Ideally suited to the hybrid OR working environment, the innovative robot-supported Artis pheno angiography system was developed for use in minimally invasive surgery, interventional radiology and interventional cardiology. The zen40HDR flat panel detector and the GIGALIX X-ray tube give the Artis pheno outstanding image quality. Resolution for 2D imaging is four times higher – compared to the company’s prior systems – in all recording processes thanks to the system’s new 2k recording technology. The StructureScout feature can adapt and optimize imaging parameters to best suit the material structure of the area being X-rayed, which enables even less radiation to be used compared to the company’s prior systems . Artis pheno is designed to support treatment of multimorbid patients and can be fitted with a comprehensive range of optional software applications to deal with complex cases. Thanks to the hygiene approach developed especially for Artis pheno, the system has large, sealed surfaces with fewer spaces, which helps customers with system cleaning. An antimicrobial coating prevents bacteria and viruses from multiplying on the system.
Because it can scan up to 15 percent faster in the body area – compared to prior systems – , syngo DynaCT is able to produce 3D images that need less contrast agent for the imaging process. If the patient is sensitive to the contrast agent, Artis pheno can also support CO2 imaging of the extremities. The system follows the tilted table and increases CO2 visibility using the new StructureScout. The C-arm is 13 centimeters wider and has a free inner diameter of 95.5 centimeters, which offers more space for handling adipose patients and means longer instruments can be used without difficulty. The Siemens Healthineers multi-tilt table is also designed to accommodate patients weighing up to 280 kilograms. The end of the table can be tilted both up and down, to stabilize the patient’s blood pressure, for example, or to make breathing easier when necessary. The robotic construction of the Artis pheno gives it a flexible isocenter that it shares with its predecessor, the Artis zeego. This means the angiography system can follow all table positions and provide the best possible imaging support for the patient’s treatment, while representing the target area of the body from virtually any angle. Artis pheno can also be combined with surgical tables from Maquet und Trumpf which enable patients to be specially positioned for operations. Typical positions involve patients lying on their side, stretched out on their side, or even sitting. Surgeons can move the easy-float tabletop on the new multi-tilt table with minimal effort, regardless of how much the tabletop has been tilted on either of its axes, or how heavy the patient is. Artis phenol recognizes the position of the tabletop at all times, and automatically aligns itself to the tabletop with every movement. The memory positions let the system move the C-arm out of the operating area quickly if necessary, giving the surgeon and the operating team free access to the patient, and then move it back to exactly the same position again for further imaging. This means results can be checked directly, even while the operation is still in progress.
Many additional optional application packages can be used with the Artis pheno. In spinal fusion procedures, for example, up to ten vertebrae can be visualized in 3D imaging using syngo DynaCT Large Volume. Syngo Needle Guidance then makes it possible to plan extensive procedures using screws or needles. Screw paths can be planned with precision, and the Automatic Path Alignment function automatically aligns the C-arm to follow them. The laser integrated in the image detector shows the surgeon the planned path, which helps improve both accuracy and speed in the OR. Using this software application can help minimize the rate of screw positioning errors in the spine and also speed up the work process in this area.
A number of applications on the Artis pheno support transarterial chemoembolization (TACE) of tumours. TACE involves supplying embolic particles coated with a chemotherapeutic drug via a catheter directly into the arteries leading to the tumour. Using syngo DynaCT 360, it takes just six seconds for the Artis pheno to generate a large-volume image of the liver or lung, for example, including the anatomy of the tumour and the vessels leading to it. Rapid rotation is vitally important in reducing movement artifacts, since the patients are given only local sedation for the TACE procedure. The syngo Embolization Guidance application renders arterial vessels visible and helps distinguish the vessels and treatment paths using colour-coding. Graphic overlaying of the selected vessel paths with the real-time X-ray images makes the vessels that supply the tumour visible for simplified microcatheter navigation which can save on the dose of both radiation and contrast agent.
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Every year, millions of CVCs are used by clinicians to deliver medications and fluids to patients in surgical and intensive care (ICU) settings. Major risks seen among ICU patients include hyperglycaemia, hypoglycaemia and glycaemic variability, and the lack of glycaemic control has been independently shown to be associated with morbidity and mortality. To monitor glucose levels, ICU patients are therefore typically subjected to frequent glucose controls, commonly by use of manual and labourintensive blood draws and off-line analysis. The Eirus TLC is now available, a 7 French, 16 cm triple lumen CVC which provides vascular access and the ability to provide simple, continuous and accurate glucose monitoring. It can be used as a standalone CVC but is also approved for use with the Eirus system for second-by-second analysis of central venous blood glucose and lactate. The catheter has an integrated semi-permeable membrane, proximal to the infusion ports, which continuously collects and analyses plasma glucose and lactate. The system does not pull any blood from the patient, it does not require any heparin nor does it require a separate additional line into the patient.
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A revolutionary air disinfection unit, the AD 2.0 has been specifically designed and proven to c ont i nuous l y eliminate airborne Healthcare Associated Infections (HCAI), including MRSA, C.difficile and Norovirus, from clinical settings. The wall mounted system can disinfect any room up to a maximum volume of 300m3. It not only removes virtually all airborne pathogens, but also targets bacteria and viruses present on surfaces (over 20% reduction on most materials). The unit is designed to be used with a consumable cartridge containing a reagent, which is ionised and reacted with traces of ozone, resulting in the generation of hydroxyl free radicals. These highly reactive free radicals then neutralise dangerous bacteria and viruses, altering their molecular structures so that they become nonviable. Each unit can be controlled remotely, with automatic notifications alerting staff when the cartridges have run out and on the unit’s current status (e.g. working, sleeping, off), making monitoring of the system very easy and largely labour-free.
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The leakage of oral secretions past the endotracheal tube (ETT) has been a causative risk factor in the development of Ventilator Associated Pneumonia (VAP) and tracheal injuries for many years. Existing solutions for endotracheal tube cuff pressure management require manual monitoring and adjustment of cuff pressure which is a critical aspect in the ICU staff workload. It has been shown that up to eight manual adjustments of cuff pressure are required daily to maintain recommended cuff pressure ranges, or more in higher risk cases of lung infections and mechanical complications. Recent clinical studies show that continuous cuff pressure control can optimise endotracheal tube cuff filling and reduce VAP. Now a new non-invasive automatic cuff pressure solution, INTELLICUFF, reduces VAP and tracheal injuries by continuously monitoring and automatically adjusting cuffed tracheal and tracheostomy tubes, providing a real-time optimisation of cuff pressure. The controller module and software are integrated parts of the Hamilton medical ventilator, controlled in the ventilation cockpit, the same unique user interface used to adjust and adapt ventilation therapy. The ventilation cockpit reduces complexity by graphically displaying the patient’s status, current treatment, and the required support including current cuff pressure control and monitoring. Transparency is provided by protocolised care so clinical staff can always be sure that cuff pressure is optimised at all times. This system is available for the company’s G5 and S1 ventilators.
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