Simple answers to complex questionsRespironics NM3 respiratory profile monitor

Mechanically ventilated patients are constantly challenging clinicians with complex

questions regarding the patient's current respiratory status and the adequacy of

ventilatory support. Conventional ventilator monitoring is limited in scope and

often does not provide enough information about the effectiveness of the delivered

ventilation. The NM3 monitors physiologic gas exchange, deadspace and alveolar

tidal volume as well as a host of accessory parameters. This valuable insight,

presented clearly and simply, helps to answer the toughest clinical questions, giving

you the information you need to provide the best possible care.

Key advantages

• Portable and easily adapts to all

conventional ventilators.

• Interfaces directly with the Esprit and

V200 ventilators to expand data collection

and display.

• Mainstream or side stream sensor

measurement capability for intubated and

non-intubated patients.

Key applications

• Confirm proper endotracheal tube placement.

• Determine true alveolar tidal volume, independent of dead space.

• Provide additional information on the magnitude of leaks.

• Provide information on setting appropriate PEEP levels.

• Monitor alveolar recruitment.

• Determine the effects of ventilator changes before the first ABG is drawn.

• Obtain non-invasive cardiac output measurements.

Bright, sharp and well organized display screens present critical information, in real time, on your

patient's response to ventilation therapy. NM3 also provides additional information on the patient’s

readiness for less ventilation support or/and a spontaneous breathing trial. All of this and more

without the need to compromise valuable space on your ventilator or patient monitor display screen.

NM3 highlights

System specifications

Ventilation Mode (Cardiac Output Option)

Adult patients on controlled mechanical ventilation, or patients

breathing spontaneously with ventilation support.

Principle of Operation (Cardiac Output Option)

Partial CO2 pt rebreathing differential FICK, noninvasive.

Measurement Frequency (Cardiac Output Option)

Rebreathing measurement made every three minutes for a duration

of 35 seconds.

NICO® Sensor (Cardiac Output Option)

Valve Type Dual Diaphragm, pneumatically controlled

Return Spring Automatically returns valve to normal position

Rebreathed Normal position: 35 ml

Volume Rebreathing Position:

125 -285 ml (small)

150 – 450 ml (standard)

200 – 835 ml (large)

CO2 /Flow Sensor Integrated into NICO Sensor

Alerts

Adjustable Limits C.O., ETCO2, SpO2, RR, No Respiration,

VCO2 and Pulse Rate (heart symbol)

Audio Adjustable volume, 2 min. silence or OFF

(LED indicator)

Visual On-screen indication and red LED for

high-priority alerts

Internal Battery

Life 45 minutes on full-charge

Recharge Time 12 hours

Type Lead acid gel cell

Parameters Measured Abbreviation

CO2 Elimination VCO2

End Tidal Carbon Dioxide ETCO2

Inspired Carbon Dioxide Insp CO2

Mixed Expired CO2 PeCO2

Respiration Rate RR

Oxygen Saturation SpO2

Pulse Rate

Positive End Expiratory Pressure PEEP

Mean Airway Pressure MAP

Peak Inspiratory Pressure PIP

Peak Expiratory Pressure PEP

Peak Inspiratory Flow PIF

Peak Expiratory Flow PEF

Systematic Vascular Resistance SVR

Airway Deadspace Vd/Aw

Deadspace to Tidal Volume Ratio Vd/Vt

Rapid Shallow Breathing Index RSBI

Minute Volume MV

Alveolar Minute Volume MValv

Inspired Tidal Volume Vti

Expired Tidal Volume Vte

Dynamic Compliance Cdyn

Airway Resistance Raw

Parameters with Cardiac Output Option Installed

Cardiac Output C.O.

Cardiac Index CI

Stroke Volume SV

Stroke Volume Index SVI

Pulmonary Capillary Blood Flow PCBF

ª

LoFlo Side stream Sensor and

accessories

Mainstream or Side stream

CO2 measurement capabilities

Capnostat 5 Mainstream Sensor

and accessories

Front panel connections for

all sensor inputs

Masimo Pulse

Oximetry

Easy to navigate

controls

Bright, color display Visual alarm indicator

Single Breath CO2 Plot with overlay Digital data Weaning monitoring

© 2009 Koninklijke Philips Electronics N.V.All rights are reserved.

Philips Healthcare reserves the right to make changes in specifications and/or to discontinue any product at any time without notice or obligation and will not be liable for any consequences resulting from the use of this publication.

Philips Healthcare is part of Royal Philips Electronics

www.philips.com/healthcarehealthcare@philips.comfax: +31 40 27 64 887

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Phases of the Volumetric Capnograpm

Phase I represents airway deadspace. It is the CO2-free portion of the

exhaled breath from the conducting airways.

Phase II represents transitional gas which is a mix of airway deadspace

and alveolar gas and is characterized by a significant rise in CO2.

Phase III represents alveolar ventilation.

Calculation of Deadspace and CO2 Production

Two lines (shown dotted) are constructed on the graph: one across

the slope of Phase III and the other such that areas p and q are equal.

Airway deadspace (VdAw) is measured from the start of expiration to

the point where the vertical line crosses the exhaled volume axis. To

the right of the vertical axis is alveolar tidal volume (Vtalv). The volume

of CO2 in the breath is equal to area X, the total area under the curve.

Adding individual breath volumes allows CO2 elimination to be calculated

(in ml/min).

Additional Calculations When PaCO2 Is Known

Physiologic Vd/Vt as well as physiologic and alveolar deadspace can also

be calculated if arterial PCO2 is known. A line representing the arterial

PCO2 value is constructed parallel to the exhaled volume axis creating

areas Y and Z. Area X represents the volume of CO2 in the exhaled tidal

volume. Areas Y and Z represent wasted ventilation due to airway and

alveolar airway deadspace respectively.

Calculations

Physiologic Vd/Vt = (Y+Z) / (X+Y+Z)

Physiologic Deadspace (Vd phys) = (Vd/Vt phys) x (Vt)

Alveolar Deadspace (Vdalv) = Vd phys – Vd airway

The Philips NM3 Monitor integrates CO2 and volume measurements to calculate CO2 elimination

(VCO2). This offers far more information than traditional End Tidal CO2 measurements, providing

the clinician a complete view of ventilation and gas exchange.

For more detailed information, contact your local Philips representative, or visit www.Philips.com/NM3

Theory of operation

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Exhaled Tidal Volume

X

YZ

PCO2

VdAwCal

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f D

ead

spac

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d C

O2 E

limin

atio

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Exhaled Tidal Volume

Vtalv

q

p

X

PCO2

Phase I Phase II Phase III

Ph

ases

of

the

SB

CO

2 C

apno

gram

Exhaled Tidal Volume