BEYOND BREATHING Today's anesthesia machines provide more than just vaporization and ventilation.

One of the surgical facilities my group practices at recently bought 15 new anesthesia machines, upgrading from what was some pretty archaic equipment dating back to the 1970s. It was high time for an upgrade, especially because the latest models are driven in large part by electronics. Here are 4 features of anesthesia machines in which electronics are making a big impact on anesthesia delivery.

1. Data integration. An anesthesia machine that electronically integrates with and captures case data (such as vital signs and drugs) can create a central hub for information and maintain an accurate and continuous clinical record, letting us focus on patient care instead of racing to write all the information down.

Compatibility with your EMR system and OR monitors gives a boost to the other members of the surgical team as well. Integrating our numbers with the numbers on the chart gives physicians, nurses and even billers and materials managers access to more information.

2. Variable ventilation. Today's patients are a diverse population, with a range of respiratory needs. Anesthesia machines programmed with variable ventilation modes, automatic settings and limits are better able to adapt to different clinical situations. Digitally controlled ventilation lets you adjust respiratory volume, pressure and speed to match the breathing rate of each patient, from the sensitive lungs of a pediatric patient to the elderly patient suffering from acute respiratory distress syndrome. The control of more variables means more control over the anesthetic agents we deliver to patients.

3. Flow control. Low-flow anesthesia is an increasingly popular solution to curb the expense of general anesthesia. Instead of burning off a lot of sevoflurane or desflurane through higher flows, delivering higher concentrations of these agents at lower flows can prove more cost-effective and prevent waste. The latest anesthesia machines have electronic flow meters that can calculate the most efficient amount of gas to use.

4. Ease of use. Touchscreen controls for gas delivery, automated calibration and leak testing, and electronic locks and bar-code scanning for drug security and inventory management put a lot of power right at your fingertips. When you're trialing anesthesia machines, make sure their interfaces are intuitive. When you're in a hurry situation, working from muscle memory, you'll want it to be easy to take immediate action. Ideally, technology is designed to make you more efficient, but if its little hang-ups place obstacles in the path of your practices, that can create a large amount of stress in a day.

Be sure to consult with the providers and groups that work at your facility. There's no better way to educate yourself on the features they most need. Given the level of monitoring capabilities demanded by different surgical specialties and your differing needs for medical record connectivity, one model might not suit every user, but the right one should serve all of your anesthesia staff's needs.

Dr??ger Medical
Fabius OS
draeger.com
(800) 437-2437
Pricing: less than $30,000
FYI: Dr??ger's Fabius OS features the same familiar user interface as the company's other anesthesia workstations, a universal design that enables clinician familiarity with the electronically controlled, electrically driven piston ventilator for treating a wide range of patients, from neonates to adults and from healthy to critically ill. The Fabius OS's standard ventilation modes let providers deliver care specifically suited for each patient and smoothly transition between care phases. A simple, durable design withstands the demanding workflow of the OR.

DRE Medical
Integra AV-S
dremed.com
(800) 462-8195
Pricing: starts at $15,000
FYI: DRE Medical's Integra AV-S comes standard with 3 gases, O2, N2O and air, and features a color touchscreen ventilator that covers all major modes of ventilation, including PSV, SIMV and SMMV. Its open architecture provides ample space for monitors and accessories on a modular, compact and mobile unit made of durable aluminum with fewer plastic components. Balanced ultra-low-flow anesthesia provides increased patient safety with a mechanical antihypoxic device. A pullout writing tablet is also available for additional working space.

GE Healthcare
Aespire with B40 Monitor
gehealthcare.com
(800) 345-2700
Pricing: not disclosed
FYI: GE Healthcare's Aespire View is a compact anesthesia solution with a 12-inch, color ventilation display and a full suite of ventilation modes. The company's Advanced Breathing System facilitates accurate low-flow anesthesia delivery and the optional Total Flow Sensing module electronically measures, displays and exports both individual gas flow and total gas flow data to help manage costs. Digital flow valve technology allows fast, precise responses, and the B40 monitor's semi-modular platform can be customized to the needs of a wide range of patients.

Maquet Medical Systems
Flow-i
maquet.com/us
(888) 627-8383
Pricing: starts at $72,000
FYI: Maquet's Flow-i anesthesia delivery system is designed to provide responsive support even in the face of rapidly changing patient or surgical conditions. A modular, ergonomic and easily maneuverable unit, it incorporates an intuitive interface for high performance ventilation and precise, accurate and cost-effective anesthetic delivery. Safeguards minimize the risk for hypoxic mixtures during low-flow anesthesia use. The vaporizers are small, lightweight and easy to use. Open architecture enables convenient hardware and software upgrades and additions.

Oceanic Medical Products
Magellan-2200
oceanicmedical.com
(913) 874-2000
Pricing: starts at $30,000
FYI: Oceanic's Magellan-2200 anesthesia machines are rugged enough to stand up to use by the U.S. Army, the company's primary customer, though civilians have found use for the devices in regional hospitals and mobile surgical facilities around the world. Made from aluminum, brass and plastic, the Magellan weighs 45 pounds (100 pounds in the protective transport case for the unit and its accessories). The pneumatically powered machines require no electricity, just compressed, medical-grade air or oxygen. They can be equipped for use with halothane, isoflurane or sevoflurane. A model without a ventilator sells for slightly less than the list price.

Penlon
Prima 460
penlon.com
(800) 328-6216
Pricing: not disclosed
FYI: Penlon's Prima 460 features an electronic flow display and conventional flow meter options, a fully integrated ventilator and absorber, healthcare information technology connectivity and low lifespan costs. In order to minimize pre-op set-up time, its systems are intuitively designed and easily trained. A function top shelf module and monitor mounts clear generous work space. If OR floor space is an issue, the Prima 450 offers the same features in an even more compact footprint.