Drager Apollo tips

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.

Monty Python

Full Member
15+ Year Member
Joined
Apr 5, 2005
Messages
1,507
Reaction score
337
Just found out our GE Aestivas will be replaced next month with Drager Apollos. Anyone familiar with that model have any experienced hints or tips? Thanks.

Members don't see this ad.
 
Our VA has them. To be honest, I really didn't experiment too much with them, but they are fancy and I don't remember having too much trouble learning how to use them. They seem like good machines. I don't remember ever having any catastrophic problems with them that put patient safety at risk. Sorry that probably isn't too helpful, but the bottom line is that you should adjust fairly easily, and once you get the hang of some of the more advanced features, you may end up really liking them.
 
Most important tip- your EtCO2 won't show up on your monitor unless the vent/screen is turned on.

Had that happen in a MAC case where I went through a number of nasal cannulas and water traps in hopes of getting EtCO2 to show, but it turned out you have to take the Apollo out of standby.

They also have this gauge that shows how efficient or inefficient your gas usage was. Didn't make much sense to me, but you might like it.
 
Members don't see this ad :)
I have almost all Apollos, and one Fabius at work. Overall, I like the Apollo, it does what I want and has a few nifty bits of programming options. My biggest problem with the model is that I cannot fix problems when they occur, as everything is internal.
 
I love the apollos, they're great machines, they have a quick automated machine check. It's easy to dial in and make changes changes quickly.

As someone mentioned, you have take it out of standby to run ETCO2, so I just turn the main gas O2 valve to 0.2 LPM and use the auxiliary O2 for the nasal cannula.

The gas efficiency meter is there so you don't waste gasses/volatiles. You can fine tune your flows to exactly what the pt needs. It's a piston based ventilator so your bag will remain in line even when you switch from manual to the vent.

You can also look at real time flow/volume loops which is pretty neat especially if you're teaching med students or AA's.
 
  • Like
Reactions: 1 users
I've never figured out the gas efficiency algorithm the Apollo uses. I ignore that feature.

I routinely run very low flows (0.3-0.4 lpm of fresh gas and it ALWAYS tells me I need to run more. That bar will be an angry red for hours and hours and yet my patients don't die.

They're nice machines. I'm not sure they're worth the big $premium over other options though.
 
  • Like
Reactions: 1 user
I've never figured out the gas efficiency algorithm the Apollo uses. I ignore that feature.

I routinely run very low flows (0.3-0.4 lpm of fresh gas and it ALWAYS tells me I need to run more. That bar will be an angry red for hours and hours and yet my patients don't die.

They're nice machines. I'm not sure they're worth the big $premium over other options though.

Same with me, my bar is usually red as well and the bag almost never completely collapses. I was referring to excess flows, I would think it could serve as a reminder that nothing bad will happen if you don't run 2-4 LPM like some people do.
 
Solid machines. 21 machines for a few years, near zero down time. A couple had sticking oxygen knobs after about a year, the rest have been fine.

If you choose to use the automatic settings for tidal volume based on weight, remember to use the ideal body weight, as otherwise you can give some massive breaths before you see the setting.

Overall I like them, but wish they had that nice toggle switch to turn on the ventilator like the old ones had.
 
They're good machines. Call me old school, but I actually prefer machines with bellows.
 
Most important tip- your EtCO2 won't show up on your monitor unless the vent/screen is turned on.

Had that happen in a MAC case where I went through a number of nasal cannulas and water traps in hopes of getting EtCO2 to show, but it turned out you have to take the Apollo out of standby.

They also have this gauge that shows how efficient or inefficient your gas usage was. Didn't make much sense to me, but you might like it.

If the Apollo has the recent software upgrade, there is a "monitor mode" you can select from one of the right tabs while in standby. Allows you to monitor ETCO2 without running any flows.
 
  • Like
Reactions: 2 users
I've never figured out the gas efficiency algorithm the Apollo uses. I ignore that feature.

As I understand it there's flow sensors in both the inspiratory and expiratory limbs and it compares the two to calculate the leak on each breath - over a minute of breaths you then have the leak per minute and that's your minimum flow. I've often found that you can sit in the red and be ok though so it might overestimate a bit.
 
I turn off the fake breathing/ventilation sound every case. It's damn annoying,
 
  • Like
Reactions: 1 user
Members don't see this ad :)
I turn off the fake breathing/ventilation sound every case. It's damn annoying,

In residency if the med students or residents were jacking around taking forever to close, I'd turn it all the way up to annoy them.
 
  • Like
Reactions: 3 users
I turn off the fake breathing/ventilation sound every case. It's damn annoying,

You can change the machine setting to have it off to begin with.
I turn it on only when I am giving a break during bypass, scares the crap out of my older partner.
 
