Mindray Anesthesia Machines

[GA8314]

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Anyone have any experience with the Mindray A7's?? Or A5's??

Our hospital (corporate) system is pushing these on us. It's ridiculous. We are trying to get the GE Avance CS2's (Aisys not available to us).

I think this is a very bad idea......

 

[chocomorsel]

We have those at one hospital. Nice. Only diference is the flow dials. That part takes getting used to.

 

[Impromptu]

We use them. They are fine machines. I think they have the ability for much greater technology than our hospital has on them, since we still do paper charting.

We have one older Datex Ohmeda in the cath lab, and most of our CRNAs groan when they have to use it. I like it just as well. We have an ancient machine in the MRI suite, which seems to require a Urim and Thummim to use fully, but after much scrutiny, I can deliver good anesthesia on it, too.

 

[GA8314]

My biggest issue is not that I feel they will be junk machines.......

Look. We all "accepted" the mantra of our politicians selling various "free trade" agreements, that we'd lose some "low value added" manufacturing such as cheap toys, plastic parts (pens etc.), and other inexpensive, lower cost items. We've lost these industries (and jobs) to, typically, countries with low wage labor.

We accepted that the TRADE OFF would be a revamping of our own economy towards high tech, high value added, and manufacturing which required high skill. We were told (and told ourselves) that THESE were the types of industries which WERE indeed important. Aircraft, solar, microprocessors, high tech machine tools, information technology, medical science/equipment/biotech.....

Now, our companies (GE Datex) are faced with massive competition from companies such as Mindray (Chinese). Chinese companies are even "worse" than traditional competitors. They make NO BONES about their official policy to support their OWN domestic suppliers. Chinese governmental involvement (subsidies) can be extensive, and often can (and do) afford their companies the chance to penetrate (eventually dominate?) markets which have been hard to access (higher value added, higher skilled, higher tech, greater barrier to entry).

Weren't these the types of industries (i.e. Anesthesia Machines) which we were supposed to value?? We gave up the cheap stuff to foreign competition, but now this??? GE makes their machines right in Madison, Wisconsin.

This order will be around $7 Million when all is said and done. The Mindray machines are made in China. The GE are made in Wisconsin..... Are we becoming THAT shortsighted? The order to Wisconsin benefits MANY more Americans, their families, local economies, indeed even our OWN healthcare system as those incomes pay taxes towards SS, Medicare etc.

THIS is my issue with Mindray. Literally, the benefit of this order almost entirely goes to China. VERY LITTLE of that benefits the US economy, or American jobs.

Thoughts?

 

[BLADEMDA]

GE makes a lot of medical equipment in China these days. Hence, Mindray=GE in terms of quality but costs thousands less. FYI, I own GE stock but the company avoids paying taxes and outsourced thousands of jobs to China.

So, while I understand the reflex to buy "American" made anesthesia machines I'm suspicious that the GE machine is no more American than the iphone.

 

[pgg]

So, while I understand the reflex to buy "American" made anesthesia machines I'm suspicious that the GE machine is no more American than the iphone.

Is a Hyundai built in Alabama less American-made than a GM built in Detroit? Of course it is. Look at where the profits go.

Likewise, a GE built in China is more American than a Draeger built in Germany.

 

[BLADEMDA]

Is a Hyundai built in Alabama less American-made than a GM built in Detroit? Of course it is. Look at where the profits go.

Likewise, a GE built in China is more American than a Draeger built in Germany.

I'd buy the Draeger as it is a better machine.

 

[GA8314]

GE makes a lot of medical equipment in China these days. Hence, Mindray=GE in terms of quality but costs thousands less. FYI, I own GE stock but the company avoids paying taxes and outsourced thousands of jobs to China.

So, while I understand the reflex to buy "American" made anesthesia machines I'm suspicious that the GE machine is no more American than the iphone.

GE may have moved some manufacturing to China. But, they still make a LOT of things here.

When Mindray starts manufacturing here for the US market, I'll concede to your points.

If we don't start connecting the dots in America, we're going to be in even bigger trouble than we already are.

 

[pgg]

I'd buy the Draeger as it is a better machine.

If you don't mind elaborating, what exactly do you mean by that? Are the Draegers really that much better than the GEs? What do they do better, and what features do they have that you use?

We have Apollos where I work now. When I started residency (2006) they had just replaced all of the machines with new Apollos.

