Freshgas Decoupling

Freshgas Compensation
 Tidal Volume and freshgasflow
in anesthesia devices

A. Tidalvolume depends from freshgasflow

(in old conventional devices i.e.. Sulla 808V, Narkomed)
Patient volume results from freshgasflow and Ventilatorflow
during inspiration
B. Tidalvolume is independ from freshgasflow
(today state of the art)

Version 1: freshgas decoupling

no freshgasflow during inspiration
flows to the inspiration line.
Only the ventilatorflow goes to the patient

Version 2: freshgas compensation

freshgas flows during inspiration into the inspiration line.
The ventilatorflow will be reduced in such a way, that the set VT
will be given to the patient.

2 | 32 carina.raby@draeger.com |
 Tidal Volume and freshgasflow
in anesthesia devices

B. Tidal volume is independ from fresh gas flow

freshgas compensation

: The volume and flow sensors provide feedback which allows

the ventilator to adjust the delivered tidal volume so that it
matches the set tidal volume, in spite of changes in the total
fresh gas flow.

3 | 32 carina.raby@draeger.com |
 Principle: Circle system
without fresh gas

Circle system without fresh gas decoupling

vaporizer

gas supply 2 - Absorber

inspiratory valve
reservoir
patient

expiratory valve

ventilator

• no buffer volume
• fresh gas is flowing continuously into the circle system
• tidal volume depends on fresh gas flow

4 | 32 carina.raby@draeger.com |
 Conventional circle system
volume controlled ventilation principle

5 | 32 carina.raby@draeger.com |
 Principle: Circle system
with fresh gas decoupling

Circle system with fresh gas decoupling

vaporizer
switching valve
for fresh gas de-coupling
gas supply 2- Absorber
inspiratory valve
reservoir
patient

expiratory valve

ventilator

• switching valve controlled by the ventilator (closed during inspiration)

• buffer volume (reservoir) fills with fresh gas during inspiration
• the set tidal volume of ventilator = the applied tidal volume

6 | 32 carina.raby@draeger.com |
 Freshgas decoupling
volume controlled ventilation principle

7 | 32 carina.raby@draeger.com |
 Fresh gas decoupling

Mandatory Inspiration

RV1

RV1: Fresh gas

decoupling
Work range = minimized valve
VT x 1.4 insp. compliance

8 | 32 carina.raby@draeger.com |
 Ventilator
Gas Flow Diagram

Spontaneous breathing during

mandatory ventilation

Flow

Ventilator movement

9 | 32 carina.raby@draeger.com |
 Ventilator
Ventilator Movement

Expiration in mechanical
ventilation modes

Flow

Ventilator movement

10 | 32 carina.raby@draeger.com |
 Ventilator
Fresh gas decoupling

• Dependency of tidal volume on set fresh gas flow without decoupling or

compensation:the higher the fresh gas flow, the higher the tidal volume delivered
• Separation of tidal volume from the fresh gas flow by decoupling Dräger anesthetic
ventilators from the gas flow control unit during inspiratory phase
• Principle: fresh gas passes during inspiration to reservoir (manual ventilation bag) and
during expiration is fed together with the stored volume directly into system
(fresh gas decoupled via non-return valve RV1)

11 | 32 carina.raby@draeger.com |
 Fresh gas compensation
volume controlled ventilation principle

12 | 32 carina.raby@draeger.com |
 Patient volume
changing freshgasflow (principle)

Conventional circle system Freshgas decoupling Freshgas compensation

Patient volume Patient volume Patient volume

time time time

Freshgasflow freshgasflow freshgasflow

time time time

13 | 32 carina.raby@draeger.com |