Operator’s Manual
AVEA
Ventilator Systems
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AVEA Ventilator Systems
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Revision History
Date
Revision
June 2002
B
All
Release
August 2002
C
All
Update to new software release. Add new graphics.
New O2 sensor configuration. Add Trends &
Events.
November 2002
D
All
Update to match new software. Add CPAP & APRV
Apnea screens. Add minimum battery charge
caution. Standardize watertraps for all patient sizes.
Add external filter/watertrap for wall air supply. Add
NIST fittings option. Add external battery option and
optional tank rack. Add Hot Wire sensor specs.
January 2003
E
All
Change ATC to ACC. Change APRV to APRV/BiPhasic. Add new Advanced Controls to APRV. Add
tethered Air & Heliox connector graphics and update
back panel. Add new alarms. Add message bar
text (Appendix F) and Popup alerts to Chapter 5.
Add Events abbreviations to in Chapter 4.
February 2003
F
Page 33, 129 and 132
Remove references to EPM Kit. Label Esophageal &
Tracheal monitoring as Future Option. Update fuse
dimensions.
March 2003
G
Page (s) 21, 31, 33, 38
– 40, 51, 56, 58, 60, 65,
67 – 70, 92, 94 - 95,
107 – 109, 128, 148
Add note on Hot wire sensors & Heliox delivery. Add
Appendix G Setting barometric pressure at altitude.
Update Vol Limit in Advanced Settings. Add
graphics for the integral water trap on the Air inlet
“smart” fitting. Update the Default settings table. Add
Battery charging in verbiage in Chapter 6.
April 2003
H
23
Correct part numbers
June 2003
J
Page(s) 19, 20, 32, 3537,44,49,56, 75, 131
Update Functions & Accessories, Front Panel
Connections. Attaching a proximal Pressure Sensor,
Tracheal Catheter, RS232, Troubleshooting, Low
Tidal Volume Alarm, Battery charging
recommendations
August 2003
K
Page(s) 35, 43-44, 46,
52, 122, Apx E
Add Warning in TCPL, Add Utilities Screen, Add
Analog Input, Add Circuit Occlusion Alarm step, Add
Circuit Occlusion Alarm description, Service Life of
sensors
September 2003
L
Page(s) 19,26,
28,59,60,101, 118,132134, 138, 142
Del Stnd cart from Comp, Add Batt Caution, Cart
accessory P/N change, Del flow from Vsync cycle,
Change battery charge time from 48 hours to 12
hours, Add Note
November 2003
M
Pages 44,75-77,82,94,
101, 103, 104, 126, 146
PN correction, PRVC description, Add PSV Note &
waveform, Add Flow Cycle note, PN correction, Add
LEV alarm note, Digital Communications Update
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June 2004
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Pages 23, 35, 43, 46,
48, 51, 65, 108, 113,
156, 183
Revision N
Add Nebulizer/ Heliox Notes, Add Increase FiO2,
Add Configuration Tab Screen, Input/Output Tab
Screen, Date/Time Tab Screen, Add Configure
Increase FiO2, Add Demand Flow, Add Monitors,
Displays and Maneuvers, Add Appendix H, Add
back up alarm description
July 2004
5
Operator’s Manual
Warranty
THE AVEA ventilator systems are warranted to be free from defects in material and workmanship and
to meet the published specifications for Two (2) years or 16,000 hours, whichever occurs first.
The liability of VIASYS Healthcare, Critical Care Division, (referred to as the Company) under this
warranty is limited to replacing, repairing or issuing credit, at the discretion of the Company, for parts
that become defective or fail to meet published specifications during the warranty period; the Company
will not be liable under this warranty unless (A) the Company is promptly notified in writing by Buyer
upon discovery of defects or failure to meet published specifications; (B) the defective unit or part is
returned to the Company, transportation charges prepaid by Buyer; (C) the defective unit or part is
received by the Company for adjustment no later than four weeks following the last day of the warranty
period; and (D) the Company’s examination of such unit or part shall disclose, to its satisfaction, that
such defects or failures have not been caused by misuse, neglect, improper installation, unauthorized
repair, alteration or accident.
Any authorization of the Company for repair or alteration by the Buyer must be in writing to prevent
voiding the warranty. In no event shall the Company be liable to the Buyer for loss of profits, loss of
use, consequential damage or damages of any kind based upon a claim for breach of warranty, other
than the purchase price of any defective product covered hereunder.
The Company warranties as herein and above set forth shall not be enlarged, diminished or affected
by, and no obligation or liability shall arise or grow out of the rendering of technical advice or service by
the Company or its agents in connection with the Buyer's order of the products furnished hereunder.
Limitation of Liabilities
This warranty does not cover normal maintenance such as cleaning, adjustment or lubrication and
updating of equipment parts. This warranty shall be void and shall not apply if the equipment is used
with accessories or parts not manufactured by the Company or authorized for use in writing by the
Company or if the equipment is not maintained in accordance with the prescribed schedule of
maintenance.
The warranty stated above shall extend for a period of TWO (2) years from date of shipment or 16,000
hours of use, whichever occurs first, with the following exceptions:
1.
Components for monitoring of physical variables such as temperature, pressure, or flow are
warranted for ninety (90) days from date of receipt.
2.
Elastomeric components and other parts or components subject to deterioration, over which the
Company has no control, are warranted for sixty (60) days from date of receipt.
3.
Internal batteries are warranted for ninety (90) days from the date of receipt.
The foregoing is in lieu of any warranty, expressed or implied, including, without limitation, any warranty
of merchantability, except as to title, and can be amended only in writing by a duly authorized
representative of the Company.
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Contents
Revision History ..............................................................................................................3
Warranty........................................................................................................................................................5
Limitation of Liabilities..................................................................................................................................5
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Notices............................................................................................................................12
Copyright Notice.........................................................................................................................................12
Trademark Notices .....................................................................................................................................12
EMC Notice .................................................................................................................................................12
MRI Notice...................................................................................................................................................12
Intended Use Notice ...................................................................................................................................13
Regulatory Notice.......................................................................................................................................13
Classification ..............................................................................................................................................13
Declaration of Conformity Notice .............................................................................................................13
Safety Information .........................................................................................................14
Terms...........................................................................................................................................................14
Warnings .....................................................................................................................................................14
Cautions ......................................................................................................................................................15
Equipment Symbols ......................................................................................................16
Chapter 1 Introduction .................................................................................................20
Some AVEA Features.................................................................................................................................21
Artificial Airway Compensation ..................................................................................................................21
Full range of Patient Size...........................................................................................................................21
Leak Compensation...................................................................................................................................22
Circuit Compliance Compensation ............................................................................................................22
Humidification ............................................................................................................................................22
Heliox Delivery (Comprehensive only, option on Standard and Plus machines) ......................................23
Chapter 2 Unpacking & Setup .....................................................................................26
Ventilator Assembly & Physical Setup.....................................................................................................26
Unpacking the Ventilator............................................................................................................................26
Items Required for Ventilator Setup...........................................................................................................26
Assembling the Ventilator..........................................................................................................................28
Setting Up the Front of the Ventilator.......................................................................................................29
Assembling the Exhalation Filter and Water Trap......................................................................................29
Attaching the Patient Circuit ......................................................................................................................32
Front Panel Connections ...........................................................................................................................33
Attaching Flow Sensors.............................................................................................................................34
Attaching a Nebulizer ................................................................................................................................35
Attaching a Proximal Pressure Sensor ......................................................................................................36
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Esophageal Balloon...................................................................................................................................37
Tracheal Catheter......................................................................................................................................37
RS-232 Connections .................................................................................................................................38
Printer Connector ......................................................................................................................................39
SVGA Connector.......................................................................................................................................39
Medical Information Buss (MIB) Connector (Future Option)......................................................................39
Setting Up the Rear of the Ventilator........................................................................................................40
Connecting the Oxygen Sensor.................................................................................................................41
Connecting Gas Fittings ............................................................................................................................41
Attaching the Gas Hoses...........................................................................................................................42
Utilities Screens.........................................................................................................................................44
Input/Output Tab........................................................................................................................................49
Analog Input Configuration ........................................................................................................................49
Analog Outputs..........................................................................................................................................50
Nurse Call Connection...............................................................................................................................51
Date/Time Tab...........................................................................................................................................52
User Verification Test ................................................................................................................................53
The Power on Self Test (POST)................................................................................................................54
The Extended Systems Test (EST) ...........................................................................................................54
The Alarms Test ........................................................................................................................................56
Default Settings for Adult, Pediatric and Neonate .....................................................................................58
AVEA User Verification Test Checklist.....................................................................................................61
AVEA Troubleshooting ..............................................................................................................................62
Chapter 3 Ventilator Operation................................................................................... 65
Membrane Buttons and LEDs ...................................................................................................................65
A.
Alarm Silence (LED)........................................................................................................................66
B.
Alarm Reset ....................................................................................................................................66
C.
Alarm Limits ....................................................................................................................................67
D.
Manual Breath.................................................................................................................................67
E.
Suction (LED)..................................................................................................................................67
F.
Increase O2 .....................................................................................................................................67
G.
Data dial..........................................................................................................................................68
H.
Accept.............................................................................................................................................68
I.
Cancel .............................................................................................................................................68
J.
Expiratory Hold ...............................................................................................................................68
K.
Inspiratory Hold (Manual)................................................................................................................69
L.
Nebulizer ........................................................................................................................................69
N.
Panel Lock (LED)............................................................................................................................70
O.
Print.................................................................................................................................................70
P.
Set-up .............................................................................................................................................70
Q.
Advanced Settings (LED)................................................................................................................70
R.
Mode ...............................................................................................................................................71
S.
Event...............................................................................................................................................71
T.
Freeze ............................................................................................................................................71
U.
Screens...........................................................................................................................................72
V.
Main ................................................................................................................................................72
W. Alarm Status LEDs..........................................................................................................................72
Patient Setup ..............................................................................................................................................73
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Patient Select Screen ................................................................................................................................73
Patient Size Select Screen ........................................................................................................................73
Ventilation Setup ........................................................................................................................................75
Ventilation Setup Screen ...........................................................................................................................75
Setting the Ventilation Breath Type and Mode ........................................................................................79
Breath Types .............................................................................................................................................80
Ventilation Modes ......................................................................................................................................85
Apnea Backup Ventilation..........................................................................................................................91
Standby .....................................................................................................................................................95
Available Breath Types & Modes by Patient Size......................................................................................97
Primary Breath Controls ............................................................................................................................98
To Activate a Primary Control....................................................................................................................99
Descriptions of Primary Breath Controls..................................................................................................100
Advanced Settings ...................................................................................................................................105
Accessing the Advanced Settings ...........................................................................................................105
Advanced Settings Characteristics and Ranges......................................................................................107
Independent Lung Ventilation (ILV) ........................................................................................................112
Chapter 4 Monitors, Displays and Maneuvers........................................................115
Graphic Displays ......................................................................................................................................115
Waveforms ..............................................................................................................................................115
Loops.......................................................................................................................................................118
MANEUVERS.............................................................................................................................................120
Esophageal Maneuver Screen ................................................................................................................121
Controls ...................................................................................................................................................121
MIP / P100 Maneuver Screen ....................................................................................................................124
Inflection Point (Pflex) Maneuver Screen ..................................................................................................127
AutoPEEPAW Maneuver Screen ...............................................................................................................132
Digital Displays.........................................................................................................................................135
The Monitor Screen .................................................................................................................................135
Events......................................................................................................................................................138
Trends .....................................................................................................................................................139
Main Screen Displays...............................................................................................................................140
Calculated I:E Ratio.................................................................................................................................140
Calculated Minute Volume (Calc Ve).......................................................................................................140
Calculated Time High & Time Low Min / Max..........................................................................................140
Main Screen Monitors..............................................................................................................................141
Chapter 5 Alarms and Indicators ..............................................................................142
Status Indicators ......................................................................................................................................142
Compressor Active ..................................................................................................................................142
Heliox Source Connected........................................................................................................................142
Mains/Battery Indicators ..........................................................................................................................142
Messages ..................................................................................................................................................144
Alarms .......................................................................................................................................................145
Alarm Categories.....................................................................................................................................145
Alarm Controls..........................................................................................................................................146
Setting an Alarm Limit..............................................................................................................................146
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Alarm Silence ..........................................................................................................................................146
Alarm Reset.............................................................................................................................................147
Alarm Types..............................................................................................................................................147
Machine Alarms.......................................................................................................................................147
Gas Supply Indicators and Alarms ..........................................................................................................147
Pressure Alarms......................................................................................................................................148
Volume Alarms ........................................................................................................................................150
Rate/Time Alarms....................................................................................................................................151
O2 Alarms ................................................................................................................................................152
Chapter 6 Maintenance and Cleaning ..................................................................... 155
Cleaning & Sterilization ...........................................................................................................................155
Cleaning External Surfaces .....................................................................................................................155
Cleaning Accessories and Parts..............................................................................................................155
Parts not made by VIASYS Healthcare (Bird) .........................................................................................156
Disposable Parts ......................................................................................................................................156
Other Accessories....................................................................................................................................156
Recommended Periodic Maintenance....................................................................................................157
Battery Care ..............................................................................................................................................158
Battery Status..........................................................................................................................................159
Fuses.........................................................................................................................................................160
Battery Fuses ..........................................................................................................................................160
Mains Fuses ............................................................................................................................................161
Appendix A Contact & Ordering Information .......................................................... 163
How to Call for Service ............................................................................................................................163
Ordering Parts ..........................................................................................................................................164
Accessories .............................................................................................................................................164
Appendix B Specifications....................................................................................... 165
Pneumatic Supply ....................................................................................................................................165
Air or Heliox Supply .................................................................................................................................165
Oxygen Supply ........................................................................................................................................165
Electrical Supply ......................................................................................................................................165
AC Power Supply ....................................................................................................................................165
DC Power Supply ....................................................................................................................................166
Data Input / Output ...................................................................................................................................166
Independent Lung Ventilation (ILV) .........................................................................................................166
Analog Inputs ..........................................................................................................................................167
Analog Outputs........................................................................................................................................167
Digital Communication.............................................................................................................................168
Printer......................................................................................................................................................168
Remote Nurse Call ..................................................................................................................................168
Video Output ...........................................................................................................................................169
Atmospheric & Environmental Specifications.......................................................................................169
Temperature and Humidity ......................................................................................................................169
Barometric Pressure................................................................................................................................169
Physical Dimensions ...............................................................................................................................169
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Overall Size .............................................................................................................................................169
Weight .....................................................................................................................................................169
Accessories ..............................................................................................................................................170
Pall Microbial Filter ..................................................................................................................................170
Water Trap...............................................................................................................................................170
Appendix C Pneumatic Diagram ..............................................................................171
Gas Delivery Engine.................................................................................................................................171
Appendix D Monitor Ranges and Accuracies.........................................................173
Appendix E Sensor Specifications & Circuit Resistance ......................................177
VarFlex® Sensor Specifications .............................................................................................................177
Hot Wire Flow Sensor Specifications .....................................................................................................178
Circuit Resistance (per EN794 –1) ..........................................................................................................178
Circuit Resistance Test............................................................................................................................179
Appendix F AVEA Message Bar Text ......................................................................180
Appendix G Adjusting Barometric Pressure for Altitude ........................................182
Appendix H Advanced Pulmonary Mechanics Monitored Parameters ..................183
Glossary .......................................................................................................................191
Index .............................................................................................................................193
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Safety Information
Notices
Copyright Notice
Copyright © 2002 VIASYS Healthcare, Critical Care Division, California.
This work is protected under Title 17 of the U.S. Code and is the sole property of the Company. No part
of this document may be copied or otherwise reproduced, or stored in any electronic information
retrieval system, except as specifically permitted under U.S. Copyright law, without the prior written
consent of the Company. For more information, contact:
World Headquarters
1100 Bird Center Drive
Palm Springs, CA 92262-8099
U.S.A.
Phone:
(760) 778-7200
(800) 328-4139
Fax:
(760) 778-7274
www.ViasysCriticalCare.com
European Office
Rembrandtlaan 1b
3723 BG Bilthoven
P.O. Box 299, 3720 AG Bilthoven
The Netherlands
Phone: (31) 30 2289 711
Fax:
(31) 30 2286 244
Trademark Notices
AVEA is a registered trademark of VIASYS Healthcare, Critical Care Division in the U.S. and some
other countries. All other brand names and product names mentioned in this manual are trademarks,
registered trademarks, or trade names of their respective holders.
EMC Notice
This equipment generates, uses, and can radiate radio frequency energy. If not installed and used in
accordance with the instructions in this manual, electromagnetic interference may result. The
equipment has been tested and found to comply with the limits set forth in EN60601-1-2 for Medical
Products. These limits provide reasonable protection against electromagnetic interference when
operated in the intended use environments (e.g. hospitals) described in this manual.
This ventilator is also designed and manufactured to comply with the following standards EN 60601-1,
IEC 601-2-12, EN 60601-1-2, EN 794-1, CAN/CSA-C22.2 No. 601.1-M90, and UL 2601-1.
MRI Notice
This equipment contains electromagnetic components whose operation can be affected by intense
electromagnetic fields.
Do not operate the ventilator in a MRI environment or in the vicinity of high-frequency surgical
diathermy equipment, defibrillators, or short-wave therapy equipment. Electromagnetic interference
could disrupt the operation of the ventilator.
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Safety Information
Intended Use Notice
The AVEA ventilator systems are designed to provide ventilator support for the critical care
management of infant, pediatric or adult patients with compromised lung function. They are intended to
provide continuous respiratory support in an institutional health care environment (e.g. a hospital). They
should only be operated by properly trained clinical personnel, under the direction of a
physician.
Regulatory Notice
Federal law restricts the sale of this device except by or on order of a physician.
Classification
Type of Equipment:
Medical Equipment, Class 1 type B
Adult/Pediatric/Infant Lung Ventilator
Declaration of Conformity Notice
This medical equipment complies with the Medical Device
Directive, 93/42/EEC, and the following Technical Standards, to
which Conformity is declared:
0086
EN 794-1
EN 60601-1
EN 60601-1-2
ISO 9001, EN 46001
EU Notified Body:
BSI (Reg. No. 0086)
Trade names:
AVEA ventilator systems
Manufactured by:
Bird Products Corporation
1100 Bird Center Drive
Palm Springs, CA 92262-8099
USA
If you have a question regarding the Declaration of Conformity for this product, please contact VIASYS
Healthcare, Critical Care Division at one of the numbers given in Appendix A.
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AVEA Ventilator Systems
Safety Information
Please review the following safety information prior to operating the ventilator. Attempting to
operate the ventilator without fully understanding its features and functions may result in unsafe
operating conditions.
Warnings and Cautions, which are general to the use of the ventilator under all circumstances, are
included in this section. Some Warnings and Cautions are also inserted within the manual where they
are most meaningful.
Notes are also located throughout the manual to provide additional information related to specific
features.
If you have a question regarding the installation, set up, operation, or maintenance of the ventilator,
contact VIASYS Healthcare Customer Care as shown in Appendix A, Contact & Ordering Information.
Terms
WARNINGS
identify conditions or practices that could result in serious adverse reactions or
potential safety hazards.
CAUTIONS
identify conditions or practices that could result in damage to the ventilator or other
equipment.
NOTES
identify supplemental information to help you better understand how the ventilator
works.
Warnings
Warnings and Cautions appear throughout this manual where they are relevant. The Warnings
and Cautions listed here apply generally any time you operate the ventilator.
The AVEA Ventilator is intended for use by a trained practitioner, under the direction of a qualified
physician.
When the ventilator is connected to a patient, a trained health care professional should be in
attendance at all times to react to an alarm or other indications of a problem.
Alarm loudness must be set above ambient sound in order to be heard.
Always have an alternate means of ventilation available whenever the ventilator is in use.
The operator should not touch the electrical connectors of the ventilator or accessories, and the
patient simultaneously.
Due to possible explosion hazard, the ventilator should not be used in the presence of flammable
anesthetics.
An audible alarm indicates an anomalous condition and should never go unheeded.
Anti-static or electrically conductive hoses or tubing should not be used within the patient circuit.
If a mechanical or electrical problem is recognized while operating the ventilator, the ventilator
must be removed from use and referred to qualified personnel for servicing. Using an
inoperative ventilator may result in patient injury.
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Safety Information
When a low gas supply alarm occurs, the oxygen concentration delivered to the patient will differ
from that set on the O2 control setting.
A source gas failure will change the FIO2 and may result in patient injury.
The functioning of this equipment may be adversely affected by the operation of other equipment
nearby, such as high frequency surgical (diathermy) equipment, defibrillators, short-wave
therapy equipment, “walkie-talkies,” or cellular phones.
Water in the air supply can cause malfunction of this equipment.
Do not block or restrict the Oxygen bleed port located on the instrument back panel. Equipment
malfunction may result.
Electric shock hazard - Do not remove any of the ventilator covers or panels. Refer all servicing to
an authorized VIASYS Healthcare service technician.
A protective ground connection by way of the grounding conductor in the power cord is essential
for safe operation. Upon loss of protective ground, all conductive parts including knobs and
controls that may appear to be insulated can render an electric shock. To avoid electrical
shock, plug the power cord into a properly wired receptacle, use only the power cord supplied
with the ventilator, and make sure the power cord is in good condition.
The AVEA is designed to ensure that the user and patient are not exposed to excessive leakage
current per applicable standards (UL2601 and IEC60601-1). However, this cannot be
guaranteed when external devices are attached to the ventilator. In order to prevent the risk of
excessive enclosure leakage current from external equipment attached to the RS-232, printer
and video ports, isolation of the protective earth paths must be provided to ensure proper
connection. This isolation should ensure that the cable shields are isolated at the peripheral
end of the cable.
Cautions
The following cautions apply any time you work with the ventilator.
Ensure that the voltage selection and installed fuses are set to match the voltage of the wall outlet,
or damage may result.
A battery that is fully drained (i.e. void of any charge) may cause damage to the ventilator and
should be replaced.
All accessory equipment that is connected to the ventilator should comply with
CSA/IEC601/UL2601.
To avoid damage to the equipment, clean the air filter regularly.
The following cautions apply when cleaning the ventilator or when sterilizing ventilator
accessories.
Do not sterilize the ventilator. The internal components are not compatible with sterilization
techniques.
Do not gas sterilize or steam autoclave tubing adapters or connectors in place. The tubing will,
over time, take the shape of the adapter, causing poor connection and possible leaks.
DO NOT submerge the ventilator or pour cleaning liquids over or into the ventilator.
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Safety Information
Equipment Symbols
The following symbols may be referenced on the ventilator or in accompanying documentation
Symbol
Source/Compliance
Symbol #03-02 IEC 60878
Indicates ATTENTION, consult ACCOMPANYING DOCUMENTS
Symbol #5016 IEC 60417
This symbol indicates a FUSE.
Symbol #5034 IEC 60417
Symbol #01-36 IEC 60878
Symbol #5035 IEC 60417
Symbol #01-37 IEC 60878
Symbol #5031 IEC 60417
Symbol #5019 IEC 60417
Symbol #01-20 IEC 60878
Symbol #5021 IEC 60417
Symbol # 01-24 IEC 60878
Symbol # 5333 IEC 60417
Symbol #02-03 IEC 60878
Symbol #5032 IEC 60417
This symbol indicates INPUT.
This symbol indicates OUTPUT
This symbol indicates DIRECT CURRENT (DC)
This symbol indicates protective EARTH (ground).
This symbol indicates the EQUIPOTENTIAL connection used to
connect various parts of the equipment or of a system to the same
potential, not necessarily being the earth (ground) potential (e.g., for
local bonding).
This symbol indicates TYPE B equipment, which indicates equipment
that provides a particular degree of protection against electric shock,
particularly with regards to allowable leakage current and reliability of
the protective earth connection.
Symbol #01-14 IEC 30878
This symbol is located on the rating plate. It indicates the equipment is
suitable for alternating current.
Symbol #5007 IEC 60417
Symbol #01-01 IEC 60878
Indicates ON (Power)
Symbol #5008 IEC 60417
Symbol #01-02 IEC 60878
Indicates OFF (Power)
Symbol #0651 ISO 7000
Horizontal return with line feed. Indicates ACCEPT entered values for
a specific field.
VIASYS Healthcare Symbol
Indicates PATIENT EFFORT
VIASYS Healthcare symbol
Indicates MANUAL BREATH
VIASYS Healthcare Symbol
MAIN SCREEN
ACCEPT
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CANCEL
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Symbols
Symbol #417 IEC 5102
EVENT READY
VIASYS Healthcare Symbol
MODE
VIASYS Healthcare Symbol
ADVANCED SETTINGS
VIASYS Healthcare Symbol
SET-UP for patient size selection
MDD Directive 93/42/EEC
CE Mark
Symbol #5307 IEC 60417
ALARM RESET
Symbol #5319 IEC 60417
ALARM SILENCE
VIASYS Healthcare symbol
ADULT patient
VIASYS Healthcare symbol
PEDIATRIC patient
VIASYS Healthcare symbol
NEONATAL (Infant) patient
Graphical Symbol in
general use internationally
for “DO NOT”
CANCEL, i.e. do not accept entered values.
VIASYS Healthcare symbol
Select DISPLAYED SCREEN function.
Symbol 5467 IEC 60417
FREEZE the current display.
VIASYS Healthcare symbol
Enable the ALARM LIMITS screen
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AVEA Ventilator Systems
VIASYS Healthcare symbol
This symbol indicates a CONTROL LOCK.
VIASYS Healthcare symbol
NEBULIZER port
VIASYS Healthcare symbol
Increase OXYGEN
VIASYS Healthcare symbol
PRINT SCREEN
VIASYS Healthcare symbol
SUCTION port
VIASYS Healthcare symbol
VARIABLE ORIFICE FLOW SENSOR connection
VIASYS Healthcare symbol
HOT WIRE FLOW SENSOR connection
VIASYS Healthcare symbol
ANALOG IN/OUT connection
VIASYS Healthcare symbol
Display the MAIN SCREEN
VIASYS Healthcare symbol
DO NOT BLOCK PORT
VIASYS Healthcare symbol
EXTERNAL BATTERY connection
VIASYS Healthcare symbol
Indicates GAS ID port
VIASYS Healthcare symbol
OXYGEN SENSOR connection
VIASYS Healthcare symbol
OVERPRESSURE relief
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Symbols
VIASYS Healthcare symbol
REMOTE NURSE CALL connection
VIASYS Healthcare symbol
USER INTERFACE MONITOR connection
VIASYS Healthcare Symbol
This symbol indicates an INTERNAL BATTERY FUSE
VIASYS Healthcare Symbol
This symbol indicates ALARM LOUDNESS
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Chapter 1 Introduction
The AVEA is a fourth generation, servo-controlled, software-driven ventilator. It has a dynamic range of
breathing gas delivery that provides for neonatal through adult patients. Its revolutionary user interface
module (UIM) provides maximum flexibility with simple operator interaction. It has a flat panel color
LCD with real time graphic displays and digital monitoring capabilities, a touch screen for easy
interaction, membrane keys and a dial for changing settings and operating parameters. A precision gas
delivery engine with servo controlled active inhalation and exhalation improves performance over
previous generations.
The AVEA has been designed to function using most commonly available accessories. It is easy to
clean and its design does not allow liquids to pool on the casing, reducing the likelihood of fluid leakage
into the body of the ventilator.
There are three models of AVEA to choose from: The Comprehensive, Plus, and the Standard. The
following matrix details the standard and optional functions available with each model.
Functions & Accessories
Standard
Plus
Comprehensive
All
All
All
Custom Cart
Option
Option
Included
External Battery (on custom cart only)
Option
Option
Option
Gas Tank Holder (on either cart)
Option
Option
Option
Internal Compressor
Option
Option
Included
Heliox Delivery
Option
Option
Included
Modes
Proximal Hot Wire Flow Sensing
Synchronized Nebulizer
24 Hour Trending
Internal Battery
Full Color Graphics Display
Loops and Waveforms
Standard Cart
Proximal Variable Orifice flow sensing
Proximal Airway Pressure Monitoring
Tracheal Catheter
Esophageal Balloon
Internal Compressor
Heliox Delivery
Optional Functions & Accessories
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Some AVEA Features
Artificial Airway Compensation1
When Artificial Airway Compensation is turned on, the ventilator automatically calculates the pressure
drop across the endotracheal tube, then adjusts the airway pressure to deliver the set inspiratory
pressure to the distal (carina) end of the endotracheal tube. This calculation takes into account flow,
gas composition (Heliox or Nitrogen/Oxygen), Fraction of Inspired Oxygen (FiO2), tube diameter,
length, and pharyngeal curvature based on patient size (Neonatal, Pediatric, Adult). This compensation
only occurs during inspiration. Artificial Airway Compensation is active in all Pressure Support and
Flow Cycled Pressure Control Breaths.
WARNING
Activating of Artificial Airway Compensation while ventilating a patient will cause a sudden
increase in the peak airway pressures and a resultant increase in tidal volume. If you choose to
activate Artificial Airway Compensation while the patient is attached to the ventilator you will
need to exercise caution to minimize the risk of excessive tidal volume delivery.
Note:
Monitored airway pressures (inspiratory) will be higher than set values when Artificial Airway
Compensation is active.
With an inspiratory pressure setting of zero, Artificial Airway Compensation will still provide an elevated
airway pressure, which will compensate for the resistance of the endotracheal tube.
When turned on the Artificial Airway Compensation indicator will appear in all modes of ventilation even
though the function may not be active (i.e.: Volume Controlled Breaths). This is to alert you to the fact
that Artificial Airway Compensation will become active if a Pressure Support or combination mode (e.g.
Volume Control SIMV) is selected.
Range:
Off/On
Default:
Off
Available in all patient sizes
Full range of Patient Size
You can select a patient size of Adult, Pediatric, or Neonate. Once the selection is made, the ventilator
offers only those parameters, which are available for your selected patient size.
1
Estimation of Inspiratory Pressure Drop in Neonatal and Pediatric Endotracheal Tubes, by Perre-Henri Jarreau, American Physiological Society 1999
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Leak Compensation
Leak Compensation is used to compensate for baseline leaks, which may occur at the patient mask
interface or around the patient’s endotracheal tube. It only provides baseline leak compensation and is
not active during breath delivery.
During exhalation, PEEP is maintained by the cooperation of the Flow Control Valve (FCV) and the
Exhalation Valve (ExV). The ExV pressure servo is set to a target pressure of PEEP and the FCV
pressure servo is set to a pressure target of PEEP - 0.4 cmH2O. The ExV servo relieves when the
pressure is above its target and the FCV supplies flow when the pressure drops below its target up to a
maximum flow rate for the patient size
Range:
Off/On
Default:
Off
Circuit Compliance Compensation
When Circuit Compliance is active, the volume of gas delivered during a volume controlled or targeted
breath is increased to include the set volume, plus the volume lost due to the compliance effect of the
circuit. Circuit Compliance is active for the set Tidal Volume during volume control ventilation, the
Target Tidal Volume in PRVC mode and for Machine Volume. It is only active in Adult and Pediatric
applications.
Exhaled volume monitors for all modes and breath types are also adjusted for the compliance
compensation volume.
Range:
0.0 to 7.5 ml/cmH2O
Default:
0.0 ml/cmH2O
The ventilator automatically measures Circuit Compliance during the Extended Systems Test (EST). It
can also be entered manually.
Note:
Although circuit compliance is displayed on the Setup screen it is not active for neonatal patients.
High circuit compliance with small tidal volumes may result in extended inspiratory times. This is a
result of the delivery of the circuit compliance volume at the set flow rate.
