GiuliaGiuliaGentle Neonatal Ventilation

Quality for life

Giu

liaThe newest technologyin neonatal nasal ventilation

The goal of the latest research in the field of neonatal

intensive care is the use of nasal ventilation in order to

minimize or avoid the practice of endotracheal intubation.

The beneficial physiological effects of nCPAP - nasal

Continuous Positive Airway Pressure - on the respiratory

system are well known. By applying continuous pressure to

the lungs throughout the respiratory cycle, it prevents

alveolar collaption and allows mechanical recruitment of

alveoli, thus improving the transition from ventilatory

supported breathing to autonomous breathing.

On this basis it is considered the best way of providing

respiratory support to infants after extubation.

Nowadays even non-invasive modes of ventilation should

include the possibility of providing mechanical support in

response to the patient’s respiratory effort.

The challenge of Ginevri’s team was to support the latest

developments of clinical research with a completely

innovative device covering the requirements of the

scientific community.

Therefore Ginevri has focused on the research of

innovative ways of enhancing the nCPAP ventilatory

support by delivering ventilator breaths via the nasal

prongs, in nSIPPV and nSIMV modes.

In the Giulia all the newest technologies in the field of

neonatal nasal ventilation are at the disposal of the

new-born, who can now be treated with the most efficient

and up to date ventilation modes applied in a gentle way.

Giu

liaSynchronised with the future

Giulia’s advanced technology and its small but highly

sophisticated flow transducer allow it to provide babies with non

invasive Synchronized Intermittent Positive Pressure Ventilation

(nSIPPV) and Synchronized Intermittent Mandatory Ventilation

(nSIMV).

The delivery of a positive pressure synchronized with the infant’s

own breathing gives a reduction of the patient’s inspiratory

effort and work of breathing (WOB). It allows the enhancement

of the transmission of gases through the neonate’s airways, as a

result of the synchrony between the positive pressure applied and

the negative intrathoracic pressure.

Pre-term infants treated with conventional ventilation may fail

extubation and require endotracheal re-intubation thus increa-

sing risks and costs of treatment.

Clinicians agree that nSIPPV and nSIMV can be used for reducing

the rate of extubation failure more effectively than nCPAP

delivery .

Increasing of functional residual capacity, minute volume and

compliance, as well as stabilization of the chest wall and

protection of endogenous surfactant, are additional proven

results achieved on babies treated using the Giulia .

Giu

liaManagement of an openrespiratory system

It’s widely known that the main limit to the

improvement of non-invasive ventilation systems

has been the concern that, due to the gas leakages

related to nasal cannula ventilation, respiratory

patterns cannot be controlled by the opening and

closing of electro-valves only.

In Giulia nasal ventilator system this difficult

limitation has been successfully overcome.

A sophisticated mathematic algorithm, running on

the internal computer of the ventilator, is able to

detect gas leakages through mouth and nose so

that the management of the main respiratory

parameters, pressure and flow, is now possible even

in an open system.

Giulia encloses an expiration “flow interruption”

valve, electronically controlled, by means of which

it is able to regulate maximum and minimum

pressure values inside the patient circuit during

inspiration as well as expiration

phase.

The result of this is a level of safety

never previously achieved in

non-invasive ventilation.

Giu

liaHow technology makes life easier

The key to the success of patient-triggered ventilation is to

minimize the delay between patient’s inspiration and pressure

increase in the circuit, due to the activation of mechanical

ventilation support.

Moreover the trigger signal has to be a measured evidence of

spontaneous respiratory effort and any artefact should be

detected and rejected by the system.

In Giulia nasal ventilator the trigger signal for the

synchronized modes is given by a flow transducer, so the

system requires a minimum inspiratory effort to be activated,

following the rapid increase of flow at the very beginning of

the inspiration. The dead space of the transducer is remarkably

reduced as it is enclosed in the joint between the nasal

cannula and the Y-piece.

In this way it is possible to achieve a real synchronism between

the ventilator and the baby’s spontaneous breathing activity

during nasal ventilation.

The two synchronized modes - nSIPPV and nSIMV - are

especially intended to perform a smooth transition from

positive pressure support to completely autonomous

breathing. Particularly, the use of nSIMV, after nSIPPV, allows

complete baby weaning in non-invasive way, by giving the

baby the possibility of breathing autonomously after each

synchronized act.

Thanks to the Giulia nasal ventilator non-invasive modes of

ventilation have been proven to be successfully suitable also

for patients with very low body weight (VLBW). For these very

special patients Ginevri has developed a dedicated flow sensor

with enhanced sensitivity and minimum response time.

In addition it has to be remarked that any change of baby

requirements can be followed by the caregivers by simply

switching the MODE knob.

Giu

liaUser friendly with care

User friendliness has always been the main guideline of Ginevri

projects and devices. Giulia neonatal nasal ventilator has been

completely developed following this philosophy.

All the necessary parameters can be adjusted on its control panel

in an intuitive and error-free way by means of rotary knobs: FLOW,

PIP, PEEP/CPAP additionally displayed on a led bar, FiO2, Inspiration

and Expiration times, Trigger Level.

Gas management is easily driven by means of an electronic Air/O2

blender that allows the users to set the required flow with the

chosen oxygen concentration.

The high resolution 10,4’’ TFT colour screen optimizes viewing of

Paw and FLOW waveforms while displaying digital values of

breathing parameters: ventilation modes, PIP, PEEP, Inspiration and

expiration times, respiratory frequency, FiO2, trigger level.

A complete alarm range is active to ensure the maximum safety for

the baby.

The Giulia neonatal nasal ventilator is compatible with all common

gas humidification systems available on the market.

Using the original Ginevri servo controlled humidifier and heated

patient circuit, the Giulia ensures the minimum level of

condensation inside the patient circuit.

The special nasal cannula, made of soft silicon, is available in two

sizes - Small and Large - and it has been especially designed to fit

in the most natural way to baby nostrils .

A floppy disk drive at the back of the device allows easy data

saving. In case of power failure a rechargeable battery module

ensures continuous operation.

Giu

liaAccessories

The Ginevri SCH 1000 servo controlledhumidifier is an equipment studied to providethe gas humidification in the patientventilation circuit. It is designed to be used inneonatal and pediatric care field.The gas thermoregulation is managed by aservo controlled proportional heating systemthat allows a constant maintenance of thedesired humidity and temperature in thepatient circuit. Humidity can be adjusted byuser on 5 differents levels.

A complete trolley assembly facilitates the correct use of any ventilationsystem. Giulia original trolley is designed to allow the safest manoeuvrability inthe neonatal care department. With the available range of useful accessoriesGiulia becomes a complete workstation at the service of caregivers.

Quality for life

GINEVRI srlVia Cancelliera, 25/b

00040 Cecchina (Roma) - Italy

Tel.: +39 06 93 459 330Fax: +39 06 93 459 393e-mail: mail@ginevri.com

www.ginevri.com

Since1954 Ginevri is a leading designer, manufacturer andworld-wide distributor of electromedical equipment forneonatal and pediatric care. Ginevri’s policy has always been topromote the best quality, safety, user friendliness and easymaintenance of its products for the full satisfaction of itscustomers: public and private hospitals.

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