Siemens Drager medical Carina, Инструкция по эксплуатации, Страница: 137 / 144

Instructions for Use Carina SW 3.n
137
Description
Information concerning CO
2
re-breathing
As with any ventilator used for NIV (mask ventila-
tion) there are conditions under which patient CO
2
re-breathing can occur while using the Carina ven-
tilator. The following guidelines are provided to alert
the user to these conditions and to suggest meth-
ods for reducing the potential for CO
2
re-breathing.
If re-breathing is a significant concern for a particu-
lar patient and these guidelines are not sufficient to
acceptably reduce the potential for CO
2
re-breath-
ing, an alternative means of ventilation should be
considered.
Never leave the mask on the patient while Carina is
not operating. When the Carina unit is not operat-
ing, the VentStar Carina LeakV (MP 00 312) does
not allow sufficient exhaust to eliminate CO
2
from
the circuit. Substantial CO
2
re-breathing will occur.
Patient monitoring should be performed initially and
with each change in ventilator setting, circuit config-
uration or patient condition to detect changes in
respiratory status that may indicate excessive CO
2
re-breathing.
In general, as circuit pressure decreases, the
potential for CO
2
re-breathing increases. Lower
pressure produces less flow through the exhalation
port, which may not purge all CO
2
from the circuit
to prevent re-breathing. Higher tidal volumes fur-
ther increase the volume of CO
2
re-breathed by the
patient in such circumstances.
Reducing dead space can also lower potential CO
2
re-breathing.
The » Airway pressure low !!! « alarm can be
delayed by up to 60 seconds. For this reason, the
delay time T
disconn
can be set from 0 to 60 seconds
for tube ventilation and from 0 to 120 seconds for
mask ventilation. At a setting of 15 seconds, for
example, the patient can remove the mask for up to
15 seconds before Carina emits an alarm.
WARNING
Never leave the mask on patient while Carina
is not ventilating. There is a risk of CO
2
re-
breathing in case of no ventilation. See below.
WARNING
Remove the mask immediately if ventilation
fails. There is a risk of CO
2
re-breathing in
case of a device failure.
WARNING
The operator should instruct the patient how
to remove the mask. There is a risk of CO
2
re-
breathing in case of a device failure.
WARNING
In general, as inspiratory time increases, the
potential for CO
2
re-breathing increases. A
higher inspiratory time decreases exhalation
time, allowing less CO
2
to be purged from the
circuit before the next cycle. In such circum-
stances, higher tidal volumes further
increases the volume of CO
2
re-breathed by
the patient.