Humidification
You can select active or passive humidification (ON/active or OFF/passive). Active humidification
assumes 99% RH; passive assumes 60% RH when using an HME. This feature adjusts the BTPS
correction factor to correct exhaled tidal volumes.
Range:
Default:
Off/On
Active (ON)
Note:
Incorrect setting of the Humidification feature will affect monitored exhaled volume accuracy.
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Chapter 1 Introduction
Heliox Delivery (Comprehensive only, option on Standard and
Plus machines)
Using patented “Smart” connector technology, the Comprehensive model AVEA can deliver Heliox
blended gas instead of Medical air. By simply changing a connector on the back panel, the ventilator
identifies the gas input and adjusts to accommodate the change. All volumes (numeric and graphic)
are automatically compensated for accurate display.
The clinical benefits of helium / oxygen gas are based on its significantly lower gas density when
compared to nitrogen / oxygen gas. This lower gas density allows the same volumetric (tidal volume) of
gas to be delivered to the patient at a significantly lower airway pressure. Additionally, the low-density
properties of the gas allow it to diffuse past airway obstructions or restrictions much easier than
nitrogen / oxygen gas mixtures.
Note
The Heliox “smart” connector is designed for use with an 80/20 Heliox tank only. Only a mixture of 20%
oxygen and 80% Helium can be used as the Heliox gas supply.
If Heliox gas is connected this green icon displays in bottom right of the touch screen.
To set the Helium / Oxygen mixture during administration simply set the desired FiO2, the balance of
the breathing gas is Helium.
For example:
A set FiO2 of 35% will deliver a 65/35 Heliox mixture to the patient.
WARNING
Connection of a gas supply at the Helium-Oxygen mixture inlet that does not contain 20%
oxygen can cause hypoxia or death.
Although an 80/20 mixture of Helium and Oxygen is marketed as medical gas, the
Helium/Oxygen gas mixture is not labeled for any specific medical use.
Note
Hot wire flow sensors will not function with Heliox gas mixtures. During Heliox delivery, a variable orifice
flow sensor should be used for monitoring delivered volumes at the proximal airway.
Note
Heated humidifier performance should be carefully monitored during Heliox therapy. Helium has
significantly greater thermal conductivity compared to nitrogen / oxygen gas mixtures and this could
cause difficulty with some heated humidification devices. A febrile patient may transfer heat via the gas
column to a proximal temperature sensor, which could affect the duty cycle of the humidifier and
decrease output. This could cause desiccation of secretions in the airway.
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Alternately, in applications where a heated wire breathing circuit is used, this heat transfer from the
patient may affect the duty cycle of the heated wire circuit, which may result in increased condensation
in the breathing circuit.
The relative settings of some types of humidifiers may need to be reduced to prevent overheating of the
breathing gas.
Note
The Oxygen alarm cannot be disabled during Heliox administration
Do not operate nebulizer while using heliox
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Chapter 2 Unpacking & Setup
Ventilator Assembly & Physical Setup
Unpacking the Ventilator
The AVEA is designed for simplicity of operation and set-up. It requires minimal assembly on site.
Items Required for Ventilator Setup
You will need the following to setup your AVEA ventilator:
Power Source. The ventilator operates from a standard 100, 110, 220, or 240 VAC power source
or an optional external 24VDC battery. There is an internal battery supplied with the ventilator,
which will operate the ventilator for short periods (see Chapter 6, Maintenance & Cleaning)
CAUTION
The ventilator should be connected to a mains AC power supply for at least 4 hours prior to switching
to internal battery power. For operation on external battery the ventilator should be connected to a
mains AC power supply for at least 12 hours with green LED lot to insure a fully charged battery.
Pressurized Oxygen, Air or Heliox Gases. The compressed gas sources must provide clean,
dry, medical grade gas at a line pressure of 20 to 80 PSIG (1.4 to 5.6 bar).
Air or Heliox Supply
Pressure Range:
Temperature:
Minimum Flow:
Air Inlet fitting
Heliox Inlet fitting
20 to 80 psig (1.4 to 5.5 bar) (Supply Air)
20 to 80 psig (1.4 to 5.5 bar) (Supply Heliox - 80% / 20% Heliox Only)
3 to 10 psig (0.2 to 0.7 bar) (Compressor Air)
5 to 40°C (41 to 104°F)
80 L/min at 20 psig (1.4 bar)
CGA DISS-type body, No. 1160 (Air). NIST fitting per BS-5682:1984
(Air) also available.
CGA DISS-type body, No. 1180 (Heliox)
Note
NIST fittings for Air and Oxygen are available from VIASYS, upon request at time of order.
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Oxygen Supply
Pressure Range:
Temperature:
Humidity:
Minimum Flow:
Inlet Fitting:
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20 to 80 psig (1.4 to 5.5 bar) (Supply Oxygen)
5 to 40º C (41 to 104º F)
Dew Point of gas should be 1.7º C (3º F) below the ambient temperature
(minimum)
80 L/min at 20 psig (1.4 bar)
CGA DISS-type body, No. 1240. NIST fitting per BS-5682:1984 (O2)
also available.
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Assembling the Ventilator
Assemble your AVEA ventilator’s wheeled base using the instructions included in the package. The
ventilator body is easily attached to the base by means of four thumbscrews. Reference Installation
Instructions L2353 for detailed directions. See figure 2.1.
Basic
Ventilator Base
Comprehensive
Ventilator Base
Figure 2.1 Basic and Comprehensive base attachment
CAUTION
The ventilator body and UIM weigh approximately 80 lbs. ( 36.4 kg) Employ safe lifting procedures
when assembling the ventilator.
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External battery option
If you have purchased the optional external battery pack, the drop
cable should be fed up the central pole of the base and out through
the cord routing well shown in figure 2.2 prior to attaching the base
to the ventilator body. Install your external batteries per the
installation instructions enclosed with the cart accessories kit (P/N
11372). Reference Installation Instructions L2353 for detailed
directions.
When the cord is in place, use the handles on each side of the
ventilator body to maneuver and align it with the thumbscrews on
the base (see figure 2.1). Tighten the thumbscrews.
Figure 2.2 External Battery Routing
Setting Up the Front of the Ventilator
Assembling the Exhalation Filter and Water Trap
To assemble and insert the exhalation filter and water trap do the following:
Screw the supplied water collection bottle
into the threaded cuff of the water trap.
Figure 2.3 Attaching the Collection Bottle to the Water Trap
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Push the exhalation filter into the water trap
assembly top as shown.
Locating Ridge for assembly
into cartridge
Figure 2.4 Attaching the Exhalation Filter.
Align the locating ridge on the water trap assembly with the slot in the
exhalation filter cartridge (see fig 2.5).
Slot matches
locating ridge of
water trap
assembly
Figure 2.5 Exhalation Filter Cartridge Showing Locating Slot
Slide the water trap/exhalation filter assembly into the cartridge (see fig 2.6)
Figure 2.6 Exhalation Filter/Water Trap Assembly in Cartridge
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Rotate the metal locking lever on the lower right of the
ventilator body forward to an open position.
Figure 2.7 Open locking lever
Insert the completed cartridge assembly
into the ventilator body as shown. Make
sure it is completely seated in the well.
Figure 2.8 Insert exhalation filter
Note
Placement of the exhalation filter/water trap assembly without the exhalation filter cartridge may cause
misalignment of the filter seal resulting in patient breathing circuit leaks.
Close the locking lever.
Figure 2.9 Close locking lever in place
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Attaching the Patient Circuit
Adult Circuit using an Active
Humidifier
Using an active humidifier, the adult patient
circuit is set up as shown in figure 2.10.
Attach your humidifier to the upright pole of
the AVEA base. Adjust the height of the
humidifier and the length of the humidifier
tubing so that the tubing is relatively
straight with no occlusions.
Inspiratory
limb of Patient
Circuit
Figure 2.10 Adult Circuit with Active Humidifier
Adult Circuit without active humidifier
Inspiratory Limb
of Patient Circuit
The setup for use with a passive
humidifier or HME is per figure 2.11.
The inspiratory limb of the patient
circuit connects directly to the gas
output of the ventilator. The passive
humidification system should be placed
in-line in the patient circuit per the
manufacturer’s instructions.
Figure 2.11 Adult Patient Circuit without active humidifier.
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Neonatal Patient Circuit
The Neonatal Patient Circuit is attached as
shown in figure 2.12.
Inspiratory Limb
of Patient Circuit
Figure 2.12 Neonatal Patient Circuit
Front Panel Connections
Standard
Plus
Comprehensive
Figure 2.13 AVEA Front Panel Configurations Standard & Comprehensive
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Attaching Flow Sensors
The AVEA can accept either a hot wire or a variable orifice proximal flow sensor. These are in addition
to the instrument’s internal inspiratory flow sensor and heated expiratory flow sensor. Three proximal
flow sensors are available for the AVEA.
The standard Hot Wire flow sensor is suitable for neonatal and pediatric applications where the peak
inspiratory flow rate is less than 30 L/min. This flow sensor is not active in adult applications.
Hot Wire Flow Sensor
A Hot Wire flow sensor attaches to the
receptacle circled in light blue directly
below the variable orifice flow sensor
connection on the front panel. The
receptacle is marked with the icon
shown here.
Retractable plastic
collar
This is a locking connector. To attach,
first pull back the locking collar, then
push firmly onto the ventilator
receptacle.
To disconnect, first retract the plastic
collar then firmly pull the connector
away from the ventilator. Do not pull
up or down as this can damage the connector
Figure 2.14 Hot wire Flow Sensor Attachment
Note
Hot wire flow sensors will not function with Heliox gas mixtures. During Heliox delivery, a variable orifice
flow sensor should be used for monitoring delivered volumes at the proximal airway.
Variable orifice flow sensors are also available on some AVEA models. The neonatal VarFlex flow
sensor is compatible in neonatal and pediatric applications where the peak inspiratory flow rate is less
than 30L/min and is not active in adult applications. For adult and large pediatric applications a
Pediatric / Adult VarFlex flow sensor is available for use with patients whose flow requirements fall
within the range of 1.2 – 180 L/min.
Detailed information on the specifications of each flow sensor can be found in Appendix E: Sensor
Specifications and Circuit Resistance.
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Variable Orifice Flow Sensor
Retractable
Plastic Collar
Variable Orifice sensors attach to the receptacle on the front
panel of the ventilator circled in dark blue and marked with the
icon shown here.
This is a locking connector. To attach, first pull back the plastic
locking collar, then push firmly onto the ventilator receptacle.
Then push the locking collar forward to lock the flow sensor in
place.
To disconnect, first retract the plastic collar then firmly pull the
connector away from the ventilator. Do not pull up or down as
this can damage the connector.
Figure 2.15 Variable Orifice
Flow Sensor Attachment
CAUTION
Fully retract the plastic locking collar before attaching these connectors. Failure to do this can cause
damage to the connector.
Attaching a Nebulizer
You can use an in-line nebulizer with the AVEA ventilator
(see Chapter 3, Ventilator Operation). The nebulizer is
synchronized with inspiration, delivers gas at the set
FiO2/FiHe and is active for 20 minutes. Attach the
nebulizer tubing to the fitting at the bottom of the front
panel as shown here. The fitting is marked with the icon
shown here.
Figure 2.16 Attaching nebulizer tubing
Note
To use the internal nebulizer, the AVEA must be connected to a high pressure Air or Heliox source.
The nebulizer is not active while the AVEA is operating on its internal compressor. The ventilator
incorporates an internal pneumatic compressor, which creates the drive pressure necessary to operate
the nebulizer.
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Note
The nebulizer requires an inspiratory flow rate of at least 15 liters per minute to activate and is flow
compensated to maintain set tidal volumes.
CAUTION
When the internal nebulizer is used, the ventilator decreases the flow rate by 6 L/min to compensate for
the nebulizer output. However, since flow from the internal nebulizer can vary, using the internal
nebulizer may impact the tidal volumes delivered to the patient.
Note
Do not operate the nebulizer while using Heliox
Attaching a Proximal Pressure Sensor
A proximal pressure sensor to monitor proximal airway pressure can be attached to the
Comprehensive and Plus models of AVEA . On the Comprehensive AVEA the connector is labeled as
Aux as shown in figure 2.17.
When active, this feature will display & alarm to proximal airway pressures.
Figure 2.17 Proximal pressure sensor connection on the Comprehensive AVEA
Note
In applications which generate high resistances within the breathing system monitored, Proximal Airway
Pressure may be higher than set Inspiratory Pressure.
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(Comprehensive Model Only)
Esophageal Balloon
The connection intended for an esophageal balloon is circled in
green at the top of the front panel as shown here. It is identified
with the legend PES.
Figure 2.18 Esophageal balloon connector
Note
See chapter 4 for placement technique for esophageal balloons.
Tracheal Catheter
A tracheal catheter will attach to the AVEA at the connection on the front panel marked as Aux. The
connector is shown in figure 2.18 and is circled in purple.
Note
See chapter 4 for placement technique for tracheal catheters.
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Other Connections
WARNING
The AVEA is designed to ensure that the user and patient are not exposed to excessive leakage
current per applicable standards (UL2601 and IEC60601-1). However, this cannot be guaranteed
when external devices are attached to the ventilator.
To prevent the risk of excessive enclosure leakage current from external equipment attached to
the RS-232, printer or video ports, the protective earth paths must be isolated to ensure proper
connection.
This isolation should ensure that the cable shields are isolated at the peripheral end of the
cable.
RS-232 Connections
The RS-232 #1 connection is used for AVEA feature upgrades, which are performed by a VIASYS
certified technician only, and communications. The communications protocol is described in document
L2317 AVEA Communications Protocol.
WARNING
The RS-232 #2 port connection is non-functional. Do not use.
SVGA Connection
MIB Connection
(non-operational)
RS-232 #1
Centronics Parallel
Printer Connection
RS-232 #2
Figure 2.19 Connections beneath the UIM screen
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Printer Connector
The AVEA has a standard 25 pin female Centronics parallel printer port for interfacing to an external
printer.
SVGA Connector
A SVGA output connector is provided to enable real time display of the screen from a separate external
display device such as an LCD projector or remote monitor. This output can be switched on and off on
the utilities screen.
Medical Information Buss (MIB) Connector (Future Option)
IEEE 1073 Medical Information Buss connection.
CAUTION
The MIB connection is currently a non-operational port. Do not make connection.
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Setting Up the Rear of the Ventilator
C
B
A
J
I
E
D
G
F
H
Figure 2.20 Rear panel
A – AC power module
H – Oxygen hose connection
B – UIM connection
I - External battery connector
C – Analog input/output/ILV
J – External battery fuse
D - Power ON/OFF Switch
E – Nurse call system connection
F – Air smart connector
G – Oxygen sensor
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Connecting the Oxygen Sensor
O2 Cell
The oxygen sensor cell is located on the rear panel, between the
two gas fittings. The oxygen sensor cable emerges from the rear
panel directly above the sensor. Carefully align and then gently
push the connector onto the oxygen sensor until it seats. When a
good connection has been made, slide the protective cover down
and push over the sensor.
Figure 2.21 Connecting the O2 Sensor
Connecting Gas Fittings
Collar
The “Smart” Air Fitting
There are two gas connections on the rear
panel of the ventilator. The one on the left of
the panel is for attaching the Air or Heliox
gas source.
The smart connector fitting type shown here
is CGA DISS-type body No. 1160 for air with
an integral water trap/filter. To prevent the
entry of moisture into the ventilator from a
wall air source, the external water trap is
placed in-line between the air hose and the
“smart” air connector.
To attach, align the connector assembly (see
figure 2.22), seat gently onto the fitting and
screw down the fitting collar until finger tight.
“Smart” Connector
Similar connectors for Air with NIST and
Air Liquide fittings are also available from VIASYS.
Figure 2.22 Attaching the Air “smart”
connector with water trap.
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The “Smart” Heliox Fitting
Collar
A DISS-type, No. 1180 smart connector fitting is
also available for use with an 80/20 Heliox gas
mixture (see figure 2.23). Follow the instructions
contained with your Heliox kit to install the
tethered Heliox connector. This fitting has no
integral water trap/filter. All AVEA “Smart”
connectors with or without the integral water
trap/filter, attach in the same way. Align the
connector (see figures 2.22 and 2.23), seat gently
onto the fitting and screw down the fitting collar
until finger tight.
Tether
Figure 2.23 Attaching the Tethered Heliox Connector
The AVEA “Smart” connectors signal to the ventilator which type of fitting is attached and therefore which
gas controls to initiate.
The fitting on the right of the panel is for attaching the Oxygen gas source. The O2 fitting type is CGA
DISS type, No. 1240. (NIST or Air Liquide oxygen fittings are also available from VIASYS)
Attaching the Gas Hoses
Oxygen Connection
Attach the Oxygen hose to the fitting on the right
of the back panel (see figure 2.24).
Figure 2.24 Connecting the O2 Hose
Heliox Connection
If you have the upgrade for Heliox delivery, attach the Heliox
hose .to the tethered “Smart” connector fitting on the left of the
back panel as shown in figure 2.25.
The air hose will not attach to the fitting designed for Heliox and
vice versa.
Figure 2.25 Connecting the Heliox Hose
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WARNING
Allow 90 seconds for the accumulator to purge before initiating patient ventilation with Heliox gas.
WARNING
Connection of a gas supply at the Helium-Oxygen mixture inlet that does not contain 20% oxygen
can cause hypoxia or death.
Although an 80/20 mixture of Helium and Oxygen is marketed as medical grade gas, the
Helium/Oxygen gas mixture is not labeled for any specific medical use.
Attaching the Air Hose
Attach the Air supply hose to the “Smart” connector
fitting with the integral water trap/filter on the left of the
back panel as shown in figure 2.26.
The fitting shown here is a DISS fitting. Fittings which
accept NIST and Air Liquide hoses are also available
from VIASYS.
The air hose will not attach to the fitting designed for
Heliox and vice versa.
Figure 2.26 Attaching the Air Hose to the water trap/filter
Note
The fitting for Air will not accept a Heliox connection and vice versa.
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Utilities Screens
Configuration Tab
Figure 2.27 Utilities Screen
Alarm Loudness.
To change alarm sound levels depress and hold the increase or decrease soft keys until the desired level
is reached.
Enable / Disable O2 Alarm.
The High and Low oxygen alarms can be disabled in the event of a failure of the oxygen sensor while the
ventilator is in use. To disable the alarm depress the Enable / Disable O2 soft key, to re-enable depress
the soft key again.
NOTE
The oxygen alarms cannot be disabled while heliox is in use. Powering the ventilator off and back on
again will automatically re-enable the oxygen alarms.
WARNING
Although disabling the oxygen alarms will not effect oxygen titration an external analyzer should
be placed in line in the breathing circuit until the oxygen sensor has been replaced.
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Flow Correction
Allows for flow correction to BTPS (Body Temperature Pressure Saturated or ATPD (Ambient
Temperature Pressure Dry). Default position is BTPS and should be used for all clinical
applications.
ILV Mode
To enable Independent Lung Ventilation and define the Master and Slave ventilators, access the Utilities
screen from the screens menu (see figure 2.30). ILV requires the use of a specially configured
accessory cable kit, which is available from VIASYS (Part Number 16246).
With both ventilators turned off, connect the ILV cable PN 16124 to the analog port of each ventilator.
Turn on the ventilator to be designated as the “Slave”. Adjust all primary and advances settings as
desired.
Next, power up the “Master” ventilator. Select “Master” from the Utilities screen. Adjust all primary and
advanced settings as desired.
Connect the patient.
Note
Ventilation will not begin until the Master ventilator has been turned on.
Each ventilator maintains independent settings for FiO2 during independent lung ventilation. Close
monitoring of set FiO2 on each ventilator is recommended.
Confirm alarm settings on each ventilator. Each ventilator will alarm independently based on alarm
settings established for that particular ventilator.
Apnea ventilation on the Slave ventilator is driven by the apnea ventilation rate of the Master ventilator
only.
Should the ventilators become disconnected during ILV, only the Master ventilator will alarm for the ILV
Disconnect condition. The Slave ventilator will alarm for Apnea under these conditions.
WARNING
DO NOT attempt to connect a standard DB-25 cable to this receptacle. This could cause damage
to the ventilator. A specially configured cable is required for ALL features associated with this
connector. Contact VIASYS Tech Support.
Setting up Independent Lung Ventilation (ILV)
The AVEA has a 25 pin receptacle on the rear panel (see figure 2.20) to allow for Independent Lung
Ventilation (ILV) .with another AVEA. The output for ILV provides a 5VDC logic signal synchronized to
the breath phase of the master ventilator. Table 2.3 at the end of this section details the relevant pins for
the signals carried by this connector.
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Note
This connector also carries the Analog Input and the Analog Output signals. Refer to Appendix B
Specifications for Analog Output Pressure (cmH2O/mv), flow ((ml/min)/mv) and Volume (ml/mv)
conversions.
ILV connector pin configuration
To connect two AVEA ventilators together for independent lung ventilation function, the cable must be
wired so that the ILV input (the slave) on one AVEA is connected to the ILV output (the master) on the
other AVEA. As shown in figure 2.27 below, the ILV slave is pin 18, and the ILV master is pin 6. In
addition, at least one of the analog grounds (pins 5, 9, 10, 11, 12 or 13) must be connected. We
recommend using a shielded cable.
For ILV operation,
Connect an analog ground on Vent 1 to analog ground on vent 2 (See figure 2.28).
Connect Pin 6 on Vent 1(Master) to pin 18 on vent 2 (Slave).
Connect Pin 18 on Vent 1 to pin 6 on vent 2.
Slave
Master
Figure 2.28 ILV Connection Pin Configuration
Figure 2.29 Analog Ground Pins
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Note
At least one analog ground is required for safe and accurate signal output and input. One analog ground
is sufficient for any and all of the other signals.
Selecting Language .
Touch the language box and use the data dial to select the desired language. Use the Accept key to
accept the change. All text displayed on the LCD screen will automatically be translated to the set
language.
Note
For ease of use all languages appear in their native text in the text selection box on the utilities screen.
Increase FiO2
Configures the step increase used during the increase oxygen maneuver. Sets the amount of
oxygen the ventilator will increase above the current set FiO2.
Example:
If the Increase FiO2 is set at 20%
AND
The set FiO2 is 40%
WHEN
The increase FiO2 Maneuver is activated the FiO2 will increase to 60%
for two minutes after which it will return to 40%.
The default setting for infants is 20% and 79% for Pediatric and Adult applications.
Note
To achieve 100% delivered FiO2 during the Increase O2 maneuver set the Increase FiO2 setting to its
maximum of 79%.
Note
The settings will be reset to default values when New Patient is selected in the set up menu.
Setting the Barometric Pressure.
Using the touch turn touch technique use the data dial to set the correct barometric pressure for the
current altitude.
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Note
Failure to properly set the barometric pressure can affect accuracy of some of the instruments monitoring
systems. See Appendix G for Barometric Pressure / Altitude conversion chart.
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Input/Output Tab
Analog Input Configuration
Under the heading “Set Analog Input Scale” there are three buttons representing three possible voltage
ranges.
If the full-scale output of the device you are interfacing with is less than 1 volt, select the 0-1 volt scale
button.
If it is 5V or less select the 0-5 volt range and if it is 10V or less, select the 0-10 volt range.
Analog Input is configured on the same connector as the ILV. The pin configuration for cables to use this
feature is shown in figure 2.29 below. Pin configuration of the connector for attachment to your other
device must be supplied by the manufacturer of that device
WARNING
All applications using this connector require specially made cables. DO NOT connect a standard
DB25 cable to this receptacle. This could result in damage to the ventilator. Contact VIASYS
Healthcare Technical Support at the numbers given in Appendix A.
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Analog Input Channel 1
Analog Input Channel 0
Figure 2.30 Analog Input connections
Analog Outputs
Set Analog Output Type
The analog output flow signal can be selected between Wye Flow (calculated flow to the patient) or
Machine Flow (the flow measured by the inspiratory flow sensor within the ventilator).
Pressure, Flow, Volume, Breath Phase
Figure 2.32 Analog Outputs Pin configuration
The pin configuration for pressure, flow, volume and breath phase analog outputs is shown above. Refer
to Appendix B Specifications for Analog Output Pressure (cmH2O/mv), flow ((L/min)/mv) and Volume
(ml/mv) conversions.
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Figure 2.33 Analog Ground Pins **
Note
At least one analog ground is required for safe and accurate signal output and input. One analog ground
is sufficient for any and all of the other signals.
Table 2.3 ILV and Analog I/O pin configuration
PIN
1
FUNCTION
Analog Input Channel 0
14
Analog Input Channel 1
18
ILV In
6
ILV Out
20
Factory Use Only. DO NOT CONNECT.
22
Analog Output, PRESSURE
23
Analog Output, FLOW
24
Analog Output, VOLUME
25
Analog Output, BREATH PHASE
5, 9,10,11,12,13
Ground, Analog (see Note)
Video Output
Enables or disables the real time video output via the SVGA connector on the bottom of the UIM. Default
position is off.
Nurse Call Connection
The AVEA can be connected to a remote nurse call system via the modular connector on the rear panel
shown in figure 2.20, E. The jack is configured to interface with normally closed (NC, open on alarm) or
normally open (NO, close on alarm) signals. Cables for both systems are available from VIASYS
Healthcare
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Date/Time Tab
Setting the Date.
Using the touch turn touch technique use the data dial to set the correct month, day and year prior to use
of the ventilator.
Setting the Time.
Using the touch turn touch technique use the data dial to set the correct time in hours and minutes prior to
use of the ventilator.
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Powering up the AVEA
To power up the ventilator, connect the power cord to a suitable AC power supply and turn on the power
switch located on the back panel of the ventilator as shown here.
ON
OFF
Figure 2.34 Power Switch
The power up/reboot time for this instrument is approximately 7 seconds.
WARNING
A protective ground connection by way of the grounding conductor in the power cord is essential
for safe operation. If the protective ground is lost, all conductive parts, including knobs and
controls, which may appear to be insulated, can render an electric shock. To avoid electrical
shock, plug the power cord into a properly wired receptacle, use only the power cord supplied
with the ventilator, and make sure the power cord is in good condition.
WARNING
If the integrity of the external power earth conductor arrangement is in doubt, unplug the
ventilator from the mains AC and operate it from its internal battery or the optional external
battery.
User Verification Test
WARNING
The User Verification Test should always be performed off patient.
The User Verification Test consists of the three following sub-tests and should be performed before
connection to a new patient.
The POST test:
The POST or Power On Self Test is transparent to the user and will only message if the
ventilator encounters an error. Normal ventilation commences at the culmination of the POST.
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The Extended Systems Test (EST). During this test the ventilator will perform:
Patient circuit leak testing
Patient circuit compliance measurement
Two point calibration of the oxygen sensor
The Alarms Test consisting of verification for:
High O2 alarm
Low Ppeak alarm
Loss of AC alarm
Circuit Disconnect
High Rate Alarm
Apnea Interval alarm
Low PEEP alarm
High Ppeak alarm
High Ppeak, Sust
Low Ve alarm
High Ve alarm
High Vt alarm
Low O2 alarm
Low Vt alarm
CAUTION
Although failure of any of the above tests will not prevent the ventilator from functioning, it should be
checked to make sure it is operating correctly before use on a patient.
The Power on Self Test (POST)
This test is run automatically and performs the following checks:
Processor Self Check
ROM Check Sum
RAM Test
The POST will also check the audible alarms and the LEDs at which time the audible alarm sounds and
the LEDs on the User Interface Module flash. Normal ventilation commences at the culmination of the
POST.
The Extended Systems Test (EST)
The EST function is accessed from the Setup screen as shown here. Press the SETUP membrane
button to the lower left of the UIM to open this screen.
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Press the EST touch screen icon to highlight.
A message will appear instructing you to remove
the patient and block the patient wye.
After confirming that the patient has been
disconnected and the circuit wye blocked press the
Continue (Cont) button.
The ventilator will perform the EST and display a
countdown clock.
During this test the ventilator will perform:
•
Patient circuit leak test
•
Patient circuit compliance measurement
•
Two point calibration of the oxygen sensor
The patient circuit compliance measurement and
leak test are performed simultaneously with the
oxygen sensor calibration. The maximum time for
the EST is 90 seconds. To restart the EST at any
time select the Cancel button to return to the set up
screen.
After each test is complete the ventilator will
display a “Passed” or “Failed” message next to the
corresponding test.
Once the test is complete press the continue
button to return to the set up screen.
Note
If you do not connect the ventilator to an oxygen supply, the O2 Sensor Calibration will immediately fail.
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The Alarms Test
Note:
To ensure proper calibration of the oxygen sensor, you should always perform an EST prior to
conducting Manual Alarms Testing.
WARNING
User Verification Testing should always be done off patient.
CAUTION
Following each alarm verification test, ensure that the alarm limits are reset to the recommended levels
shown in this chapter before proceeding to the next test.
Test Setup Requirements:
Air Supply Pressure
O2 Supply Pressure
AC Line Voltage
Patient Circuit
Compliance
Resistance
Adult Setting
Pediatric Setting
Neonate Setting
> 30 psig (2.1 bar)
Same
Same
> 30 psig (2.1 bar)
Same
Same
115 + 10 VAC
Same
Same
6’ (2 m) Adult
6’ (2 m) Adult
Infant
20 ml/cmH2O
20 ml/cmH2O
N/A
5 cmH20/L/sec
5 cmH20/L/sec
N/A
To perform the Alarms Test on the AVEA ventilator using default settings, complete the following steps
(A table describing the default settings for Adult, Pediatric and Neonatal patient sizes is included at the
end of the Alarms Test section).
1. Make the appropriate connections for air and O2 gas supply. Connect the power cord to an appropriate
AC outlet. Attach an appropriate size patient circuit and test lung to the ventilator.
2. Power up the ventilator and select NEW PATIENT when the Patient Select Screen appears. Accept this
selection by pressing PATIENT ACCEPT. This will enable default settings for the Manual Alarms Test.
3. Select the appropriate patient size for your test (Adult, Pediatric or Neonate) from the Patient Size
Select Screen. Accept this selection by pressing SIZE ACCEPT. Set Humidifier Active off.
4. Make any desired changes or entries to the Ventilation Setup Screen and accept these by pressing
SETUP ACCEPT.
5. Press Alarm Limits button on the upper right of the user interface.
6. Verify that no alarms are active and clear the alarm indicator by pressing the alarm reset button on the
upper right of the user interface.
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7. Set the % O2 control to 100%. Disconnect the Oxygen sensor from the back panel of the ventilator and
verify that the Low O2 alarm activates. Return the O2 control setting to 21% with the sensor still
disconnected from the rear panel. Remove sensor from back panel. Provide blow-by to the sensor from
an external oxygen flow meter. Verify that the High O2 alarm activates. Return the % O2 to 21%,
reconnect the Oxygen sensor to the back panel. Clear all alarm messages by pressing the alarm reset
button.
8. Set PEEP” to 0. Set Low PEEP alarm to 0. Disconnect the patient wye from the test lung. Verify that
the Low Ppeak alarm activates, followed by the Circuit Disconnect alarm. This second alarm should
activate after the default setting of 20 seconds for the apnea interval has elapsed. Reconnect the test
lung to the circuit clear the alarm by pressing the reset button.
9. Disconnect the AC power cord from the wall outlet. Verify that the Loss of AC alarm activates.
Reconnect the AC power cord. Clear the alarm by pressing the reset button.
10. Occlude the exhalation exhaust port. Verify that the High Ppeak alarm activates, followed 5 seconds
later by the activation of the High Ppeak, Sust. alarm.
