Designed for High Flow Oxygen Therapy

8 June, 2020
Vincent Medical and Inspired™

About Vincent Medical

Established since 1997

Listed on board Hong Kong Stock Exchange
Specialist in Respiratory care consumables
2,100 dedicated medical staff
Located in Hong Kong, Dongguan Tong Xia and Dongguan Song Shan Lake
One of the largest exporter of Respiratory consumables from China
Heated Humidification since 2008
Supplier of Newport circuits since 2004, and Humidifiers to Medtronic since 2019
Qualified global supplier for major respiratory market players
Vincent Medical and Inspired™
High-Flow Therapy

High-flow therapy often also known as

(HHHF )Heated humidified high flow therapy,
(HFNC) High Flow Nasal Cannula or
(HFNO) High Flow Nasal Oxygen,

is a type of respiratory support method

that delivers a high flow of medical gas
to a patient through an interface Pharynx
intended to create a wash-out
of the upper airway. The applied gas is
heated to best match human body
temperature and humidified
targeting ideal body saturation Larynx
vapor pressure. It is used in acute &
chronic breathing problems.
High-Flow Therapy
High-Flow Therapy

High-flow therapy is also often used in THRIVE

(Transnasal Humidified Rapid-Insufflation Ventilatory
Exchange)

THRIVE is a physiological mechanism

for oxygenating and ventilating
patients who are under general
anaesthesia and who have
diminished or absent respiratory effort.

Through the
process of preoxygenation the ‘apnoea time’
can be increased.
Majority of COVID-19 patients die
on or after being on Ventilators
COVID – 19

While the majority of people with COVID-19 have uncomplicated or

mild illness (81%), some will develop severe illness requiring oxygen
therapy (14%) and approximately 5% will require intensive care unit
treatment.
Clinical management of severe acute respiratory infection (SARI) when COVID-19
disease is suspected. WHO

Transmission of COVID-19
• The main routes of transmission are respiratory droplets and contact
transmission.
• Aerosol transmission is possible when exposed to high concentrations
of aerosol in a relatively closed environment for a long time.
Novel coronavirus pneumonia protocol (seventh edition) .China National Health Commission
COVID-19 common questions

Frequent question/concern about the use

of HNFO  Cross infection

“High flow therapy being an open system

can spread contagious diseases via
expiratory gas.”

“How can we contain virus in a COVID-19

positive patient while implementing
HNFO?”
COVID-19 common questions

Post-SARS Studies by the Chinese University of Hong

Kong, published in 2016 & 2019, show that aerosol
dispersion occurs within 1M from nasal cannula.

Solution:
1. Ensure caregivers are equipped with appropriate PPE
esp. within 1M from patient – high risk area

2. Put a surgical mask on a patient over nasal cannula

BEFORE turning on the machine – controls distance
and direction of dispersion (See also Handbook of COVID-19
Prevention and Treatment & COVID Transmission Assessment report by
Vapotherm)
International Clinical Guidelines and Experts
Pointing Towards High Flow Oxygenation
 Identify Hypoxia and Oxygenate Early
(Society of Critical Care Medicine Infographics)

For patients showing

mild to moderate
SARI (severe acute
Always avoid endo- respiratory infection)
tracheal intubation if symptoms, HFNC is
possible! recommended for
Heavy sedation early oxygenation.
Airway trauma
Low rate of survival
Virus exposure for
caregivers
COVID-19 and High-Flow Therapy

Why were the clinical staff more likely to use HFNC in

COVID-19 patients?

• The current knowledge shows that The HFNC is non-inferior

to NIV on intubation rate in critically ill patients.
• The use of HFNC is more comfortable than NIV and the skin
breakdown is less likely to occur.
• The setup of HFNC is much easier than NIV.

Why avoid ventilators for COVID-19 patient in

High Flow vs general ?

a. Studies show 80% of patients die on or after being on

Machine ventilators. Alternative – best to go on HFNO first.
b. Lack of resources in hospitals.
c. Expensive.
d. Adverse effects of Invasive ventilation
i. Requires heavy sedation.
ii. Intubation is high risk exposure for caregivers.
Mechanical iii. Intubation causes airway trauma.
iv. Longer on vent, the more difficult it is for patient to
Ventilator relearn to breath.
About O2FLO

O2FLO is a simple to use system that delivers warmed and humidified respiratory
gases to spontaneously breathing patients and is capable of providing high flow
therapy.
Features

