Simulating Dolphin Pulmonary Capacity

At Michigan Instruments, our Test Lung Simulators are used for a number of different applications. From classroom instruction to product evaluation, pulmonary research or clinical intervention, our customers value the versatility, accuracy, and realism of our test lung simulations. But what if the simulation and testing isn’t for a human?

The Challenge:

A veterinary facility located in Ponte Verde, Florida recently reached out to the experts at Michigan Instruments with a unique request.

They were developing a ventilator designed for use on dolphins when putting them under anesthesia and needed a way to test this piece of equipment. The Test Lung Simulator had to be able to measure at a much larger pulmonary capacity than is necessary for humans – 12 liters to be exact – and there was nothing available on the market.

In short, they needed to simulate dolphins under anesthesia, and needed a device that could simulate and measure large tidal volumes to successfully test their equipment before using it on live animals. They looked to Michigan Instruments for help.

The Solution:

The team at Michigan Instruments began developing and testing a unique solution for the veterinary clinic, helping them ensure their ventilators were safe and effective for medical use.

By taking three of our dual adult test lungs and manufacturing a special airway assembly that connected all three together, we were able to provide the lung capacity that was required to simulate the dolphin pulmonary system.

We forged and built the custom airway in-house, developed in-depth operational documents and sent the test lungs directly to the veterinary clinic with everything they needed to accurately test their equipment.

The Results:

The veterinary clinic was able to successfully test their ventilators in preparation for use on large mammals such as dolphins. They were also able to train other specialists on their ventilator’s operation in advance of any anesthetic surgery.

From Michigan Instruments’ perspective, it was a lot fun to develop this custom product for such a unique application!

“It was a fun adventure,” says Eric Hadesh, Document Control Manager at Michigan Instruments, “it was definitely something we don’t do day-to-day and it was interesting to determine how best to complete and assemble the system, then come up with the pictures and documentation. It was a great learning experience for us, but also an exceptional application of our lung simulation products and capabilities.”

This is just one example of many that shows how Michigan Instruments continues to forge ahead as an innovative pioneer in the respiratory care industry. Setting the standard in quality, versatility and durability, we never shy away from a challenge and are always operating from a ‘what’s next’ mentality.

Learn more about our test lung simulators or contact us today with any questions. We love a good challenge and can’t wait to hear about how you would like to use any of our state-of-the-art products to better train your people, test your products, or perform groundbreaking medical research.

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Training & Test Lung Uses for Respiratory Care Product Manufacturers

Put Your Trust in Michigan Instruments’ Training Test Lungs

 

For decades, Michigan Instruments Training & Test Lungs and PneuView® Software Systems have provided realistic respiratory simulations, providing many test lung uses for equipment manufacturers.

Training & Test Lung Uses/Manufacturing Applications

  • Design, test & improve Respiratory Care products
  • Confirm the performance of products prior to delivery to customers
  • Troubleshoot performance problems, applying realistic “loads” on the products
  • Train your Engineering, Tech Support, Marketing, and Sales personnel on use of your products
  • Demonstrate products to customers and prospects.

Our Training & Test Lungs provide adjustable compliance and resistance, simulating both healthy and diseased lung conditions. They also provide realistic residual lung volumes and allow ventilation volumes of up to 4.0 liters (Dual Adult TTL). If you’re testing respiratory care masks or other patient accessories, you may be interested in our recently introduced Head Simulation Modules as well.

Our mechanical lung provides real-time feedback with on-board volume scales and pressure gauges. Multiple ports on the test lungs provide access for additional monitoring, sampling, or introduction of gas or agents during testing. Adding the PneuView electronics and software allows you to view, record, and replay the dynamic data from the test lung.

Learn more about these lung simulation products here, or contact us today to learn more.

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Bench Study: Ventilator Use in Patient Transport

The study referenced here and available for download (PDF) here used the Michigan Instruments Dual Adult TTL to test several emergency and transport ventilators over their range of operation.