11. Set the control setting for rate to 1 bpm. Verify that Apnea Interval alarm activates after the default
setting of 20 seconds. Return the control setting to its default value and clear the alarm by pressing the
reset button.
12. Set the Low PEEP alarm setting to a value above the default control setting for PEEP on your
ventilator. Verify that the Low PEEP alarm activates. Return the alarm setting to its default value and
clear the alarm by pressing the reset button.
13. Set the High Ppeak alarm setting to a value below the measured peak pressure or in neonatal
ventilation, the default control setting for Inspiratory Pressure on your ventilator. Verify that the High
Ppeak alarm activates. Return the alarm setting to its default value and clear the alarm by pressing the
reset button.
14. Set the Low Ve alarm setting to a value above the measured Ve on your ventilator. Verify that the Low
Ve alarm activates. Return the alarm setting to its default value and clear the alarm by pressing the
reset button.
15. Set the High Ve alarm setting to a value below the measured Ve on your ventilator. Verify that the High
Ve alarm activates. Return the alarm setting to its default value and clear the alarm by pressing the
reset button.
16. Set the High Vt alarm setting to a value below the set Vt on your ventilator. Verify that the High Vt alarm
activates. Return the alarm setting to its default value and clear the alarm by pressing the reset button.
17. Set the Low Vt alarm setting to a value above the set Vt on your ventilator. Verify that the Low Vt alarm
activates. Return the alarm setting to its default value and clear the alarm by pressing the reset button.
18. Set the High Rate alarm to a value below the default control setting for rate on your ventilator. Verify
that the alarm activates. Return the alarm to its default setting and clear the alarm by pressing the reset
button.
19. Occlude the inspiratory limb of the patient circuit. Verity that the Circuit Occlusion alarm .activates.
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CAUTION
Although failure of any of the above tests will not prevent the ventilator from functioning, it should be
checked to make sure it is operating correctly before use on a patient.
Default Settings for Adult, Pediatric and Neonate
The Default settings are the operational settings that take effect when you press the “New Patient”
button on power up.
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Ventilation Setup:
ET tube Diameter
ET Tube Length
Artificial Airway
Compensation
Leak
Compensation
Circuit
Compliance
Compensation
(Circ Comp)
Humidification
Patient Weight
Adult Setting
Pediatric Setting
Neonate Setting
7.5 mm
30 cm
Off
5.5 mm
26 cm
Off
3.0 mm
15 cm
Off
Off
Off
Off
0.0 ml/cmH2O
0.0 ml/cmH2O
Active On
1 kg
Active On
1 kg
Active On
1 kg
Adult Setting
Pediatric Setting
Neonate Setting
Volume A/C
8 bpm
500 ml
Volume A/C
12 bpm
100 ml
TCPL A/C
20 bpm
N/A
60 L/min
15 cmH2O
20 L/min
15 cmH2O
8 L/min
15 cmH2O
0.0 sec
0.0 sec
0.0 sec
1.0 sec
0.75 sec
0.35 sec
0 cmH2O
6 cmH2O
1.0 L/min
0 cmH2O
6 cmH2O
1.0 L/min
0 cmH2O
3 cmH2O
0.5 L/min
21%
21%
21%
Adult Setting
0 (off)
5
0 (off)
1 (Dec)
2.0 L/min
3.0 cmH2O
Pediatric Setting
0 (off)
5
0 (off)
1 (Dec)
2.0 L/min
3.0 cmH2O
Neonate Setting
N/A
N/A
N/A
1 (Dec)
2.0 L/min
3.0 cmH2O
5
25%
5 sec
0L
5
25%
0.5 sec
0 ml
5
10%
0.35 sec
0 ml
0.0 ml/cmH2O
NOT active in
Neonates.
Primary Controls:
Breath Type/Mode
Breath Rate (Rate)
Tidal Volume
(Volume)
Peak Flow
Inspiratory
Pressure (Insp
Pres)
Inspiratory Pause
(Insp Pause)
Inspiratory Time
(Insp Time)
PSV
PEEP
Inspiratory Flow
Trigger (Flow
Trig)
%O2
Advanced Settings:
Vsync
Vsync Rise
Sigh
Waveform
Bias Flow
Inspiratory
Pressure Trigger
(Pres Trig)
PSV Rise
PSV Cycle
PSV Tmax
Machine Volume
(Mach Vol)
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Volume Limit
(Vol Limit)
Inspiratory Rise
(Insp Rise)
Flow Cycle
T High PSV
T High Sync
T Low Sync
Demand Flow
Adult Setting
2.50 L
Pediatric Setting
500 ml
Neonate Setting
300.0 ml
5
5
5
0% (off)
Off
0%
0%
On
0% (off)
Off
0%
0%
On
0% (off)
N/A
N/A
N/A
On
Adult Setting
200 bpm
3.00 L
Pediatric Setting
200 bpm
1000 ml
Neonate Setting
200 bpm
300 ml
0.0 L
0.0 ml
0.0 ml
0.0 (off)
0.0 (off)
0.0 (off)
30.0 L/min
30.0 L/min
5.0 L/min
3 cmH2O
3 cmH2O
3 cmH2O
75 cmH2O
75 cmH2O
50 cmH2O
3 cmH2O
20 sec
3 cmH2O
20 sec
1 cmH2O
20 sec
Adult Setting
----79%
-----
Pediatric Setting
----79%
Neonate Setting
----20%
---
---
---
---
---
Alarm Settings:
High Rate
High Tidal Volume
(High Vt)
Low Tidal Volume
(Low Vt)
Low Exhaled
Minute Volume
(Low Ve)
High Exhaled
Minute Volume
(High Ve)
Low Inspiratory
Pressure (Low
Ppeak)
High Inspiratory
Pressure (High
Ppeak)
Low PEEP
Apnea Interval
Auxiliary Controls:
Manual Breath
Suction
↑ O2
Nebulizer
Inspiratory Hold
(Insp Hold)
Expiratory Hold
(Exp Hold)
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AVEA User Verification Test Checklist
Machine Serial Number:________________________________ Test Date: __________________
TEST
PASS
FAIL
Automated Tests
Power-on self test
Patient circuit leak test
Patient circuit compliance measurement
Two point calibration of the oxygen sensor
Manual Alarms Checks
Low PEEP Alarm
High Ppeak Alarm
Sustained High Ppeak Alarm
Low Ve Alarm
High Ve Alarm
High Vt Alarm
Low Vt Alarm
High O2 Alarm
Low O2 Alarm
Low Ppeak Alarm
Circuit Disconnect Alarm
Loss of AC Alarm
High Rate Alarm
Apnea Interval Alarm
Signature of tester:_______________________________________________
Title___________________________________________________________
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AVEA Troubleshooting
Remove ventilator from patient with any potential problem
Symptom
Problem
Will not pass EST - Fails Leak
Circuit wye not fully occluded
Solution(s)
Ensure circuit wye is fully
occluded
Leak in patient circuit
Check for leaks in circuit and
reseat circuit connections to
ventilator. Replace circuit if
necessary.
Filter cartridge not properly seated Remove exhalation cartridge
and check condition of
connections. Reinstall and
recheck. Replace if
necessary
Leak in exhalation corner
Replace exhalation
diaphragm.
Will not pass EST - Fails O2
Connector on O2 sensor not
Check sensor connection
calibration
connected properly
Inlet gas pressure too low
Verify inlet air and oxygen
pressure above 20psig
Defective O2 sensor
Replace O2 Sensor
No reading from proximal flow sensor Sensor / Patient size incompatible See operators manual for
correct sensor/mode
configurations
Sensor not connected
Ensure sensor properly
connected
Loose external connection
Check external connection
Defective sensor
Replace sensor
Vti > Vte when operating without
proximal flow sensors
Vte > Vti
Internal fault
Call Technical Service
Normal Condition when operating
on test lung.
Normal if readings are within
ventilator accuracy specifications
of +/-10%
Defective expiratory flow sensor
No action required
Leak in patient circuit, water
collector or exhalation system
Normal if readings are within
ventilator accuracy specifications
of +/-10%
Defective expiratory flow sensor
Leak in patient circuit, water
collector or exhalation system
Internal fault
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No action required if within
specification
Clean/replace expiratory flow
sensor
Verify with leak test
No action required if within
specification
Clean/replace expiratory flow
sensor
Verify with leak test
Call Technical Service
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Symptom
Problem
Solution(s)
Volume waveform above or below
baseline on patient with internal
sensor
Humidifier "Active on/off" set
incorrectly
Set for "Active on” for
humidifier, "Active off" for
“HME"
No action required if within
specification
Normal if readings are within
ventilator accuracy specifications
of +/-10%
Bad expiratory flow sensor
Volumes become inaccurate over
time
Nebulizer output absent
Internal fault
Clean or replace expiratory
flow sensor
Call Technical Service
Foreign material on flow sensor
Clean/replace sensor
Internal fault
Call Technical Service
Ventilator running on compressor
Flow less than 15 L/min
Connect wall air
Increase flow if appropriate
Internal fault
Call Technical Service
FiO2 monitor inaccurate or reads "***" O2 sensor requires calibration
O2 sensor at end of life
PEEP too high
Exhalation filter cartridge clogged
or saturated
Defective exhalation diaphragm
Unit will not run on A/C power
Perform EST
Replace O2 Sensor
Replace cartridge
Change exhalation
diaphragm
Blown fuse on power entry module Replace fuse
Power cord not connected to
mains power
Check connections
Unit will not run properly on battery
Battery not sufficiently charged
Improper charge level indicator Internal battery
Excessively discharged battery
Internal battery may require
up to 4 hours for full charge.
External battery may require
up to 12 hours with green
LED lit for a full charge.
Requires up to 4 hours for
full charge
Improper charge level indicator External battery
Excessively discharged battery
Loose connections
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Symptom
Problem
Solution(s)
Decreased run time on battery
Battery not fully charged
Does not run on compressor
Defective battery
Internal fault
Internal battery may require
up to 4 hours for full charge.
External battery may require
up to 12 hours for a full
charge.
Call technical Service
Call Technical Service
Auto cycling
Improper sensitivity settings
Check flow and pressure
trigger settings
Circuit leaks
Perform EST and correct
leaks as required. Bias Flow
should be set to
approximately 1.5 lm greater
than Flow Trigger setting.
Turn on Demand Flow
Call Technical Service
Reduce minute volume
Insure proper connection
Vent INOP display
Low gas alarm on compressor
"Loss of gas" alarm
Device Error indicator
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System fault
Minute volume exceeds 40 L/min
Air/Heliox connector not properly
connected
Internal fault
Call Technical Service
Defective sensor
Replace sensor
Exhalation flow sensor not
connected
Check connections
O2 sensor connector not
connected
Defective O2 sensor
Check O2 sensor
Replace O2 sensor
Internal fault
Call Technical Service
Improper connection sequence
External battery connection
should be made with AC
power disconnected.
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Chapter 3 Ventilator Operation
Membrane Buttons and LEDs
Figure 3.1a User Interface Module (International) Showing Button Icons
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Figure 3.1b User Interface Module (English) Showing Button Labels
The Membrane buttons are the UIM controls, which surround the Touch Screen. Moving
clockwise around the UIM from the top right (see arrow), they are:
A. Alarm Silence (LED)
Pressing this button will disable the audible portion of an alarm for 2 minutes (± 1 second)
or until the Alarm Silence button is pressed again. This button is not functional for a VENT
INOP alarm.
Note
Pressing the alarm silence button will not prevent the audible alarms sounding again later
for certain alarm conditions.
B. Alarm Reset
Cancels the visual indicator for alarms that are no longer active.
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C. Alarm Limits
Opens the alarm limits screen for data entry or adjustment. Toggles the screen on and off.
Note:
Pressing the Freeze button while the Alarm Limits window is open will automatically close
the window and freeze the graphics.
D. Manual Breath
Pressing this button during the expiration phase of a breath delivers a single mandatory
breath at current ventilator settings. No breath is delivered if the key is pressed during
inspiration.
Note
The Manual Breath button is not active in APRV / BIPHASIC.
E. Suction (LED)
Pressing this button initiates a “Disconnect for Suction” maneuver.
The ventilator will:
Enable an “Increase % O2” maneuver for 2 minutes (see Increase O2 below).
Disable the demand system on loss of PEEP;
Silences alarms for 120 seconds.
If the SUCTION key is pressed again during the 2 minutes that the “disconnect for
suction” maneuver is active, the maneuver will be cancelled.
F. Increase O2
When this key is pressed, the ventilator increases the oxygen concentration delivered to
the patient for 2 minutes. If the ↑ %O2 key is pressed again within this two-minute period,
the maneuver is cancelled and the ventilator will return to prior settings.
Defaults:
+20% Neonatal; 79% Adult/Pediatric
Adult/Pediatric:
79% above the set % O2
Neonate:
20% above the set % O2 or 100%, whichever is less
To configure the Increase FiO2
Access the Configuration tab on the Utilities Screen:
Increase FiO2:
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Configures the step increase used during the increase oxygen maneuver. Sets the
amount of oxygen the ventilator will increase above the current set FiO2.
Example:
If the Increase FiO2 is set at 20%
AND
The set FiO2 is 40%
WHEN
The increase FiO2 Maneuver is activated the FiO2 will
increase to 60% for two minutes after which it will return to
40%.
The default setting for infants is 20% and 79% for Pediatric and Adult applications.
Note
The settings will be reset to default values when New Patient is selected in the setup
Note
To achieve 100% delivered FiO2 during the Increase O2 maneuver set the Increase FiO2
setting to its maximum of 79%.
WARNING
Heliox delivery will be interrupted for the time that either the “Suction” or the
“Increase O2” buttons are pressed during administration of Heliox. Tidal volume
may be affected after the 2-minute “timeout” period, or when the button is pressed,
until the accumulator has been purged.
G. Data dial
Changes the values for a selected field on the touch screen.
H. Accept
Accepts data entered into a field on the touch screen.
I. Cancel
Cancels data entered into a field on the touch screen. The ventilator will continue to
ventilate at current settings.
J. Expiratory Hold
When the EXP HOLD button is pressed, at the start of the next breath interval the
ventilator will not allow the patient to inspire or exhale for a maximum of 20 seconds
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(adult/pediatric) or 3 seconds (neonate). Expiratory Hold is NOT active in TCPL
breaths.
K.
Inspiratory Hold (Manual)
When the INSP HOLD button is pressed, once the preset of a volume control or pressure
control breath has been delivered, the patient will not be allowed to exhale for a maximum
of 3.0 seconds (± 0.1 second).
L. Nebulizer
The ventilator supplies blended gas to the nebulizer port at 10 ± 1.5 psig (0.7 bar) when
an in-line nebulizer is attached and the Nebulizer key is pressed, provided that the
calculated delivered flow is >15 L/min.
Delivery of the nebulized gas is synchronized with the inspiratory phase of a breath and
lasts for 20 minutes. Press the Nebulizer key a second time to end the treatment prior to
the end of the 20-minute period.
CAUTION
Use of an external flow source to power the nebulizer is not recommended.
WARNING
Using the nebulizer may impact delivered tidal volumes.
Note
Do not operate the nebulizer while using heliox
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M.
Patient Size
The Patient Size Indicators for Adult, Pediatric, and Neonate at the
bottom of the UIM show which patient size is currently selected. These
LED indicators have no associated membrane button on the UIM.
Note
The ventilator will not allow patient size changes when the active mode of ventilation is
not available in the new patient size selection. The ventilator will display a message
instructing you to first change the ventilation mode. For example, in neonatal ventilation
with TCPL active, you cannot change to a pediatric or adult patient size without first
changing the mode to one available for those patients.
The ventilator will also not allow size changes if Machine Volume is active. A message
displays indicating that Machine Volume must first be turned off before making a patient
size change.
N. Panel Lock (LED)
The LOCK key disables all front panel and screen controls except MANUAL BREATH,
Suction,↑ %O2, ALARM RESET, ALARM SILENCE, and LOCK.
O. Print
The PRINT key outputs the contents of the currently displayed screen to a suitably
connected parallel printer.
P. Set-up
Opens the ventilator Setup screen.
Note
Pressing the Set-Up button a second time before accepting Set-Up will close the window
and restore the previous settings. The Set-Up screen uses an on screen accept button.
To change patient size without selecting new patient requires that patient Set-Up be
accepted after selecting patient size.
Q. Advanced Settings (LED)
Opens the Advanced Settings screen for data entry or adjustment. Toggles the screen on
& off.
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Note
Pressing the Freeze button while the Advanced Setting window is open will automatically
close the window and freeze the graphics.
R. Mode
Opens the Mode Select screen for data entry or adjustment toggles the screen on or off.
Pressing the Mode indicator at the top of the touch screen will also access the screen.
Note
Pressing the Mode button a second time before accepting the Mode will close the window
and restore the previous settings. The Mode screen uses an on screen accept button.
S. Event
Records an event for future reference. Some Events are recorded automatically others
can be logged manually to display in this screen. See Chapter 4, Monitors and Displays,
for a full list of Events.
T. Freeze
The FREEZE key freezes the current screen and suspends real-time update of screen
data until pressed again. While the screen is frozen, a scrollable cursor appears. The
Data Dial can be used to scroll the cursor through data points on waveform, loop or trend
screens. To restore the screen to active press the Freeze button a second time.
Figure 3.2 shows a flow/volume loop in “freeze” mode. The cursors trace the “frozen”
loop curve along an X-Y plot line. The values along the curve of the loop are displayed as
shown below.
Flag showing X
and Y values at
various points
along the loop
tracing
Dashed
Cursor Line
Flow/Volume
Loop Tracing
Cursor, currently
overlays the “X”
axis at Zero
Figure 3.2 Flow/Volume Loop in Freeze Mode
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U. Screens
Opens the Screen Selection box. See figure 3.3. You can also open this by pressing the
Screen indicator in the top center of the touch screen.
Note
Pressing the Screens button a second time closes the window.
Figure 3.3 Screens Selection Box.
V. Main
Returns the display to the main screen.
W. Alarm Status LEDs
The Alarm status indicators at the top right of the UIM flash red or yellow to indicate a high
or medium priority alarm (See chapter 5 Alarms and Indicators).
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Patient Setup
Patient Select Screen
The Patient Select screen allows you to choose to
resume ventilation of the current patient (RESUME
CURRENT) or select (NEW PATIENT) to
reconfigure ventilator settings.
Figure 3.4 Patient Select Screen
If you press the Resume Current key, the ventilator begins ventilation at the most recent
patient settings.
The New Patient key clears loops and trend buffers and resets all settings to default
values.
Press Patient Accept to accept your selection.
Patient Size Select Screen
The Patient Size Select screen appears as the
first step of the new patient setup sequence.
Press the Size Accept button to accept your
choices. The ventilator Setup screen is revealed
as the Patient Size Select screen closes (see
Fig. 3.5).
Note
The new patient size selection will not be active
until the on screen SETUP ACCEPT button is
pressed.
Figure 3.5 Patient Size Selection Screen
Note
The ventilator will not allow patient size changes when the active mode of ventilation is
not available in the new patient size selection. The ventilator will display a message
instructing you to first change the ventilation mode. For example, in neonatal ventilation
with TCPL active, you cannot change to a pediatric or adult patient size without first
changing the mode to one available for those patients.
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Ventilation Setup
Ventilation Setup Screen
Figure 3.6 Ventilation Setup
In the Setup screen, controls are available to set the following:
Artificial Airway Compensation (AAC)
Range
ON/OFF
Default:
OFF
When Artificial Airway Compensation is turned on, the ventilator automatically calculates
the pressure drop across the endotracheal tube and adjusts the airway pressure to deliver
the set inspiratory pressure to the distal (carina) end of the endotracheal tube. This
calculation takes into account flow, gas composition (Heliox or Nitrogen/Oxygen), Fraction
of Inspired Oxygen (FiO2), tube diameter, length, and pharyngeal curvature based on
patient size (Neonatal, Pediatric, Adult). This compensation only occurs during
inspiration. Artificial Airway Compensation is active in all Pressure Support and Flow
Cycled Pressure Control Breaths.
Note:
Monitored airway pressures (inspiratory) will be higher than set values when Artificial
Airway Compensation is active.
WARNING
Activation of Artificial Airway Compensation while ventilating a patient will cause a
sudden increase in the peak airway pressures and a resultant increase in tidal
volume. Exercise caution when activating Artificial Airway Compensation while the
patient is attached to the ventilator to minimize the risk of excessive tidal volume
delivery.
Even if inspiratory pressure is set at zero, Artificial Airway Compensation will still provide
an elevated airway pressure to compensate for the resistance of the endotracheal tube.
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When turned on, the Artificial Airway Compensation (AAC) indicator will appear on the
touch screen in all modes of ventilation, even though Artificial Airway Compensation may
not be active in the current mode (i.e. in volume controlled breaths). This is to alert you to
the fact that Artificial Airway Compensation is turned on and will become active if a
Pressure Support mode or a combination mode (i.e.: Volume Control SIMV) is selected.
Tube Diameter:
Range:
Default:
2.0 to 10.0 mm
7.5 mm
5.5 mm
3.0 mm
(Adult)
(Pediatric)
(Neonate)
Range:
2.0 to 30.0 cm
2.0 to 26.0 cm
2.0 to 15.0 cm
(Adult)
(Pediatric)
(Neonate)
Default:
30.0 cm
26.0 cm
15.0 cm
(Adult)
(Pediatric)
(Neonate)
Tube length:
Leak Compensation (LEAK COMP)
Range
ON/OFF.
Default:
OFF
During exhalation, PEEP is maintained by the cooperation of the Flow Control Valve
(FCV) and the Exhalation Valve (ExV). The ExV pressure servo is set to a target pressure
of PEEP and the FCV pressure servo is set to a pressure target of PEEP - 0.4 cmH2O.
The ExV servo relieves when the pressure is above its target and the FCV supplies flow
when the pressure drops below its target up to a maximum flow rate for the patient size. It
is not active during breath delivery.
Circuit Compliance
When Circuit Compliance is active, the volume of gas delivered during a volume
controlled or targeted breath is increased to include the set volume plus the volume lost
due to the compliance effect of the circuit.
Exhaled volume monitors, are adjusted for the compliance compensation
volume in all modes of ventilation.
Range:
0.0 to 7.5 ml/cmH2O
Default:
0.0 ml/cmH2O
Circuit compliance can be measured automatically by the ventilator during an Extended
Systems Test (EST) or entered manually.
Note
Circuit Compliance is active for set Tidal Volume in volume control ventilation, Target
Tidal Volume in PRVC and Machine Volume in Adult and Pediatric applications only.
Although circuit compliance is displayed on the set up screen it is not active for
neonatal patients.
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Humidifier
You can select active or passive humidification (ON/active or OFF/passive). Active
humidification assumes 99% RH; passive assumes 60% RH when using an HME. This
feature adjusts the BTPS correction factor to correct exhaled tidal volumes.
Range: Active ON/OFF
Default: Active ON
Note:
Incorrect setting of the Humidification feature will affect monitored exhaled volume
accuracy
Patient Weight
Patient Weight can be set in the following ranges.
Adult
Pediatric
Neonate
1 to 300 Kg
1 to 75 Kg
0.1 to 16 Kg
Default:
1 Kg
Patient weight is a variable determined by the clinician and is used for the purpose of
displaying monitored volume per unit weight.
Identification
Patient ID. You may input a 24-character (two x 12-character), alphanumeric patient
identification. To create a patient ID, press the Touch Screen directly over the Patient
IDENTIFICATION field.
A secondary screen appears showing the
characters available for patient identification. Turn
the data dial at the bottom of the UIM (see figure
3.7) to scroll through the characters. Press the
ACCEPT membrane key to accept each character
and build your Patient ID code. When the Patient
ID code is complete, check the rest of the screen
parameters and if you are satisfied with the setup,
press the SETUP ACCEPT button.
Figure 3.7 Data Dial, Accept & Cancel Button
Note
Primary breath controls active for the selected (highlighted) mode are visible at the bottom
of the touch screen during setup. The Advanced Settings dialog box and the Alarm Limits
dialog box can also be opened during setup. All controls are active and may be modified
while in the Set Up screen.
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EST (Extended Systems Test)
From the Setup screen, press the EST button.
A message will appear instructing you to remove the
patient and block the patient wye. After confirming that
the patient is disconnected and the circuit wye blocked,
press Continue (Cont).
The ventilator begins the EST and displays a countdown
clock. During the EST the ventilator will perform:
A Patient circuit leak test.
A Patient circuit compliance measurement.
A two point calibration of the oxygen sensor
The patient circuit compliance measurement and leak
test are performed simultaneously with the oxygen
sensor calibration. The maximum time for the EST is 90
seconds. To restart the EST at any time, press Cancel to
return to the set up screen.
After each test is complete the ventilator will display a
“Passed” or “Failed” message next to the corresponding
test.
Once the test is complete, press Continue to return to the
set up screen.
Note:
If the ventilator is NOT connected to an oxygen supply
the O2 Sensor Calibration will immediately fail.
Figure 3.8 Extended Systems Test Screens
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CAUTION
Although failure of any of the above tests will not prevent the ventilator from functioning, it
should be checked to make sure it is operating correctly before use on a patient.
Setting the Ventilation Breath Type and Mode
To access the Mode selection options, press the Mode membrane button to the left of the
LCD screen.
Figure 3.9 Adult Mode Select Screen
Figure 3.10 Infant Mode Select Screen
The choices displayed in the Mode Select screen are a combination of breath type and
ventilation delivery mode (e.g. a Volume limited breath with Assist /Control ventilation is
shown as Volume A/C). APNEA Backup ventilation choices appear when CPAP/PSV or
APRV / BIPHASIC mode is selected. Apnea Backup is active in all Assist Control, SIMV,
APRV / BIPHASIC and CPAP/PSV modes.
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Note
When CPAP/PSV or APRV / BIPHASIC (Airway Pressure Release Ventilation) is
selected, you MUST
1. Set the primary and advanced settings for CPAP/PSV or APRV / BIPHASIC
2
3
Select the breath type for APNEA backup mode by pressing the Apnea Settings key
Set the primary and advanced controls visible at the bottom of the touch screen, for
the selected apnea breath type before pressing the MODE ACCEPT button. The
controls for the apnea breath type will not be visible once the MODE ACCEPT button
has been pressed. Only those controls that are active and required for CPAP/PSV or
APRV / BIPHASIC will remain. To review the Apnea backup settings press the Mode
button at any time and select APNEA Settings.
Breath Types
This section contains a brief description of the breath types and ventilation mode
combinations available for adult, pediatric and neonatal patients.
There are two basic breath types:
Mandatory breaths (delivered according to set ventilator parameters)
and
Demand breaths (triggered by the patient)
All breaths are defined by four variables:
Trigger (initiates the breath),
Control (controls the delivery),
Cycle (primary breath termination), and
Limit (secondary breath termination).
Mandatory Breaths
Mandatory breaths can be triggered by the machine, the patient, or the operator. There
are 4 mandatory breath types delivered by the AVEA.
1. Volume breaths, which are:
•
•
•
Controlled by flow (inspiratory);
Limited by pre-set volume or maximum inspiratory pressure.
Cycled by volume, flow, and time.
Note.
The Volume Controlled breath is the default breath type for adult and pediatric patients.
The Intra-Breath Demand System in Volume Ventilation
AVEA features a unique intra-breath demand system in Volume Controlled
ventilation, designed to provide additional flow to the patient during periods of
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demand. AVEA measures the Peak Inspiratory Pressure (Ppeak) every 2
milliseconds throughout the breath cycle and sets a “virtual” Pressure Support Target
of the greater of: PEEP + 2 cmH2O or Ppeak – 2 cmH2O.
The minimum “virtual” Pressure Support level is set PEEP + 2 cmH2O.
The maximum is 2 times the set PEEP.
Simultaneously, the ventilator monitors and compares the Ppeak measurement to its
previous value. Should the Ppeak decrease by the 2 cmH2O, the ventilator will
recognize the patient demand and automatically “switch over” to deliver a Pressure
Support breath at the virtual Pressure Support Target. This allows flow to exceed the
set Peak Flow, thereby meeting the patient’s demand.
Once the set tidal volume has been delivered, the ventilator “looks” at the inspiratory
flow. If the Peak Inspiratory Flow is greater than set peak flow, the ventilator
determines that the patient is continuing to demand flow and cycles the breath when
inspiratory flow falls to 25% of peak inspiratory flow. If the Peak inspiratory Flow is
equal to the set flow, the ventilator determines that there is no continued patient
demand and ends the breath as a Volume Control breath.
Default is on. Can be turned off by accessing advanced setting of Peak Flow in
Volume Controlled Ventilation.
2. Pressure breaths, which are:
•
•
•
Controlled by pressure (inspiratory + PEEP);
Limited by pressure (inspiratory + PEEP + margin);
Cycled by time or flow.
3. Time Cycled Pressure Limited (TCPL) breaths (available for neonatal patients
only), which are:
•
•
•
Controlled by inspiratory flow;
Limited by pressure (inspiratory + PEEP);
Cycled by time, flow (inspiratory), or volume (Volume Limit).
Note
TCPL breath type is only available for Neonates. This is the default breath type for
neonate patients.
WARNING
Total resistance of the inspiratory and expiratory limbs of the breathing circuit with
accessories should not exceed 4cmH2O at 5 L/min if inspiratory flows > 15 liters per
minute are used in TCPL ventilation modes. For instructions on how to perform a
circuit resistance test see Appendix E.
4. Pressure Regulated Volume Control (PRVC) breaths are pressure breaths
where the pressure level is automatically modulated to achieve a preset volume.
PRVC breaths are:
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•
•
•
Controlled by pressure (inspiratory + PEEP) and volume;
Limited by pressure (inspiratory + PEEP + margin);
Cycled by time or flow.
PRVC breath operation is as follows:
When PRVC is selected, a decelerating flow, volume controlled test breath, to the set
tidal volume with a 40 msec pause, is delivered to the patient. The demand
system is active during this test breath.
The ventilator sets the target pressure at the end inspiratory pressure of the test
breath for the first pressure control breath.
The next breath and all subsequent breaths are delivered as pressure control
breaths. The inspiratory pressure is based on the dynamic compliance of the
previous breath and the set tidal volume.
Inspiratory pressure is adjusted automatically by the ventilator to maintain the target
volume. The maximum step change between two consecutive breaths is 3
centimeters of water pressure. The maximum tidal volume delivered in a single breath
is determined by the Volume Limit setting.
The test breath sequence is initiated when any of the following occur:
Entering the Mode (PRVC)
Changing the set tidal volume while in PRVC
Reaching the Volume Limit setting
Delivered tidal volume > 1.5 times the set volume
Flow termination of the test breath
Exiting Standby
Activation of any of the following alarms
High Peak Pressure Alarm
Low Peak Pressure Alarm
Low PEEP Alarm
Patient Circuit Disconnect Alarm
I-Time Limit
I:E Limit
Note
If flow cycling is active during a PRVC or Vsync breath flow cycling of the breath can only
occur if the target tidal volume has been delivered. This allows for expiratory synchrony
while assuring delivered tidal volume.
Note
Demand Flow is active for all mandatory breaths. The maximum peak inspiratory
pressure achievable by the ventilator is limited by the high peak pressure alarm setting.
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Demand Breaths
All demand breaths are patient-triggered, controlled by pressure, and flow or time cycled.
Demand breaths can be either pressure supported (PSV) or spontaneous. All demand
breaths are accompanied by the yellow patient demand indicator, which flashes in the
upper left of the screen.
1.
PSV (Pressure Support Ventilation)
A PSV breath is a demand breath in which the pressure level during inspiration is a
preset PSV level plus PEEP. The minimum pressure support level is PEEP + 2
cmH2O in adult and pediatric applications, independent of the set PSV pressure level.
