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Treaton MV200, User Manual

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Appendix 1.5 Description of BiSTEP mode 

 

App.1-7 

 

 

Figure App. 1.6 – Airway pressure curve 

The  difference  is  that  any  spontaneous  breath  in  the  low  or  high  pressure  phase  is supported 
with the pressure. 

At the inverse ratio of high and low pressure phases, Thigh/Tlow<1, the operation of device ap-
proximates to the APRV mode: 

 

Figure App. 1.7 – The operation of device is approaching to the APRV mode 

 

P(t) 

PS 

Phigh 

Plow 

Tlow 

Thigh 

P(t) 

PS 

Phigh 

Plow 

Tlow 

Thigh 

Summary of Contents for MV200

Page 1: ...4th edition 12 2016 I IN NT TE EN NS SI IV VE E C CA AR RE E V VE EN NT TI IL LA AT TO OR R MV200 U US SE ER R M MA AN NU UA AL L TESM 941144 001 01 UM 2nd edition 10 2019 ...

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Page 3: ... 1 Preparing of the device and accessories 3 4 3 3 2 Installation of the electronic unit and the supporting arm 3 4 3 3 3 Installation of humidifier 3 6 3 3 4 Assembling of the breathing circuit 3 7 3 3 5 Connecting to the oxygen source 3 11 3 4 Device turning on and off 3 14 3 5 Cleaning disinfection and sterilization 3 16 3 5 1 Cleaning disinfection of external parts and non sterilized component...

Page 4: ...lation parameters 4 22 4 8 2 Menu of apnea parameters 4 24 4 8 3 Menu of iSV mode parameters 4 25 4 8 4 Menu of Pmax Tinsp limits 4 25 4 9 Setting of the type of inspiration trigger 4 26 4 10 Automatic calibration of the oxygen sensor 4 27 4 11 Additional functions 4 28 4 11 1 Alveolar recruitment maneuver 4 28 4 11 2 Oxygenation 4 30 4 11 3 Suction 4 30 4 11 4 Standby mode 4 31 4 11 5 Leak compen...

Page 5: ...69 4 19 Features of using antibacterial and heat and moisture exchange filters 4 71 4 20 Nebulizer 4 72 4 21 Open valve function 4 75 5 OPTIONAL FEATURES OF THE DEVICE 5 1 5 1 Mainstream CO2 sensor capnometer 5 1 5 2 Volume capnometry 5 5 5 3 Cardiac output by Fick 5 7 5 4 Pulse oximetry module 5 9 5 5 Metabolism measurement module 5 14 5 6 Compensation of endotracheal tube resistance 5 19 5 7 Aux...

Page 6: ... 1 1 Appendix 1 1 Description of CMV VCV mode App 1 1 Appendix 1 2 Description of CMV PCV mode App 1 2 Appendix 1 3 Description of SIMV VC SIMV PC SIMV DC modes App 1 3 Appendix 1 4 Description of CPAP PS mode App 1 4 Appendix 1 5 Description of BiSTEP mode App 1 5 Appendix 1 6 Description of NIV mode App 1 8 Appendix 1 7 Description of APRV mode App 1 9 Appendix 1 8 Description of PCV VG mode App...

Page 7: ...2 AutoPEEP App 2 1 Appendix 2 3 Mean pressure in the circuit for the respiratory cycle Pmean App 2 2 Appendix 2 4 Time constant of the respiratory tract τexp τinsp App 2 3 Appendix 2 5 Work of breathing WOB App 2 4 Appendix 2 6 Rapid shallow breathing index RSBI App 2 5 Appendix 2 7 Stress index SI App 2 5 Appendix 2 9 Ideal body weight of the patient IBW App 2 8 APPENDIX 3 ELECTROMAGNETIC ENVIRON...

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Page 9: ... optimum angle provide convenience of operation The device is equipped with the built in respiratory mixture flow generator analogue of the tur bine and does not need sources of the compressed air For connection to the high pressure oxygen line the device is equipped with the pneumatic socket The built in oxygen sensor measures oxygen concentration in the respiratory mixture and allows controlling...

Page 10: ...h the expiration valve with the electromagnetic mechanism operated by the ventilation controller The expiration valve has the small lag effect that does not exceed 5 ms and provides necessary dynamics of pressure maintenance in the breathing circuit The ex piration valve has the removable part containing flow sensor and transmitting system of meas ured pressure to the device The membrane and the r...

Page 11: ...is structurally placed in the expiration valve behind the membrane Calibration of the expiratory flow sensor is carried out without stopping of ventilation Pressure measurement in respiratory ways is made by means of two independent pressure sensors embedded in elec tronic unit The device can contain the additional pressure measurement channel where the measurement catheter can be connected for ex...

Page 12: ... proper and efficient use of the device and to avoid its damage The Triton Electronic Systems Ltd holds responsibility for reliability and operational characteris tics of the device only if service and installation of the device are carried out by specialists of Triton Electronic Sys tems Ltd or personnel passed special training and authorized by Triton Electronic Systems Ltd on carrying out of th...

Page 13: ...ngress of water and solid particles General sign of prohibition Alternative current Mains power switch Sound alarm pause button The button calling the menu window cancellation of parameter set menu exit etc The button calling the menu of additional functions nebulizer The button calling the delayed alarms log Oxygen inlet necessary operating pressure 0 15 0 6 MPa Additional oxygen inlet for connec...

Page 14: ...e Output port of metabolism measurement module is used for elimination of the gas sam ple to the atmosphere Symbols on the transport cart Symbols warning of the overturning danger see p 3 2 Symbols and icons on the ventilator screen General and patient symbols Open Close menu window button Battery condition symbol level of filling is proportional to the energy green at a charge yellow at a dischar...

Page 15: ...Flow Flow graph iSV Graph of iSV mode Paux Auxiliary external pressure graph Paw Airway pressure graph PCО2 Capnogram PО2 Oxigram for operating with the metabolism measurement module calculated as the dif ference FiO2 EtO2 REF Reference loop SpO2 Photopletismogram VCO2 Volume capnography graph Vol Volume waveform V F Volume Fow loop V P Volume Pressure loop F P Flow Pressure loop V Paux Volume Aux...

Page 16: ...n in the inhaled air the device has the built in electro chemical oxygen sensor with the operation resource at least 10 thousand hours For the service control the device has the special operating time counter After 6 000 operating hours the message appears at the screen of the device Carry out maintenance The engineer who has carried out maintenance should enter the command in the service menu Res...

Page 17: ...lley maximum 450х450х650 mm maximum 600х600х1450 mm 1 9 Weight electronic unit electronic unit installed at the mobile trolley maximum 20 kg maximum 35 kg 1 10 Input oxygen pressure Operation from a high pressure oxygen sources 0 15 0 6 MPa 1 5 6 bar 1 11 Operation from a low pressure oxygen sources 0 0 005 MPa 0 0 05 bar 1 12 Accuracy of the mixer when regulating the oxygen concentration in the g...

Page 18: ...entilation APRV 2 9 Pressure controlled ventilation with guaranteed respi ratory volume PCV VG 2 10 Non invasive ventilation of lungs NIV 2 11 Intellectual support ventilation option iSV 2 12 Automatic backup ventilation mode in cases of pres sure and volume apnea APNEA 3 Ventilation parameters 3 1 Tidal volume Vt Measuring accuracy In range 10 100 ml In range 100 3000 ml 10 3000 ml 2 0 05Vt ml ab...

Page 19: ...meters of basic respiratory monitoring 4 1 Peak inspiratory pressure indication range 0 100 cmH2O 0 10 kPa PIP 4 2 Positive end expiratory pressure the minimum pres sure in the circuit indication range 0 50 cmH2O 0 5 kPa PEEP 4 3 Minute volume of breathing indication range 0 60 lpm MV 4 4 Expiratory volume indication range 0 6000 ml Vexp 4 5 Inspiratory volume indication range 0 6000 ml Vinsp 4 6 ...

Page 20: ...nuous operation in accordance with IEC 60601 1 Regarding safety the device complies with IEC 60601 1 ISO 80601 2 12 ISO 80601 2 55 ISO 80601 2 61 The device is classified as class I type of protection when powered from mains from internal power supply in the absence of connection to the mains with applied part of type B and applied part of type BF pulse oximetry sensor According to electromagnetic...

Page 21: ...en 3 Mobile trolley transport cart TESM 186307 01 for installation and transporta tion of the electronic unit TESM 186307 01 TESM 186307 4 Oxygen hose TESM 046002 01 for connection of the unit to the cylinder or the distribution system of com pressed oxygen of medical facility 5 Basket TESM 189014 for storage of the accessories Mounted on transport cart option ...

Page 22: ...ory virus bacterial heat and mois ture exchanging filter 22F HME filter for assembling of the breathing circuit 10 Respiratory filter virus bacterial Luer Lock used during measuring the auxiliary external pressure option 11 Breathing bag test lung 3L 22F or 0 5 L 10 15 F for functional test of device before connection to the patient 12 Sidestream airway adapter for the connection of metabolism mea...

Page 23: ...dapter pediatric neonatal TESM 706021 14 Pulse oximetry sensor RM501 00 124 01 finger clip RM501 00 004 01 neonatal universal option 15 Nebulizer sprayer of inhalation solutions 16 Mask for non invasive ventilation available on request 17 Catheter for measurement of auxiliary pressure in trachea TESM 046502 and esophagus stomach 18 Power cable for connection of the ventilator to the mains power 19...

Page 24: ...valve 19 4 Dust filter TESM 009926 for the replacement in the cooling fan and fresh gas intake fan 19 5 Water trap for the replacement in the oximeter channel of the metabolism measurement module 19 6 Ring TESM 049124 for the replacement in the screwed cap of filter regulator for connection to the O2 in let port Some items may be optional depending on the functional configuration of the device and...

