Siemens Drager medical Carina, Инструкция по эксплуатации, Страница: 138 / 144

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Instructions for Use Carina SW 3.n
Description
SyncPlus
SyncPlus is an automatic function for supporting
NIV (mask ventilation).
This automatic technology are supported by 3 main
features:
– Multi-sence trigger
– Automatic leakage compensation
– Cycle learning
Multi-sence trigger
Carina is using 3 triggering criteria for detecting
patient breath effort for both inspiratory and expira-
tory detection.
– Pressure
– Flow rate
– Flow gradient (rate of change in flow)
This mixture of triggering criteria helps to maintain
the trigger sensitivity at a higher level.
Flow gradient will often be 80 % as this is normally
the fastest measurement criteria.
Automatic leakage compensation (hose system
with leak valve)
Carina is trying to detect the level of constant leak-
age besides the leakage from leakage valve. Then
Carina defines the new base line on the level of
leakage. This function helps to reduce any missed
triggering smoothing breath care for the patient.
Technically, there is no limitation for leakage com-
pensation. But the alarm »
Large Leakage !!! « will
occur, if a defined constant leakage flow level is
exceeded. Alarm is not active in ventilation mode
SPN-CPAP.
Cycle learning
Carina is trying to learn the average cycle of patient
spontaneous breath. This helps to predict the tim-
ing of the patient's breath. The Carina then sets the
highest sensitivity based on the timing of the
patients end inspiratory breath. This function helps
to keep high sensitivity and avoids missed trigger-
ing for patients.
During ventilation with Carina, the trigger criteria in
the »
Mask « and » Tube « application methods are
automatically compensated.
Volume Guarantee (VG)
The ventilation mode extension VG allows for the
volume support on SPN-PS mode. Carina controls
inspiratory plateau pressure automatically, in order
to deliver the set tidal volume. Changes in the
mechanical properties of the respiratory system are
compensated. Tidal volume of delivered breaths
remains constant. VG is to be used with ventilation
modes SPN-PS.
Carina determines the pressure required for the set
tidal volume with consideration of the lung condi-
tions (compliance, resistance) and the patient's
spontaneous breathing demand.The inspiratory
pressure is limited by the alarm limit Paw high. The
maximum pressure applied is limited by P
max
and
therefore restricted to 5 mbar below the upper pres-
sure limit Paw high. Always set Pmax and Paw high
in order to generate an alarm in the event of an
increase in airway pressure due to reduced compli-
ance. Control of PIP is performed in the range from
+2 mbar up to P
max
. The user determines the pres-
sure the ventilator is allowed to apply via P
max
.
There is a situation where the ventilator will not be
able to deliver the target volume:
PIP is reached to P
max
. In this situation, Carina will
display the message » Pmax limit reached ! «.
P
max
should be set on the maximum allowable
value. The control operates in a breath-to-breath
fashion. The volume delivered to the lung is calcu-
lated based on the actual measured flow, pressure
and average flow and pressure.
Then, actual tidal volume is compared to the target
volume and a new plateau pressure is then calcu-
lated for the next breath.
After a change in target volume, it will take between
5 to12 breaths before the corresponding inspiratory
pressure has been reached.