Flow-i Anesthesia Machine

Advanced anesthesia for all situations

This document is intended to provide information to an international audience outside of the US.
The power
to care

If there’s one thing you can be certain of in the OR,

it’s that a patient’s situation can change in a matter of
seconds. We live to assure that you can be prepared.

The Flow-i is a product of the designers

behind the well-known Servo ventilator
platform. The result is a next-generation
anesthesia machine with better patient
safety in an easy-to-use workstation.

The Flow-i lets you treat even your most

challenging patients. From neonates to
the morbidly obese – patients benefit
from lung-protective and cost-efficient
anesthetic care when they need it the
most.

Experience the Flow.

FLOW- I 3
Precise ventilation
when you need it most
Ventilation performance is not only about
modes. Most importantly, it’s about ensuring
the power and precision needed to ventilate
any patient.

Next-generation technology at the core

The Flow-i was created by the engineers behind the world-
class Servo ventilator platform. It is designed to deliver
set tidal volumes regardless of compliance and resistance
to handle the most complex cases – from neonates to
bariatric patients.

The innovative technology inside Flow-i ensures excellent

ventilation performance and outstanding agent efficiency
– we call it the Flow core technology.

Servo gas modules

The Servo gas modules enable ICU-quality ventilation.
They deliver up to 200 l/min inspiratory flow and are capa- Figure 1: The Flow-i Anesthesia Machine can deliver the
ble of adjusting pressure and flow constantly within every set tidal volumes even when there is high abdominal and
breath, according to each patient’s needs. thoracic pressure, thus avoiding hypoventilation.1

4 FLOW- I
 Servo gas modules
The Flow core
N2 O Electronic injection vaporizer
technology
Air

O2
CO2 absorber

Reflector
O2

APL/PEEP
valve Volume Reflector

Volume Reflector rebreathing system Electronic injection vaporizers

Our patented Volume Reflector is a smart rebreathing Electronic injection technology enables precise delivery
system. In combination with Servo gas modules, it enables of agents, primarily during the inspiratory phase, with
accurate tidal volumes down to 5 ml, providing better minimal waste. The lightweight and maintenance-free
ventilation performance compared to bellows, turbine and vaporizers can be refilled and exchanged while the
piston-operated systems1, see figure 1. machine is running, and do not require annual calibration.

The rigid Volume Reflector is never empty, ensuring A tiny miracle

uninterrupted ventilation, and compensates effectively Read the story of how a premature infant weighing only
for any leakage.2 And because it’s oxygen driven, the risk 393 g (13.9 oz) was successfully anesthetized and ventilat-
of hypoxic mixtures becomes almost impossible. The ed using a Flow-i during major abdominal surgery. Today,
Volume Reflector has a small system volume for fast she is a healthy little girl.
wash-in and wash-out and a rebreathing fraction of 98%.
www.getinge.com/393g

FLOW- I 5
 Smart tools that support
decision-making
Our close collaboration with clinicians around the
world has shaped the range of vital tools you’ll find in
the Flow family. These include innovations to automate
manual tasks, improve patient outcomes and take
safety to new levels.

6 FLOW- I
Low-flow anesthesia
the safest5 way

Active inspired O2Guard »O2Guard is the only

protects your patients
O2Guard is designed to prevent hypoxia.4 This unique
commercially active
safety mechanism overrules the clinician´s settings and
increases the flow of fresh gas and oxygen should the O2
inspired hypoxic guard
level drop below 21%. Conventional guards will only trigger
an alarm. The O2Guard is a standard feature on all Flow
available.«5
models. Learn more at www.getinge.com/o2guard.w

Agent conc.
(MAC) Agent concentration in target
Brain organ – MAC Brain guides you
Lung Due to pharmacokinetics there is a time delay in agent
concentrations between the lungs and the target organ,
Time
the brain. The unique MAC Brain tool visualizes the
difference to support better dosing and planning of agent
delivery.

Visual support when

lowering the flows
0.2 0.0
The VRI (Volume Reflector Indicator) is a useful visual VR balance
guide that enables you to optimize the rebreathing (l/min)
fraction and thus save anesthetic agent. The tool makes
it simple to set the optimal Fresh Gas Flow (FGF) and
volume ratio. Agent consumption can easily be monitored
via the interface.
Rebreathing fraction
(%) 80

FLOW- I 7
Automatic Gas Control
makes low flow easier

Automatic Gas Control (AGC) makes it simpler and safer to

deliver low-flow anesthesia with high precision. Just specify
the target end-tidal anesthetic agent level and the speed
required and AGC does the rest.

