Clinical guide
English
Contents
Introduction............................................................................................................................. 1 Indications for use .............................................................................................................. 1 Contraindications ................................................................................................................ 2 Adverse effects .................................................................................................................. 2 General warnings and cautions........................................................................................... 2 The Astral system ................................................................................................................... 4 The Astral device ................................................................................................................ 5 The Astral device interface ................................................................................................. 6 Touch screen ...................................................................................................................... 7 Information bar ................................................................................................................................... 8 Menu bar ............................................................................................................................................ 9 Bottom bar .......................................................................................................................................... 9 Main screen ........................................................................................................................................ 9 Pressure bar ........................................................................................................................................ 9 Circuits and patient interfaces .......................................................................................... 10 Patient circuit accessories ................................................................................................ 11 Optional accessories......................................................................................................... 11 Power supplies ................................................................................................................................. 11 Astral Mobility bag ............................................................................................................................ 11 ResMed Hospital Trolley ................................................................................................................... 11 Remote Alarm II ................................................................................................................................ 12 Pulse oximeter .................................................................................................................................. 12 Astral Desktop Stand ........................................................................................................................ 12 Using the Astral device ........................................................................................................ 13 Connecting to mains power.............................................................................................. 13 Powering on the device .................................................................................................... 13 Powering off the device.................................................................................................... 14 Accessing Clinical mode ................................................................................................... 14 Using the Setup Assistant ................................................................................................ 15 Starting and stopping ventilation ...................................................................................... 17 Locking and unlocking the touch screen .......................................................................... 18 Navigating the menus ....................................................................................................... 18 Navigating the menus ....................................................................................................................... 18 Monitors menu ................................................................................................................................ 19 Setup menu ..................................................................................................................................... 20 Alarms menu ................................................................................................................................... 20 Information menu ............................................................................................................................ 21 Programs .......................................................................................................................... 21 Working with programs .................................................................................................................... 21 Setting up a new program ................................................................................................................ 23 Adjusting patient settings ................................................................................................................. 24 Monitoring ventilation ....................................................................................................... 25 Device settings ................................................................................................................. 28 Adjusting device settings .................................................................................................................. 29 Assembling patient circuits ................................................................................................. 30 Circuit options .................................................................................................................. 30 Circuit adapters ................................................................................................................ 31 Fitting the circuit adapter .................................................................................................. 31 Connecting a single limb circuit with intentional leak ....................................................... 32 Connecting a single limb circuit for invasive use .............................................................................. 34 Connecting a single limb circuit with expiratory valve ...................................................... 34 Connecting a double limb circuit (Astral 150 only)............................................................ 36 Changing the circuit selection .......................................................................................... 36 Learn Circuit ..................................................................................................................... 37 Accessories ........................................................................................................................... 39 Attaching patient circuit accessories ................................................................................ 39 Attaching a humidifier ...................................................................................................... 39 Attaching a Heat Moisture Exchange (HME) .................................................................... 40 Attaching an antibacterial filter ......................................................................................... 41 Adding supplemental oxygen ........................................................................................... 42 Attaching a nebuliser ........................................................................................................ 44 Attaching other accessories ............................................................................................. 45 Attaching a pulse oximeter ............................................................................................................... 45 Attaching a remote alarm .................................................................................................................. 46 Astral Carry Bag ................................................................................................................ 47 Travelling with the Astral device ...................................................................................... 48 Power .................................................................................................................................... 49 Connecting to mains power ............................................................................................. 49 Connecting to a ResMed Power Station (RPSII) .............................................................. 50 Connecting the Astral External Battery ............................................................................ 51 Using the External Battery ................................................................................................................ 51 Using the internal battery ................................................................................................. 52 Battery run time ................................................................................................................................ 53 Storing and recharging ...................................................................................................................... 53 Connecting to an external DC power source.................................................................... 54 Using the Astral device for the first time ........................................................................... 55 Ventilation modes ................................................................................................................ 56 (A)CV mode - Assisted volume-controlled ventilation....................................................... 57 P(A)CV mode - Assisted pressure-controlled ventilation .................................................. 58 P-SIMV - Pressure Synchronised Intermittent Mandatory Ventilation .............................. 60 V-SIMV - Volume Synchronised Intermittent Mandatory Ventilation ................................ 62 PS mode - Pressure support ............................................................................................ 64 (S)T mode - Spontaneous Ventilation with backup rate .................................................... 66 P(A)C mode ...................................................................................................................... 67 CPAP mode ...................................................................................................................... 68 Flow shape settings ......................................................................................................... 69 Interdependence of controls............................................................................................. 70 Dynamic settings limits .................................................................................................................... 70 Automatic reconfiguration of settings .............................................................................................. 71 Triggering and cycling ....................................................................................................... 72 Triggering with intentional leak circuits ............................................................................................ 72 Cycling with intentional leak circuits ................................................................................................. 73 Triggering with valve circuits ............................................................................................................ 73 Changing the Trigger Type ................................................................................................................ 74 Cycling with valve circuits ................................................................................................................. 75 Supplementary features ...................................................................................................... 77 Manual breath settings ..................................................................................................... 77 Sigh settings ..................................................................................................................... 79 Apnoea Settings ............................................................................................................... 80 Control settings for Apnoea ventilation ............................................................................................ 80 (A)CV Breath pattern ......................................................................................................................... 81 P(A)CV breath pattern ....................................................................................................................... 81 Safety volume settings ..................................................................................................... 82 Mouthpiece settings ......................................................................................................... 83 Alarms ................................................................................................................................... 85 Alarm priority .................................................................................................................... 86 Viewing the active alarms ................................................................................................. 88 Muting alarms ................................................................................................................... 88 Resetting alarms ............................................................................................................... 89 Adjusting alarm settings ................................................................................................... 90 Setting the alarm volume.................................................................................................. 91 Testing the alarm sounders and indicators ....................................................................... 92 Testing the Remote Alarm................................................................................................ 93 Testing the alarms ................................................................................................................ 93 Testing the power alarms ................................................................................................. 94 Testing the pressure alarms ............................................................................................. 94 Testing the ventilation monitoring alarms ......................................................................... 95 Testing the oximetry alarms ............................................................................................. 95 Testing the oxygen alarms................................................................................................ 95 Testing the breathing circuit alarms .................................................................................. 96 Alarm settings and conditions ............................................................................................ 96 Tidal volume alarms .......................................................................................................... 96 Minute volume alarms ...................................................................................................... 97 Respiratory rate alarms ..................................................................................................... 97 Pressure alarms ................................................................................................................ 98 High pressure ................................................................................................................................... 98 Obstruction High pressure ................................................................................................................ 98 Low pressure .................................................................................................................................... 99 PEEP ............................................................................................................................................... 100 Breathing circuit alarms .................................................................................................. 100 High leak ......................................................................................................................................... 100 NV Mask.......................................................................................................................................... 101 Flow sensor not calibrated .............................................................................................................. 101 Circuit configuration alarms............................................................................................................. 101 Oxygen alarms ............................................................................................................... 101 Oximetry alarms ............................................................................................................. 102 SpO2 ............................................................................................................................................... 102 Pulse rate ........................................................................................................................................ 102 Apnoea alarm ................................................................................................................. 102 Ventilation stopped alarm ............................................................................................... 102 Power alarms ................................................................................................................. 103 System alarms ................................................................................................................ 103 Detecting circuit disconnection and de-cannulation ....................................................... 104 Data management process ............................................................................................... 106 Data management summary .......................................................................................... 107 Deleting patient data .......................................................................................................... 108 Cleaning and maintenance ................................................................................................ 109 Single patient use ........................................................................................................... 109 Weekly ............................................................................................................................................ 109 Monthly ........................................................................................................................................... 109 Multi-patient use ............................................................................................................ 110 Replacing components ................................................................................................... 110 Replacing the air filter ..................................................................................................................... 110 Replacing the expiratory flow sensor and antibacterial filter (Astral 150 only) ................................ 111 Replacing the double limb adapter (expiratory valve) ...................................................................... 113 Replacing the Oxygen sensor ......................................................................................................... 113 Replacing the internal battery ......................................................................................................... 114 Servicing ......................................................................................................................... 115 Maintenance Timetable................................................................................................................... 115 Internal Battery................................................................................................................................ 115 Device information .......................................................................................................................... 116 Additional considerations for hospital or healthcare facilities ......................................... 116 Technical specifications ..................................................................................................... 117 Monitoring ...................................................................................................................... 122 Time parameters ............................................................................................................................. 122 Volume and flow parameters .......................................................................................................... 122 Pressure parameters ....................................................................................................................... 123 Other parameters ............................................................................................................................ 123 Accuracy of controls ....................................................................................................... 124 Measurement System and Accuracy ............................................................................. 126 Functional variants .......................................................................................................... 127 Guidance and Manufacturer’s Declaration Electromagnetic Emissions & Immunity ..... 127 Guidance and manufacturer’s declaration—electromagnetic emissions ........................................ 127 Guidance and manufacturer’s declaration – electromagnetic immunity ......................................... 128 Recommended separation distances between portable and mobile RF
communications equipment and the device ................................................................................... 129 Symbols .......................................................................................................................... 130 Standards compliance..................................................................................................... 131 Training and support ....................................................................................................... 131 Alarm troubleshooting ....................................................................................................... 132 General troubleshooting ................................................................................................. 136 Recommendations for suctioning ..................................................................................... 138 Limited warranty ................................................................................................................ 139 Appendix A: Definitions ..................................................................................................... 140 Ventilation settings definitions........................................................................................ 140 Measured and calculated parameter definitions ............................................................. 142 Appendix B: Ventilation parameters ................................................................................. 144 Ventilation Parameters summary table ........................................................................... 144 Ventilation displayed parameters .................................................................................... 147 Supplementary Features ................................................................................................. 148 Supplementary Features displayed parameters ............................................................. 150 Appendix C: Alarm parameters ......................................................................................... 152 Alarm Parameters summary table .................................................................................. 152 Introduction
Introduction
The Astral device provides mechanical ventilation to both ventilation dependent and
non-dependent patients. It delivers pressure and volume ventilation through either a valve or
leak circuit, and is compatible with a range of accessories to support specific use cases.
The information in this guide applies to both the Astral 100 and the Astral 150 devices. Where
information applies to only one of these devices, that device will be specified.
WARNING

Read the entire manual before using the Astral device.

Use the Astral device only as directed by a physician or healthcare provider.

Use the Astral device only for the intended use as described in this manual. Advice
contained in this manual does not supersede instructions given by the prescribing
physician.

Install and configure the Astral device in accordance with the instructions provided in
this guide.
CAUTION
In the US, Federal law restricts this device to sale by or on the order of a physician.
Indications for use
The Astral device provides continuous or intermittent ventilatory support for patients weighing
more than 5 kg who require mechanical ventilation. The Astral device is intended to be used in
home, institution/hospital and portable applications for both invasive and non-invasive
ventilation.
CAUTION
The Astral device is not intended for use as an emergency transport ventilator.
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Introduction
Contraindications
The Astral device is contraindicated in patients with the following pre-existing conditions:

pneumothorax or pneumomediastinum

pathologically low blood pressure, particularly if associated with intravascular volume
depletion

cerebrospinal fluid leak, recent cranial surgery or trauma

severe bullous lung disease

dehydration.
Adverse effects
Patients should report unusual chest pain, severe headache or increased breathlessness. The
following side effects may arise during use of the device:

drying of the nose, mouth or throat

nosebleed

bloating

ear or sinus discomfort

eye irritations

skin rashes.
General warnings and cautions
The following are general warnings and cautions. Further specific warnings, cautions and notes
appear next to the relevant instruction in the manual.
A warning alerts you to possible injury.
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Introduction
WARNING

If you notice any unexplained changes in the performance of the device, if it is making
unusual or harsh sounds, if the device or the power supply are dropped or mishandled
discontinue use and contact your healthcare provider.

For ventilator-dependent patients, always have alternate ventilation equipment
available, such as a back-up ventilator, manual resuscitator or similar device. Failure to
do so may result in patient injury or death.

The Astral device is a restricted medical device intended for use by qualified, trained
personnel under the direction of a physician.

Ventilator-dependent patients should be continuously monitored by qualified
personnel or adequately trained carers. These personnel and carers must be capable of
taking the necessary corrective action in the event of a ventilator alarm or malfunction.

The Astral device is not intended to be operated by persons (including children) with
reduced physical, sensory or mental capabilities without adequate supervision by a
person responsible for the patient's safety.

The Astral device is not intended to be operated by patients unless they have been
given adequate instruction concerning the operation of the device by a person
responsible for the patient's safety.

The Astral device must not be used in the vicinity of an MRI device.

The effectiveness of ventilation and alarms should be verified including after any
ventilation or alarm setting change, any change in circuit configuration, or after a
change to co-therapy (eg, nebulisation, oxygen flow).

The Astral device and AC Power Supply can get hot during operation. To prevent
possible skin damage do not leave the Astral device or AC Power Supply in direct
contact with the patient for extended periods of time.
A caution explains special measures for the safe and effective use of the device.
CAUTION

Repairs and servicing should only be performed by an authorised ResMed service
representative.

The airflow for breathing produced by the device can be as much as 6ºC higher than
the temperature of the room. Caution should be exercised if the room temperature is
warmer than 35ºC.

Do not expose the device to excessive force, dropping or shaking.
A note advises of special product features.
Notes:

When using Astral for long term invasive ventilation in the home, due consideration should
be given to relevant practice guidelines such as the AARC Clinical Practice Guideline for
Long Term Invasive Mechanical Ventilation in the Home - 2007 Revision & Update
(www.rcjournal.com/cpgs/pdf/08.07.1056.pdf)

For assistance and reporting of issues associated with the Astral device, contact your Health
Care Provider or authorised ResMed representative.
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The Astral system
The Astral system
The Astral system comprises a number of components, including:

Astral device with:
- hypoallergenic air inlet filter
- internal battery

Power Supply Unit (PSU)

AC Power cord

Astral carry bag

Single limb adapter

Single limb leak adapter

Double limb adapter (Astral 150)

ResMed USB stick

Astral User Guide
 Astral Clinical Guide CD.
Optional accessories are also available for use with the Astral device, and include:

Remote Alarm II

Astral External Battery

Astral Mobility Bag

ResMed Hospital Trolley

ResMed HumiCare D900 Humidifier
 Pulse oximeter.
For a full list of accessories, see the Ventilation accessories guide on www.resmed.com on the
Products page under Service and Support. If you do not have internet access, please contact
your ResMed representative.
WARNING
Before using any accessory, always read the accompanying User Guide.
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The Astral system
The Astral device
The following images describe the components of the Astral device.
Description
1
Adapter port
Can be fitted with single limb adapter, single limb leak adapter or double limb adapter (Astral 150 only).
2
Handle
3
Inspiratory port (to patient)
Provides an outlet for pressurised air to be delivered to the patient via the patient circuit. Includes FiO2 sensor
on the Astral 150. The FiO2 sensor is an optional accessory on the Astral 100.
4
Ethernet connector (service use only)
5
USB connector (for download to ResScan)
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The Astral system
6
Mini USB connector (service use only)
7
DC power inlet
8
Device on/off push button
9
SpO2 Sensor connector
10
Remote alarm five pin connector
11
Low flow oxygen input (up to 30 L/min)
12
Air inlet (complete with hypoallergenic filter)
The Astral device interface
The interface of the Astral device comprises several different features described in the
following image.
Description
1
Touch screen
2
Power source indicators
AC (mains power supply)
DC (external battery or car accessory adapter)
Internal battery
3
Therapy on/off indicator
Device ready
Constant green display when the device is turned on but not ventilating.
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The Astral system
Device ventilating
Flashes blue when the device is ventilating and the Ventilation LED setting is 'ON'.
Otherwise is 'OFF'.
4
Alarm mute/reset button
Illuminates when an alarm is triggered and flashes when the sound is muted.
5
Alarm bar
Flashing red
High priority alarm
Flashing yellow
Medium priority alarm
Constant yellow
Low priority alarm
Touch screen
The main method of interacting with the Astral device is via the touch screen. The display on
the touch screen changes according to the function being performed.
Description
1
Clinical mode access button
Locked
2
Unlocked
Manual breath button
only shown if enabled
3
Information bar
4
Internal battery indicator
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The Astral system
5
Lock touch screen button
6
Menu bar
7
Bottom bar
8
Start/Stop ventilation button
9
Main screen
10
Sub-menus
11
Pressure bar
Information bar
The Information bar is displayed at the top of the touch screen. The Information bar displays the
operating status of the device, including patient type, current circuit configuration, programs,
information messages, ventilation status, alarms and power status.
Description
Patient type – Adult
Patient type – Paediatric
Circuit type – Single limb with intentional leak
Circuit type – Single limb with expiratory valve
Circuit type – Double limb
P1
Program number and ventilation mode in use
(A)CV
Multiple alarms are active simultaneously. The highest priority active alarm is displayed first.
Message
window
Will display alarms or information. Image above shows device in Standby. (Displayed when the device is
powered on but not ventilating). Date and time will be displayed when the device is ventilating and there
are no active alarms.
Information messages are displayed in blue text. If the device Alert tone setting is 'On', you will be alerted
to new information messages by a single beep.
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The Astral system
Menu bar
The Menu bar provides access to the four main menus in the Astral device.
Monitors menu
View real-time patient data in either waveform or monitoring formats including pressure, flow, leak,
tidal volume, synchronisation and oximetry.
Setup menu
Configure and view ventilation therapy and device settings.
Alarms menu
Configure and view alarms including alarm volume.
Information summary menu
View therapy statistics, used hours, events, reminder and device information.
Bottom bar
The Bottom bar changes with the function of the device.
It can display buttons to Stop or Start ventilation and Apply or Cancel functions. It can also
display real-time readings.
Main screen
The Main screen displays the monitoring data, ventilation and device controls. Each function is
accessed through the various menus and tabs.
Pressure bar
The Pressure bar displays real-time therapy data while the Astral device is ventilating.
Patient pressure is shown as a bar graph. Peak inspiratory pressure is shown as a numerical
value and watermark. Spontaneously triggering and cycling is indicated by
and
.
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The Astral system
The example below displays the pressure bar when a patient is spontaneously breathing.
Description
1
2
Peak inspiratory pressure (PIP) value
Spontaneous cycled breath marker—indicates patient-cycled breath
3
Peak inspiratory pressure marker
4
Current pressure
5
Positive end expiratory pressure (PEEP) setting
6
Spontaneous triggered breath marker—indicates patient-triggered breath
Circuits and patient interfaces
The following circuits are available for use with the Astral device.

Single limb circuit with intentional leak (provides a leak compensated estimate of patient
flow and exhaled tidal volume)

Single limb circuit with expiratory valve
 Double limb circuit (exhaled gas returns to the device for monitoring). (Astral 150 only)
The Astral device is compatible with the following invasive and non-invasive patient interfaces:
Invasive

endotracheal tubes

tracheostomy tubes
Noninvasive

vented and non-vented masks

mouthpiece.
WARNING
When using a noninvasive interface, the measurement of patient exhaled gas volume may
be affected by leak.
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The Astral system
Patient circuit accessories
The following patient circuit accessories are available for use with the Astral device:

Humidifier

Heat Moisture Exchange (HME)
 Antibacterial filter
For information on attaching and using patient circuit accessories, see Attaching patient circuit
accessories (see page 39).
Optional accessories
WARNING
The Astral device should only be used with accessories recommended by ResMed.
Connection of other accessories could result in patient injury or damage to the device.
The Astral device is compatible with a range of accessories as follows:

ResMed External Battery

Astral DC adapter

Astral Mobility Bag

ResMed Hospital Trolley

ResMed Remote Alarm II

Pulse Oximeter

Astral Desktop stand.
Power supplies
In addition to the internal battery and mains power sources, the Astral device can be powered
from the following sources:

ResMed External Battery

Astral DC adapter.
Astral Mobility bag
The Astral Mobility Bag offers extra protection to the Astral device and enables patients to easily
transport the device while ventilating. The bag may be carried by hand, worn as a backpack or
attached to a wheelchair.
The bag holds the Astral device, optional battery pack and an Astral power supply unit.
ResMed Hospital Trolley
The ResMed Hospital Trolley is designed to hold and move compatible ResMed ventilators and
accessories between points of therapy in the hospital and limited care facilities. For further
information, see the Hospital Trolley user guide.
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The Astral system
Remote Alarm II
The Remote Alarm II is self-powered (via battery) and connected to the Astral device via a cable.
If required, a second Remote Alarm can be attached to the first Remote Alarm. This enables
Remote Alarms to be placed in two separate locations. The Remote Alarm II can also be
connected to a hospital alarm management system. For more information, see the Remote
Alarm II user guide.
Pulse oximeter
Attaching a pulse oximeter to the Astral device enables real-time SpO2 and pulse readings to be
viewed from the Monitoring menu. For further information, see Attaching a pulse oximeter (see
page 45).
Astral Desktop Stand
The Astral Desktop Stand provides an ergonomic and convenient solution for placing the Astral
device on a bedside table. The stand holds the Astral at an inclined angle for convenient
operation by both the carer and the patient. The stand holds both the Astral device and its
external power supply.
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Using the Astral device
Using the Astral device
WARNING
Make sure the area around the device is dry, clean and clear of bedding or clothes or other
objects that could block the air inlet. Blocking the cooling vents could lead to overheating
of the device. Blocking the air inlet could lead to patient injury.
CAUTION

To prevent possible damage to the ventilator, always secure it to its stand or place it
on a flat, stable surface. For mobile situations, ensure the Astral device is contained
within its mobility bag.

