Clinically Relevant Solutions
Optimizing Patient Care
Gentle Lung® Suite
Nihon Kohden’s ventilator systems offer convenient tools for clinicians to practice lung protective ventilation:
Patients receiving mechanical ventilation may suffer from ventilator-induced lung injury. This may be caused by inappropriate tidal volume¹, inappropriate driving pressure², and inappropriate PEEP³.
Guided Solutions
Lung protective ventilation is a well-established practice not only in ARDS patients but also in postoperative patients⁴. Gentle Lung Suite provides guided tools for individualized lung protective strategies
Provides clinicians insights into patients’ lungs to help determine if a recruitment maneuver could be beneficial.
Preparation for RA:
- Clinicians can set and visualize settings with a PEEP time-based graph of incremental and decremental PEEP-step sequences
During RA:
- The ventilator performs incremental increase and decrease of PEEP as set.
- A real-time graph of PEEP and estimated compliance are displayed during RA.
Post RA analysis:
- The ventilator compares tidal volume and lung compliance between incremental and decremental portions of RA at the same PEEP
- The application provides results of gain in compliance and recruitable volume for the clinician to make an informed decision if the patient will benefit from recruitment maneuver.
¹ The Acute Respiratory Distress Syndrome Network.Ventilation with Lower Tidal Volumes as Compared with Traditional Tidal Volumes for Acute Lung Injury and the Acute Respiratory Distress Syndrome. N Engl J Med. 2000 Feb;342(18):1301–8.
² Amato MBP, Meade MO, Slutsky AS, Brochard L, Costa ELV, Schoenfeld DA, et al. Driving Pressure and Survival in the Acute Respiratory Distress Syndrome. N Engl J Med. 2015;372(8):747–55.
³ Briel M, Meade M, Mercat A, Brower RG, Talmor D, Walter SD, et al. Higher vs lower positive end-expiratory pressure in patients with acute lung injury and acute respiratory distress syndrome: Systematic review and meta-analysis. JAMA. 2010;303(9):865–73.
⁴ Fumagalli J, Santiago RRS, Teggia Droghi M, Zhang C, Fintelmann FJ, Troschel FM, et al. Lung Recruitment in Obese Patients with Acute Respiratory Distress Syndrome. Anesthesiology. 2019;130(5):791–803.
⁵ Talmor D, Sarge T, Malhotra A, O’Donnell CR, Ritz R, Lisbon A, et al. Mechanical ventilation guided by esophageal pressure in acute lung injury. N Engl J Med. 2008 Nov 13;359(20):2095–104.
Customized, stepwise lung recruitment maneuvers enable clinicians to focus on the patient.
Preparation for RM:
- Clinicians evaluate RA results, to determine if RM may be beneficial.
- A visual guide of a PEEP time-based graph is available as clinicians set the parameters for the RM.
During RM:
- The ventilator performs stepwise RM as set while clinicians can focus on monitoring their patients.
Post RM:
- After patient’s lungs are recruited, clinicians may choose to continue to PEEP-Titration or resume normal ventilation.
¹ The Acute Respiratory Distress Syndrome Network.Ventilation with Lower Tidal Volumes as Compared with Traditional Tidal Volumes for Acute Lung Injury and the Acute Respiratory Distress
Syndrome. N Engl J Med. 2000 Feb;342(18):1301–8.
² Amato MBP, Meade MO, Slutsky AS, Brochard L, Costa ELV, Schoenfeld DA, et al. Driving Pressure and Survival in the Acute Respiratory Distress Syndrome. N Engl J Med. 2015;372(8):747–55.
³ Briel M, Meade M, Mercat A, Brower RG, Talmor D, Walter SD, et al. Higher vs lower positive end-expiratory pressure in patients with acute lung injury and acute respiratory distress syndrome:
Systematic review and meta-analysis. JAMA. 2010;303(9):865–73.
⁴ Fumagalli J, Santiago RRS, Teggia Droghi M, Zhang C, Fintelmann FJ, Troschel FM, et al. Lung Recruitment in Obese Patients with Acute Respiratory Distress Syndrome. Anesthesiology.
2019;130(5):791–803.
