Demo Optimedics Freedom plus NIV device

Added: 2026-05-31

[00:00:04]Good afternoon everyone. My name is Rajendra Singh Parmar. I'm from OptiMedix LLP and um uh we are representing uh all-in-one non-invasive neonatal ventilator. We have got uh two models. Um one is a Freedom Plus Advance and another one is Freedom Plus Advance Plus uh NHFOV. So um we have we have with with the Freedom Plus Advance we have got all the therapies which are being used um in today's time for non-invasive starting from uh starting from uh synchronized non-invasive ventilation, NIPPV is like a bilevel ventilation, then we have got NCPAP, we have got bubble CPAP, and then we have got NHFOV in this model, and we have got high-flow nasal therapy also. So in synchronized ventilation, uh what we claim is uh we can do uh uh in synchronized yeah, static so uh in synchronized ventilation, uh see main requirement of any good non-invasive neonatal ventilator is uh we always ventilate the small babies with either through nasal prong or nasal mask. So baby's mouth may be open, may be closed.

[00:01:13]So in case of a leak, uh uh the any good good non-invasive ventilator has to perform two things which is prime requirement. One is A, it has to do a leak compensation. B, it should not auto trigger, it should trigger only those breaths which are actually going to the going uh which are already actually triggered by the baby.

[00:01:33]So just to demonstrate that, what I did is here is uh I have put a leak wall over here. So right now I have kept on a rate of 40.

[00:01:41]All the all 40 breaths are uh are the mandatory breaths, but for right now when I'm going to trigger, see all the screen breaths green breaths are the trigger breath, okay? So now just to prove that our algorithm, so now I'm going to create a leak and it should still it should deliver the same PIP PWEP and it should not auto trigger any breath. So, as you can see is sir you can hear the noise of the leak. Okay, so even with the leak also there is no auto trigger and still the my PIP and PWEP is been compensated. And even in the leak condition it's like a baby's mouth open and if baby is taking actual breath, see so those breaths have been triggered.

[00:02:24]So, there is no any extra breath which is being triggered because of the leak.

[00:02:28]No false triggering only those breaths have been triggered which are actually taken by the baby. So, that's where we are different to another algorithm from other other brands. So, this is there in NISBPV and then we have got in NCPAP in NIPPV it's like a bilevel ventilation where patient can breathe spontaneously at both level PIP and PWEP. And in our NCPAP mode we have got apnea detection and we also have the apnea monitoring also.

[00:02:59]Plus in HFND we have got electronic blending inside so you don't have to set the manual manual oxygen flow. You can directly set the dial in the FIO2 and flow just like any other ventilators. And in bubble CPAP also the advantage which we have is you can monitor the airway pressure and you can monitor the FIO2 percentage also delivered FIO2 percentage also. And then NHFOV you you can set the delta P, you can set the mean airway pressure just like any other just like any other high frequency ventilator. But here you can give the high frequency ventilation through through nasal nasal interfaces.

[00:03:40]>> Is upper limit of the PIP?

[00:03:42]>> PIP upper limit is 25 in NISBPV and NIPPV.

[00:03:46]>> He mentioned that he's working on a cannula also which will be hopefully available soon.

[00:03:52]The cost you said is around 4 to 5 lakhs.

[00:03:54]>> to >> lakh rupees 5 lakh plus tax for a Freedom Plus Advance and this model we are yet to uh Yes, 5 lakh plus tax. This model will be more with high frequency soon.

[00:04:07]>> Then you are looking at invasive ventilator?

[00:04:09]>> Uh in future for sure.

[00:04:12]>> So as we discussed, I mean if you are using an IPPV as a prime modality and you have already an invasive ventilator or two and it's a small unit, this is a good option because you can go for an IPPV and nasal high frequency. As we know, most babies can be managed with non-invasive ventilation as we discussed in the morning.

[00:04:29]So this is something to think about and we have two or three doctors here using it. We have good feedback as well.

[00:04:36]We will just demonstrate the pneumothorax.

[00:04:39]So he has this model for the air leak.

[00:04:42]Just don't come in the way. You can come here.

[00:04:49]Where is the needle?

[00:04:50]You can make it safer minimum. So you can see here the lung. Yeah.

[00:04:56]You need time to set it up. We can We can demonstrate with the Masimo one.

[00:05:03]So we have the baby and the lung is moving with the ventilation. So it can be invasive or non-invasive, doesn't matter. So you can see here that the chest is moving well. Now he's going to create a pneumothorax by uh restricting the lung inside. This is a thoracic cavity, so he's creating a pressure inside. So that is now the lung is not moving as well and you can see it's a monitor. We can leave it or So So you can see here that the lung is not expanding. The the sick pressure increase there is only to make it less compliant here in the interthoracic area. So that's what happens when the pneumothorax is there.

[00:05:45]So you can see here immediately the CO2 was 45 before, now it has gone up. And obviously, if it's a tension pneumothorax, you'll see the baby dropping the saturation, dropping the blood pressure.

