Flow controller SWISS optio jetflow for high flow oxygen therapy

After increasing the flow rate of its long-proven flow controller SWISS optio jetflow from 32 l/min to 40 l/min, Gloor Medical takes flow rates to a completely new level. As a first of its kind, healthcare staff can now select flow rates of up to 80 l/min.

High flow nasal cannula (HFNC) oxygen therapy is an alternative to conventional oxygen therapy. It uses a system that mixes oxygen and air to administer an FiO2 (concentration of oxygen in the gas mixture) of 21%–100% at flow rates of up to 60 l/min. To avoid condensation, the mixture of oxygen and air passes through a humidifier to a heated inspiratory circuit. This mixture is then administered to the patient by way of a nasal cannula.

In adults, HFNC is used in many situations, including bronchoscopies, weaning from intubation, patients who do not tolerate invasive ventilation, acute respiratory failure in emergency settings or intensive care, etc. ^{(1, 2)} High flow oxygen therapy may result in positive effects such as improved oxygenation, reduced inspiratory effort & work of breathing, improved lung mechanics, increased carbon dioxide (CO2) clearance by washout of dead space, improved comfort and increased end-expiratory lung volumes (EELV).^{(3, 4)} The later probably due to the positive end-expiratory pressure (PEEP) effect. Especially the PEEP effect is flow-dependent and better with higher flow rates. ^{(5, 6, 7, 8)}

While the usual design of high flow medical devices is based on a flowmeter, Gloor Medical took its own approach. The advantage of the flow controller design versus the flowmeter is tangible & obvious. Obvious because setting the desired flow rate can easily be done via flow selector. No need to consider whether the floating ball should be above, below or in the centre of the marking. Also position, angle and height of medical staff can lead to different flow settings. The tangible advantage is the rugged and compact design of the flow controller which makes it much less prone to damages. Especially the measuring tube of common flowmeter design often leads to costly repairs or replacements due to bumping patient beds into walls / elevator doors or simply dropping the device.

The quality of the device is also reflected in the plastic free full-metal body that incorporates an increased antibacterial effect. The flow controller has a service life of 18 years with one mandatory overhaul only (after 9 years) and supporting our efforts for sustainable & environmental-friendly products.
 

1. Ward JJ. High-flow oxygen administration by nasal cannula for adult and perinatal patients. Respir Care. 2013;58:98–122.
2. Gotera C, Díaz Lobato S, Pinto T, Winck JC. Clinical evidence on high flow oxygen therapy and active humidification in adults. Rev Port Pneumol. 2013;19:217–27.
3. Mauri T, Turrini C, Eronia N, Grasselli G, Volta CA, et al. Physiologic Effects of High-Flow Nasal Cannula in Acute Hypoxemic Respiratory Failure. Am J Respir Crit Care Med. 2017 May 1;195(9):1207-1215 (abstract).
4. Goligher EC, Slutsky AS. Not Just Oxygen? Mechanisms of Benefit from High-Flow Nasal Cannula in Hypoxemic Respiratory Failure. Am J Respir Crit Care Med. 2017 May 1;195(9):1128-1131
5. Mauri T, Alban L, Turrini C, Cambiaghi B, Carlesso E, Taccone P, et al. Optimum support by high-flow nasal cannula in acute hypoxemic respiratory failure: effects of increasing flow rates. Intensive Care Med. 2017 Jul 31 [Epub ahead of print] (abstract).
6. Parke RL, Bloch A, McGuinness SP. Effect of Very-High-Flow Nasal Therapy on Airway Pressure and End-Expiratory Lung Impedance in Healthy Volunteers. Respir Care. 2015 Oct;60(10):1397-403.
7. Pisani L, Fasano L, Corcione N, Comellini V, Musti MA, Brandao M, et al. Change in pulmonary mechanics and the effect on breathing pattern of high flow oxygen therapy in stable hypercapnic COPD. Thorax. 2017 Apr;72(4):373-375 (abstract).
8. Luo JC, Lu MS, Zhao ZH, Jiang W, Xu B, Weng L, et al. Positive End-Expiratory Pressure Effect of 3 High-Flow Nasal Cannula Devices. Respir Care. 2017 Jul;62(7):888-895 (abstract)
 

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