Information on LEONI 4
Information and publications on functions and operation.
Discover the latest developments and technologies for the treatment and care of premature babies and newborns. For further information and detailed study results, please refer to the comprehensive references.
NIV trigger
Synchronized breathing support for spontaneous breathing efforts.
Studies show the benefit of synchronized NIV by reducing reintubation rates, decreasing the frequency of desaturations, bradycardias and central apnea episodes.1, 2.
1 Barrington KJ, Bull D, Finer NN. Randomized trial of nasal synchronized intermittent mandatory ventilation compared with continuous positive airway pressure after extubation of very low birth weight infants. Pediatrics 2001;107:638–41.
2 Gizzi C, Montecchia F, Panetta V, et al. Is synchronized NIPPV more effective than NIPPV and NCPAP in treating Apnea of Prematurity (AOP)? A randomised crossover trial. Arch Dis Child Fetal Neonatal Ed 2015; 100: 17–23.
Nasal high-flow therapy
Effective and non-invasive respiratory support. The functional dead space is minimized. No separate tubing system required3.
3 Hess DR. Aerosol Therapy During Noninvasive Ventilation or High-Flow Nasal Cannula. Respir Care. 2015 Jun;60(6):880–91; discussion 891-893.; Kotecha SJ, Adappa R, Gupta N, Watkins WJ, Kotecha S, Chakraborty M. Safety and Efficacy of High-Flow Nasal Cannula Therapy in Preterm Infants: A Meta-analysis. Pediatrics. 2015 Sep;136(3):542–53.; Milési C, Essouri S, Pouyau R, Liet J-M, Afanetti M, Portefaix A, et al. High flow nasal cannula (HFNC) versus nasal continuous positive airway pressure (nCPAP) for the initial respiratory management of acute viral bronchiolitis in young infants: a multicentre randomized controlled trial (TRAMONTANE study). Intensive Care Med. 2017 Feb;43(2):209–16.; Nasaler Highflow – Bessere Alternative der Sauerstoffapplikation bei schwerer Hypoxie?, Jens Bräunlich, Hubert Wirtz, Dtsch Med Wochenschr 2015; 140: 1823–1826.
Ventilation performance.
Tidal volumes as low as 0.1 ml enable ventilation for even the smallest premature infants. Volume guarantee4 and volume limitation5 protect the sensitive lungs of premature and newborn babies.
4 Keszler M. State of the art in conventional mechanical ventilation. J Perinatol2009;29(4):262-75.
5 Burns KEA, et al. Pressure and volume limited ventilation for the ventilatory management of patients with acute lung injury: A systematic review and meta-analysis. PloS One. 2011;6:e14623.
Abdominal sensor
In the first few months of life, diaphragmatic or abdominal breathing is very pronounced in our smallest patients. What could be more natural than monitoring children's breathing activity at the diaphragm and using the signals gathered to trigger inhalation and exhalation? With the Löwenstein abdominal sensor, it is possible to generate reliable trigger signals for non-invasive ventilation without direct intervention in the breathing mechanics, without additional weight on the patient interface and without increasing the dead space.
Our LEONI 4 neonatal ventilator synchronizes the non-invasive ventilation modes s-nIPPV and s-nCPAP6 with the optional abdominal sensor and simultaneously functions as apnea monitoring in both ventilation modes.
6 Moretti C., et al. Synchronized Nasal Intermittent Positive Pressure Ventilation, 2021, Vol 45 (4), 745-759.
CLAC®
CLAC: Closed- Loop Automatic oxygen Control - LOOP AUTOMATIC OXYGEN CONTROL
Löwenstein has developed a unique algorithm for automated oxygen control in premature and newborn babies (CLAC: Closed-Loop Automatic Oxygen Control) and integrated it into LEONI 4. The entire operation, including the visualization of measurement data and alarm settings, is managed through the ventilator's user interface. The user can quickly assess the patient's current status through the graphically displayed overview. CLAC relieves users of the routine adjustment of inspiratory oxygen in the breathing gas (FiO2) by continuously monitoring the patient's demand and condition and adjusting the device settings accordingly.7.
Manual intervention is always possible whenever needed.
Löwenstein Medical selected Masimo SET (Signal Extraction Technology) for its "best-in-class" SpO2 algorithm performance to ensure reliable measurements under challenging monitoring conditions (low perfusion and motion artifact), which is essential for the functionality of the CLAC option.
7 Pädiatrie 2014; 133: e379-e385.