Once the target is reached, the system automatically Cost saving per year

€106,000
reduces fresh gas flow and anesthesia agent delivery to
minimal levels. Now you have precise control combined
with improved patient comfort and reduced risk of error.
since the change
to Flow-i with AGC*

“Automatic gas control on the

Maquet Flow-i reduces sevoflurane
consumption by, on average, one
third in pediatric anesthesia.”9

8 FLOW- I
 More time for your patients More efficient delivery
Parameters can be preset before the A unique real-time EtAA speed control and
patient arrives at the OR, freeing up time prediction tool makes it easy to determine
during the busy induction phase. AGC also time to end-tidal target, enabling more
eliminates the many adjustments demanded when using a efficient gas delivery. It also helps to avoid inadequate
manual approach – over 200 adjustments can be reduced depth of anesthesia.
to zero.6

Significant cost savings Reduced environmental footprint

AGC enables a major reduction in con- Greenhouse gases, such as anesthetic
sumption of expensive anesthetic agents. agents, are main drivers of climate change.
In 2015, Maria Middelares hospital in The anesthesia practice in a midsize hospi-
Belgium changed to Flow-i with AGC. The following year, tal has an environmental effect comparable to that of up
the net agent consumption was 42% lower compared to to 1,200 cars per year.8 Using AGC anesthetists can confi-
previous year. For the hospital, this has resulted in savings dently run lower gas flows to reduce the agent consump-
of over €106,000 per year in anesthetic agent expenses.7 * tion, which in turn will reduce the climate footprint.

Unique speed selection tool to help plan OR procedures

FLOW- I 9
Complex becomes routine
- easy steps to lung recruitment

Lung-protective ventilation can make a big difference

to reduce treatment-related complications and improve
patient outcome. And it is simpler than you may think.

90% affected by atelectasis

Whenever a patient is anesthetized, there is a risk of
postoperative complications caused by a collapse of the
alveoli. In fact, atelectasis affects over 90%10 of patients
undergoing surgery, regardless of gender, age, health
condition or length of surgery.

Far from being only a short-time side effect, atelectasis

90%
has been shown to persist in patients’ lungs long after
they leave the operating room.11 Patients run the risk of
inflammatory response, and the hospital’s costs can be
increased unnecessarily.
are affected by
Gentle steps against atelectasis atelectasis
Lung recruitment maneuvers have become the tool of
choice to counter atelectasis, to improve oxygenation
and help to prevent postoperative complications. What
once was considered complex and time consuming is
now seamlessly integrated into your workflow.

10 FLOW- I
EIP (End Inspiratory Pressure),
PEEP and Cdyn are presented
breath by breath in real
time for easy assessment
of compliance changes in
relation to PEEP changes.

Knowing the time to target

helps OR workflow planning.

The automatic recruitment

maneuver starts and stops
with the touch of a button.

PEEP should be programmed

to be applied at the end of
the procedure to help sustain
open lungs.

How it works
The Recruitment Manuever (RM) tool allows you to select
between automatic or manual maneuver. Whichever you
choose, the recruitment will be stepwise, with the aim of
gently opening the alveoli. »It’s simple, it’s safe and
In the automatic RM, pressure is increased stepwise for a it’s efficient, and it gives
time period set by you. EIP, PEEP and Cdyn are displayed
breath by breath in real time, making it easy to assess really good feedback in
your patients’ compliance changes and identify the opti-
mal lowest PEEP to keep the lungs open.
terms of the advantages
Trends are stored, which means you can tailor the set-
tings for each patient and also perform lung recruitment
conferring on the patient.«
manually. Dr. Martin Shields, Belfast, UK

FLOW- I 11
 Easy to capture screen
shots and record
events. Tiltable and
rotatable screen for
optimal positioning.

Configurable quick
access presets for
key functions such as
agent, oxygen and FGF
adjustments.

Designed to make
every day flow
More than just a machine, your anesthesia system is
the key to your workflow. Smart design features give
you the best possible user experience.

Easy to learn. Simple to use. Pause for full control

A user-friendly interface helps to reduce training demands The pause button stops all gas and agent flows, alarms
and minimize the risk of errors. The clear and colorful and ventilation to allow you to focus on the patient. End
touch display gives you one point of control for all func- the pause, and everything resumes from where you left off.
tions. Tools are right where you want them, so you can
work in an ergonomic and comfortable position.
Automated system check
The routine system check is made easier by an automated
workflow that requires minimal manual interactions. The
vaporizers are also included in the system check.

12 FLOW- I
See the bigger picture
– ownership with less stress
and easier flow

Minimizing your long-term costs

The purchase price is just a one part of the total cost
of owning an anesthesia machine. So we have designed
Flow-i to minimize cost of ownership. From an intuitive
interface that optimizes workflows and minimizes staff
training time, to innovations that reduce consumption of
anesthetic agents.

Getinge Care: protecting your investment

Optimizing uptime is an excellent way to boost
productivity and reduce costs. A Getinge Care service
plan ensures your equipment always performs to its full
potential, allowing you to focus on saving lives.

Smart fleet management reduces risks

We make it easy to manage a large fleet. Getinge Online
gives you fleet overview and can be accessed from any
device. Getinge Online
Getinge Online gives you access to real-time
Extensive training programs information about your Flow-i machines, e.g.
Keeping skills updated improves patient outcomes, agent consumption, running hours, next preven-
reduces risks and boosts productivity. We tailor training tive maintenance. Through the portal a service
to meet your needs, which includes e-learning in addition technician can resolve most issues remotely,
to hands-on training courses. saving time and costs.

