The new standard for Resting Energy Expenditure

The new standard for Resting Energy Expenditure
Technical Specifications
• Ashcraft C.M. et al. “A Test of Validity of a New OpenCircuit Indirect Calorimeter. “ J Parenter Enteral Nutr. 2014
Mar 10
• Sundström M et al. “Indirect calorimetry in mechanically
ventilated patients. A systematic comparison of three
instruments. “ J. Clin Nutr. 2013 Feb;32(1):118-21
• Blond E. et al. “A new indirect calorimeter is accurate and
reliable for measuring basal energy expenditure, thermic
effect of food and substrate oxidation in obese and health
“ e-SPEN e-Journal of Clinical Nutrition and Metabolism 6
(2011) e7ee15
• More scientific studies on
www.cosmed.com/bibliography
Product
Quark RMR
Standard packaging
Standard Tests
Indirect Calorimetry
Flowmeter
Type
Flow Range
Accuracy
Resistance
Visualization resolution
Gas Analyzers
Type
Range
Accuracy
Response time
Hardware
Dimensions & weight
Interface ports
Electrical requirements
Internal emergency battery
Environmental conditions
Software
Available languages
PC Configuration
Modules
ICU kit for vent Patients
Mixing Chamber
Accessories & Options
Gas Calibration Kit
Pulse Oximetry
Ethanol Burning Kit
Medical Cart
Resting Energy Expenditure (REE, RMR), w/ canopy hhood, face mask or mouthpiecesantibacterial filter, Respiratory Quotient (RQ), Substrates Analysis (%FAT, %PRO, %CHO)
Turbine Ø-18mm (Canopy/Mask)
Flow-REE (ICU) - Optional
Bidirectional Digital Turbine
Disposable PNT (Lilly)
0-8 l/s
0-1,7 l/s
± 2% or 20 ml/s (flow) ± 2% or 100 ml/
±2%
min (ventil.)
<2,35 cmH2O/l/s @ 1 l/s
<0.27 cmH2O/l/s @ 1 l/s
4 ml/s
1 ml/s
O2
CO2
Paramagnetic
NDIR
0-100% (Standard 0-30% - ICU 0-70% - or 0-10%
user defined)
± 0.02 %
± 0.02 %
100 ms
100 ms
Unit: 17 x 30 x 45 cm/8 Kg Canopy: 32 x 50 x 30 cm/0.6 Kg
USB A-B, RS-232, HR-TTL, SpO2
100-240V ± 10% 50/60 Hz
12V; 1,2 Ah
Temperature 0-50 °C (32 - 122 °F); Barometer 400-800 mmHg; Humidity 0-100%
OMNIA
Italian, English, Spanish, French, German, Portuguese, Greek, Dutch, Turkish, Russian,
Chinese (Traditional), Chinese (Simplified), Korean, Romanian, Polish, Czech, Norwegian
I3 or higher processor speed. Compatible with Windows 7, 8, 8.1, 10 (32 or 64 bit). RAM
4GB (8GB recommended). HD with 4GB of free space (plus tools)
Description
REF
Allowing Quark RMR measurement of REE in patients
C03610-01-11
undergoing mechanically assisted ventilation.
7 liters Mixing Chamber (physical)
C03261-01-11
Description
REF
Gas cylinder required for O2/CO2 calibration (16% O2, 5% CO2,
A-860-000-004 (Gas)
N2 bal) and a pressure regulator
A-870-150-005 (Regul.)
Oximeter (Xpod) requires probe
C02600-01-05
Oximeter ipod (w/ finger probe)
C02390-01-05
Kit consists of a glass ampoule for the verification of
C03471-01-11
respiratory quotient
Medical-graded with isolation transformer (according to
C03550-01-04 (230VAC)
MDD directive). Designed to hold the whole equipment
C03550-02-04 (120VAC)
during bedside applications.
