Evone: Controlled inspiration and expiration

Evone is the only commercially available ventilator applying FCV^® , directing both the inspiration and the expiration of an anesthetized patient requiring mechanical ventilation. Evone’s FCV^® ventilation mode is based on a controlled inspiration and expiration flow from a set PEEP to a set peak pressure and vice versa, relying on intratracheally measured pressures.

Evone’s FCV^® ventilation mode can be used with any adult endotracheal tube (~2 – 10 mm ID). This mode allows the use of Ventinova’s Tritube, an ultrathin endotracheal tube (outer diameter 4.4 mm) with an inflatable cuff to secure the airway.

Additionally, Evone has a (High Frequency) Jet Ventilation mode, which requires an open airway. Jet ventilation can be used as breathing support while emerging the patient from mechanical ventilation to spontaneous breathing. Therefore, Evone is able to fully ventilate in case of an obstructed (sealed) airway and an open airway.

 Potential Benefits

The following benefits as compared to volume controlled ventilation (VCV) and pressure controlled ventilation (PCV) may be expected while ventilating patients in FCV^® mode:
• Improved lung recruitment and less atelectasis ^1–4
• Better aeration of the lungs ^1–5
• Higher ventilation efficiency (oxygenation and CO2 removal) ^2–4,6
• Lower energy dissipation in the lungs ^3,7,8

Applications

Evone can be used in the operating room and intensive care unit (ICU) in sedated patients under direct supervision.

Evone, in combination with Tritube offers several new surgical options for treatment during ENT/laryngeal/tracheal surgery. Our ventilation techniques FCV^® and EVA^® enable full ventilation through small bore lumen, providing adequate ventilation even in cases involving critically obstructed airways. In comparison to jet ventilation, it strongly reduces the risk on barotrauma and aerosole generation. The use of FCV^® during laryngeal /airway surgery is described on our Evidence page ’small lumen’.

FCV^® may be beneficial in patients prone to develop atelectasis or to desaturate during surgery. Successful use of FCV during single lung ventilation and in obese patients are described on our Evidence pages ‘Higher efficiency’.

Potential benefits of the use of FCV® in ICU are being investigated. Clinical use, in-vivo studies and theory are described on our Evidence page ‘lower energy’.

References

1 Schmidt, J. et al. Glottic visibility for laryngeal surgery: Tritube vs. microlaryngeal tube: A randomised controlled trial. Eur J Anaesthesiol 36, 963–971 (2019).
2 Schmidt, J. et al. Improved lung recruitment and oxygenation during mandatory ventilationwith a new expiratory ventilation assistance device: A controlled interventional trial in healthy pigs. Eur J Anaesthesiol 35, 736–744 (2018).
3 Spraider, P. et al. Individualized flow-controlled ventilation compared to best clinical practice pressure-controlled ventilation: a prospective randomized porcine study. Crit Care 24, 662 (2020).
4 Schmidt, J. et al. Flow-Controlled Ventilation Attenuates Lung Injury in a Porcine Model of Acute Respiratory Distress Syndrome: A Preclinical Randomized Controlled Study. Crit Care Med 48, e241–e248 (2020).
5 Weber, J. et al. Flow-controlled ventilation (FCV) improves regional ventilation in obese patients – a randomized controlled crossover trial. BMC Anesthesiology 20, 24 (2020).
6 Weber, J. et al. Flow-controlled ventilation improves gas exchange in lung-healthy patients— a randomized interventional cross-over study. Acta Anaesthesiologica Scandinavica 64, 481–488 (2020).
7 Barnes, T. & Enk, D. Ventilation for low dissipated energy achieved using flow control during both inspiration and expiration. Trends in Anaesthesia and Critical Care 24, 5–12 (2019).
8 Barnes, T. et al. Minimisation of dissipated energy in the airways during mechanical ventilation by using constant inspiratory and expiratory flows – Flow-controlled ventilation (FCV). Med. Hypotheses 121, 167–176 (2018).

Order information

Order number Evone: 6000 / Order number Trolley: 18030.