Ensure the device is protected against water if used outdoors.
Connecting to mains power
To connect to mains power:
1. Connect the DC plug of the supplied ResMed external power supply unit to the rear of the
Astral device.
2. Connect the power cord to the ResMed power supply unit.
3. Plug the other end of the power cord into the power outlet.
For further information on powering the Astral device, see Power (see page 49).
Powering on the device
To power on the Astral device, simply press the green power on/off button at the back of the
device. The device will perform a system check as shown on the main screen.
On completion of the system check, the Patient Home screen and active program is displayed.
The Astral device is factory pre-set with one active program.
If more than one program displays on the Patient Home screen, the active program will be
highlighted orange. For further information, see Programs (see page 21).
Note: Settings configured in the active program will be used when ventilation is started.
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Using the Astral device
Powering off the device
The Astral device can only be powered off when ventilation is stopped.
Removing AC power does not power off the device. The device remains powered on internal
battery.
Turning off the device must be done manually and must be performed before leaving the device
disconnected from AC power for any extended period of time. Failure to do so may result in
battery depletion and activation of alarms.
To power off the device, press the green on/off button at the back of the device and follow the
on-screen prompts. To ensure the device is fully powered down, touch the screen.
Note: While the device remains connected to external mains power, the internal battery
continues to charge.
Accessing Clinical mode
The closed padlock
indicates the device is in Patient mode. To access clinical functions, such
as the Setup Assistant and program configurations, you must enter Clinical mode.
Clinical mode can be accessed from any screen, whether or not the Astral device is ventilating.
To access Clinical mode:
1. From the patient home screen, press and hold
for 3 seconds, then release.
2. Select:
- 20 min—the device will return to patient mode after 20 minutes of inactivity, or
- Unlimited—the device will remain unlocked until powered off or manually locked.
CAUTION
Only select Unlimited if the device will remain under the continuous supervision of
qualified trained personnel under the direction of a physician.
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Using the Astral device
The padlock is unlocked and the Main Settings screen is displayed.
To exit Clinical mode:
1. Press
. The Exit Clinical Mode screen is displayed.
2. Press Confirm. The padlock is locked and the Patient Home screen is displayed.
Note: If you do not make a selection within 7 seconds, the device returns to the previous
screen.
Using the Setup Assistant
To quickly set up the Astral device and start ventilation, use the Setup Assistant.
The Setup Assistant guides you through the process of setting up the device for use by a new
patient. The Setup Assistant prompts you to assemble components and automates testing of
the circuit. For detailed instructions on assembling patient circuits, and other components and
accessories, see Assembling patient circuits. (see page 30)
The Setup Assistant can only be accessed when the Astral device is in Clinical mode.
Note: Using the Setup Assistant will clear the current settings of the active program.
To use the Setup Assistant:
1. Access Clinical mode.
2. From the Main menu press Setup
. The Setup menu is displayed.
3. Select Setup Assistant and press Start.
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Using the Astral device
4.
A warning message will display. Select Continue.
5. Select the patient type. This will automatically configure default alarm and setting ranges.
6. The Select Circuit type screen is displayed. Select the circuit type to be connected to the
device.
7. The Learn Circuit screen is displayed. Press Start.
8. Follow the prompts to attach and test the circuit. For detailed instructions on how to attach
the circuit, see Assembling patient circuits (see page 30).
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Using the Astral device
When the Learn Circuit is complete, you will be prompted to select your required ventilation
mode.
9. The default settings for the mode are displayed.
10. Review and adjust the settings and alarms as required.
For further information on adjusting setting parameters and alarm settings, see Adjusting
patient settings (see page 24) and Adjusting alarm settings (see page 90).
11. Press
to start ventilation.
Starting and stopping ventilation
WARNING
Always ensure that the values in the ventilation therapy and alarm settings are
appropriate before starting therapy.
Note: If using the device for the first time, ResMed recommends performing a functional test
before starting ventilation. See Using the Astral device for the first time (see page 55).
To start ventilation:
1. Press the green on/off button at the back of the device (if power is not already on).
2. Press
. Ventilation is started.
3. Add oxygen if required.
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Using the Astral device
To stop ventilation:
Ventilation can be stopped at any time and from any screen.
1. If oxygen is connected, turn off the oxygen.
.
2. Press and hold
when prompted.
3. Release
4. Press Confirm. Ventilation is stopped.
Locking and unlocking the touch screen
The touch screen can be unlocked at any time in both Patient and Clinical modes.
To manually lock the touch screen, from the Information bar press
is locked the button is highlighted orange.
. When the touch screen
Unlocking the touch screen
Touch the screen anywhere and follow the on-screen prompts.
Navigating the menus
The Astral device has four menus accessible via the Menu bar. Each menu is further broken
down into various sub-menus.
Navigating the menus
This chapter focuses on what the menus are and their structure. For information on adjusting
and configuring features, see Using the Astral device (see page 13).
Waveforms
Monitors
Monitoring
Trends
Programs*
Setup
Setup Assistant*
Circuit
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Settings
Main Settings
Manual Breath
Data Transfer
Transfer Data
Import / Export
Device Config.
Display
Date / Time
Units / Option
Reset
Using the Astral device
Alarms 1
Tidal Volume (Vt)
Minute Ventilation (Mv)
Respiratory Rate
Pressure
Low PEEP
Alarms 2
Ventilation Stop
Leak
Non-vented Mask (NV Mask)
Alarms 3
FiO2
SpO2
Pulse
Apnoea Response
Apnoea Response
Apnoea Definition
Alarm Volume
Alarm Level
Alarm Test
Events
Alarms
Settings
System
Device
Information
Alarms
Information
* Available in Clinical mode only.
Monitors menu
The Monitors menu allows you to view real-time ventilation data and is comprised of three submenus:

Waveforms

Monitoring

Trends
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Using the Astral device
Setup menu
The Setup menu displays six different sub-menus:

Programs—to configure therapy programs

Setup Assistant—guides you through device setup

Circuit—to set up the circuit

Settings—to change the ventilation mode and related settings

Data transfer—to transfer data between the device and a personal computer via a USB stick

Device config.—to change the device configuration.
Alarms menu
Display the Alarms menu to view/update the individual thresholds for each alarm to trigger.
Real-time values are displayed between the upper and lower thresholds. The options available
for adjustment change depending on the circuit configuration.
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Using the Astral device
Information menu
The Information menu is comprised of two sub-menus:

Events—all logged event activity that has taken place is displayed. A breakdown of specific
alarms, settings or system events can also be viewed.

Device—information about the actual device is displayed, eg, Model and Serial numbers,
software versions, internal battery health along with the hours since the last service and
patient hours used.
Programs
WARNING
The safety and effectiveness of ventilation therapy and alarms settings should be verified
for each enabled Program.
Working with programs
The Astral device comes factory preset with one active program. Additional programs can be
enabled. Astral 100 provides a maximum of two programs. Astral 150 provides for a maximum
of four programs.
Programs allow for different circuit, ventilation and alarm settings. Programs provide convenient
patient access to different device configurations to suit their needs such as sleeping, daytime
use, and exercise or physiotherapy. Once configured, enabled programs can be selected from
the Patient Home Screen.
When configuring each new program, connect the appropriate circuit and perform a Learn
Circuit.
To enable / disable additional programs:
1. Access Clinical mode.
2. From the Setup main menu, select Programs.
3. Enable additional programs by pressing the slider.
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Using the Astral device
Note: The current active program is highlighted in orange and cannot be disabled.
In the screen below, P1: (A)CV is the current active program. P2 has been enabled and is
showing the factory preset mode.
4. Select P2: (A)CV. P2 becomes the active program.
5. Select and start the Setup assistant. See Using the Setup Assistant (see page 15).
Once the Setup assistant is complete, P2 will now be configured to the settings you have
chosen and is ready to Start ventilation. In the example below, P2 has been changed from
(A)CV mode to P(A)CV.
Note: Each program retains its own circuit configuration. When switching between
programs, ensure you use the correct circuit as 'learned' for that program.
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Using the Astral device
Setting up a new program
Adjustments to program settings can only be made to the current active program. To make
changes to settings of other programs, you must first activate that program.
Adjustments to patient settings can be made while the device is Ventilating or in Standby mode.
WARNING
Always review and adjust Alarm Settings when setting up a new program. For
information, see Adjusting alarm settings (see page 90).
To adjust the Ventilation mode of the current active program:
1. Access Clinical mode, the Main Settings screen will be displayed automatically.
The current active Ventilation mode and settings are displayed.
2. Press the Ventilation mode button. The Select Ventilation Mode screen will display, the
current active Ventilation mode will be highlighted orange. Select your required Ventilation
mode.
You will be returned to the Main Settings page. All changes you have made will be outlined
in orange, indicating a pending status until you press Apply. If the mode change is cancelled
you will be returned to the current active mode's primary settings page. Any modifications
will be disregarded.
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Using the Astral device
Once settings have been applied the program is updated with the new Mode selection.
Perform a Learn Circuit.
To make changes to the patient settings within this mode, see Adjusting patient settings
(see page 24).
Note: If the mode change is cancelled you will be returned to the current active mode's
primary settings page. All modifications will be disregarded.
Adjusting patient settings
To adjust patient settings of the current active program:
1. Access Clinical mode.
The Main settings screen will be displayed.
2. Select the setting that you want to adjust. The selected setting is highlighted in orange and
the up and down scroll arrows appear.
3. Increase or decrease the selected setting as desired.
4. If adjustments to other selected settings are required, select the desired settings and repeat
this process. All settings that have been adjusted are shown with an orange outline.
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Using the Astral device
5. If no further adjustments are required, select Apply.
6. Review and adjust alarm settings as required. For information, see Adjusting alarm settings
(see page 90).
Notes:

The Apply button is disabled if one or more settings cannot be applied. See Interdependence
of controls (see page 70). A message is displayed indicating the reason.

If the mode change is cancelled you will be returned to the current active mode's primary
settings page. All modifications will be disregarded.
Monitoring ventilation
During ventilation, ventilation parameters are continuously monitored and displayed in real-time.
The measures are displayed as follows:

Numerical values on the Monitoring screen and a summary of critical values in the bottom
bar

Graphically on the Waveforms, Trends screen and Pressure bar.
Monitoring screen
The Monitoring screen displays all measured parameters in numerical form.
For details on the available monitoring parameters see the Ventilation Parameters Summary
Table (see page 144).
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Using the Astral device
Waveforms
The Waveforms screen displays the last 15 seconds of patient airway pressure and flow in a
graph. The graph updates in real-time.
Description
1
Spontaneous triggered breath marker—indicates patient-triggered breath.
2
White vertical cursor—indicates the current position and moves from left to right.
Continuously displayed monitors
During ventilation, the Bottom bar displays the current measures for VT, MV, Resp.rate, Ti, %
Spont Trig, and Leak. For a detailed description of the Bottom bar see Getting to know the Astral
device (see page 6).
During ventilation, the Pressure bar displays real-time airway pressure, PEEP and PIP. For a
detailed description of the Pressure bar see Getting to know the Astral device (see page 6).
Both the Bottom bar and Pressure bar remain visible from other screens. This permits critical
ventilation parameters to be continuously monitored while performing other tasks on the Astral
device.
Note: The ventilation measures on the Bottom bar will be hidden while an action request is
displayed. For example Apply/Cancel.
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Using the Astral device
Trends screen
The Trends screen shows the 5th and 95th percentile values, as well as the median for the last
30 days for each of the following parameters:

Leak

Minute ventilation

Peak inspiratory pressure

Tidal volume

Respiratory rate

Inspiratory time

SpO2

Pulse rate

FiO2
Information is displayed as bar graphs, with two graphs per screen.
Use the up and down scroll arrows to cycle through the graphs.
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Using the Astral device
Device settings
All device configuration settings are stored independently of patient programs. The configurable
settings are described in the following table.
Device setting Adjustable Description
by patient
Determines how to set-up the inspiratory phase for volume controlled breaths.
Inspiratory
Phase Duration
Options
Can be set to either Ti Option or PIF Option.
Default: Ti Option
Alert tone
Y
Sets alert tones to on or off.
Default: On
Note: When 'On' you will be alerted to the display of new information messages by a
single beep.
Alarm volume
Y
Sets the volume level of the alarm system.
Settings from 1, 2, 3, 4 or 5.
Default: 3
Auto power off
Y
Automatically powers off the device after 15 minutes of inactivity.
Conditions: The device is in Ventilation standby mode (not ventilating), is being
powered by the Internal battery or an External battery
Default: On
Minimum alarm
volume
Display
brightness
Allows a minimum volume level to be set for the device. Any setting less than the set
minimum will be visible, but greyed out (and therefore not able to be selected).
Y
Sets the brightness of the screen from Auto with a selection of five different
brightness levels.
Default: Auto
Backlight
timeout
Y
Allows the screen backlight to turn off (go black) if the screen has not been touched
for two minutes or more and there are no active alarms.
Setting to 'Off' will mean the screen back-light will be permanently on.
Default: On
Rotate display
Y
Device Vent LED Y
Flips the current orientation of the display.
Sets the status of the Ventilation active LED to On or Off during ventilation.
Default: On
Date
Y
Allows setting of the day, month and year of the current date.
Time
Y
Allows setting of the hours and minutes of the current time.
Language
Y
Sets the current language of the device selected from the list of available languages.
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Using the Astral device
Device setting Adjustable Description
by patient
Pressure Unit
Specifies displayed units for all pressure data and settings as cm H2O, mBar or hPa.
Default: cm H2O
Note: The reference unit for all accuracy and monitoring claims is hPa. The conversion
factor between units in accordance with industry practice is one.
Adjusting device settings
Access adjustable device settings from the Setup menu and select Device config.
The current active selections are highlighted in orange.
To change settings, simply select another of the available options. The revised setting is
highlighted in orange.
In Patient mode, only the settings that can be adjusted are displayed.
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Assembling patient circuits
Assembling patient circuits
WARNING

Use a double limb circuit for direct measurement of exhaled volumes. In this
configuration, the expired volume is returned to the ventilator for independent
measurement. (Astral 150 only)

The Astral device does not support monitoring of exhaled volumes when used with a
single limb circuit with expiratory valve.

The patient circuit should be arranged so as not to restrict movement or pose a
strangulation risk.

Only use circuit components that comply to the relevant safety standards including
ISO 5356-1 and ISO 5367.
CAUTION
For paediatric use, ensure that the patient circuit type fits and is suitable for use with a
child. Use a paediatric patient type for patients that weigh less than 23 kg and normally
require less than 300 mL tidal volume.
Circuit options
The Astral device supports a range of circuits with the use of interchangeable circuit adapters.
Breathing circuits may be of 10, 15 or 22 mm diameter.
The following table may assist in selecting suitable circuits and settings for different patient
types
Tidal volume range
Recommended patient type
setting
Suitable circuit diameters
50 mL to 300 mL
Paediatric
10 mm, 15 mm or 22 mm
> 100 mL
Adult
15 mm or 22 mm
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Assembling patient circuits
Circuit adapters
There are three circuit adapters:
Adapter
For use with
1
Single limb leak
Single limb circuit with intentional leak
2
Single limb
Single limb circuit with expiratory valve (expiratory valve integrated into the circuit)
3
Double limb
(Astral 150 only)
Double limb circuit (expiratory valve integrated into the adapter) OR single limb
circuit with intentional leak
A Learn Circuit should be performed after any change of circuit. Astral will provide accurate therapy as long as the
Learn Circuit is passed. See Learn Circuit (see page 37).
Fitting the circuit adapter
Before connecting the patient circuit, the adapter specific to the required circuit type must be
fitted.
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Assembling patient circuits
To fit the adapter:
1. Turn over the device and place on a soft surface (to protect the LCD screen).
2. Press and hold the eject button. Pull the cover out towards you.
3. Lift the adapter out of the socket.
4. Replace with the new adapter, ensuring it sits firmly in the socket.
5. Place the cover over the enclosure, ensuring the runners on the device and the cover are
aligned. Slide the cover back into place until the latch clicks.
Connecting a single limb circuit with intentional leak
An intentional leak may be provided in-line using the ResMed Leak Valve or via an integrated
mask vent.
When using a circuit with intentional leak, estimation of the patient respiratory flow is enhanced
by ResMed's automatic leak management feature Vsync. Vsync technology allows the device
to estimate the patient respiratory flow and tidal volume in the presence of unintentional leak.
WARNING

At low pressures, the flow through the mask vents may be inadequate to clear all
exhaled gases, and some rebreathing may occur when using a single limb circuit with
intentional leak.

Ensure the vent holes at the mask or at the ResMed Leak Valve are unobstructed.
Ensure the area around the vent holes is clear of bedding, clothes, or other objects and
that the vents holes are not directed towards the patient.
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Assembling patient circuits
To connect a single limb circuit with intentional leak:
1. Check the device is fitted with the single limb leak adapter. Otherwise, change the adapter.
2.
3.
4.
5.
6.
Note: The Astral 150 can also support a single limb circuit with intentional leak using a double
limb adapter.
Connect the inspiratory limb to the inspiratory port.
Attach any required circuit accessories (eg, humidifier or filter).
Select the circuit type and perform a Learn Circuit.
If using a non-vented mask or tracheostomy connector, attach a ResMed Leak Valve to the
free end of the air tubing ensuring that the Leak Valve is as close as possible to the patient.
Attach the patient interface (eg, mask) to the Leak valve or the free end of the air tubing as
appropriate and adjust the mask type setting on the Astral device.
Note: If using the ResMed Leak Valve, select Leak Valve for the Mask type setting.
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Assembling patient circuits
Connecting a single limb circuit for invasive use
CAUTION
Always set up the ResMed Leak Valve in the breathing circuit with the arrows and the
symbol pointing in the direction of air flow from the Astral device to the patient.
For invasive ventilation, since the patient's upper respiratory system is bypassed by an artificial
airway device (for example endotracheal or tracheostomy tube) humidification of the inspired
gas is required to prevent lung injury.
Connecting a single limb circuit with expiratory valve
In a single limb circuit with expiratory valve, air pressure at the patient is monitored using the
proximal pressure sensor line.
To enable fast and accurate connection, use an Astral Quick Connect Single Limb Circuit. This
custom accessory with its integrated proximal pressure sensor and expiratory valve control line,
is designed specifically for use with Astral ventilators.
To connect an Astral 'Quick Connect' Single Limb Circuit with expiratory valve:
1. Check the device is equipped with the single limb adapter (otherwise change the adapter).
2. Connect the air tubing to the inspiratory port on the device.
3. Attach the Astral Quick Connect circuit to the single limb adapter on the device (see diagram
below).
4. Attach any required circuit accessories (eg, humidifier or filter).
5. Select the circuit type and perform a Learn Circuit.
6. Attach a patient interface (eg, mask) to the connector on the pneumatic valve.
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Assembling patient circuits
To connect a standard single limb valved circuit to the Astral:
1. Connect the Proximal pressure line to the upper connector of the Astral device single limb
adapter.
2. Connect the PEEP control line to the lower connector of the Astral device single limb
adapter.
3. Connect the air tubing to the inspiratory port of the device.
4. Attach any required circuit accessories (eg, humidifier or filter).
5. Select the circuit type and perform a Learn Circuit.
6. Attach a patient interface (eg, mask) to the connector on the pneumatic valve.
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Assembling patient circuits
Connecting a double limb circuit (Astral 150 only)
A flow sensor within the Astral device measures exhaled air flowing through the expiratory
valve integrated into the double limb circuit adapter. (This arrangement enables patient-exhaled
tidal volume to be accurately measured and monitored).
To connect a double limb circuit:
1. Ensure the device is fitted with the double limb adapter (otherwise change the adapter).
2. Connect the ends of the air tubing to the inspiratory and adapter ports on the device.
3. Attach any required circuit accessories (eg, humidifier or filter).
4. Select the circuit type and perform a Learn Circuit.
5. Attach a patient interface (eg, mask) to the end of the air tubing.
Changing the circuit selection
To change the circuit selection on the Astral device:
1. From the Setup main menu, select Circuit.
2. Select Change Circuit Type. (The current circuit type will be shown in orange).
3. Select the circuit you want to change to which will be highlighted orange. You will be taken
to the Learn Circuit screen.
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Assembling patient circuits
4. Press Start to run the Learn Circuit and follow the on-screen prompts.
Learn Circuit
In order to support a wide range of circuit configurations and accessories, the Astral device
provides a Learn Circuit function to determine the impedance and compliance characteristics of
the circuit. As part of the Learn Circuit functionality the Astral performs a device self-test where
the Oxygen cell and expiratory flow sensors are checked and calibrated.
CAUTION
To ensure optimum and accurate performance, it is recommended that the Learn Circuit
function be performed with every change of circuit and at regular intervals not less than
once per month.
Do not connect patient interfaces prior to performing the Learn Circuit. Patient interfaces
include any components placed after the single circuit's expiratory valve or exhalation port, or
double limb circuit's 'Y' piece (eg. HMEF, catheter mount, mask, tracheostomy tube).
The following table may assist in selecting suitable circuits and settings for different patient
types
Tidal volume range
Recommended patient type
setting
Suitable circuit diameters
50 mL to 300 mL
Paediatric
10 mm, 15 mm or 22 mm
> 100 mL
Adult
15 mm or 22 mm
To perform a Learn Circuit:
1. From the Setup main menu, select the Circuit sub-menu.
2. Press Start and follow the on-screen prompts.
Do not connect patient interfaces prior to performing the Learn Circuit. Patient interfaces
include any components placed after the single circuit's expiratory valve or exhalation port, or
double limb circuit's 'Y' piece (eg. HMEF, catheter mount, mask, tracheostomy tube).
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Assembling patient circuits
The prompts will guide you through a number of steps including:

With the patient interface disconnected from the patient connection port, the Astral device
will characterise the impedance of the inspiratory path.

With the patient connection port sealed, the Astral device will characterise the total circuit
compliance, and then the impedance of the expiratory path.
A test result screen is displayed if any of the tests fail, otherwise the Learn Circuit
function has been successfully completed and you will be returned to the Main settings
page.
The following icons are used to report the Learn Circuit results.
Description
Icon
Ok
Learn Circuit has passed
Caution! Circuit resistance is high. The device will use the learned circuit characteristics. Accuracy of
control and monitoring may not be met. Ensure that ventilation and alarms are effective before
proceeding further.
Warning! Learn Circuit has failed. Default circuit characteristics will be applied.
Accuracy of control and monitoring will be degraded. Ensure that ventilation and alarms are
effective before proceeding further.
Care must be taken to ensure the resistance of the ventilator breathing circuit is appropriate to
the patient size. Should ventilation cease for any reason, the patient must overcome this
resistance in order to breath.
The International Standards Organisation (ISO) has judged that patients ventilated with tidal
volumes in excess of 300 mL should use breathing circuits with a resistance no more than
6 cm H2O pressure drop at a flow rate of 30 L/min.
The Astral Learn Circuit applies a pass/fail threshold of 6 cm H2O at 30 L/min in Adult range, and
6 cm H2O at 15 L/min in Paediatric range.
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Accessories
Accessories
For a full list of accessories, see the Ventilation accessories guide on www.resmed.com on the
Products page under Service and Support. If you do not have internet access, please contact
your ResMed representative.
Attaching patient circuit accessories
WARNING

Adding or removing circuit components can adversely affect ventilation performance.
ResMed recommends performing a Learn circuit every time an accessory or component is
added to or removed from the patient circuit.

Do not use electrically conductive or anti-static air tubing.
Attaching a humidifier
A humidifier or HME is recommended for use with the Astral device.
WARNING

For invasive ventilation, since the patient's upper respiratory system is bypassed by an
artificial airway device (for example endotracheal or tracheostomy tube) humidification
of the inspired gas is required to prevent lung injury.

Always place the humidifier on a level surface below the level of the device and the
patient to prevent the mask and tubing filling with water.

Only use humidifiers that comply to the relevant safety standards, including ISO 8185
and set up the humidifier according to the manufacturer's instructions.

Monitor the air tubing for water condensation and / or spillage from the humidifier.
Use appropriate precautions to prevent water in the circuit transferring to the patient
(eg, a water trap).
For non-invasive ventilation, for patient experiencing dryness of the nose, throat or mouth,
humidification of the inspired gas will prevent subsequent irritation and discomfort.
CAUTION
Make sure that the water tub is empty and thoroughly dried before transporting the
humidifier.
To attach a humidifier to a patient circuit:
1. Connect a length of air tubing to the inspiratory port on the device.
2. Connect the other end of the air tubing to the inlet port on the humidifier.
3. Connect the patient circuit to the outlet port on the humidifier.
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Accessories
The image below shows proper use of a humidifier in combination with a double limb circuit.
When using heated humidification with a double limb circuit, condensation may form in the
expiratory flow sensor if the air is cooled to below its dew point. Condensation may also form in
the patient circuit and is most likely to form at high humidity settings and low ambient
temperatures.
Condensation forming in the expiratory flow sensor may cause a loss of expiratory flow
measurement and compromised therapy.
To prevent condensation at the Expiratory flow sensor, always follow the manufacturer's
instructions on how to prevent condensation and regularly check the patient circuit for
condensation.
To ensure accurate therapy, Astral's Learn Circuit function should be performed.
Attaching a Heat Moisture Exchange (HME)
HME's are passive humidification systems that retain heat and moisture from the patient's
exhaled gases via an internal membrane. An HME should not be used with active
humidification. An HME can be used with the Astral device with a double limb circuit or single
limb circuit with integrated valve.
WARNING
Only use HMEs that comply to the relevant safety standards, including ISO 9360-1 and
ISO 9360-2.
Place the HME between the patient end of the circuit and the patient interface.
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Accessories
Do not connect patient interfaces prior to performing the Learn Circuit. Patient interfaces
include any components placed after the single circuit's expiratory valve or exhalation port, or
double limb circuit's 'Y' piece (eg. HMEF, catheter mount, mask, tracheostomy tube).
Attaching an antibacterial filter
WARNING

Regularly check the antibacterial filter and expiratory valve for signs of moisture or
other contaminants, particularly during nebulisation or humidification. Failure to do so
could result in increased breathing system resistance and/or inaccuracies in expired
gas measurement.

Only use antibacterial filters that comply to the relevant safety standards, including
ISO 23328-1 and ISO 23328-2.
CAUTION
The antibacterial filter must be used and replaced according to the manufacturer's
specifications.
To attach an antibacterial filter:
1. Fit the antibacterial filter to the inspiratory port of the device.
2. Connect the air tubing to the other side of the filter.
3. Perform the Learn Circuit function.
4. Attach the patient interface to the free end of the air tubing.
WARNING

To prevent the risk of cross-contamination, an antibacterial filter is mandatory if the
device is to be used on multiple patients.

The expiratory module, internal antibacterial filter, expiratory flow sensor and cushion
come into contact with exhaled gases but do not form part of the inspiratory pathway.
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Accessories
Adding supplemental oxygen
The Astral device is designed to be compatible with levels of supplemental oxygen up to
30 L/min.
At a fixed rate of supplemental oxygen flow, the inhaled oxygen concentration will vary
depending on the Ventilation mode and settings, patient breathing pattern, mask selection, and
leak rate.
WARNING

Use only medical grade oxygen sources.

Always ensure that the device is ventilating before the oxygen supply is turned on.