Flow rate 2 to 60 LPM Up to 95% O2 delivery Optimal humidity

( Real-time oxygen delivery
concentration display ) from 31 – 37℃

Easy handling and Quick

Start Enhanced Alarm 2.8” LCD Display Screen
No disinfection processing System
3 min warm up
Features

Single Direction Gas Flow, Quick Warm Up

needs no sterilization 5 min to 37℃ @ 60 LPM.
Features

Traceable Records
Enhanced Safety System 1MB Internal memory records
•Patented Infrared water level sensor (alarm trigger) 10,000 logs (~7-day use)
•Tube detection and alarm 8GB SD card to record and export
the alarm and usage history.
Features

User friendly UI Advanced Condensation Control

Easily operated by buttons and rotating knob 6-pin Integrated Heated Breathing Circuit
with Insulation Sleeve
Specification

Power Input 100-240V~, 50/60Hz

Power 300VA
FiO2 21%~95% , ±5%
Adult Mode DP Temperature range 31~37℃
Humidity Output >33mg/L @ 37℃ ;
>12mg/L @ 31~36℃
Flow range 10~60LPM
Pediatric Mode DP Temperature range 31~34℃
Humidity Output >12mg/L
Flow range 2~25LPM
Water Tank Capacity 90~160ml
Noise Level ≤50 dB(A)
Size 243mm x 220mm x 170mm
Weight ~2.8kg
Accessories
High Flow Nasal Cannula
(New version is under development.)

Adult - Size: S,M,L Infant Size: S,M,L,XL

Accessories

Heated Circuit Options

Regular Circuit Integrated Circuit (To be launched)

External connection to temperature probe Built-in temperature sensors on Integrated Embedded Circuit
chamber & patient ends Built-in temperature sensors and
Embedded heater wire tube
Accessories
Heater Wire Circuit Options
Accessories

Chamber Options

Regular Chamber Double wall chamber

Accessories

Trolley

Dust Cover Bag

Comparison

vs
Comparison
Parameters
O2FLO AIRVO 2 HIFENT HUMID-BH Precision Flow Plus
Max flow 60LPM 60LPM 80LPM 40LPM
rate
Flow Adult mode Adult mode High flow mode
High Flow 5-40 LPM(increment:
Setting 10-60 LPM (increment: 1LPM) 10-25 LPM (increment: 1LPM) 10-80 LPM
1LPM)
Pediatric Mode 25-60 LPM (increment: 5LPM Low flow mode
Low Flow 1-8
2-25 LPM (increment: 1LPM) Junior Mode 2-25 LPM
LPM((increment:0.5LPM)
2-25 LPM (increment: 1LPM)
Temp. 31-370C, increment: 10C 310C, 340C ,370C 310C, 340C ,370C
33-43°C, increment: 1℃
setting
Humidity >33mg/L @ 370C ; >33mg/L @ 370C ; >33mg/L(2~60L/min、37°C)
>12mg/L @ 310 C~360 C >10mg/L @ 310 C, 340 C >10mg/L(2~80L/min、34°C) Minimum of 12 mg/L.
>10mg/L(2~60L/min、31°C)
FiO2 21%~95% , ±5% 21%~95% , ±5% 21% ~100% , ±3% 21~100% , ±2%
Power Input 100-240V 50/60Hz 100-115V, 220-240V 50-60Hz 220V, 50Hz 100-240VAC, 50-60Hz
Noise ≤50dB ≤50dB 10L/min,<20dB（A） NA
Size 243mm x 220mm x 170mm 295mm x 170mm x 175 mm 358x197x165mm 300x200x180mm
Weight ~3.0kg ~2.2Kg / ~4.81 kg
 Comparison
Advantages
O2FLO AIRVO 2 HIFENT HUMID-BH Precision Flow Plus

Disinfection Gas won’t go back to unit and will Need disinfection Need disinfection The entire patient circuit is disposable and
go out from disposable chamber. (dry heat 90℃ for 90 min) (Ozonator to sterilize for no need for disinfection, The main unit,
No need for disinfection  10-15 mins) including the docking station for the
Reduce workload and time for disposable water path and temperature
reprocessing! sensor ports should be wiped down .
Warm-up 5 min to 37℃ at flow rate of 60 10 min to 31℃, 30min to 10 min to 31℃, 30min to
± 2℃ of 33℃ set point Warm-up time less
time LPM. 37℃ at flow rate of 35 37℃ at flow rate of 35
than five minutes
Faster!  LPM. LPM.
Chamber Patented Infrared water level When alarm occurs, the When alarm occurs, the When alarm occurs, gas flow continues
water out detection. When alarm is activated, chamber runs dry, the chamber runs dry, the without heating or water circulation.
alarm there is still water in the chamber, chamber float may be chamber float may be
the unit still runs for a short time. damaged and need to be damaged and need to be Need to replace water bag or straighten
Allows time for refill. Safer!  replaced. replaced. inlet tube and restart unit.

