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ICU ventilator performance for neonates in the OR


The extreme physiology of neonatal lungs makes neonates difficult to ventilate1 and increases the risk of hypoventilation, hypoxemia, bradycardia and even cardiac arrest. The MAQUET FLOW-i® anesthesia delivery system is an increasingly popular choice for clinicians facing the challenges of ventilating neonates in the OR. The reasons are many.

Precise ventilation despite high airway resistance and low pulmonary compliance

ICU ventilation tableBased on the core technology of the SERVO ventilator series, the FLOW-i anesthesia delivery system is designed to handle the neonatal ventilatory challenges. This is made possible because of the successful combination of the SERVO controlled gas modules with the unique MAQUET VOLUME REFLECTOR®.

The Volume Reflector technology and the gas modules accurately deliver tidal volumes down to 5 ml. The rigidity of the Volume Reflector and patient cassette prevents erratic changes in volumes and pressures. Ventilation will remain uninterrupted, even in low fresh gas settings and in the event of leaks. The small system volume allows for fast wash-in and wash-out, thus providing better control of the anesthesia.

Peace of mind with reduced risk of hypoxia

The unique O2GUARD™ automatically increases the fresh gas and oxygen if measured FiO2 is lower than 21% for more than 20 seconds.3 O2GUARD provides added peace of mind in reducing the risk for hypoxia and this feature is standard on all FLOW-i anesthesia machines. Furthermore, the Volume Reflector design minimizes the risk for hypoxic mixtures due to leakage during low flow anesthesia. It is the evolution of advanced anesthesia delivery.

A situation with potential for even greater threat is the low apneic oxygenation time of neonates, which can instantly turn a seemingly stable situation into a critical one. But thanks to the small system volume and the fast wash-in / wash-out of FLOW-i, the response is immediate. A ramp-up from 30% to high concentration of FiO2 in less than 30 seconds has been experienced by several users.

For more information please read the patient case linked below, or see Prof. Javier Garcia-Fernandez Symposia on “Best practice for mechanical ventilation during neonatal and pediatric anesthesia” (both are available from

Learn more about best practice in this symposia with Prof. Javier Garcia-Fernandez...

Read about a premature infant weighing only 393 grams when anesthetized and ventilated...

1. Garcia-Fernandez J, Castro L, Belda F. J. Ventilating the newborn and child. Current Anaesthesia and Critical CareVolume 21, Issues 5-6, Pages 262–268, October–December, 2010.
2. Patient Case Report, contributed by Dr. Waltraud Bruchelt and Dr. Günter Baumann, Department for Anaesthesiology and Intensive Care Medicine, University Hospital Graz, Austria.
3. Ghijselings I, Hendrickx J, De Wolf A M. Performance of the Inspired Hypoxic O2Guard. OLV Hospital, Aalst, Belgium; Northwestern University, Chicago IL.