Oxygen flow must be turned off when the device is not ventilating so that oxygen does
not accumulate within the device enclosure. Explanation: Accumulation of oxygen
presents a risk of fire. This applies to most types of ventilators.

Oxygen supports combustion. Oxygen must not be used while smoking or in the
presence of an open flame. Only use oxygen in well-ventilated rooms.

Supplemental oxygen must be added into Astral’s oxygen inlet at the rear of the
device. Adding oxygen elsewhere, ie, into the breathing system via a side port or at the
mask, has potential to impair triggering and accuracy of therapy/monitoring and impair
alarms (eg, High Leak alarm, Non-vented mask alarm)

The patient circuit and the oxygen source must be kept at a minimum distance of 2 m
away from any sources of ignition.

Monitor supplemental oxygen using the integrated FiO2 sensor and alarms. To monitor
the fraction of inspired oxygen, use an external O2 monitor compliant with ISO 806012-55. Sampling should be taken from the connection to the patient interface.

When operating Astral in its mobility bag do not add more than 6 L/min of
supplemental oxygen.

Astral is not designed for use with heliox, nitric oxide or anaesthetic gases.

Do not position the Astral device on its side as this may affect FiO2 monitoring
accuracy.
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Accessories
To add supplemental oxygen:
1. Unlock the low flow oxygen inlet at the rear of the device by pushing up on the locking clip.
2. Insert one end of the oxygen supply tubing into the oxygen connector port. The tubing will
automatically lock into place.
3. Attach the other end of the oxygen supply tubing to the oxygen supply.
4. Start ventilation
5. Turn on oxygen and adjust to the desired flow rate or FiO2 level.
Supplemental oxygen can also be added from an oxygen bottle (at 400kPA) however a flow
regulator must be fitted to ensure the delivered oxygen remains at or below 30 L/min.
Before you remove supplemental oxygen from the device, ensure the Oxygen supply has been
turned off.
To remove supplemental oxygen:
1. Unlock the low flow oxygen inlet at the rear of the device by pushing up on the locking clip.
2. Remove the oxygen supply tubing from the oxygen connector port.
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Accessories
Attaching a nebuliser
If required, a nebuliser can be used in conjunction with the Astral device. ResMed recommends
Aerogen® nebuliser products—designed to operate in-line with standard ventilator circuits and
mechanical ventilators without changing ventilator parameters or interrupting ventilation.
WARNING

Always connect an antibacterial filter to the expiratory inlet of the Astral device to
protect the expiratory valve.

Regularly check the antibacterial filter and expiratory valve for signs of moisture or
other contaminants, particularly during nebulisation or humidification. Failure to do so
could result in increased breathing system resistance and/or inaccuracies in expired
gas measurement.

Use of a gas jet nebuliser may affect ventilator accuracy. Monitor the patient and
compensate for the gas volume introduced by the gas jet nebuliser as appropriate.

For full details on using a nebuliser, see the User Guide that comes with that device.
Connect the nebuliser unit with a T-piece into the inspiratory limb of the breathing circuit before
the patient.
Pictured above: Aeroneb® Solo in-line.
For full instructions for use, please consult the Aeroneb Solo System Instruction Manual.
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Accessories
Attaching other accessories
Attaching a pulse oximeter
WARNING
Only use compatible NONIN finger pulse sensors*.
CAUTION
Factors that may degrade pulse oximeter performance or affect the accuracy of the
measurement include the following: excessive ambient light, excessive motion,
electromagnetic interference, blood flow restrictors (arterial catheters, blood pressure
cuffs, infusing lines, etc.), moisture in the sensor, improperly applied sensor, incorrect
sensor type, poor pulse quality, venous pulsations, anemia or low haemoglobin
concentrations, cardiogreen or other intravascular dyes, carboxyhaemoglobin,
methemoglobin, dysfunctional haemoglobin, artificial nails or fingernail polish, or a
sensor not at heart level.
To connect the pulse oximeter:
1. Connect the plug of the finger pulse sensor to the plug of the pulse oximeter.
2. Connect the plug of the pulse oximeter to the SpO2 (pulse oximeter) connector at the rear of
the device.
* Please refer to the Respiratory Care accessories catalogue for part numbers of oximeter
accessories with confirmed compatibility.
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Accessories
Once you have attached the pulse oximeter, a message will briefly display in the information
bar. Real-time SpO2 and Pulse readings can be viewed from the Monitoring menu.
Attaching a remote alarm
The ResMed Remote Alarm II has been designed for use with Astral devices. The Remote
Alarm II alerts you to an alarm that requires immediate attention. It triggers an audible and visual
alarm when an alarm is triggered on the Astral device. For full instructions on using the Remote
Alarm II, see the User Guide that comes with that device.
To connect the Remote Alarm II to the Astral device:
1. Connect one end of the alarm cable to the (3 pin) input connector on the remote alarm.
2. Connect the other end to the (5 pin) output connector located at the rear of the Astral
device.
CAUTION
To remove the cable, pull firmly on the connector. Do not twist.
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Accessories
Astral Carry Bag
The Astral device should always be packed in its Carry Bag when not in use to prevent damage
to the device.
WARNING
The Astral should not be operated while in the Carry Bag. To ventilate while travelling, use
the Astral Mobility bag.
To use the Carry Bag
1. Prior to placing the device in the Carry Bag, remove:
- the power connection from the rear of the device
- all patient circuit components
- all accessories, including Remote Alarm and oximeter
- the USB Stick.
2. Place the Astral device carefully into the Carry Bag, ensuring the handle is at the top and the
screen faces the printed image on the bag.
3. Secure the Astral device in place by using the Velcro strap. (To ensure the most secure
position, thread the Velcro strap through the handle and attach.)
4. Place the Power Supply unit and any heavy components in the side zippered pocket.
5. Ensure all zippers are completely closed and the device secure before lifting the Carry Bag.
CAUTION
Do not place any heavy or bulky objects in the zippered pocket on the inside front of the
bag. This could result in damage to the LCD Touch screen.
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Accessories
Travelling with the Astral device
WARNING
The Astral device should not be operated while in the Carry Bag. To ventilate while
travelling, use the Mobility Bag accessory.
When travelling with the Astral device:

The Astral device should always be packed in its carry bag when not in use to prevent
damage to the device.

The carry bag is for carry-on luggage only. The carry bag will not protect the Astral device if it
is put through checked baggage.

For your convenience at security stations, it may be helpful to keep a printed copy of the
user guide in the Astral carry bag to help security personnel understand the device and refer
them to the following statement.

ResMed confirms that the Astral device meets the Federal Aviation Administration (FAA)
requirements (RTCA/DO-160, section 21, category M) for all phases of air travel.
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Power
Power
WARNING

Beware of electrocution. Do not immerse the device, power supply or power cord in
water.

Make sure the power cord and plug are in good condition and the equipment is not
damaged.

Keep the power cord away from hot surfaces.

Explosion hazard—do not use in the vicinity of flammable anaesthetics.
The Astral device can be used with four different power sources:

Mains power

External battery

Internal battery
 External DC power supply (eg, car 12V power outlet).
For information on power supplies and sources see the Technical Specifications.
Connecting to mains power
WARNING
Ensure that the power cord does not pose a tripping or choking hazard.
To connect to mains power:
1. Connect the DC plug of the supplied ResMed external power supply unit to the rear of the
Astral device.
2. Before connecting the power cord to the ResMed power supply unit, ensure the end of the
connector of the power cord is correctly aligned with the input socket on the power supply
unit.
3. Plug the other end of the power cord into the power outlet.
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49
Power
Note: The power cord is equipped with a push-pull locking connector. To remove, grasp the
power cord housing and gently pull the connector from the device. Do not twist its outer
housing or pull on the cord.
Connecting to a ResMed Power Station (RPSII)
The RPSII provides the Astral device with electrical autonomy for eight hours of typical use. To
use, connect the power cord of the RPSII to the DC inlet port on the device.
CAUTION
When using the Astral device with an RPSII, the internal battery will not be charged.
50
Power
Connecting the Astral External Battery
The Astral External Battery has been designed specifically for use with the Astral Series of
ventilators. It is intended to provide Astral ventilators with an additional eight hours of electrical
autonomy during typical use.
For full details on using the Astral External Battery, refer to the External Battery user guide.
Using the External Battery
Connecting a fully charged External Battery to the Astral device can provide up to a total of 16
hours power during typical use. A second fully charged External Battery can be connected to
the Astral device to provide up to a total of 24 hours power during typical use. A maximum of
two External batteries can be connected to the Astral device.
Once the External Battery is connected to the Astral device, the DC mains indicator on the User
Interface will illuminate.
Information on system and battery charge levels can be accessed in one of two ways.
1. Battery Indicator
The capacity of the External Battery will be added to the RunTime indicator on the
Information bar of the Astral interface. (this may take a couple of minutes). The total will be
the sum of the Astral internal battery plus either one or two external batteries.
Under normal operating conditions, the ventilator will display:
- Total system state of charge as a percentage when in ventilation standby mode or
connected to mains power. The battery percentage is an average of all batteries
connected to the system. Full details of individual battery capacities can be reviewed in
the information page.
- Estimated remaining run time while delivering therapy.
2. Battery information page
The battery information page can be accessed from the device information page. This screen
will display the current charge level (0-100) for any batteries currently detected by the
system, as well as the total system charge.
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Power
WARNING
Do not attempt to connect more than two external batteries. Battery specific messages
and alarms on the Astral device will not operate for any additional units.
Alarms and messages relating to the External Battery may occur from time to time. All message
information will be displayed on the Astral user interface, and will be accompanied by an audible
signal. Refer to the Alarms troubleshooting section for further information.
Using the internal battery
An internal battery is included in the Astral device. It ensures a continuous power supply when
mains power is disrupted and no external battery is connected to the device. When the Astral
starts using the internal battery as its power source, you are notified by the Internal battery
use alarm and with the internal battery power source indicator.
The internal battery operates for approximately eight hours under typical conditions. During
ventilation, alarms will alert the user to a low battery condition. During standby, no alarms will
be announced. The user should regularly check the battery status.
WARNING

When using the Astral device as a backup ventilator, ensure the internal battery level is
checked on a regular basis.

As the battery ages, the available capacity decreases. When the remaining battery
capacity is low, do not rely on the internal battery as the primary power supply.

The internal battery should be replaced every two years, or when there is a noticeable
reduction in usage time when fully charged.
CAUTION

Revert to AC mains power when the remaining capacity of the battery is low.

The internal battery may stop charging when ambient temperatures of 35°C or more
are reached.

The internal battery will be depleted if the device is left in storage for an extended
period of time. During storage, ensure the internal battery is recharged once every six
months.

Storing the Astral device at temperatures exceeding 50°C for extended periods will
accelerate battery ageing. This will not affect the safety of the battery or the device.
While connected to mains power, the internal battery continues to charge when the device is
operating or in standby.
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Power
When the internal battery is being used to power the device, the amount of charge remaining in
the battery is displayed in the information bar as shown in the following table.
Display
Description
When the internal battery is in use, but the device is not ventilating, the battery charge level is
displayed.
When the internal battery is in use during ventilation, the remaining usage is displayed as estimated
by current operating conditions.
When the internal battery is charging, the charge battery symbol and percentage charged is
displayed.
For more information on the expected operating time of the internal battery see the Technical
Specifications.
Battery run time
The internal battery powers the Astral device for eight hours under conditions typical to the
chronic home ventilator-dependent patient.
Internal battery run time is determined by the:

percent charge

environmental conditions (such as temperature and altitude)

condition and age of the battery

device settings
 patient circuit setup and unintentional leak.
The internal battery should be replaced every two years or when there is a noticeable reduction
in usage time when fully charged.
Storing and recharging
If the internal battery is not used, it must be discharged and recharged every six months.
It takes approximately four hours to fully recharge the internal battery from depletion; however
this can vary depending on environmental conditions and the device operating state.
To prepare the internal battery for long-term storage:
1. Check that the battery charge level is between 50 and 100%. If not, charge the device to at
least 50% prior to storage.
2. Remove the power cord from the Astral.
3. Turn off the device.
To recharge the internal battery:
1. Connect the device to mains power.
2. Charging commences as indicated by a flashing battery charging indicator symbol in the
Information bar.
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Power
Connecting to an external DC power source
CAUTION

When using a car auxiliary adapter, start the car before plugging in the device's DC
adapter.

If the external DC power source drops to below 11V, the Astral will switch to internal
battery.
To connect DC power:
1. Connect the DC plug of the external DC power supply unit to the rear of the device.
2. Plug the other end of the power cord into the power outlet.
54
Using the Astral device for the first time
Using the Astral device for the first time
When using the Astral device for the first time, ResMed recommends you first perform a
functional test. A functional test will ensure the device is in proper working order before starting
therapy. Information to assist you in resolving any issues is available in Troubleshooting.
CAUTION
If any of the following checks fail, contact your Healthcare provider or ResMed for
assistance.
To perform a functional test:
1. Turn off the device by pressing the power switch at the back of the device.
2. Check the condition of the device and accessories.
Inspect the device and all accessories. Damaged components should not be used.
3. Check the patient circuit setup.
Check the integrity of the patient circuit (device and provided accessories) and that all
connections are secure.
4. Turn on the device and test alarms.
WARNING
If no alarm sounds, do not use the ventilator.
Press the power switch at the back of the device to turn on the device. Check that the alarm
sounds two test beeps and the LEDs for the alarm signal and the alarm mute/reset button
flash. The device is ready for use when the Patient Home screen is displayed.
5. Disconnect the device from the mains and external battery (if in use) so that the device is
powered by the internal battery. Check that the Battery Use alarm is displayed and the
battery LED is on.
Note: If the charge state of the internal battery is too low an alarm occurs. See
Troubleshooting (see page 132).
6. Reconnect the external battery (if in use) and check that the LED for the DC power supply is
lit. The External DC Power Use alarm will be displayed and the Alarm LED will light.
7. Reconnect the device to mains power.
8. Check the pulse oximeter sensor (if in use).
Attach the accessories according to the set up descriptions. From the Monitoring menu, go
to the Monitoring screen. Check that the values for SpO2 and pulse are displayed.
9. Check the oxygen connection (if in use). Check for damage to hoses or leaks. Check
remaining capacity of oxygen cylinders.
10. Perform a Learn Circuit.
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Ventilation modes
Ventilation modes
Astral supports a variety of ventilation modes. Available modes will vary depending on the
circuit type chosen. Mode settings can be accessed from Main Settings tab from the Settings
menu.
Note: Not all modes are available in all regions.
Mode
Circuit type
Leak
circuits
Supplementary feature
Safety Vt
Manual
breath
Sigh breath




Valve
circuits
Apnoea
ventilation
(A)CV


P(A)CV


P-SIMV



V-SIMV



PS



*
CPAP

(S)T

P(A)C

* For valve circuits only
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


Ventilation modes
(A)CV mode - Assisted volume-controlled ventilation
(A)CV is a volume target ventilation mode delivering volume-controlled mandatory breaths:
- Inspiration can either be initiated by the ventilator at a set respiratory rate (time-triggered
breath) or the patient (spontaneous-triggered breath). A spontaneous breath re-schedules
the next time-triggered breath. Both Trigger and Resp. rate can be set to Off, but not at
the same time. When Trigger is set to Off, the mode name will be shown on the
Information bar as CV.
- End of inspiration (switch from inspiration to expiration) is controlled by the ventilator
(time-cycled breath).
Parameter
Setting
Resp. rate (per min)
Adult: Off, 2 to 50 [15]
Paed: Off, 5 to 80 [15]
PEEP (cm H2O)
Off, 3.0 to 20.0 [5.0]
Vt (mL)
Adult: 100 to 2500 [500]
Paed: 50 to 300 [100]*
PIF (L/min)
When Volume Breath option is set to PIF:
Adult: 10 to 120 [50]
Paed: 5 to 60 [10]
Ti (sec)
When Volume Breath option is set to Ti:
Adult: 0.3 to 3.0 [1.0]
Paed: 0.3 to 3.0 [0.6]
Flow shape (%)
100, 75, 50, 25 [25]
Trigger Type
Flow / Pressure
Trigger
When Trigger Type is set to Flow
(double limb circuit only)
Adult: Off, 0.5 to 15 [1.0] (L/min)
Paed: Off, 0.5 to 15 [0.5] (L/min)
When Trigger Type is set to Pressure
(double and single limb circuit)
Off, Very low to Very high [Medium]
* The International ventilator standard indicates that Paediatric patient type is intended to be used for a patient receiving less than 300 mL,
however Astral permits adjustment of ‘Vt’ setting parameter up to 500 mL for cases where ‘Vt’ is set such that it compensates for leak in the
breathing circuit.
Supplementary features:

Apnoea response

Sigh breath (Astral 150 only)

Manual breath (Astral 150 only)
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Ventilation modes
(A)CV breath pattern showing one patient triggered breath amongst time triggered breaths, with
inspiratory duration defined by Ti. The patient-triggered breath re-schedules the next timetriggered breath.
P(A)CV mode - Assisted pressure-controlled ventilation
P(A)CV is a pressure target ventilation mode delivering pressure-controlled mandatory breaths:
- Inspiration can either be initiated by the ventilator at a set respiratory rate (time-triggered
breath) or the patient (spontaneous-triggered breath). Spontaneous-triggered breaths reschedule the next time-triggered breath. Both Trigger and Resp. rate can be set to Off,
but not at the same time. When Trigger is set to Off, the mode name will be shown on
the Information bar as PCV.
- End of inspiration (switch from inspiration to expiration) is controlled by the ventilator
(time-cycled breath).
Parameter
Setting
Resp. rate (per min)
Adult: Off, 2 to 50 [15]
Paed: Off, 5 to 80 [15]
PEEP (cm H2O)
Off, 3.0 to 20.0 [5.0]
P control (cm H2O)
Adult: 2 to 50 [7]
Paed: 2 to 50 [7]
Ti (sec)
Adult: 0.2 to 5.0 [1.0]
Paed: 0.2 to 5.0 [0.6]
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Ventilation modes
Parameter
Setting
Trigger type
Flow / Pressure
Available with double limb circuits only.
Trigger
When Trigger Type is set to Flow:
Adult: Off, 0.5 to 15 [1.0] (L/min)
Paed: Off, 0.5 to 15 [0.5] (L/min)
When Trigger Type is set to Pressure:
Off, Very Low to Very High [Medium]
Supplementary features:

Safety Vt (Tidal Volume)

Apnoea response

Sigh breath (Astral 150 only)

Manual breath (Astral 150 only)
The P(A)CV breath pattern showing one patient triggered breath amongst time-triggered
breaths. The Safety Vt feature is turned off.
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Ventilation modes
P-SIMV - Pressure Synchronised Intermittent Mandatory Ventilation
P-SIMV is a mixed ventilation mode delivering pressure-controlled mandatory breaths and
pressure-supported spontaneous breaths.
Mandatory breaths are delivered at a set frequency and spontaneous breaths are permitted
between mandatory breaths.
For mandatory breaths
The inspiratory pressure support is set using P control and is initiated by either:
- the ventilator at a set respiratory rate
- the patient - if the patient effort is close enough to the next scheduled mandatory breath.
This time is 60% of the breath period or 10 seconds, whichever is less.
End of inspiration (switch from inspiration to expiration) is controlled by the ventilator (timetriggered breath)
For spontaneous breaths
The inspiratory pressure support is set using PS. Inspiration is either:
- Initiated by the patient (spontaneous-triggered breath)
- Ended by the patient (spontaneous-cycled breath)
The patient is free to take any number of spontaneous breaths between mandatory breaths.
Parameter
Setting
Resp.rate (per min)
Mandatory breaths:
Adult: 2 to 50 [10]
Paed: 5 to 80 [20]
PEEP (cm H2O)
Off, 3.0 to 20.0 [5.0]
P control (cm H2O)
Mandatory breaths:
Adult: 2 to 50 [7]
Paed: 2 to 50 [7]
PS (cm H2O)
Spontaneous breaths:
Adult: 2 to 50 [7]
Paed: 2 to 50 [7]
Ti (sec)
Mandatory breaths
Adult: 0.2 to 5.0 [1.0]
Paed: 0.2 to 5.0 [0.6]
Cycle (%)
Spontaneous breaths:
5 to 90, Auto [Auto]
Trigger type
Flow / Pressure
Trigger
When Trigger Type is set to Flow:
(double limb circuit only)
Adult: 0.5 to 15 [1.0] (L/min)
Paed: 0.5 to 15 [0.5] (L/min)
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Ventilation modes
Parameter
Setting
When Trigger Type is set to Pressure:
(double and single limb circuit)
Off, Very Low to Very High [Medium]
Rise Time (msec)
Min, 150 to 900 [Min]
Supplementary features:

Apnoea response

Manual breath
Spontaneous breaths are permitted between mandatory breaths as shown in the figure above.
In order to promote synchrony with the patient's spontaneous efforts, mandatory breaths may
be patient triggered. Such patient triggering will cause some variation in the mandatory
ventilation respiratory rate.
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Ventilation modes
V-SIMV - Volume Synchronised Intermittent Mandatory Ventilation
V-SIMV is a mixed ventilation mode delivering volume-controlled mandatory breaths and
pressure-supported spontaneous breaths.
Mandatory breaths are delivered at a set frequency and spontaneous breaths are permitted
between mandatory breaths.
For mandatory breaths
The inspiratory volume is set using Vt and is initiated by either:
- the ventilator at a set respiratory rate
- the patient - if the patient effort is close enough to the next scheduled mandatory breath.
This time is 60% of the breath period or 10 seconds, whichever is less.
End of inspiration (switch from inspiration to expiration) is controlled by the ventilator (timetriggered breath)
For spontaneous breaths
The inspiratory pressure support is set using PS. Inspiration is:
- initiated by the patient (spontaneous-triggered breath) and
- ended by the patient (spontaneous-cycled breath)
The patient is free to take any number of spontaneous breaths between mandatory breaths.
Parameter
Setting
PEEP (cm H2O)
Off, 3.0 to 20.0 [5.0]
PS (cm H2O)
Spontaneous breaths:
Adult: 2 to 50 [7]
Paed: 2 to 50 [7]
Vt (Tidal Volume) (mL)
Mandatory breaths:
Adult: 100 to 2,500 [500]
Paed:50 to 300 [100]*
PIF (L/min)
When Volume Breath option is set to PIF
Mandatory breaths:
Adult: 10 to 120 [50]
Paed: 5 to 60 [10]
Ti (Inspiratory time) (sec)
When Volume Breath option is set to Ti
Mandatory breaths:
Adult: 0.3 to 3.0 [1.0]
Paed: 0.3 to 3.0 [0.6]
Flow shape (%)
Mandatory breaths:
100 (Constant), 75, 50, 25 [25]
Cycle (%)
Spontaneous breaths:
5 to 90, Auto [Auto]
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Ventilation modes
Parameter
Setting
PEEP (cm H2O)
Off, 3.0 to 20.0 [5.0]
Trigger type
Flow/Pressure
Trigger
When Trigger Type is set to Flow:
(double limb circuit only)
Adult: 0.5 to 15 [1.0] (L/min)
Paed: 0.5 to 15 [0.5] (L/min)
When Trigger Type is set to Pressure:
(double and single limb circuit)
Very Low to Very High [Medium]
Rise Time (msec)
Spontaneous breaths:
Min, 150 to 900 [Min]
* The International ventilator standard indicates that Paediatric patient type is intended to be used for a patient receiving less than 300 mL,
however Astral permits adjustment of ‘Vt’ setting parameter up to 500 mL for cases where ‘Vt’ is set such that it compensates for leak in the
breathing circuit.
Supplementary features:

Apnoea response

Manual breath (Astral 150 only)
Spontaneous breaths are permitted between mandatory breaths as shown in the figure above.
In order to promote synchrony with the patient's spontaneous efforts, mandatory breaths may
be patient triggered. Such patient triggering will cause some variation in the mandatory
ventilation respiratory rate.
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Ventilation modes
PS mode - Pressure support
PS is a pressure target ventilation mode delivering pressure-supported spontaneous breaths:
- Inspiration is either initiated by the ventilator at a set rate (time-triggered breath), or the
patient (spontaneous-triggered breath). Spontaneous-triggered breaths re-schedule the
next time-triggered breath. Set respiratory rate can be disabled.
- End of inspiration (switch from inspiration to expiration) is controlled by the patient
(spontaneous-cycled breath).
Parameter
Setting
Resp. rate (per min)
Adult: Off, 2 to 50 [15]
Paed: Off, 5 to 80 [15]
PEEP (cm H2O)
Off, 3 to 20.0 [5.0]
PS (cm H2O)
Adult: 2 to 50 [7]
Paed: 2 to 50 [7]
Cycle (%)
5 to 90, Auto [Auto]
Trigger type
Flow/Pressure
Trigger
When Trigger Type is set to Flow:
Adult: 0.5 to 15 [1.0] (L/min)
Paed: 0.5 to 15 [0.5] (L/min)
When Trigger Type is set to Pressure:
Very Low to Very High [Medium]
Rise Time (msec)
Min, 150 to 900 [Min]
Ti Min (sec)
0.2 to 4.0 [0.2]
Ti Max (sec)
Adult: 0.3 to 4.0 [1.5]
Paed: 0.3 to 4.0 [0.8]
Supplementary features:

Apnoea response

Safety Vt (Tidal Volume)

Manual breath (Astral 150 only)
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Ventilation modes

This graph shows PS mode with Resp. rate enabled with a transition from spontaneoustriggered to time-triggered breaths. Cycling is constrained within the limits of Ti Min and Ti
Max.