Page 25: ...2 3 Front panel 2 9 2 3 Front panel Figure 2 1 Front view of the electronic unit ...

Page 26: ...nal functions including nebulizer 21 Exp port for connection of the expiratory line of the breathing circuit 9 Manipulator encoder for the control of the device 22 Output port of metabolism measurement module for elimination of the gas sample to the atmosphere 10 Bottom part of the device 23 Handles for carrying of the device 11 Turn on off button to turn off hold down for 3 5 seconds 24 Port for ...

Page 27: ...ng of the external USB flash memory 5 Equipotential terminal potential balancing 6 Filter regulator with the port for connection of the device to the oxygen source 7 Water trap of the filter regulator 8 Fresh gas intake filter 9 Connector for the low pressure oxygen line 10 Metal bracket for prevention of accidental disconnection of the power cord 11 Mains fuses holder Figure 2 2 Back view of the ...

Page 28: ...difier 6 Chassis 7 Swivel wheel with brake 8 Swivel wheel 9 Openings for installation 1 pc and fixing 2 pcs of the electronic unit 10 Basket for storage of the accessories the balloon holder can be mounted instead At installation of the transport cart it is necessary to use all three screws to secure the electronic unit to the ventilator s installation table to prevent the electronic unit from fal...

Page 29: ...ed from mains with in ternal power supply in the absence of connection to the mains with applied parts of B type and pulse oxymetry channel of BF type Concerning electromagnetic compatibility EMC the device meets the requirements of IEC 60601 1 2 The device is intended for use in the electromagnetic environment specified in Appendix 3 During operation it is strongly recommended to use of the devic...

Page 30: ... Disinfection of the switched on device is prohibited the power plug must be removed from the socket Immersion of electrical connectors of sensors cables etc into liquid disinfectant solutions is prohibited The operation the device may affect equipment in the vicinity for example high frequency electrosurgical devices shortwave therapy equipment cell phones Do not use the device in the operating c...

Page 31: ...cing the device on the transport cart increased tilting danger in case of o placing or moving the cart on sloped floors o pulling the cart over obstacles like doorsteps o heavy items leaning against the cart o equipment and accessories mounted outside the center of gravity Do not lean against the cart When placing the device with the transport cart on an inclined plane swivel wheels with brakes mu...

Page 32: ...e and its components in accor dance with it 3 5 3 3 2 Installation of the electronic unit and the supporting arm Install the electronic unit on the table of the cart Pin in the bottom part of the block should coincide with the hole on the cart Figure 2 3 position 9 Figure 3 1 Installation of the electronic unit on the table of the cart After transportation or storage at the low temperatures it is ...

Page 33: ...to prevent injuries of the patient and personnel and damage of the device Install the supplied supporting arm the circuit holder on either side of the cart according to Figure 3 3 Place breathing circuit on the supporting arm in a form convenient for use Figure 3 3 Installation of the supporting arm circuit holder The arm is equipped with self locking buttons see Figure 3 4 for changing the seg me...

Page 34: ...is applied For the operation of the humidifier use only distilled water 3 3 4 Assembling of the breathing circuit Prepare elements of the breathing circuit filters breathing bag test lung and water trap of oximeter channel of metabolism measurement module from the delivery kit Assemble the circuit as shown in Figure 3 6 Through the inlet port Insp fitting gas is supplied under breathing pressure t...

Page 35: ... Ltd UK disp 3 7 3 9 RT206 Fisher Paykel Healthcare Ltd New Zealand disp 3 8 3 6 038 31 768 Flexicare Medical Ltd UK disp 3 8 3 6 RT105 Fisher Paykel Healthcare Ltd New Zealand disp 3 8 3 6 038 01 163 Flexicare Medical Ltd UK disp 3 8 3 6 900МR784 Fisher Paykel Healthcare Ltd New Zealand reusable 3 8 3 6 Pediatric 038 02 155B Flexicare Medical Ltd UK disp 3 7 3 9 5513 Intersurgical Ltd UK disp 3 7...

Page 36: ...d temperature sensor Note At the extreme necessity at the discretion of the physician the short term operation without the humidifier is allowed In this case assemble circuit according to the Figure 3 7 Use the passive humidifier i e recommended heat moisture exchange HME filter Figure 3 7 Assembly of the breathing circuit without the humidifier ...

Page 37: ...paring for operation 3 9 Figure 3 8 Assembly of disposable or reusable breathing circuit with humidifier MR810 Figure 3 9 Assembly of disposable or reusable breathing circuit with humidifier MR810 VADI VH 2000 ...

Page 38: ...reathing circuit should contain virus bacterial filter Breathing circuit should contain at least one water trap in the expiration line Otherwise the manufacturer is not liable for the consequences of the device malfunctioning When using heat moisture exchange filters it is necessary to consider the features of their operation see it 4 19 During the ventilation it is necessary to monitor the level ...

Page 39: ...t to the О2 inlet on the rear panel of the elec tronic unit using the cap nut with the seal Connect the supplied oxygen hose with NIST connector to the filter regulator on the rear panel of device see Figure 3 13 Thoroughly insert the oxygen hose nut into filter regulator threaded inlet and turn as shown on the Figure 3 13 Using of the coaxial or dual chamber breathing circuit is recommended for s...

Page 40: ...DIN 13260 2 that is part of the hose Figure 3 14 Connection to the central gas supply system of the hospital On special order the hoses can be equipped with other adapters for connection to the main gas supply of the medical facility The filter regulator is set to maintain the input pressure of the ventilator up to 2 kgf cm2 bar If the pressure is less than 2 kgf cm2 bar it is transmitted to the i...

Page 41: ...with oxygen concentrator at the time of the maximum inspiratory flow the oxygen pressure can vary greatly however a significant change in FiO2 does not occur due to the capacity of the oxygen line To avoid low oxygen pressure alarms pressure drops during inspiration turn off the low oxygen pressure alarm o When operating from an oxygen concentrator its output capacity should be at least 10 lpm Opt...

Page 42: ...y indicator is lit red indicating the accumulator or charger failure the usage of the ventilator is prohibited as it does not provide the ability to work in violation of the mains supply In the absence of mains supply it is allowed to operate from the backup internal or external power supply in accordance with it 4 2 If the external pressure monitoring function is available make sure that monitori...

Page 43: ...modules of the device At the operation with a faulty accumulator failures of the mains power can cause shutdown of the device and the termination of ventilation without any notice The responsibility for the negative consequences of operation of the device with defective accumulator lies on the hospital medical staff To turn the device off press the button during 5 6 seconds it is protecting measur...

Page 44: ...e not intended for sterilization only by wiping using gauze swab or soft cloth moistened in cleaning and disinfectant solution Squeeze the cloth before wiping to prevent penetration of solution into the device Use only dis tilled water for cleaning and disinfection solution preparation Recommended cleaners and disinfectants Hydrogen peroxide solution 3 with ionic surface active substance solution ...

Page 45: ... 2 Before start the monitoring ensure that optical windows of the sensor are complete ly dry and clean no stains from solution or water drops Pulseoximeter sen sor Disconnect the connector of sensor from the ventilator Clean and disin fect the external surfaces of the sensor according to procedures mentioned above 3 5 2 Reprocessing of sterilized components Reprocessing of certain components shall...

Page 46: ...ance solution 0 5 Neutral soap solution Neodisher Mediclean forte 1 manufactured by Dr Weigert Disinfectants Lysetol AF и Gigasept FF manufactured by Schülke Mayr Sekusept PLUS manufactured by Henkel Ecolab CIDEX manufactured by Johnson Johnson or gluteraldehyde solution with concentration 3 6 It is possible to use other certificated cleaners and disinfectants acceptable for medical use with simil...

Page 47: ...r 1 min Rinsing Cold distilled water 3 min Thermal disinfection 93 C 44 min Drying C 12 min Packing After cleaning and disinfection assemble and put the component into the sterilization pocket The sterilization packing should comply with ISO 11607 standard Sterilization Sterilize the components in hot steam sterilizer at 134 C and 0 21 MPa Duration of sterilization is to be not less than 3 minutes...

Page 48: ...tion Reprocess according to Reprocess ing procedure mentioned above The number of cycles is not less than 100 excluding damages during operation Replace the water trap with new one in case of defect detection Patient circuit components Disassemble the patient circuit completely Disassemble the water traps dispose the wa ter Clean and disinfect the components of water trap separately The general re...

Page 49: ...asive ventilation of lungs unassisted breath through the mask with continuous posi tive airway pressure and pressure support of spontaneous breaths NIV Airway pressure release ventilation APRV Intellectual support ventilation iSV APNEA ventilation emergency mode it is triggered if respiratory standstill apnea is de tected Note Accessible ventilations modes are defined by functional equipment of th...

Page 50: ...tient is not used repeatedly At installation in the breathing circuit up to 3 virus bacterial filters pressure in the patient tee changes no more than on 3 cmH2O at the flow 60 lpm in case of timely replacement of filters at their remoistening The device provides possibility of independent breath of the patient if normal ventilation is im possible because of troubles with electro and pneumo supply...

Page 51: ...y the graphic symbol on the de vice display Figure 4 4 position 4 The figure in the centre of the symbol shows the level of the remained charge the maximum value 100 corresponds to completely charged accumulator If charge of accumulator provides less than 10 minutes of device operation the high priority alarm signal 10 min left is activated At activation of the high priority alarm signal 10 min le...

Page 52: ...evice can be reduced That can not be a reason for claims to the manufacturer For the maintenance of capacity and increasing of the service life of the accumulator it is necessary to conduct periodically its training at least once a half a year see Section 6 If the device is connected to the mains power but the indicator accumulator is red it means that charging device and or the accumulator are fa...

Page 53: ...ng of sound alarm for 2 minutes or before appearing of new alarm The icon thus will have blue white color Menu button call of menu window cancellation of parameter setting exit from the menu etc The button is duplicated by the touch button with the same graphic designation Button call of menu of additional functions including nebulizer Button call the list of delayed alarms on the log screen The l...

