CONFIDENTIAL 11436 Sorrento Valley Road San Diego, CA 92121 858.202.3100 The Clinical Advantage of...

CONFIDENTIALCONFIDENTIAL

11436 Sorrento Valley Road • San Diego, CA 92121•11436 Sorrento Valley Road • San Diego, CA 92121• www.sequal.com • 858.202.3100• 858.202.3100

The Clinical Advantage of the Eclipse 2 and the Art of Oxygen Dosing

Brian Silence

International Regional Business Representative



What is Oxygen?

Life-sustaining gas in earth’s atmosphere 21% of air is oxygen (symbol is O2 )

78% of air is nitrogen (symbol is N2 )

Humans can live only 3-4 minutes without O2

Body constantly needs/uses O2 to create energy O2 + fuel = energy + CO2 (aka METABOLISM)



How Do We Get O2 ?

Humans get O2 by breathing in air

Adults take about 12-14 breaths each minute

Each breath is about 500 mls (½ liter) of air

Each breath contains 21% O2

Each breath is inhaled into the lungs

The lungs transfer O2 into the blood

The blood transports O2 throughout the body



The Airways are Surrounded by the Lungs



The Alveolar Part of the Lung



Physiology of a Healthy Person

• There are about 300 million alveolar sacswith a total surface area the size of a tennis court size – 100 square yards!

• There are about 20 generations ofbronchioles



How much O2 ?

SPO2 = 97%

How much CO2 ?

PaCO2 = 40 mm Hg

Gas Exchange in the Normal Lung



Basic Definitions/Terms

COPD – chronic obstructive pulmonary disease COPD is a combination of chronic bronchitis and

emphysema

Chronic hypoxia – low levels of oxygen in the blood Lower than normal levels of oxygen in the blood is

caused by COPD, a severe, life-threatening lung disease that effects 12-24 million Americans

Pulse oximetry – a quick and easy way to measure blood oxygen levels Another term that is used is “oxygen saturation”




SPO2 – The “pulse ox” reading indicates how well the blood leaving the lungs is saturated with oxygen

The normal oxygen saturation while breathing room air (21% O2) with no lung disease is ≥ 97%

When a patients “pulse ox level” (or) “oxygen saturation” falls below 89%, there are serious physiological and psychological consequences

A patient’s “pulse ox level” is determined by: The concentration of oxygen they are breathing, and The type and severity of their lung disease




FIO2 – the concentration of O2 in the gas that is inhaled into the lungs (expressed as a decimal)

A person breathing room air (21% O2) has an FIO2 of .21

The FIO2 is determined by the amount of additional oxygen a person is breathing

Each L/min of supplemental O2 raises the FIO2 by 3% (.03)

1 L/min of O2 gives an FIO2 of .24 (.21 + .03 = .24)





Oxygen Therapy

The Goal

Administer supplemental O2 to bring the SPO2 into a normal range

The SPO2 is level is determined by the FIO2 in the alveoli

Normal SPO2 is ≥ 97%

COPD patients have low SPO2 levels (≤ 90%)

FIO2 determined by the amount of O2 inhaled



Pulse-only Portable Concentrators

Scaled version of standard PSA concentrator ≤ 10 pounds; easily transportable

Standard AC, DC and rechargeable battery

Marketed to provide stationary & ambulatory oxygen

Small size limits oxygen production 480 – 1050 mls/minute of therapeutic oxygen (≥ 90%)

Can only operate in pulse-dose mode!