[00:05:57]And it becomes an emergency where you may need to treat it without even x-ray.

[00:06:02]So, the cold light can be used. I mean, obviously, in this mannequin, we cannot show, but you're familiar with the cold light. If you don't have a cold light, Dr. Karthik suggested as well, and you can just clean your iPhone and use the above light is powerful enough. You have to switch off the room, darken the room, and then try the cold light. And you can see here once we drain the leak either with needling or with So, you're just going to insert it and You need more.

[00:06:32]So, this is just like inserting the chest drain.

[00:06:37]So, I've shared with you the previous Yeah, so the needle has been removed.

[00:06:40]So, you can see that the the pressure is still there, but the lung is moving well, and the CO2 will start reducing now. So, obviously, this is just a demonstration of what happens to the intrathoracic cavity when a pneumothorax happens.

[00:06:53]And uh the CO2 has started dropping now. So, it's uh You saw it went up to 140s, now it's dropping rapidly.

[00:07:02]And obviously, the oxygenation would improve as well. So, what we do with the pneumothorax, I have shared video on that, and from the last uh workshop, you can see the supportive care video as well.

[00:07:12]Uh you don't need to drain every single pneumothorax. We do get many babies with spontaneous air leak where you just supportively manage the baby. And once the You can come back to this, it's fine. So, once we have uh supportive care for the baby, non-invasive ventilation can be used with pneumothorax. And uh lung needs to be open. So, the same principle applies. If you can't recruit the lung, then you need to drain. And the first step to drain in a stable baby who is not ventilated can be needling. So, as you know, needling is done in the second intercostal space. And uh you can use a neoflon or a venflon. I mean, not a 16 or 18 gauge venflon.

[00:07:49]Uh you it's easier to keep it for removing the air, even if you need to keep removing. Connect a three-way to it and keep removing the air as it accumulates. If it's persistent, you need to put in a chest drain. And if the baby doesn't improve with needling alone, you need to do a chest drain.

[00:08:05]X-ray repeat will guide you. And once you insert the chest drain, you keep it till the bubbling stops. Negative suction connected to the tube is optional. You don't need to do in every baby, but if improvement is slow, you can do the negative suction to remove it.

[00:08:19]-5 to -10 maximum.

[00:08:21]And you stop the negative suction first, then you remove the I mean, you clamp the drain. And then, if there is no worsening, you can remove. A repeat x-ray is optional. You can watch the oxygen. And if you have the end-tidal CO2, we will discuss with Massimo next. If you have the end-tidal CO2 as well, you can review that to see a trend of whether the baby tolerates the clamping or not. And intubation and pneumothorax management, the scale has changed. You don't need to intubate a baby just because you have an air leak.

[00:08:49]But mostly, if you need a chest drain, you are going to put. If it's a PPHN associated with pneumothorax, you need to intubate most of the time. Again, these babies, sedation is an option. And I told you, volume guarantee may not work. So, you may have to switch to SIMV with pressure support or high frequency.

[00:09:04]Once the pneumothorax has been drained, you can switch back to volume guarantee.

[00:09:07]So, these are temporary measures.

[00:09:09]So, I hope this is clear. Any questions on this? Uh >> I have a question to Rajinder. Rajinder, how do you do the leak compensation there? How did you manage that in your machine?

[00:09:21]>> Okay, sir. So, what I what we are doing is we are measuring actually the del Yes, sir. So, actually, what we are doing is we are measuring the pressure at the proximal end. So, our goal is to achieve our goal is to achieve the set PIP and set PEEP. So, as soon as we we see a drop uh drop in the pressure at the proximal end, the machine will compensate for that for that leak and it will try and achieve achieve the leak up to up to 40% with the measurement at the proximal end.

[00:09:53]>> And how do you do synchronization?

[00:09:55]Because yours is the only machine which can >> Okay, sir. So, Yes, sir. So, we have we have sir, we have designed a algorithm called OptiSync.

[00:10:06]So, our main main idea of designing the simulator also sir, before to design any algorithm, we need to have a spontaneous breathing baby where I can I can design my ventilator breathing algorithm. And so, we have designed this spontaneously breathing simulator and with that, what we did is sir, we have tried and differentiate the two part. A, the patient effort and B, the leak. So, we have with the help of the computer and these some of the some of the ventilator analyzer, we have tried and differentiate the two things.

[00:10:45]Because if there's a leak has got a different different pattern and the spontaneous breathing has got a different pattern of the pressure and flow. So, we have we have identified those those pattern those two different patterns and depending on those two patterns, we have synchronizing only those breaths which are actually synchronal taken by the baby and we are substituting those change in the pressure which are caused by the leak. So, this is how we have designed our algorithm for synchronization.

[00:11:16]>> Thank you and you know, if there is an innovator as we discussed earlier, it will be better.