Page 54: ...t shown Default parameters for the new patient Adult man height 174 cm Child man height 70 cm Height control range in the pediatric mode from 57 to 150 cm with step of 1 cm to 100 cm 2 cm to 150 cm Weight control range in the child mode at height 57 cm from 2 0 to 5 0 kg with step of 0 1 kg Height control range in the adult mode from 130 to 250 cm with step of 2 cm Height of the patient is correct...

Page 55: ...y ratio Flow Initial flow Texp Expiratory time TrigWnd Trigger window Tplat Plateau time MV Minute volume Ptrig Pressure trigger sensitivity Ftrig Flow trigger sensitivity Tramp Pressure rise time relatively to Tinsp Figure 4 2 Window of associated parameters Ventilation begins after pressing of the graphic button Apply or through 10 s if it there are no actions on editing of ventilation parameter...

Page 56: ...hysical activity at the increased body temperature at the raised metabolism at the expressed pain syndrome minute ventilation can increase many times At the same time in the condition of the lowered metabolism for example under anes thesia etc minute ventilation can decrease noticeably Further correction of minute volume during ventilation is carried out by the doctor according to the information ...

Page 57: ...ings Alarm thresholds MV for the new patient are set automatically at the start of ventilation MV max 1 5 MV MV min 0 7 MV Default value of the bottom alarm threshold Vt min 4 4 ml kg IBW for all modes Default value of the top alarm threshold Vt max 16 ml kg of IBW During operation at regulation of parameters limits of alarms do not change If MV changes the bottom threshold 0 7 MV from 100 MV alwa...

Page 58: ...sed for more exact calculation of inspiration pressure and target tidal volume This is especially important for ventilation of children When using one type of breathing circuit without autoclaving the circuit calibration is generally not required Calibration procedure of the breathing circuit is described in it 4 16 5 After disassembling disinfection or replacement of the removable part of the exp...

Page 59: ...s highlighted by the bright white color at the moment of patient s breathing attempt 3 Set ventilation mode At the same time it is a touch button opening the Ventilation modes submenu window 4 Accumulator condi tion symbol See it 4 2 5 Line of icons of ad ditional functions Icons are used for the quick access to additional features and displaying of their status Depending on the completeness of th...

Page 60: ...dow in the menu mode warning about the impossibility of changing the parameter in the mode of parameter setting 7 Area section of in dication of graphs menu windows trends depending on the selected mode Changing of the mode of graphs displaying is made in Menu Display settings Graphs Changing of the mode of trends displaying is made in Menu Trends 8 Touch button screenshot Saving the current state...

Page 61: ...om row 8 parameters and of top row that appears in the setting mode Each ventilation mode corresponds to a specific set of defined parameters for details see it 4 7 The window of each parameter is the touch button 14 Icon of enable disable windows of extended respirato ry monitoring and window of metabolic parameters Respiratory monitoring RESP2 RESP3 see it 4 18 window of metabolic parameters see...

Page 62: ...menu of general ventilation parameters setting and selection of patient s type it 4 8 Trigger type Parameter allows to set type of the inspiration trigger pressure or flow one it 4 9 Trig window Parameter allows to set the duration of the trigger window in percent or seconds Selecting the units of the trigger window in percent or in seconds FiO2 sensor autocalibr Parameter provides the possibility...

Page 63: ...uble control with pressure support of spontaneous breaths PS Appendix 1 3 CPAP PS Spontaneous breathing with continuous positive airway pressure with pressure support of spontaneous breaths PS Appendix 1 4 BiSTEP Spontaneous breathing with two levels of continuous positive airway pressure with pressure support of spontaneous breaths PS Appendix 1 6 APRV Airway pressure release ventilation Appendix...

Page 64: ...t displayed Selection of ventilation parameter for its setting is made by pressing the window graphic touch button of the appropriate parameter Window of the set parameter changes background color to blue one Rotate or press the encoder to change or confirm changing of parameter While parameter is adjusted new value of parameter is not applied by ventilator The device detects but not apply new par...

Page 65: ...tory rate can lead to situation when I E is out of allowable range with the same inspiratory time The type of conflict is reflected by the color of conflicting parameter Yellow color indicates a medium priority conflict The device can take this parameter for execution but warns about incorrect parameter This situation occurs when the sensitivity of the inspiratory pressure trigger exceeds PEEP Thi...

Page 66: ...s 1 2 3 4 5 6 7 8 Top line TrigWnd Pramp Bottom line FiO2 Pmax RB PEEP PS Pi Tinsp Ptrig Parameter setting line in the SIMV VC mode SIMV VС Windows of parameters 1 2 3 4 5 6 7 8 Top line Pramp Tplat FormFlow TrigWnd Bottom line FiO2 Pmax RB PEEP PS VT Tinsp Ptrig Parameter setting line in the SIMV DC mode SIMV DС Windows of parameters 1 2 3 4 5 6 7 8 Top line Pramp TrigWnd Bottom line FiO2 Pmax RB...

Page 67: ...parameters Pmax maximum acceptable inspiratory pressure Pmax parameter is used in all modes to limit the pressure in the patient breathing circuit and to prevent barotrauma If the pressure in the patient breathing circuit for some reason has become equal to or higher than Pmax the device immediately opens the exhaust valve and begins expiration At any ratio of parameters the device ensures that Pm...

Page 68: ... newly set inspiration support pressure plus PEEP exceeds the maximum allowable pressure Pmax then the PS and PEEP background will be painted in red and the application of parameters will be forbidden In the BiSTEP mode PS parameter is used to support spontaneous breaths only on the low pressure phase Plow At high pressure phase support pressure is fixed at 5 cmH2O to prevent barotrauma Pi inspira...

Page 69: ...inspiratory pressure in the breath ing circuit can be achieved untimely As a result due to the activation of the expiratory trigger the pressure support of spontaneous inspiration PS can be prematurely interrupted Pramp parameter determines the time when the target pressure will be reached Optimal value of Pramp can be determined by the shape of the inspiration pressure curve see Figure below Figu...

Page 70: ...ariation range is defined by IBW see it 5 6 ET TST 4 5 10 0 mm Apnea parameters Calls the window of apnea parameters see it 4 8 2 iSV parameters Calls the window of iSV parameters see it 4 8 3 Pmax Tinsp limits Allows in some modes to increase the upper limits of the adjustment of Pmax Tinsp see it 4 8 4 Compl meas period Determines time between compliance and resistance measurement cycles 2 0 10 ...

Page 71: ...5 Plateau time Selecting of the parameter unit s Т disconn in NIV Delay time of disconnection alarm triggering in the NIV mode Default parameter value is 5 seconds 0 60 s 1 If user tries to enter a patient s height 57 cm the ventilator goes into the patient s weight editing mode to the minimum value of 2 kg The reverse transition occurs when user enters a weight 5 kg At weight values between 2 0 a...

Page 72: ...on of parameter Description of parameter Values Control Сontrolled ventilation with volume or pressure control by volume by pressure Piapnea Inspiratory pressure above apnea PEEP level in the apnea mode child mode adult mode 10 25 cmH2O 10 80 cmH2O Vapnea Tidal volume in the apnea mode child mode adult mode 10 400 ml 200 2000 ml RBapnea Respiratory rate in the apnea mode child mode adult mode 15 6...

Page 73: ...e disable of the inverse mode of ventilation when inspira tion is longer than expiration default value off off on 4 8 4 Menu of Pmax Tinsp limits Designation of parameter Description of parameter Values Pmax limit Allows to increase the upper limit of Pmax to 105 cmH2O line is available only in the CMV VCV CMV PCV SIMV VC SIMV PC SIMV DC PCV VG modes at the adult type of pa tient 87 105 cmH2O Tins...

Page 74: ... with step of 0 5 cmH2O in the range up to 3 0 lpm with step of 0 1 lpm The sensitivity of the trigger is a parameter that determines the minimum value of the patient s respiratory effort required to run the spontaneous inspiration support algorithm In the NIV mode flow trigger is not used because its operation is impossible in the presence of leak The algorithm of the inspiratory trigger in NIV h...

Page 75: ...match between the sensor readings of FiO2 and set value of FiO2 is conducted If the mismatch is greater than the absolute value of 3 the FiO2 sensor is automatically calibrated The display shows message about the oxygen sen sor calibration Calibration is performed without stopping of ventilation with the O2 level of 21 so there is short time about 1 min decreasing of FiO2 to 21 Upon completion of ...

Page 76: ...ble through the submenu of additional functions entrance through the main menu or with the button on the front panel of the ventilator 4 11 1 Alveolar recruitment maneuver Current procedure is active only in CMV PCV and CMV VCV modes with the type of patient Adult Activation of the function is available through Menu Addtitional functions Alveolar re cruitment maneuver or icon on the main screen En...

Page 77: ...ed Returning to the initial ventilation settings The procedure is repeated automatically after 3 minutes Alveolar recruitment maneuver is turned off at the activation of the functions Sigh Leak compensation Suction Figure 4 7 Paw waveform at the active phase of the alveolar recruitment maneuver To disable the maneuver click on the Stop row during procedure it replaces the row Start in the Alveolar...

Page 78: ...unction for 3 minutes Oxygenation is performed see it 4 11 2 At this time the ventilator waits for disconnecting of the patient If the disconnection does not occur the device returns to the previous mode the Suction function is switched off If disconnection occurs the device stops ventilation Window with the message of disconnection and with timer showing time of its beginning appears Operation wi...

Page 79: ...e operation with the interface except encoder button Start and Vent param Reset cancellation of all selected additional functions To resume the ventilation press the encoder or Start button To edit or save ventilation parameters press the button Vent param At the clicking on this button Parameters menu appears Menu allows to change the indicated ventilation parameters At the clicking on the Exit i...