In neonatal applications the minimum pressure support level is zero.
PSV breaths are:
•
•
•
Controlled by pressure (preset PSV level + PEEP);
Limited by pressure (preset PSV level + PEEP)
Cycled by time (PSV Tmax) or flow (PSV Cycle).
Pressure Support is active when CPAP/PSV, SIMV or APRV/BiPhasic modes are
selected
2.
Spontaneous breath
In adult and pediatric applications, a Spontaneous breath is a demand breath where
the pressure level during inspiration is preset at PEEP + 2 cmH2O.
In neonatal applications a Spontaneous breath is a demand breath delivered only at
the preset PEEP.
Note
IF PSV level is insufficient to meet patient demand, premature termination of the breath
may occur with auto-cycling. In these cases the PSV level should be increased slightly.
Figure 3.11 PSV Waveform
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In figure 3.11breath number 1 represents the flow tracing which occurs when the PSV
level is insufficient to meet the patient demand. Breath two shows resolution after
increasing the PSV level slightly. (Pressure tracing will show a similar appearance).
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Ventilation Modes
Leak Compensation.
The ventilator incorporates a leak compensation system. This system compensates for
baseline leaks at the patient - interface. To activate leak compensation, use the touch
screen control displayed in the Setup screen.
Assist Control Ventilation (A/C)
This is the default mode for all patient types. In Assist Control ventilation mode, all breaths
initiated and delivered are mandatory breaths. The initiation of a breath is triggered by
one of the following:
•
•
•
Patient effort activates the inspiratory trigger mechanism,
The breath interval, as set by the RATE control, times out,
The operator presses the MANUAL BREATH key.
Initiation of a breath by any means resets the breath interval timing mechanism. It is
possible for the patient to initiate every breath if he/she is breathing faster than the preset
breath rate. If the patient is not actively breathing, the ventilator automatically delivers
breaths at the preset interval (set breath rate).
Breath Interval
elapsed
PRESSURE
Breath Interval
elapsed
TIME
1
Mandatory Breath (Breath interval expired)
2
Mandatory Breath (Patient triggered)
Figure 3.12 Assist Control Ventilation Waveform
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Synchronized Intermittent Mandatory Ventilation (SIMV)
In SIMV mode, the ventilator can deliver both mandatory and demand breath types.
Mandatory breaths are delivered when the SIMV “time window” is open and one of the
following occurs:
A patient effort is detected;
The breath interval has elapsed with no patient effort detected;
Pressure
The MANUAL BREATH key has been pressed.
Time
Assist Window Open
Patient triggered Volume breath
Pressure supported breath
Figure 3.13 SIMV Waveform
The breath interval is established by the preset breath rate. It resets as soon as the
interval time determined by the set breath rate has elapsed, or when the MANUAL
BREATH key is pressed.
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Airway Pressure Release Ventilation (APRV / BIPHASIC)
APRV / BiPhasic is a Time Cycled Pressure mode in which the ventilator cycles between
two different baseline pressures based on time, which can be synchronized with patient
effort. Controlled ventilation can be maintained by timed cycling the transitions between
baseline pressures. Additionally, pressure support can be added to improve comfort for
the spontaneous breathing patient.
In this mode, the patient is allowed to breathe spontaneously at two preset pressure
levels. These are set using the Pres High and Pres Low controls. The maximum
duration at each pressure during time cycling is set with the Time High and Time Low
controls.
The operator can also adjust the length of the respective trigger (Sync) windows with the
Time High and Time Low Sync controls, which are advanced settings of Time High and
Time Low. The Sync windows are adjustable from 0 to 50%, in 5% increments of set
Time High and Time Low.
The ventilator synchronizes the change from Pressure Low to Pressure High with the
detection of inspiratory flow or the first inspiratory effort detected within the T Low Sync
window. Transition from Pressure High to Pressure Low occurs with the first end of
inspiration detected after the T High Sync window opens.
NOTE:
Time High and Time Low are maximum time settings for a time-cycled transition. Actual
times may vary depending on the patient’s spontaneous breathing pattern and the Sync
window setting.
Setting the Sync to 0% cycles the transition between pressure levels on time only and will
not provide synchronization with patient efforts.
The Manual Breath button is not active in APRV / BiPhasic.
The monitored PEEP in APRV/BIPHASIC is relative to the breath type. In the absence of
spontaneous breathing, the monitored PEEP will be the Pressure Low. In the presence of
spontaneous breathing the monitored PEEP will reflect the baseline pressure over which
spontaneous breathing is occurred.
Adjustable PSV in APRV / BiPhasic
APRV / BiPhasic features adjustable PSV. The PSV is delivered above the current phase
baseline pressure. PSV breaths are available during Time High also, by activating T High
PSV (an advanced setting of Time High). If T High PSV is activated, during Time High,
the ventilator will deliver the same PSV level for both Pressure Low and Pressure High.
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Apnea Ventilation in APRV / BiPhasic
Apnea ventilation is available in APRV / BiPhasic. If the patient does not initiate a
spontaneous effort, or the ventilator does not time cycle between pressure levels before
the apnea interval has elapsed, the ventilator will alarm for apnea and begin apnea
ventilation at the apnea ventilation settings. A spontaneous effort from the patient or a
transition in baseline pressure will reset the apnea alarm and timer and return the
ventilator to APRV / BiPhasic ventilation.
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(APRV / BIPHASIC)
Pressure
Time High
Pressure High
Time Low
Pressure Low
Time
Demand Breath
Spontaneous Breath triggers change to Pressure High
Spontaneous Breath triggers change to Pressure Low
Figure 3.14 APRV / BIPHASIC Mode
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Pressure
Continuous Positive Airway Pressure (CPAP) Pressure Support
Ventilation (PSV)
Time
Demand Breath
Figure 3.15 CPAP Waveform
In CPAP/PSV mode, all breaths are patient-initiated demand breaths unless the MANUAL
BREATH key is pressed or apnea backup ventilation is activated. When the MANUAL
BREATH key is pressed, a single breath is delivered at the currently selected apnea
backup control settings.
Pressure Support is active in CPAP mode (see Demand Breaths in this Chapter).
CAUTION
When CPAP/PSV is selected, you must
1. Select the breath type for APNEA backup mode AND
2. Set the primary controls visible at the bottom of the touch screen, for the selected
apnea breath type before pressing the MODE ACCEPT button. The controls for the
apnea breath type will not be visible once the MODE ACCEPT button has been
pressed. Only those controls that are active and required for CPAP/PSV will remain.
To review the settings for Apnea backup ventilation open the mode window, and
select Apnea Settings
Note
IF PSV level is insufficient to meet patient demand, premature termination of the breath
may occur with auto-cycling. In these cases the PSV level should be increased slightly.
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Figure 3.16 PSV Waveform
In figure 3.16 breath number 1 represents the flow tracing which occurs when the PSV
level is insufficient to meet the patient demand. Breath two shows resolution after
increasing the PSV level slightly. (Pressure tracing will show a similar appearance).
Apnea Backup Ventilation
Apnea Backup Ventilation is available in Assist Control, SIMV, CPAP/PSV and APRV /
BIPHASIC modes.
Apnea Backup in Assist Control or SIMV
When in Assist Control or SIMV modes, the apnea backup rate is determined by the
operator-set mandatory breath Rate or the Apnea Interval setting (whichever provides the
highest respiratory rate).
When the Apnea Interval setting (found in the Alarm Limits window) determines the
backup rate, the ventilator will continue to ventilate at this rate until the apnea has been
resolved.
All other controls for apnea ventilation in Assist Control and SIMV are set when the
primary control values for these modes are selected.
Apnea ventilation will terminate when one of the following criteria are met:
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•
A manual breath is delivered
•
The mandatory respiratory rate is increased above the apnea interval setting.
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Apnea Backup in CPAP/PSV or APRV / BIPHASIC
When CPAP/PSV or APRV / BIPHASIC is selected, you MUST:
1. Set the primary and advanced settings for CPAP/PSV or APRV / BIPHASIC
and
2. Select the breath type for APNEA backup mode (Volume or Pressure in
adult and pediatric patients or Volume, Pressure or TCPL in neonatal
patients) by pressing the Apnea Settings key.
3. Set the primary and advanced controls appearing at the bottom of the touch
screen, for the selected apnea breath type before pressing the MODE
ACCEPT button. The controls for apnea backup ventilation will not be
visible once the MODE ACCEPT button has been pressed. Only the
controls that are active and required for CPAP/PSV or APRV /
BIPHASIC will remain.
See figures 3.17 to 3.20 for Apnea backup settings available in each mode.
Figure 3.17 Volume Apnea Backup Settings for APRV / BIPHASIC mode
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Figure 3.18 Pressure Apnea Backup setting for APRV / BIPHASIC Mode
Figure 3.19 Volume Apnea Backup settings for CPAP Mode
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Figure 3.20 Pressure Apnea Backup settings for CPAP mode
Apnea ventilation will terminate when one of the following criteria are met:
•
The patient initiates a spontaneous breath
•
A manual breath is delivered
•
A timed transition between baseline pressures in APRV / BiPhasic
To review the Apnea backup settings press the Mode button at any time and select
APNEA Settings.
Note
When changing from a controlled mode of ventilation to CPAP/PSV or APRV /
BIPHASIC, the default apnea settings will be the same as those set in the controlled
mode. If a New Patient is selected, the default apnea settings are the same as the factory
set default settings for each of the controlled modes.
Note
The current set FiO2 is delivered during Apnea ventilation.
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Standby
To initiate Standby, press the Screens membrane button on the UIM identified by the icon
shown here.
The Screen Select box will display, see figure 3.21.
Figure 3.21 Screen selection
Press STANDBY. The following message will display
Figure 3.22 Standby Message
If you select “YES”, the ventilator will stop ventilating, the safety valve will close and the
ventilator will supply 2 L/min of gas continuously to the patient circuit and will display the
message shown in figure 3.22.
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Figure 3.23 Standby Screen
To resume patient ventilation, press the Resume button. The ventilator will restart
ventilation at the most recent settings. Do not re-connect the patient to the ventilator until
the RESUME button has been pressed and ventilation has restarted.
CAUTION
The 2 liters of bias flow, which is maintained during standby, is intended to reduce the risk
of circuit overheating in the event an active humidifier is in use and left on.
To ensure flow through the entire ventilator circuit, the patient wye should be plugged to
direct flow down the expiratory limb of the circuit. Failure to do this may result in damage
to the ventilator circuit if the humidifier is left on. Consult the circuit manufacturer to
confirm that 2 L/min of flow is sufficient to prevent overheating.
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Chapter 3 Ventilator Operation
Available Breath Types & Modes by Patient Size
Adult and Pediatric Ventilation Modes
The following breath types & ventilation modes are available for Adult and Pediatric
patients. When a mode is selected, its description is displayed at the top left of the touch
screen.
Table 3.1 Adult and Pediatric Displayed Modes
Displayed Mode
Volume A/C
Pressure A/C
Volume SIMV
Pressure SIMV
CPAP / PSV
PRVC A/C
PRVC SIMV
APRV /
BIPHASIC
Description
Volume breath with Assist ventilation (Default for adult and pediatric patients)
Pressure breath with Assist ventilation
Volume breath with Synchronized Intermittent Mandatory Ventilation (SIMV) and an adjustable level
of pressure support for spontaneous breaths.
Pressure Breath with Synchronized Intermittent Mandatory Ventilation (SIMV) and an adjustable level
of pressure support for spontaneous breaths.
Continuous Positive Airway Pressure (Demand Breath) with Pressure Support Ventilation
Pressure Regulated Volume Controlled breath with Assist Ventilation
Pressure Regulated Volume Controlled breath with Synchronized Intermittent Mandatory Ventilation
(SIMV) and an adjustable level of pressure support for spontaneous breaths.
Spontaneous demand breath at two alternating baseline pressure levels or controlled ventilation
cycled by time.
Neonatal Ventilation Modes
The following table shows the breath types and ventilation modes available for Neonatal
patients
Table 3.2 Neonatal Displayed Modes
Displayed Mode
Volume A/C
Pressure A/C
Volume SIMV
Pressure SIMV
Description
Volume breath with Assist ventilation (Default for adult and pediatric patients)
Pressure breath with Assist ventilation
Volume breath with Synchronized Intermittent Mandatory Ventilation (SIMV) and an adjustable level
of pressure support for spontaneous breaths.
Pressure Breath with Synchronized Intermittent Mandatory Ventilation (SIMV) and an adjustable level
of pressure support for spontaneous breaths.
TCPL A/C
TCPL SIMV
Time Cycled Pressure Limited breath with Assist ventilation (Default for neonatal patients)
CPAP / PSV
Continuous Positive Airway Pressure (Demand Breath) with Pressure Support Ventilation
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Time Cycled Pressure Limited breath with SIMV and an adjustable level of pressure support for
spontaneous breaths.
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AVEA Ventilator Systems
Primary Breath Controls
The Primary Breath Controls are the operator set controls, which directly affect the way a
breath is delivered to your patient. They are displayed along the bottom of the AVEA LCD
touch screen. Only the active controls for the selected mode of ventilation will be
displayed.
Table 3.3 Primary Breath Controls
Displayed
Control
Description
Range
Accuracy
Breath rate shown in Breaths
per Minute
1 to 150 bpm (Neo / Pediatric)
1 to 120 bpm (Adult)
± 1 bpm
Tidal Volume in milliliters
0.10 to 2.50 L (Adult)
25 to 500 ml (Pediatric)
2.0 to 300 ml (Neonate)
± (0.2 ml + 10% of setting)
cmH2O
Insp Pres
Inspiratory Pressure in
centimeters of water pressure
0 to 90 cmH2O (Adult/Pediatric)
0 to 80 cmH2O (Neonate)
± 3 cmH2O or ± 10% whichever is greater
L/min
Peak Flow
Peak Inspiratory Flow in Liters
per Minute
3 to 150 L/min (Adult)
1 to 75 L/min (Pediatric)
0.4 to 30.0 L/min (Neonate)
± 10% of setting or ± (0.2 L/min + 10% of
setting), whichever is greater
sec
Insp Time
Inspiratory Time in Seconds
0.20 to 5.00 sec
(Adult/Pediatric)
0.15 to 3.00 sec (Neonate)
± 0.10 sec
sec
Insp Pause
Sets an inspiratory pause which
will be in effect for each Volume
breath delivered
0.0 to 3.0 sec
± 0.10 sec
cmH2O
PSV
Pressure Support in centimeters
of water pressure
0 to 90 cmH2O (Adult/Pediatric)
0 to 80 cmH2O (Neonate)
± 3 cmH2O or ± 10% whichever is greater
cmH2O
PEEP
Positive end expiratory pressure
in centimeters of water pressure
0 to 50 cmH2O
± 2 cmH2O or ± 5% of setting, whichever is
greater
Sets inspiratory flow trigger
point in liters per minute
0.1 to 20.0 L/min
+ 1.0 / − 2.0 L/min ( for PEEP < 30 cmH2O)
bpm
Rate
ml
Volume
L/min
Flow Trig
+ 2.0 / − 3.0 L/min ( for PEEP > 30 cmH2O)
± (0.2 L/min + 10% of setting) (Wye flow
sensor only)
Controls the percentage of
oxygen in the delivered gas.
21% to 100%
± 3% O2
cmH2O
Pres High
In APRV / BIPHASIC mode,
controls the baseline pressure
achieved during Time High.
0 to 90 cm H2O
± 3 cmH2O
sec
Time High
In APRV / BIPHASIC mode sets
the minimum time for which the
high-pressure setting is
maintained.
0.20 to 30.0 sec
± 0.1 sec
sec
Time Low
In APRV / BIPHASIC mode sets
the minimum time for which the
low pressure setting is
maintained.
0.20 to 30.0 sec
± 0.1 sec
cmH2O
Pres Low
In APRV / BIPHASIC mode
controls the baseline pressure
achieved during Time Low.
0 to 45 cmH2O
± 2 cmH2O or ± 5% of setting, whichever is
greater
%
%O2
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Chapter 3 Ventilator Operation
To Activate a Primary
Control
To activate a primary breath control, press
the touch screen directly over the control. The control highlights (changes color) indicating
that it is active.
Figure 3.24 Highlighted Control
To modify the settings for the highlighted
control, turn the data dial below the touch
screen (see figure 3.25). Turning in a
clockwise direction increases the
selected value, turning counterclockwise
decreases it.
Figure 3.25 Data dial.
To accept the displayed value, either press the touch screen directly over the highlighted
control or press the ACCEPT membrane button to the left of the data dial. The control
color will change back to normal and the ventilator will begin operating with the new
setting. If you press the CANCEL button or do not actively accept the new setting within
15 seconds, ventilation will continue at the previous settings.
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Descriptions of Primary Breath Controls
Breath Rate (Rate)
The breath rate control sets the breath interval. Its function is dependent upon the
selected mode of ventilation and it has different effects on the breath cycle, depending on
which mode is selected.
Range:
1 to 150 bpm (Neonate / Pediatric)
1 to 120 bpm (Adult)
Breath Interval: (60/Rate) secs
Defaults:
8 bpm
12 bpm
20 bpm
(Adult)
(Pediatric)
(Neonate)
Tidal Volume (Volume)
A volume breath delivers a predetermined volume of gas to the patient. Tidal Volume,
together with the Insp Flow, and Waveform settings determine how the volume breath is
delivered.
Range:
0.10 to 2.50 L
25 to 500 ml
2.0 to 300 ml
(Adult)
(Pediatric)
(Neonate)
Defaults:
0.50 L
100 ml
2.0 ml
(Adult)
(Pediatric)
(Neonate)
Sigh:
1.5 x Volume
(Adult/Pediatric only)
Note
When operated from the internal compressor, the maximum Tidal Volume that the
ventilator can achieve is 2.0 L.
The maximum minute volume that the ventilator is capable of delivering using wall gas
supply is at least 60L and using internal compressor is 40L.
Inspiratory Pressure (Insp Pres)
During a mandatory pressure breath, the ventilator controls the inspiratory pressure in the
circuit. For Pressure & TCPL breaths, the pressure achieved is a combination of the
preset Insp. Pres. level plus PEEP.
Range:
0 to 90 cmH2O
0 to 80 cmH2O
Maximum Flow: > 200 L/min
< 120 L/min
< 50 L/min
Default:
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(Adult/Pediatric)
(Neonate)
(Adult)
(Pediatric)
(Neonate)
15 cmH2O
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Peak Flow
Peak flow is the flow delivered by the ventilator during the inspiratory phase of a
mandatory volume or TCPL breath.
Range:
Defaults:
3 to 150 L/min
(Adult)
1 to 75 L/min
(Pediatric)
0.4 to 30.0 L/min
(Neonate)
60 L/min
(Adult)
20 L/min
(Pediatric)
8.0 L/min
(Neonate)
Inspiratory Time (I-Time)
The I-Time control sets the inspiratory time cycle variable for all mandatory pressure,
TCPL or PRVC breaths.
Range:
0.20 to 5.00 seconds
0.15 to 3.00 seconds
(Adult/Pediatric)
(Neonate)
Default:
0.50 second
0.35 second
(Adult/Pediatric)
(Neonate)
Note
If the preset I-Time is greater than actual I- Time (as determined by Vt, FP, and the
waveform), an Inspiratory Pause time equal to the preset I-Time minus the actual I- Time is
added to the breath.
Inspiratory Pause (Insp Pause)
Sets an Inspiratory Pause, which will be in effect for each volume breath delivered.
A preset inspiratory pause will be delivered with each volume breath.
Range:
0.00 to 3.00 seconds
Default:
0.00 second
PSV (Pressure Support)
The PSV control sets the pressure in the circuit during a pressure supported breath.
Range:
0 to 90 cmH2O
0 to 80 cmH2O
Maximum Flow: > 200 L/min
< 120 L/min
< 50 L/min
Default:
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(Adult/Pediatric)
(Neonate)
(Adult)
(Pediatric)
(Neonate)
0 cmH2O
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Note
In adult and pediatric ventilation, a minimum of 2 cmH2O of PSV above PEEP is applied
even when the control is set to zero.
Note
IF PSV level is insufficient to meet patient demand, premature termination of the breath
may occur with auto-cycling. In these cases the PSV level should be increased slightly.
Figure 3.26 PSV Waveform
In figure 3.26 breath number 1 represents the flow tracing which occurs when the PSV
level is insufficient to meet the patient demand. Breath two shows resolution after
increasing the PSV level slightly. (Pressure tracing will show a similar appearance).
Note
Monitored airway pressures (inspiratory) will be higher than set when AAC is active. With
an inspiratory pressure setting of zero, AAC will still provide an elevated airway pressure,
to compensate for the resistance of the endotracheal tube.
Positive End Expiratory Pressure (PEEP)
PEEP is the pressure that is maintained in the patient circuit at the end of exhalation.
Range:
0 to 50 cmH2O
Defaults:
6 cmH2O
3 cmH2O
(Adult/Pediatric)
(Neonate)
Inspiratory Flow Trigger (Flow Trig)
The inspiratory trigger mechanism* is activated when the Net Flow becomes greater than
the Inspiratory Flow Trigger setting. Net Flow is defined as [Delivered Flow − Exhaled
Flow] (or Wye Inspiratory Flow when using a wye flow sensor). When the Inspiratory Flow
Trigger is enabled, a low level of Bias Flow is delivered to the patient circuit during the
exhalation phase of the breath.
Range:
0.1 to 20.0 L/min
Defaults:
1.0 L/min
0.2 L/min
(Adult/Pediatric)
(Neonate)
*See Also Pressure Trigger in Advanced Settings, this chapter.
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Note
To ensure adequate bias flow for inspiratory triggering the bias flow setting should be at
least 0.5 liters per minute greater than the flow trigger threshold.
%O2
The % O2 control sets the percentage of oxygen in the delivered gas.
Range:
21 to 100%
Default:
21% (Air)
Note
During Heliox administration the %O2 control sets the percent of Oxygen in the delivered
gas. The balance of the delivered gas is Helium.
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Pressure High (Pres High)
This control is only available in APRV / BIPHASIC Mode. It controls the baseline pressure
achieved during Time High.
Range: 0 to 90 cmH2O
Default: 15 cmH2O
Time High
Available in APRV / BIPHASIC mode only, this control sets the maximum time for which
the Pressure High setting is maintained.
Range: 0.2 to 30 seconds
Default: 4 seconds
Time Low
In APRV / BIPHASIC mode, this control sets the maximum time for which the Pressure
Low setting is maintained.
Range: 0.2 to 30 seconds
Default: 2 second
Pressure Low
In APRV / BIPHASIC Mode, this control sets the baseline pressure achieved during Time
Low.
Range: 0 to 45 cmH2O
Default: 6 cmH2O
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Chapter 3 Ventilator Operation
Advanced Settings
When the mode and the primary breath controls have been set, you can further refine
delivery of the breath by accessing the Advanced Settings.
Accessing the Advanced Settings
To access the advanced settings group,
press the ADV SETTINGS membrane
button located to the left of the touch
screen between the Mode and the Set-up
buttons. The LED indicator on the button
illuminates and the Advanced Settings
screen appears. When you select a
primary control by pressing and
highlighting the control at the bottom of
the touch screen, the available advanced
settings for that selected control appear in
the advanced settings screen.
Figure 3.27 The Advanced Settings
membrane button
Primary Controls, which feature an
advanced setting, will display a
yellow triangle to the right of the
control name.
Figure 3.28 Advanced settings indicator
Note
Not every primary control will have an associated advanced setting.
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Table 3.4 Controls and Advanced Settings Associated with Breath Type & Mode
BREATH
TYPE
& MODE
VOL A/C
VOL SIMV
PRES
A/C
PRES
SIMV
PRVC
A/C
PRVC
SIMV
RATE
bpm
*
*
*
*
*
VOLUME
ml
*
*
*
CPAP/PSV
APRV /
BIPHASIC
TCPL
A/C
TPCL
SIMV
*
* Apnea
* Apnea
*
*
*
* Apnea
* Apnea
* Apnea
* Apnea
*
*
* Apnea
* Apnea
*
*
* Apnea
* Apnea
*
*
* Apnea
* Apnea
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
PRIMARY
CONTROLS
INSP PRES
cmH2O
PEAK
FLOW
L/min
*
*
Mode
*
*
*
*
*
*
*
*
*
*
*
*
*
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Mode
Mode
*
*
*
*
*
*
*
*
*
*
*
*
*
*
Mode
Mode
Mode
Mode
Mode
Mode
*
Mach
Insp
Vol
vol,
rise,
limit,
Vol
Bias
PSV
limit,
flow,
rise,
Insp
Pres
PSV
rise,
trig
cycle,
Flow
PSV
Vol
cycle, Limit, Tmax,
PSV
Bias
Flow
rise,
flow,
Cycle
PSV
Pres
cycle,
trig,
PSV
Flow
Tmax,
Cycle
Bias
flow,
Pres
trig
* Available only with Vsync activated for adult or pediatric patients only.
** Available for adult and pediatric patients only.
ADVANCED
SETTINGS
AVAILABLE
WITHIN
EACH
MODE
Mode
Mode
*
INSP TIME
sec
INSP
PAUSE
sec
PSV
cmH2O
PEEP
cmH2O
FLOW TRIG
L/min
% OXYGEN
%o2
PRES HIGH
cmH2O
TIME HIGH
sec
TIME LOW
sec
PRES LOW
cmH2O
*
Mode
Vsync*,
Vsync
rise*,
Sigh,**
Waveform,
Bias flow,
Pres trig
Vol limit
(when
Vsync =
ON), Flow
Cycle*,
Demand
Flow
Vsync*,
Vsync
rise*,
Sigh,**
Waveform,
Vol. Limit,
PSV rise,
PSV cycle,
PSV
Tmax,
Bias flow,
Pres trig,
Flow
Cycle*,
Demand
Flow
Mach
vol,
Vol
limit,
Insp
rise,
Flow
cycle,
Bias
flow,
Pres
trig
Revision N
Vol limit,
PSV rise,
PSV cycle,
PSV Tmax,
Bias flow,
Pres trig
Vol limit,
PSV rise,
PSV
cycle,
PSV
Tmax,
Bias flow,
Pres trig
T High
Sync
T High
PSV
T Low
Sync
Vol
limit,
Flow
cycle,
Bias
flow,
Pres
trig
Vol
limit,
Flow
cycle,
PSV
rise,
PSV
cycle,
PSV
Tmax,
Bias
flow,
Pres
trig
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Chapter 3 Ventilator Operation
Advanced Settings Characteristics and Ranges
Volume Limit (Vol Limit)
The Vol Limit setting sets the volume limit for a Pressure Limited breath. When the
volume delivered to the patient meets or exceeds the preset Vol Limit, the inspiratory
phase of the breath is terminated.
Range:
Normal:
0.10 to 2.50 L
25 to 750 ml
2.0 to 300.0 ml
(Adult)
(Pediatric)
(Neonate)
Defaults:
2.50 L
500 ml
300 ml
(Adult)
(Pediatric)
(Neonate)
The Vol Limit setting sets the volume limit for a Pressure limited breath. When the volume
delivered to the patient meets or exceeds the preset Vol Limit, the inspiratory phase of the
breath is terminated.
Volume Limit is active for Pressure, PRVC / Vsync, TCPL, and PSV breaths only. In
neonatal applications Volume Limit requires the use of a wye flow sensor. Whenever a
proximal flow sensor is used (Neonatal, Pediatric or Adult applications) the Volume Limit
is activated by the inspiratory tidal volume measured by the wye flow sensor. In adult and
pediatric applications where no wye flow sensor is used Volume Limit is determined by
the calculated inspiratory wye flow. When the volume limit threshold has been reached
the ventilator alarm status indicator will change to yellow and display the words Volume
Limit. The alarm status indicator cannot be reset until the ventilator has delivered a
breath, which does not meet the volume limit threshold. To reset the alarm status window
use the alarm-reset button.
Note
Excessive inspiratory flow rates or highly compliant ventilator circuits may allow delivery of
a tidal volume that exceeds the volume limit setting. This is due to the ventilator circuit
recoiling and providing additional tidal volume to the patient. Delivered tidal volumes
should be closely monitored to ensure Volume Limit accuracy.
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Machine Volume (Mach Vol)
The Machine Volume control sets the minimum tidal volume delivered from the ventilator
when the control is activated in a pressure control breath. This control is always used
with the time cycling criterion in pressure control ventilation. Machine volume is circuit
compliance compensated in adult and pediatric applications.
Range:
Normal:
0.10 to 2.50 L
25 to 500 ml
2.0 to 300.0 ml
(Adult)
(Pediatric)
(Neonate)
Defaults:
0L
0 ml
0 ml
(Adult)
(Pediatric)
(Neonate)
Once you set the machine volume, the ventilator calculates the decelerating inspiratory
flow required to deliver the Machine Volume in the set inspiratory time. When a Pressure
Control breath is delivered and Peak Flow decelerates to this calculated peak inspiratory
flow, if the Machine Volume has not been met the ventilator will automatically transition to
a continuous flow until the Machine Volume has been delivered. Once the set Machine
Volume has been delivered the ventilator will cycle into exhalation. When the Machine
Volume is met or exceeded during delivery of the pressure control breath, the ventilator
will complete the breath as a normal Pressure Control breath.
During this transition in flow, the Inspiratory Time will remain constant and the Peak
Inspiratory Pressure will increase to reach the set Machine Volume. The maximum Peak
Inspiratory Pressure is determined by the High Peak Pressure alarm setting.
Note
Pmax is disabled when Machine Volume is set. In the event Flow Cycling is active in
Pressure Control the ventilator will not Flow Cycle until the Machine Volume has been
met. Machine Volume must be set to zero to change patient size.
To set Machine Volume in adult and pediatric applications (with circuit compliance
compensation active) simply set the minimum desired tidal volume.
In neonatal applications with proximal flow sensor in use:
L1523
•
Adjust the peak inspiratory pressure to reach the desired tidal volume.
•
Select Vdel as one of the monitored parameters. Read the Vdel (uncorrected
Tidal Volume delivered from the machine) during a pressure control breath.
•
Set the Machine volume to or slightly below the Vdel measurement. This will set
the machine volume to a level that will provide more consistent tidal volume
delivery in the case of slight decreases in lung compliance.
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Chapter 3 Ventilator Operation
Note
To protect against larger changes in lung compliance, the machine volume should be set
higher and Volume Limit should be added.
Insp Rise
The Inspiratory Rise setting controls the slope of the pressure rise during a mandatory
breath. This control is a relative control with fast being a setting of 1 and slow, a setting of
9.
Range:
1 to 9
Default:
5
The Inspiratory Rise control is not active for TCPL breaths.
Flow Cycle
The flow cycle setting sets the percentage of the peak inspiratory flow (Peak Flow), at
which the inspiratory phase of a Pressure Control, TCPL or PRVC/Vsync breath is
terminated.
Range:
0 (Off) to 45%
Default:
0% (Off)
Flow cycling is active for Pressure, PRVC/Vsync or TCPL breaths only.
Note
If flow cycling is active during a PRVC or Vsync breath flow cycling of the breath can only
occur if the target tidal volume has been delivered. This allows for expiratory synchrony
while assuring delivered tidal volume.
Note
If Flow Cycling is active during a pressure control breath, monitored airway pressures
(inspiratory) will be higher than set when AAC is active. In pediatric and adult ventilation
with an inspiratory pressure setting of zero AAC will still provide an elevated airway
pressure, which will compensate for the resistance of the endotracheal tube.