Primary objective – prolong battery life



Personal Ambulatory Oxygen SystemAn Oxygen Dosing Device

Scaled version of proprietary ATF technology A true portable oxygen concentrator

17 pounds; easily transportable

Standard AC, DC and rechargeable battery

3,000 mls/minute of therapeutic oxygen

Both continuous flow and pulse dose mode

Known Increase in dose setting in both CF and PD mode Continuous flow: 0.5 – 3 L/min

Pulse dose: 16 mls (setting 1) up to 96 mls (setting 6)

AutoSat feature in pulse dose mode



Multiple choicesMultiple choices

How do they workHow do they work

CapabilitiesCapabilities

LimitationsLimitations

Titrate for doseTitrate for dose

Understand the primary Understand the primary objectiveobjective

PROVIDE ADEQUATE PATIENT PROVIDE ADEQUATE PATIENT OXYGENATIONOXYGENATION

Oxygen Conserving Devices(OCDs)



Oxygen Conserving Devices(OCDs)

• There are 2 basic designs– Pneumatic

– Electronic

• Both types detect a patient’s inspiratory effort and immediately trigger to deliver a pre-set amount (bolus) of oxygen



Oxygen Delivery Fundamentals



Minimum Requirement for an Oxygen Delivery Device

Provide adequate oxygen saturation during use

Be reliable with a reasonable warranty

Be affordable to purchase

Have bench study or clinical evidence to support claims made



Pulse-only Portable Concentrators

XPO2 Inogen One Evergo

Lifestyle Freestyle



Pulse-only Portable ConcentratorsTechnical Specifications

COMPANY PRODUCT WEIGHT MAX O2 PRODUCTION

AirSep FreeStyle 6 lbs 480 mls/min

Invacare XPO2 7 lbs 900 mls/min

AirSep LifeStyle 10 lbs 750 mls/min

Inogen Inogen One 10 lbs 750 mls/min

Respironics EverGo 10 lbs 1050 mls/min



Pulse-only Portable Concentrators Specifications

COMPANY PRODUCT MAXIMUM RECORDED DOSE (ml)

Airsep Freestyle 26 ml

Inogen Inogen One 26 ml

Respironics Evergo 36 ml

Airsep Lifestyle 41 ml

Invacare XPO2 42 ml



Eclipse-2 Compared to Pulse-only Portable Concentrators

COMPANY PRODUCT MAXIMUM RECORDED DOSE (ml)

Airsep Freestyle 26 ml

Inogen Inogen One 26 ml

Respironics Evergo 36 ml

Airsep Lifestyle 41 ml

Invacare XPO2 42 ml

SeQual Eclipse 2 96 ml



COMPANY PRODUCT MAXIMUM RECORDED FIO2

Airsep Freestyle 25%

Airsep Lifestyle 27%

Inogen Inogen One 27%

Respironics Evergo 29%

Invacare Home Fill 30%

Pulse-only Portable Concentrators Specifications



COMPANY PRODUCT MAXIMUM RECORDED FIO2

Airsep Freestyle 25%

Airsep Lifestyle 27%

Inogen Inogen One 27%

Respironics Evergo 29%

Invacare Home Fill 30%

SeQual Eclipse 2 45%




Average FIO2 About 32%

Maximum FIO2% at 20 Breaths per MinuteC

R-5

0

Eas

yPu

lse

5

Eco

nO

2Miz

er

Esc

O2r

t

Ho

me

Fill

O2n

Dem

and

II

O2X

pre

ss

Oxy

-Ser

v II

Res

po

nd

O2

Tru

-Do

se

Esc

O2r

t (D

ual

)

Hel

ios

Mar

ath

on

Sp

irit

300

Sp

irit

600

Sp

irit

120

0

Ecl

ipse

Fre

esty

le

Ino

gen

On

e

Lif

eSty

le

Oxy

Tec

900

ePo

d

Imp

uls

e E

lite

(A M

od

e)

Imp

uls

e E

lite

(B M

od

e)

Lib

erty

Min

iO2

PD

1000

PD

4000

Eas

yMat

e

Esc

O2r

t (S

ing

le)