To allow the patient sufficient time to exhale, Ti cannot exceed two-thirds of the breath
period. (Breath period is equal to 60/Resp. rate).

To allow sufficient time to reach the targeted inspiratory pressure, Rise time cannot exceed
two-thirds of Ti Max.
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Ventilation modes
(S)T mode - Spontaneous Ventilation with backup rate
(S)T is a bilevel ventilation mode delivering pressure-supported spontaneous breaths:
- Inspiration is either initiated by the ventilator at a set rate (time-triggered breath) or the
patient (spontaneous-triggered breath). Spontaneous-triggered breaths re-schedule the
next time-triggered breath. Resp. rate and Trigger can be set to Off, but not at the same
time. When Trigger is set to Off, the mode name will be shown on the Information bar as
T. When Trigger is active, and Resp.rate is set to Off, the mode name will be shown on
the information bar as S.
- End of inspiration (switch from inspiration to expiration) is controlled by the patient
(spontaneous-cycled breath) between Ti Min and Ti Max.
Parameter
Setting
Resp. rate (per min)
Adult: Off, 2 to 50 [15]
Paed: Off, 5 to 80 [15]
EPAP (cm H2O)
2 to 25 [5]
IPAP (cm H2O)
Adult: 4 to 50 [12]
Paed: 4 to 50 [12]
Trigger
Off, Very Low to Very High [Medium]
Rise Time (msec)
Min, 150 to 900 [Min]
Ti Min (sec)
0.1 to 4.0 [0.2]
Ti Max (sec)
Adult: 0.3 to 4.0 [1.5]
Paed: 0.3 to 4.0 [0.8]
Cycle
66
Very Low to Very High [Medium]
Ventilation modes
P(A)C mode
P(A)C is a bilevel ventilation mode delivering pressure-controlled mandatory breaths:
- Inspiration is either initiated by the ventilator at a set rate (time-triggered breath) or the
patient (spontaneous-triggered breath). Spontaneous-triggered breaths re-schedule the
next time-triggered breath. Resp. rate and Trigger can be set to Off, but not at the same
time. When Trigger is set to Off, the mode name will be shown on the Information bar as
PC.
- End of inspiration is controlled by the ventilator (time-cycled breath).
Parameter
Setting
Resp. rate (per min)
Adult: Off, 2 to 50 [15]
Paed: Off, 5 to 80 [15]
EPAP (cm H2O)
2 to 25 [5]
IPAP (cm H2O)
Adult: 4 to 50 [12]
Paed: 4 to 50 [12]
Ti (sec)
Adult: 0.3 to 4.0 [1.0]
Paed: 0.3 to 4.0 [0.6]
Trigger
Off, Very Low to Very High [Medium]
Rise Time (msec)
Min, 150 to 900 [Min]

To allow the patient sufficient time to exhale, Ti cannot exceed two-thirds of 60/Resp. rate.

To allow sufficient time to reach the targeted inspiratory pressure, Rise time cannot exceed
two-thirds of Ti.
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Ventilation modes
CPAP mode
CPAP mode delivers a constant level of pressure during inspiration and expiration.
With CPAP administered via a valved breathing system, the inspiratory triggering level is
settable to optimise the control of the exhalation valve and minimise the patient's work of
breathing. Adjust trigger sensitivity to accurately report patient respiratory rate.
In a vented system, the inspiratory triggering level is settable to optimise monitoring and alarm
performance.
Parameter
Setting
CPAP (cm H2O)
All circuits:
3.0 to 20.0 [5.0]
Trigger type
Double limb circuit:
Flow/Pressure
Trigger
Double limb circuit:
When Trigger Type is set to Flow:
Adult: 0.5 to 15 [1.0] (L/min)
Paed: 0.5 to 15 [0.5] (L/min)
When Trigger Type is set to Pressure:
Very Low to Very High [Medium]
Single limb circuit:
Very Low to Very High [Medium]
Single with intentional leak:
Very Low to Very High [Medium]
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Ventilation modes
Supplementary features:

Apnoea response (Valve circuits only)
CPAP operation with a single limb circuit with intentional leak is displayed.
Flow shape settings
The Astral device supports four flow shape settings:
1.
2.
3.
4.
100% (Constant)
75%
50%
25%
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Ventilation modes
The figure illustrates how Flow Shape affects breath delivery for a fixed volume. With volume
breath option set to PIF (Peak Inspiratory Flow), adjusting the flow shape alters the inspiratory
duration, whereas with volume breath option set to Ti (Inspiratory time), adjusting the flow
shape alters the Peak Inspiratory Flow.
When the flow shape is set to 100%, the flow is generally constant during inspiration. For
decreasing percentages, the flow starts at the peak flow and declines to approximately the
percentage setting of this value at the end of inspiration.
To select between Ti and PIF options:
1. From the Setup menu select Device config.
2. Select Units
3. Select Ti of PIF.
Interdependence of controls
Dynamic settings limits
The adjustable range of one setting may be restricted by the value of another. When a dynamic
limit of this kind is reached, a message describing the limitation (interdependence) is displayed
on the Information bar and the Apply button is disabled.
To enable the Apply button, modify one of the conflicting settings. For example in this case, to
continue IPAP must be increased or EPAP decreased.
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Ventilation modes
Automatic reconfiguration of settings
In pressure control modes, reducing the high pressure alarm limit may result in changes to the
following settings (depending on mode):

P control

PS

P control max

PS max

PEEP

IPAP

EPAP

CPAP

Apnoea breath settings

Sigh breath Magnitude
 Manual breath Magnitude
When making adjustments to the high pressure alarm limit, you are prompted to confirm the
changes to any affected settings. If these setting changes are not accepted, the change to the
high pressure alarm limit is not applied.
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Ventilation modes
Triggering and cycling

The Astral device has adjustable trigger and cycle sensitivities to provide optimal synchrony
between the patient and the device and to minimise work of breathing.

Triggering is the device response to an increase in patient effort. Once the set inspiratory
trigger threshold is reached, the device starts the inspiratory phase.

Cycling (also called expiratory triggering) is the response to a decrease in patient inspiratory
flow. Once the set cycling threshold is reached the device cycles from the inspiratory to
expiratory phase.
The higher the sensitivity selected, the smaller the patient effort required to trigger inspiration,
and the smaller the reduction in patient inspiratory flow to initiate expiration.
The triggering method depends on the circuit type.
Circuit type
Trigger type
Trigger detection
Single limb circuit with intentional
leak
Flow
Vsync
Single limb circuit with integrated
valve
Pressure
Double limb circuit
Choice between
Very Low to Very High
NIV+
Very Low to Very High
Pressure: Very Low to Very High NIV+
Flow: 0.5 - 15 L/min
Flow
Triggering with intentional leak circuits
When using a circuit with intentional leak, estimation of the patient respiratory flow is enhanced
by ResMed's automatic leak management feature—Vsync.
Vsync technology allows the device to estimate the patient respiratory flow in the presence of
unintentional leak. Using the respiratory flow signal, the device is able to trigger and cycle
closely with the patient's effort.
The Astral device has five trigger sensitivity levels (Very Low to Very High). The higher the
sensitivity selected the smaller the patient effort required to trigger inspiration.
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Ventilation modes
Cycling with intentional leak circuits
The Astral device is able to detect a decrease in patient respiratory flow during inspiration,
indicating the optimum point to commence exhalation.
The Astral device provides five cycle sensitivity levels (from Very Low to Very High). The higher
the sensitivity selected, the smaller the reduction in inspiratory flow to cycle to expiration.
Note: Cycling is constrained within the limits of TiMin and TiMax. This means that the inspiratory
period cannot be less that TiMin or longer than TiMax.
Triggering with valve circuits
When using single or double limb valve circuits, the Astral device uses ResMed's NIV+ trigger
sensitivity technology. Unlike simple conventional triggering which only considers the
magnitude of the pressure change, NIV+ also considers the shape of the pressure waveform to
significantly improve trigger sensitivity.
Pressure trigger with single and double limb circuits
The Astral device is able to detect a negative change of pressure, relative to the pressure base
line at the end of expiration, indicating the start of a patient spontaneous breath. There are five
sensitivity levels of trigger sensitivity from Very Low to Very High.
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73
Ventilation modes
Flow trigger with double limb circuits
Flow triggering is suitable for use with double limb circuits for invasive applications with no
expected leak eg, cuffed tracheostomy. By monitoring the exhaled gas, the Astral device is able
to detect an increase in patient respiratory flow at the end of expiration, indicating the start of a
spontaneous breath. The flow trigger threshold represents the increase in patient respiratory
flow at the end of expiration. When that threshold is reached the device starts the inspiratory
phase.
Flow trigger range
L/min
Adult:
0.5-15 [Default = 1.0]
Paediatric:
0.5-15 [Default = 0.5]
The lower the setting number the higher the sensitivity.
Changing the Trigger Type
For double limb circuits, changing Trigger type can be done while the device is ventilating or in
Standby.
To change between pressure and flow trigger types on double circuits:
1. From the Setup menu, select Circuit.
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Ventilation modes
2. From the Trigger type option, press Change. The current Trigger Type is highlighted.
3. Select Flow. You will be returned to the Circuit screen where the changed Trigger type will
be displayed.
Cycling with valve circuits
Cycling in the Astral device is based on flow and can be set to automatic or manual.
Automatic cycling adjustment
Allows for the duration of the inspiratory phase (Ti) to vary from one breath to another,
according to the characteristics of the patient's spontaneous breathing. Therefore, Ti varies
according to the shape of the flow curve and the maximum flow value.
In the figure below, a dotted line is drawn between the start of inspiration and point (A) marked
at the peak inspiratory flow (PIF) at 2.3 seconds. Cycling occurs when the decelerating flow
curve intersects with this dotted line (B). The two breaths in the figure have different PIF values
and therefore different Ti times.
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Ventilation modes
Manual cycling adjustment
The manual cycling set point is expressed as a percentage of the maximum flow. Cycling to
expiration occurs when the decreasing patient respiratory flow reaches the set cycling
threshold. The higher the percentage the more sensitive the cycling.
Note: Cycling is constrained within the limits of TiMin and TiMax. This means that the inspiratory
period cannot be less that TiMin or longer than TiMax.
To change between automatic or manual cycling features
1. From the Setup main menu, select Settings.
2. From the Settings menu, select the Main settings tab.
3. From the on-screen selections, press Cycle.
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Supplementary features
Supplementary features
Manual breath settings
Manual breath
feature allows the user to manually insert a breath within the currently
delivered breathing pattern.
The Manual breath feature is used to trigger manual breath(s) and can be pressed at any time.

If pressed during expiration, the manual breath will be delivered immediately.

If pressed during inspiration, the manual breath will be delivered 300 ms after the end of the
current inspiration.
The manual breath can be configured as a magnified version of the primary breath
(magnification factor set from 100 to 250%).
For pressure-target breaths, the inspiratory duration and pressure are magnified proportionally.
For volume-target breaths, the delivered volume is magnified proportionately.
Adjustable parameters:
Parameter
Setting
Manual Breath
Off, On [On]
Magnitude (%)
100 to 250 [150]
For pressure-controlled mandatory breaths, the P control and breath duration are magnified by the magnification
factor. This applies to mandatory breaths in P(A)CV mode and in P-SIMV and SIMV modes.
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Supplementary features
For pressure-assisted spontaneous breaths only the PS is magnified.
For volume-controlled mandatory breaths, the volume is magnified by firstly flattening the flow
shape, then by extending the Ti and finally by increasing the PIF. This applies to mandatory
breaths in (A)CV and V-SIMV modes.
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Supplementary features
Sigh settings
The Sigh breath feature allows the user to program the delivery of a 'sigh breath' at a regular
interval (sigh interval) within the currently delivered breathing pattern.
The sigh breath is a magnified version of the primary breath (Magnification factor set from 120
to 250%).
For pressure-target breaths, the inspiratory duration and P control are magnified proportionally.
For volume-target breaths, volume is magnified.
Adjustable parameters  (A)CV & P(A)CV Modes only:
Parameter
Setting
Sigh Breath
Off, On [Off]
Sigh Alert
Off, On [Off]
Interval (min)
3 to 60 [10]
Magnitude (%)
120 to 250 [150]
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Supplementary features
Apnoea Settings
The Astral device allows the clinician to define what should happen when the device detects an
apnoea.
An apnoea refers to the absence of breath within a configurable period: T apnoea (Apnoea
Interval).
Apnoea can be defined as an absence of patient-triggered breaths (No Spont Breath), or an
absence of any breaths (No Breath), whether they are patient, time, or manually-triggered
breaths.
Three types of Apnoea response settings can be selected on the Astral device:
1. Alarm only
2. Alarm + apnoea ventilation ((A)CV breath pattern)
3. Alarm + apnoea ventilation (P(A)CV breath pattern)
4. Off
When Alarm + apnoea ventilation ((A)CV or P(A)CV) is selected, apnoea ventilation is
automatically triggered following the detection of an apnoea event. Apnoea ventilation is
displayed on the Information bar.
The Apnoea response will deactivate when the patient triggers three consecutive breaths.
ResMed recommends that Apnoea ventilation is enabled whenever the Resp. rate is set to Off.
Control settings for Apnoea ventilation
Parameter
Setting
Apnoea response
All modes
Alarm only
Valve ventilation modes only
(A)CV + Alarm (for (A)CV breath pattern)
Valve ventilation modes only
P(A)CV + Alarm (for P(A)CV breath pattern)
All modes (Adult)
Off
Apnoea Detection
No breath, No Spont. breath [No breath]
T apnoea (min:sec)
Adult: 0m 15s to 15m 0s [0m 20s]
Paed: 0m 5s to 0m 30s [0m 10s]
WARNING
Setting Apnoea Detection to No breath, and T apnoea to a value greater than 60/Resp. rate
will disable the Apnoea Alarm and Response.
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Supplementary features
(A)CV Breath pattern
Parameter
Setting
Vt (mL)
Adult: 100 to 2,500 [500]
Paed: 50 to 300 [100]*
Ti (sec)
When Volume Breath option is set to Ti:
Adult: 0.3 to 3.0 [1.0]
Paed: 0.3 to 3.0 [0.6]
PIF (L/min)
When Volume Breath option is set to PIF:
Adult: 10 to 120 [50]
Paed: 5 to 60 [10]
Resp. rate (per min)
Adult: 4 to 50 [15]
Paed: 12 to 80 [15]
* The International ventilator standard indicates that Paediatric patient type is intended to be used for a patient receiving less than 300 mL,
however Astral permits adjustment of ‘Vt’ setting parameter up to 500 mL for cases where ‘Vt’ is set such that it compensates for leak in the
breathing circuit.
P(A)CV breath pattern
Parameter
Setting
P control (cm H2O)
Adult: 2 to 50 [7]
Paed: 2 to 50 [7]
Ti (sec)
Adult: 0.2 to 5.0 [1.0]
Paed: 0.2 to 5.0 [0.6]
Resp. rate (per min)
Adult: 4 to 50 [15]
Paed: 12 to 80 [15]
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Supplementary features
Safety volume settings
Astral's Safety Volume feature is an optional adaptive control mechanism that provides volume
assurance to pressure modes (P(A)CV and PS only). It combines the benefits of pressuretargeted ventilation with the assurance of a volume target.
It can be used to defend against hypoventilation in the event of reduced lung compliance or to
defend against ventilator-induced lung injury or over-ventilation in the event of compliance
improving over time.
A target Safety Volume (Safety Vt) can be set and the respective pressure value (PS or PControl)
is automatically adjusted to achieve the target.
The maximum inspiratory assistance is constrained by PS max or P control max.
The maximum breath-to-breath change in pressure assistance is limited to +/- 2 cm H2O to
minimise disturbance or discomfort to the patient.
Adjustable parameters:
Parameter
Setting
Safety Vt (mL)
Adult: Off, 100 to 2500 [Off]
Paed: Off, 50 to 300 [Off]
PS max (PS mode)
PS to 50 [PS + 5]
P control max (P(A)CV)
P control to 50 [P control + 5]
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Supplementary features
Mouthpiece settings
The Astral device can provide mouthpiece ventilation and also supports patient exhalation while
disconnected from the mouthpiece to allow speech.
Mouthpiece ventilation may be suitable for daytime use on conscious patients.
Mouthpiece ventilation may be preferable to invasive or mask ventilation to reduce skin
irritation, improve patient comfort and appear more discreet.
The decision to use mouthpiece ventilation is generally a consultative process between clinician
and patient after considering the risks and advantages of this form of therapy.
To assess the patient condition during mouthpiece ventilation, SpO2 can be monitored using a
Pulse oximeter. If the connection to the patient's finger is disconnected, the No SpO2
monitoring alarm will activate.
The following settings are recommended for mouthpiece ventilation on the Astral device:
Setting
Description
Detail / explanation
Interface
ResMed 15mm Non-vented mouthpiece with
catheter mount.
Circuit
Single limb circuit with valve.
Ventilation mode
(A)CV
(A)CV mode allows the patient to stack
breaths as a set volume is delivered with
each breath.
Patient settings
Vt, Trigger, Flow shape
Set based on patient comfort and
preference.
PEEP
Off
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Supplementary features
Two mouthpiece set up configurations are available for patients who:
1. Require secure ventilation protected by an apnoea alarm
2. Require intermittent ventilation without alarm.
Mouthpiece Setup 1
The following settings are appropriate for patients requiring secure ventilation protected by an
apnoea alarm. In this case, the patient is required to take spontaneous breaths.
Setting
Range
Detail / explanation
Resp. rate
Off
This prevents time breaths when the mouthpiece is not in the patient's
mouth.
Apnoea interval
As appropriate
This is the time it will take for a patient disconnection to be detected.
Apnoea definition
No Spont. breath
The Apnoea alarm triggers if there are no patient breaths for the duration of
the Apnoea interval.
Apnoea response
Alarm
An Apnoea ventilation high priority alarm is displayed in the information bar.
Low pressure
alarm
Off
Permits a partial breath or false trigger to occur without alarm.
Mouthpiece Setup 2
WARNING
This configuration will not raise an Apnoea alarm. The Astral will not detect patient
disconnection.
The following settings are appropriate for patients who require intermittent ventilation. This
arrangement provides back up breaths at a configured rate.
Setting
Range
Resp. rate
Any value other than Configuring an appropriate back up rate disables the Apnoea alarm. An
Off
appropriate back up rate may be used to prompt patient breathing.
Apnoea interval
120 sec
Must be set to a period longer than the time between backup breaths.
Apnoea definition
No breath
The Apnoea alarm will not trigger if there are no patient breaths as the
backup breath rate will reset the Apnoea Interval timer.
Apnoea response
Alarm
No alarm will display.
Low pressure
alarm
Off
Permits the patient to release the mouthpiece while backup breaths are
delivered without alarms occurring.
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Detail / explanation
Alarms
Alarms
The Astral device activates alarms to alert you to conditions that require attention to ensure
patient safety. When an alarm is activated, the Astral device provides both audible and visual
alerts, and displays an alarm message in the Alarm display on the Information bar.
1
Indicator
Description
Alarm display
Displays either the alarm message for the highest priority active alarm, or
the last alarm not yet reset.
Press the Alarm display for further alarm information.
Certain conditions may result in multiple alarms.
indicates that there
are multiple active alarms. Press
when displayed to view all alarms
and respond appropriately. Alarms are displayed in order of priority.
2
Active Alarms screen
Displays the full set of active alarms. Will automatically display upon
activation of an alarm in Patient mode.
3
Information menu
Some alarms clear automatically. To view a history of alarms, view the
alarm log through the Information menu.
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Alarms
4
Alarm mute/reset button
State:

no light – no active alarms

steady light – active alarm/s

flashing light – alarm mute on.
This button also allows you to:

mute the audible alert

reset the currently displayed alarm (if permitted).
5
Alarm bar
Indicates the priority of the alarm in the Alarm display.
Alarm priority
Alarms are classified into relative priority (high, medium and low) according to the severity and
urgency of the alarm condition. Respond to all alarms. An immediate response is required for
high priority alarms.
Alarm priority
Alarm bar
Audible alert
High
Red flashing light
10 beeps every 5 seconds
Medium
Yellow flashing light
3 beeps every 15 seconds
Low
Yellow steady
2 beeps every 25 seconds
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Alarms
The following list of alarms is ordered by relative importance within priority. Adjustable alarms
can be changed to suit therapy and care requirements.
High priority alarms
Medium priority alarms
Low priority alarms
Total power failure **
High Pressure*
Power disconnected
Low Pressure*
Low PEEP*
Using internal battery
Obstruction / High Pressure*
High PEEP
Battery 1 fault
High Pressure*
Low pulse rate*
Battery 2 fault
Apnoea*
High pulse rate*
Power fault / No charging
Low MVe*
Device overheating
Low MVi*
Pressure line disconnected
High MVi*
Last self test failed
High MVe*
Flow sensor not calibrated
Low Vte*
No SpO2 monitoring
High Vte*
No FiO2 monitoring
Low Vti*
Low internal battery
High Vti*
Low Resp rate*
High Resp rate*
High leak*
Ventilation stopped*
Low SpO2*
High SpO2*
Low FiO2*
High FiO2*
NV mask (blocked vent)*
Ventilation not started. Incorrect
adapter
Critically low internal battery
Circuit fault
Incorrect circuit
Unexpected restart
Internal Battery inoperable
* Alarm is adjustable.
** No LED will flash during a Total power failure alarm.
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Alarms
Viewing the active alarms
in the Alarm display indicates that there are multiple active alarms. Although multiple
alarms can be active simultaneously, the Alarm display only shows the highest priority alarm.
The full set of active alarms is displayed in the Active alarms screen.
When the highest priority alarm is cleared, the next highest priority alarm displays in the Alarm
display.
To view the active alarms:
1. From any screen, press the Alarm display on the Information bar. The Active alarms screen
is displayed. This screen contains a full list of currently active alarms, displayed in order of
their relative priority.
2. Press OK to close the Active alarms screen and return to the previous screen.
Muting alarms
You can temporarily mute the audible alert on the Astral device for a two minute period. The
Alarm display and Alarm bar continue to display the alarm as usual. If after two minutes the
alarm condition is still present, the audible alert will sound again.
You can also use the Alarm Mute in advance, to 'pre-silence' alarms that you expect to occur.
This can be helpful during suctioning procedures or when intending to disconnect the patient
from the ventilator for a short period.
If any of the following high priority alarms are triggered, the Alarm mute is automatically
cancelled:

Total power failure

Critically low internal battery

Incorrect circuit.
To mute the audible alert on an active alarm:
Press
.
The alarm is silenced for two minutes. During that period,
bar and
is displayed on the Information
flashes.
Note: Pressing the Alarm mute/reset button again during the Alarm Mute period will reset the
displayed alarm. See Resetting alarms (see page 89).
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Alarms
To silence alarms before they activate:
1. Press
. Alarm mute is active for two minutes. During that period,
on the Information bar and
is displayed
flashes.
2. To cancel Alarm mute, press the flashing
again.
Resetting alarms
The following alarms cannot be manually reset. For these alarms you must correct the cause of
the alarm. Resolving the alarm will automatically clear the display.