I hear they're getting ready to order 25 or 30 of the new Perseus machines to replace the Apollos. How do you feel about the US Navy spending several million dollars to buy a German company's product, when there's a US company's product that does essentially the same thing?

There are Fabius machines at one place I moonlight. At my last Navy hospital we had Aestivas.

I can't honestly say that the quality of my anesthetics varied one bit.

 

[GA8314]

Pgg, I agree.

I was reading a healthcare journal and it was stated that Mindray may be a target for acquisition by a Chinese STATE LED hedge fund. In the article it mentioned China's official policy towards favoring their own domestic suppliers of medical equipment, and how medical technology is part of the Chinese governments 5 year economic plan.

I wonder if the importance of developing those industries, and penetrating markets is enough for the Chinese government to offer robust subsidies to those companies such as Mindray (and obviously so if they were to be acquired by a state owned fund....). So much for "free trade". We are the only ones that don't seem to understand that the joke is on us.....

 

[teeva]

I thought the Drager Apollo was the best anesthesia machine until I worked at a place with the GE Advance CS2. I agree with the above, I don't think my anesthetic is any different. So I have to judge based on other things. The Advance has a nice big screen, all digital controls, and is a less unwieldy behemoth. The GE monitor is also nicer than any other system I've used.

 

[BLADEMDA]

 

[BLADEMDA]

I've tried most of all the new technology machines. IMHO, the machine I've posted above was the best machine ever made in terms of durability. It was built like a tank and would last decades without any issues.

The newer machines by GE are full of newer features like PS, PCV, PC-VG, etc and certainly aid in selecting a choice for ventilation. But, in terms of durability nothing matched the Draeger Narkomed 4.

Today, the best machine on the market is still made by Draeger. It's the BMW of anesthesia machines. GE makes the Chevrolet.

 

[BLADEMDA]

I liked the Narkomed 2C as well. That was an anesthesia machine.

 

[BLADEMDA]

Anesthesia machines are like cars. The manufacturer matters a lot less than the skill of the driver. They all get you safely from point A to Point B provided the driver is good at his job.

Now, as far as Mindray anesthesia machines go they are equivalent to GE machines but cost at least $5-10K less; that can add up to a large amount if a department is buying 20-30 machines.

Second, Draeger sells the most expensive machine on the market. Like BMW quality doesn't come cheap.

 

[BLADEMDA]

 

[BLADEMDA]

If you don't mind elaborating, what exactly do you mean by that? Are the Draegers really that much better than the GEs? What do they do better, and what features do they have that you use?

We have Apollos where I work now. When I started residency (2006) they had just replaced all of the machines with new Apollos.

I hear they're getting ready to order 25 or 30 of the new Perseus machines to replace the Apollos. How do you feel about the US Navy spending several million dollars to buy a German company's product, when there's a US company's product that does essentially the same thing?

There are Fabius machines at one place I moonlight. At my last Navy hospital we had Aestivas.

I can't honestly say that the quality of my anesthetics varied one bit.

Best anesthesia machine on the market today. Are they worth $10K more per machine over the GE? No. But, our soldiers deserve the best. If Obama can spend $500K to have lunch in NYC then what's the issue with the best anesthesia machine?

 

[pgg]

Best anesthesia machine on the market today. Are they worth $10K more per machine over the GE? No. But, our soldiers deserve the best. If Obama can spend $500K to have lunch in NYC then what's the issue with the best anesthesia machine?

The issue is that we're buying foreign goods when we have perfectly good options made here.

You acknowledge that the Drager isn't $10K better than the GE. Then why buy it? Are we just Keeping Up With The Joneses here to maintain appearances?

As for durability, I can't honestly say I've ever had a problem with a structural failure in any anesthesia machine. The only problems I can say there has ever been a pattern to, with either the Drager or GE machines, has been the EMR tied to them.

One of the reasons we originally selected the Drager Apollos was because the EMR we chose (Innovian) was also a Drager product, and it made some sense to confine support contracts to one company. Now that we're scrapping Innovian and moving to Cerner at all DOD facilities, I don't see the reason for Drager loyalty.

Now, as far as Mindray anesthesia machines go they are equivalent to GE machines but cost at least $5-10K less; that can add up to a large amount if a department is buying 20-30 machines.

So, we're about to buy 25 or 30 new Perseus machines. That adds up to a lot. It's a multimillion dollar purchase, presumably with another pile of money for installation, support, maintenance. A $10K/machine premium is several hundred thousand dollars.