The TTL was able to simulate various respiratory conditions with decreased or increased compliance and resistance. The TTL was also used to simulate spontaneous breathing patients, using one lung as the “driver” and one as the spontaneous breather. This allowed the investigators to evaluate the responsiveness of the ventilators to patient effort. In Summary: applying realistic loads and forces on these ventilators revealed important differences, including significant weaknesses in the performance of some models.

Originally published in RESPIRATORY CARE • NOVEMBER 2013 VOL 58 NO 11

Evaluation of Ventilators Used During Transport of Critically Ill Patients: A Bench Study

by Salah Boussen PhD MD, Marc Gainnier PhD MD, and Pierre Michelet PhD MD

OBJECTIVE: To evaluate the most recent transport ventilators’ operational performance regarding volume delivery in controlled mode, trigger function, and the quality of pressurization in pressure support mode.

METHODS: Eight recent transport ventilators were included in a bench study in order to evaluate their accuracy to deliver a set tidal volume under normal resistance and compliance conditions, ARDS conditions, and obstructive conditions. The performance of the triggering system was assessed by the measure of the decrease in pressure and the time delay required to open the inspiratory valve. The quality of pressurization was obtained by computing the integral of the pressure-time curve for the first 300 ms and 500 ms after the onset of inspiration.

RESULTS: For the targeted tidal volumes of 300, 500, and 800 mL the errors ranged from –3% to 48%, –7% to 18%, and –5% to 25% in the normal conditions, – 4% to 27%, –2% to 35%, and –3% to 35% in the ARDS conditions, and 4% to 53%, 6% to 30%, and 30% to 28% in the obstructive conditions. In pressure support mode the pressure drop range was 0.4 –1.7 cm H2O, the trigger delay range was 68 –198 ms, and the pressurization performance (percent of ideal pressurization, as measured by pressure-time product at 300 ms and 500 ms) ranges were –9% to 44% at 300 ms and 6%– 66% at 500 ms (P < .01).

CONCLUSIONS: There were important differences in the performance of the tested ventilators. The most recent turbine ventilators outperformed the pneumatic ventilators. The best performers among the turbine ventilators proved comparable to modern ICU ventilators. Key words: mechanical ventilation; transport ventilator; bench study; ICU patient transport; pressure support ventilation; inspiratory trigger; ventilator performances.

[Respir Care 2013;58(11): 1911–1922. © 2013 Daedalus Enterprises]

Download the full study here: rc.rcjournal.com/content/respcare/58/11/1911.full.pdf

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Head Simulation Module (HSM) Applications

For years, Michigan Instruments Training & Test Lung Simulators have been used by ventilator manufacturers and respiratory therapists to validate, calibrate and train staff on ventilator equipment. We have recently introduced our Head Simulation Modules to offer additional training and testing options for respiratory care products.

 

The Test Lung Simulators are fully adjustable and mimic the human pulmonary system, providing real time feedback. They effectively simulate patient activity and response to the treatment being used, making them ideal simulators to use for product testing, validation and professional training.

The Head Simulation Modules provide a wider range of applications where visible and immediate response to the patient impact can be seen.

Utilizing lung simulators with the head simulation modules (HSM), hospital staff can be trained on more equipment and patient care scenarios than ever before. Ensuring staff is trained and capable of the patient procedures is critical, even for scenarios that may not occur often. Users can monitor and see lung volume, lung pressure, airway pressure on the test lung itself. Our PneuView® software also provides additional data, which can be recorded*, saved, and reviewed for additional training

Head Simulation Module Testing & Training Applications

  • CPAP and BiPAP Systems
  • Effective use of Manual Resuscitators
  • Non-Invasive ventilators and Ventilation Modes
  • Oxygen Delivery Systems

Allows assessment and training for:

  • Actual volume delivery during manual resuscitation
  • Effects of varying lung compliance and airway resistance on BVM performance
  • Incidence of Gas-trapping or AutoPEEP seen during manual resuscitation
  • Actual FiO2 delivery to the lungs during manual resuscitation (requires PneuView with oxygen sensor or independent oxygen analyzer)

Learn more about our Head Simulation Modules here. If you would like additional technical information or pricing, please contact us today.