Total power failure

Critically low internal battery

Low Pressure

Incorrect circuit

Pressure line disconnected

Battery inoperable.
Resetting an alarm removes that alarm from the Alarm display and the Active alarms screen,
and turns off the visual and audible alerts. An active alarm should only be reset after the
situation that caused the alarm has been attended to. If the alarm condition has not been
corrected, the alarm will activate again.
The Astral device may automatically clear an alarm when the condition that triggered the alarm
is corrected. When an alarm is cleared it no longer displays in the Active alarms screen and the
audible and visual alerts cease.
When an alarm is cleared or manually reset, the Alarm display then shows the next highest
priority active alarm.
To view a complete alarm history, see the Events log available from the Information menu.
To reset the displayed active alarm:
1. Press
to mute the alarm. The button illuminates and flashes.
again to reset the alarm. The alarm message is removed from the Alarm
2. Press
display. It is also cleared from the Active alarms screen.
Note: You can carry out this procedure with the Active alarms screen open, if you want visibility
of all the active alarms as you perform the reset.
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Alarms
To reset all active alarms:
1. Press the Alarm display on the Information bar. The Active alarms screen is displayed.
2. Press Reset all to reset multiple alarms. Only those alarms that can be reset, will be reset.
Any remaining alarms will require user intervention and correction.
3. Complete any required action to resolve the remaining alarms.
4. Press OK to close the Active alarms screen and return to the previous screen.
Adjusting alarm settings
CAUTION
Adjusting alarm thresholds to maximum or minimum values may render the alarm
ineffective.
WARNING
The safety and effectiveness of alarms settings should be verified for each enabled
Program.
Note: To adjust the volume of the audible alert, see Device settings (see page 28).
To adjust the alarm settings for the current active program:
1. Access Clinical mode. The Settings screen is displayed.
2. Press
.
3. Press the alarm setting that you want to adjust. The selected setting is highlighted in orange
and the up and down scroll arrows appear. Minimum and maximum settable values appear
with the scroll arrows.
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Alarms
4. Increase or decrease the alarm setting as required.
5. To adjust other alarm settings, select the desired settings and repeat this process. All
settings that have been adjusted are displayed with an orange outline.
6. When no further adjustments are required, press Apply.
Note: If a change to the High Pressure alarm setting conflicts with one or more ventilation
parameter settings, a confirmation screen is displayed providing a summary of the revised
ventilation parameter settings. To accept these settings press Confirm.
WARNING
The safety and effectiveness of alarms settings should be verified for each enabled
Program.
CAUTION
Adjusting alarm thresholds to maximum or minimum values may render the alarm
ineffective.
Setting the alarm volume
The volume level of the Astral device can be set from one to five (with five being the loudest
and the default being three).
It is also possible to set a minimum volume level, where any settings below the minimum are
greyed out and disabled from use. This feature is configurable in the Clinical menu only.
In the example below the current alarm volume is '5' however the minimum alarm volume has
been set at '3'. The '1' and '2' volume options are now disabled and not able to be selected by
the patient or carer.
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Alarms
Testing the alarm sounders and indicators
To confirm the alarm will sound as intended, regularly test the alarm.
The Astral device incorporates two alarm sounders. During an alarm condition both sounders
are operated in parallel. To confirm the correct operation of each sounder, regularly perform the
Alarm test function. During this test each sounder will be operated separately and in sequence.
To test the alarm sounders and indicators:
1. Press
. The Alarms screen is displayed.
2. Press
. The Alarm volume screen is displayed.
3. Press Test to test the alarm. The alarm beeps twice and the LED flashes to indicate it is
working correctly. Confirm the alarm beeps twice. Confirm the Alarm bar flashes red, then
yellow. Confirm the mute button flashes.
WARNING
If no alarm sounds, do not use the ventilator.
CAUTION
If only one beep is heard, or the Alarm bar does not flash red, then yellow, return the
device for servicing.
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Testing the alarms
Testing the Remote Alarm
The Remote Alarm generates an audible and visual signal when an alarm is triggered on the
ventilator.
CAUTION
A test of the Remote Alarm should be performed prior to initial use and every change of
battery. Test the alarm periodically as per the facility policy. For dependent patients
perform a test on a daily basis.
To test the Remote alarm, press
on the Remote Alarm.
The following will occur:

The alarm LED illuminates and the alarm sounds.

The LED corresponding to the set volume illuminates.

The Disconnect LED blinks if the alarm is not connected to the device and lights
permanently if connected.

The battery level LED corresponding to the battery level illuminates. Yellow LED if battery
life is low, or green LED if battery life is good. (Replace the battery if the battery life is low).

If a second Remote Alarm is connected, the second Remote Alarm will also sound.
Testing the alarms
WARNING
Do not perform alarm tests while the patient is connected to the ventilator.
This section describes functional tests to confirm correct technical operation of Astral alarms.
The efficacy of therapy alarm limits should be assessed clinically.
It is recommended that alarms be tested individually. To do so, turn off all alarms except the
alarm that is going to be tested. If the ventilator fails any of the alarm tests, see Troubleshooting
(see page 132).
It is not necessary to test all alarms for every alarm condition. There is no specific sequence in
which the alarms must be tested.
Many of the following tests require use of a passive test lung.
CAUTION
When the alarm tests are completed ensure the Astral device is restored to its original
state.
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Testing the alarms
Testing the power alarms
Alarm
Test procedure
Power disconnected
1. Ensure the Astral device is connected to an external power
source.
2. Power on the Astral device.
3. Disconnect the power cord.
Using internal battery
1. Ensure the Astral device is not connected to an external
power source.
2. Power on the Astral device.
Low battery
1. Ensure the Astral device is powered on and is operating on
the internal battery.
2. With a test lung attached continue ventilation until the
battery discharges and the alarms activate.
Critically low internal battery
Internal battery inoperable
1. Remove the internal battery.
2. Connect the Astral device to an external power source.
3. Power on the Astral device.
Total power failure
1. Remove the internal battery.
2. Connect the Astral device to an external power supply.
3. Power on the Astral device. (This will activate the Battery
inoperable alarm).
4. Wait five minutes and remove the power cord from the
external power source.
Testing the pressure alarms
All pressure alarm tests are conducted using a test lung, single limb circuit and in (A)CV mode.
Alarm
Test procedure
High Pressure
1. Start ventilation.
2. Record the peak inspiratory pressure (PIP).
3. Set the Pressure alarm limit to less than PIP.
High Pressure
1. Start ventilation.
2. Block the exhalation port (eg, when using a proximal valve,
pinch the control tube during inspiration).
Low PEEP
1. Start ventilation.
2. Set the PEEP setting to 10 cm H2O.
3. After 30 seconds disconnect the test lung.
Disconnection / Low Pressure
1. Start ventilation.
2. Record the peak inspiratory pressure (PIP).
3. Set the Low PIP alarm limit above PIP.
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Testing the alarms
Testing the ventilation monitoring alarms
For Astral 150, all ventilation monitoring alarm tests are conducted using a test lung and double
limb circuit in (A)CV mode.
For Astral 100, all ventilation monitoring alarm tests are conducted using a test lung and single
limb circuit in (A)CV mode.
Set (A)CV mode to defaults and start ventilation.
Alarm
Test procedure
Low Vte
Set the alarm limit above the current volume.
High Vte
Set the alarm limit below the current volume.
Low Vti
Set the alarm limit above the current volume.
High Vti
Set the alarm limit below the current volume.
Low MVe
Set the alarm limit above the current minute volume.
High MVe
Set the alarm limit below the current minute volume.
Low MVi
Set the alarm limit above the current minute volume.
High MVi
Set the alarm limit below the current minute volume.
Low Resp Rate
Set the alarm limit above the set respiratory rate.
High Resp Rate
Set the alarm limit below the set respiratory rate.
Shallow breathing (RSBI)
Set the alarm limit below the current RSBI.
Apnoea
Set the respiratory rate to Off.
Testing the oximetry alarms
To test oximetry alarms attach a pulse oximeter to the Astral device and connect the sensor to a
person.
Alarm
Test procedure
Low SpO2
Set the alarm limit to 99%.
High SpO2
Set the alarm limit below the current SpO2 measure.
Low pulse rate
Set the alarm limit above the current pulse rate.
High pulse rate
Set the alarm limit below the current pulse rate.
No SpO2 monitoring
With at least one other oximetry alarm enabled, disconnect the oximeter.
Testing the oxygen alarms
To perform these tests on Astral 100 an oxygen sensor must be fitted. Tests are performed
without supplementary oxygen. Run a Learn Circuit prior to testing.
Alarm Event
Test procedure
Low FiO2
Start ventilation. Set the alarm limit to 24%.
High FiO2
Start ventilation. Set the alarm limit to 19%.
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Alarm settings and conditions
Testing the breathing circuit alarms
All breathing circuit alarm tests are conducted in (S)T mode using default settings and a single
limb circuit with intentional leak.
Alarm
Test procedure
Disconnection
Refer to Testing alarms activate in the case of circuit disconnection. (see
page 105)
Leak
Leave the circuit open and start ventilation.
NV mask
Block the circuit (no mask attached) and start ventilation.
Alarm settings and conditions
This section details the alarms and their activation conditions. If the alarm has adjustable
settings these are described. Unless otherwise noted, alarms are applicable to all modes.
Values provided within [square brackets] are the default settings.
As soon as the activation condition is met, the Astral device provides both audible and visual
alerts without delay.
Tidal volume alarms
Tidal volume alarms activate when the monitored tidal volume parameter (Vti or Vte) exceeds
the Vt alarm setting.
Tidal volume alarms may be used to detect:

change in patient lung condition

leak or obstruction in patient circuit or valve.
Alarm
Activates when
Alarm setting (mL)
Low Vti
Inspiratory tidal volume is less than Low Vt for the
duration of three breaths at the current average
respiratory rate.
Adult: Off, 50 to 2990 [100]
Paed: Off, 10 to 995 [25]
High Vti
Inspiratory tidal volume is greater than High Vt for
three consecutive breaths.
Adult: Off, 60 to 3000 [2500]
Paed: Off, 25 to 1000 [500]
Low Vte
Expiratory tidal volume is less than Low Vt for the
duration of three breaths at the current average
respiratory rate.
Adult: Off, 50 to 2990 [100]
Paed: Off, 10 to 995 [25]
High Vte
Expiratory tidal volume is greater than High Vt for
three consecutive breaths
Adult: Off, 60 to 3000 [2500]
Paed: Off, 25 to 1000 [500]
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Alarm settings and conditions
Minute volume alarms
Minute volume alarms activate when the monitored minute volume parameter (MVi or MVe)
exceeds the MV alarm setting (no delay).
Minute volume alarms will not activate during the first 60 seconds of ventilation.
Minute volume alarms may be used to detect:

change in patient lung condition

leak or obstruction in patient circuit or valve.
Alarm message
Activates when
Alarm setting (L)
Low MVi
Inspiratory minute ventilation is less than Low MV
Adult: Off, 0.5 to 59.9 [3]
Paed: Off, 0.2 to 59.9 [0.5]
High MVi
Inspiratory minute ventilation is greater than High MV Adult: Off, 0.6 to 60 [20]
Paed: Off, 0.3 to 60 [10]
Low MVe
Expiratory minute ventilation is less than Low MV
High MVe
Expiratory minute ventilation is greater than High MV Adult: Off, 0.6 to 60 [20]
Paed: Off, 0.3 to 60 [10]
Adult: Off, 0.5 to 59.9 [3]
Paed: Off, 0.2 to 59.9 [0.5]
Respiratory rate alarms
Respiratory rate alarms activate when the average respiratory rate (Resp. rate) exceeds the corresponding alarm
setting (no delay).
Respiratory rate alarms will not activate during the first 60 seconds of ventilation.
Alarm message
Activates when
Alarm setting (per min)
Low Resp Rate
Respiratory rate is less than the Low Resp rate setting Adult: Off, 2 to 79 [4]
Paed: Off, 5 to 98 [12]
High Resp Rate
Respiratory rate is greater than the High Resp rate
setting
Adult: Off, 3 to 80 [80]
Paed: Off, 6 to 99 [99]
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Alarm settings and conditions
Pressure alarms
Pressure alarms include:

High Pressure

Obstruction / High Pressure

Low Pressure

PEEP.
High pressure
When a high inspiratory pressure is detected, the Astral device immediately cycles to the
expiratory phase and an information message is displayed. Sustained high pressure will result in
the following alarms.
High pressure may be caused by change in patient conditions.
Alarm
Activates when
Alarm setting (cm H2O)
High Pressure
(Medium priority)
For 3 consecutive breaths, the Monitored Pressure
exceeds the Pressure alarm setting or the Inspiratory
port outlet pressure exceeds
57 cm H2O.
10 to 55 [40]
High Pressure
(High priority)
For 10 consecutive breaths, the Monitored Pressure
exceeds the Pressure alarm setting or the Inspiratory
port outlet pressure exceeds
57 cm H2O.
10 to 55 [40]
Note: A high pressure alarm will initially be raised as a Medium priority and will be escalated to
High priority if the condition persists.
Obstruction High pressure
WARNING
When a high expiratory pressure is detected, ventilation is suspended. Ventilation can
only resume when the monitored pressure reduces to below 3 cm H2O and the monitored
expiratory flow reduces below 1 L/min.
Obstruction / High Pressure may be caused by a circuit obstruction. Obstruction can typically be
caused by a pinched PEEP valve control tube or a blocked exhalation valve outlet.
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Alarm settings and conditions
Alarm
Activates when
Alarm setting (cm H2O)
Obstruction /
High Pressure
Monitored airway pressure during exhalation is
greater than the Pressure alarm limit.
10 to 55 [40]
or
The monitored airway pressure during exhalation
exceeds the obstruction limit* and does not
reduce by at least 1 cm H2O per second.
or
The monitored airway pressure during exhalation
exceeds the obstruction limit* after 1.5 seconds
into exhalation or at the end of exhalation (whichever
comes first).
* The obstruction limit depends on the circuit type.
Circuit type
Obstruction limit
Single limb with valve
PEEP + 2 cm H2O, or
(PEEP + PIP)/2, or
PEEP + (Pressure support/2), whichever is greater, except in (A)CV mode in which the
obstruction limit must also exceed 20 cm H2O.
Double limb
PEEP + 2 cm H2O, or
(PEEP + PIP)/2, or
PEEP + (Pressure support/2), whichever is greater.
Single limb with intentional
leak
EPAP + 2 cm H2O, or
(EPAP + IPAP)/2, whichever is greater.
Low pressure
Low pressure may be caused by the circuit disconnecting during inspiration.
Note: To allow for mouthpiece ventilation and other exhale to atmosphere configurations, this
alarm may be turned off. For more information see Mouthpiece Settings (see page 83).
Alarm setting (cm H2O)
Alarm
Activates when
Low Pressure
Monitored PIP is lower than the Low PIP alarm setting Volume modes
for two consecutive breaths.
((A)CV, V SIMV)
Off, PEEP+2 to 54 [5]
(Min is 2 when PEEP set to 'Off')
Monitored pressure reaches less than half of the set
pressure support for two consecutive breaths where
measure Ti >= Rise time.
Pressure modes (excluding
CPAP)
Monitored PIP is less that set CPAP 2 cm H2O.
CPAP mode
Off / On [On]
Off / On [On]
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Alarm settings and conditions
PEEP
PEEP alarms activate when the monitored positive expiratory end pressure parameter (PEEP)
exceeds the corresponding alarm setting. When ventilation starts, or after a PEEP setting
change, PEEP alarms are temporarily disabled until:

the monitored PEEP is within 2 cm H2O of the PEEP setting for three consecutive breaths,
or
 30 seconds has passed.
PEEP alarms may be caused by:

circuit disconnection

high leak

device fault

obstruction.
Alarm
Activates when
Alarm setting
Low PEEP
Monitored PEEP is less than 2 cm H2O below the PEEP Low PEEP
ventilation setting for three consecutive breaths.
Off / On [Off]
High PEEP
Monitored PEEP is greater than 2 cm H2O above the
PEEP setting for three consecutive breaths.
N/A
Breathing circuit alarms
Breathing circuit alarms detect adverse conditions in the breathing circuit or circuit configuration.
Breathing circuit alarms may activate under conditions of:

High leak

NV mask

Flow sensor not calibrated

Circuit incorrectly configured.
High leak
Alarm
Activates when
High Leak
(double limb)
The difference between MVe and Mvi is greater than Off, 20 to 80 [Off] (%)
the Leak alarm setting for a 10 second period.
High Leak
(single limb with
intentional leak)
Estimated unintentional leak is greater than the Leak
alarm setting for a 20 second period.
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Alarm setting
5 to 80, Off [40] (L/min)
Alarm settings and conditions
NV Mask
Alarm
Activates when
Alarm setting
NV mask
A non-vented mask is used in a vented circuit.
Off / On [On]
A non-vented mask is detected when intentional leak
is less than expected by a threshold of 6 L/min or 30
% whichever is greater, for a period of 30 seconds.
Note: This alarm may be impaired if supplementary
oxygen is added at the mask or the circuit.
Flow sensor not calibrated
Alarm
Activates when
Alarm setting
Flow sensor not
calibrated
The expiratory flow sensor is not calibrated. A Learn
Circuit should be performed.
N/A
(double limb)
Circuit configuration alarms
Alarm
Activates when
Alarm setting
Incorrect circuit
The circuit connected to the ventilator differs from the N/A
circuit type setting.
Ventilation not
started. Incorrect
adapter
A single limb circuit with intentional leak is attached
to the ventilator but the correct adapter has not been
fitted.
N/A
A single limb circuit with expiratory valve is attached
but the proximal pressure line is disconnected.
N/A
(single limb with
intentional leak)
Pressure line
disconnected
(single limb)
Oxygen alarms
High and low FiO2 alarms are only available when an oxygen sensor is installed. The absence at the start of
ventilation, or loss during ventilation, of oxygen monitoring is indicated by the No FiO2 alarm.
Alarm
Activates when
Alarm setting (FiO2 %)
Low FiO2
Measured oxygen is less than FiO2 for a continuous
period of 30 seconds.
Off, 18 to 99 [18]
High FiO2
Measured oxygen is greater than FiO2 for a
continuous period of 30 seconds.
Off, 19 to 100 [70]
No FiO2 monitoring
FiO2 alarms are on, and the connected O2 sensor is not N/A
operating or calibrated correctly.
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Alarm settings and conditions
Oximetry alarms
The oximetry alarms are only available when the pulse oximeter is connected to the Astral
device. The alarms are enabled even when the ventilator is in standby.
The SpO2 and Pulse rate alarms are automatically disabled when the pulse oximeter is
disconnected from the Astral device.
SpO2
Oxygen saturation alarms activate when the monitored SpO2 parameter exceeds the
corresponding alarm setting (no delay).
Alarm
Activates when
Alarm setting (SpO2 %)
Low SpO2
Saturation of peripheral oxygen is less than the low SpO2
setting as measured by the pulse oximeter.
Off, 50 to 99 [85]
High SpO2
Saturation of peripheral oxygen is greater than the high SpO2
setting as measured by the pulse oximeter.
Off, 51 to 100 [Off]
No SpO2
monitoring
SpO2 alarm settings are on and the pulse oximeter has been
disabled for more than 5 seconds or has been disconnected.
N/A
Pulse rate
Pulse rate alarms activate when the average pulse rate (Pulse) exceeds the corresponding alarm
setting (no delay).
Alarm
Activates when
Alarm setting (per/min)
Low pulse rate
Pulse rate is less than the low Pulse setting as measured by
the pulse oximeter.
Off, 20 to 249 [30]
High pulse rate
Pulse rate is greater than the high Pulse setting as measured
by the pulse oximeter.
Off, 21 to 250 [150]
Apnoea alarm
For details on how to configure the Apnoea alarm and activation conditions see Apnoea settings
(see page 80).
Ventilation stopped alarm
The ventilation stopped alarm alerts the carer that a user has stopped the ventilator.
This alarm should be enabled if unexpected user intervention is possible.
Alarm
Activates when
Alarm setting
Ventilation stopped
The Stop Vent. button is pressed and Stop Vent.
prompt is confirmed.
Off / On [Off]
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Alarm settings and conditions
Power alarms
Power alarms are not adjustable.
CAUTION
Data cannot be saved while there is a Critically low internal battery or Battery inoperable
alarm. Program selections made while these alarms are active may be lost if the device is
restarted. Recording of ventilation data and alarms is suspended.
Alarm
Activates when
Low battery
Approximately 20 minutes of ventilation time remaining on internal battery power.
Critically low internal Approximately 10 minutes of ventilation time remaining on internal battery power.
battery
Total power failure
There is total loss of power due to failure of the internal battery, or a loss of external power
while the internal battery is removed.
Power disconnected The power source is changed from an external source to the internal battery.
Using internal battery The Astral device is powered on and is using battery power.
Battery inoperable
The internal battery is faulty or has been removed.
System alarms
System alarms are not adjustable. They include:

Unexpected restart—The purpose of the alarm is to alert the carer that the device has
unexpectedly restarted.

Last device test failed—The purpose of the alarm is to remind the carer that the last device
test failed as this may affect ventilator performance and accuracy.

System fault—The purpose of the alarm is to alert the carer that a technical fault has been
detected within the Astral device. Depending on the nature of the technical fault, ventilation
will stop if it is unsafe to proceed.
Alarm message
Activates when
Unexpected restart
A system fault causes the Astral device to restart.
Last device test failed
Ventilation is started after the device self-test fails.
Device overheating
Internal component/s of the device are becoming too hot.
System fault
When a technical fault is detected within the Astral device at initial power up or
during ventilation.
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Detecting circuit disconnection and de-cannulation
Detecting circuit disconnection and de-cannulation
Inadvertent disconnection of a circuit component or accidental removal of a cannula poses a
hazard to a dependent patient. Unfortunately, no single alarm can reliably detect such an event
due to the number of possible combinations of therapy settings, circuit configurations and
patient interfaces.
However, Astral provides a number of alarms that can be configured specifically for this
purpose.
WARNING
Alarm settings are sensitive to any changes to the circuit, ventilation settings or cotherapy. Test the effectiveness of the alarm after any of these changes are made.
CAUTION
Alarms should be configured and tested to ensure that circuit disconnection and decannulation is detected. We recommend configuring and testing multiple alarms and
testing disconnection at the ventilator and at the cannula. Independent monitoring can be
used as an alternative.
The following table provides the most appropriate alarms for use in detecting circuit
disconnection.
Single with leak
Pressure target modes
Volume target modes
Low pressure alarm
N/A
Low Vt (expiratory) alarm
Low MV (expiratory) alarm
Apnoea alarm
Leak alarm
SpO2 alarm
Single with valve
Low pressure alarm
Low pressure alarm
Low Peep alarm
Low PEEP alarm
High Vt (inspiratory) alarm
Apnoea alarm
High Mv (inspiratory) alarm
SpO2 alarm
Apnoea alarm
SpO2 alarm
Double with valve
Low pressure alarm
Low Vt (expiratory) alarm
Low Mv (expiratory) alarm
Apnoea alarm
Leak alarm
SpO2 alarm
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Detecting circuit disconnection and de-cannulation
The most difficult disconnection to detect is a patient interface (eg, cannula, mask or
mouthpiece) being disconnected from the patient.
To test that alarms activate in the case of circuit disconnection:
1. With the breathing circuit configuration in place, start ventilating the patient then wait for a
few cycles for ventilation to stabilise.
2. Disconnect the circuit at the patient interface then check that the alarm(s) configured to
detect circuit disconnection activate.
3. Reconnect the circuit and check that the alarm(s) clear automatically.
4. Repeat steps 2 and 3, disconnecting the circuit at the device and / or at different connection
points of concern.
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Data management process
Data management process
Monitoring data from the Astral device can be viewed in the ResScan™ patient management
software. Data is transferred from the device to ResScan using a USB stick. Once downloaded
to ResScan, the data can be viewed in several report formats to easily monitor treatment results
and compliance.
To connect the ResMed USB to the Astral device:
Plug a USB stick into the USB connector at the rear of the device. The
displayed in the Information bar to indicate the USB is attached.
symbol is
To remove the USB stick, simply pull it out of the USB connector on completion of transfer. If
data was being transferred at the time, a message in the Information bar alerts you to a failed
transfer.
WARNING
Only connect devices specially designed and recommended by ResMed to the data
communication ports. Connecting other devices could result in patient injury, or damage
to the Astral device.
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Data management process
To transfer data:
1. From the Settings menu select Patient Data from the Data Transfer sub-menu.
2. Press Save >. When the transfer is complete a status message is displayed.
3. Press Clear to acknowledge you have read the message and enable further transfers.
4. Remove the USB stick from the Astral device.
5. At the computer where ResScan is installed, plug the USB stick into the USB port.
6. Follow the download procedure specified in the ResScan User Guide.
Data management summary
The table below summarises the data available for use in ResScan.
Detailed data
Summary data1
(5th, Median, 95th)
Logged for the last 7 days
Logged for the last 365 days
Pressure
25 Hz
Flow
25 Hz
Volume
25 Hz
PIP
1 Hz

PEEP
1 Hz

Avg. P
1 Hz

Maximum Inspiratory flow
1 Hz

Leak
1 Hz

SpO2
1 Hz

Pulse
1 Hz

FiO2
1 Hz

Vt
1 Hz

MV
1 Hz

Resp. rate
1 Hz

I:E ratio
1 Hz

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Detailed data
Summary data1
(5th, Median, 95th)
Ti
1 Hz

Te
1 Hz

% Spont. trig

% Spont. cyc

RSBI
1 Hz

AHI2
Median
AI2
Median
1
One set of summary data is provided per day for each program used.
The Apnoea Index (AI) and Apnoea Hypopnoea Index (AHI) are only recorded when a single limb circuit with intentional leak is used. AI
indicates the number of times per hour that patient flow reduces by more than 75% of nominal flow for a period of 10 seconds or more. AHI
indicates the number of times per hour that patient flow reduces by more than 50% of nominal flow for a period of 10 seconds or more.
2
Deleting patient data
To delete patient data
1. Access Clinical mode.
2. From the main menu, select .
3. From the Events sub menu, select the Delete tab.
4. Select delete. All patient data and event logs will be deleted and patient hours will reset to
zero.
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Cleaning and maintenance
Cleaning and maintenance
The cleaning and maintenance described in this section should be carried out regularly.
Refer to the user guides for the patient interface, humidifier and other accessories in use for
detailed instructions for care and maintenance of those devices.
WARNING

A patient treated by mechanical ventilation is highly vulnerable to the risks of infection.
Dirty or contaminated equipment is a potential source of infection. Clean the Astral
device and its accessories regularly.