Connectivity with MSync

MSync makes it easy to connect the Flow-i to
patient monitor, HIS and patient data manage-
ment system. Patient data is transferred via HL7
(MSync) in real time to support decision-making.

FLOW- I 13
Flow-i at a glance
Advanced anesthesia
for all situations

15” tiltable touch screen

Flexible and intuitive to use

Open architecture
Customize to match your needs

Rotatable arm
With integrated LED light

Electronic vaporizers in double slots

Fast and precise delivery of anesthetic
agents. Lightweight and possible to fill
during use. Holds 300 ml. No heating time
for Desflurane.

Multipurpose rails
Extensive mounting options

14 FLOW- I
Next-generation Flow core technology Pause function
Reduces the need for an ICU ventilator in the OR: . Temporarily stops gas flows and ventilation, giving you
. Servo gas modules deliver up to 200 l/min inspiratory time to focus on the patient.
flow and adjusts pressure and flow continiously within
every breath. Battery backup and size
. Innovative Volume Reflector rebreather ensures accu- . 90 minutes for added safety in case of power failure.
rate and precise gas delivery. . Footprint: 99 x 69 cm
. Small system volume (2.7 l) allows fast wash-in and Easy cleaning and service
wash-out, saving time and agent consumption. . Just 7 parts need to be dismantled for cleaning,
Lung recruitment (option) saving costs and supporting infection control.
. Automated and stepwise, or manual. . Preventive maintenance is optimized to reduce
. EIP, PEEP and Cdyn displayed in real time. complexity with few and easily accessible parts,
only changed every two years.
Low-flow anesthesia
. Fresh Gas Flow (FGF) limit: 0.1 l/min Low cost of ownership
. VRI (Volume Reflector Indicator) displays FGF and . Modern, easily upgradable platform.
minute volume ratio to optimize rebreathing fraction . Maintenance free components, the oxygen and flow
. Automatic Gas Control (AGC) option. sensors are non-consumptive.
. Lower anesthesic agent consumption.
Active hypoxic guard . Reduced training requirements.
. O2Guard actively intervenes when there is risk of
hypoxia, providing added safety at low flows.

Designed around your needs

Flow-i C20 Flow-i C30 Flow-i C40

2-3 drawers 1 drawer 1-2 drawers
Height adjustable Ceiling mounted

FLOW- I 15
References
1. Data from benchmarking test, data on file.
2. Lucangelo U, et al. Flow-i ventilator performance in the presence of a circle system leak.
J Clin Monit Comput. 2017 Apr;31(2):273-280
3. Brattwall, M. et al. Brief review: Theory and practice of minimal fresh gas flow anesthesia.
Can J Anaesth. 2012 Aug;59(8):785-97.
4. De Cooman, S. et al. Hypoxic guard systems do not prevent rapid hypoxic inspired
mixture formation. J Clin Monit Comput 2014, 10.1007/s10877-014-9626-y.
5. Hendrickx JF, De Wolf AM, De Hert S. O2, anybody? Eur J Anaesth 2015, 32:371–373.
Hypoxic guard systems – how safe are they? and interview with Dr Jan Hendrickx, Aalst
Belgium, MX-6295, Rev03.
6. Getinge case story MX-7418, rev01: Agent savings with Flow-i AGC at Maria Middelare
hospital, Belgium.
7. Lucangelo U, Garufi G, Marras E, et al. End-tidal versus manually-controlled low-flow
anaesthesia. J Clin Monit Comput. 2014; 28: 117-121.
8. Ryan SM, Nielsen CJ. Global Warming Potential of Inhaled Anesthetics: Application to
Clinical Use. Anesth Analg. 2010; 11: 92-98.
9. Moran, Barr, Holmes. Saving Sevoflurane: Automated gas control can reduce consumption
of anesthetic vapor by one third in pediatric anesthesia. Paediatr Anaesth. 2019 Jan 22.
10. Tusman G, Bohm SH, Warner DO, Sprung J: Atelectasis and perioperative pulmonary com
plications in highrisk patients., Curr Opin Anesthesiol 2012, Feb;25:1-10.
11. Lindberg P, Gunnarsson L, Tokics L, Secher E, Lundquist H, Brismar B, Hedenstierna G:
Atelectasis and lung function in the postoperative period, Acta Anaesthesiol Scand 1992;
36:546-53.

© Maquet Critical Care AB 2019 · Getinge Flow-i, Maquet Volume Reflector, O2Guard and AGC are trademarks by Maquet Critical Care AB · Subject to modifications · MX-0671 Rev10

Getinge is a global provider of innovative solutions for operating rooms, intensive care units, sterilization departments and
for life science companies and institutions. Based on our firsthand experience and close partnerships with clinical experts,
healthcare professionals and medtech specialists, we are improving the everyday life for people – today and tomorrow.

This document is intended to provide information to an international audience outside of the US. The assertions stated by
the physician are strictly those of the physician and do not necessarily reflect the views of Getinge. Flow-i may be pending
regulatory approvals to be marketed in your country. Contact your Getinge representative for more information.

Manufacturer · Maquet Critical Care AB · Röntgenvägen 2 SE-171 54 Solna · Sweden · +46 (0)10 335 73 00

www.getinge.com