Waveform
During the delivery of a volume breath, flow can be delivered in one of two user selectable
waveforms: square wave or decelerating wave. The default waveform is Decelerating
Wave.
Square Wave (Sq)
With this waveform selected, the ventilator delivers gas at the set peak flow for the
duration of the inspiration.
Decelerating Wave (Dec)
With this waveform selected, the ventilator delivers gas starting at the peak flow and
decreasing until the flow reaches 50% of the set peak flow.
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Demand Flow
Enables and disables the Intra-Breath Demand system in volume controlled
ventilation. The default position is on.
Note
Should the patient’s inspiratory demand be sustained beyond the controlled inspiratory
time plus the minimum expiratory time with the demand system turned off auto-cycling
or double cycling may occur. This is the result of the patient demanding more flow than
available resulting in a breath trigger after the minimum expiratory time. This may be
resolved by increasing the inspiratory flow rate to meet the patients demand or turning the
demand system back on.
Sigh
The ventilator delivers sigh volume breaths when this setting is ON. A sigh volume breath
is delivered every 100th breath in place of the next normal volume breath.
Range:
Off, On (every 100 breaths)
Sigh Volume:
1.5 times set tidal volume
Sigh Breath Interval (sec):
Set Normal Breath Interval x 2 (Assist mode)
or
set Normal Breath Interval (SIMV mode)
Default:
Off
Sigh breaths are only available for Volume breaths in Assist and SIMV modes for adult
and pediatric patients.
Bias Flow
The Bias Flow control sets the background flow available between breaths. Additionally,
this control establishes the base flow that is used for flow triggering.
Range:
Defaults:
0.4 to 5.0 L/min
2.0 L/min
Note
To ensure adequate bias flow for inspiratory triggering the bias flow setting should be at
least 0.5 liters per minute greater than the flow trigger threshold. Consult the ventilator
circuit manufacturer to ensure that bias flow setting is sufficient to prevent overheating of
the ventilator circuit.
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Pres Trig
Sets the level below PEEP at which the inspiratory trigger mechanism is activated. When
the pressure in the patient circuit falls below PEEP by the set pressure trigger level, the
ventilator will cycle to inspiration.
Range:
Default:
0.1 to 20.0 cmH2O
3.0 cmH2O
Vsync
Vsync breaths are:
•
Controlled by pressure (inspiratory + PEEP) and volume;
•
Limited by pressure (inspiratory + PEEP + margin);
•
Cycled by time. Inspiratory time in Vsync is determined indirectly by setting the
peak inspiratory flow. The set inspiratory time is displayed in the message bar.
Vsync breath operation is as follows:
When Vsync is selected, a decelerating flow, volume test breath to the set tidal volume
with a 40 msec pause is delivered to the patient. The ventilator sets the target pressure at
the end inspiratory pressure of the test breath or the first pressure control breath. The
next breath and all subsequent breaths are delivered as pressure control breaths.
Inspiratory pressure is adjusted automatically, based on the dynamic compliance of the
previous breath, to maintain the target volume. The maximum step change between two
consecutive breaths is 3 centimeters of water pressure. The maximum tidal volume
delivered in a single breath is determined by the Volume Limit setting.
This test breath sequence is initiated when any of the following occur:
•
•
•
•
•
•
•
Entering the Mode (Vsync)
Changing the set tidal volume while in Vsync
Reaching the Volume Limit setting
Delivered tidal volume > 1.5 times the set volume
Flow termination of the test breath
Exiting Standby
Activation of any of the following alarms
-
High Peak Pressure Alarm
Low Peak Alarm
Low PEEP Alarm
Patient Circuit Disconnect Alarm
I-Time Limit
I:E Limit
Vsync is only available for adult and pediatric patients.
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Note
If flow cycling is active during a PRVC or Vsync breath flow cycling of the breath can only
occur if the target tidal volume has been delivered. This allows for expiratory synchrony
while assuring delivered tidal volume.
Note
The Peak Flow control sets the flow rate, which is used by the ventilator for the test breath
only. The ventilator uses the Peak Flow setting and Inspiratory Pause to determine the
maximum inspiratory time during Vsync ventilation.
Vsync Rise
With Vsync active, this control sets the slope of the pressure rise during the volume
breath. It is a relative control ranging from fast (1) to slow (9).
Range:
1 to 9
Default:
5
PSV Rise
This control sets the slope of the pressure rise during a pressure-supported breath. It is a
relative control with a range from fast (1) to slow (9).
Range:
1 to 9
Default:
5
PSV Cycle
Sets the percentage of peak inspiratory flow at which the inspiratory phase of a PSV
breath is terminated.
Range:
5 to 45%
Default:
25% (Adult/Pediatric)
10% (Neonate)
PSV Tmax
Controls the maximum inspiratory time of a pressure-supported breath.
Range:
0.20 to 5.00 seconds (Adult/Pediatric)
0.15 to 3.00 (Neonate)
Default:
5.00 seconds (Adult)
0.5 seconds (Pediatric)
0.35 seconds (Neonate)
Note
PSV Rise, PSV Cycle and PSV Tmax are active even if the PSV level is set to Zero
Independent Lung Ventilation (ILV)
Independent lung ventilation allows 2 ventilators to be synchronized to the same breath
rate (the rate control set on the master ventilator), while all other primary and advanced
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controls for each ventilator can be set independently. Master and slave ventilators need
not operate in the same mode during ILV.
The AVEA offers a port to allow Independent Lung Ventilation (ILV). This connection is
located on the rear panel (see figure 2.19, C). The output provides a 5 VDC logic signal,
synchronized to the breath phase of the master ventilator.
A specially configured accessory cable kit, available from VIASYS (P/N 16246) is
required to implement ILV.
WARNING
Do NOT attempt to connect a standard DB-25 cable to this receptacle. This could
cause damage to the ventilator. A specially configured cable is required for ALL
features associated with this connector. Contact VIASYS Tech Support.
To enable Independent Lung Ventilation, refer to Chapter 2, Ventilator Setup,
Independent Lung Ventilation (ILV).
NOTE
During ILV, the alarm limits for each ventilator should be set to appropriate levels for each
ventilator to assure appropriate patient protection.
WARNING
Since the master ventilator controls the breath rate for both ventilators, care should be
taken when setting the other independent breath controls for the slave ventilator, to
ensure sufficient time is allowed for exhalation to occur.
CAUTION
If the cable connecting the master and slave ventilators becomes detached, the slave
ventilator will alarm for loss of signal. In this event, only the master ventilator will continue
to provide ventilation to the patient.
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Graphic Displays
Graphics Colors
Graphic displays on AVEA may appear as red, blue, yellow, green or purple tracings. These colors
may provide useful information to the operator about breath delivery and are consistent between both
waveform and loop graphic displays.
A RED tracing indicates the inspiratory portion of a mandatory breath. A YELLOW tracing indicates
the inspiratory portion of an assisted or spontaneous breath (patient assisted or spontaneous breaths
are also denoted with a yellow demand indicator that appears in the left hand corner of the mode
indicator). BLUE tracings represent the expiratory phase of a mandatory, assisted or spontaneous
breath. A GREEN tracing during the expiratory phase of a single breath indicates that a purge of the
expiratory flow sensor or the wye flow sensor (if attached) has occurred. A PURPLE tracing indicates
safety state, which occurs when the safety valve is open.
Waveforms
Three waveforms can be selected and simultaneously displayed on the MAIN screen as shown in figure
4.1.
Note
Waveforms are circuit compliance compensated.
Waveform
Heading
Display
Figure 4.1 Waveform Graphs Displayed on the Main Screen
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When you press and highlight the waveform heading display on the touch screen a scrollable menu
appears showing the choice of waveforms (see figure 4.2).
Waveform
Selection Menu
Highlighted
Waveform
Heading
Y-axis of
graph
X axis of
graph
Figure 4.2 Waveform Selection
To scroll through the waveform choices, turn the data dial under the
touch screen. To make your selection, touch the touch screen menu
again or press the Accept membrane button shown here next to the
data dial.
Figure 4.3 Data dial
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Each waveform is continuously updated unless the PRINT or FREEZE membrane button is pressed.
The PRINT button transfers data to a connected parallel printer.
The FREEZE button freezes the current screen and suspends the screen update until pressed a
second time.
Table 4.1 Waveform Choices
Heading Display
Waveform Shown
Paw (cm H2O)
Airway Pressure
Pinsp (cmH20)
Airway Pressure at Machine Outlet
Pes (cmH2O)
Esophageal Pressure
Ptr (cmH2O)
Tracheal Pressure
Ptp (cmH20)
Transpulmonary Pressure
Flow(L/min)
Flow
Vt (ml)
Airway Tidal Volume
Finsp
Fexp
Inspiratory flow
Expiratory Flow
Analog 0
Based on analog input scale
Analog 1
Based on analog input scale
Axis Ranges
The scale (vertical axis) and sweep speed (horizontal axis) of the displayed graphs are also modifiable
using the touch screen. To change the displayed range, press either axis of the displayed graph to
highlight it. The highlighted axis can then be modified using the data dial below the touch screen (see
figure 4.3). To accept the change, touch the highlighted axis again or press Accept.
Time Ranges
0
0
0
0
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12 seconds
30 seconds
60 seconds
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Loops
Accessing the Loops Screen
To access the loops screen press the
screens membrane button to the left of the
touch screen on the UIM. The button is
labeled with the icon shown here.
Select LOOP from the options that appear.
Figure 4.4 Screen Selection
Choice of Loops
The ventilator displays 2 loops in real time, selected from the following.
•
Vt-Flow
Flow / Volume Loop. Inspiratory flow / Volume. If proximal flow sensor is used
values are based on proximal flow sensor measurements.
Available for all patients.
•
PAW - Vt
Airway Pressure / Volume loop. Active for all patients.
•
PES - Vt
Esophageal Pressure vs. Volume loop. This requires the use of an optional
esophageal catheter and is active for adult and pediatric patients only.
•
PTR - Vt
Tracheal Pressure vs. Volume loop. This requires the use of an optional tracheal
catheter and is active for adult and pediatric patients only.
•
PINSP – Vt
Inspiratory Pressure vs. Volume loop.
•
PTp – Vt
Transpulmonary vs. Volume. This requires the use of an optional
esophageal catheter and is active for adult and pediatric patients only.
Note
Loops are circuit compliance compensated
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Using the Freeze Button to Compare
Loops
You can freeze the Loops screen and select a
reference loop for comparison. When real-time data
refreshing resumes (by pressing the Freeze button
again), the selected loop will remain in the
background behind the real time graphic.
To create a reference loop refer to figure 4.6, 4.7 and
4.8 and do the following.
Figure 4.5 Frozen Flow / Volume Loop
Saving a loop
Press the Freeze button to freeze the loop you wish
to use as a reference then press the Save Loop
touch screen display in the right hand bar, beneath
the frozen graphic display. See figure 4.6.
Figure 4.6 Reference Loop ON/OFF button (OFF)
This puts the selected loop into memory and
places a time reference into a field in the left
hand bar beneath the graphics display as shown in
figure 4.7. A total of four (4) loops can be saved at
one time. When the fifth loop is saved, the oldest
loop is removed.
Figure 4.7 Saved Loops Display
Creating a reference loop
Press the touch screen directly over the
touch screen field in the left bar which represents
the saved loop you wish to use as a reference.
The field will highlight (see figure 4.7). Press the
“Ref Loop ON/OFF” field on the right hand bar
(see figures 4.6 and 4.8) to turn the reference loop
on.
Figure 4.8 Reference Loop ON/OFF
button (ON)
When you press the Freeze button again, the reference loop remains visible in the background, while
the active display places current loops in real time over the top of it.
To turn off the reference loop, freeze the screen again and press the “Ref Loop On/Off” toggle button
shown in figure 4.8.
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MANEUVERS
The AVEA is capable of performing various respiratory mechanics maneuvers. These maneuvers can be
accessed from the screens menu and selecting the Maneuvers screen. Depending on the model, the
following maneuvers may be available: Esophageal, MIP / P100, Inflection Point (Pflex), and AutoPEEPAW.
Each maneuver screen includes all controls, monitors, and waveform or loop graphics pertinent to the
selected maneuver.
Note
Maneuvers are not available for Neonate patients. Some alarms may be disabled during a maneuver.
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Esophageal Maneuver Screen
Controls
Balloon Leak / Size Test
The Balloon Test verifies the integrity and size of the balloon catheter. The
ventilator will display a Pass or Fail message in the message bar at the
bottom of the screen.
If the Balloon Test is not passed all connections should be checked to
assure they are secure and balloon integrity should be evaluated.
Note
The Balloon Test must be performed without the balloon in the patient
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Balloon Fill Start / Stop
When the Start key is actuated, the ventilator delivers the volume specified
below into the catheter before esophageal pressure measurement
commences.
Adult Catheter:
0.5 to 2.5 mL
Pediatric Catheter:
0.5 to 1.25 mL
The ventilator will evacuate and refill the balloon every 30 minutes to
maintain measurement accuracy.
When the Stop key is actuated, the ventilator evacuates the balloon prior to
removal of the catheter from the patient.
Note
Do Not inflate the balloon until after it has been placed in the patient. The balloon should be
evacuated prior to removal from patient.
Chest wall Compliance (CCW)
The preset Chest wall Compliance (CCW) is used by the ventilator to
calculate work of breathing.
Range:
0 to 300 mL/cmH2O
Resolution:
1 mL/cmH2O
Default:
200 mL/cmH2O
Alarms
All currently available alarms are active during the Esophageal maneuver.
To Perform Esophageal Maneuvers
Esophageal measurements require the use of an esophageal balloon which can be purchased from
VIASYS Healthcare.
From the Maneuvers Screen menu select Esophageal
Before placing the balloon in the patient a balloon test should be performed. Connect the
esophageal balloon extension tubing to the EPM panel on the AVEA as described in Chapter 2.
Remove the new esophageal balloon from its package and connect it to the pinned connector on the
patient end of the extension tubing.
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Allow the balloon to hang freely and not contact any surfaces and press the Balloon Test soft key on
the maneuver screen. The ventilator will perform a leak test by evacuating the balloon, filling it to the
proper specification, measuring the balloon pressure and finally evacuating the balloon. A message will
appear on the message bar after the test stating Pass or Fail.
In the event that the balloon does not pass the leak test, inspect the balloon for damage and replace if
necessary. If no damage is present on the balloon check all connectors on the balloon and extension
tubing and repeat the test.
Note
Disconnecting the balloon after passing a balloon test will require that the test be repeated.
Once the balloon has passed the leak test it is ready for placement in the patient. Proper placement of
the balloon is imperative for accurate measurements. During insertion the waveform produced can
provide information to confirm proper placement. An approximate level of placement can be made by
measuring the distance from the tip of the nose to the bottom of the earlobe and then from the earlobe
to the distal tip of the xiphoid process.
1. The esophageal pressure waveform correlates to the airway pressure in that they become
positive during a positive pressure breath and negative during a spontaneous breath.
2. The esophageal tracing may show small cardiac oscillations reflective of cardiac activity.
3. Once placed using the above criteria appropriate balloon location can be confirmed by
performing an occlusion technique. This requires that the airway be occluded and the
esophageal and airway pressures compared for similarity.
After the balloon has been inserted and turned on, the ventilator will fill the balloon to the appropriate
level and begin monitoring data. The ventilator will automatically evacuate and refill the balloon every
thirty minutes to ensure accuracy of monitored values.
WARNING
Esophageal balloon placement should only be conducted in patients under the direction of a
physician who has assessed the patients for contraindications to the use of esophageal
balloons.
WARNING
Incorrect placement of an esophageal balloon can affect the accuracy of monitored values.
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MIP / P100 Maneuver Screen
The MIP (Maximum Inspiratory Pressure) / P100 maneuver measures the negative deflection in the
pressure tracing during the patient’s active effort to demand a breath. During the maneuver, the
inspiratory flow valve remains closed and no inspiratory flow is delivered. The MIP is an indication
of the maximum negative pressure that the patient can draw, while P100 is an indication of the
pressure drop that occurs during the first 100 milliseconds of the breath.
Controls
Duration
The preset Duration shall determine the maximum amount of time that the
maneuver will last. Normal ventilation will be suspended for the duration of
the maneuver and will resume after the duration has timed out.
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5.0 to 30.0 seconds
Default:
10 seconds
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Sensitivity
The maneuver sensitivity establishes the level below PEEP that the airway
pressure must drop, which determines the onset of a patient effort. This
allows the clinician to set the maneuver appropriate to patient ability.
Range:
0.1 to 5.0 cmH2O
Resolution:
0.1 cmH2O
Default:
3.0 cmH2O
Note
Excessively high setting of the maneuver sensitivity can affect the accuracy of timing for P100
determination.
Start / Stop
The maneuver begins when the START key is actuated. The maneuver will
be immediately terminated should the operator activate the STOP key and
normal ventilation will resume.
Note
If the Start key is activated during a mandatory inspiratory breath the maneuver will not commence until
the ventilator cycles into exhalation and the minimum expiratory time of 150 msec has elapsed.
Alarms
All currently available alarms shall be active during the MIP / P100 maneuver except
Apnea Interval and Low PEEP.
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To Perform a MIP / P100 Maneuver
The MIP / P100 maneuver allows the measurement of the Maximum Inspiratory Pressure (MIP)
achieved by the patient during an expiratory hold maneuver. The ventilator can also measure the P100
value which is the maximum inspiratory pressure achieved in the first 100 milliseconds of the
maneuver.
From the Maneuvers Screen select MIP P100
The MIP maneuver screen allows the operator to set:
Duration – This is the time period that ventilation is suspended to conduct the maneuver. Once the
Start button is depressed normal ventilation will be suspended until the Duration time period has
elapsed or the operator presses the Stop button.
Sensitivity – This sets the sensitivity threshold that the ventilator uses to begin the timer for the P100
maneuver. The default position is three centimeters but can be adjusted by the operator to assure
accuracy in patients with minimal inspiratory effort.
Note: The maneuver sensitivity setting is used for the maneuver only and does not affect
trigger sensitivity.
Start / Stop – Starts and Stops the maneuver.
WARNING
Normal ventilation is suspended for the duration of the maneuver. The patient should be
evaluated for contraindications prior to executing the maneuver. The patient should be directly
monitored by trained medical personnel during the maneuver.
To execute a MIP / P100 maneuver set the Duration and Sensitivity controls to the desired level. Press
the Start soft key on the maneuver screen. The ventilator will close the inspiratory and expiratory
valves and begin monitoring. At the completion of the maneuver the ventilator will display the MIP and
P100 values in their respective windows on the maneuver screen. The MIP and P100 will also be
available as trended data on the Trends screen. The maneuver can be aborted at anytime by pressing
the Stop soft key.
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Inflection Point (Pflex) Maneuver Screen
The Inflection point (Pflex) maneuver is performed on patients during mandatory ventilation. The
upper and lower inflection points are automatically indicated on the inspiratory portion of a
Pressure/Volume (PAW / Vol) Loop.
Note
Normal ventilation shall be suspended for the duration of the maneuver.The maneuver will be aborted if
a patient effort is detected and the message bar will indicate a message stating that patient effort was
detected.
Controls
Tidal Volume (Volume)
This is the volume of gas delivered to the patient during the maneuver.
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Range:
0.10 to 2.50 L (Adult)
25 to 500 mL (Pediatric)
Resolution:
0.01 L
1 mL
(Adult)
(Pediatric)
Default:
0.25 L
25 mL
(Adult)
(Pediatric)
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Peak Flow
Sets the Peak Flow used for the maneuver.
Note: A square wave flow pattern is used for the maneuver.
Range:
0.5 to 5.0 LPM
Resolution:
0.1 LPM
Default:
1.0 LPM
Maneuver PEEP (PEEP)
The Maneuver PEEP determines the baseline pressure at which the
maneuver begins.
Note: The Maneuver PEEP can be set independent of the PEEP used
during normal ventilation.
Range:
0 to 50 cmH2O
Resolution:
1 cmH2O
Default:
0 cmH2O
PEEP Equilibration Time (PEEP Teq)
The PEEP Equilibration Time determines the amount of time allowed for
equilibration of the airway pressure before slow flow commences. Upon
activation of the maneuver the ventilator will set PEEP to the Maneuver
PEEP level for the PEEP Equilibration Time prior to beginning the slow flow
maneuver.
Range:
0.0 to 30.0 seconds
Resolution:
0.1 second
Default:
1.0 second
Sensitivity
The preset Sensitivity establishes the level below the peak airway pressure
that the pressure must drop to abort the Pflex maneuver.
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Note
The maneuver will be aborted if a patient effort is detected and the message bar will indicate a
message stating that patient effort was detected.
Range:
0.1 to 5.0 cmH2O
Resolution:
0.1 cmH2O
Default:
3.0 cmH2O
Start / Stop
The maneuver shall begin when the START key is actuated. The maneuver
shall be immediately terminated when the STOP key is actuated, a patient
effort is detected or the maneuver tidal volume has been delivered and
normal ventilation will resume.
Upper Pflex and Lower Pflex determination
Once the maneuver tidal volume has been delivered the ventilator will cycle into
exhalation. At the end of exhalation, the PAW / Vol loop will freeze automatically, the
upper and lower inflection points, as well as the delta Pflex volume, will be calculated and
displayed. The ventilator will return to normal ventilation at the current ventilator
settings.
The user can, should they choose to do so, override the Pflex values by moving the Pflex
indicators to a new point along the PV loop and pressing the appropriate set key. The
corresponding Pflex values and delta Pflex volume change to represent values based on
the current position of the indicators. The ventilator will store up to four PV loops and
their respective inflection points simultaneously.
Note
Once the values have been redefined by the operator the original values cannot be restored.
Alarms
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All currently available alarms shall be active during a Pflex maneuver except Apnea
Interval and I-Time Limit.
To Perform a Pflex Maneuver
The Pflex maneuver allows the clinician to determine opening pressures of the lung during a slow flow
volume controlled breath. Because this maneuver is performed at a slow inspiratory flow rate the
effects of respiratory system resistance are minimized.
Note
Requires a passive patient. In the event that a patient effort is detected the ventilator will abort the
maneuver and deliver a patient effort detected message while simultaneously returning to normal
ventilation at the current settings.
From the Maneuvers Screen select Pflex
The Pflex maneuver screen allows the operator to set:
Tidal Volume (Vt) – This is the tidal volume delivered to the patient during the maneuver. This setting
has no effect on the settings during normal ventilation and can be set to any tidal volume desired
independent of the current mode of ventilation.
Flow – This setting is adjustable from 0.5 to 5 l/min and controls the inspiratory flow used to deliver the
maneuver tidal volume.
PEEP - The is the PEEP used for the Slow Flow Maneuver. The operator can select any PEEP level
independent of the control PEEP used during controlled ventilation.
PEEPTeq – This control sets the equilibration at the Maneuver PEEP after which the Slow Flow
Maneuver begins.
Sensitivity – This sets the sensitivity threshold that the ventilator uses to detect patient effort during the
Slow Flow Maneuver. The default position is three centimeters but can be adjusted by the operator to
assure accurate sensitivity in all applications.
Start / Stop – Starts and Stops the maneuver.
Note
All maneuver control settings are independent of control settings in normal ventilation.
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WARNING
Normal ventilation is suspended for the duration of the maneuver. The patient should be
evaluated for contraindications prior to executing the maneuver. The patient should be directly
monitored by trained medical personnel during the maneuver.
To execute a Pflex maneuver set the Tidal Volume, Flow, Maneuver PEEP, PEEP Equilibration time
and Sensitivity. Press the Start soft key on the maneuver screen. The ventilator will suspend normal
ventilation and begin delivering the Maneuver Tidal Volume at the set Flow. The corresponding
Pressure / Volume curve will be drawn by the ventilator as the volume is delivered to the patient. Once
complete the ventilator will automatically resume normal ventilation and Freeze the graphics display.
The maneuver can be aborted at anytime by pressing the Stop soft key. If at anytime during the
maneuver the ventilator detects a patient effort, the ventilator will cycle into exhalation and normal
ventilation will resume.
The measured Pflex, Pflex Lwr, Pflex Upr and Vdelta will be displayed, if they can be determined. At
this point the operator can choose to accept the inflection points as determined by the ventilator or the
operator can choose to set the inflection points manually.
To set the inflection points manually simply scroll the cursor to the desired position with the Data Dial
and press the Set Pflex Lwr or Set Pflex Upr softkey. The Vdelta will be automatically recalculated.
The measured data can be saved by pressing the Save Loop softkey. Up to four loops may be saved,
when a fifth loop is saved the oldest loop and data will be erased.
Note
If the loop and corresponding data are not saved by the operator the data will be erased after exiting
the maneuver screen.
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AutoPEEP Maneuver Screen
AutoPEEP is the airway pressure at the end of exhalation immediately prior to the beginning of the
next mandatory inspiration. During the execution of this maneuver the ventilator will execute an
expiratory hold in which both the inspiratory and expiratory valves will be closed. The ventilator will
establish the AutoPEEP measurement when the system pressure reaches equilibration, at the next
mandatory breath interval or 6 seconds whichever is shorter.
Controls
Sensitivity
The preset Sensitivity establishes the level that the airway pressure must
drop below PEEP to abort the AutoPEEP maneuver.
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Range:
0.1 to 5.0 cmH2O
Resolution:
0.1 cmH2O
Default:
3.0 cmH2O
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Start / Stop
The maneuver begins when the START key is actuated and the ventilator is
in exhalation. The maneuver will stop immediately when the STOP key is
activated, the maneuver is completed or a patient effort is detected and
normal ventilation will resume.
Note
The maneuver will be aborted if a patient effort is detected and the message bar will indicate a
message stating that patient effort was detected.
Alarms
All currently available alarms shall be active during the AutoPEEP maneuver.
To Perform an AutoPEEP Maneuver
The AutoPEEP maneuver allows the measurement of PEEP generated within the breathing system
(patient and circuit) during an expiratory hold maneuver. This maneuver requires a passive patient.
From the Maneuvers Screen select AutoPEEP
The AutoPEEP maneuver screen allows the operator to set:
Sensitivity – This sets the sensitivity threshold that the ventilator uses to detect patient effort during the
AutoPEEP Maneuver. The default position is three centimeters but can be adjusted by the operator to
assure accurate sensitivity in all applications.
Start / Stop – Starts and Stops the maneuver.
To execute an AutoPEEP maneuver the operator sets the Sensitivity appropriate for the patient and
presses the Start softkey. The ventilator will then close the inspiratory and expiratory valves and allow
the pressure to equilibrate between the patient and the breathing circuit. At the completion of the
maneuver the ventilator will display the AutoPEEP and dAutoPEEP values in their respective windows
on the maneuver screen. The AutoPEEP and dAutoPEEP will also be available as trended data on the
Trends screen. The maneuver can be aborted at anytime by pressing the Stop soft key.
Note
The AutoPEEP value will be set at the next mandatory breath interval or 5 seconds whichever is
sooner.
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Tracheal Catheter Placement
Some advanced mechanics measurements on the AVEA require the use of a tracheal catheter. To
ensure accuracy of measurements and to minimize risk of adverse events the tracheal catheter should
be placed in the endotracheal tube and not extend beyond the tip.
To assure proper placement, measure the length of the endotracheal tube, and its associated adapters.
Insert the tracheal catheter into the endotracheal tube to a distance not greater than this measurement.
WARNING
Inserting the tracheal catheter beyond the tip of the endotracheal tube may cause irritation and
inflammation of the trachea and airways or produce vagal responses in some patients.
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Digital Displays
The Monitor Screen
To access the monitor screen press the
Screens membrane button to the left of the
touch screen on the UIM. The button is
labeled with the icon shown here.
Select MONITOR from the selection box
that appears.
Figure 4.4 Screen Selection
The monitor screen can display a total of 15 different monitored values simultaneously. Monitor
Displays are updated at the start of the next inspiration or every 10 seconds, whichever occurs first.
Each value can be independently selected from a the available choices (see table 4.2).
1.
Use the touch screen to select and highlight the monitor you wish to set.
2.
Turn the data dial beneath the touch screen to scroll through the menu choices.
3.
To accept your selection, either touch the highlighted display or press the accept button
adjacent to the data dial (see figure 4.3).
Figure 4.5 The Monitor Screen
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Table 4.2 Monitored Values Menu Choices
For a full description of the specifications and calculation of monitored displays see Appendix D,
Monitoring Specifications.
Note
Depending on the model and options, not all of the following displays may be available
Display
ml
Vte
ml/kg
Vte/kg
ml
Vti
ml
Vti/kg
ml
Spon Vt
ml/Kg
Spon Vt/Kg
ml
Mand Vt
Value
Display
Expired tidal volume
cmH2O
Ppeak
Peak inspiratory pressure
Expired tidal volume adjusted for
patient weight
cmH2O
Pmean
Mean inspiratory pressure
Inspired tidal volume
cmH2O
Pplat
Plateau pressure
Inspired tidal volume adjusted for
patient weight
cmH2O
PEEP
Positive end expiratory pressure
Spontaneous tidal volume
psig
Air Inlet
Air inlet pressure
Spontaneous tidal volume adjusted
for patient weight
psig
O2 Inlet
Oxygen inlet pressure
%
FiO2
Percentage of oxygen
Mandatory tidal volume
Value
ml/kg
Mand Vt/Kg
Mandatory tidal volume adjusted
for patient weight
ml/cmH2O
Cdyn
Dynamic compliance
Vdel
This is the uncorrected tidal
volume measured by the
inspiratory flow sensor inside the
ventilator.
ml/cmH2O
Cdyn/Kg
Dynamic compliance adjusted for
patient weight
ml/cmH2O
Cstat
Respiratory system compliance
(Static compliance)
%
% Leak
Percent leakage
ml/cmH2O
Cstat/Kg
L
Ve
Minute Volume
Respiratory system compliance
adjusted for patient weight (Static
compliance
F/Vt
Rapid Shallow Breathing Index (f /
Vt) which is the spontaneous
breath rate per tidal volume
ml/kg
Ve/kg
Minute volume adjusted for patient
weight
L
Spon Ve
Spontaneous minute volume
cmH2O/LPS
Rrs
ml/kg
Spon Ve/kg
Spontaneous minute volume
adjusted for patient weight
L/min
PIFR
Peak Inspiratory flow rate
Total Breath Rate (spontaneous
and mandatory)
L/min
PEFR
Peak Expiratory flow rate
bpm
Spon Rate
Spontaneous breath rate
C20/C
Mand Rate
Mandatory Breath Rate
Ratio of the dynamic compliance
during the last 20% of inspiration
(C20) to the total dynamic
compliance (C).
CCW
Chest wall Compliance (CCW), is
the ratio of the tidal volume
(exhaled) to the Delta Esophageal
Pressure (dPES).
CLUNG
Lung Compliance (CLUNG), is the
ratio of the tidal volume (exhaled)
to the delta transpulmonary
pressure
bpm
Rate
sec
Ti
Inspiratory time
sec
Te
Expiratory Time
I:E
Inspiratory/expiratory ratio
B2/Min/L
Rapid shallow breathing index
f/Vt
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Display
Value
Display
Value
RRS
Respiratory System Resistance
(RRS), is the total resistance during
the inspiratory phase of a breath
P100
RPEAK
Peak Expiratory Resistance
(RPEAK) is defined as the resistance
at the time of the Peak Expiratory
Flow (PEFR).