Safety & Quality Standards
MDD (93/42 EEC); FDA 510(k); EN 60601-1 (safety) / EN 60601-1-2 (EMC)
COSMED Srl
To know more:
Via dei Piani di Monte Savello 37
Albano Laziale - Rome 00041, Italy
+39 (06) 931-5492 Phone
+39 (06) 931-4580 Fax
[email protected] | cosmed.com
IIndirect
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Description
REF
Indirect Calorimetry Laboratory
C09074-01-99
Quark RMR unit, Canopy hood (with veil), Turbine Flowmeter (2 pcs.) w/ sampling line,
antibacterial filters, OMNIA PC software, calibration syringe, HR monitor (receiver and
transmitter), power supply cable, USB cable, user manual
The new standard for Resting Energy Expenditure
measurement in research and clinical practice
Calories, you can’t
manage what you
don’t measure
© 2015/08 COSMED E & OE. Subject to alterations without prior notice. REF C03098-02-93
Validation articles
“
Quark RMR was demonstrated to be unbiased, precise, reproducible,
and accurate device for measuring energy expenditure
(1)
I
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Measurement of Resting Energy
Expenditure (REE) & substrates
REE by dilution with canopy
REE breath by breath by face mask
Optional kit for measuring REE in
mechanically assisted patients
Suitable for patients above 15kg of
weight
Independent validated on
spontaneously breathing subjects and
on mechanically ventilated patients
REE on mechanically ventilated patients Data Management & Software
Options
The optional ICU module for Quark RMR
allows the integration with the ventilator for
the measurement of REE in patients undergoing mechanically assisted ventilation in
intensive care units. The module is extremely
versatile allowing two different set-ups
according to specific testing requirements.
■
Exercise Testing Kit. With the optional CPET
(Cardio Pulmonary Exercise Testing)
module users can perfom full exercise
protocols to measure VO2 and VCO2 up
to maximal effort.
■
Ethanol burning kit. It consists of a lamp,
Quark RMR is a modern device suitable both
for research and clinical applications. By
measuring REE and providing the correct
energy balance in critically ill patients,
hospital may improve patient outcome, and
decrease the length of hospitalization which
will have a significant and immediate impact
on hospital bottom line. Scientific evidence
highlights that negative energy balances are
correlated with increasing number of complications, particularly infections.(2)
Quark RMR accuracy and reliability have been
validated against Gold Standard methods
either with spontaneously breathing subjects
and with mechanically assisted patients.
■
Easy-to-use beautifully designed touchscreen (native) graphic user interface
with intuitive workflow and hierarchy.
■
Manage/display data and plots via
Dashboards (default and user defined).
■
Select and define charts, data and
widgets.
■
Powerful chart creation (up to 4 Y axis
and one X axe) with full control on
settings.
■
Change blower settings directly from
dedicated widget.
■
Select time interval to display averaged
parameters (REE, RQ, variability, etc.)
both in real time and in post analysis.
■
Designed to work with both standard
PC and tablets.
■
SQL Database allowing virtually unlimited records and data safety.
■
Full Network Database Management
(optional). OMNIA allows installations in
complex Server/Client environments.
■
Multi-users access rights management (Principal Investigator, Physician,
Technician, Administrator…) with event
logging.
In-line Measurement within Patient’s Circuit
■
Disposable low-flow range PNT
flowmeter (Flow-REE) inserted at the
patient’s circuit
■
“Breath by breath” gas sampling
through a line connected proximally to
the Y-piece of the ventilator tubing
■
Inspiratory and expiratory phases
directly measured by the flowmeter
■
All parts are single patient, no need for
cleaning and disinfecting
■
FiO2 ≤ 70%
■
Independent from type of ventilator in
use
External Flow Measurement by Ventilator’s outlet
■
Patient minute ventilation measured by
a turbine flowmeter connected to the
expiratory port of the ventilator
■
“Breath by breath” gas sampling
through a line connected proximally to
the Y-piece of the ventilator tubing
■
The Quark RMR is a compact bed-side indirect
calorimetry solution designed to allow accurate and instantaneous estimation of Resting
Energy Expenditure (REE) and respiratory
ratio (R), in a non-invasive way, through the
measurement of oxygen consumption (VO2),
carbon dioxide production (VCO2), together
with other ventilatory parameters, and metabolism substrate utilization (%FAT, %PRO,
%CHO). Quark RMR allows thus improved
nutrition support and accurate planning of
nutritional therapies.