Do not immerse the device, pulse oximeter or power cord in water. Always turn off and
unplug the device before cleaning and be sure it is dry before plugging back in.
The Astral device can be cleaned using an anti-bacterial solution on a clean, non-dyed disposable
cloth. After replacing any accessory in the patient circuit, ResMed recommends you perform a
Learn Circuit.
CAUTION
Clean only exterior surfaces of the Astral device.
The following disinfectants are compatible for use when cleaning the external surfaces of the
Astral device:

Actichlor Plus

Bleach (1:10) (May also be known as 'dilute hypochlorite').

Isopropanol

Cavicide *

Mikrozid *
* Suitable for cleaning on a monthly basis only
Single patient use
For all circuit components, follow the manufacturer's recommendations for cleaning and
maintenance.
Weekly
1. Wipe the exterior of the device with a damp cloth using a mild cleaning solution.
2. Inspect the condition of the expiratory adapter for entry of moisture or contaminants.
Replace as necessary, or at regular intervals not less than once every six months.
3. Test the alarm sounders, see Testing the alarm sounders (see page 92).
Monthly
1. Inspect the condition of the air filter and check whether it is blocked by dirt or dust. With
normal use, the air filter needs to be replaced every six months (or more often in a dusty
environment).
2. Check the charge level of the internal battery by:
- removing external power and operating the device on internal battery for a minimum of
10 minutes.
- reviewing the remaining battery capacity, see Using the Internal battery (see page 52).
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Cleaning and maintenance
- restoring external power once the test is complete.
Multi-patient use
WARNING

To prevent the risk of cross-contamination, an antibacterial filter, placed on the
inspiratory port is mandatory if the device is to be used on multiple patients as under
some fault conditions, expired gas may be returned through the inspiratory port.

The expiratory module, internal antibacterial filter, expiratory flow sensor and cushion
come into contact with exhaled gases but do not form part of the inspiratory pathway.
In addition to the cleaning and maintenance instructions for single patient use, you must
perform the following before the device is provided to a new patient.
Component
Device
See Cleaning and maintenance (see page 109).
Double limb adapter (used with Double limb circuits)
For general hygiene the Double limb adapter should be
replaced or protected with an AB filter.
Mask
Masks should be reprocessed when used between patients.
Refer to the User guide provided with the mask in use.
Patient circuits
Replace or sterilise. Refer to the manufacturer's
recommended cleaning instructions.
Humidifier
Refer to the User Guide provided with the humidifier in use.
Internal battery
Check the charge level by removing the external power and
operating the device on internal battery for a minimum of ten
minutes. Review the remaining battery capacity and restore
external power.
Replacing components
Replacing the air filter
Inspect the condition of the air filter and check whether it is blocked by dirt or dust. With normal
use, the air filter needs to be replaced every six months (or more often in a dusty environment).
CAUTION
Do not wash the air filter. The air filter is not washable or reusable.
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Cleaning and maintenance
To remove and replace the air filter
1. Unlock the air filter cover by turning in an anti-clockwise direction.
2. Pull the air filter cover from the device.
3. Pull the air filter from the cover and discard.
4. Insert a new filter into the cover.
5. Insert the air filter and cover back into the device.
6. Turn in a clockwise direction to secure in place.
Replacing the expiratory flow sensor and antibacterial filter (Astral 150 only)
CAUTION

Regularly check the double limb adapter (expiratory valve) for moisture and
contaminants. Particular care should be taken when using nebulisers or humidifiers.

When replacing the expiratory flow sensor and antibacterial filter also replace the
adapter cushion and adapter.
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Cleaning and maintenance
To remove and replace the expiratory flow sensor and antibacterial filter:
1. Turn over the device and place on a soft surface (to protect the LCD screen).
2. Press and hold the eject button. Pull the cover out towards you.
3. Lift out the adapter and discard.
4. Remove the blue adapter cushion (including the white antibacterial filter) and discard.
5. Remove and insert a new expiratory flow sensor.
6. Insert a new antibacterial filter.
7. Insert a new blue cushion ensuring the rear tab and surrounds sit flush in the enclosure.
8. Insert a new adapter, gently pushing down so it sits firmly in place.
9. Place the cover over the enclosure, ensuring the runners on the device and the cover are
aligned. Slide the cover back into place until the latch clicks.
CAUTION
Following the replacement of the Expiratory flow sensor, you must run a Learn Circuit to
calibrate the new sensor and ensure accurate therapy and monitoring.
To calibrate the Expiratory flow sensor, connect a double limb circuit. Prior to performing the
Learn Circuit, ensure double circuit is selected on the Circuit sub-menu.
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Cleaning and maintenance
Replacing the double limb adapter (expiratory valve)
Regularly check the double limb adapter for moisture and contaminants. Replace as necessary
using the procedure as described in Connecting circuits.
Replacing the Oxygen sensor
To remove and replace the Oxygen sensor (O2 cell):
1. Unscrew the cover of the O2 cell enclosure.
2. Remove the cover of the O2 cell enclosure.
3. Holding on to the tab of the O2 cell, gently pull the cell up and out of the enclosure. Gently
pull the wire to remove it from the connector in the device.
The device is now ready for the new O2 cell to be installed.
4. Carefully insert the connector of the new O2 cell into the socket. This connector can only be
inserted one way with the flat section to the wall of the enclosure. Press into place using a
blunt tool eg. flat-bladed screwdriver.
5. Holding on to the tab of the O2 cell, gently replace the O2 cell into the enclosure ensuring
the wires are tucked into place.
6. Replace the cover and screw into place.
CAUTION
Following the replacement of the Oxygen sensor, you must run a Learn Circuit to calibrate
the new sensor and ensure accurate therapy and monitoring.
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Cleaning and maintenance
Replacing the internal battery
WARNING
Turn off and disconnect oxygen before replacing the internal battery.
CAUTION

Lithium-ion batteries have built-in safety protection circuits, but can still be dangerous
if they are not used correctly. Damaged batteries can fail or catch fire.

As the battery ages, the available capacity decreases. When the remaining battery
capacity is low, do not rely on the internal battery as the primary power supply.

Only recharge the internal battery inside the device or by using a ResMed approved
charger. Avoid hard, physical impact on the device.

Use the internal battery in accordance with the intended use stated in this guide.
Damage to equipment or injury can result from modifying the equipment or its
operation.

The internal battery should be replaced every two years or when there is a noticeable
reduction in usage time when fully charged.
To remove and replace the internal battery:
Before replacing the internal battery, turn off the Astral device and remove from mains power.
1.
2.
3.
4.
Turn over the device and unscrew the battery cover.
Remove the battery cover from the device.
Remove the battery from the device.
Insert a new battery into the battery enclosure. Ensure the connectors on the battery sit
face down into the enclosure against the battery connection points on the device.
5. Replace the battery cover.
6. Screw the battery cover securely in place.
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Cleaning and maintenance
Servicing
WARNING
Inspection and repair should only be performed by an authorised agent. Under no
circumstances should you attempt to service or repair the device yourself. Failure to do so
could void your Astral device warranty, damage the Astral device or result in possible
injury or death.
Note: Retain the original packaging of the Astral device for use when shipping to/from an
authorised ResMed Service Centre.
Maintenance Timetable
The Astral device should be serviced by an authorised ResMed Service Centre according to the
following schedule. The Astral device is intended to provide safe and reliable operation provided
that it is operated and maintained in accordance with the instructions provided by ResMed. As
with all electrical devices, if any irregularity becomes apparent, you should exercise caution and
have the device inspected by an authorized ResMed Service Centre.
With regular servicing, the expected service life of an Astral device is 8 years.
Servicing schedule from the date of first use:
Recommended service interval
Conducted by
Instructions
Every six months
Personnel who have been
trained in the use of Astral
Replacement of the air filter (replace
earlier if dirty).
Replacement of Single or Double limb
circuit adapters if used.
Two years
Qualified technician
Two year Preventative maintenance.
Replacement of the internal battery
and FiO2 sensor if fitted.
35,000 hours
Qualified technician
Pneumatic block Preventative
maintenance.
Internal Battery
The expected life of the internal battery is two years. The internal battery should be replaced
every two years or when there is a noticeable reduction in usage time when fully charged.
During storage ensure that internal battery is recharged once every six months.
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Cleaning and maintenance
Device information
Device information, including number of hours since the last service, can be found by
pressing
and selecting Device.
Additional considerations for hospital or healthcare facilities
Component
Hospital or healthcare facility
Device
Follow the cleaning and disinfection protocol and schedule of the hospital/healthcare facility.
Double limb adapters For general hygiene, the double limb adapter should be replaced between patients or
protected with an AB filter.
Air filter
Replace every six months (or more if necessary).
Mask
Masks should be reprocessed or replaced between patients. Cleaning, disinfection and
sterilisation instructions are available from the ResMed website,
www.resmed.com/masks/sterilization. If you do not have internet access, please contact your
ResMed representative.
Patient circuits
Follow the protocol of the hospital/healthcare facility and the recommendations of the
manufacturer.
Humidifier
Follow the protocol of the hospital/healthcare facility and the recommendations of the
manufacturer.
Antibacterial filter
Replace as required and between patients.
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Technical specifications
Technical specifications
Operating pressure range
Single limb with valve or double limb with valve:
Expiratory: 3 hPa
Inspiratory: 50 hPa
Single limb with intentional leak:
Expiratory: 2 hPa
Inspiratory: 50 hPa
CPAP:
3 to 20 hPa
Maximum working pressure limit:
10 to 55 hPa
Forced cycling occurs if the Pressure alarm limit is exceeded.
Operating tidal volume range (volume
control modes)
Adult patient type: 100 to 2500 mL
Paediatric patient type: 50 to 300 mL*
Maximum single fault pressure
60 hPa (in all modes)
Breathing resistance under single fault* Paediatric circuit (at 15 L/min)
Inspiration: 2.2 hPa
Expiration: 2.4 hPa
Adult circuit (at 30 L/min)
Inspiration: 5.7 hPa
Expiration: 4.2 hPa
Operational range for circuit resistance
and compliance**
Paediatric patient setting:
Circuit resistance range (circuit with intentional leak):
0 to 8 hPa at 60 L/min
Circuit resistance range (circuit with valve):
0 to 20 hPa at 60 L/min
Circuit compliance range:
0 to 4 mL / hPa
Adult patient setting:
Circuit resistance range (circuit with intentional leak):
0 to 20 hPa at 120 L/min
Circuit resistance range (circuit with valve):
0 to 35 hPa at 120 L/min
Circuit compliance range:
0 to 4 mL / hPa
Maximum flow
220 L/min
Inspiratory trigger (nominal)
characteristics
Inspiratory trigger occurs when patient flow exceeds trigger setting.
Double limb with valve (flow trigger):
0.5 to 15.0 L/min
Single limb with valve or double limb with valve:
1.6 to 10.0 L/min (in five steps)****
Single limb with intentional leak:
2.5 to 15.0 L/min (in five steps)
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Technical specifications
Expiratory cycle (nominal)
characteristics
Cycle occurs when inspiratory flow declines to the set percentage of peak
inspiratory flow.
Single limb with valve or double limb with valve:
5 to 90%
Single limb with intentional leak:
8 to 50% (in five steps)
Sound pressure level
35 ± 3 dBA as measured according to ISO80601-2-12:2011.
Sound power level
43 ± 3 dBA as measured according to ISO80601-2-12:2011
Alarm volume range
59 - 89 dBA (in five steps)
Data storage
7 days of high-resolution airway pressure, respiratory flow and delivered
volume (sampled at 25 Hz).
7 days of breath-related therapy data (sampled at 1 Hz).
365 days of statistical data per program.
Dimensions (L x W x H)
285 mm x 215 mm x 93 mm
Weight
3.2 kg
Inspiratory port / double limb adapter
22 mm taper, compatible with ISO 5356-1:2004
Anaesthetic & Respiratory Equipment – Conical Connectors
Pressure measurement
Internally mounted pressure transducers
Flow measurement
Internally mounted flow transducers
Power supply
AC 100–240V, 50–60Hz, 90 W 3.75 A continuous, 120 W / 5A peak
115V/400 Hz
External DC Power Supply
12 - 24V DC 90 W, 7.5 A / 3.75 A
Internal Battery
Lithium-Ion battery, 14.4 V, 6.6 Ah, 95 Wh
Operating hours (best case): 8 h with a new battery under normal conditions
(see below).
Test conditions: Adult, P(A)CV mode, P control: 20 cm H2O, PEEP: Off, Rate:
15 bpm, Ti: 1.2 sec.
Note: Time may vary with environmental conditions.
Total lifetime: 3,000 hours of operation on internal battery
Operating hours (worst case) > 4 hour run time under the following
conditions:
Test conditions: Adult, nonvented, PACV mode, Double limb circuit, Pressure
Assist = 30 cm H2O, PEEP = 20 cm H2O Rate:20 bpm,
Ti: 1.0 sec, Rise Time = Off, Vts = off, Trig = Off. All other parameters
remain at default settings.
Housing construction
Flame retardant engineering thermoplastic
118
Technical specifications
Environmental conditions
Operating temperature: 0°C to 40°C
Charging temperature: 5°C to 35°C
Operating humidity: 5 to 93% RH non-condensing
Storage and transport temperature (inside packaging): -20°C to 50°C
Storage and transport temperature (outside of packaging): -25°C to 70°C
Note: Storing the Astral device at temperatures exceeding 50°C for
extended period of time mayl accelerate battery ageing. Refer to Using the
internal battery (see page 52)
Storage and transport humidity: 5 to 93% RH non-condensing
Air pressure: 1100 hPa to 700 hPa
Altitude: 3000 m
Note: The performance may be limited below 800 hPa / 2000m.
IP22 (Protected against finger sized objects. Protected against dripping
water when tilted up to 15 degrees from specified orientation.) When
placed horizontally on flat surface, or vertically with handle up.
IP21 (Protected against finger sized objects and against vertically dripping
water) When placed on a desktop stand or when used with the ResMed
Hospital trolley.
Oxygen measurement
Internally mounted oxygen sensor.
1,000,000 % hours at 25°C
Electromagnetic compatibility
Product complies with all applicable electromagnetic compatibility
requirements (EMC) according to IEC60601-1-2, for residential, commercial
and light industry environments.
It is recommended that mobile communication devices are kept at least one
metre away from the device.
For further details see "Guidance and manufacturer’s declaration –
electromagnetic emissions and immunity" (see page 127).
Aircraft use
Medical-Portable Electronic Devices (M-PED) that meet the Federal Aviation
Administration (FAA) requirements of RTCA/DO-160 can be used during all
phases of air travel without further testing or approval by the airline
operator.
ResMed confirms that the Astral meets the Federal Aviation Administration
(FAA) requirements (RTCA/DO-160, section 21, category M) for all phases of
air travel.
IATA classification for internal battery: UN 3481 – Lithium-Ion batteries
contained in equipment.
Automotive use
Product complies with ISO 16750-2 Road Vehicles - Environmental
Conditions and Testing for Electrical and Electronic Equipment - Part 2:
Electrical Loads" - 2nd Edition 2006, Tests 4.2, 4.3.1.2, 4.3.2, 4.4, 4.6.1 and
4.6.2. The functional status classification shall be Class A.
Product complies with ISO7637-2 "Road Vehicles - Electrical Disturbance by
Conduction and Coupling - Part 2 Electrical Transient Conduction Along
Supply Lines Only" - 2nd Edition 2004, Section 4.4 Transient Immunity Test.
The functional status classification shall be Class A to test level III and
Class C to test level IV.
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119
Technical specifications
Data connections
The Astral device has three data connection ports (USB connector, mini USB
connector, and Ethernet port). Only the USB connector is for customer use.
The USB connector is compatible with the ResMed USB stick.
Recommended patient circuit
Refer to www.resmed.com.
components and compatible accessories
IEC 60601-1 classifications
Class II (double insulation)
Type BF
Continuous operation
Suitable for use with oxygen.
Applied parts
Patient interface (Mask, endotracheal tube or tracheostomy tube)
Oximeter
Operator position
The device is designed to be operated within arm's length. An operator
should position their line of sight within an angle of 30 degrees from a
plane perpendicular to the screen.
The Astral device complies with IEC60601-1:2005 legibility requirements.
This device is not suitable for use in the presence of a flammable anaesthetic mixture.
* The International ventilator standard indicates that Paediatric patient type is intended to be used for a patient receiving less than 300 mL,
however Astral permits adjustment of ‘Vt’ setting parameter up to 500 mL for cases where ‘Vt’ is set such that it compensates for leak in the
breathing circuit.
** Limits are the sum of device and circuit impedance.
*** Learn Circuit function will fail if a circuit outside the acceptable range is attached.
**** Individual configurations may be more sensitive.
The life of oxygen cells is described by hours used multiplied by the % of oxygen used. For example 1 000 000 % hours oxygen cell will last for
20 000 hours at 50% FiO2 (20 000 x 50 = 1 000 000) or 40 000 hours at 25% FiO2 (40 000 x 25 - 1 000 000). Astral's oxygen cell will last for 25,000
hours (1041 days) at 40% FiO2
120
Technical specifications
Pneumatic flow path
English
121
Technical specifications
Monitoring
This section specifies the monitored parameters of the Astral device. Monitored therapy
parameters are only displayed during ventilation. Other parameters (eg, battery charge level and
oximetry data) are monitored even when not ventilating.
The Astral device monitors the following parameters:
Time parameters
Parameter
Updates
Units
Range
Resolution
Accuracy
Ti
End of
inhalation
sec
0 to 10
0.01
±(20 ms + 5%)
Te
End of
exhalation
sec
0 to 15
0.01
±(20 ms + 5%)
I:E
End of breath
N/A
1:9.9 to 9.9:1
0.1
±10%
Resp. rate
End of breath
1/min
0 to 99
1
±1/min
Volume and flow parameters
Parameter
Updates
Units
Range
Resolution
Accuracy
Flow
Continuous
L/min
-250 to +250
0.1
±1 L/min or 10%
whichever is
greater
Vti
End of
inhalation
mL
0 to 3000
1
10 mL or 10%,
whichever is
greater
Vte
End of breath
mL
0 to 3000
1
For double limb
circuit:
10 mL or 10%,
whichever is
greater
For single limb with
intentional leak:
15 mL or 15%*,
whichever is
greater
MVi
End of breath
L
0 to 99
0.1
±15% (VTi >= 100
mL)
MVe
End of breath
L
0 to 99
0.1
±15% (VTe >= 100
mL)
Peak Inspiratory Flow (PIF)
End of
inhalation
L/min
0 to 250
0.1
±1 L/min or 15%
whichever is
greater
Measured Unintentional
Leak (for intentional leak
circuits)
Once per
second
L/min
0 to 250
1
N/A
122
Technical specifications
Parameter
Updates
Units
Range
Resolution
Accuracy
Measured Unintentional
Leak
(for double limb circuit
with expiratory valve)
End of breath
%
0 to 100
1
N/A
Range
Resolution
Accuracy
* When Resp. rate  8/min and Pressure  40 hPa.
Pressure parameters
Parameter
Updates
Units
Pressure
Continuous
cm H2O or hPa 0 to 99
or mbar
0.1
±(0.5 hPa + 4% of
actual pressure)
PIP
End of
inhalation
cm H2O or hPa 0 to 99
or mbar
0.1
±15%
PEEP
End of
exhalation
cm H2O or hPa 0 to 30
or mbar
0.1
±(0.5 hPa + 4% of
actual pressure)
Avg. P
End of breath
cm H2O or hPa 0 to 99
or mbar
0.1
±(0.5 hPa + 4% of
actual pressure)
Parameter
Updates
Units
Range
Resolution
Accuracy
RSBI
End of breath
1/min-L
0 to 999
1
N/A
% Spont. Trig.
Start of
inhalation
%
0 to 100
1
N/A
% Spont. Cyc.
End of
inhalation
%
0 to 100
1
N/A
Measured Battery Time
Once per
minute
HH:MM
N/A
1 min
N/A
Measured Battery Charge
Level
Once per
minute
%
0 to 100
1
N/A
FiO2*
End of
inhalation
%
18 to 100
1
±(2.5% + 2.5% of
actual oxygen
concentration)
SpO2
Once per
second
% SpO2
0 to 100
1
Refer to Nonin
Xpod 3012
technical
specifications at
www.nonin.com
Pulse rate
Once per
second
1/min
18 to 321
1
Refer to Nonin
Xpod 3012
technical
specifications at
www.nonin.com.
Other parameters
* FiO2 monitoring automatically compensates for atmospheric pressure variation.
English
123
Technical specifications
Notes:

All flows and volumes are measured at BTPS conditions.

To achieve specified accuracies, a successful Learn Circuit must be performed prior to
measurement testing. Specified accuracies exclude mask compliance.

