Lowenstein Medical elisa 300, Инструкция по эксплуатации

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A 3 | Functions
44
Instructions for Use elisa 300-500 | Supplement A | SW 2.09.x | Rev. 11
A 3.5.4
Manual HOLD manoeuvre
The device offers a manual hold manoeuvre, which facilitates the determination
of the end-inspiratory pressure situation. After selecting the manual hold button
and simultaneously pressing the Enter button, a prolonged inspiration of up to 15
seconds is applied at the pressure level of the respective ventilation settings, and
TPP insp. is continuously measured.
The remaining time of the manoeuvre is displayed in a bar chart. Upon termina-
tion of the manoeuvre, ventilation continues.
After five manoeuvres, the button is blocked for 30 seconds. Another manual hold
manoeuvre can be performed after the lockout time.
Remark
The maximum duration of the manual hold manoeuvre is 15 sec -
onds.
A 3.6
IAP (Intra-abdominal pressure)
A kit for measurement of the intravesical pressure can be connected to the ven-
tilator via the additional pressure port Paux II. This allows the acquisition of the
intra-abdominal pressure, using intravesical pressure (IVP) as a surrogate parame -
ter. Intra-abdominal hypertension (IAH) is defined as an intra-abdominal pressure
(IAP) equal to or above 12 mmHg, and abdominal compartment syndrome (ACS)
is defined as an IAP above 20 mmHg with evidence of organ dysfunction/fail -
ure. Both levels of increased intra-abdominal pressure cause significant morbid -
ity and mortality among intensive care patients. This includes acute renal failure,
pulmonary impairment, and reduced blood flow to the gastro-intestinal organs.
In addition, increased IAP can cause elevation of the diaphragm with consequent
increase in intra-thoracic pressure, which has a major effect on pulmonary com-
pliance. The high intra-thoracic pressure may interfere with the cerebral venous
return via the jugular venous system leading to intra-cranial congestion and brain
dysfunction. Clinically, significant intra-abdominal hypertension may be present in
the absence of abdominal distension. Therefore, increased IAP is commonly meas -
ured by recording intravesical pressure (IVP).
Remark
The IAP (intra-abdominal pressure) function is not available for eli-
sa 300.
Warning
Check that the intravesical pressure measurement kit is connect-
ed to the correct port and familiarise yourself with intravesical
pressure measurement with a closed system.