Page 80: ...with volume control the device adds a measured amount of leakage to the inspiration volume set by the user VТ However the addition can not exceed 100 of VТ This limitation minimizes the risk of harm to the patient in case of errors in the leakage determi nation due to technical failures or any other reasons When leakage compensation is disabled base flow support flow of device is 10 lpm It is ne c...

Page 81: ...expiration activation of an extraordinary inspiration begins at the end of the forbidden expiratory phase Additionally the inspiration is delayed if pressing coincided with forbidden phases in BiSTEP or APRV mode If the button is pressed more than 15 seconds then at the end of 15 seconds the inspiration is interrupted and ventilation with the current settings begins Pressing the button is ignored ...

Page 82: ...at the inspiratory phase procedure of compliance plateau formation was performed and dura tion of inspiratory phase was more than set inspiratory time maximum compliance plateau duration measurement of compliance and resistance will be not performed If manual breath is activated at the moment of formation of AutoPEEP measurement procedure procedure will be immediately stopped AutoPEEP will be not ...

Page 83: ... marker line is moved to the desired position by encoder at the repeated pressing the icon freezing of the curves is canceled Current cycle begins to draw from the random moment Figure 4 8 Pressed button Freezing At rotating the encoder marker line moves to the left right and accordingly to its position instan taneous values including time are changed Moving the marker line can also be done by tou...

Page 84: ...value of speed for adult type of patient is 1 for pediatric one is 2 Select function for each graph from the following list Paw Airway pressure waveform Flow Flow waveform Vol Volume waveform Loop Loop curves volume flow volume pressure flow pressure volume auxiliary external pressure PCO2 mmHg Capnogram mmHg PCO2 Capnogram РO2 Oxigram for metabolism measurement SpO2 Photopletismogram PPG iSV grap...

Page 85: ...aximum inspiratory pressure Pmax blue line PEEP marker if PEEP 0 cmН2О light blue line Pressure curve green or blue line depending on the inspiration expiratory phase Figure 4 9 Pressure in the patient airways Paw Scale of flow rate graph is automatically selected in the range 250 lpm depending on the maximum flow rate in the current mode All graphics display instant current values of parameters i...

Page 86: ...nt ventilation mode The iSV graph displays the respiratory rate and tidal volume scales iSV graph shows limits of safe ventilation by RB and Vt top and bottom values in graphical and numerical view target values of RB and Vt in graphical and numerical view real values of RB and Vt in graphical and numerical view target minute ventilation values in and ml min adaptation minute ventilation values in...

Page 87: ...quency of spontaneous breaths 9 FlowPeak Peak inspiratory flow 10 Leak Leakage flow from the breathing circuit 11 MV MVspont Minute volume Minute volume of spontaneous breaths 12 MValv Vd Minute alveolar ventilation Functional dead space 13 Paux Auxiliary external pressure 14 Ptp Transpulmonary pressure 15 PIP Pm PEEP Peak inspiratory pressure Mean pressure for the respiratory cycle Positive end e...

Page 88: ...rameter the device displays the trend window Figure 4 10 Window of trends In the main part of the screen from 1 to 4 trend graphs are displayed according to the choice of user In the top part of the screen 5 additional fixed trends associated with graphs are displayed they are PIP peak inspiratory pressure PEEP positive end expiratory pressure ...

Page 89: ... line displays the time and date of recording Trends are cyclically recorded in non volatile memory and restored when the power is turned on Duration of trends is the last 240 hours of device s operation To return from the trend window to the main mode press the Menu button or click the encoder Edit parameter Using Edit parameter operator can set time scale of the main trends the width of the tren...

Page 90: ...level in lungs cmH2O 18 RCexp t Expiratory time constant s 19 SI Stress index cmH2O 20 Wvent Work of the ventilator breathing J l 21 Wspont Work of the patient breathing J l 22 PEEPtot True pressure level in lungs at the end of expiration cmH2O 23 FiO2 Fractional concentration of inspired oxygen 24 Сcirc Compliance of the breathing circuit ml cmH2O 25 Rcirc Resistance of the breathing circuit cmH2...

Page 91: ...ending on their priority the date and time of their occurrence Figure 4 11 Alarm log Navigation in the alarm log is performed by rotating the encoder To exit press the Menu button or the encoder Alarms are logged cyclically The log can hold at least 1 000 alarms The log is stored in non volatile memory Save alarm log parameter records the alarm log to removable media connected to the USB port on t...

Page 92: ... air 0 0 0 5 1 0 1 5 atm 1 0 atm Low PIP Low inspiratory pressure alarm threshold 0 value means disabled alarm 0 20 cmH2O 0 cmH2O Low PEEP Low PEEP alarm threshold 0 value means disabled alarm 0 10 cmH2O 0 cmH2O MV MV_max top alarm threshold of minute breathing volume MV_min 60 lpm 12 lpm MV_min bottom alarm threshold of minute breathing volume 0 MV_max lpm 2 lpm Vexp Vexp_max top alarm threshold ...

Page 93: ...turation of arterial blood by oxygen hyperoxia from 90 or from SpO2_min to 100 100 SpO2_min bottom alarm threshold of SpO2 hemoglobin saturation of arterial blood by oxygen hypoxia 60 95 SpO2_max 86 PR_max top alarm threshold of pulse rate taxycardia 80 PR_min 350 1 min 90 PR_min bottom alarm threshold of pulse rate bradycardia 15 100 PR_max 1 min 50 Low pulse volume alarm on off off Changing and ...

Page 94: ...ow of the device see it 4 6 Designation Description of parameters Values Alarm sound vol Volume level of sound alarm 30 100 Beeper sound vol Volume level of signal of spontaneous breaths BEEP signal 5 100 For the purposes of patient s safety user can not disable of set alarm volume less than 30 ...

Page 95: ...rameters Versions of modules parameter allows to see software version numbers of the units and modules which are present at the device their serial numbers CIVL ventilation controller CIND display controller PU power unit GM gas mixer circuit PR CONV protocol converter circuit Oximet sidestream oximeter metabolism measurement module PR CONV protocol converter SpO2 pulse oximetry module CMS network...

Page 96: ...akage test in the breathing circuit being under pressure during inspiratory time and also test of pressure drop of the device in the passive exhalation line the specified tests are carried out by the manufacturer and in the service centers for these tests it is necessary to enter the system password Technological child mode parameter is intended for the test of device by the manufacturer and in th...

Page 97: ... o The Day brightness and Night brightness parameters are used for changing of the display brightness during the day 05 00 00 00 and night 00 00 05 00 time in the range 50 100 and 30 100 respectively Default values are 100 for day brightness and 60 for night brightness Breathing circuit calibration parameter is recommended after changing of the breathing circuit type Before starting of the calibra...

Page 98: ...sables emulation of the patient o PR and SpO2 averaging time parameter allows to change the averaging time of the displayed parameters 4 8 16 s Service menu parameter Alarm autosetting is used for restoring of the alarm threshold factory settings see it 4 14 The maximum pressure limit value Pmax 45 cmH2O and the corresponding alarm threshold are also recovered Service menu parameter Factory settin...

Page 99: ...nt particularly if concentration measurement error exceeds 2 during air ventilation FiO2 sensor of electrochemical type is applied in the device Its lifetime depends on the time spent in oxygen environment and on oxygen concentration At medium operation parameters lifetime of the FiO2 sensor should be at least 1 5 years Calibration of the FiO2 sensor usually is important in the final phase of the ...

Page 100: ...en sensor replacement procedure from the menu Menu Service menu Calibration CIVL 3 Could not set CIVL to oxygen sensor replacement mode Ventilation controller don t respond to calibration request Contact the customer service 4 No information about atmospheric pressure or information is incorrect Gas mixer malfunction Contact the customer service 5 The oxygen sensor is missing or malfunctioning Low...

Page 101: ...ondition Operator s actions 1 Calibration successfully completed Calibration is completed successfully Continue operation with the device 2 Time out of expiratory flow sensor calibration No messages about calibration results from the ventilation con troller Contact the customer service 3 Calibration cancelled Calibration is cancelled by user Continue operation with the de vice 4 Could not set CIVL...

Page 102: ...principle of measuring the mass of the passed gas On the expiratory flow sensor measures the volume of the passed breathing mixture It is possible to use different types of breathing gas humidification in the device Insp conditions and Exp conditions parameters are intended for selection of conditions for the conversion of the breathing mixture mass passed through the device to the appropriate vol...

Page 103: ...eted Breathing circuit calibration is successful Continue operation with the device 2 Error insp pressure sensor is not calibrated Inspiration pressure sensor in not calibrated Reset the device restart breathing circuit calibration if the message appears again contact the customer service 3 Error exp pressure sensor is not calibrated Expiration pressure sensor in not calibrated 4 Error no response...

Page 104: ... of the device Repeat the breathing circuit calibration If message appears again contact the customer service 12 Coefficients writing error Ventilation controller malfunction Contact the customer service 13 Breathing circuit calibration time out No messages from ventilation controller about results of breathing circuit calibration Contact the customer service 14 Gas mixer malfunction Gas mixer mal...

Page 105: ...ion about all current and previous alarms The lists of alarm messages are stated in Tables 4 15 4 17 where the text of the alarm message the short message in brackets which is displayed in the Alarm List and the alarm log as well as the response of the device and operator actions are mentioned The list of informational messages is stated in Ta ble 4 18 For convenience of the personnel audible alar...

Page 106: ...5 and the message indication zone if there are no active alarms Figure 4 4 position 6 some messages are recorded only in the alarm log and events The list of informational messages with the indication of the full and abbreviated text of the message indication place and comments is presented in Table 4 17 Please note that informational messages about the the metabolograph functioning are displayed ...