Pressure may be displayed in cm H2O, hPa or mbar. The conversion factor of the pressure
units is 1. This means the displayed pressure will have the same values regardless of the
unit selected.
Accuracy of controls
The following table shows the setting range and accuracy for the adjustable parameters.
Parameter
Range
Delivered Pressure
2 to 50 hPa
IPAP
4 to 50 hPa
0.2 hPa
Refer to delivered pressure
EPAP
2 to 25 hPa
0.2 hPa
Refer to delivered pressure
CPAP
3 to 20 hPa
0.2 hPa
Refer to delivered pressure
PEEP
Off, 3 to 20 hPa
0.2 hPa
Refer to delivered pressure
PS
2 to 50 hPa
0.2 hPa
Refer to delivered pressure
P control
2 to 50 hPa
0.2 hPa
N/A
Vt (Tidal volume)
Adult: 100 to 2500 mL
Paed: 50 to 300 mL*
10 mL
5 mL
Valved circuits:
±12 mL or 10%, whichever is greater
Resp. rate
Adult: Off, 2 to 50 bpm
Paed: Off, 5 to 80 bpm
1 bpm
±2%
Ti (Inspiration time)
(A)CV, V-SIMV (mandatory Adult: 0.1 sec
breaths):
Paed: 0.05 sec
0.3 to 3.0 sec
P(A)CV, P-SIMV (mandatory
breaths):
0.2 to 5.0 sec
P(A)C:
0.3 to 4.0 sec
PIF (Peak Inspiratory Flow)
(A)CV, V-SIMV (mandatory
breaths):
Adult: 10 to 120 L/min
Paed: 5 to 60 L/min
1 L/min
N/A
Cycle (expiratory trigger)
5 to 90%, Auto
5%
N/A
Trigger (inspiratory trigger)
(A)CV, P(A)CV:
Off, 0.5 to 15 L/min
V-SIMV, PSIMV, PS, CPAP:
0.5 to 15 L/min
0.5 L/min
N/A
124
Resolution
Accuracy
±(0.5 hPa + 5% of target)
±(20 ms + 5% of setting)
Technical specifications
Parameter
Range
Resolution
Inspiratory Pressure Trigger
(A)CV, P(A)CV:
Off, Very Low to Very High
PS, P-SIMV, V-SIMV, CPAP:
Very Low to Very High
N/A
Trigger sensitivity – Vented
(S)T, P(A)C:
Very Low to Very High, Off
CPAP:
Very Low to Very High
N/A
Rise Time
Min, 150 to 900 msec
Flow Shape
Constant, 75, 50, 25%
Ti Min
PS:
0.2 to 4.0 sec
(S)T:
0.1 to 4.0 sec
Adult: 0.1 sec
Paed: 0.05 sec
N/A
Ti Max
0.3 to 4.0 sec
Adult: 0.1 sec
Paed: 0.05 sec
N/A
Cycle Sensitivity
Very Low to Very High
Apnoea Interval
Adult: 15 to 120 sec
Paed: 5 to 30 sec
1 sec
±50 msec
Apnoea Resp Rate
Adult: 4 to 50 bpm
Paed: 12 to 80 bpm
1 bpm
±2%
Apnoea Ti
When Volume Breath
option is set to Ti.
If Apnoea Response is
(A)CV + Alarm:
0.3 to 3 sec
If Apnoea Response is
P(A)CV + Alarm:
0.2 to 5 sec
Adult: 0.1 sec
Paed: 0.05 sec
±(20 ms + 5% of setting)
Apnoea Vt
If Apnoea Response is
(A)CV + Alarm:
Adult: 100 to 2500 mL
Paed: 50 to 300 mL*
Adult: 10 mL
Paed: 5 mL
Valved circuits:
±10 mL or 10%, whichever is greater
Apnoea flow shape
Constant
N/A
Apnoea PIF
When Volume Breath is set 1 L/min
to PIF.
If Apnoea Response is
(A)CV + Alarm:
Adult: 10 to 120 L/min
Paed: 5 to 60 L/min
N/A
50 ms
Accuracy
N/A
N/A
N/A
English
125
Technical specifications
Parameter
Range
Resolution
Accuracy
Apnoea P control
When Apnoea Response is 0.2 hPa
P(A)CV + Alarm:
2 to 50 hPa
±(0.5 hPa+ 5% of target)
Manual Breath Magnitude
100 to 250%
10%
N/A
Sigh Interval
3 to 60 min
1 min
N/A
Sigh Magnitude
120 to 250%
10%
N/A
* The International ventilator standard indicates that Paediatric patient type is intended to be used for a patient
receiving less than 300 mL, however Astral permits adjustment of ‘Vt’ setting parameter up to 500 mL for cases where
‘Vt’ is set such that it compensates for leak in the breathing circuit.
Notes:

All flows and volumes are measured at BTPS conditions.

To achieve specified accuracies, a successful Learn Circuit must be performed prior to
measurement testing.

Delivered pressure is regulated at the patient port.
Measurement System and Accuracy
The Technical Specifications published above are provided in accordance with
ISO 10651-2 2004 and IEC 60601-2-12 2001.
Due to the introduction of a new critical care standard, manufacturers are required to declare
measurement uncertainty.
In accordance with ISO 80601-2-12 2011 the measurement uncertainty of the manufacturer's
test equipment is:
For measures of flow
+/- 2%
For measures of volume
+/- 2 mL
For measures of pressure
+/- 1%
For measures of time
+/- 10 ms
In accordance with ISO 80601-2-12 2011 the tolerance of monitoring parameters inclusive of
measurement uncertainty is:
Time parameters
+/- (30ms + 5%)
Flow parameters
+/-12%
Volume parameters
+/-12 ml or 12% whichever is greater
Pressure parameters
+/- (0.5 hPa + 5%)
Ventilator performance comparisons should be made on the basis of wholly including or
excluding measurement uncertainty.
126
Technical specifications
Functional variants
Functional variations between Astral 100 and Astral 150.
Feature
Circuit
Therapy
O2
Astral 100
Astral 150
Single limb with expiratory valve
Y
Y
Single limb intentional leak
Y
Y
Double limb
N
Y
Preset programs
2
4
Leak therapy modes
Y
Y
Valve therapy modes
Y
Y
Apnoea ventilation
Y
Y
Manual breath button
N
Y
Sigh (pre-programmed)
N
Y
SpO2 monitoring
Y
Y
FiO2 monitoring
Optional extra
Y
Oxygen inlet
Low flow
Low flow
Guidance and Manufacturer’s Declaration Electromagnetic Emissions
& Immunity
Medical electrical equipment needs special precautions regarding EMC and needs to be
installed and put into service according to EMC information provided in this document.
This declaration currently applies for the following ResMed devices:

Astral™ Series of Ventilators.
Guidance and manufacturer’s declaration—electromagnetic emissions
These devices are intended for use in the electromagnetic environment specified below. The
customer or the user of the device should assure that the device is used in such an
environment.
Emissions test
Compliance
Electromagnetic environment—guidance
RF emissions CISPR 11
Group 1
The device uses RF energy only for its internal
function. Therefore, its RF emissions are very low
and are not likely to cause any interference in
nearby electronic equipment.
RF emissions CISPR 11
with or without USB adapter
with or without Oximeter adapter
Class B
The device is suitable for use in all establishments,
including domestic establishments and those
directly connected to the public low-voltage network
that supplies buildings used for domestic purposes.
Harmonic Emissions
IEC 61000-3-2
with or without specified accessories
Class A
Voltage Fluctuations/Flicker Emissions
IEC 61000-3-3
with or without specified accessories
Complies
English
127
Technical specifications
WARNING

The device should not be used adjacent to or stacked with other equipment. If adjacent
or stacked use is necessary, the device should be observed to verify normal operation
in the configuration in which it will be used.

The use of accessories other than those specified for the device is not recommended.
They may result in increased emissions or decreased immunity of the device.

Additional equipment connected to medical electrical equipment must comply with the
respective IEC or ISO standards (eg, IEC 60950 for data processing equipment).
Furthermore all configurations shall comply with the requirements for medical
electrical systems (see IEC 60601-1-1 or clause 16 of the 3Ed. of IEC 60601-1,
respectively). Anybody connecting additional equipment to medical electrical
equipment configures a medical system and is therefore responsible that the system
complies with the requirements for medical electrical systems. Attention is drawn to
the fact that local laws take priority over the above mentioned requirements. If in
doubt, consult your local representative or the technical service department.
Guidance and manufacturer’s declaration – electromagnetic immunity
These devices are intended for use in the electromagnetic environment specified below. The
customer or the user of the device should assure that the device is used in such an
environment.
Immunity test
Compliance level
Electromagnetic environment—guidance
Electrostatic
±6 kV contact
discharge (ESD) ±8 kV air
IEC 61000-4-2
±6 kV contact
±8 kV air
Floors should be wood, concrete or ceramic tile. If
floors are covered with synthetic material, the
relative humidity should be at least 30%.
Electrical fast
transient/burst
IEC 61000-4-4
±2 kV for power
supply lines
±1 kV for
input/output lines
±2 kV
Not Applicable
Mains power quality should be that of a typical
commercial or hospital environment.
Surge
IEC 61000-4-5
±1 kV differential
±1 kV differential
mode
mode
±2 kV common mode ±2 kV common mode
Voltage dips,
short
interruptions
and voltage
variations on
power supply
input lines
IEC 61000-4-11
<5% Ut (>95% dip in
Ut) for 0.5 cycle
40% Ut (60% dip in
Ut) for 5 cycles
70% Ut (30% dip in
Ut) for 25 cycles
<5% Ut (>95% dip in
Ut) for 5 sec
<12V (>95% dip in
240V) for 0.5 cycle
96V (60% dip in 240V)
for 5 cycles
168V (30% dip in
240V) for 25 cycles
<12V (>95% dip in
240V) for 5 sec
Mains power quality should be that of a typical
commercial or hospital environment.
If the user of the device requires continued operation
during power mains interruptions, it is recommended
that the device be powered from an uninterruptible
power source.
The internal battery will provide backup power of
eight hours.
Power
frequency
(50/60 Hz)
magnetic field
IEC 61000-4-8
3 A/m
3 A/m
Power frequency magnetic fields should be at levels
characteristic of a typical location in a typical
commercial or hospital environment.
128
IEC60601-1-2 test
level
Mains power quality should be that of a typical
commercial or hospital environment.
Technical specifications
Immunity test
IEC60601-1-2 test
level
Compliance level
Electromagnetic environment—guidance
Conducted RF
IEC 61000-4-6
3 Vrms
150 kHz to 80 MHz
3 Vrms
150 kHz to 80 MHz
Portable and mobile RF communications equipment
should be used no closer to any part of the device,
including cables, than the recommended separation
distance calculated from the equation applicable to
the frequency of the transmitter.
Radiated RF
IEC 61000-4-3
10 V/m
80 MHz to 2.5 GHz
10 V/m
80 MHz to 2.5 GHz
Recommended separation distance
d = 1.17 √P
d = 0.35 √P 80 MHz to 800 MHz
d = 0.70 √P 800 MHz to 2.5 GHz
Where (P) is the maximum output power rating of
the transmitter in watts (W) according to the
transmitter manufacturer and d is the recommended
separation distance in meters (m). Field strengths
from fixed RF transmitters, as determined by an
electromagnetic site survey, a should be less than
the compliance level in each frequency range. b
Interference may occur in the vicinity of equipment
marked with the following symbol:
Field strengths from fixed transmitters, such as base stations for radio (cellular/cordless) telephones and land mobile
radios, amateur radio, AM and FM radio broadcast and TV broadcast cannot be predicted theoretically with accuracy.
To assess the electromagnetic environment due to fixed RF transmitters, an electromagnetic site survey should be
considered. If the measured field strength in the location in which the device is used exceeds the applicable RF
compliance level above, the device should be observed to verify normal operation. If abnormal performance is
observed, additional measures may be necessary, such as reorienting or relocating the device.
b
Over the frequency range 150 kHz to 80 MHz, field strengths should be less than 10 V/m.
Notes:
a

Ut is the AC mains voltage prior to application of the test level.

At 80 MHz and 800 MHz, the higher frequency range applies.

These guidelines may not apply in all situations. Electromagnetic propagation is affected by
absorption and reflection from structures, objects and people.
Recommended separation distances between portable and mobile RF
communications equipment and the device
These devices are intended for use in an environment in which radiated RF disturbances are
controlled. The customer or the user of the device can help prevent electromagnetic
interference by maintaining a minimum distance between portable and mobile RF
communications equipment (transmitters) and the device as recommended below, according to
the maximum output power of the communications equipment.
Rated maximum output Separation distance according to frequency of transmitter (m)
power of transmitter
150 kHz to 80 MHz
80 MHz to 800 MHz
800MHz to 2.5 GHz
(W)
d = 1.17 √P
d = 0.35 √P
d = 0.7 √P
0.01
0.12
0.04
0.07
0.1
0.37
0.11
0.22
1
1.17
0.35
0.7
English
129
Technical specifications
Rated maximum output Separation distance according to frequency of transmitter (m)
power of transmitter
150 kHz to 80 MHz
80 MHz to 800 MHz
800MHz to 2.5 GHz
(W)
d = 1.17 √P
d = 0.35 √P
d = 0.7 √P
10
3.70
1.11
2.21
100
11.70
3.50
7.0
For transmitters rated at a maximum output power not listed above, the recommended
separation distance d in metres (m) can be determined using the equation applicable to the
frequency of the transmitter, where P is the maximum output power rating of the transmitter in
watts (W) according to the transmitter manufacturer.
Notes:

At 80 MHz and 800 MHz, the separation distance for the higher frequency range applies.

These guidelines may not apply in all situations. Electromagnetic propagation is affected by
absorption and reflection from structures, objects and people.
Symbols
The following symbols may appear on your product or packaging.
Indicates a Warning or Caution
Type BF applied part
Follow instructions for use
Class II equipment
Batch code
China RoHS
Catalogue number
Serial number
Humidity Limitation
Temperature Limitation
Keep upright
Keep dry
Fragile, handle with care
Recyclable
Fire if damaged
Manufacturer
European Authorised Representative
CE Labelling in accordance with EC directive
93/42/EEC
Canadian Standards Association
Prescription only (In the US, Federal law
restricts these devices to sale by or on the order of a
physician.)
130
European RoHS
On/Off
Power plug
Oximeter connector
Ventilation indicator
Alternating current
Direct current
Battery
Alarm Mute / Reset (Audio Pause)
Oxygen supply inlet connector
Connector for control line of external expiratory valve
Connector for the breathing pressure measuring line
Expiratory Connector (From Patient)
Inspiratory Connector (To Patient)
USB connector
Ethernet connector
Technical specifications
Device weight
Protected against finger sized objects.
Protected against dripping water when tilted up to 15
degrees from specified orientation.
Remote Alarm connector
Remote Alarm Test button
Lithium Ion battery
Environmental information
This device should be disposed of separately, not as unsorted municipal waste. To dispose of
your device, you should use appropriate collection, reuse and recycling systems available in your
region. The use of these collection, reuse and recycling systems is designed to reduce pressure
on natural resources and prevent hazardous substances from damaging the environment.
If you need information on these disposal systems, please contact your local waste
administration. The crossed-bin symbol invites you to use these disposal systems. If you require
information on collection and disposal of your ResMed device please contact your ResMed
office, local distributor or go to www.resmed.com/environment.
Standards compliance
The Astral meets the following standards:

IEC 60601-1 Medical Electrical Equipment - General Requirements for Basic Safety and
Essential Performance

IEC 60601-1-2 Medical electrical equipment - Part 1-2: General requirements for basic safety
and essential performance - Collateral standard: Electromagnetic compatibility Requirements and tests

IEC 60601-1-8 General requirements, test and guidance for alarm systems in medical
electrical equipment and medical electrical systems

IEC 60601-1-11 Medical electrical equipment - Part 1-11: General requirements for basic
safety and essential performance - Collateral standard: Requirements for medical electrical
equipment and medical electrical systems used in the home healthcare environment

ISO 10651-2 Lung ventilators for medical use - Particular requirements for basic safety and
essential performance - Part 2: Home care ventilators for ventilator-dependent patients

ISO 10651-6 Lung ventilators for medical use - Particular requirements for basic safety and
essential performance - Part 6: Home care ventilatory support devices.
Training and support
Training and support materials are available from the ResMed website,
www.resmed/astral/support. If you do not have internet access, please contact your ResMed
representative.
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131
Alarm troubleshooting
Alarm troubleshooting
If there is a problem, try the following suggestions. If the problem cannot be solved, contact
your care provider or ResMed.
The most common reason for an alarm to sound is because the system has not been properly
assembled or a Learn Circuit has not been correctly performed for each program.
Notes:

The alarm actions listed below are based on having the appropriate alarm settings for the
patient's therapy. When an adjustable alarm is activated, re-confirm the alarm settings.

The alarm log and alarm settings are maintained when the device is powered down and in
the event of a power loss.

If an alarm activates repeatedly, discontinue use, switch to a backup ventilator and return the
device for servicing.
Alarm message
Action
Apnoea
1.
2.
3.
4.
Check the patient's status and airway.
Verify that the therapy and alarm settings are appropriate.
Consider adjusting the trigger settings.
Inspect the circuit and proximal lines for leak. Perform a Learn Circuit.
Battery Inoperable
1. If the device has been stored in extreme temperatures, wait until the
device returns to room temperature.
2. If the device has been stored for long periods of time, the battery may
have discharged. Connect to mains power.
3. If the alarm persists, replace the battery.
Circuit fault
1. Perform a Learn Circuit.
2. If the alarm persists, replace the circuit.
Battery 1 fault
Check battery connections. If problem persists replace External Battery 1 with new
external battery.
Battery 2 fault
Check battery connections. If problem persists, replace External Battery 2 with a
new external battery.
Critically low internal battery
Connect the Astral to mains AC power and allow the battery to recharge.
Device overheating
1.
2.
3.
4.
5.
6.
7.
8.
Move the device to a cooler location.
Inspect the air inlet for foreign objects.
Inspect the air inlet filter. If necessary, replace the air inlet filter.
Inspect the cooling fan inlet and outlet for foreign objects.
Remove the Astral from the mobility bag.
Check the circuit for obstructions.
Perform a Learn Circuit.
Switch to a lower impedance circuit (if available).
Flow sensor fault
Replace the double limb adapter and perform a Learn Circuit.
Flow sensor not calibrated
Perform a Learn Circuit.
132
Alarm troubleshooting
Alarm message
Action
High FiO2
1.
2.
3.
4.
Check the patient's status.
Check and adjust the oxygen supply.
Verify that therapy and alarm settings are appropriate.
Perform a Learn Circuit to recalibrate the oxygen sensor.
High Leak
1. Check the patient's status.
2. Inspect the circuit, expiratory valve and proximal lines for leak. When
in use, check for leaks around the mask.
3. When using vented therapy, check the mask type setting.
4. Verify that therapy and alarm settings are appropriate.
5. Perform a Learn Circuit.
High MVe
1. Check the patient's status.
2. Inspect the double limb adapter. If necessary, replace the expiratory
valve.
3. Verify that therapy and alarm settings are appropriate.
4. Perform a Learn Circuit.
High MVi
1.
2.
3.
4.
High PEEP
1. Check the patient's status.
2. Inspect the circuit and expiratory valve for obstruction. When in use,
check for obstruction in proximal lines.
3. Verify that therapy and alarm settings are appropriate.
4. Perform a Learn Circuit.
High pressure
1.
2.
3.
4.
High Pulse Rate
1. Check the patient's status.
2. Verify that therapy and alarm settings are appropriate.
High Resp Rate
1.
2.
3.
4.
5.
High SpO2
1. Check the patient's status.
2. Verify that therapy and alarm settings are appropriate.
Check the patient's status.
Inspect the circuit and expiratory module for leaks.
Verify that therapy and alarm settings are appropriate.
Perform a Learn Circuit.
Check the patient's status and airway.
Inspect the circuit for obstruction.
Verify that therapy and alarm settings are appropriate.
Perform a Learn Circuit.
Check the patient's status.
Verify that therapy and alarm settings are appropriate.
Check and adjust the trigger settings.
Check for and correct leak.
Perform a Learn Circuit.
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133
Alarm troubleshooting
Alarm message
Action
High Vte
1. Check the patient's status.
2. Inspect the double limb adapter. If necessary, replace the expiratory
valve.
3. Verify that therapy and alarm settings are appropriate.
4. Perform a Learn Circuit.
High Vti
1.
2.
3.
4.
Incorrect circuit
1. Check that the circuit is correctly connected and matches the circuit
type selected.
2. Inspect the circuit, expiratory valve and proximal lines.
Last self-test failed
1. Perform a Learn Circuit.
2. If problem persists, return the device for service.
Low internal battery
Connect the Astral to mains AC power to allow the battery to recharge.
Check the patient's status.
Inspect the circuit and expiratory module for leaks.
Verify that therapy and alarm settings are appropriate.
Perform a Learn Circuit.
Low FiO2
1.
2.
3.
4.
5.
Check the patient's status.
Check for leak.
Check the oxygen supply and connections to the device.
Verify that therapy and alarm settings are appropriate.
Perform a Learn Circuit to recalibrate the oxygen sensor.
Low MVe
1.
2.
3.
4.
Check the patient's status and airway.
Inspect the circuit and the expiratory valve for obstruction or leaks.
Verify that therapy and alarm settings are appropriate.
Perform a Learn Circuit.
Low MVi
1.
2.
3.
4.
Check the patient's status and airway.
Inspect the circuit for obstruction.
Verify that therapy and alarm settings are appropriate.
Perform a Learn Circuit.
Low PEEP
1. Check the patient's status.
2. Verify that therapy and alarm settings are appropriate.
3. Inspect the circuit and the expiratory valve for obstruction or leaks.
When in use, check for obstructions in proximal lines.
4. Perform Learn Circuit.
Low pressure
1. Check all circuit connections, especially the patient interface and the
proximal sense line.
2. Verify that therapy and alarm settings are appropriate.
3. Inspect the circuit and expiratory valve for damage or secretions.
4. Perform a Learn Circuit.
Low Pulse Rate
1. Check the patient's status.
2. Verify that therapy and alarm settings are appropriate.
134
Alarm troubleshooting
Alarm message
Action
Low Resp Rate
1.
2.
3.
4.
5.
Low SpO2
1. Check the patient's status.
2. Verify that therapy and alarm settings are appropriate.
Low Vte
1.
2.
3.
4.
Check the patient's status and airway.
Inspect the circuit and the expiratory valve for obstruction or leaks.
Verify that therapy and alarm settings are appropriate.
Perform a Learn Circuit.
Low Vti
1.
2.
3.
4.
Check the patient's status and airway.
Inspect the circuit for obstruction.
Verify that therapy and alarm settings are appropriate.
Perform a Learn Circuit.
No FiO2 monitoring
Check the patient's status.
Inspect the circuit and the proximal lines for leak.
Check and adjust settings.
Verify that therapy and alarm settings are appropriate.
Perform a Learn Circuit.
Perform a Learn Circuit to calibrate the oxygen sensor.
No SpO2 monitoring
1. Check the SpO2 connection to patient's finger and the Astral.
2. If the alarm persists, use another SpO2 oximeter or finger sensor.
NV Mask
1. Check that the mask vents are clear and unobstructed.
2. Check the mask type setting.
3. Perform a Learn Circuit.
Note: This alarm could be impaired if supplementary oxygen is added at the mask
or into the circuit.
Obstruction /
High pressure
1. Check the patient's status and airway.
2. Inspect the circuit and the expiratory valve for obstruction. When in
use, check for kinks in proximal lines.
3. Perform a Learn Circuit.
Power fault / no charging
1. Check all connections between the ventilator and external battery.
2. Check connection to mains power (if present). If problem persists,
contact your ResMed Service Centre.
Power disconnected
Pressure Line disconnected
If intending to use external power:
1. Check the power cable connection between the mains or battery, the
power supply pack and the device.
2. If using an external battery, check the external battery charge level
and replace/charge if empty.
3. If using mains AC, check the supply output.
4. If the problem continues, try an alternative external supply type (i.e.
Mains AC, Mains DC or External Battery).
1. Check the connection of the proximal sense line.
2. Perform a Learn Circuit.
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135
Alarm troubleshooting
Alarm message
Action
Shallow breathing
1.
2.
3.
4.
5.
Check the patient's status.
Inspect the circuit and proximal lines for obstructions or leak.
Check and adjust the trigger settings.
Verify that therapy and alarm settings are appropriate.
Perform a Learn Circuit.
System fault
1. Perform a Learn circuit.
2. If problem persists, or the device fails self test, return the device for
service.
Total power failure
1. Check the patient's status and airway.
2. Connect the device to AC mains.
3. Check the battery charge level of the internal and external (if
applicable) battery.
The total power failure alarm can only be silenced by connecting the device to
AC mains power.
Unexpected restart
The device detected a fault and was reset.
1. Check the patient's status.
2. If the alarm persists, switch to a back-up ventilator and return the
device for service.
Using internal battery
Confirm operation on internal battery is intended or restore external power.
1. Check that the correct expiratory adapter is installed for the selected
circuit type.
2. Perform a Learn Circuit.
Ventilation not started. Incorrect
adapter
Ventilation stopped
Confirm it is appropriate to stop ventilation.
Ventilation stopped / High
pressure
The hardware pressure safety limit was exceeded. If problem recurs, return the
device for service.
General troubleshooting
Issue
Action
Condensation forming in circuit
Condensation may form due to high humidity settings and low ambient
temperatures. Adjust humidifier settings in accordance with manufacturer's
instructions.
136
Alarm troubleshooting
Issue
Action
Condensation forming in circuit
Condensation may form due to high humidity settings and low ambient
temperatures. Adjust humidifier settings in accordance with manufacturer's
instructions.
Touch screen damaged or nonresponsive
If you are unable to power off the Astral device normally, use the following forced
shutdown procedure:
1. Disconnect any external power source (eg. AC mains or external
battery).
2. Press and hold the green on/off button and the alarm mute/reset
button for at least 10 seconds. After 10 seconds the alarm bar will
flash yellow.
3. Release both buttons. Astral will then power off.
4. The Astral device can be powered back on by pressing the on/off
button and used as intended.
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137
Recommendations for suctioning
Recommendations for suctioning
Suctioning involves application of negative pressure (vacuum) to the airway through a catheter
tube to remove airway secretions causing airway obstruction.
Astral supports two methods of suctioning based on the selection of catheter  open and
closed.
The need for suctioning can be detected by the ventilator through:

Increased peak inspiratory pressure during volume-controlled ventilation. To detect this
condition, appropriately configure the High Pressure alarm.