Respiratory Drive (P100), is the
negative pressure that occurs 100
ms after an inspiratory effort has
been detected
WOBV
Ventilator Work of Breathing
(WOBV), is the summation of
airway pressure minus the
baseline airway pressure times the
change in tidal volume to the
patient during inspiration, and
normalized to the total inspiratory
tidal volume
WOBP
Patient Work of Breathing (WOBP),
normalized to the total inspiratory
tidal volume
WOBI
Imposed Work of Breathing
(WOBI), is defined as the work
performed by the patient to
breathe spontaneously through the
breathing apparatus, i.e. the E.T.
tube, the breathing circuit, and the
demand flow system.
RIMP
Imposed Resistance (RIMP), is the
airway resistance between the wye
of the patient circuit and the
tracheal sensor
RLUNG
Lung Resistance (RLUNG), is the
ratio of the tracheal pressure
differential to the inspiratory flow
12 ms prior to the end of
inspiration
PIFR
The actual peak inspiratory flow
rate for the inspiratory phase of a
breath.
PEFR
The actual peak expiratory flow
rate for the expiratory phase of a
breath.
dPAW
Delta Airway Pressure (dPAW), is
the difference between peak
airway pressure and baseline
airway pressure.
dPES
Delta Esophageal Pressure (dPES),
is the difference between peak
esophageal pressure and baseline
esophageal pressure
AutoPEEP
AutoPEEP, is the airway pressure
at the end of an expiratory hold
maneuver.
dAutoPEEP
Delta AutoPEEP (dAutoPEEP), is
the difference between airway
pressure at the end of an
expiratory hold maneuver and the
airway pressure at the start of the
next scheduled breath after the
expiratory hold maneuver
AutoPEEPES
AutoPEEPES is the difference
between esophageal pressure
measured at the end of exhalation
minus the esophageal pressure
measured at the start of a patientinitiated breath and the sensitivity
of the ventilator’s demand system
Ptp Plat
Transpulmonary pressure during
an inspiratory hold
MIP
Maximum Inspiratory Pressure is
the maximum negative airway
pressure that is achieved by the
patient, during an expiratory hold
maneuver
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Transpulmonary pressure,
AutoPEEP (PtpPEEP) is the
difference between the
corresponding airway and the
esophageal pressures at the end
of the expiratory hold during an
AutoPEEP maneuver.
Ptp Plat
The ventilator is capable of
calculating and displaying the
Transpulmonary pressure during
an inspiratory hold, which is the
difference between the airway
plateau pressure (Pplat aw) and the
corresponding esophageal
pressure.
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Events
Pressing the EVENT membrane button to the
left of the touch screen opens a scrollable
menu of event markers that are placed in the
trend buffer along with the 34 monitored
parameters. To select an event use the data
dial to scroll the event menu and highlight the
desired event. Press the ACCEPT button
adjacent to the data dial to place the event in
the trend buffer. Events will appear on the
data spreadsheet in green text with an
asterisk next to the time code (see Trends
discussion below).
Figure 4.6 The Events menu
Selectable events include:
Event
Abbreviation
Arterial Blood Gas
BG
Chest X-ray
CXR
Suction
Sxn
Intubation
ETT
Feeding
Feed
Diagnostic (Dx) Procedure
Dx
Therapeutic (Rx) Procedure
Rx
The following events are automatically recorded in the event log:
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Event
Abbreviation
Change a primary or advanced control setting
Stgs
Powering the ventilator on
Pon
Powering the ventilator off
Poff
Entering Standby
eSby
exiting Standby
xSby
Activation of the nebulizer
Neb
Activation of the expiratory hold
eHold
Activation of the inspiratory hold
iHold
A manual breath
Man
Activation of the suction button
Sxn
Activation of the increase O2 button
IncO2
Activation of New Patient
NewPt
Involuntary Power Loss & Recovery
Prec
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Trends
The monitored parameters described in the previous section are trended as one minute averaged
values over a running 24-hour period. Trend data is accessed by pressing the screen button on the
membrane panel to the left of the touch screen or by pressing the screen indicator in the top center
portion of the touch screen display. The screen menu will appear. Press the TREND button on the
screen menu to open the trends screen.
Figure 4.7 The Trends Window
Note
If left open the Trends Window will update every 10 minutes.
Four histograms and a spreadsheet are displayed on the touch screen. Each histogram and column on
the spreadsheet can be configured from the list of monitored parameters as well as events. Touch the
title bar of any histogram or the heading of any column to open a scrollable menu. Move through the
list by turning the data dial. Highlight the item to be displayed and press the highlighted display or the
ACCEPT button above the data dial to accept the new item for display.
Histograms can be scaled by touching either axis. With the axis highlighted, use the data dial to adjust
the scale. Touch the axis again or press the ACCEPT button to accept the change.
To look at histogram or spreadsheet trends over time, press the FREEZE button and use the data dial
to move the cursor through the time line. The time line is shown as yellow text on the spreadsheet.
Event markers appear in green text.
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Main Screen Displays
Calculated I:E Ratio
The AVEA displays the calculated I:E Ratio (Calc I:E) based on the set breath rate, set tidal volume,
and set peak flow for Volume breaths, or the set breath rate and set inspiratory time for Pressure,
TCPL, and PRVC breaths. The display is located next to the Calculated Minute Volume display at the
bottom left of the Main screen.
Range:
1:99.9 to 99.9:1
Limitations: For Volume breaths, the calculated I:E Ratio shall only change if the set tidal volume,
set breath rate, or set peak flow is changed. For Pressure, TCPL, PRVC, breaths,
the calculated I:E Ratio shall only change if the set breath rate or set inspiratory time
is changed.
Note
Calculated I:E ratio is not active in APRV / BIPHASIC mode
Calculated Minute Volume (Calc Ve)
The ventilator displays the Calculated Minute Volume at the bottom left of the Main screen as follows:
Calc Ve = [(Set tidal volume) × (Set breath rate)]
Limitation:
For Volume breaths only. The Calc Ve display only changes if the set tidal volume or
set breath rate is changed.
Calculated Time High & Time Low Min / Max
The AVEA displays the calculated minimum and maximum Time High and Time Low in APRV /
BiPhasic ventilation. The display is located immediately under the Time High and Time Low primary
controls on the main screen.
Min
Max
Min
Max
Note
Time High and Time Low are maximum time settings for a time-cycled transition. Actual times may
vary depending on the patient’s spontaneous breathing pattern and the Sync window setting.
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Main Screen Monitors
Five monitored parameters are continuously displayed to the left of the graphic displays. These are
selected in the same way as the displays on the Monitors screen.
1.
Use the touch screen to select and highlight the monitor you wish to set.
2.
Turn the data dial beneath the touch screen to scroll through the menu choices.
3.
To accept your selection, either touch the highlighted display or press the accept
button adjacent to the data dial.
Highlighted
Parameter
Selection Menu
for Monitored
Parameter
Figure 4.8 Selectable Monitored Parameters Displayed on the Main Screen
Note
The main screen monitored parameters may be different than the monitored parameters on the loops
or trends screens.
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Status Indicators
The ventilator displays the following status indicators.
Compressor Active
If the internal compressor is active, the Compressor Active icon shown here will display at the bottom of
the touch screen with no accompanying tone.
Heliox Source Connected
If Heliox gas is connected this green icon displays in bottom right of the touch screen.
Mains/Battery Indicators
There are visual status indicators on the ventilator front panel for the mains power and the internal and
external batteries (Figure 5.1).
The sequence in which the power sources are used by the ventilator is:
Mains AC Power
External Battery (if installed)
Internal Battery
Power On Indicator
The green Power On indicator lights up whenever the power switch is on ( I ) and power is being supplied
from any of the available power sources (AC, external battery, or internal battery).
On battery indicator while operating on internal or external battery, a battery icon will blink in the lower
right hand corner of the display.
AC Power Indicator
The green AC indicator is on whenever the ventilator is connected to AC power. It displays whether the
power switch is on ( I ) or off (O).
Operating On Battery Indicator
When operating on battery power (Internal or External) a yellow blinking battery indicator will appear in
the lower right hand corner of the LCD screen.
External Battery Power Indicator
The EXT indicator above the battery status indicators is lit whenever the external battery is providing the
primary source of power for the ventilator.
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Internal Battery Power Indicator
The INT indicator above the battery status indicators is lit whenever the internal battery is providing the
primary source of power for the ventilator.
Battery Status Indicators
The battery status indicator shown in figure 5.1 for the INTernal or optional EXTernal battery will illuminate
incrementally depending on the available charge remaining in the battery.
Note
If the ventilator is plugged into the mains power supply and no battery status light is illuminated for the
internal battery or optional external battery (if equipped), the battery should be checked and/or replaced.
Replacement of the Internal battery must be done by a VIASYS trained technician.
Green (80% or more charge remaining for external battery, 90% or more charge remaining for the
internal battery),
Yellow (Less than 80% for external battery, 90% for the internal battery)
Red (less than 40% for external battery, 30% for the internal battery)
Note
When approximately 2 minutes of battery charge remain the ventilator will initiate a non-cancelable alarm.
The ventilator should be immediately connected to an appropriate AC power source.
A/C Indicator
GREEN
YELLOW
RED
Figure 5.1 Front Panel Display Areas. Comprehensive model shown.
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Messages
The AVEA displays messages in one of two ways.
In a “Popup” message box
In the Message bar at the bottom right of the touch screen
Alert Messages that require an acknowledgement from the user, appear in a “pop-up” message box with
an “OK” or “Continue” button. When you press the acknowledgement button, the message disappears
and the ventilator continues normal functioning.
“Popup” Alert Messages
These messages will require you to press a button to clear the “Popup” box.
Can't change Mode to APRV / BiPhasic when ILV is active.
Can't set Pres Low higher than Pres High.
Can't set Pres High lower than Pres Low.
Stored Settings and Configuration Data lost.
Settings restored to defaults. Check Barometric Pressure .setting.
Stored Settings lost. Settings restored to defaults.
Stored Configuration Data lost. Check Barometric Pressure setting.
Can't change size to PED or ADULT when Mode is TCPL.
Can't change size to NEO when Mode is PRVC.
Can't change size to NEO when Mode is APRV / BiPhasic.
Can't change patient size when Machine Volume is active.
ILV is not available when Mode is APRV / BiPhasic.
Can't disable O2 Alarms when Heliox is in use.
The Message Bar
Messages not requiring acknowledgement or response appear in the Message Bar located at the bottom
right of the touch screen. A complete list of text, with explanations, for those messages that appear in the
message bar, is provided in Appendix F.
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Alarms
Alarm Categories
AVEA ventilator alarms are grouped into three categories:
High priority (warning)
This category of alarm requires immediate action. For a high priority alarm, the alarm indicator is RED and
the alarm icon flashes at a rate of 2 Hz (fast). A high priority alarm sounds a series of five tones, three
low and two high, repeated at intervals of 6 seconds.
Medium priority (caution)
A medium priority alarm displays a yellow indicator and the alarm icon flashes at ½ Hz (slow). A medium
priority alarm sounds three tones, all at the same pitch, repeated at intervals of 20 seconds.
Low priority (advisory)
A low priority alarm (or advisory) displays a yellow indicator and the alarm icon does not flash.
A low priority alarm sounds a single tone, which is not repeated
There are visual displays for all categories of alarms. A text message appears in the indicator at the
upper right of the touch screen.
The alarm icons flash until the cause of the alarm is no longer present. Both high and medium priority
alarms that have been resolved will appear as a solid yellow message indicator with no icon displayed
until the Alarm Reset button is pressed. (See table 5.1 for alarm messages).
Multiple alarms can be displayed simultaneously. If 2 or more alarms are current, a white triangle
appears on the right of the alarm indicator/message. Touching the screen over the triangle will open a
drop down box for display of up to nine alarm messages. In the event that there are more than nine
active or resolved alarms available for display, the nine highest priority alarms will be displayed.
To close the drop down box and display a single alarm message, touch the triangle again.
Alarm messages are prioritized in order of appearance, the highest priority alarm is always displayed in
the top position of the alarm indicator display.
The alarm indicator is solid green with no message when no alarms are currently active.
Backup Alarm (advisory)
A continuous tone alarm sounds when a vent-inop occurs and the Back Up Alarm electronics detects the
primary alarm is not functioning.
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Alarm Controls
Setting an Alarm Limit
To set the limits for each alarm, press the red Alarm
LIMITS membrane button on the right of the user
interface marked with the icon shown here.
The Alarm Limits screen will appear (see figure 5.2). To set the limits for an alarm, press the touch
screen immediately over the alarm control. The control will highlight (change color) on the screen.
Figure 5.2 Alarm Limits Screen
With the control selected, rotate the large data dial below the touch
screen until the control reaches the setting you require. To accept
the new setting, either press the touch screen over the control
again or press the ACCEPT button.
Note:
Red indicators appearing on the primary controls display the relative alarm settings of any associated
alarm.
Alarm Silence
You can disable the audible alarm for 2 minutes ± 1 second by pressing the Alarm Silence key. Pressing
the Alarm Silence key again before the 2-minute period is up will cancel the “silence”. This feature is
functional for all alarms, with the exception of the “Vent Inop” alarm, which cannot be silenced.
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Note
The activation of the auditory alarm silence button will not prevent the subsequent activation of auditory
alarm signals for certain alarm conditions.
Alarm Reset
The Alarm Reset button deactivates visual indicators for alarms that are no longer active.
Alarm Types
Machine Alarms
Safety Valve Open
This is a high priority audible/visual alarm. SAFETY VALVE OPEN is displayed, and a high priority tone
sounds whenever the Safety Valve is open.
Ventilator Inoperative
This is a high priority audible/visual alarm. VENT INOP is displayed if the ventilator fails due to a nonrecoverable condition, such as loss of power or supply gases. A high priority tone sounds. The safety
valve opens, indicated by a SAFETY VALVE OPEN alarm message, and the patient is allowed to breathe
room air.
Note
PEEP is not maintained during a VENT INOP or a SAFETY VALVE OPEN alarm condition. When the
ventilator safety valve is open the ventilator graphics will indicate a safety state by displaying the color
purple.
Fan Failure
This is a low priority audible/visual alarm. FAN FAILURE is displayed and low priority tone sounds,
whenever the circulating fan at the rear of the ventilator cabinet stops rotating.
Gas Supply Indicators and Alarms
Loss of Air
This is a high priority audible/visual alarm. LOSS, AIR is displayed and a high priority tone sounds. This
alarm is triggered if the wall air supply to the ventilator drops below 18.0 psig (1.2 bar), and the ventilator
does not have a functional internal compressor or the compressor output is insufficient to meet instrument
demand. The patient continues to be ventilated by the oxygen supply only.
Loss of O2
This is a high priority audible/visual alarm. LOSS, O2 is displayed and a high priority tone sounds. This
alarm is triggered if the oxygen supply to the ventilator drops below 18.0 psig (1.2 bar) and the % O2
control is set >21%. The patient continues be ventilated by the air supply (wall air or internal compressor)
only.
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Loss of Gas Supply
This is a high priority audible/visual alarm. LOSS, GAS SUPPLY is displayed and a high priority tone
sounds. This alarm is triggered if the ventilator loses all sources of gas (wall air, internal compressor if
present, and wall oxygen). The safety valve opens, indicated by a SAFETY VALVE OPEN visual display,
and the patient is allowed to breathe room air.
Note
PEEP is not maintained during a LOSS, GAS SUPPLY alarm condition. When the ventilator safety valve
is open the ventilator graphics will indicate a safety state by displaying the color purple.
Loss of Heliox
This is a high priority audible/visual alarm. LOSS, HELIOX is displayed and a high priority tone sounds.
The alarm is triggered if Heliox is being used and the Heliox supply to the ventilator drops below 18.0 psig
(1.2 bar). The patient continues to be ventilated by the oxygen supply only.
Pressure Alarms
Low Peak Pressure
This is a high priority audible/visual alarm. LOW PPEAK is displayed and a high priority tone sounds,
whenever the peak inspiratory pressure for a given breath is less than the preset threshold for Low PPEAK.
Range:
3 to 99 cmH2O
Default:
3 cmH2O
Limitations:
Not active for spontaneous breaths.
High Peak Pressure
This is a high priority audible/visual alarm. HIGH PPEAK is displayed and a high priority tone sounds
whenever the preset High PPEAK threshold is exceeded. Inspiration is terminated and circuit pressure is
allowed to return to the current set baseline pressure + 5 cmH2O. Circuit pressure must return to baseline
+5 cmH2O before the next breath can be delivered.
Normal High PPEAK Alarm
Alarms if the inspiratory pressure in the patient circuit exceeds the set High PPEAK alarm
threshold during the inspiratory phase of a breath, except during sigh breath cycles.
Range:
10 to 105 cmH2O (Adult/Pediatric)
10 to 85 cmH2O (Neonate)
Defaults:
75 cmH2O
(Adult/Pediatric)
50 cmH2O
(Neonate)
Not active for Sigh Breaths
Sigh High PPEAK Alarm
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Alarms if the inspiratory pressure in the patient circuit exceeds the Sigh High PPEAK alarm
threshold during a sigh breath cycle.
1.5 x (Normal High PPEAK), up to a maximum of 105 cmH2O
Range:
Active only for Sigh Breaths.
Note
Maximum Circuit Pressure Limit:
The ventilator has an independent mechanical pressure relief valve, which limits the maximum pressure
at the patient wye to 125 cmH2O.
Sustained High Peak Pressure
This is a high priority audible/visual alarm. HIGH PPEAK, SUST is displayed and a high priority tone
sounds if the High PPEAK alarm remains active for more than 5 seconds, (i.e. the circuit pressure does not
return to PEEP + 5 cmH2O within 5 seconds). No breaths are delivered during this alarm condition.
The Safety and Exhalation valves open allowing the patient to breathe from room air and the Safety Valve
alarm activates. Bias flow is suspended while this alarm is active. PEEP may not be maintained. This
alarm remains active (flashing) until the condition causing it has been resolved.
Low PEEP
This is a high priority audible/visual alarm. LOW PEEP is displayed and a high priority tone sounds if the
baseline pressure (PEEP) is less than the Low PEEP alarm threshold for a period greater than 0.25 ±
0.05 seconds.
Range:
0 to 60 cmH2O
Defaults:
3 cmH2O
(Adult/Pediatric)
1 cmH2O
(Neonate)
The alarm is off if set to zero.
Occlusion Alarm
This is a high priority audible/visual alarm. CIRCUIT OCCLUSION is displayed and a high priority tone
sounds whenever the pressure level in the inspiratory limb of the circuit exceeds the preset High Ppeak
threshold + inspiratory limb resistance correction factor. Inspiration is terminated and the circuit pressure
is allowed to return to the current set baseline pressure +5 cmH2O. Circuit pressure must return to
baseline +5 cmH2O before the next breath can be delivered.
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Volume Alarms
Low Exhaled Minute Volume (Low Ve)
This is a high priority audible/visual alarm. LOW MINUTE VOLUME is displayed and a high priority tone
sounds whenever the monitored exhaled minute volume is less than the Low Exhaled Minute Volume
threshold setting.
Range:
Off (indicated by 0), 1 to 50 L
(Adult)
Off (indicated by 0), 0.1 to 30.0 L
(Pediatric)
Off (indicated by 0), 0.01 to 5.00 L (Neonate)
Default:
Off
High Exhaled Minute Volume (High Ve)
This is a medium priority audible/visual alarm. HIGH MINUTE VOLUME is displayed and a medium
priority tone sounds whenever the monitored exhaled minute volume is greater than the High Exhaled
Minute Volume threshold setting.
Range:
Defaults:
0 to 75 L
(Adult)
0.0 to 30.0 L
(Pediatric)
0.00 to 5.00 L
(Neonate)
30.0 L
(Adult/Pediatric)
5.00 L
(Neonate)
Low Exhaled Tidal Volume (Low Vt)
A high priority audible/visual alarm shall be activated, and LOW TIDAL VOLUME shall be indicated,
whenever the absolute monitored exhaled tidal volume does not exceed the Low Tidal Volume alarm
threshold setting.
Range: Off (indicated by 0.00) to 3.00 L
Off (indicated by 0) to 1000 mL
(Adult)
(Pediatric)
Off (indicated by 0.0) to 300.0 mL (Neonate)
Resolution:
0.01 L (Adult)
1 mL
(Pediatric)
0.1 mL (Neonate)
Accuracy:
± 0.01 L of monitored exhaled tidal volume (Adult)
± 1 mL of monitored exhaled tidal volume
(Pediatric)
± 0.1 mL of monitored exhaled tidal volume (Neonate)
Defaults:
0.00 L (Adult)
0 mL
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0.0 mL (Neonate)
Note
The Low Exhaled Tidal Volume alarm will assert on a single occurrence of a low exhaled volume. In
patients who have variable tidal volumes, the Low Exhaled Tidal Volume alarm may be turned off (default)
and the Low Exhaled Minute Volume alarm can be used to avoid nuisance alarms.
High Tidal Volume (High Vt)
This is a low priority audible/visual alarm.. HIGH Vt is displayed and a low priority tone sounds if the
absolute monitored exhaled tidal volume is greater than the High Tidal Volume threshold setting.
Range:
Defaults:
0.10 to 3.00 L
(Adult)
25 to 1000 ml
(Pediatric)
2.0 to 300.0 ml
(Neonate)
3.00 L
(Adult)
1000 ml
(Pediatric)
300.0 ml
(Neonate)
Rate/Time Alarms
Apnea Interval
This is a high priority audible/visual alarm. APNEA INTERVAL is displayed and a high priority tone
sounds if the ventilator does not detect a breath initiation (by any means) within the preset period of time.
Apnea ventilation will begin when this alarm is activated.
Range:
6 to 60 seconds
Default:
20 seconds
High Rate
This is a medium priority audible/visual alarm. HIGH RATE is displayed and a medium priority tone
sounds if the monitored total breath rate exceeds the alarm setting.
Range:
1 to 200 bpm
Default:
200 bpm
Maximum Inspiratory Time Limit (Max I-Time)
This is a low priority audible/visual alarm. I-TIME LIMIT is displayed and a low priority tone sounds if the
inspiratory time for any breath exceeds the maximum set inspiratory time plus pause time. Maximum
inspiratory time is 5.0 seconds for adult/pediatric, and 3.0 seconds for neonate. The inspiratory phase of
the breath is terminated when this alarm activates.
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I:E Ratio Limit (I:E Limit)
This is a low priority audible/visual alarm. I:E LIMIT is displayed and a low priority tone sounds, if the I:E
Ratio for a mandatory breath exceeds 4:1. The inspiratory phase of the breath is terminated when this
alarm activates.
This alarm is not active in APRV / BIPHASIC mode.
O2 Alarms
Low O2% (Low FiO2)
This is a high priority audible/visual alarm. LOW FiO2 is displayed and a high priority tone sounds if the
monitored Delivered O2% falls below the set FiO2 minus 6% or 18% FiO2, whichever is greater.
High O2% (High FiO2)
This is a high priority audible/visual alarm. HIGH FiO2 is displayed and a high priority tone sounds if the
monitored Delivered O2% rises above the set FiO2 + 6%.
Table 5.1 Alarm Conditions
Message
Alarm Condition
Range
Priority
SAFETY VALVE
OPEN
Safety valve is open
N/A
High
VENT INOP
Ventilator failure due to a recoverable or non-recoverable
condition. The safety valve opens, indicated by a SAFETY
VALVE message, and the patient is allowed to breathe room
air. PEEP is not maintained
N/A
High
LOSS, AIR
Wall air drops below 18.0 psig (1.2 bar) and no functional
compressor is installed or the compressor output is insufficient
to meet instrument demand. Patient will continue to be
ventilated by O2 supply only.
N/A
High
LOSS, O2
Oxygen supply to the ventilator drops below 18.0 psig (1.2 bar)
and the %O2 is set to > 21%. Patient will continue to be
ventilated by the air supply only
N/A
High
LOSS, HELIOX
The alarm is triggered if heliox is being used and the heliox
gas supply to the ventilator drops below 18.0 psig (1.2 bar).
The patient continues to be ventilated by the oxygen supply
only.
N/A
High
LOSS, GAS
SUPPLY
All sources of gas fail; wall air, internal compressor (if
installed) and oxygen. The safety valve opens, indicated by a
SAFETY VALVE OPEN message, and the patient is allowed to
breathe room air. PEEP is not maintained.
N/A
High
LOW PPEAK
The peak inspiratory pressure for a breath is less than the set
LOW PPEAK. Not active for spontaneous breaths.
3 to 99 cmH2O
Default 3 cmH2O
High
HIGH PPEAK
Peak inspiratory pressure is greater than the set HIGH PPEAK.
Inspiration is terminated and the circuit pressure is allowed to
return to baseline pressure + 5 ± 1.5 cmH2O before the next
breath is delivered.
Normal Breath Range:
10 to 105 cmH2O (Adult)
default 75 cmH2O
10 to 85 cmH2O (Pediatric)
default 50 cmH2O
Sigh Breath Range:
High
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Alarm Condition
Range
Priority
1.5 x set normal HIGH PPEAK
Only active for sigh breaths
EXT HIGH PPEAK
Activates whenever the HIGH PPEAK alarm has been active for
more than 5 seconds (i.e. If the circuit pressure fails to return
to PEEP + 5 cmH2O within 5 seconds). The safety and
exhalation valves open and no breaths are delivered. The
SAFETY VALVE OPEN alarm activates. Bias flow is
suspended while this alarm is active. PEEP may not be
maintained. This alarm will remain active until the condition is
resolved.
N/A
High
LOW PEEP
Baseline pressure (Positive End Expiratory Pressure) is less
than the set LOW PEEP alarm threshold for a period greater
than 0.25 ± 0.05 seconds. This alarm is OFF if set to zero.
0 to 60 cmH2O
Defaults:
3 cmH2O (Adult/Pediatric)
1 cmH2O (Neonate)
High
LOW Ve
Monitored exhaled minute volume (Ve) is less than the set
LOW Ve alarm threshold.
OFF (0), 1 to 50 L (Adult)
OFF (0), 0.1 to 30 L (Pediatric)
OFF (0), 0.01 to 5.00 L (Neonate)
Default OFF
Medium
HIGH Ve
Monitored exhaled minute volume (Ve) is greater than the set
HIGH Ve alarm threshold.
0 to 75 L (Adult)
0.0 to 30.0 L (Pediatric)
0.00 to 5.00 L (Neonate)
Defaults:
30.0 L (Adult/Pediatric)
5.00 (Neonate)
Medium
HIGH Vt
The absolute monitored exhaled tidal volume is greater than
the set HIGH Vt alarm threshold.
0.10 to 3.00 L (Adult)
25 to 1000 ml (Pediatric)
2.0 to 300.0 ml (Neonate)
Defaults:
3.00 L (Adult)
1000 ml (Pediatric)
300.0 ml (Neonate)
Visual Alert
Low Vt
The absolute monitored exhaled tidal volume does not exceed
the Low Tidal Volume alarm threshold setting
Off to 3.00 L (Adult)
Off to 1000 mL (Pediatric)
Off to 300.0 mL (Neonate)
High
APNEA
INTERVAL
Active in A/C, SIMV, APRV / BIPHASIC and CPAP/PSV
modes if the ventilator does not detect a breath within the
preset APNEA time interval.
6 to 60 seconds
Default 20 seconds
High
HIGH RATE
The monitored total breath rate exceeds the set alarm RATE.
1 to 200 bpm
Default 200 bpm
Medium
I-TIME LIMIT
The inspiratory time for a breath exceeds the set MAX I-TIME
plus pause time, which is 5.0 seconds for adult/pediatric
patients and 3.0 seconds for neonatal patients.
N/A
Low
I:E LIMIT
The inspiratory: expiratory ratio for a mandatory breath
exceeds 4:1. The inspiratory phase of the breath is
terminated.
Not active in APRV / BIPHASIC
mode.
Low
LOW FiO2
Delivered oxygen percentage falls below the set FiO2 minus
6% or 18% FiO2., whichever is greater.
N/A
High
HIGH FiO2
Delivered oxygen percentage rises above the set FiO2 plus 6%
N/A
High
CIRCUIT
DISCONNECT
A high priority audible/visual alarm is activated, and CIRCUIT
DISCONNECT displayed, whenever the patient circuit
becomes disconnected from the ventilator or patient.
N/A
High
LOW BATTERY
A high priority audible/visual alarm is activated, and LOW
BATTERY displayed, whenever the internal battery has been
depleted to a level that provides a minimum of two minutes of
safe operation.
N/A
High
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Message
AVEA Ventilator Systems
Alarm Condition
Range
Priority
LOSS, AC
POWER
A high priority audible/visual alarm is, and LOSS, AC
POWER displayed, whenever the power switch is on and AC
power has been removed from the ventilator (i.e. power cord
disconnect or loss of supply power).
N/A
High
ILV
DISCONNECT
A high priority audible/visual alarm is activated, and ILV
DISCONNECT displayed, whenever the master ventilator
becomes disconnected from the slave ventilator during ILV.
N/A
High
INVALID GAS ID
A medium priority audible/visual alarm shall be activated, and
INVALID GAS I.D. shall be indicated whenever a defective gas
I.D. connector is installed in the ventilator. When a defective
Gas I.D. connector is detected, the gas corrections default to
air.
N/A
Medium
FAN FAILURE
A low priority audible/visual alarm is activated, and FAN
FAILURE indicated, whenever the fan has stopped rotating.
N/A
Low
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Chapter 6 Maintenance and Cleaning
Cleaning & Sterilization
The AVEA is designed for easy maintenance. All exposed parts of the ventilator are corrosion
resistant.
CAUTION
DO NOT submerge the ventilator or pour cleaning liquids over or into the ventilator.
To minimize cleaning and replacement frequency, the AVEA design places the exhalation manifold,
flow sensor and diaphragm behind the exhalation filter and water trap.
In the event that they do require cleaning, use the methods given below under “Cleaning of Accessories
and Ventilator Parts”.
Cleaning External Surfaces
All external surfaces of the ventilator can be wiped clean with one of the following:
Isopropyl Alcohol
Chlorine Compounds*
Maximum Concentration: 1:10
*These compounds are diluted by volume in water
Cleaning Accessories and Parts
1. Using Alcohol or Chlorine compounds
The following accessory can be wiped clean using the Isopropyl Alcohol or Chlorine Compounds listed
above:
The exhalation cartridge.
2. Using an Enzyme Pre-Soaking Solution
The following accessory parts are cleanable using an enzyme pre-soaking solution such as
Klenzyme®:
The water trap
The Infant Hot Wire flow sensor
The recommended method for cleaning these parts is as follows:
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1.
Prepare an enzyme based pre-soaking solution (Klenzyme® made by Steris Corporation,
Mentor, OH or equivalent) in accordance with manufacturer’s instructions, using sterile
distilled water at 20-30°C (68-86°F).
2.
Immerse the part to be cleaned in the prepared solution for 10 minutes. Make sure that
all lumens and air pockets are completely filled with the solution. Agitate periodically to
loosen any attached debris.
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3.
Remove the part from the solution after 2-5 minutes and rinse immediately by immersing
in at least 1 gallon of sterile distilled water at 20-30°C (68-86°F). Leave the part in the
rinsing bath for at least 1 minute agitating periodically to ensure thorough rinsing.
4.
Visually inspect the part after removing it from the rinse to ensure that no debris remains
on the part. Repeat the cleaning method if necessary.
3. Steam Sterilization
These parts can also be steam sterilized (autoclave).
The water trap
The Infant Hot Wire flow sensor
Water collection jars.
Steam Sterilization (autoclave), maximum temperature 138°C (280°F), minimum temperature 132°C
(270° F) for a maximum of 18 minutes and a minimum of 15 minutes (minimum number of cycles 30)
Parts not made by VIASYS Healthcare (Bird)
The exhalation filter should be sterilized per the instructions supplied by the manufacturer, (Pall
Medical) enclosed with the filter.