*Available in PneuView3.1 Software only

This information is intended to provide some guidance and suggestions for use of the Test Lung Simulators. It does not encompass the full range of applications for which the TTL and PneuView Systems are appropriate. We welcome your suggestions for future Application & Use Case scenarios, and encourage you to share your own experiences and applications with us via email at mii@michiganinstruments.com.

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Setting Up Worsening Pneumonia in the Right Lung

Pulmonary Test Lung Simulation

Michigan Instruments Test Lungs can be of great assistance in the classroom. The adjustable lung compliance and airway resistance allows the instructor or student to demonstrate or investigate a wide variety of ventilation phenomena.

The relationships between pressure, volume, and flow are more easily understood when displayed using the TTL and PneuView 3 Software. There are few things more valuable in an academic environment than both hands on and visual experience.

The TTL offers a look into the inner workings of the human pulmonary system that students would not otherwise have, and does it in a safe, non-clinical situation.

Test Lung Simulation, Classroom Setting:

Worsening Pneumonia in the Right Lung

Procedure:

  1. Set up the Dual Adult TTL or PneuView for ventilation of both lungs.
  2. Set each lung compliance to 0.05 L/cm H2O.
  3. Set upper airway resistance to Rp5.
  4. Set lower airway resistance to Rp20
  5. Using a ventilator or resuscitation bag, ventilate the TTL at a rate of 12 bpm and tidal volume of approximately 0.800 L.
  6. Note the tidal volume delivered to each lung.
  7. Change the compliance of the right lung to 0.03, then 0.02, and finally 0.01, and note the differing lung volumes with each change.

Learn more about the capabilities of our newest Lung Simulators today!

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PneuView3 Improvements, Compared to PneuView2

PneuView3 Improvements from Michigan Instruments are worth mentioning!

Did you know that Michigan Instruments’ NEW Training and Test Lung embodies a mechanical respiratory simulation of the human pulmonary system that can measure airway pressure, lung pressure, tidal volume, and many other parameters?

Originally developed 40 years ago, the “Michigan Instruments TTL” was developed to simulate the human pulmonary system. The PneuView3 software was completely redeveloped with insight from our customers, biomechanical engineers, respiratory therapists and educators at area universities. With the New PneuView3 Software, the redesigned training and test lung, which is fully to scale, gives users the ability to simulate hundreds of patient scenarios.

The system includes a mechanical test lung (or lungs) simulator that’s precisely engineered with a set of electronic sensors, a signal conditioning package, and an integrated micro control unit.

The PneuView3 software application calculates respiratory parameters and waveforms, displaying them in real time. It also allows you to export data for later review.

A range of models are available, including:

  • Dual adult
  • Single adult
  • Adult-Infant

All are available as instrumented or non-instrumented models.

An Improved User Experience

Take a look at the different interfaces of the old and new software. You’ll find a much easier way to set up a project, patient parameters, and see the output in real time. This allows your Training & Test Lung to be used for staff training, ventilator calibrations, and more.

PneuView2

What makes the new “Michigan Lung” and the PneuView3 Software Different?

Most training and test lungs perform just a handful of simulations and are not fully to scale, which means that their parameters are adjusted according to a scale model. This gives the Michigan Lung the advantage of moving and “feeling” like a real lung when it’s ventilated.

The re-designed Michigan Lung and PneuView3 Software provide a comprehensive lung simulation that can be used in the improvement of respiratory products, calibration of ventilators and in research to enhance patient care and treatment.

PneuView3

While the previous version was great for those with extensive training, the PneuView3 Software is streamlined and intuitive, allowing for easier setup, learning, and operation.

