VENTILATOR SUPPORT | Mermaid Care

Advisory system for ICU Ventilation

BEACON provides ventilator-dependent open-loop advice for optimizing and weaning-off ICU ventilated adult patients.

BEACON uses inputs measured and data inputs from the ventilator and manual data entry by the clinician into a computer program that has been designed to assist clinical decisions for changes to the ventilator settings for the individual patient undergoing mechanical ventilation.

The objective of the BEACON Caresystem is to present advice for ventilator adjustment and the rationale behind the advice, in a clear and easy-to-use graphical format.

BEACON mounted on top of Ventilator

BEACON mounted on Trolley

BEACON mounted on rails in the ICU

Simple and Clear Advice Screen

BEACON continuously monitors the patient, and provides advice at any given time. The advice is given in a simple and clear format as shown below.

A) Each of the ventilator settings (FiO2, Vt, Rf etc) are shown according to Ventilator brand. B) The current Ventilator settings are shown. C) BEACONs ventilator advice is shown

The advice is applied by changing the ventilator settings on the ICU ventilator (note: BEACON is open-loop)

Explore the Reason behind the Advice

BEACONs Simulation screen explains the reason behind the advice provided by BEACON. The Simulation screen has several layers of information, relevant for your level of expertise and for the understanding of the advice

On the left side of the screen, the Current, Simulated and Advice settings of the Ventilator are shown, where

Current is the actual settings of the ventilator
Advice is the new advice calculated and provided by BEACON
Simulated is a simulation functionality, where the user can simulate other ventilator settings than advised by BEACON

On the right side of the screen, the Hexagon is shown. The Hexagon shows the balance of over- and under-ventilation of the current and advised ventilator settings for the patient:

Too much oxygen vs too little oxygen,
Too much pressure vs. too little pressure, and
Too much support vs too little support,

Historical review of All Advices

BEACONs Historical review screen shows all previous advices provided by BEACON. The Historical review screen has several layers of information, relevant for your level of expertise and for the understanding of the past advices

Spontaneous Breathing Test

BEACON has built-in an automatic Spontaneous Breathing Test (SBT). When certain conditions are met, the SBT will be initiated by BEACON automatically

ECMO Transfer

BEACON has built-in an automatic recommendation for ECMO transfer. When certain conditions are met, the ECMO recommendation will be initiated by BEACON automatically

Shunt, Low V/Q & High V/Q Estimation

BEACON can be used to estimate the Gas-Exchange characteristics for the patient. It is shown as the SHUNT value (%), the Low V/Q value (delta PO2) and the High V/Q value (delta PCO2). This can be very useful, if a PEEP ti-tration maneuver is carried out and you want to verify the effect of the different PEEP levels.

Indirect Calorimetry

BEACON can be used to guide Nutrition by using the Gas Exchange measurements VO2/VCO2 and the calculated REE

The user can explore the values behind each ventilation measures (label) of the Hexagon

Each Hexagon label window contains values related to:

The Pressure/Volume balance of over/under ventilation (Support and Control Mode)
The Oxygenation balance of over/under ventilation (Support and Control Mode)
The Support balance of over/under ventilation (Support Mode only)

If the user wants to understand the current state of all organs related to ventilation management, then this is shown Physiology information window. The information is divided into organs:

Lung:
- Gas Exchange
- Volume/Ventilation
- Mechanics
Brain
Blood
Metabolism
Circulation

The user can simulate other ventilator settings than advised by the system and see the impact on the ventilation measures

This can be useful, in order to understand the effects of other ventilators settings before applying them

This can also be useful for bedside training, where residents are being trained on patients rather than on simulation systems.

On the Historical Review screen all advices are shown by displaying the Hexagon for each advice (2 are shown in this example)

The Historical review screen is very useful during ICU rounds, in order to provide the ICU Doctor and/or Respiratory Therapist with a simple overview of how the patient has progressed over time

For each Hexagon, information about ventilator settings and changes can be shown

For each Hexagon, information about the patient's physiological status can be shown

The information is divided into organs (similar to the Physiological information window on the Simulation screen:

Lung:
- Gas Exchange
- Volume/Ventilation
- Mechanics
Brain
Blood
Metabolism
Circulation

The Gas Exchange information screen displays the estimated (measured) SHUNT, Low V/Q and High V/Q for the patient

The Graph display of BEACON, shows the VO2, VCO2, REE and RQ:

VO2 - is the measured Oxygen Consumption of the patient
VCO2 - is the produced Carbon Dioxide production of the patient
REE - is the calculated Resting Energy Expenditure of the patient, based on the VO2 and VCO2 measurements
RQ - is the calculated difference between VO2 and VCO2

For VO2 and VCO2, the average Variable in % is shown over a time window of 30 minutes

For REE, the current REE is shown and average REE is shown over a time window of 30 minutes

Based on the REE, BEACON provides advice for Nutrition

When certain conditions are met, the SBT indicator (lower left corner) will be shown. The indicator contains a counter, which shows how long time the SBT will run.

If the SBT passes, the SBT indicator will be shown in green ad n with a check mark.

The conditions for initiating and passing the SBT, can all be configured in BEACON.

When certain conditions are met, the ECMO recommendation (yellow warning) will be shown.

The user can enable the ECMO screen of BEACON, and verify which ECMO conditions are met, and acknowledge ECMO status for the patient.

The conditions for recommending ECMO, can all be configured in BEACON.