Page 107: ...is below the set bottom threshold Check the patient for adequate ventilation and circuit for hermiticity If necessary adjust the bottom alarm threshold Alarm is dis abled when expiratory volume exceeds the bottom alarm threshold 5 High Vexp High Vexp High Vexp Expiratory volume is above the set top threshold Without lea kage this alarm is equal to high inspiration volume alarm Check the patient fo...

Page 108: ...rms of iSV mode see the descrip tion in it 4 17 5 Check the patient condition Check the alarm limits adjust them if neces sary Technical alarms 14 TRANSITION TO FEM TRANSITION TO FEM The critical malfunction in the device occurred The device operation is failed Use alternative ventilator Remove the de vice from operation see it 4 17 6 Contact service department 15 Tech Failure Tech Failure The tec...

Page 109: ...f oxy gen to the device If necessary change the limit of O2 tolerance Alarm automatically disappears when the oxygen concentration is returned to the normal range 24 High O2 concen tration High О2 The measured value of the oxygen concentration exceeds the set value on the specified value Alarm disappears when the oxygen concen tration returns to the normal range 25 Fan malfunction Fan malfunct The...

Page 110: ...nnected from the patient Connect the sensor to the patient 9 Low pulse signal Low pulse The relative level of blood pul sation at measuring point is 0 3 or less Provide the required level of perfusion at the location of the SpO2 sensor application Change the location of the SpO2 sensor ap plication The alarm is disabled when the pulse filling value becomes higher than 0 3 Technical alarms 10 Calib...

Page 111: ...ossible without external pressure monitoring Paux Contact service department 4 17 3 Low priority alarms Table 4 17 Low priority alarms No Alarm mes sage Alarm conditions Reaction of ventilator operator s actions Physiological alarms 1 Plimit reached Plimit reached The pressure in the circuit reached a value of Pmax 10 cm H2O Special alarms of iSV mode see the de scription in it 4 17 5 Check the pa...

Page 112: ...Capnometer not initialized Cap no not init The capnometer is not initia lized during the device switch ing on The module is missing Contact service de partment 12 Calorimeter not initialized Ca lor not init The metabolism measurement module is not initialized during the device switching on The module is missing Contact service de partment 13 CAN Eth not in itialized CAN Eth no ini The CAN Eth is n...

Page 113: ...O2 sensor calibration FiO2 s calib x FiO2 sensor is being calibrated 11 FiO2 sensor autocalibration FiO2 s autocal x FiO2 sensor is being autocalibrated 12 Capnometer calibration Cap no calibr x Zero calibration of capnometer 13 Breathing circuit calibration Circuit calibr x Breathing circuit calibration 14 Check delayed alarms Chk delay alrm x Message about the delayed alarms Check them in the al...

Page 114: ...the alarm is generated with the delay when it is detected that the real minute ventilation does not reach the target value The delay is necessary to achieve the set minute ventilation for example in the case of changing the target value from 25 to 300 with the maximum pressure increase in step of 2 cmH2O To identify situations when the target minute ventilation can not be achieved the identificati...

Page 115: ...ical failure mode It is not possible to use the ventilator in FEM please contact the customer service in that case Technical failure mode The technical failure mode is switched on automatically in case of ventilator s module malfunction during the turning on The ventilator switches to technical failure mode when you turn it on again in FEM or turn it on for the first time when it was switched to F...

Page 116: ...4 17 Alarms 4 68 It is not possible to use the ventilator in technical failure mode please contact the customer service in that case ...

Page 117: ...ism see it 5 6 RESP2 window RESP 3 window Table 4 18 Description of extended respiratory monitoring parameters RESP 2 window Name of parameter Designation Additional description True pressure level in lungs at the end of expi ration PEEPtot Pressure in the lungs at the end of expiration taking into account the incomplete expiration PEEPtot PEEP AutoPEEP Displayed if both pa rameters are measured c...

Page 118: ...r of breathing cycle filling Tinsp Ttot The ratio of inspiratory time to total duration of the respiratory cycle Factor of spontaneous breathing MVe_sp MVe The ratio of spontaneous breathing minute volume to the total breathing volume Resistance to the exha lation Rexp Total respiratory resistance during expiratory phase Elasticity of respiratory ways elastance E Reverse value of static compliance...

Page 119: ... it is suspected that is causes autoPEEP increas ing Figure 4 12 The effect of extending of the expiraiton flow due to the increased filter resistance The heat and moisture exchange filter in the breathing circuit can significantly increase resis tance to the inspiration and expiration Increased resistance causes the increased patient s work during spontaneous breathing or in itialization trigger ...

Page 120: ...eration Connect the connecting tube supplied with the nebulizer to the Nebulizer fitting on the front panel of ventilator and to the inlet fitting of the nebulizer see Figure 4 13 Figure 4 13 Connection of the connecting tube of the nebulizer to the nipple on the front panel of the ventilator Connect the nebulizer to the breathing circuit as shown in Figure 4 14 Operating position of the nebulizer...

Page 121: ...rates independently All controls are located on the nebulizer Figure 4 15 Connecting of the nebulizer AeroNeb Pro During the operation in every breathing cycle the device delivers pressure of 1 8 bar into the spray chamber of nebulizer Pure oxygen is used to create the pressure At every inspiration medicines are sprayed from the inhaler container Since spraying is carried out with oxygen FiO2 valu...

Page 122: ...to instance Use measured values of expiratory volume and respiratory rate indicated correctly to control the adequacy of ventilation with the nebulizer Displayed value of the oxygen concentration in the breathing mix blue EtO2 may differ from that set on the device one FiO2 This happens because the device measures and regulates the oxygen concentration directly on the outlet of the device and at l...

Page 123: ...ic compliance measurement 1 hardware inspiration 2 hardware expiration 3 spontaneous inspiration 4 spontaneous expiration Figure 4 16 Spontaneous inspirations and expiration at any phase of ventilator s breathing cycle Open valve function increases flow of the inspired mixture in the presence of spontaneous pa tient s effort allowing him to breathe 3 regardless of the hardware respiratory cycle ph...

Page 124: ...4 21 Open valve function 4 76 For your notes ...

Page 125: ...ompatible with ventilator The module includes the mainstream CO2 sensor and ventilation adapters for different types of patients 1 Enclosure of the sensor 2 Ventilation adapter adult and neonate 3 Socket for the connection to the ventilator 4 Cable of the sensor Figure 5 1 Mainstream capnometer It is not recommended to connect an mainstram capnometer when the de vice is switched on Connection of t...

Page 126: ...arming is about 2 minutes Herewith a Capno warming message appears in the capnogram field Make zero calibration of capnometer if necessary the first use of the module or change of the ventilation adapter type Insert the ventilation adapter between the elbow and tee of the ventilator circuit according to the scheme on Figure 5 4 Figure 5 4 Connection of the mainstream capnometer to breathing circui...

Page 127: ...ignificantly influence on measuring accuracy of the mainstream capnometer There is no drift in CO2 concentration measuring accuracy within 6 hours the measuring accu racy complies with stated one Measurement accuracy CO2 concentration 0 2 0 06Kmeas CO2 partial pressure 0 2 0 06Pmeas mmHg Total system response time and rise time not more than 180 ms Zero calibration of the mainstream capnometer Zer...

Page 128: ...h airway adapter to ventilator and display the PCO2 graph 2 Take a breath to the airway adapter ensure that EtCO2 measurement and PCO2 graph are displayed on the screen 3 Set the upper alarm limit of EtCO2 parameter lower then measured value 4 Ensure that alarm High EtСО2 is activated 5 Set the lower alarm limit of EtCO2 parameter higher then measured value 6 Ensure that alarm Low EtСО2 is activat...

Page 129: ... expiration is the combined integration of patient flow curve and the capnogram from the mainstream capnometer Figure 5 5 Figure 5 5 Synchronization of the capnogram with the flow curve СО2 elimination per breathing cycle is 2 1 pat 3 2 pat 2 2 2 t t t t i dt t CO t F dt t CO t F VCO 1 where VCO2i СО2 elimination per i breathing cycle units ml СО2 t the relative concentration of CO2 Fpat t the pat...

Page 130: ... m 1 4 Minute ventilation contains not only gas that participates in the gas exchange but ventilation is wasted in the airways Thus the high minute ventilation does not always indicate the actual achievement of the alveolar area Some part of the tidal volume falls into non perfused or poorly perfused lung areas MValv Vd ratio characterizes the ratio of alveolar ventilation and dead space ventilati...

Page 131: ...CO2 partial pressure in the venous blood mmHg PаCO2 СО2 partial pressure in the arterial blood mmHg PvCO2 PaCO2 delta of blood or arterial venous difference mmHg Kr solubility of СО2 in the blood plasma in the blood plasma equal 0 53 at Т 38 ºС For displaying of the digital values of cardiac output and minute CO2 elimination select CO VCO2 for the one of the modules of the measurement parameters M...

Page 132: ...ked for cor rectness permitted range 10 150 mm Hg venous CO2 concentration is always higher than arterial delta of blood from 3 to 12 mmHg if the values are outside the allowable limits boundary values are taken If PaCO2 and or PvCO2 values were not updated for more than 4 hours or EtCO2 value changed for more than 30 since last CO measurement the ventilator displays the warning message Update PaC...

Page 133: ...n for example by pulling for the sensor cable To disconnect and undock of the connector it is necessary to take up his enclosure and pull it The outer part of the movable connector housing unlocks the fastener while moving Therefore unlocking the connector is possible only by pulling by the hand of his enclosure To avoid damage of the sensor never try to pull on the cable to unlock the connector F...

Page 134: ...compression during application of the pulse oximetry sensor The universal pulse oximetry sensor can be applied for all patient groups If you use the universal pulse oximetry sensor on neonates or infant apply the sensor on palm or foot Fig 5 9 There is no difference from which side an emitter located Fix the sensor by strap Figure 5 9 Application of universal pulse oximetry sensor to neonate or in...