  • The new Michigan Lung and PneuView3 Software provide comprehensive data by displaying dozens of parameters like pressures, flows, and volumes.
  • High-Frequency Ventilation is available for human lung simulations of all types.
  • The new lungs feature an increased resolution of output data.
  • Built-in temperature and FIO2 (Fraction of Inspired Oxygen) calculations are included.
  • The software is compatible with all modern Windows®-based operating systems.

Learn more about the Michigan Lung Test & Training Lungs.

Do you have questions about the new “Michigan Lung”, the PneuView3 Software or would like a quote? Contact us at sales@michinst.com or 616.554.9696.

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Michigan Instruments Donates Two TTL Units to Local University

Grand Rapids, MI – Grand Valley State University students will soon have the opportunity to simulate the proper management of life-like respiratory ailments using the latest in training and test lung devices. Grand Rapids-based, Michigan Instruments Inc. developers of the world-renowned “Michigan Lung” plans to donate two TTL respiratory simulation units to the program, with a value of approximately $25,000. Grand Valley and Muskegon Community Colleges are collaborating to offer Muskegon’s Respiratory Therapy education for GVSU students. Nursing and Physician Assistant students at GVSU will also benefit from the simulation units.

These sophisticated devices provide students with real-time data, measurements, and response that simulate those of a real respiratory patient. With this information, students learn how to properly ventilate and manage a variety of respiratory conditions.

“It is our privilege to provide the latest advancements in training and test lung products to a local program like Grand Valley State University’s,” stated Joe Baldwin, President of Michigan Instruments, Inc. “Our ‘Test Lungs’ are known and recognized worldwide and we are fortunate to work with a program like GVSU’s to ensure students in our community are able to receive the absolute best training possible right here in West Michigan.”

Michigan Instruments Inc, partnered with local software design and development firm, Atomic Object, to architect and develop cutting-edge software called “PneuView 3” — their latest training and test lung software application which calculates and displays, in real time, numerous respiratory parameters and waveforms. Software improvements combined with intricate design modifications to the Michigan Lung, provide users with even greater simulation capabilities.

The Michigan Lung is regarded as the most versatile, reliable training and test lungs on the market, and its latest multifaceted, fully to-scale mechanical design and software upgrades allow for simulation of hundreds of patient scenarios.

About Michigan Instruments

MII has designed and manufactured specialized medical equipment related to the fields of cardiovascular medicine, mechanical CPR, and respiratory therapy for over forty years. The company has built a reputation for medical device products of exceptional quality, which has earned the respect of thousands of customers, associates, and medical professionals throughout the world.

MII complies with Food and Drug Administration (FDA) and International Organization of Standardization (ISO) regulations for Good Manufacturing Practices. Both the FDA and ISO systems require continuous control over all activities that assure the quality of Michigan Instruments products and services. MII has built a strong foundation for growth based on the dedication of its’ staff, a close relationship For more information, contact us today.

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Increase in Training Test Lung Calibration Charge

Michigan Instruments would like to announce a change in cost associated with the calibration of many Training and Test Lung respiratory simulation models.

On November 1, 2014, the cost for models 1600, 1601, 1603 and 4600 (recommended every 3 years) and models DAN, AIN and SLN (recommended every 2 years) will be $560. For models 3600i, 5600i, 5601i, DA3, AI3, and SL3 (recommended every 2 years) will be $700.

There will no longer be a separate for charge for “as found” or “as received” data. This data will be taken (if the unit is received in a condition to permit it) and provided with final data and certifications.

Factory calibration encompasses all aspects of sensor, electronic, mechanical and software tuning to ensure maximum accuracy of all measurements and simulated parameters provided by TTL/PneuView systems. This procedure includes the setting of the compliance and resistance characteristics of the lungs and setting offset and gain characteristics for each of the pressure transducer channels.

Is it possible to do this independently?

Pressure and volume calculation accuracy may be easily verified with the aid of a calibrated syringe and independent pressure measurement device. All versions of the PneuView system ship with pre-formatted templates to aid the user with the verification of calibration accuracy. These templates include step-by-step instructions, which should be followed periodically to ensure maintenance of calibration accuracy or anytime accuracy comes into question, such as if the unit suffers some type of physical damage.