Alarm With SD card to record and export None None EMR and nurse call connectivity for
record the alarm and usage record. indicating an alarm condition on a hospital
Record traceable! nurse call system and interfacing EMR
capable technologies.
Power AC 100-240V~, 300VA (Dual 100-115V, 2.2A Or 220- 220V±22V，50±1Hz
100-240VAC, 50-60Hz
voltage, just need the right plug!) 240V, 1.8A
High-Flow Therapy
Competitors of high flow product

Market players:
1. Fisher & Paykel AIRVO2  market leader
2. Vapotherm High VNI
3. Respircare HIFENT (India market USD 1,950-2,000)

Price information on AIRVO2….

Hospital price Distributor Price

Australia USD1800 Iran USD 2000

China USD 7000-8500 Japan USD 2500-3000

Consumables: USD 70-150 per set of circuit and chamber.

AIRVO2 problems:
•120 days leadtime.

•Have problem of screen black out, after sales service not always
available.

•Servicing and consumable sales directed back to F&P. (No recurring

income for distributors)

•Oxygen sensors not stable.

Why Choose Inspired O2FLO™?
We are safe and reliable.
Cleared by U.S. FDA for EUA and MNPA (China FDA)
 These are very strict regulatory bodies
Why choose inspired™ O2FLO vs HIFENT?
We have better alarm. “Water out alarm” of Respircare will cause chamber to break as chambers would
already have run dry. Our low water level alarm base on patented infrared detection is better, safer, allows
nurses time to react (refill the water source).
Our filters are better. VM’s is made of 100% woven cotton high efficiency filtration. Respiracre filter is sponge
with low filtration efficiency.
We designed the O2FLO ™ with recording function, option for external memory AND provide an 8GB SD card
to record running and alarm data. (The devices comes with 1MB internal memory that records 10,000 logs,
equivalent to 7 days of use.)
VM system has lower water condensation, and higher humidity output.

VM unit meet IEC60601-11 can be used in homecare with higher safety requirement.

Our Heater plate is designed to operate only at 24V voltage, which would still be relatively safe from causing
much damage should the insulating coating on the heater plate be scratch off, and an electric shock occurs.
Having said that, our O2FLO is safer than 220/110V votage used in heater plate of Respircare.
Why choose inspired™ O2FLO vs AIRVO2?
VM offers wide selections of disposables. The cheapest US$40 per set. While F&P is US$150.

No need for sterilization - our gas path is one direction from outside direct to chamber and from chamber to
patient via circuit and nasal prongs. Sterilization time 55 minutes on the AIRVO2 is an issue before use.

The display is on the side and easy to see - while AIRVO2 is obstructed by the circuit.

Our User Interface is more friendly to use. Large LCD screen located on the side of the humidification chamber
(not behind), easily viewed and accessed.

We offer 2 circuit options

- one with a temperature sensor cable on the exterior which is for most conscious,
- second type that offers an integrated temperature sensor in a corrugated circuit.
In future we will also offer an embedded circuit with temperature sensor which has the best rainout control.
Our 3-pin circuit would be beneficial for "THRIVE" use in Anesthesia, it is the economical option yet serves the
same purpose.
Why choose inspired™ O2FLO vs AIRVO2?
We have patented Chamber provides low water sensor alarm to pre-alert staff to avoid a dry
chamber alarm

We do not infringe on any patents.

Flexicare has a water vapor expelling circuit technology, being sued by R&P right now.
Respicare copied F&P gas pathway – possible lawsuit!

Our specification is the same as AIRVO2 in terms of performance and intended use

With SD card to record and export information on device alarms and usage. Record traceable!
(Patient details will have to be manual inputted by physician after records have been exported.)
VM is a consumables manufacturer for 20+ years, makes humidification chambers, circuits, filters,
etc. for many big MNC respiratory players in the market. Our quality has been proven. Smaller
players, e.g. Respicare are new – reliability?

VM is well stocked. AIRVO2 leadtime is 120days on average BEFORE COVID-19.

Upcoming improvements of O2FLO

•Developing new and better interfaces for both Adult

& Pediatric. Launching Q3 2020.

•Transport/Battery mode to be launched in the future.

Thank you!
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