Decreased tidal volume during pressure-controlled ventilation. To detect this condition,
appropriately configure the Low Vti alarm

A deterioration of oxygen saturation. To detect this condition, use a Pulse Oximeter and
appropriately configure the Low SpO2 alarm.
If patient pre or post suctioning oxygenation is required, it can be achieved by the following
means (or a combination of the following means):

adjusting the low flow oxygen input to increase delivered FiO2

patient hyperventilation using the Astral Manual breath feature (take care to allow sufficient
exhalation time to avoid breath stacking).
SpO2 monitoring can be used during pre and post oxygenation, during and after suctioning to
assess the patient condition.
For open suctioning, the ventilation circuit may be temporarily disconnected to allow suctioning.
Due to this disconnection the PEEP, Low Inspiratory Pressure, and/or Minute Ventilation alarms
may be triggered. Press
to pre-silence alarms for two minutes.
To facilitate suctioning, the SpO2 and Pulse rate monitors continue to display if ventilation is
temporarily stopped.
For closed suctioning, due to the vacuum pressure applied while ventilating, Tidal volume, Minute
volume and/or PEEP alarms may be triggered. Press
minutes.
to pre-silence alarms for two
CAUTION
Following open or closed suctioning, restore the patient circuit and check ventilation is
correctly restored.
To assess the patient condition and the effectiveness of the secretions removal, peak
inspiratory flow (during pressure-controlled ventilation), peak inspiratory pressure (during
volume-controlled ventilation) or tidal volume during pressure-controlled ventilation, as well as
SpO2 can be monitored.
Astral places no restrictions on which ventilation mode is used while suctioning. Astral may
respond differently depending on the mode and therapy settings. It is recommended that the
'expected response' is clearly documented in the patient care plan.
138
Limited warranty
Limited warranty
ResMed Ltd (hereafter 'ResMed') warrants that your ResMed product shall be free from
defects in material and workmanship from the date of purchase for the period specified below.
Product
Warranty period
90 days

Mask systems (including mask frame, cushion, headgear and tubing)—
excluding single-use devices
Accessories—excluding single-use devices
Flex-type finger pulse sensors
Humidifier water tubs

Batteries for use in ResMed internal and external battery systems
6 months

Clip-type finger pulse sensors
CPAP and bilevel device data modules
Oximeters and CPAP and bilevel device oximeter adapters
Humidifiers and humidifier cleanable water tubs
Titration control devices
1 year
CPAP, bilevel and ventilation devices (including external power supply units)
Battery accessories
Portable diagnostic/screening devices
2 years










This warranty is only available to the initial consumer. It is not transferable.
If the product fails under conditions of normal use, ResMed will repair or replace, at its option,
the defective product or any of its components.
This Limited Warranty does not cover: a) any damage caused as a result of improper use,
abuse, modification or alteration of the product; b) repairs carried out by any service organization
that has not been expressly authorized by ResMed to perform such repairs; c) any damage or
contamination due to cigarette, pipe, cigar or other smoke; and d) any damage caused by water
being spilled on or into an electronic device.
Warranty is void on product sold, or resold, outside the region of original purchase.
Warranty claims on defective product must be made by the initial consumer at the point of
purchase.
This warranty replaces all other expressed or implied warranties, including any implied warranty
of merchantability or fitness for a particular purpose. Some regions or states do not allow
limitations on how long an implied warranty lasts, so the above limitation may not apply to you.
ResMed shall not be responsible for any incidental or consequential damages claimed to have
resulted from the sale, installation or use of any ResMed product. Some regions or states do
not allow the exclusion or limitation of incidental or consequential damages, so the above
limitation may not apply to you.
This warranty gives you specific legal rights, and you may also have other rights which vary from
region to region. For further information on your warranty rights, contact your local ResMed
dealer or ResMed office.
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139
Appendix A: Definitions
Appendix A: Definitions
Ventilation settings definitions
The available settings will vary with the selection of the ventilation mode. Each mode details the
settings available.
Setting
Definition
Apnoea Definition
Apnoea Definition sets the type of breath which must be delayed for an apnoea
to be detected.
Apnoea Interval
(T apnoea)
Apnoea Interval (T apnoea) sets the period without breath or spontaneous breath
required for an apnoea to be detected.
Apnoea Response
Apnoea Response sets the behaviour of the ventilator when an apnoea is
detected.
Circuit Type
Circuit Type sets whether a Double limb circuit, Single limb circuit with
expiratory valve or Single limb circuit with intentional leak is in use.
CPAP
Continuous Positive Airway Pressure (CPAP) sets the pressure maintained
throughout a spontaneous breath.
Cycle
Cycle (also known as Expiratory Trigger) sets the threshold where start of
expiration within a breath is detected.
Cycle Sensitivity
Cycle Sensitivity sets the sets the threshold where start of expiration within a
breath is detected.
EPAP
Expiratory Positive Airway Pressure (EPAP) sets the pressure to be delivered to
the patient during expiration.
Flow shape
Sets the target flow waveform for the delivery of mandatory controlled volume
breaths.
Inspiratory duration option
(Insp Duration Option)
Inspiratory duration option (Insp Duration Option) sets whether Inspiration Time
(Ti) or Peak Inspiratory Flow (PIF) is used to configure volume controlled breaths.
Interval
Sigh interval sets the period between sigh breaths.
IPAP
Inspiratory Positive Airway Pressure (IPAP) sets the pressure to be delivered to
the patient during inspiration.
Magnitude
Magnitude sets the size of the manual or sigh breath delivered relative to the
size of the normal ventilation breath. Separate magnitude settings are available
for configuration of manual or sigh breaths.
Manual Breath
Manual Breath sets whether a manual breath is available for delivery.
Mask Type
Mask Type sets the type of mask or in-line vent in use when the circuit type is
single with leak.
Patient type
Select from Adult or Paediatric. This setting configures the default values and
ranges available for ventilation settings and determines circuit resistance
acceptance criteria applied in the Learn Circuit.
PEEP
Positive End Expiratory Pressure (PEEP) sets the pressure maintained during
exhalation.
140
Appendix A: Definitions
Setting
Definition
PS
Sets the pressure support above PEEP to be delivered during inspiration for
pressure supported breaths (spontaneous breaths).
PS Max
Maximum Allowed Pressure Support (PS Max) sets the maximum pressure
support above PEEP allowed to achieve the target safety tidal volume.
P control
Pressure control (P control) sets the pressure support above PEEP to be delivered
during inspiration for pressure assisted breaths.
P control max
Maximum allowed pressure control (P control max) sets the maximum pressure
control above PEEP allowed to achieve the target safety volume.
PIF
Peak Inspiratory Flow (PIF) sets the maximum delivered flow for volume
controlled breaths.
Resp. rate
Respiratory rate (Resp. rate) sets the breaths per minute (bpm) to be delivered by
the ventilator to the patient. The measured respiratory rate may be greater due to
patient triggered breaths.
Rise Time
Rise time sets the time taken for the ventilator to reach inspiratory pressure for
pressure controlled breaths.
Sigh Alert
Sigh alert sets whether the ventilator gives a single beep just prior
to delivery of a sigh breath.
Sigh Breath
Sigh Breath sets whether a magnified breath (a sigh breath) will be delivered at
the sigh interval.
Interval
Sigh interval sets the period between sigh breaths.
Ti
Inspiration time (Ti) sets the duration of the inspiratory phase of a breath.
Ti Max
Maximum inspiratory time (Ti Max) sets the maximum duration of the inspiratory
phase of a breath.
Ti Min
Minimum Inspiratory Time (Ti Min) set the minimum duration of the inspiratory
phase of a breath.
Trigger
Sets the trigger threshold above which the ventilator triggers a new breath.
The trigger is blocked for the first 300 ms following the start of exhalation.
Trigger type
Trigger type sets whether a pressure based trigger threshold or flow based
trigger threshold is used when a Double circuit is selected.
Vt
The Tidal Volume (Vt) sets the volume of gas, measured in mL, to be delivered to
the patient in a mandatory controlled volume breath.
Safety Vt
Safety tidal volume (Vts) sets the target minimum tidal volume (Vt) for each
ventilator delivered breath.
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141
Appendix A: Definitions
Measured and calculated parameter definitions
The following measured and calculated parameters are displayed during configuration or during
ventilation. Each Ventilation mode details the parameters displayed.
Parameter
Definition
FiO2
Average of percentage of Oxygen delivered to circuit.
I:E
I:E is the ratio of the inspiratory period to the expiratory period.
The measured I:E ratio is displayed as a monitored parameter during ventilation.
The expected I:E ratio is calculated and displayed on the settings screens if the
Resp. rate setting is not set to Off.
Leak
Leak is the average unintentional leak. It is reported as a percentage for Double
limb circuits and as a flow for Single limb circuits with intentional leak.
The measured Leak is displayed as a monitored parameter during ventilation.
MVe
Expiratory Minute Volume (MVe) is the product of the respiratory rate and
expired tidal volume averaged over the last eight breaths.
The measured MVe is displayed as a monitored parameter during ventilation.
MVi
Inspiratory Minute Volume (MVi) is the product of the respiratory rate and
inspired tidal volume averaged over the last eight breaths.
The measured MVi is displayed as a monitored parameter during ventilation.
Pressure
Pressure is the current airway pressure of the patient as measured at the patient
port.
The measured Pressure is displayed as a monitored parameter during ventilation.
PEEP
End expiratory pressure (PEEP) is the airway pressure measured 50 ms prior to
the end of the last expiration.
The measured PEEP is displayed as a monitored parameter during ventilation.
Pmean
Mean airway pressure of the patient over the last breath.
% Spont cycle
% Spont cycle is the percentage of breaths that are spontaneously cycled over
the past 20 breaths.
% Spont trig
% Spont trig is the percentage of breaths that are spontaneously triggered over
the last 20 breaths.
The measured %Spont Trig is displayed as a monitored parameter during
ventilation.
PIF
Peak Inspiratory Flow (PIF) is the maximum flow reached during the last
inspiration.
The measured PIF is displayed as a monitored parameter during ventilation.
The expected PIF is calculated and displayed for volume controlled breaths on the
settings screens when the Inspiratory Phase Duration Option is set to Ti.
PIP
Peak Inspiratory Pressure (PIP) is the maximum airway pressure reached during
the last inspiration.
The measured PIP is displayed as a monitored parameter during ventilation.
142
Appendix A: Definitions
Parameter
Definition
Pulse rate
The measured Pulse rate (pulse) is displayed as a monitored parameter when a
pulse oximeter is used.
Resp. rate
Respiratory rate (Resp. rate) is the number of breaths per minute averaged over
the last eight breaths.
The measured Resp. rate is displayed as a monitored parameter during
ventilation.
RSBI
Rapid Shallow Breathing Index (RSBI) is calculated by dividing the breath rate by
Tidal Volume.
The measured RSBI is displayed as a monitored parameter during ventilation.
SpO2
The measured Oxygen Saturation (SpO2) is displayed as a monitored parameter
when a pulse oximeter is used.
Te
Expiratory time Te is the period in seconds of the last expiratory phase.
The measured Te is displayed as a monitored parameter during ventilation.
Ti
Inspiratory time Ti is the period in seconds of the last inspiratory phase.
The measured Ti is displayed as a monitored parameter during ventilation.
The expected Ti is calculated and displayed for volume controlled breaths on the
settings screens when the Inspiratory Phase Duration Option is set to PIF.
Vte
Expiratory Tidal Volume (Vte) is the volume expired during the last breath.
The measured Vte is displayed as a monitored parameter during ventilation.
Vti
Inspiratory Tidal Volume (VTi) is the volume inspired during the last breath.
The measured VTi is displayed as a monitored parameter during ventilation.
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143
Appendix B: Ventilation parameters
Appendix B: Ventilation parameters
Ventilation Parameters summary table
The following table provides a summary of the Astral device parameter ranges and the [default
settings].
P-SIMV
V-SIMV





Setting
CPAP
PS

P(A)C
P(A)CV

Leak
Ventilation
CPAP
(A)CV
Respiratory rate
Valve Ventilation
(S)T
Adjustable
Parameters
(A)CV, P(A)CV, P(A)C

Adult: Off, 2 to 50 [15]

Paed: Off, 5 to 80 [15]
Mandatory breaths: V-SIMV, P-SIMV

Adult: 2 to 50 [15],

Paed: 5 to 80 [15]
PS, (S)T

Adult: Off, 2 to 50 [15]

Paed: Off, 5 to 80 [15]

EPAP
(cm H2O)
PEEP
(cm H2O)




PS
(cm H2O)
Off, 3.0 to 20.0 [5.0]



2 to 25 [5]

CPAP
(cm H2O)
P Control
(cm H2O)


3.0 to 20.0 [5.0]
Adult: 2 to 50 [7]
Paed: 2 to 50 [7]



PS


Adult: 2 to 50 [7]
Paed: 2 to 50 [7]
Spontaneous breaths: V-SIMV, PSIMV

Adult: 2 to 50 [7]

Paed: 2 to 50 [7]
IPAP
(cm H2O)
144


Adult: 4 to 50 [12]
Paed: 4 to 50 [12]
Appendix B: Ventilation parameters
Setting
CPAP
P(A)C
Leak
Ventilation
CPAP
V-SIMV
P-SIMV
PS
P(A)CV
(A)CV
Valve Ventilation
(S)T
Adjustable
Parameters
Vt
(mL)


V-SIMV (mandatory breaths), (A)CV

Adult: 100 to 2,500 [500]

Paed: 50 to 300 [100]*
PIF
(L/min)


When Volume Breath option is set to
PIF:
(A)CV, V-SIMV (mandatory breaths)

Adult: 10 to 120 [50]

Paed: 5 to 60 [10]
Ti
(sec)





When Volume Breath option is set to
Ti:
(A)CV, V-SIMV (mandatory breaths)

Adult: 0.3 to 3.0 [1.0]

Paed: 0.3 to 3.0 [0.6]
P(A)CV, P-SIMV (mandatory breaths)

Adult: 0.2 to 5.0 [1.0]

Paed: 0.2 to 5.0 [0.6]
P(A)C

Adult: 0.3 to 4.0 [1.0]

Paed: 0.3 to 4.0 [0.6]

Cycle
(%)


P-SIMV, V-SIMV (spontaneous
breaths), PS
5 to 90, Auto [Auto]
Cycle is fixed at 5% for CPAP
(valved).
Trigger type






Flow/Pressure
P(A)CV and CPAP double limb circuit
only
Trigger (sensitivity)
[Trigger type = Flow]
(L/min)






When Trigger Type is set to Flow
trigger
(double limb circuit only)
(A)CV, P(A)CV

Adult: Off, 0.5 to 15 [1.0]

Paed: Off, 0.5 to 15 [0.5]
V-SIMV, PSIMV, PS, CPAP

Adult:0.5 to 15 [1.0]

Paed:0.5 to 15 [0.5]
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145
Appendix B: Ventilation parameters
P-SIMV
V-SIMV
CPAP





Setting
CPAP
PS

P(A)C
P(A)CV
Leak
Ventilation
(A)CV
Trigger (sensitivity)
[Trigger type =
Pressure]
Valve Ventilation
(S)T
Adjustable
Parameters
When Trigger Type is set to Pressure
trigger
(double and single limb circuit)
(A)CV, P(A)CV
Off, 1, 2, 3, 4, 5 [3]
PS, P-SIMV, V-SIMV, CPAP
1, 2, 3, 4, 5 [3]

Trigger (sensitivity)
[Vented]


(S)T, P(A)C
Off, Very Low to Very High [Medium]
CPAP
Very Low to Very High [Medium]

Rise Time
(msec)
Flow Shape
(%)
Ti Min
(sec)








Min, 150 to 900 [Min]
Constant, 75, 50, 25 [25]

PS
0.2 to 4.0 [0.2]
(S)T
0.1 to 4.0 [0.2]
Ti Min is fixed at:

0.2 for P-SIMV, V-SIMV, and
CPAP (valved)

0.1 for CPAP (leak)
Ti Max (Maximum
Inspiration Time)
(sec)


Adult: 0.3 to 4.0 [1.5]
Paed: 0.3 to 4.0 [0.8]
Ti Max is fixed at:

The lesser of ( (2/3) x (60/f) ) or 4
for P-SIMV and V-SIMV

4 for CPAP (leak)

3 for CPAP (valved) Adult

1.5 for CPAP (valved) Paediatric
146
Appendix B: Ventilation parameters

Cycle Sensitivity
Setting
CPAP
P(A)C
Leak
Ventilation
CPAP
V-SIMV
P-SIMV
PS
P(A)CV
(A)CV
Valve Ventilation
(S)T
Adjustable
Parameters
Very Low to Very High [Medium]
Cycle Sensitivity is fixed at Very
High for CPAP (leak).
* The International ventilator standard indicates that Paediatric patient type is intended to be used for a patient receiving less than 300 mL,
however Astral permits adjustment of ‘Vt’ setting parameter up to 500 mL for cases where ‘Vt’ is set such that it compensates for leak in the
breathing circuit.
Ventilation displayed parameters
The following therapy parameters are displayed on the device but cannot be changed directly.
They are determined by the adjustable parameters and internal algorithms.
Parameters
V-SIMV
Setting


When Volume Breath option is set to
Ti, PIF is display only.
Ti
(sec)


When Volume Breath option is set to
PIF, Ti is display only.

CPAP
PIF
(L/min)
P(A)C

(S)T

CPAP
I:E Ratio
PS
P(A)CV
Leak
Ventilation
(A)CV
P-SIMV
Valve Ventilation
Displayed if Respiratory Rate not set
to Off
English
147
Appendix B: Ventilation parameters
Supplementary Features
The following table indicates the supplementary features applicable to each ventilation mode.
The adjustable parameters, the available setting range and default are displayed.
Features



Off / On [Off]
Manual Breath
Magnitude
(%)





100 to 250 [150]
Sigh Breath


Off / On [Off]
Sigh Alert


Off / On [Off]
Sigh Interval
(min)


3 to 60 [10]
Sigh Magnitude
(%)


120 to 250 [150]
Apnoea Response








CPAP

P(A)C
V-SIMV

(S)T
P-SIMV
Manual Breath
CPAP
PS
Setting
P(A)CV
Leak
Ventilation
(A)CV
Valve Ventilation

Valve Ventilation:
Alarm Only, (A)CV+Alarm,
P(A)CV+Alarm, Off
Leak Ventilation:
Alarm Only, Off
Apnoea Interval
(T apnoea)
(min: sec)

Apnoea Resp Rate
(1/min)

Apnoea Detection

148








Adult: 0m 15s to 15m 0s [0m 20s]
Paed: 0m 5s to 0m 30s [0m 10s]





Adult: 4 to 50 [15]
Paed: 12 to 80 [15]








No Breath / No Spont Breath [No
Breath]
Appendix B: Ventilation parameters
P-SIMV
V-SIMV
CPAP





Setting
CPAP
PS

P(A)C
P(A)CV
Leak
Ventilation
(A)CV
Apnoea Ti
(sec)
Valve Ventilation
(S)T
Features
When Volume Breath option is set to
Ti:
If Apnoea Response is (A)CV +
Alarm:

Adult: 0.3 to 3 [1.0]

Paed: 0.3 to 3 [0.6]
If Apnoea Response is P(A)CV +
Alarm:

Adult: 0.2 to 5.0 [1.0]

Paed: 0.2 to 5.0 [0.6]
Apnoea Vt
(mL)






If Apnoea Response is (A)CV +
Alarm:
Adult: 100 to 2500 [500]
Paed: 50 to 500 [100]
Apnoea Flow Shape
(%)






Constant
Apnoea PIF
(L/min)






When the Volume Breath is set to
PIF.
If Apnoea Response is (A)CV +
Alarm:

Adult: 10 to 120 [50]

Paed: 5 to 60 [10]
Apnoea P Control
(cm H2O)
Safety Vt (mL)








If Apnoea Response is P(A)CV +
Alarm:

Adult: 2 to 50 [7]

Paed: 2 to 50 [7]
Adult: Off, 100 to 2500 [Off]
Paed: Off, 50 to 500 [Off]

PS Max
Pcontrol Max (cm
H2O)

PS setting to 50 [PS +5]

P control to 50 [Pcontrol +5]
English
149
Appendix B: Ventilation parameters
Supplementary Features displayed parameters
The following therapy parameters are displayed on the device but cannot be changed directly.
They are determined by the adjustable parameters and internal algorithms.

Manual Breath PIF
(L/min)


Manual Breath Vt
(mL)






Manual Breath PS
(cm H2O)
Sigh Ti
(sec)


Sigh PIF
(L/min)


Sigh Vt
(mL)


Sigh P Control
150






CPAP
(S)T
CPAP
V-SIMV

Manual Breath P Control
(cm H2O)

Leak Ventilation
Manual Breath Ti
(sec)
Apnoea I:E

P-SIMV
PS
P(A)CV
(A)CV
Valve Ventilation
P(A)C
Features
Appendix B: Ventilation parameters






Apnoea PIF Display
(L/min)






Apnoea Ti Display (Inspiration
Time)






Apnoea Rise Time
(sec)






Apnoea Flow Shape
(%)
CPAP
(S)T
CPAP
Leak Ventilation
V-SIMV
P-SIMV
PS
P(A)CV
(A)CV
Valve Ventilation
P(A)C
Features
Flow shape = Constant
English
151
Appendix C: Alarm parameters
Appendix C: Alarm parameters
Alarm Parameters summary table
The following table provides a summary of the Astral device alarm settings and the [default
settings].
Alarm
P(A)CV
P-SIMV
V-SIMV
PS
CPAP
(S)T
P(A)C
CPAP
Leak
Ventilation
(A)CV
Valve Ventilation
Vt - Low
(Tidal Volume)
(mL)









Vt - High
(Tidal Volume)
(mL)

MV - Low
(Minute Volume)
(L)

MV - High (Minute
Volume)
(L)

Low Resp rate
(1/min)

High Resp rate
(1/min)

Pressure
(High Airway
Pressure)
(cm H2O)

Low PIP
(Peak Inspiratory
Pressure)
(cm H2O)

Low PIP
(Peak Inspiratory
Pressure)
(cm H2O)
152
Setting
Adult: Off, 50 to 2990 [100]
Paed: Off, 10 to 995 [25]








Adult: Off, 60 to 3000 [2500]
Paed: Off, 25 to 1000 [500]








Adult: Off, 0.5 to 59.9 [3.0]
Paed: Off, 0.2 to 59.9 [0.5]








Adult: Off, 0.6 to 60 [20.0]
Paed: Off, 0.3 to 60 [10.0]








Adult: Off, 2 to 79 [4]
Paed: Off, 5 to 98 [12]








Adult: Off, 3 to 80 [80]
Paed: Off, 6 to 99 [99]









10 to 55 [40]
Off, PEEP+2 to 54 [5]
Min is 2 when PEEP set to Off







Off / On [On]
Appendix C: Alarm parameters
Alarm
P-SIMV
V-SIMV
PS
CPAP
(S)T
P(A)C
CPAP
Setting
P(A)CV
Leak
Ventilation
(A)CV
Valve Ventilation
Low PEEP









Off / On [On]
Vent Stopped









Off / On [Off]
Leak
(%)






Off, 20 to 80 [Off]
(double limb circuit with expiratory
valve)
Leak



Off / 5 to 80 [40]
NV mask



Off / On [On]
FiO2 - Low
(%)









Off, 18 to 99 [Off]
FiO2 - High
(%)









Off, 19 to 100 [Off]
SpO2 - Low
(%)









Off, 50 to 99 [85]
SpO2 - High
(%)









Off, 51 to 100 [Off]
Pulse - Low
(1/min)









Off, 20 to 249 [30]
Pulse - High
(1/min)









Off, 21 to 250 [150]
English
153
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