Page 135: ...n the logarithmic scale 3 the numerical value of SpO2 4 the numerical values of SpO2 alarm thresholds 5 photoplethysmogram PPG curve 6 numerical value of the pulse rate 7 the numerical values of pulse rate alarm Figure 5 11 Window of the pulse oximetry channel By clicking on the SpO2 graph field with numeric values which are graphical buttons menu of thresholds settings becomes available In this m...

Page 136: ...urve non physiological curves can be recognized by the angular or the toothed form or by the increased noise General or local hypothermia or labored blood circulation in the hand can lead to instable operation of device and unreliable result of measurement To eliminate the violations of local circulation till the press necrosis and to obtain reliable measurement results reinstall the pulse oximetr...

Page 137: ...4 The measurements carried out by the pulse oximetry module are proba bilistic and it can be expected that only two thirds of these measure ments can fall within the limits of the standard deviation in comparison with the measurements performed with the CO oximeter Intravascular administration of dyes such as methylene blue indigo car mine or any substances containing dyes that alter the usual abs...

Page 138: ...rgy consumption resting energy expenditure at rest VCO2 minute volume of the exhaled СО2 lpm VO2 minute volume of the consumed О2 lpm N the number of minutes in the day Pneumatic system of the metabolism measurement module has two ports Input REE pneumo connector is located directly on the water trap of the device and is used for the sampling line connection Output port figure 2 1 position 22 is a...

Page 139: ...h other The measurement results are not valid If the lea kage occurred Use only clean and dry sampling lines without drops of liquid inside For dripping of the condensate produced in connecting device middle part of it should be hung higher that its ends Port of the adapter connected to the sampling line should be faced up to eliminate the accumulation of moisture in the adapter see Figure 5 13 Fi...

Page 140: ...e it 4 13 Metabolism status messages Metabolism status messages are displayed only in the bottom line of the Metabolism window These messages are not displayed neither in the area of alarm list indication nor Alarm log section Table 5 1 Metabolism status messages No Alarm message Alarm conditions Reaction of ventilator operator s actions 1 Measuring Measurement Metabolism module is working properl...

Page 141: ...O in accordance with it 4 16 2 Calculation of metabolic parameters is blocked in the absence of fixing of respiration during zero calibration and occlusion of sampling line When operating with metabolism measurement module remember that explosion of liquid through sampling line in its measuring path can affect normal operation so the device has number of measures for protection against moisture Th...

Page 142: ...tempts to block it the metabolism measurement module will automatically be turned off with the status message Occlusion If test was not successful disconnect of the sampling line from water trap and directly close the inlet port of water trap If message about occlusion appears the reason is in the tube or its loose connection with inlet port and if not the reason is inside pneumatic system of the ...

Page 143: ...r the current ideal body weight of the patient is set by default The function of the endotracheal tube compensation is available in CPAP PS mode by adjust ing of ETC parameter in the line of ventilation parameters setting top row The user can select the desired level of the tube resistance compensation from 0 to 100 A value of 0 corresponds to the OFF state the initial state of the device at power...

Page 144: ... pressure to calculate transpulmonary pressure on the inspiration and expiration phase In addition multifunction nasogastric catheter allows to monitor pressure in the stomach and feed the patient Before switching on the device make sure that monitoring line for pressure measurement disconnected from the Paux fitting Figure 2 1 position 15 Connect the monitoring line when the device is switched on...

Page 145: ...ble Figure 5 17 Additional external pressure curve Assembly of the circuit of external auxiliary pressure measurement in trachea Assembly scheme for pressure measurement in trachea is shown on Figure 5 18 Figure 5 18 Connection scheme of the tracheal catheter Connect a respiratory virus bacterial filter with the Luer connector and an monitoring line to the Paux pressure port ...

Page 146: ...r from the delivery set of the device through the adapter of the catheter into the flex tube connector Cut the catheter tube according to the length of the endotracheal tube Figure 5 20a Connect the monitoring line to the catheter Figure 5 20b а b Figure 5 20 Connecting of the catheter а and monitoring line b Connect the endotracheal or tracheostomy tube to the flex tube connector Figure 5 21a The...

Page 147: ...pplied with the catheters Connect a hydrophobic virus bacterial filter with the Luer connector and monitoring line to the Paux pressure port Figure 5 22 Figure 5 22 Connection of the esophageal balloon catheter or multifunction nasogastric cathe ter to the ventilator Indication of transpulmonary pressure To display the calculated transpulmonary pressure select the Ptp value for one of the mea sure...

Page 148: ... the low pressure oxygen source set the oxygen flow approximately corresponding to the minute respiration volume If the minute volume is greater than the ca pacity of the oxygen concentrator set the maximum flow value It is allowed to set the maxi mum flow value on the oxygen concentrator even at the required minute respiration volume 5 lpm In this case there will be only a certain oxygen overchar...

Page 149: ...the button on the main screen of de vice figure 4 4 position 8 Image is saved in the file scr0000 bmp number changes with the increasing of the number of files in the SCREEN directory file system FAT During screenshot up to 40 sec the work with the interface touch screen buttons and encoder is blocked the content of the screen is not updated This condition is indicated by symbol Ventilation is not...

Page 150: ...lator To avoid malfunctions before turning on the device connect standard USB flash memory de vice USB flash to the USB connector on the rear panel To record a trend fragment enter the trend view function select the necessary fragment i e the beginning and end of the trend The record scale of a trend fragment can be changed via Menu Trends Edit on 156 312 or 104 minutes If USB flash drive is inser...

Page 151: ...he FiO2 sensor perform the training of the built in rechargeable battery 6 1 Maintenance schedule Routine Periodicity Description 1 Visual inspection and test of controls monthly it 6 2 2 Cleaning of fan filters monthly it 6 3 3 Check of sealing gaskets of oxygen hose and water trap 1 time in 3 months it 6 4 4 Check of the filter regulator 1 time in 3 months it 6 5 5 Check of the expiration valve ...

Page 152: ...ing fan and fresh air fan on the rear panel of the device Fig ure 2 2 positions 2 8 easily pulling them toward to you Remove the dust filters and clean them by washing in soap solution rinse in clean water and dry In the case of their substantial deterioration use the new dust filters supplied 2 pcs or order them through the service organi zation Make sure that filters are completely dry set them ...

Page 153: ...n replace by supplied spare filter For this purpose unscrew the filter housing and then the filter itself from the housing Figure 6 2 In sert the new filter never try to clean old and repeat the steps in reverse order Figure 6 2 Disconnection of filter regulator housing 6 6 Check of the expiration valve Detach removable part of the expiration valve check the condition of the membrane see Figure 6 ...

Page 154: ...e graphic button Monitoring By setting different FiO2 values in the range 21 100 check that the absolute error of the measured values of FiO2 does not exceed 3 If the measurement error exceeds 3 disconnect the device from the oxygen source and ca librate the oxygen sensors it 4 16 2 If calibration fails replace oxygen sensors Replacement of the oxygen sensor of metabolism measurement module requir...

Page 155: ...ding access to the battery compartment cover Remove the 4 screws of battery compartment cover Pull out the cover and take it out of the slots in the housing of the device Figure 6 5 Successively take out the accumulators from the housing If necessary use a flat screwdriver Disconnect the accumulator cable and the jumper between the accumulators Figure 6 5 Replacement of accumulator Connect new acc...

Page 156: ...eds 15 calibrate flow sensor on expiration it 4 16 3 If it doesn t help device shall be sent for repair 6 10 Check of PEEP Assemble the scheme on Figure 6 6 Connect the breathing circuit to the device Connect the endotracheal tube ETT to the patient tee Install the breathing bag on the patient tee pre viously ETT shall be placed in the breathing bag 3L Turn on the device set any mandatory ventilat...

Page 157: ...nected from the breathing circuit Turn on the ventilator and the mainstream CO2 sensor will also be turned on Wait for sensor warming up the message about warming on the display disappears Enter Menu Service menu Calibration CAPNO Select Zero calibration for MS capno During calibration approximately 30 sec ensure ab sence of CO2 in the measuring chamber of adapter If calibration is successful the ...

Page 158: ...6 11 Check and calibration of mainstream CO2 sensor 6 8 For your notes ...

Page 159: ...n or expiration filter is occluded Check breathing circuit for occlu sion or compression check the inspiration expiration filters if necessary clean Faulty expiration valve Call for Triton Electronic Systems Ltd service or your local repre sentative Alarm message about high oxygen pressure is displayed The device is connected to the compressed oxygen source without the filter regulator or fil ter ...

Page 160: ...7 Troubleshooting 7 2 For your notes ...

Page 161: ... long term storage after use the device should be placed in polyethylene case and if possible packaged in manufacturer s packaging way to protect against possible mechanical damage In case of long term storage of device to maintain its operability carry out tests according Sec tion 6 at least every six months If necessary accessories with a limited service life should be replaced At malfunction th...

Page 162: ...8 Transportation 9 Storage 10 Disposal 10 2 For your notes ...

Page 163: ...manufacturing of the equipment specified on the equipment and in the current Manual In any case the warranty op eration period can not exceed 18 months from the date of manufacture of the equipment For the equipment repaired in the authorized service center there is an additional warranty of 6 months and it is calculated from the date of completion of the repair specified in the current Ma nual Th...

Page 164: ...ice center assemble a complete delivery set of equipment and pack it in order to avoid damage to the equipment during transportation It is preferable to use the equipment original package 4 After delivery of the equipment to service center you will be informed about the results of technical examination and the timing of receipt of the repaired equipment in case of recogni tion of the case as a gua...

Page 165: ...ature name 13 COMMISSION DATE MARK Commission date ____________________________ day month year Operating company customer _______________________________________________________________________ company name ____________________________________________________________________________ responsible representative position signature name stamp Service company provider __________________________________...

Page 166: ...13 commission date mark 12 2 For your notes ...