Quark RMR comes with the OMNIA Metabolic Module, the new software designed
by COSMED. Compatible with the entire
COSMED product range, OMNIA allows the
user to operate complex equipment without
requiring long learning paths.
Design
■
Latest technology in gas analyzers: paramagnetic, stable and durable for the
O2; rapid infrared for the CO2. Both
analyzers are reliable and do not need
maintenance for long periods.
■
Flowmeters (disposable pneumotach and multi-use
turbine) guarantee great accuracy on the
different measurement modes (canopy,
mask and through mechanical ventilation).
■
Quick and user-friendly calibration procedures guarantee accurate measurements either on
flow/volume (using the 3-liter calibration syringe) and gas concentration.
■
REE by dilution with Canopy Hood
The Quark RMR is supplied with a dilution
helmet for the measurement of the expiratory
flow of patients with spontaneous breathing.
This method does not require a mouthpiece
or facemask and is more comfortable for
obese patients. Gas is sampled at the expiratory port through a sampling line, while
the ventilation is measured by a turbine.
The ventilation output of the helmet is
easily regulated in order to maintain the CO2
expired fraction (FeCO2) within a prefixed
range of values.
■
Bidirectional digital turbine flowmeter
(reusable).
■
“Bubble” canopy hood (18,7 L) with
removable blanket.
■
Integrated canopy blower pump inside
the main unit (selectable flow rate).
■
Internal emergency battery with acustic
alarms.
■
Optional canopy hood kit for pediatric
use (15-30 kg).
Ideal for bed-side applications Quark RMR
compact dimensions and the optional
medical graded cart configuration,
make it the ideal choice for bed-side
applications.
■
REE on spontaneously breathing subjects
Powered by OMNIA software innovative user
interface, touch screen ready, easy-touse and self-explanatory.
Software allows users to detect the “Bias
Flow” and identifies the inspiratory and
expiratory phases with the use of an
algorithm based on flow and expiratory
CO2 analysis
■
Easy and less invasive set-up
■
Lower costs with less consumables
■
Compatible with most of ventilators in
the market
■
parts and connectors to be connected
to the Quark RMR. Burning ethanol
generates a predictable ratio of VO2
and VCO2 and it can be used to verify
the Quark RMR accuracy of Respiratory
Quotient measurement.
Disposable flowmeter (Flow-REE) inserted at
patient’s circuit during testing in ICU settings
Compatible with Win 7,8, 8.1, 10 (32/64).
Mac OS compatibility when installed in
Virtual PC OS (Parallel, VMware).
Alternatively to the canopy hood, REE can also be
measured on spontaneously breathing subjects
using a multi-use silicone face mask (5 sizes available)
REE breath by breath by Face Mask
(1)
Ashcraft C.M. et al. “A Test of Validity of a New Open-Circuit
Indirect Calorimeter. “ J Parenter Enteral Nutr. 2014 Mar 10
(2)
Villet S et al “Negative impact of hypocaloric feeding and
energy balance on clinical outcome in ICU patients” Clin
Nutr. 2005 Aug;24(4):502-9.
In addition to canopy, Quark RMR allows
“breath-by-breath” gas exchange analysis by
using multi-use silicone face masks (available
in 5 sizes: 3 adult, 2 pediatric), or, alternatively, with mouthpiece and AB filter.
An alternative test method connects the turbine
directly with a mouthpiece and an antibacterial filter
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