Maybe that $300K premium to get the "durable" "BMW" of anesthesia machines would be better spent getting our soldiers the best in another category? Maybe echogenic block needles instead of plain ones? Maybe less pennypinching and pressure from the pharmacy when it comes to getting Great Drug A instead of Good Drug B? Maybe we should spend Obama's NYC lunch budget more wisely?

Don't you want your tax dollars spent optimally? Premiums only paid for products or services that are measurably superior to alternatives? If you were outfitting a surgicenter you had an ownership stake in, would you spend another $10K of your money in each room just to get the Roundel on the machines?

 

[deleted87051]

We have 10yr old GE's and are encountering problems such as pull handles breaking off and buttons getting sticky. Dangerous? No. Annoying? Yes. These were not issues with the old Dragers.

All the machines are great when they're brand new. But they wear at different rates. In my experience, Dragers are more ruggedly built.

 

[teeva]

BMWs aren't reliable. The analogy fails.

I used the Narkomed sometimes in residency. Even the "backup" OB room had it though it was used too much to be called just a backup room. Those machines always worked though, and the only annoying thing about them was all the whiney residents and attendings who complained about them.

 

[deleted87051]

BMWs aren't reliable. The analogy fails.

Yes and Chevy's are pretty damned nice these days. There is definitely a convergence.

 

[BLADEMDA]

BMWs aren't reliable. The analogy fails.

I used the Narkomed sometimes in residency. Even the "backup" OB room had it though it was used too much to be called just a backup room. Those machines always worked though, and the only annoying thing about them was all the whiney residents and attendings who complained about them.

"Lexus" of Anesthesia machines? Do you like that better?

 

[BLADEMDA]

Best Block needle on the market. DoD needs to "throw these in" with your Lexus Anesthesia machines.

 

[Monty Python]

I liked the Narkomed 2C as well. That was an anesthesia machine.

I loved that slick BMW-feel on the lever to switch from bag to vent (red circle), and the monitor selection thumb-wheel and confirmation trigger (yellow circle) - see attachment. I've got a decommissioned ethrane vaporizer from a 2C coverted into a desk lamp with the vaporizer dial functioning as a rheostat.

 

[norwood]

IMHO the most important difference between the older machines and the latest ones is that I can operate the older style without looking at it, much less fumbling through menus.

I want to focus on my patient, not on navigating menus. This was what bugged me back when I tried an Aisys machine.

 

[Tenerife]

Re: Mindray A/5. My former group works in multiple facilities with a mix of models and manufacturers. Several A/5s were recently purchased.

Issues with plastic parts cracking, drawers breaking, etc. Multiple service calls for problems with ventilators and electrical components. Machines down with loaners for extended period. Service was responsive but still a hassle for the anesthesia tech and OR personnel. Poor performance versus competitors in obese patients, long prone cases, and low-flow anesthetics.

Some issues were due to the OR cleaning solutions, but the performance problems were engineering.

Has caused conflict within the department because it has been decided that they must all be replaced despite being relatively new. Expensive decision.

 

[IlDestriero]

Some things are worth the higher price. Ventilators and laryngoscopes are pretty high on that list.
I don't think I'm interested in trialling the Chinese anesthesia machines.

 

[BLADEMDA]

The Germans make the best anesthesia machines.

 

[pgg]

The Germans make the best anesthesia machines.

You've asserted that s bunch of times in this thread but haven't given any actual reasons why the Drager line is functionally, clinically superior to the GE line. Just a vague statement on durability, which I can't agree with. Can you elaborate?

 

[BLADEMDA]

You've asserted that s bunch of times in this thread but haven't given any actual reasons why the Drager line is functionally, clinically superior to the GE line. Just a vague statement on durability, which I can't agree with. Can you elaborate?

The Germans make the best anesthesia machine but are they worth $10K more over the GE? No. They are perhaps worth a $2-$3K premium per machine over the GE. Now, the same logic applies to automobiles. Is one car really worth 3 times the cost over another one? nope.

This isn't an argument just a statement of my opinion on the matter. If it was my money I wouldn't spend $10k more per machine but since it is the DoD which is known for wasting millions at the blink of an eye I suspect the extra money simply doesn't matter much.