Warning: Do not immerse the filter in liquid when cleaning.
The AVEA is designed to accept certain non-proprietary accessories. If you choose to use a different
filter with your ventilator, follow the manufacturer’s instructions to clean/sterilize the part.
Disposable Parts
The following are considered disposable parts and VIASYS Healthcare does not, therefore, recommend
a method of cleaning or sterilization.
Disposable variable orifice flow sensors
Tracheal adapters
Tracheal catheters
Esophageal catheters
Other Accessories
For all other accessories purchased for use with your AVEA but not supplied by VIASYS Healthcare,
follow the manufacturer’s recommendations for cleaning or sterilization.
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Recommended Periodic Maintenance
VIASYS Healthcare Critical Care Division is committed to product support. If you have any questions
concerning your ventilator’s operation or maintenance contact your product support representative as
shown in Appendix A, Contact Information.
A Preventive Maintenance service should be performed on your AVEA ventilator once per year. Call
VIASYS Healthcare Customer Care at the number given in Appendix A to arrange for a qualified
Service Technician to perform this.
WARNING
Electric shock hazard - Do not remove any of the ventilator covers or panels. Refer all servicing
to an authorized VIASYS Healthcare service technician.
The annual maintenance will include the following.
Replacement of:
The Air inlet Filter
The Oxygen Inlet Filter
The Compressor Inlet Filter (on compressor equipped models)
The Compressor Outlet Filter (on compressor equipped models)
The Exhalation Diaphragm.
At this time the following maintenance will be performed:
Removal & replacement of the above items
Calibration of the following 9 pressure transducers
Air
O2
Blended Gas
Expiratory
Inspiratory
Exhaled Flow delta
Wye flow delta
Auxiliary
Esophageal
•
Testing of the compressor output (on compressor equipped models)
•
Verification Testing to confirm the ventilator is functioning within optimum parameters.
•
Screen Calibration
AVEA Maintenance should only be performed by a trained and authorized service technician. VIASYS
Healthcare will make available to qualified technicians, service manuals, which include such items as
circuit diagrams, component parts lists, calibration instructions and other information to assist in repair
of those parts of the ventilator designated by the manufacturer as repairable items.
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WARNING
If a mechanical or electrical problem is recognized while operating the ventilator, the ventilator
must be removed from use and referred to qualified personnel for servicing.
Using an inoperative ventilator may result in patient injury.
Battery Care
The AVEA has an internal, Nickel Metal Hydride battery pack that will
provide power backup for short periods in the event that the mains
power supply is lost (see figure 6.1). Under normal operating conditions
and when fully charged, the internal battery is capable of powering the
ventilator alone for 1 hour or the ventilator and compressor for 30
minutes.
Figure 6.1 Internal Battery Pack
NOTE
The internal battery is intended only for short duration backup in the event of disruptions in line power.
The internal battery provides 30 minutes of battery power for the ventilator and compressor nominally.
The recharging cycle for this battery can be up to 4 hours depending on the state of discharge. Should
you wish to perform intra-facility transport of patients you should equip your instruments with the
optional external battery. The addition of the external battery will extend the time period to 2 hours for
ventilator and compressor.
VIASYS Critical Care recommends that when used in transport situations the expected transport time
should not be greater than 50% of the usable battery life. This provides a safety margin in the event of
schedule delays or premature consumption of the battery power. Should the expected transport time be
delayed beyond this, a dedicated transport system should be considered. As with any patient transport,
suitable manual ventilation backup should be available.
CAUTION
The ventilator should be connected to a mains AC power supply for at least 4 hours prior to switching
to internal battery power. For operation on external battery the ventilator should be connected to a
mains AC power supply for at least 12 hours to insure a fully charged battery.
An optional sealed lead-acid external battery pack is also available. This can significantly extend the
operating period of the ventilator when it is not connected to an AC source. Under normal operating
conditions, fully charged external and internal batteries combined are capable of powering the ventilator
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Chapter 6 Maintenance and Cleaning
and compressor for a period equal to or greater than 2 hours, and the ventilator on wall air for a period
equal to or greater than 4 hours.
Both battery types are re-chargeable and require minimal maintenance when installed. Do not allow
your battery to become completely discharged as this may damage the ventilator. To ensure that the
batteries remain charged and to prolong their life, we recommend that you keep the ventilator plugged
in to the AC power supply when not in use. The Battery Status Indicators on the front panel will enable
you to monitor the available charge remaining in your battery. (See chapter 5, Alarms & Indicators).
CAUTION
Should your internal battery require replacement, contact your VIASYS Healthcare representative. Do
NOT attempt to replace the battery yourself. The battery should only be replaced by a qualified
technician.
Precedence of power use
The sequence in which the power sources are used by the ventilator is:
1. AC
2. External Battery (if installed)
3. Internal Battery
CAUTION
Do not store the ventilator in hot areas for prolonged periods of time. Temperatures above 80°F (27 °C)
can shorten battery life. Failing to charge the ventilator while in storage may also shorten battery life.
CAUTION
When the integrity of the external power earth conductor arrangement is in doubt, operate the ventilator
from its internal battery or the optional external battery.
Battery Status
Battery status indicators showing the state of charge of each of the internal and external batteries
appear on the front panel of the ventilator. These appear as shown in figure 5.1.
If the battery charge is allowed to drop below the low range of the battery monitor, a battery status
indicator LED may no longer be displayed. The unit should be plugged into the AC power supply to
allow the batteries to re-charge. When the battery voltage becomes large enough to power the battery
monitor, the battery status indicators will display.
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CAUTION
A battery that is fully drained (i.e. void of any charge) may cause damage to the ventilator and should
be replaced. Contact your VIASYS Healthcare Customer Care representative at the number given in
Appendix A Contact information.
Failure to charge
If the internal batteries do not show significant re-charge after being re-connected to an AC power
source for 4 hours contact your VIASYS Healthcare Customer Care representative as shown in
Appendix A to arrange for replacement. Total time to re-charge will depend upon the extent of battery
depletion and ventilator usage while charging is taking place.
Note
A ventilator not in use and not connected to AC, will continue to slowly discharge. A fully charged
battery may reach a deep discharge state (below 11 VDC) in approximately 35 days for the internal
battery and 100 days for the external battery. However, even with a fully charged battery, if the
ventilator is unplugged from AC for more than 4 hours, the internal battery status indicator will display
red indicating a low battery condition. In this condition the ventilator should be plugged into an AC outlet
for 10-12 minutes to restore the battery to the correct charge state.
Fuses
The AVEA has the following replaceable fuses associated with internal DC, external DC and AC power
sources.
WARNING
Do not remove or replace fuses or perform any maintenance tasks on the ventilator while your
patient is connected. Always perform these tasks “off patient”.
Battery Fuses
The internal and optional external battery fuses are
10A, 250V 5 x 20 mm fast blow type.
The fuse for the optional external battery is located on
the back panel next to the external battery connector
and is replaceable. The fuse for the internal battery is
located to the right of the UIM connection. To remove
fuses, carefully unscrew with a flat blade screwdriver
and pull out the fuse holder.
External
Battery Fuse
Holder
External
Battery
Connector
Figure 6.2 External Battery Connector & Fuse
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WARNING
To avoid fire hazard, use only the fuse specified in the ventilator’s parts list or one that is
identical in type, voltage rating, and current rating to the existing fuse.
Mains Fuses
The main AC power fuses are housed within the power entry module located on the back panel. They
are slow blow-type. Check that the correct voltage for your mains supply is showing through the
window in the power entry module.
Table 6.1 Mains fuses
Line Voltage
Fuse
Amperage
100/120VAC
250V 6.35 x 31.75mm
3.2A
230/240VAC
250v 6.35 x 31.75mm
1.5A
Replacing a Mains Electrical Fuse
WARNING
Ensure that the mains power cord is unplugged before attempting to remove or replaces fuses.
To replace mains electrical fuses, refer to figures 6.3 through 6.7 and do the following:
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1.
Unplug the ventilator from the mains AC power source and unplug the power cord from
the power entry module on the rear of the ventilator.
2.
Using a small flat blade screwdriver, pry open the cover of the power entry module.
3.
Carefully ease the red fuse holder out of the power entry module.
4.
The fuse holder contains two identical fuses, either 3.1Amp for (for 100/120 volt lines) or
2.0 Amp (for 230/240 volt lines) as shown in table 6.1.
5.
Replace the failed fuse in the fuse holder with a fuse whose type, voltage rating, and
current rating is identical to the fuses supplied from the factory.
6.
Carefully replace the red fuse holder into the power entry module. Check to ensure that
the correct line voltage is uppermost as you re-insert the fuse holder into the
power entry module.
7.
Close the power entry module cover and check to make sure that the correct voltage is
displayed through the window.
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Changing the AC Fuses:
Figure 6.3
Opening the
power
entry module
with a
screwdriver
Figure 6.4
Removing the
fuse holder
Figure 6.5
Fuse holder
showing fuse
placement
Figure 6.6
Fuse-holder
with 230V
label uppermost
for 230/240VAC
systems.
Figure 6.7
closed power
entry module
with 115V
showing in the
window for
100/120 volt
systems
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Appendix A Contact & Ordering Information
How to Call for Service
To get help on performing any of the preventive maintenance routines, or to request service on your
ventilator, contact VIASYS Healthcare Customer Care:
Technical Service
Hours: 7:00 AM to 4:30 PM (PST) Monday through Friday
Phone: (760) 778-7200
Fax:
(760) 778-7377
After hours service:
Phone: (800) 328-4139 from within the US and select option 2.
VIASYS Healthcare Customer Care Helpline
Hours:
24 hours, seven days a week
Phone:
Fax:
(800) 328-4139 from within the US and select option 1.
(760) 778-7377
VIASYS Healthcare Critical Care
1100 Bird Center Drive
Palm Springs, CA 92262-8099
U.S.A.
Phone:
+760 778 7200
(800) 328-4139 (from within the US only)
Fax:
+760 778 7274
Online service for warranty replacements parts can be found at
www.viasyshealthcare.com/bird
Select “Warranty Form” from the choices on the left of the screen.
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Ordering Parts
To obtain AVEA Ventilator parts contact customer service at:
VIASYS Healthcare Customer Service:
Hours:
7:00 Am to 4:30 PM (PST)
Monday through Friday
Phone:
(800) 328-4139
(760) 778-7200
Fax:
(760) 778-7274
Accessories
Neonatal Kit Part Number 50-40012-00
VIASYS Part Number
50000-40038
Description
Neonatal disposable flow sensor
Quantity
1
External Battery Option
To add the external battery option to your AVEA, you will need to order the following parts:
VIASYS Part Number
33977
Description
External Battery Tray Assembly
Quantity
1
16217
External Battery Wire Harness
1
68269
AVEA External Battery
2
Other Replacement Parts and Accessories
VIASYS Part Number
71667
71612
100/120 VAC Mains Power Supply Fuse
56000-20064
230/240 VAC Mains Power Supply Fuse
33978
51000-40640
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Description
Internal/External Battery Fuse
Gas Tank Rack Assembly
Filter Cartridge
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Appendix B Specifications
Pneumatic Supply
Air or Heliox Supply
Pressure Range:
20 to 80 psig (1.4 to 5.5 bar)
(Supply Air)
20 to 80 psig (1.4 to 5.5 bar)
(Supply Heliox – 80% / 20% Heliox only)
3 to 10 psig (0.2 to 0.7 bar)
(Compressor Air)
Temperature:
5 to 40º C (41 to 104º F)
Humidity:
Dew Point of gas should be 1.7º C (3º F) below the ambient temperature (minimum)
Minimum Flow:
80 L/min at 20 psig (1.4 bar)
Air Inlet Fitting:
CGA DISS-type body, No. 1160. NIST fitting per BS-5682:1984 (Air) also
available.
Heliox Inlet Fitting: CGA DISS-type body, No. 1180. NIST fitting per BS-5682:1984 (Heliox) also
available.
Oxygen Supply
Pressure Range:
20 to 80 psig (1.4 to 5.5 bar)
(Supply Oxygen)
Temperature:
5 to 40º C (41 to 104º F)
Humidity:
Dew Point of gas should be 1.7º C (3º F) below the ambient temperature (minimum)
Minimum Flow:
80 L/min at 20 psig (1.4 bar)
Inlet Fitting:
CGA DISS-type body, No. 1240. NIST fitting per BS-5682:1984 (O2) also
available.
Electrical Supply
AC Power Supply
The ventilator operates within specification when connected to the following AC power supplies:
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Nominal
Voltage Range
Frequency Range
100 VAC
(85 to 110 VAC)
47 to 65 Hz
120 VAC
(102 to 132 VAC)
55 to 65 Hz
230 VAC
(196 TO 253 VAC)
47 to 65 Hz
240 VAC
(204 TO 264 VAC)
47 to 65 Hz
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DC Power Supply
The ventilator can also operate from a 24 VDC power source (internal or external battery).
Internal Battery:
Maximum charge time to achieve a full charge is 4 hours. Under normal operating conditions, the
internal battery is capable of powering the ventilator alone for 1 hour and powering the ventilator and
compressor for 30 minutes when fully charged. The ventilator should be connected to a main A/C
supply and charged for at least 4 hours prior to switching to battery power.
External Battery: 22.0 to 26.4 VDC
Under normal operating conditions, fully charged external and internal batteries combined are capable
of powering the ventilator and compressor for a period of time equal to or greater than 2 hours and the
ventilator alone for a period of time equal to or greater than 7 hours. With a discharged battery the
ventilator should be connected to a main AC supply and charged for at least 12 hours to insure a full
charge.
Data Input / Output
Independent Lung Ventilation (ILV)
The ventilator provides an output (master) and an input (slave) for synchronization of ventilators. The
output supplies a 5 VDC logic signal synchronized to the breath phase of the master via a 25-pin
connector on the rear of the ventilator. The pin configuration for this connector is as follows:
PIN
FUNCTION
1
Analog Input Channel 0
14
Analog Input Channel 1
18
ILV In
6
ILV Out
20
Factory Use Only, DO NOT CONNECT
22
Analog Output, PRESSURE
23
Analog Output, FLOW
24
Analog Output, VOLUME
25
Analog Output, BREATH PHASE
5,9,10,11,12,13
Ground, Analog
Note
At least one analog ground is required for safe and accurate signal output and input.. One analog
ground is sufficient for any and all of the other signals.
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Appendix B Specifications
Analog Inputs
The ventilator provides 2 programmable channels for analog signal inputs as shown above. Each
channel is scalable for the input ranges specified.
Ranges:
0 to 1 VDC
0 to 5 VDC
0 to 10 VDC
Resolution:
0.25 mV (for 0 to 1 VDC)
1.37 mV (for 0 to 5 VDC)
2.5 mV (for 0 to 10 VDC)
Analog Outputs
The ventilator provides 4 signals to the analog output connector:
1. Airway Pressure, PAW:
Range:
-60 to 140 cmH2O
Scale:
1 cmH2O/25 mV
Accuracy:
± 50 mV or ± 5% of reading, whichever is greater
Zero Offset:
1.5 VDC at 0 cmH2O
2. Flow
Inspiratory/Expiratory:
When selected, the ventilator provides a continuous analog voltage representative of inspiratory
flow minus expiratory flow.
Range:
-300 to 200 L/min (Adult)
-120 to 80 L/min (Pediatric)
-60 to 40 L/min
Scale Factor:
(Neonate)
1 L/min / 10 mV (Adult)
1 L/min / 25 mV (Pediatric)
1 L/min / 50 mV (Neonate)
Accuracy:
Zero Offset:
± 10% of reading or ± 30 mV, whichever is greater
3.0 VDC at 0 L/min
Machine:
When selected, the ventilator provides a continuous analog voltage representative of machine
delivered flow.
Range:
Scale Factor:
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0 to 200 L/min
(Adult)
0 to 100 L/min
(Pediatric)
0 to 50 L/min
(Neonate)
1 L/min / 25 mV (Adult)
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1 L/min / 50 mV (Pediatric)
1 L/min / 100 mV (Neonate)
Accuracy:
± 10% of reading or ± 30 mV, whichever is greater
Zero Offset:
None
3. Volume:
Range:
Scale Factor:
-1.00 to 4.00 L
(Adult)
-200 to 800 ml
(Pediatric)
-100 to 400 ml
(Neonate)
1L/V
(Adult)
1 ml / 5 mV
(Pediatric)
1 ml / 10 mV
(Neonate)
Accuracy:
± 10% of reading or ± 30 mV, whichever is greater
Zero Offset:
4. Breath Phase
1.000 VDC
The ventilator provides a continuous analog voltage representative of breath phase (Inspiration = 5
VDC, Expiration = 0 VDC).
Digital Communication
The ventilator has two RS-232 ports installed for bi-directional communication of data: RS-232 Ch1 is
currently used for software updates as well as data communications to external systems. The
communications protocol is available from VIASYS Healthcare Critical Care P/N L2317. RS-232 Ch2 is
currently undefined.
Printer
The ventilator has a standard 25-pin female Centronics parallel printer port for interfacing to an external
printer.
Remote Nurse Call
The ventilator has a modular jack configured to interface with external systems that are either wired for
normally open (N.O., close on alarm) or normally closed (N.C., open on alarm) signals.
In the active state, the remote alarm can sink 1.0 A.
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Appendix B Specifications
Video Output
The ventilator provides a video output connector, which allows for interfacing to an externally located
256-color, 800 x 600, SVGA monitor.
Atmospheric & Environmental Specifications
Temperature and Humidity
Storage
Temperature:
−20 to 60º C (−4 to 140º F)
Humidity:
0 to 95% RH non-condensing
Operating
Temperature:
5 to 40º C (41 to 104º F)
Humidity:
0 to 95% RH non-condensing
Barometric Pressure
760 to 545 mmHg
Physical Dimensions
Overall Size
Ventilator
17” W x 16” D x 10.5” H or (43.2 cm X 40.6 cm X 26.7 cm)
UIM
16.25” W x 2.5” D x 13.75” H (41.3 cm X 6.4 cm X 34.9 cm)
Weight
Ventilator w/ UIM no compressor
< 73 lbs. (33.1 kg)
Ventilator w/UIM and Compressor < 80 lbs (36.3 kg)
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Accessories
Pall Microbial Filter
Resistance
The exhalation filter supplied with your AVEA ventilator is manufactured by Pall Medical of Ann Arbor,
MI, USA. The published maximum resistance of this filter is 4cmH2O at 100 L/min for the 725 filter.
Compliance
The compliance for the filter is < 0.4 ml/cmH2O.
Materials
Materials used in the construction of the filter have passed USP Class VI 121° C Plastic and
Cytotoxicity test.
For further information please contact Pall Medical.
Water Trap
Resistance
The resistance of the internal exhalation water trap assembly including the collection bottle is < 0.5
cmH2O at 50 L/min.
Compliance
The compliance of the internal exhalation water trap assembly including the collection bottle is < 0.2
ml/cmH2O.
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Appendix C Pneumatic Diagram
Gas Delivery Engine
The Gas Delivery Engine receives and conditions supplied Oxygen and Air from external and/or internal
(compressor) sources. It then mixes the gas to the concentration required and delivers the desired flow, or
pressure to the patient.
The Gas Delivery Engine begins with the Inlet Pneumatics. The Inlet Pneumatics accepts clean O2, or Air; it
provides extra filtration and regulates air and O2 gas before entering the Oxygen Blender. The Oxygen Blender
mixes the gases to the desired concentration before reaching the Flow Control Valve. The Flow Control Valve
controls the flow rate of the gas mixture to the patient. Between the Oxygen Blender and Flow Control Valve,
the Accumulator System is installed to provide peak flow capacity. The Flow Sensor provides information about
the actual inspiratory flow for closed loop servo control. The gas is then delivered to the patient through the
Safety/Relief Valve and Outlet Manifold.
Compressor
Flow
(Optional)
Air
Oxygen
Inlet
Pneumatics
Oxygen
Blender
Accumulator
System
Flow Control
Valve
Flow Sensor
Safety/Relief
Valve &
Manifold
Figure C1 Gas Delivery Engine
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Appendix D Monitor Ranges and Accuracies
DISPLAY
DESCRIPTION
RANGE
ACCURACY
VOLUME MONITORS
The volume measured during the inspiratory phase of the breath is accumulated as the inspired tidal volume, and the volume
measured during the exhalation phase is accumulated as the exhaled tidal volume. This volume does not include the volume
delivered by the Circuit Compliance Compensation function for volume breaths.
Vte
Vte/kg
Exhaled tidal volume.
0 to 4 L
(± 20ml + 10% of reading)-Adult machine
sensor
(± 1 ml + 10% of reading)-Neonate wye
sensor
Exhaled tidal volume adjusted for patient weight
0 to 4 ml/kg
Inspired tidal volume.
0 to 4 L
Inspired tidal volume adjusted for patient weight
0 to 4 ml/kg
Spontaneous tidal volume.
0 to 4 L
Spon Vt/kg
Spontaneous tidal volume adjusted for patient
weight
0 to 4 ml/kg
Mand Vt
Mandatory tidal volume. Displayed as a rolling
average of either 8 breaths or one minute,
whichever occurs first.
0 to 4 L
(± 20ml + 10% of reading)-Adult machine
sensor
(± 1 ml + 10% of reading)-Neonate wye
sensor
Mandatory tidal volume adjusted for patient weight
0 to 4 ml/kg
Derived
Delivered machine volume measured by the
ventilator’s inspiratory flow sensor.
0 to 4L
(± 20ml + 10% of reading)-
Percent leakage. The difference between the
inspired and exhaled tidal volumes in terms of %
difference.
Derived
Derived
Minute Volume. Volume of gas exhaled by the
patient during the last minute.
0 to 99.9 L
Derived
Minute volume adjusted for patient weight
0 to 999 ml/kg
Derived
Spontaneous minute volume.
0 to 99.9L
Derived
Spontaneous minute volume adjusted for patient
weight
0 to 999ml/kg
Derived
0 to 200 bpm
± 3% or ± 2 bpm whichever is greater
Vti
Vti/kg
Spon Vt
Mand Vt/kg
Vdel
% Leak
Ve
Ve/kg
Spon Ve
Spon Ve/kg
(± 20ml + 10% of reading)-Adult machine
sensor
(± 1 ml + 10% of reading)-Neonate wye
sensor
(± 20ml + 10% of reading)-Adult machine
sensor
(± 1 ml + 10% of reading)-Neonate wye
sensor
RATE/TIME MONITORS
Rate
Spon Rate
L1523
Breath Rate.
Spontaneous breath rate.
0 to 200 bpm
± 3% or ± 2 bpm whichever is greater
Ti
Inspiratory time.
0.00 to 99.99
sec
± 0.03 sec
Te
Exhalation Time.
0.00 to 99.99
sec
± 0.03 sec
I:E
Inspiratory/expiratory ratio
Note: Not active for demand breaths.
1:99.9 to
99.9:1
Derived from accuracies for monitored Ti
and Te
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Display
f/Vt
Description
Range
Accuracy
Rapid shallow breathing index.
0 to 500
b2/min/L
Derived from accuracies for spontaneous
breath rate and spontaneous minute
volume
PRESSURE MONITORS
Ppeak
Peak inspiratory pressure.
Not active with spontaneous breaths
0 to 120
cmH2O
± 3.5% of reading or ± 2 cmH2O,
whichever is greater
Pmean
Mean airway pressure.
0 to 120
cmH2O
± 3.5% of reading or ± 2 cmH2O,
whichever is greater
Pplat
Plateau pressure. If no plateau occurs, then the
monitor displays * * *
0 to 120
cmH2O
± 3.5% of reading or ± 2 cmH2O,
whichever is greater
PEEP
Positive end expiratory pressure.
0 to 60 cmH2O
± 3.5% of reading or ± 2 cmH2O,
whichever is greater
Air Inlet
Air inlet gas supply pressure.
0 to 80 psig
± 5 psig (1.4 – 5.5 bar)
O2 Inlet
Oxygen inlet gas supply pressure.
0 to 80 psig
± 5 psig (1.4 - 5.5 bar)
0 to 100%
± 3%
0 to 300
ml/cmH2O
Derived
GAS COMPOSITION MONITORS
FiO2
Delivered percent O2.
MECHANICS
Cdyn
Dynamic Compliance (CDYN and CDYN / Kg),
absolute and normalized to patient weight.
Cdyn/Kg
Respiratory System Compliance (CRS), (a.k.a.
Static Compliance CSTAT), absolute and normalized
to patient weight.
Note: This requires an Inspiratory Hold maneuver.
0 to 300
ml/cmH2O
Rrs
Respiratory system resistance.
Note: Calculation is performed during an Inspiratory
Hold maneuver.
0 to 100
cmH2O/L/sec
Derived
PIFR
Peak Inspiratory flow rate.
0 to 300 L/min
(All patients)
± 10% of setting or ± (0.2 L/min + 10%
of setting), whichever is greater
PEFR
Peak Expiratory flow rate.
0 to 300 L/min
(All patients)
± 10% of setting or ± (0.2 L/min + 10%
of setting), whichever is greater
Ccw
The ratio of the tidal volume (exhaled) to the Delta
Esophageal Pressure (dPES). Requires an
esophageal balloon.
0 to 300
mL/cmH2O
+ 10%
CLUNG
The ratio of the tidal volume (exhaled) to the delta
transpulmonary pressure. The delta
transpulmonary pressure is the difference between
the airway plateau pressure (during an inspiratory
pause) and esophageal pressure (at the time the
airway plateau pressure is measured) minus the
difference between the airway and esophageal
baseline pressures. Requires an inspiratory hold
and esophageal balloon.
0 to 300
mL/cmH2O
+ 10%
C20 / C
The ratio of the dynamic compliance during the last
20% of inspiration (C20) to the total dynamic
compliance (C).
0.00 to 5.00
+ 10%
Cstat
Cstat/Kg
L1523
0.00 to 5.00
ml/cmH2O⋅kg
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Derived
0.00 to 5.00
ml/cmH2O⋅kg
July 2004
Operators Manual
Display
175
Appendix D Monitor Ranges & Accuracies
Description
Range
Accuracy
RRS
The total resistance during the inspiratory phase of
a breath. Respiratory System Resistance is the
ratio of the airway pressure differential (peak –
plateau) to the inspiratory flow 12 ms prior to the
end of inspiration. Requires an inspiratory hold.
0 to 100
cmH2O/L/sec
+ 10%
RPEAK
The Peak Expiratory Resistance (RPEAK), is defined
as the resistance at the time of the Peak Expiratory
Flow (PEFR).
0.0 to 100.0
cmH2O/L/sec
+ 10%
RIMP
The airway resistance between the wye of the
patient circuit and the tracheal sensor. Requires an
inspiratory hold and tracheal catheter.
0.0 to 100.0
cmH2O/L/sec
+ 10%
RLUNG
The ratio of the tracheal pressure differential (peak
– plateau) to the inspiratory flow 12 ms prior to the
end of inspiration. Requires an inspiratory hold and
tracheal catheter.
0.0 to 100.0
cmH2O/L/sec
+ 10%
dPAW
The difference between peak airway pressure
(PPEAK AW) and baseline airway pressure (PEEPAW).
−120 to 120
cmH2O
+ 2 cm H2O or + 5% whichever is greater
dPES
The difference between peak esophageal pressure
(PPEAK ES) and baseline esophageal pressure
(PEEPES).
−120 to 120
cmH2O
+ 2 cm H2O or + 5% whichever is greater
The airway pressure at the end of an expiratory
hold maneuver. Requires a passive patient.
0 to 50 cmH2O
+ 2 cm H2O or + 5% whichever is greater
The difference between airway pressure at the end
of an expiratory hold maneuver and the airway
pressure at the start of the next scheduled breath
after the expiratory hold maneuver. Requires a
passive patient.
0 to 50 cmH2O
+ 2 cm H2O or + 5% whichever is greater
The difference between esophageal pressure
measured at the end of exhalation (PEEPES) minus
the esophageal pressure measured at the start of a
patient-initiated breath (PES start) and the sensitivity
of the ventilator’s demand system. The sensitivity
of the ventilator’s demand system is the difference
between the baseline airway pressure (PEEPAW)
and the airway pressure when the patient initiates a
breath (PAW start). Requires an esophageal balloon.
0 to 50 cmH2O
+ 2 cm H2O or + 5% whichever is greater
Ptp Plat
Transpulmonary pressure during an inspiratory
hold, which is the difference between the airway
plateau pressure (PPLAT AW) and the corresponding
esophageal pressure. Requires an inspiratory hold
and esophageal balloon.
−60 to 120
cmH2O
+ 2 cm H2O or + 5% whichever is greater
Ptp PEEP
The difference between the corresponding airway
and esophageal pressures at the end of the
expiratory hold during an AutoPEEP maneuver.
Requires an inspiratory hold and esophageal
catheter.
−60 to 120
cmH2O
± 2 cmH2O or ± 5%, whichever is greater
MIP
The maximum negative airway pressure that is
achieved by the patient, during an expiratory hold
maneuver.
−60 to 120
cmH2O
± 2 cmH2O or ± 5%, whichever is greater
P100
The negative pressure that occurs 100 ms after an
inspiratory effort has been detected.
−60 to 120
cmH2O
± 2 cmH2O or ± 5%, whichever is greater
AutoPEEP
dAutoPEEP
AutoPEEPES
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Display
Description
Range
Accuracy
WOBV
The summation of airway pressure (PAW) minus the
baseline airway pressure (PEEPAW) times the
change in tidal volume to the patient (∆V) during
inspiration, and normalized to the total inspiratory
tidal volume (Vti).
0.00 to 20.00
Joules/L
+ 10%
WOBP
Patient Work of Breathing (WOBP), normalized to
the total inspiratory tidal volume. Patient work of
breathing is defined as the summation of two work
components: work of the lung and work of the chest
wall. Requires an esophageal balloon.
0.00 to 20.00
Joules/L
+ 10%
WOBI
The work performed by the patient to breathe
spontaneously through the breathing apparatus, i.e.
the E.T. tube, the breathing circuit, and the demand
flow system. Requires a tracheal catheter.
0.00 to 20.00
Joules/L
+ 10%
Note
Monitored values are displayed as BTPS
L1523
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Appendix E Sensor Specifications & Circuit
Resistance
VarFlex® Sensor Specifications
Table E.1 Varflex Flow Sensor Specifications
Sensor
Infant 15 mm
Adult 15 mm
Part Number
Type
Circuit Location
Performance Specifications
Flow Range
Diff Pres Range
Accuracy*
Resistance
Dead Space
Freq. Response**
Airway Pres Range
Calibration (EEPROM)
Linearity
Operating Temperature
7002500
Single Use
Wye
7002300
Single Use
Wye
0.024 to 30 L/min
± 5.72 cmH2O
± (0.012 L/min + 5% or reading
4.5 cmH2O @ 30 L/min
0.7 ml installed
17 Hz
-140 to 140 cmH2O
29 Point Curve
< 1% between points
5° to 40° C
41° to 104° F
1.2 to 180 L/min
± 5.72 cmH2O
± (0.1 L/min + 5% or reading
2.4 cmH2O @ 60 L/min
9.6 ml installed
26 Hz
-140 to 140 cmH2O
29 Point Curve
< 1% between points
5° to 40° C
41° to 104° F
1.36 in (3.5 cm)
15 mm OD
15 mm OD
48 in (121.9 cm)
Bicore Proprietary
22 g (0.7 oz)
Single Patient Use
NA
Sensor – Lexan
Flap – Mylar
Tubing – PVC
Connector - ABS
2.45 in (6.2 cm)
15 mm OD
15 mm OD
73 in (185.4 cm)
Bicore Proprietary
31 g (1.0 oz)
Single Patient Use
NA
Sensor – Lexan
Flap – Mylar
Tubing – PVC
Connector - ABS
Physical Specifications
Sensor Length
Diameter Insp (Vent Side)
Diameter Exp (Patient)
Tube Length
Connector
Weight
Service Life
Sterilization
Material
L/min: Dry air at 77° F (25° C) and 14.7 psig barometric pressure.