To schedule an appointment with Michigan Instruments click here.

To contact our Service Department:

Phone: 800-530-9939
Extension: 343
E-Mail: service@michinst.com

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Understanding the Role of Inertia in Mechanical Test Lungs

It’s no secret—mechanical systems move differently than biological systems particularly when it comes to inertia. This concept has a number of significant implications when working with a mechanical test lung.

During ventilation, the inertia of the lung chamber must first be overcome before it can start to expand. Prior to this point, any gas delivered to the lung has been delivered into a chamber with static compliance. Only when the lung chamber begins to move do we see the dynamic compliance changes that would be expected of a normal patient. This results in a sharp peak in pressure data taken at the beginning of inspiration as the lung chamber overcomes inertia and at the end of expiration as the chamber returns to rest. Static compliance compensation is rarely included in ventilators and other medical instruments since it does not represent a normal patient scenario.

Physical Symptoms of Inertia

The most common physical symptom of this problem occurs during the expiratory phase. When a test lung with considerable inertia returns to rest at the end of a breath it can cause a pressure “bounce” in the airway that is sometimes strong enough to trigger an assisted breath from an IMV/SIMV compatible machine. While the false peaks in the pressure wave are rarely large enough to trigger limit warnings in a ventilator, this second breath caused by the bounce can skew tests measuring rate parameters such as breath rate and minute volume.

How to Resolve Measuring Rate Parameters

While frustrating, this problem is not unsolvable. Some mechanical test lungs are equipped with counterbalances to help minimize the inertia of the lung chamber while advanced breath parsing in instrumentation allows knowledgeable users to eliminate most of the false peaks that come up in testing. Tests themselves are often adjusted to get rid of these inaccuracies.

Almost all modern ventilation tests call for a PEEP of at least 5 cmH2O which (while being representative of actual ventilation practices) helps to reduce the inertia of mechanical and biological lungs alike. Decreasing I:E ratio can also help as it allows for a more gradual progression between the breath phases.

If you have any questions regarding the role inertia plays in mechanical test lungs, feel free to contact Michigan Instruments anytime, we are here to help!

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Simulating a Pneumothorax on a Dual Adult Lung

A number of our customers have been requesting information on how to simulate a pneumothorax using the Michigan Instruments Dual Adult Lung. The following will describe how this condition can be simulated on a Training & Test Lung, using setup options offered by this device. The principles described can be applied to many laboratory situations that do not require the use of this lung.

A pneumothorax is usually characterized in humans by a collection of gas or fluid between a lung and the wall of the chest cavity. The added pressure (usually on only one lung) created by this condition often results in a patient having one uncompliant lung and one healthy lung—a situation in which standard ventilation can be difficult or even dangerous to perform.

The Simulation

This scenario can be simulated on a model 1600 or 5600i TTL by reducing the compliance of one lung (usually to 0.02 or 0.03 liters/cmH2O) while leaving the second lung in a healthy state (0.05 liters/cmH­2O).

Airway resistances should be left within the normal healthy range (Rp20 for upper airway, Rp5 for lower airway) unless a compound pneumothorax is being simulated. When a TTL set up in this manner is ventilated the operator will note that, while pressures are relatively even throughout the system, volume and flow are heavily skewed toward one lung (as it would be in an actual patient scenario).

The pneumothorax can be accentuated (for observational purposes only) by further reducing the compliance of the affected lung (to 0.01 liters/cmH2O) and setting the upper and both lower airway resistances to Rp20. This extreme scenario, while effective at conveying the effects of a pneumothorax, is not representative of a simple pneumothorax in humans and should not be used to assess the effectiveness of treatment methods for this condition.

Most test lungs can be used to simulate many different pulmonary conditions. If you have questions on how to create a specific scenario on your test lung please leave a comment below or contact techsupport@michinst.com. More information is available at https://www.michiganinstruments.com/training-test-lungs/.

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