Page 167: ...onnel or service organization The frequency and order of maintenance are specified in Section 6 of current Manual MA No MA date Company position MA resp person Remarks works performed Signature of MA re sponsible person 14 2 Device repair Repair date Malfunction Company position repair resp person Works performed Signature of repair re sponsible person ...

Page 168: ...14 Maintenance and repair data 14 2 For your notes ...

Page 169: ...spiratory rate with the set duration of the respiratory cycle Figure App 1 1 Graphs of pressure top and flow bottom in CMV VCV modes with de creasing flow The shaded area shows volumes of both inspiration and expiration In the CMV VCV mode possibility of support of the spontaneous breaths initiated by the patient is provided This possibility is realized by setting of the trigger sensitivity Automa...

Page 170: ... over PEEP and rigidly held during inspiration The device displays the measured tidal and minute breath volumes The minute breath volume is measured on an exhalation by summation of expiratory volumes within a minute Figure App 1 2 Graphs of pressure top and flow bottom in CMV PCV modes In the CMV PCV mode possibility of support of the spontaneous breaths initiated by the patient is provided This ...

Page 171: ...ent breaths of the patient are supported by the set level of pressure invariable throughout all time support pressure PS Criterion of the spontaneous breath termination is flow falling to the set level ETS from the maximum Reserve criterion is time if the flow does not manage to decrease to ETS for the maximum allowed inspiratory time Decreasing of the mandatory breaths frequency and tidal volume ...

Page 172: ...neous inspiration is flow drop to the set flow ETS value from maximum expiratory trigger or trigger of the end of inspiration Reserve criterion of end of inspiration is time if the flow does not have time to decrease to ETS for the maximum allowed inspiratory time Tinsp In CPAP PS mode the maximum inspiratory time Tinsp is limited to 4 s In the CPAP PS mode the Tinsp parameter defines the inspirat...

Page 173: ...ycle is the activation of the inspiration trigger flow or pressure The criterion for the end of spontaneous inspiration is a flow drop to the set value ETS from the maximum Reserve criterion is time if the flow does not have time to decrease to ETS for the maximum allowed inspiratory time In the absence of spontaneous breathing through a preset time Tapnea apnea alarm is trig gered and the device ...

Page 174: ...vice is close to the CMV PCV mode under the following conditions sponta neous respiratory patient s contribution is small respiratory rate is quite high it means time Thigh corresponds to the physiological inspiratory time 0 5 1 5 seconds and Thigh Tlow ratio is selected in the range of 1 3 The difference is that any spontaneous breath will be supported with the pressure Figure App 1 5 Pressure su...

Page 175: ...s breath in the low or high pressure phase is supported with the pressure At the inverse ratio of high and low pressure phases Thigh Tlow 1 the operation of device ap proximates to the APRV mode Figure App 1 7 The operation of device is approaching to the APRV mode P t PS Phigh Plow Tlow Thigh P t PS Phigh Plow Tlow Thigh ...

Page 176: ...bration Menu Service menu Calibration Breathing circuit cali bration measuring the circuit parameters shall always be carried out after circuit change and autoclaving This is suitable for any mode but is especially important for the transition from in vasive to non invasive ventilation and vice versa Due to the presence of the leakage model the ventilator can compensate large leak up to 90 lpm At ...

Page 177: ...ows to release the lungs from the reserve gas with specified intervals due to the low pressure phase Tlow Restoring of the previous level of PEEP in the beginning of Thigh phase is performed by fresh gas without carbon dioxide thereby eliminating the above premise for hypercapnia So APRV mode allows to replace periodically the residual gas in the lungs improving excretion of carbon dioxide APRV mo...

Page 178: ...the flexibility of the mode it is com bined with the A C assisted control mechanism It is mechanism of trigger window for the mandatory breaths The user can allow the inspiration to be initiated by the patient by the TrigWnd parameter trigger window The trigger window is the time from the end of expiration to the beginning of the next expiration the duration of the trigger window can be set from 0...

Page 179: ...ilation mode with the pressure control Piapnea is set by the user In the NIV mode only apnea ventilation with the pressure control is available Apnea ventilation mode is not intended for the long term patient ventilation Therefore the tran sition of the ventilator to this mode triggers an alarm attracting the attention of the user show ing the need for making a decision about the future strategy o...

Page 180: ...nics providing the minimum work of breathing automatically adjusts the I E ratio prevents the situation with the development of perceptible autoPEEP provides ventilation at the minimum possible airway pressure uses double control automatically calculates static and dynamic in real time taking into account RCexp limits of the safe ventilation for Vt RB and I E ensures strict compliance of the venti...

Page 181: ...rate tidal volume approaches the dead space volume It results only in dead space ventilation and the absence of alveolar ventilation Such conditions do not occur at the small deviations of respira tory mechanics parameters the compliance resistance that are transported to the Otis equia tion through the expiratory constant However at the more significant deviations of these para meters from the no...

Page 182: ...e harder are the lungs respectively the less is com pliance respectively I E ratio tends to 2 1 And conversely the less number of the constants are in the breathing cycle the higher is the resistance I E ratio tends to 1 4 giving priority to ex piration With the height of the real patient and standard values of compliance and resistance for each patient height there is a direct correlation ideal R...

Page 183: ...8 20 10 21 23 15 0 9 15 7 24 29 15 1 15 7 30 39 15 1 14 7 40 59 15 1 12 6 60 89 15 1 10 5 90 99 18 1 5 10 5 100 20 1 5 10 5 Regardless of the type of breath hardware synchronized hardware or supporting the average value of compliance as well as the average RCe value for the Otis equation are calculated after three breaths to correct hardware and supporting breaths with DC At the switching from ano...

Page 184: ...ontaneous breathing the device carries out mandatory ven tilation The parameters of breaths are calculated in real time by the Otis equation Hardware breaths are performed in the double control mode The second part of the mode reminds CPAP PS but the volume of supporting breaths is regu lated automatically through the pressure If the spontaneous breath occurs pressure support PS is provided At the...

Page 185: ... to its initial value that is set by the physician at the absence of tachypnea At the termination of spontaneous breathing at the stage of adaptation when the percentage of MV is increased the pattern is supported with hardware breaths calculated for the current ac cumulated MV At the further absence of spontaneous breaths the current MV decreases to the value MV set by the physician with step of ...

Page 186: ...erve pressure and usually prevents the achievement of Pmax and alarm triggering However at the intense coughing this measure is not always effective alarms can be generated frequently It can distract and annoy the staff and even lead to a reduction in its vigilance In such a situation it is recommended to select ventilation modes with pressure control CMV PCV SIMV PC that are more resistant to pre...

Page 187: ...eters obtained by this method are named as C and R and are displayed in sepa rate block of measurement parameters The values of the parameters C and R vary on every respiratory cycle At C and R parameters obtaining a modern mathematical method for calculating lung mechan ics called the LSF least square fitting is used The LSF method is based on the analysis of the mathematical model of the lungs m...

Page 188: ...s the gas flows from the lungs to the breathing circuit Pressure equalization occurs in the circuit lungs system At the moment when the pressure change in the circuit becomes equal or less than 0 5 cmH2O s but no earlier than 0 5 s and not later than 3 seconds the procedure ends and inspiration begins autoPEEP P t3 P t2 Expiration hold in any case can not exceed 3 seconds Appendix 2 3 Mean pressur...

Page 189: ...to 2 phases fast and slow at the calculation of τexp because t of different areas of lungs can significantly differ Fast one is associated mainly with the gas flow from the breathing circuit The slow one is related mainly with the gas flow from the broncho pulmonary tract The ventilator detects τexp for slow expiratory phase To elim inate the distortion of the result by the expiration part from th...

Page 190: ... are discarded measurement is carried out in the area A B Evalua tion of the correctness of τexp values is carried out by calculating the confidence factor of flow curve approximation that should be at least 0 6 Otherwise the measurement is considered to be misleading and dashes are displayed instead of the R Average value of the time constant of the section A B is calculated using this procedure ...

Page 191: ...ency of spontaneous breaths τexp time constant of the respiratory tract at the expiration Calculation of the RSBI is performed only at spontaneous inspiration in CPAP PS BiSTEP APRV modes Measurement of texp is made at the each exhalation and is averaged for the last 4 cycles Appendix 2 7 Stress index SI The device uses a graphical method for finding the stress index SI The idea of the stress inde...

Page 192: ... index SI At b 1 the equation becomes linear Appendix 2 8 Patient s respiratory effort P0 1 The value P0 1 characterizes the patient s ability to the independent breathing P0 1 value is the pressure difference between the moment of start of the inspiration t 0 and moment of com pletion of 100 ms in the occluded circuit This pressure difference is generated by the inspiratory effort of the patient ...

Page 193: ...lue is measured at the closed inspiratory and expiratory branches of the patient s circuit P0 1 P t100 P t0 Many studies have shown that the patient feels occlusion of the circuit if the occlusion time ex ceeds 0 15 seconds He begins to worry that affects the measurement process 0 1 seconds is a compromise for both physicians and patients The following procedure is used in the device Figure App 2 ...

Page 194: ...e there is a nonlinear depen dence between the weight and the height For pediatric mode centile WHO World Health Or ganization tables compiled on the basis of multi center studies conducted in many countries are used Brief description of tables is as follows Measurements of weight and height in child ren of the same age are performed and research results are divided into a number of corri dors or ...

Page 195: ... 110 18 3 18 3 70 8 4 8 2 111 18 9 19 0 71 8 6 8 4 112 19 2 19 4 72 8 9 8 6 113 19 6 19 8 73 9 1 8 8 114 20 0 20 2 74 9 3 9 0 115 20 4 20 7 75 9 5 9 1 116 20 8 21 1 76 9 7 9 3 117 21 2 21 5 77 9 9 9 5 118 21 6 22 0 78 10 1 9 7 119 22 0 22 4 79 10 3 9 9 120 22 4 23 4 80 10 4 10 1 122 25 0 23 4 81 10 6 10 3 124 26 0 24 0 82 10 8 10 5 126 27 0 24 7 83 11 0 10 7 128 28 0 25 3 84 11 3 11 0 130 30 0 26 ...

