (VDaw), Dead space fraction (VDaw/VTE), power supply, batteries, gas supplies exhaled volume of CO (VeCO ), inspired volume of CO (ViCO ) stand information. Our Graphic User Interface simplifies the 2 2 2 2 Loudness Adjustable (1 – 10) SpO2 (option) (SpO2 sensor) interaction between hospital caregivers and the ICU ventilator, * real time values displayed as waveforms thereby eliminating many of the chances of human error in the process of delivering respiratory care. This award winning user interface is scientifically proven to reduce workload and im prove safety.

80 1 Conventional Reducing the risk of BPD IntelliTrig McCallion N et. al, Volume-targeted versus pressure-limited ventilation in the neonate. CO2 sidestream capnography Heliox 70 nCPAP The use of synchronized nasal Changing breathing patterns or circuit Cochrane review, Issue 3, 2005 This option enabels monito- The HAMILTON-G5 takes the 2 Martin Keszler, Volume-targeted ventilation. NeoReviews Vol.7 No.5 May 2006 60 intermittent positive pressure leaks are a challenge in non-invasive venti- ring the sampling of the expira- risk out of heliox administra- 3 Cheifetz Ira M. et. al. Tidal Volumes For Ventilated Infants Should Be Determined with a Pneu- 50 Synchronized ventilation (IPPV) as imple- lation. motachometer Placed at the Endotracheal Tube. Am J Respir Crit Care Med Vol 162. 2000 tory gases of non-intubated tion by correcting automatically nasal IPPV 4 40 mented in the HAMILTON-G5 With the innovative IntelliTrig technology, Bhat Y R, Abhishek N. Mainstream end-tidal monitoring in ventilated neonates, receiving simultaneous the ventilator’s gas delivery and (nCPAP-PS) with nCPAP-PS mode reduces the HAMILTON-G5 auto matically responds neonates. Singapore Med J 2008; 49(3) oxygen administration using volume monitoring. The blue 30 5 the risk of BPD and BPD/death to varying leaks and adapts sensitivity Kneyber et. al, with heliox decreases resistance nCPAP. The sensor can easily be 360° visible alarm lamp indi- and facilitates CO removal in obstructive airway disease. Intensive Care Med (2006) 32 20 significantly in babies with thresholds for optimal response to the neo- 2 attached at the HAMILTON-G5 cates heliox application and gas 6 International Design Excellence Award. www.idsa.org 8 10 very low birth weight. nates breathing pattern. 7 Tassaux, D. et.al. Evaluation of the user-friendliness of new generation ICU . Intensive hand rail. supply management. 0 Care Med 2008; 34: S140 BDP rate BDP / death 8 Bhandari V., et al. Pediatrics, 2009;124:517-526.

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