⁵ Talmor D, Sarge T, Malhotra A, O’Donnell CR, Ritz R, Lisbon A, et al. Mechanical ventilation guided by esophageal pressure in acute lung injury. N Engl J Med. 2008 Nov 13;359(20):2095–104.
Continuation of recruitment maneuver or independently initiated to help determine PEEP at best compliance.
Preparation for PEEP-T:
- A visual guide of the PEEP time-based graph is available as clinicians set the parameters for PEEP-T
- Clinicians set the decremental PEEP starting from the ending PEEP of RM or the patient’s current PEEP level.
During PEEP-T:
- The ventilator performs stepwise PEEP as set.
- Real-time graphs of PEEP and estimated compliance are displayed during PEEP-T
Post PEEP-T analysis:
- The application provides the results of PEEP at the highest compliance measured during PEEP-T.
- A cursor will appear on time graphs for clinicians to view values of measured results throughout PEEP-T
¹ The Acute Respiratory Distress Syndrome Network.Ventilation with Lower Tidal Volumes as Compared with Traditional Tidal Volumes for Acute Lung Injury and the Acute Respiratory Distress
Syndrome. N Engl J Med. 2000 Feb;342(18):1301–8.
² Amato MBP, Meade MO, Slutsky AS, Brochard L, Costa ELV, Schoenfeld DA, et al. Driving Pressure and Survival in the Acute Respiratory Distress Syndrome. N Engl J Med. 2015;372(8):747–55.
³ Briel M, Meade M, Mercat A, Brower RG, Talmor D, Walter SD, et al. Higher vs lower positive end-expiratory pressure in patients with acute lung injury and acute respiratory distress syndrome:
Systematic review and meta-analysis. JAMA. 2010;303(9):865–73.
⁴ Fumagalli J, Santiago RRS, Teggia Droghi M, Zhang C, Fintelmann FJ, Troschel FM, et al. Lung Recruitment in Obese Patients with Acute Respiratory Distress Syndrome. Anesthesiology.
2019;130(5):791–803.
⁵ Talmor D, Sarge T, Malhotra A, O’Donnell CR, Ritz R, Lisbon A, et al. Mechanical ventilation guided by esophageal pressure in acute lung injury. N Engl J Med. 2008 Nov 13;359(20):2095–104.
Monitors the transpulmonary pressure to help individualize a lung protective treatment strategy
Main Functions of Ptp App:
- Measures Driving Pressure and Peak value, Mean value, Plateau values, and End-Expiratory value of Ptp continuously using an esophageal balloon catheter.
- A real-time Ptp waveform is displayed for simple monitoring.
Studies suggested that end-expiratory Ptp is best between 0-10 cmH₂O to improve oxygen and respiratory compliance in patients with ARDS⁵. Ptp App provides realtime measurement of Ptp to help clinicians closely monitor Ptp while cautiously adjusting PEEP to achieve this goal.
¹ The Acute Respiratory Distress Syndrome Network.Ventilation with Lower Tidal Volumes as Compared with Traditional Tidal Volumes for Acute Lung Injury and the Acute Respiratory Distress
Syndrome. N Engl J Med. 2000 Feb;342(18):1301–8.
² Amato MBP, Meade MO, Slutsky AS, Brochard L, Costa ELV, Schoenfeld DA, et al. Driving Pressure and Survival in the Acute Respiratory Distress Syndrome. N Engl J Med. 2015;372(8):747–55.
³ Briel M, Meade M, Mercat A, Brower RG, Talmor D, Walter SD, et al. Higher vs lower positive end-expiratory pressure in patients with acute lung injury and acute respiratory distress syndrome:
Systematic review and meta-analysis. JAMA. 2010;303(9):865–73.
⁴ Fumagalli J, Santiago RRS, Teggia Droghi M, Zhang C, Fintelmann FJ, Troschel FM, et al. Lung Recruitment in Obese Patients with Acute Respiratory Distress Syndrome. Anesthesiology.
2019;130(5):791–803.
⁵ Talmor D, Sarge T, Malhotra A, O’Donnell CR, Ritz R, Lisbon A, et al. Mechanical ventilation guided by esophageal pressure in acute lung injury. N Engl J Med. 2008 Nov 13;359(20):2095–104.
© 2025 All Rights Reserved | OrangeMed
Website Designed & Managed by: Mediablend