20

25

30

35

40

45

50

Pneumatic Electronic Liquid Portable POC



The Clinical Advantage

•



COMPANY PRODUCT MAX OPERATING ALTITUDE

Invacare Home Fill Tanks not approved for flight

Airsep Lifestyle 5000 ft

Airsep Freestyle 5000 ft

Inogen Inogen One 6000 ft

Respironics Evergo 8000 ft

SeQual Eclipse 2 13,200 ft




Decreased work of breathing

Increased FIO2 for patients

Increased SPO2 for patients

Adjust for missed breaths while exercising

Adjustable SensitivityClinical Advantage



Effect of Breathing Rate on FIO2

Puritan Bennett HELIOSFIO2 @ pulse setting 4




FIO2 @ 5 Pulse SettingInvacare XPO2

0

5

10

15

20

25

30

35

0 2 4 6 8 10 12 14 16

Elapsed Time (minutes)

Bre

ath

s P

er M

inu

te (

500m

l per

bre

ath

)

21

26

31

36

41

46

%P

uri

ty (

FIO

2)

bpm

Purity

Invacare XPO2FIO2 @ pulse setting 5



FIO2 @ 6 Pulse SettingRespironics EverGo

15

20

25

30

35

0 2 4 6 8 10 12 14


Bre

ath

s P

er M

inu

te (

500m

l per

bre

ath

)

21

26

31

36

41

46

bpm

Purity


Respironics EvergoFIO2 @ pulse setting 6




FIO2 @ 6 Pulse SettingEclipse II

0

5

10

15

20

25

30

35

0 2 4 6 8 10 12 14 16


Bre

ath

s P

er M

inu

te (

500m

l per

bre

ath

)

21

26

31

36

41

46

%P

uri

ty (

FIO

2)

bpm

Purity

Eclipse 2FIO2 @ pulse setting 6

AutoSat



AutoSat

Average Pulse Bolus Size

1 2 3 4 5 6

16 32 48 64 80 96

16.00 32.00 48.00 64.00 80.00 96.0016.00 32.00 48.00 64.00 80.00 96.0016.00 32.00 48.00 64.00 80.00 96.0016.00 32.00 48.00 64.00 80.00 96.0016.00 32.00 48.00 64.00 80.00 96.0016.00 32.00 48.00 64.00 80.00 96.0016.00 32.00 48.00 64.00 80.00 96.0016.00 32.00 48.00 64.00 80.00 96.0016.00 32.00 48.00 64.00 80.00 96.0016.00 32.00 48.00 64.00 80.00 96.0016.00 32.00 48.00 64.00 80.00 96.0016.00 32.00 48.00 64.00 80.00 96.0016.00 32.00 48.00 64.00 80.00 96.0016.00 32.00 48.00 64.00 80.00 96.0016.00 32.00 48.00 64.00 80.00 96.0016.00 32.00 48.00 64.00 80.00 96.0016.00 32.00 48.00 64.00 80.00 96.0016.00 32.00 48.00 64.00 80.00 96.0016.00 32.00 48.00 64.00 80.00 96.0016.00 32.00 48.00 64.00 80.00 96.0016.00 32.00 48.00 64.00 80.00 96.0016.00 32.00 48.00 64.00 80.00 96.0016.00 32.00 48.00 64.00 80.00 96.0016.00 32.00 48.00 64.00 80.00 96.0016.00 32.00 48.00 64.00 80.00 96.0016.00 32.00 48.00 64.00 80.00 96.00

Pulse SettingBreath Rate (BPM)

6789101112131415161718192021222324252627282930



Advantages of Continuous Flow vs. Pulse

Continuous Flow is the Gold Standard

Measured Volume of Gas vs. Pulse

Obtain Higher FiO2’s at Higher Flows

Able to Sleep with Continuous Flow



Advantages of Pulse vs. Continuous Flow

Pulse Saves Battery Life



Low Power Consumption

50 to 150 Watts Extends Battery Charge Lower Electricity Bills Variable Speed Compressor AutoSat Maximum Efficiency



Thank You

CONFIDENTIAL 11436 Sorrento Valley Road San Diego, CA 92121 858.202.3100 The Clinical Advantage of...

Documents

Transcript of CONFIDENTIAL 11436 Sorrento Valley Road San Diego, CA 92121 858.202.3100 The Clinical Advantage of...