 

[IlDestriero]

I think that the E550 4matic is absolutely worth 2x a Honda Accord and easily 3 times a civic. And I'm not even a car guy.
A more interesting question would be is a 911 convertible worth 3 times a Mazda Miata or 2x a Lotus?

 

[pgg]

The Germans make the best anesthesia machine but are they worth $10K more over the GE? No. They are perhaps worth a $2-$3K premium per machine over the GE. Now, the same logic applies to automobiles. Is one car really worth 3 times the cost over another one? nope.

This isn't an argument just a statement of my opinion on the matter. If it was my money I wouldn't spend $10k more per machine but since it is the DoD which is known for wasting millions at the blink of an eye I suspect the extra money simply doesn't matter much.

You keep saying the Drager is better than the GE. What makes the Drager better than the GE?

 

[Ronin2258]

I have played with Mindray equipment on a locums assignment after training on GE/Ohmeda throughout residency.

I was very underwhelmed.

Perhaps it was because they weren't maintained well, but I couldn't get the gas flows to be accurate (I want 2L and end up with either 1.5 or 3.4...very irritating,) and the knobs would constantly stick, and I felt the thing was not a rugged machine. The digital flowmeters were not very good at keeping up with changes, the touch screens were very dicey, and there were not ventilator options I like to use. *cough*PSVPro*cough* I felt like I was working on something that some fiend kit-bashed together with his own three hands.

The last time I played with a Drager for any prolonged period was an old (at the time,) Narkomed that was being used on research animals about 10 years ago. Not a bad machine, but without comparing a more modern Drager to the GE Advance I trained on and use now, I can't make a comparison.

Personal opinion, I would go with the big two brands of Drager and GE first. They have a track record that is proven. Don't let them sell you short. The workstation is all that keeps the patient alive and going when the surgeons cut them and we poison them. Get as good as you can.

 

[risnwb]

Have both mindray and drager at current spot. Trained on the GE machines (all models). So far the mindray machines have performed well, only problem is annoying flow meters as others have mentioned. It's not that they are sticky, just that it's more difficult than it should be to get a high concentration of air or nitrous (you have to crank the nitrous all the way to the max and have the O2 barely on). The mindray machines we have a5 I believe, come with plenty of vent settings, including good pressure support and simv settings, just named differently than the GE psvpro. The mindray pressure support works better than the drager in my experience.

However, after using mindray, drager, and GE, all extensively, I have to say the GE machines have the most features, intuitive controls, and just worked best.

Also I like the option of having an accelerometer when doing a long case where I need paralysis and arms tucked, and have no access to head, and as far as I know GE is the only company that has a module for that...

 

[IlDestriero]

Isn't the accelerometer a function of the monitor and not the machine? You can have GE monitors and Drager vents.

 

[GA8314]

Fortunately, we won this battle and are getting GE Avance CS2. Not the Aisys, but our hospital system is cheap (hence the Mindray consideration).

Frankly, it's nice that this order is going to Madison Wisconsin, and not Shenzhen China.

After last weeks jobs numbers, it MUST be clear to thinking people that we ignore the importance of supporting good jobs in this country at ALL of our expense.

 

[tokenmayor]

GE anesthesia is Finland: http://www.helsinkibusinesshub.fi/wp-content/uploads/2013/08/GE-Healthcare-Finland.pdf

GE appliances are no longer owned by GE, just use the brand: China's Haier buys General Electric's appliance unit for $5.4 billion

GE is moving plants out of US to save money: GE closing plant in Waukesha, moving 300-plus jobs to Canada, and workers aren’t happy

 

[dannyboy1]

if it can vaporize gas and has a working ventilator then its good enough for me.......

 

[BLADEMDA]

The mindray Anesthesia machines seem to be pretty decent "copies" of the GE version. I'm hearing they cost 30% less per machine.

The Video below was from 2011.

 

[BLADEMDA]

Again, this machine is 30-40% less money than a comparable GE anesthesia machine:

 

[BLADEMDA]

 

[Aether2000]

Administering anesthesia at several hospitals and 8 surgery centers, I see many of these amazing machines. They all have their idiosyncrasies, are fundamentally better in airway monitoring compared to older machines, but have incessant alarms that continue to chirp in the OR prior to the patient's entry. I trained in residency on a Narkomed 2A, old Ohio Unitrol and Modulus I machines, and Ohio 30/70 Proportionator machines, without pulse oximetry or gas analyzers. Some of the machines had ETCO2 add-on free standing units. We were expected to keep one hand on the patient's temporal pulse during most of the case. I much prefer today's anesthesia machines and techniques.