Page 196: ...Appendix 2 9 Ideal body weight of the patient IBW App 2 10 For your notes ...

Page 197: ... guidance Electrostatic discharge ESD IEC 61000 4 2 2008 6 kV contact 8 kV air 6 kV contact 8 kV air Floors should be wood con crete or ceramic tile If floors are covered with synthetic ma terial the relative humidity should be at least 30 Electrical fast transient burst IEC 61000 4 4 2012 2 kV for power supply lines 1 kV for input output lines 2 kV for power supply lines 1 kV for input output lin...

Page 198: ...urer and d is the rec ommended separation dis tance in metres m Field strengths from fixed RF transmitters as determined by an electromagnetic site sur vey a should be less than the compliance level in each frequency range b Interference may occur in the vicinity of equipment marked with the following symbol Note 1 At 80 MHz and 800 MHz the higher frequency range applies Note 2 These guidelines ma...

Page 199: ... frequency of transmitter m 150 kHz to 80 MHz outside ISM bands 150 kHz to 80 MHz in ISM bands 80 MHz to 800 MHz 800 MHz to 2 5 GHz d 1 2 P d 1 2 P d 1 2 P d 2 3 P 0 01 0 12 0 12 0 12 0 23 0 1 0 38 0 38 0 38 0 73 1 1 20 1 20 1 20 2 30 10 3 80 3 80 3 80 7 27 100 12 00 12 00 12 00 23 00 For transmitters rated at a maximum output power not listed above the recommended separation distance d in meters ...

Page 200: ...Appendix 3 Electromagnetic environment App 3 4 For your notes ...

Page 201: ...Appendix 4 Pneumatic scheme of ventilator App 4 1 APPENDIX 4 PNEUMATIC SCHEME OF VENTILATOR ...

Page 202: ...Appendix 4 Pneumatic scheme of ventilator App 4 2 For your notes ...

Page 203: ...7 6 Contact ser vice department A detailed description of the malfunction and an indication of the unit in which the malfunction occurred are given in Table App 5 1 This information is to be reported to the service depart ment Table App 5 1 Technical malfunction messages No Alarm message Alarm conditions Module 1 Technical malfunction 1 Tech malf 1 There is no communication with the gas mixer CIVL...

Page 204: ...the operator Technical messages are intended for service per sonnel A detailed description of the technical messages and an indication of the unit in which the malfunction occurred are given in Table App 5 2 Table App 5 2 Technical malfunction messages No Alarm message Alarm conditions Module 1 Technical Message 1 Tech msg 1 CIND restart type R CIND 2 Technical Message 2 Tech msg 2 CIND restart ty...

Page 205: ...cal Technology Co Ltd Taiwan by special order MR810 Fisher Paykel Healthcare Ltd New Zealand MR850 Bundle Fisher Paykel Healthcare Ltd New Zealand 1 8 humidifier chamber G 314002 VADI Medical Technology Co Ltd Taiwan by special order MR370 Fisher Paykel New Zealand 1 9 patient circuit disposable adult 038 01 155B Flexicare Medical Ltd UK 1 5009 Intersurgical Ltd UK 1 10 patient circuit disposable ...

Page 206: ... UK 1 038 41 355 Flexicare Medical Ltd UK 1 21 HME filter pediatric disposable Filta Therm 1641 Intersurgical Ltd UK by special order 038 42 355 Flexicare Medical Ltd UK 1 22 hydrophobic filter 010 740 Flexicare Medical Limited UK by special order REF 2715 Intersurgical Ltd UK 1 23 breathing bag 0 5 L 038 83 805NL Flexicare Medical Limited UK by special order 0 5 L 2805 Intersurgical Ltd UK 1 24 b...

Page 207: ...special order 1 35 mask for NIV FaceFit REF2252 Intersurgical Ltd UK by special order 1 36 mask NIV431 Fisher Paykel Healthcare Ltd New Zealand by special order 1 37 flex tube G 322011 VADI Medical Technology Co Ltd Taiwan by special order 1 38 gas monitoring line 2 m 010 700 Flexicare Medical Li mited UK by special order 2 45 m REF2732 Intersurgical Ltd UK 1 39 nut М6 6Н 5 016 GOST 3032 76 1 1 40...

Page 208: ... Electronic Sys tems Ltd Russian Federation 1 2 3 membrane TESM 236501 Triton Electronic Sys tems Ltd Russian Federation 1 2 4 dust filter TESM 009926 Triton Electronic Sys tems Ltd Russian Federation 2 2 5 water trap 60 13100 00 Dryline Water Trap Adu lit ARTEMA Sweden by special order 2 6 ring TESM 049124 Triton Electronic Sys tems Ltd Russian Federation 2 3 Accompanying documents 3 1 User manua...

Page 209: ...nterruption of ventilation service manual Available Available 1 9 Disable O2 monitoring and alarm triggering at the oxy gen sensor failure Available 1 10 Ability to ventilate only by air in the absence of oxygen Ability to disable the alarm in the absence of oxygen and ventilation only by air Available Available 1 11 User interaface Control via the touch screen quick keys buttons for parameters th...

Page 210: ...compensated circuit disconnection alarm is triggered 2 6 Manual breath manual ventilation Immediate breath by the operator com mand if necessary clinician may perform breaths with the desired frequency 2 7 Freezing analysis of graphs Stopping of the graphs for the analysis of in stantaneous values 2 8 Screen lock Protects the device from unintended modifi cation of the ventilation modes 2 9 Displa...

Page 211: ...eteness of exhalation AutoPEEP 5 3 Flow at the end of expiration residual gas flow from the lungs arising from incomplete exhalation ExpEndFlow 5 4 Expiratory time constant time constant that determines the potential rate of pressure change in the lungs during expiration τexp Rexp Cexp RCexp 5 5 Inspiratory time constant time constant that determines the potential rate of pressure change in the lu...

Page 212: ...es and 1 loop at the user s choice Ability to save freeze the reference loop and to the store the mo ment of saving Analysis of the main para meters of the respiratory cycle 7 3 Graphs spirometric curves with automatic scaling of the amplitude versus time Paw pressure Flow flow Vol volume Loops volume flow V F volume pressure V P flow pressure F P Optional PCО2 capnogram in mmHg PCO2 capnogram in ...

Page 213: ...of amount of carbon dioxide exhaled by the patient VCO2 functional dead space Vd alveolar minute ventilation MValv alveolar ventilation Valv 8 3 Function of cardiac output calculation in accordance with A Fick method Provides calculation and displaying of car diac output by A Fick 8 4 Pulse oximetry module Provides the evaluation of oxygen saturation of arterial hemoglobin SpO2 in the range of 60 ...

Page 214: ...CTERISTICS App 7 6 No Parameter Value description Interface for connecting USB flash memory device USB connector on the rear panel Transmitted data screenshot current status of the screen the alarm log the service log selected segment of trend ...

Page 215: ...rature Pressure conversion is carried out for the relative humidity of 30 and am bient temperature of 25 C ATPD Type of flow correction on inspiration and expiration Ambient Temperature Pressure Dried ambient temperature and pressure with humidity 0 this correction is similar to ATP at 0 relative humidity ATPS Type of flow correction on inspiration and expiration Ambient Temperature Pressure Satur...

Page 216: ...output by oxygen consumption estimation Compl meas period Compliance measurement period Defines the time between the cycles of com pliance and resistance measurements Compliance See C Compliance of the breathing circuit See Ccirc CPAP PS Constant Positive Airway Pressure The ventilation mode supporting spontane ous breathing with the set positive airway pressure The device supports the spontaneous...

Page 217: ...onal dead space See Vd The default value is calculated as a function of the patient s growth Gas mixer See GM Gas mixture Gas entering the patient environmental air enriched with oxygen warmed and moistened At operation of nebulizer with medications GM Gas mixer Part of the hardware responsible for mixing of external air and oxy gen inside the ventilator Humidifier Device for increasing the humidi...

Page 218: ... concentration obtained using one of the laboratory techniques Paux Auxiliary external pressure Paw Airway pressure waveform graph PCV VG Mandatory ventilation with guaranteed delivery of target respiratory volume at minimum possible pressure Functionally mode repeats the CMV PCV mode with one exception instead of the target pressure the user sets the target in spiratory volume The inspiratory pre...

Page 219: ...ng of oxygen saturation of arterial blood hemoglobin SpO2 peripheral pulse rate PR displaying of photoplethysmo gram PvCO2 Venous CO2 concentration obtained using one of the laboratory techniques PО2 Oxigram for operation with metabolism measurement module calculated as the difference FiO2 EtO2 graph Qmax The maximum oxygen flow passed through the port R LSF Resistance resistance of airways to the...

Page 220: ...ss index Index characterizes the correctness of PEEP and Vt selection It is determined in the CMV VCV and SIMV VC modes for hardware breaths at the rectangular shape of the flow waveform Sigh Mode of the deepen sigh SIMV DC Synchronized Intermittent Mandatory Ventilation Double Control Ventilation mode the analogue of the SIMV PC except that the ventilator s breath is per formed in a double check ...

Page 221: ... ventilation VT tidal volume Vd dead space volume RB respiratory rate Vapnea Tidal volume in the apnea mode VCO2 Elimination of СО2 per minute difference between СО2 concentration in the in haled and exhaled mixture Volume capnography waveform Vd Functional dead space The inspiratory air volume that almost does not take part in gas exchange The default value is calculated as a function of the pa t...

Page 222: ...GLOSSARY Gl 8 ments It is calculated only by the hardware breaths Work is 0 for spontaneous breaths Т disconn in NIV Delay time of disconnection alarm triggering in the NIV mode ...

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