* Includes ± 1% for linearity & hystersis with no zero drift for the pressure transducer and ± 2 % for
temperature and humidity variations.
The sensor must be corrected for barometric pressure, and oxygen concentration.
** Frequency Response is signal attenuation to 0.707 input and assumes 100 Hz sample rate.
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AVEA Ventilator Systems
Hot Wire Flow Sensor Specifications
Table E-2 Hot wire sensor specifications
Part Number
Type:
Circuit Location:
Performance Specifications
Flow Range:
Vol. Accuracy:
Flow Resistance:
Dead Space:
Freq. Response*:
Calibration:
Linearity:
Operating Temperature:
Physical Specifications
Sensor length
Diameter Insp (Vent Side)
Diameter Exp (Patient Side)
Tube length
Connector
Weight
Service Life
Sterilization
Materials
51000-40081
Multiple use heated wire
Wye
0 (+/- 0.002) to 30 L/min
+/-10%
15 cmH2O @ 20 L/min
0.8 mL
16 Hz
36 point curve
< 2%
5 to 40oC
1.68”
15 mm OD
15 mm OD
N/A
Pin & Socket type
< 10g (not including wire)
25 cycles
Steam Autoclave
Sensor - Delrin
Wire – Platinum
Screen – Stainless Steel 304 or 316
Pin – PhBz, gold over nickel plated
Spacer - Delrin
Circuit Resistance (per EN794 –1)
It is important to check the inspiratory and expiratory resistance specification of patient circuits used
with the AVEA to ensure they do not exceed the following limits when adding attachments or other
components or subassemblies to the breathing circuit.
NOTE
Refer to product labeling supplied with any accessory to be added to the breathing circuit for this
information.
0.6 KPA (6cmH2O) at 60 L/min for adult patients
0.6 KPA (6cmH2O) at 30 L/min for pediatric patients
0.6 KPA (6cmH2O) at 5 L/min for neonatal patients
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Appendix E Circuit Resistance &Sensor Specifications
WARNING
Total resistance of the inspiratory and expiratory limbs of the breathing circuit with accessories
should not exceed 4cmH2O at 5 L/min if inspiratory flows > 15 liters per minute are used in TCPL
ventilation modes.
Circuit Resistance Test
To measure the resistance of the inspiratory and expiratory limbs of the breathing circuit with
accessories connect the patient breathing circuit as described in Chapter 2.
1. Select TCPL SIMV with settings:
Rate
1
Inspiratory Pressure
15 cmH2O
Peak Flow
8.0 L/min
Inspiratory Time
0.35 sec
PEEP
0 cmH2O
Flow Trigger
20 Lmin
% O2
21 %
Bias Flow
5 L/min
Pressure trigger
20 cmH2O
2. Select waveform Pinsp
3. With the patient wye blocked, allow the baseline pressure (PEEP) to stabilize for
10 seconds and press the FREEZE key.
4. Use the data dial to read the pressure from the Pinsp waveform. The pressure
must not exceed 4cmH2O at 5 L/min if inspiratory flows > 15 liters per minute are
used in TCPL ventilation modes.
L1523
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Appendix F AVEA Message Bar Text
AVEA MESSAGE BAR TEXT
"Confirm Apnea Settings."
"Proximal Flow Sensor required."
"Bias Flow insufficient to allow Flow
Trigger."
"Heliox concentration will change."
"Nebulizer not available."
"Confirm inspiratory pressure settings."
"Settings restored to defaults."
"Compliance Compensation not active
for NEO."
"Minimum 0.2 sec Inspiratory Time."
"Maximum 4:1 I:E Ratio."
"Maximum 3 sec Inspiratory Time."
"Maximum 5 sec Inspiratory Time."
"Invalid Calibration"
"Error saving Serial/Model Number"
Clear Messages
"FCV Characterization in progress."
"FCV Characterization complete."
"FCV Characterization failed."
Installed Software Version
Current Time, Date, and Runtime Hours
“DPRAM Comm. Error, Ctrl"
"Printing."
L1523
CAUSE
Selection of CPAP/PSV or APRV on Mode Select popup
when active.
Acceptance of Volume Limit setting when
Size is NEO, Volume Limit is active, and no Wye Flow
Sensor connected (Varflex or Hotwire).
Acceptance of Bias Flow setting or Flow Trigger setting
when Flow Trigger < (Bias Flow + 0.5 lpm).
Acceptance of %O2 setting when Heliox is being used.
Acceptance of Peak Flow setting < 15 lpm when
Nebulizer is active or on pressing of Nebulizer membrane
key when Peak Flow setting < 15 lpm
Selection of Volume Limit control when Volume Limit
active (i. e., not at default / highest value for patient size).
Patient Accept when New Patient selected.
Size Accept when Size is NEO, and Circ Comp setting is
non-zero.
Acceptance of any combination of settings that will
produce an I-Time of less than 0.2 seconds.
Acceptance of any combination of settings that will
produce an I:E Ratio of 4:1 or greater.
Acceptance of any combination of settings when size is
NEO that will produce an I-Time of greater than 3
seconds.
Acceptance of any combination of settings when size is
PED or ADULT that will produce an I-Time of greater
than 5 seconds.
Service State Only:
Validation failure, while calibration dialog box is active for
selected device.
Service State Only:
On accept of Serial Number or Model Number Change.
Service State Only:
Validation success, while calibration dialog box is active
for selected device.
Service State Only:
On start of Flow Control Valve characterization
procedure.
Service State Only:
On successful completion of Flow Control Valve
characterization procedure.
Service State Only:
Unsuccessful completion of Flow Control Valve
characterization procedure. Validation failure
characterization and tuning data.
Power Up
Main key pressed.
Loss of Communication with Control microprocessor
Print Screen button was pressed; commenced sending
screen data to printer.
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Appendix F Message Bar Text
AVEA MESSAGE BAR TEXT
"Printer Out of Paper."
"Printer Offline."
"Printer Error."
"Printer Ready."
"Printer Busy."
"Volume Limit disabled."
"Proximal Flow Sensor disconnected."
"Flow sensor is not Heliox-compatible."
"Proximal Airway Line disconnected."
"Proximal Flow Sensor conflict.
"Esophageal monitoring not available."
"Tracheal monitoring not available."
"Flow Sensor Error."
"Wye Sensor Error."
"Device Error."
"Esophageal Balloon Leak Test Failed."
“Stopped: Patient Effort Detected”
CAUSE
Print Screen button was pressed, printer reported it is out
of paper.
Print Screen button was pressed; printer is not available.
Print Screen button was pressed; printer reported an
error condition.
Sending screen data to printer has completed.
Print Screen button was pressed, device has not
completed sending data from previous activation.
On disconnect of WFS (Neo or Hotwire) when Size is
NEO and Volume Limit is active.
On disconnect of WFS, any type.
On connect of Hotwire WFS when Heliox is active.
On disconnect of Proximal Pressure connection.
On simultaneous connect of Hotwire and VarFlex WFS.
On connect of Esophageal Balloon when size is NEO.
On connect of Tracheal Catheter when size is NEO.
On power up, failure to validate any internal flow sensor.
On connect and failure to validate any proximal flow
sensor.
On detection of a fault classified as “Device Error” (see
Fault Section)
On failure of Esophageal Balloon leak test.
Upon detecting Patient effort in maneuvers which require
a passive patient
“Proximal Flow Sensor Ready”
L1523
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Appendix G Adjusting Barometric Pressure for
Altitude
The default setting for barometric pressure on AVEA is 760 mm Hg. For institutions at altitudes of 1000
feet or greater, barometric pressure can be set by the operator.
Open the screens menu by pressing the screen indicator on the touch screen or the “SCREENS”
membrane button located to the left of the touch screen.
Select utility from the screens menu. Press the touch screen button for barometric pressure and use the
data dial to change the setting. Once you have reached the desired barometric pressure setting, press
the “ACCEPT” membrane button adjacent to the data dial.
To close the utilities screen and return to the main screen, press the screen indicator again and select
MAIN from the menu or press the membrane button to the left of the touch screen labeled “MAIN”.
Below is a chart of approximate Barometric Pressure at varying altitude:
Table G.1 Altitude to Barometric Pressure Conversion2
Altitude
(ft)
2
Barometric
Pressure
(mm Hg)
0
760
1000
733
2000
707
3000
681
4000
656
5000
632
6000
609
7000
588
8000
567
9000
545
CRC Handbook of Chemistry and Physics 61st Edition,1980-1981, CRC Press, Inc. Boca Raton, Florida
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Appendix F Message Bar Text
Appendix H Advanced Pulmonary Mechanics
Monitored Parameters
Rapid Shallow Breathing Index (f / Vt)
The ventilator is capable of displaying the calculated value for Rapid Shallow Breathing
Index (f / Vt), which is the spontaneous breath rate per tidal volume, and is based on the
following formula:
f / Vt = f 2 / Ve , where f = spontaneous breath rate (BPM) and
Ve = spontaneous minute ventilation in LPM
Range:
0 to 500 b2/min/L
Resolution:
1 b2/min/L
Chest wall Compliance (CCW)
Chest wall Compliance (CCW), is the ratio of the tidal volume (exhaled) to the Delta
Esophageal Pressure (dPES).
CCW =
Vte
dPES
Range:
0 to 300 mL/cmH2O
Resolution:
1 mL/cmH2O
Note:
Requires an esophageal balloon catheter.
Accuracy:
± 10%
Lung Compliance (CLUNG)
Lung Compliance (CLUNG), is the ratio of the tidal volume (exhaled) to the delta
transpulmonary pressure. The delta transpulmonary pressure is the difference between
the airway plateau pressure (during an inspiratory pause) and esophageal pressure (at
the time the airway plateau pressure is measured) minus the difference between the
airway and esophageal baseline pressures.
CLUNG =
Range:
L1523
Vte
, where dPPLAT TP = (PPLAT AW − PES) − (PEEPAW − PEEPES)
dPPLAT TP
0 to 300 mL/cmH2O
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AVEA Ventilator Systems
Resolution:
Note:
1 mL/cmH2O
Requires an Inspiratory Hold maneuver and an esophageal balloon catheter.
Accuracy: ±10%
Compliance Ratio (C20 / C)
Compliance Ratio (C20 / C), is the ratio of the dynamic compliance during the last 20%
of inspiration (C20) to the total dynamic compliance (C).
Range:
0.00 to 5.00
Resolution:
0.01
Accuracy: ± 10%
Respiratory System Resistance (RRS)
Respiratory System Resistance (RRS), is the total resistance during the inspiratory
phase of a breath. Respiratory System Resistance is the ratio of the airway pressure
differential (peak – plateau) to the inspiratory flow 12 ms prior to the end of inspiration.
Range:
0 to 100 cmH2O/L/sec
Resolution:
0.1 cmH2O/L/sec
Limitation:
Active for volume breaths only.
Note:
Requires an Inspiratory Hold maneuver.
Accuracy:
± 10%
Peak Expiratory Resistance (RPEAK)
The ventilator shall be capable of calculating and displaying the Peak Expiratory
Resistance (RPEAK), which is defined as the resistance at the time of the Peak Expiratory
Flow (PEFR).
RPEAK =
PPEFR
PEFR
Range:
0.0 to 100.0 cmH2O/L/sec
Resolution:
0.1 cmH2O/L/sec
Accuracy: ± 10%
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Appendix F Message Bar Text
Imposed Resistance (RIMP)
Imposed Resistance (RIMP), is the airway resistance between the wye of the patient
circuit and the tracheal sensor.
Range:
0.0 to 100.0 cmH2O/L/sec
Resolution:
0.1 cmH2O/L/sec
Note:
Requires an Inspiratory Hold maneuver and a tracheal catheter.
Accuracy:
± 10%
Lung Resistance (RLUNG)
Lung Resistance (RLUNG), is the ratio of the tracheal pressure differential (peak –
plateau) to the inspiratory flow 12 ms prior to the end of inspiration.
Range:
0.0 to 100.0 cmH2O/L/sec
Resolution:
0.1 cmH2O/L/sec
Note:
Requires an Inspiratory Hold maneuver and a tracheal catheter.
Accuracy:
± 10%
Peak Inspiratory Flow Rate (PIFR)
The ventilator is capable of monitoring and displaying the actual peak inspiratory flow
rate for the inspiratory phase of a breath.
Range:
0 to 300 LPM
(All patients)
Resolution:
1 LPM
0.1 LPM
(Adult/Pediatric)
(Neonate)
Accuracy:
± 10%
Peak Expiratory Flow Rate (PEFR)
The ventilator is capable of monitoring and displaying the actual peak expiratory flow
rate for the expiratory phase of a breath.
L1523
Range:
0 to 300 LPM
(All patients)
Resolution:
1 LPM
0.1 LPM
(Adult/Pediatric)
(Neonate)
Accuracy:
± 10%
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AVEA Ventilator Systems
Delta Airway Pressure (dPAW)
Delta Airway Pressure (dPAW), which is the difference between peak airway pressure
(PPEAK AW) and baseline airway pressure (PEEPAW).
dPAW = PPEAK AW − PEEPAW
Range:
−120 to 120 cmH2O
Resolution:
1 cmH2O
Accuracy:
± 2cmH20 or ± 5%, whichever is greater
Delta Esophageal Pressure (dPES)
Delta Esophageal Pressure (dPES), is the difference between peak esophageal
pressure (PPEAK ES) and baseline esophageal pressure (PEEPES).
dPES = PPEAK ES − PEEPES
Range:
−120 to 120 cmH2O
Resolution:
1 cmH2O
Accuracy:
± 2cmH20 or ± 5%, whichever is greater
AutoPEEPAW
AutoPEEPaw, is the airway pressure at the end of an expiratory hold maneuver.
Range:
0 to 50 cmH2O
Resolution:
1 cmH2O
Accuracy:
± 2cmH20 or ± 5%, whichever is greater
Note
Requires a passive patient.
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Appendix F Message Bar Text
Delta AutoPEEPAW (dAutoPEEPAW)
Delta AutoPEEPAW (dAutoPEEPAW), is the difference between airway pressure at the
end of an expiratory hold maneuver and the airway pressure at the start of the next
scheduled breath after the expiratory hold maneuver.
Range:
0 to 50 cmH2O
Resolution:
1 cmH2O
Note:
Requires a passive patient.
Accuracy: ± 2cmH20 or ± 5%, whichever is greater
AutoPEEPES
AutoPEEPES is defined as the difference between esophageal pressure measured at
the end of exhalation (PEEPES) minus the esophageal pressure measured at the start of
a patient-initiated breath (PES start) and the sensitivity of the ventilator’s demand system.
The sensitivity of the ventilator’s demand system is the difference between the baseline
airway pressure (PEEPAW) and the airway pressure when the patient initiates a breath
(PAW start).
AutoPEEPES = (PEEPES − PES start) − (PEEPAW − PAW start)
Range:
0 to 50 cmH2O
Resolution:
1 cmH2O
Note:
Requires an esophageal balloon catheter.
Accuracy:
± 2cmH20 or ± 5%, whichever is greater
Transpulmonary Pressure, Plateau (Ptp Plat)
The ventilator is capable of calculating and displaying the Transpulmonary pressure
during an inspiratory hold, which is the difference between the airway plateau pressure
(PPLAT AW) and the corresponding esophageal pressure.
PtpPlat = PPLAT AW − PES
L1523
Range:
−60 to 120 cmH2O
Resolution:
1 cmH2O
Accuracy:
± 2cmH20 or ± 5%, whichever is greater
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AVEA Ventilator Systems
Note
Requires an inspiratory hold and an esophageal catheter.
Transpulmonary Pressure, AutoPEEP (Ptp PEEP)
Transpulmonary pressure, AutoPEEP (PtpPEEP) is the difference between the
corresponding airway and esophageal pressures at the end of the expiratory hold
during an AutoPEEP maneuver.
PtpPEEP = PAW − PES (at the end of an expiratory hold)
Range:
−60 to 120 cmH2O
Resolution:
1 cmH2O
Accuracy:
± 2 cmH2O or ± 5%, whichever is greater
Note:
Requires an inspiratory hold and an esophageal catheter.
Maximum Inspiratory Pressure (MIP)
Maximum Inspiratory Pressure (MIP), is the maximum negative airway pressure that is
achieved by the patient, during an expiratory hold maneuver.
Range:
−60 to 120 cmH2O
Resolution:
1 cmH2O
Accuracy:
± 2cmH20 or ± 5%, whichever is greater
Respiratory Drive (P100)
Respiratory Drive (P100), is the negative pressure that occurs 100 ms after an inspiratory
effort has been detected.
P100 = Pend 100 − PEEPAW
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Range:
−60 to 120 cmH2O
Resolution:
1 cmH2O
Accuracy:
± 2cmH20 or ± 5%, whichever is greater
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189
Appendix F Message Bar Text
Ventilator Work of Breathing (WOBV)
Ventilator Work of Breathing (WOBV), is defined as the summation of airway pressure
(PAW) minus the baseline airway pressure (PEEPAW) times the change in tidal volume to
the patient (∆V) during inspiration, and normalized to the total inspiratory tidal volume
(Vti).
If PAW > PEEPAW ,
∑ (P
AW
WOBV =
− PEEPAW )∆V
Insp
Vti
Range:
0.00 to 20.00 Joules/L
Resolution:
0.01 Joules/L
Accuracy:
± 10%
Patient Work of Breathing (WOBP) (Normalized to Delivered Tidal Volume)
Patient Work of Breathing (WOBP), normalized to the total inspiratory tidal volume.
Patient work of breathing is defined as the summation of two work components: work of
the lung and work of the chest wall.
WOBP = WOBLUNG + WOBCW
Tiend
where WOBLUNG =
∑ ( PEEP
ES
− PES )∆V
(if PEEPES > PES
Testart
and V > 0)
VP
(if PEEPES > PES)
2CCW
2
and WOBCW =
Work of the lung (WOBLUNG) is calculated using esophageal pressure when the baseline
esophageal pressure (PEEPES) is greater than the esophageal pressure (PES),
indicating patient effort.
Work of the chest wall (WOBCW) for a spontaneously breathing patient is calculated
using only the portion of the total tidal volume delivered due to a patient effort (VP) and
the chest wall compliance (CCW).
L1523
Range:
0.00 to 20.00 Joules/L
Resolution:
0.01 Joules/L
Accuracy:
± 10%
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190
AVEA Ventilator Systems
Note
Requires an esophageal balloon catheter.
Imposed Work of Breathing (WOBI)
Imposed Work of Breathing (WOBI), is defined as the work performed by the patient to
breathe spontaneously through the breathing apparatus, i.e. the E.T. tube, the
breathing circuit, and the demand flow system.
Imposed work is assessed by integrating the change in tracheal pressure and tidal
volume, and normalizing the integrated value to the total inspiratory tidal volume (Vti).
(Requires the use of an optional tracheal catheter.) Based on the following formula:
WOBI =
∫ (PEEP
Vti
AW
0
− PTR ) *
dV
,
dt
where PEEPAW = airway baseline pressure
PTR = tracheal pressure
Vti = inspired tidal volume
Range:
0.00 to 20.00 Joules/L
Resolution:
0.01 Joules/L
Accuracy:
± 10%
Note
Requires a tracheal catheter
L1523
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July 2004
Glossary
Breath Interval
Preset
Trigger
BTPS
ATPD
Demand Flow
AC
Bias Flow
bpm
Breath Period
Breath Rate
BTPD
Button
cmH2O
Controls
Event
Flow
Indicators
L
LED
L/min
Mode
Monitored Parameter
O2
Patient Breathing
Circuit
Paw
PEEP
Ppeak
L1523
Elapsed time from the start of one breath to the start of
the next.
An operator set ventilator parameter.
Value at which the ventilator initiates delivery of a breath
as a result of measured patient effort.
Body Temperature at Ambient Pressure, Saturated.
Ambient Temperature, Ambient Pressure, Dry.
The flow generated by the ventilator to meet the patient’s
flow demand in order to maintain PEEP at the preset
level.
Alternating Current (mains electricity).
Flow through the patient breathing circuit during the
expiratory phase. This flow is used for flow triggering.
Breaths per minute.
The length of time between machine-initiated breaths.
Depends on the Breath Rate setting.
The number of breaths delivered in a minute.
Body Temperature at Ambient Pressure, Dry
A push button switch used to toggle a function on or off.
Centimeters of water pressure.
Any button, switch, or knob that allows you to modify the
ventilator’s behavior.
The occurrence or activation of certain controls or
functions of the ventilator or a patient care activity, which
can be stored in the trend buffer.
The rate at which gas is delivered. Measured in liters per
minute (L/min).
A visual element showing operational status.
Liters. A unit of volume.
Light Emitting Diode
Liters per minute. A unit of flow.
An operating state of the ventilator that determines the
allowable breath types.
A measured value displayed in the monitor window.
Oxygen
The tubing that provides the ventilatory interface between
the patient and ventilator.
Airway Pressure. Measured in cmH2O.
Positive End Expiratory Pressure. Pressure maintained in
the circuit at the end of exhalation.
Peak Inspiratory Pressure. Shows the highest circuit
pressure to occur during inspiration. The display is
updated at the end of inspiration. Ppeak is not updated for
spontaneous breaths.
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AVEA Ventilator Systems
Pplat
PSIG
Sigh Breath
WOB
L1523
Plateau Pressure. Measured during an Inspiratory Hold
maneuver or during zero flow in a pressure control breath.
Used to calculate Static Compliance (Cstat).
Pounds per square inch gauge. 1 PSIG = .07bar
A Volume Controlled machine breath having a tidal
volume equal to one-and-a-half times (150%) of the
current tidal volume setting.
Patient Work of Breathing i.e. a measure of Patient Effort.
Revision N
July 2004
Index
loss of O2 · 147
low exhaled minute volume · 150
low O2 percent · 152
low peak pressure · 148
low PEEP · 149
low priority · 145
maximum inspiratory time · 151
medium priority · 145
safety valve open · 147
vent inop · 147
annual maintenance · 157
apnea backup
CPAP or APRV / BIPHASIC · 92
apnea back-up ventilation · 79
Artificial Airway Compensation · 75
assemble and insert the exhalation filter and
water trap · 29
assembling the ventilator · 28
assembly on site · 26
assist control ventilation mode · 85
attaching the flow sensors · 34
attaching the patient circuit · 32
autoclave · 156
A
access the advanced settings group · 105
activating a primary breath control · 99
active humidifier · 32
adult patient circuit · 32
advanced settings · 105
accessing the screen · 105
advanced settings indicator · 105
bias flow · 110
flow cycle · 109
insp rise · 109
machine volume · 108
pres trig · 111
PSV cycle · 112
PSV rise · 112
PSV Tmax · 112
sigh · 110
volume limit · 107
Vsync · 111
Vsync rise · 112
waveform · 109
air inlet pressure · 136, 174
air supply · 26
alarm conditions · 152
alarm indicator · 145
alarm indicators · 72
alarm limits · 146
alarm loudness · 44
alarm reset button · 147
alarm silence · 146
alarm types · 147
alarms · 145
apnea interval · 151
extended high peak pressure · 149
fan failure · 147
high exhaled minute volume · 150
high O2 percent · 152
high peak pressure, normal · 148
high peak pressure, sigh · 149
high priority · 145
high rate · 151
high tidal volume · 151
IE ratio · 152
loss of air · 147
loss of gas supply · 148
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B
Backup Alarm · 145
Barometric Pressure · 47, 144
base flow · 110
battery cord · 29
battery pack · 158
external · 158
battery replacement · 159
battery status indicator · 143
battery status indicators · 159
bias flow · 102, 110, 191
breath interval · 68, 85, 86, 100
breath interval timing mechanism · 85
breath rate · 85, 86, 100, 136, 140, 151, 153,
173
breath type and delivery mode · 79
breath types · 80, 86, 191
breath types and modes by patient size
adult and pediatric · 97
neonatal · 97
breaths, defined by four variables · 80
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AVEA Ventilator Systems
adjusted for patient weight · 136
external battery · 53, 159
external water trap · 41
C
calculated IE Ratio · 140
calculated minute volume · 140
cautions · 15
choice of waveforms · 116
circuit compliance · 22, 76
circuit compliance compensation · 22, 76
Circuit Occlusion Alarm · 57, 149
cleaning and sterilization
accessories and parts · 155
external surfaces · 155
colors on waveform display · 115
compliance effect of the circuit · 22, 76
compressed gas sources · 26
connecting the O2 sensor · 41
contacting the manufacturer · 163
control knob · 116, 117, 135, 141, 146
controls associated with each breath type &
mode · 106
cord routing · 29
CPAP/PSV mode · 79, 83, 90
customer service · 164
F
flashing alarms · 145
flow cycle · 109
flow trig · 98
freezing a loop · 119
freezing the loops screen · 119
fuses · 161
G
gas line pressure · 26
gas sources · 26
air supply · 26
oxygen supply · 26
graphs · 117
H
Heliox connection · 42
heliox delivery · 23
high priority alarm · 145
hot wire sensor · 34
humidification · 22, 32, 77
D
data dial · 99
default mode for all patient types · 85
demand breaths · 83
disable the audible alarm · 146
displayed value · 99
dynamic compliance · 136, 174
I
independent lung ventilation · 45, 46, 112
indicators · 142
external battery · 142
internal battery · 142
mains AC · 142
inhaled tidal volume · 173
adjusted for ideal body weight · 173
insp pause · 98
insp pres · 98
insp rise · 109
insp time · 98
inspiratory pause · 101
inspiratory pressure · 100
inspiratory time · 101, 136, 173
Inspiratory/Expiratory ratio · 136, 173
inspired tidal volume · 136
adjusted for patient weight · 136
internal battery · 53, 159
E
electromagnetic components · 12
EMC · 12
Enable/Disable O2 Alarms · 44
enzyme pre-soaking solution · 155
esophageal balloon · 37
connection · 37
event log · 138
event markers · 138
events · 138
events automatically recorded · 138
exhalation filter · 29, 30, 31, 155, 156
exhaled tidal volume · 173
adjusted for ideal body weight · 173
expiratory Time · 136, 173
expired tidal volume · 136
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Operators Manual
multiple alarms · 145
L
leak compensation · 76
loops
colors · 115
comparing loops · 119
freezing a loop · 119
reference · 119
reference loops · 119
saving a loops · 119
selection · 118
loops in real time · 118
loops screen · 118
low priority alarm · 145
N
nebulizer · 35, 69
neonatal patient circuit · 33
new patient key · 73
NIST fittings · 41
O
O2 percentage · 98
optional external battery · 29
ordering parts · 163
oxygen inlet pressure · 136, 174
oxygen sensor · 40
cable · 41
cell · 41
oxygen supply · 27
M
mach vol · 108
main screen monitors · 141
mandatory breath · 80
mandatory tidal volume · 136, 173
adjusted for patient weight · 136, 173
mean inspiratory pressure · 136, 174
medium priority alarm · 72, 145
membrane button
expiratory hold · 68
membrane buttons
accept button · 68
advanced settings · 70
alarm limits · 67
alarm reset · 66
alarm silence · 66
cancel · 68
freeze · 71
increase O2 · 67
inspiratory hold · 69
main · 72
manual breath · 67
mode · 71
nebulizer · 69
panel lock · 70
print · 70
screens · 72
setup · 70
suction · 67
membrane buttons and LEDs · 66
minute volume · 136, 173
adjusted for patient weight · 136, 173
monitor screen · 135
monitored values · 135
monitored values choices · 136
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195
Index
P
parallel printer port · 39
passive humidifier or HME · 32
patient effort · 85, 86, 191
patient ID · 77
patient select screen · 73
patient size · 21
patient size indicators · 70
patient size select screen · 73
patient-triggered breaths · 83
peak Expiratory flow rate · 136, 174
peak flow · 98
peak Inspiratory flow rate · 136, 174
peak inspiratory pressure · 136, 174
PEEP · 67, 81, 82, 83, 98, 100, 102, 111, 136,
147, 148, 149, 152, 153, 174, 191
percent leakage · 136, 173
percentage of oxygen · 136, 174
plateau pressure · 136, 174
positive end expiratory pressure · 102, 136,
174
power cord · 53
power on indicator · 142
power source · 26
pres high · 98, 104
pres low · 98
pres trig · 111
pressure breaths · 81
pressure high control · 104
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AVEA Ventilator Systems
pressure low control · 104
pressure regulated volume control breaths · 81
pressure support ventilation · 90
preventive maintenance · 157
primary breath controls · 98, 100
breath rate · 100
flow trigger · 102
inspiratory pause · 101
inspiratory pressure · 100
inspiratory time · 101
PEEP · 102
pressure high · 104
pressure low · 104
pressure support · 101
tidal volume · 100
time high · 104
time low · 104
printing · 117
protective ground connection · 53
PSV · 98
PSV breath · 83
PSV control · 101
PSV cycle · 83, 112
PSV rise · 112
PSV Tmax · 83, 112
R
radio frequency energy · 12
rapid shallow breathing index · 136, 174
rate · 98
rear panel diagram · 40
reference loop · 119
remote nurse call system · 51
replaceable fuses · 160
respiratory system resistance · 136, 174
resume button · 96
resume current key · 73
ventilation setup · 75
sequence in which the power sources are used
· 159
service calls · 163
Setting Date · 52
setting the breath type and ventilation mode ·
79
Setting the Language · 47
Setting the Time · 52
setting up your AVEA ventilator · 26
sigh · 110, 148, 149, 152
sigh volume breaths · 110
SIMV mode · 86
smart connectors
attachment · 42
smart Heliox connectors · 42
specifications
accessories · 170
atmospheric & environmental · 169
data input & output · 167
electrical · 165
physical dimensions · 169
pneumatic · 165
spontaneous breath · 83
spontaneous breath rate · 136, 173
spontaneous minute volume · 136, 173
adjusted for patient weight · 136, 173
spontaneous tidal volume · 136, 173
adjusted for ideal body weight · 173
adjusted for patient weight · 136
standby mode · 95
static compliance · 136, 174
status indicators · 142
steam sterilization · 156
symbols · 16
synchronized intermittent mandatory
ventilation · 86
T
S
tidal volume · 100
time cycled pressure limited breaths · 81
time high · 98, 104
control · 104
time low · 98, 104
control · 104
tracheal catheter · 37
trade names · 12
trended data · 139
histograms · 139
spreadsheet · 139
safety information · 14
save loop button · 119
saving a loop · 119
scaling histograms · 139
screen select box · 95
screens
mode selection · 79
patient select · 73
patient size · 73
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July 2004
Operators Manual
trends screen · 139
W
warnings · 14
warranty · 5
water collection bottle · 29
water trap · 29, 30, 155
waveform · 101, 109, 116, 117, 141
choices · 117
waveforms
colors · 115
freeze · 117
freezing · 115
main screen · 115
menu · 116
printing · 117
V
variable orifice sensor · 35
ventilation modes · 85
ventilator specifications · 165
ventilator synchronization · 45
VGA output connector · 39
visual alarm display · 145
volume breaths · 80
volume limit · 81, 107
Vsync · 111
pressure control breaths · 111
volume test breath · 111
Vsync rise · 112
Vt · 98
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197
Index
Revision N
July 2004
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