 

[anbuitachi]

the question is, where would this 10k /machine saved go? to the administrators pocket?

 

[BLADEMDA]

the question is, where would this 10k /machine saved go? to the administrators pocket?

Regardless of where the savings will go the Mindray machine is an equivalent substitute for the GE Machine. Maybe, one can ask for the top of the line Mindray vs a basic GE machine which still results in cost savings while delivering a top of the line machine to the anesthesia dept.

 

[norwood]

Regardless of where the savings will go the Mindray machine is an equivalent substitute for the GE Machine. Maybe, one can ask for the top of the line Mindray vs a basic GE machine which still results in cost savings while delivering a top of the line machine to the anesthesia dept.

 

[RussianJoo]

this machine is garbage, our hospital bought them because they're like half the price of the GE machines. you can't change the frequency of the bp cuff cycling while it's cycling. Also zeroing the A-line is a special process, you can't see inspiratory vs expiratory tidal volumes so you can't tell how big of leak there is after a thoracotomy. And a few other glitches/issues.

 

[risnwb]

My former hospital bought them. Hated the machines. Glad to be back to GE at my current job.


Sent from my iPhone using SDN mobile

 

[BLADEMDA]

this machine is garbage, our hospital bought them because they're like half the price of the GE machines. you can't change the frequency of the bp cuff cycling while it's cycling. Also zeroing the A-line is a special process, you can't see inspiratory vs expiratory tidal volumes so you can't tell how big of leak there is after a thoracotomy. And a few other glitches/issues.

Well, I'm not advocating that all of your anesthesia machines be from Mindray but why not 1/2? That's a substantial savings for the hospital. I can see not wanting all your anesthesia machines to be Mindrays but as a routine machine they work just fine. I'm not a fan of Chinese made anything but I think the Mindrays at 1/2 the price of GE do have place in a busy O.R.

 

[GA8314]

The issue is that we're buying foreign goods when we have perfectly good options made here.

You acknowledge that the Drager isn't $10K better than the GE. Then why buy it? Are we just Keeping Up With The Joneses here to maintain appearances?

As for durability, I can't honestly say I've ever had a problem with a structural failure in any anesthesia machine. The only problems I can say there has ever been a pattern to, with either the Drager or GE machines, has been the EMR tied to them.

One of the reasons we originally selected the Drager Apollos was because the EMR we chose (Innovian) was also a Drager product, and it made some sense to confine support contracts to one company. Now that we're scrapping Innovian and moving to Cerner at all DOD facilities, I don't see the reason for Drager loyalty.




So, we're about to buy 25 or 30 new Perseus machines. That adds up to a lot. It's a multimillion dollar purchase, presumably with another pile of money for installation, support, maintenance. A $10K/machine premium is several hundred thousand dollars.

Maybe that $300K premium to get the "durable" "BMW" of anesthesia machines would be better spent getting our soldiers the best in another category? Maybe echogenic block needles instead of plain ones? Maybe less pennypinching and pressure from the pharmacy when it comes to getting Great Drug A instead of Good Drug B? Maybe we should spend Obama's NYC lunch budget more wisely?

Don't you want your tax dollars spent optimally? Premiums only paid for products or services that are measurably superior to alternatives? If you were outfitting a surgicenter you had an ownership stake in, would you spend another $10K of your money in each room just to get the Roundel on the machines?

Pgg, I've always respected your views. If you have any influence, consider strongly the bigger picture (which your prior post suggests you already are) in terms of supporting GE in Madison Wisconsin, versus some German company or most definitely some state backed Chinese quasi-communist/capitalist company (Mindray).

 

[GA8314]

Well, I'm not advocating that all of your anesthesia machines be from Mindray but why not 1/2? That's a substantial savings for the hospital. I can see not wanting all your anesthesia machines to be Mindrays but as a routine machine they work just fine. I'm not a fan of Chinese made anything but I think the Mindrays at 1/2 the price of GE do have place in a busy O.R.

Come on Blade. They are 1/2 the price BECAUSE they are supported by the Chinese state, they pay their workers shi.t, and their labor laws are like something from the Industrial Revolution in England....... What do you expect.

In fact, this is a CASE STUDY in why our trade agreements need a serious reevaluation.