FCV ® technology a unique mode of optimising and meticulously control gas flow throughout the ventilation cycle, minimizing mechanical impact on patients lungs and providing lung protecting ventilation at its best.

In 1952 the polio epidemic in Denmark triggered a paradigm shift in artificial ventilation. Iron lungs were abandoned in favor of Positive Pressure Ventilation. During the following decades the underlying concept of Positive Pressure Ventilation was never questioned.

Today after 70 years of struggling with the limitations and sometimes fatal consequences of conventional positive pressure ventilation it is time for another paradigm shift based on physics and physiology.

Our new one-of-a-kind ventilator carefully designed and built to also be precise measurement tool, allows the clinician to perfectly adapt the ventilation to the individual needs for the patient. It implements FCV® a unique mode of optimising and meticulously control gas flow throughout the ventilation cycle, minimizing mechanical impact on patients lungs and providing lung protecting ventilation at its best.

We can ventilate so much better.

Professor Dr. D. Enk, MD, PhD.
Inventor | Anesthesiologist. Intensivist.

  • FCV® technology creates a stable gas flow during inspiration followed by a unique active gas flow control during expiration. Flow Controlled Ventilation.
  • FCV® technology maintains a fully dynamic flow, without pauses, with linear changes in both volume and pressure. There are no sudden drops in intrathoracic pressure due to the unique active controlled expiration.
  • Unlike conventional ventilators (“inspiration assist devices “) relying on a passive expiration, FCV® technology provides a Fully Controlled Ventilation (100% of the ventilation cycle)
  • FCV® is a more efficient ventilation as compared to conventional modes, allows ventilation through small lumens (~2 mm ID) and results in less energy dissipation in the lungs.

Patient ventilation with minimal impact and maximal control


Small Lumen

Ultrathin cuffed endotracheal tube : Tritube®

FCV® enables ventilation through ultrathin cuffed endotracheal tube Tritube® (O.D. 4.4 mm) . It provides numerous new possibilities for difficult airway (expected or unexpected) and shared airways during Head and Neck surgical procedures.

Benefits of Small lumen

Higher Efficiency

Conventional ventilation uses relatively high gas flows, requiring high pressure to reach obstructive lung parts. With FCV® lower flows are used that range typically between 8 and 16 L/Min to adequately ventilate a patient. At lower flows , gas is better able to reach the lung units that have higher resistance and the dependent lung parts that have better perfusion.

A passive expiration results in an abrupt deflation especially in the low compliant lung units. By controlling the expiration flow, FCV® mantains airway pressure and keeps gas flowing in the alveoli longer. Thus, FCV® can avoid or delay airway and alveaolar collapse, and thereby avoid atelectasis while improving gas exchange.

Together, FCV® results in a higher efficient ventilation as compared to conventional ventilation techniques. These properties of FCV® have been demonstrated in multiple scientific studies.

Benefits of Higher Efficiency

Better lung recruitment at higher efficiency

Lower Energy

Conventional mechanical ventilation generates more power than is needed to induce inspiration and expiration. The net overspill of energy is dissipated in the lungs, which has been shown even when applied for only a few hours to be a source of lung injury, so-called ‘ventilator-induced lung injury’ (VILI).

Recently, clear theoretical evidence was provided for lower energy dissipation in the lungs by FCV® as compared to VCV or PCV. A relatively simple analysis and numerical calculations indicated that energy dissipation is minimized by controlling the ventilation flow to be constant and continuous during both inspiration and expiration, and by ventilating at an I:E ratio close to 1:1. In other words, by using FCV®

Energy dissipation can be calculated from the hysteresis area of pressure-volume loops obtained during ventilation. PV loops calculated based on routine ventilation protocols showed a 53% reduction in energy dissipation by FCV® as compared to PCV and a 32% reduction as compared to VCV.

Additionally, it was emphasized that accurate measurement of intratracheal pressures is crucial for calculating energy dissipation. Where other VCV and PCV ventilators rely on calculated airway pressures, Evone is the only device that actually measures intratracheal pressures and is thus capable of measuring energy dissipation accurately.

This theory was further validated on a patient. Pressure-volume (PV) loops were recorded in real time, and the energy dissipated in the patient’s lungs was calculated from the hysteresis area of the PV loops. Strikingly, the energy dissipation was just 0.17 J/L, which is even lower than values reported for spontaneous breathing (0.2–0.7 J/L)

Benefits of Lower Energy

Left: Idealized PV loops (the enclosed area of each loop is the dissipated energy) during PCV (red line), VCV (blue line) and FCV® (blue line during inspiration, green line during expiration). The dashed line is the static compliance curve of the lung/chest system in this example.

right: Real-time measured PV loops of a patient ventilated with FCV® demonstrating minimized hysteresis area of the PV loops (=energy dissipation). (Adopted from Barnes and Enk, TACC 2019 24 )

Stained lung tissue samples retrieved after VCV or FCV® ventilation of ARDS pigs, revealing less thickening of alveolar walls in FCV® group, cell infiltration was lower, and surfactant protein A concentration was higher in the FCV® group, indicating the potential for FCV® to attenuate lung injury and to provide lung-protective effects.(Adapted from Schmidt et al. 2020 10)

FCV technology®  | BENEFITS

The following benefits as compared to volume controlled ventilation (VCV) and pressure controlled ventilation (PCV) may be expected while ventilating patients in FCV® mode:

Small lumen ventilation

Improved lung recruitment and less atelectasis 1–4

Higher ventilation efficiency (oxygenation and
CO2 removal) 2–4,6

Lower energy dissipation in the lungs 3,7,8

“The dissipated energy is minimal with this FCV technology.”

Prof. emer. Tom Barnes
Fellow of the Institute of Physics, London, UK

“Tritube makes it much easier for me to work in difficult airways.”

Dr. Hans Mahieu
Med. Laryngologist, Meander Amersfoort Hospital

“FCV technology keeps lung access in a smooth way.”

Dr. med. Dietmar Enk
Inventor/Anesthesiologist/Intensivist, University Münster,