Last edited:
  • Like
Reactions: 5 users
I like the Apollo. Very easy to use. If you put in age and weight you get an estimated mac level and starting vent settings. For really obese patients the Vt can be high but otherwise no issues.
 
  • Like
Reactions: 1 user
Do any of you guys use the apollo machine for cardiac cases? There were concerns in the past about ventilation problems where I'm at so we use aestiva machines in our heart rooms. I've never used them for heart cases and wondering what you guys experiences are with them.
 
Do any of you guys use the apollo machine for cardiac cases? There were concerns in the past about ventilation problems where I'm at so we use aestiva machines in our heart rooms. I've never used them for heart cases and wondering what you guys experiences are with them.

We used them in residency for hearts. Didn't have any problems. I'd set it to bypass mode when on pump, then resume normal vent functions/monitoring when coming off pump. What specific problems have they had at your place?
 
  • Like
Reactions: 1 users
We use the Apollo on hearts several times a week, and haven't run into issues with ventilation, nor have I ever heard of this before.

Sent from my SM-G920V using SDN mobile app
 
I turn off the fake breathing/ventilation sound every case. It's damn annoying,

902320-product-thumb1.jpg


Search your feelings teeva... you know it to be true.
 
  • Like
Reactions: 2 users
Do any of you guys use the apollo machine for cardiac cases? There were concerns in the past about ventilation problems where I'm at so we use aestiva machines in our heart rooms. I've never used them for heart cases and wondering what you guys experiences are with them.

Been using them for cardiac cases for a long long time.
Prolly 8- 10 years.
No problems.
I like them. :thumbup:
 
  • Like
Reactions: 1 user
Love these machines.

Love the Volume AF mode
Love the Darth Vader breathing noise
Love the MAC autocalculation based on age

One caveat, if you use PEEP it will give you an "apnea pressure" or "continuous" pressure alarm that is related to the end-expiratory pressure being above the "low pressure" limit. A twiddle of the knows or press of the "Auto Set Limits" button will fix it.
 
I think they're extremely well made and full featured machines (the German's can engineer anything). Unfortunately they've also got German ergonomics. Aside from the vaporizers on the left which I actually like, that machine is so user unfriendly. The drawers are hard to get to recessed under the desktop (I know its movable but there's always a computer or wall or something in the way), and it drives me nuts that you have to hit 2 buttons to switch from Vent to Spontaneous instead of just flipping a lever.

It's like the BMW iDrive of anesthesia machines.
 
  • Like
Reactions: 1 user
Do any of you guys use the apollo machine for cardiac cases? There were concerns in the past about ventilation problems where I'm at so we use aestiva machines in our heart rooms. I've never used them for heart cases and wondering what you guys experiences are with them.

We use one on our Pedi hearts where I am. The only problem I've picked up on that may pertain to ventilation and hearts, is switching to manual takes a few seconds after after confirming manual. Which could be a problem when trying to get the "lungs down," unless you disconnect the circuit. Otherwise, I don't have any issues with it.
 
I like the Apollo. Very easy to use. If you put in age and weight you get an estimated mac level and starting vent settings. For really obese patients the Vt can be high but otherwise no issues.
Yeah, that feature should really read "ideal body weight" as that's what you should base your Vt on anyways. Where I work, putting in actual body weight will lead to a preset tidal volume wayyyy above 8cc/kg IBW
 
We use one on our Pedi hearts where I am. The only problem I've picked up on that may pertain to ventilation and hearts, is switching to manual takes a few seconds after after confirming manual. Which could be a problem when trying to get the "lungs down," unless you disconnect the circuit. Otherwise, I don't have any issues with it.

Yes, definitely just disconnect the tubing for sternal saw time. Saves you from forgetting to turn pop off valve down too.
A switch would have been nice.
 
I like the Apollo. Very easy to use. If you put in age and weight you get an estimated mac level and starting vent settings. For really obese patients the Vt can be high but otherwise no issues.

The weight is for Ideal Body Weight. If you put in the weight in standby mode it does say IBW. If you input the weight while the ventilator is working, it doesn't say IBW, IIRC. It usually gives a default TV of a little over 8 mL/kg IBW. Many people don't realize this and put in actual body weight.
 
We used them in residency for hearts. Didn't have any problems. I'd set it to bypass mode when on pump, then resume normal vent functions/monitoring when coming off pump. What specific problems have they had at your place?


This was before I was here, but when the Apollo fist came out there were issues with them shutting down and they didn't want to deal with that mid cards case. Also any issues that need to be addressed (i.e. Flow sensor), would require ceasing ventilation and a reboot of the system. Not saying this can't happen during a lap appy, but they didn't want to risk it for a heart case, so we use the aestiva machines in the heart rooms.
 
Top