Evaluation: Hamilton-T1 Transport Ventilator for Intrahospital Use

October 17, 2019 | Evaluations & Guidance

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  • The Hamilton-T1 is a full-featured portable ventilator designed to provide automated ventilatory support to patients during interhospital or intrahospital transport and in emergency situations.
  • The Hamilton-T1 is very similar to the Hamilton-C1 critical care ventilator, the main difference being that the T1 has been shaped and ruggedized for transport use.
  • Another unit, identical in size and function to the Hamilton-T1, is the Hamilton-MR1, which has the further advantage that it is MR conditional (up to 50 mT) and has an integrated gauss meter.
  • The Hamilton-T1 can be used to ventilate pediatric and adult patients and, with the neonatal option, can be used for ventilating neonates.
  • Operating principles:
    • The ventilator has an internal turbine, which turns at approximately 30,000 rpm during normal ventilation. This internal gas source provides the required ventilation pressure. To obtain a given pressure in the breathing circuit, the pressure of the patient outlet is measured 1,000 times a second by the internal pressure sensor. The results of this constant measurement are used to regulate the outlet pressure of the blower.
    • The expiratory valve manages the outflow of the gas. It regulates the pressure placed on the membrane, which has a direct effect on the gas in the breathing circuit (back pressure).
  • Major features:
    • This device has numerous features that are comparable to those found in intensive care ventilators, including adaptively targeted mandatory pressure breaths (PC-CMVa and PC-IMVa,s), flow-volume loops, trends, integrated capnography, and leak compensation. (Classifications such as this use the ventilator mode taxonomy developed by Robert Chatburn; we use this taxonomy to help readers compare ventilator models from different manufacturers. For more information about this taxonomy, see Mechanical Ventilation: Manufacturer-Specific Terminology for Ventilation Modes and Features. )
    • The product supports noninvasive ventilation (NIV) and high-flow oxygen therapy (HiFlowO2).
    • This device can provide positive end-expiratory pressure (PEEP) as high as 35 cm H2O, which may be useful in ventilating some patients.
    • An advanced feature of the T1 is Adaptive Support Ventilation (ASV). In ASV, the clinician inputs the patient's ideal body weight and a target percentage of the minute volume (relative to that weight). The ventilator then sets and adjusts tidal volume and respiratory rate to meet that minute volume requirement while trying to minimize the work rate of breathing. Breaths are pressure controlled, with both optimal targeting and intelligent targeting (i.e., expert rules are used to ensure that the optimal ventilator pattern is also safe). The device will switch between mandatory and spontaneous breaths based on patient trigger efforts. There is some evidence that ASV may reduce the amount of time patients are intubated and may require fewer interventions by clinicians.

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