AVEA ® user guide
™
AVEA Ventilator Systems
Operator’s Manual
ii
Operator's manual
This document is protected by United States and International Copyright laws.
This document may not be copied, reproduced, translated, stored in a retrieval system,
transmitted in any form, or reduced to any electronic medium or machine-readable form,
in whole or in part, without the written permission of CareFusion. Information in this
document is subject to change without notice.
This document is for informational purposes only and should not be considered as
replacing or supplementing the terms and conditions of the License Agreement.
© 2006–2016 CareFusion Corporation or one of its affiliates. All rights reserved.
AVEA, CareFusion, and the CareFusion logo are trademarks of CareFusion Corporation or
one of its affiliates. All other trademarks are the property of their respective owners.
CareFusion
22745 Savi Ranch Parkway
Yorba Linda, CA 92887
U.S.A.
CareFusion Germany 234 GmbH
Leibnizstrasse 7
97204 Hoechberg
Germany
800.231.2466 toll-free
714.283.2228 tel
714.283.8493 fax
+49 931 4972.0 tel
+49 931 4972.423 fax
carefusion.com
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Version History
Date
Version
Changes
September 2005
A
Release
May 2006
B
Removed references to the Plus model
Removed “non-operational” from figure 2-19
Added a note regarding the setting of Peak Inspiratory Pressure
Added Ppeak to the list of alert messages
December 2006
C
Updated the Primary Controls table
Added NCPAP to the troubleshooting table
Updated the Rate specification
Added the chapter “Infant NCPAP”
February 2007
D
Updated the figure and added a description of the balloon size and type selection
Added a note regarding the date and time
Added Addendums Filter/Water Trap, Processing Instructions, Sterilization, L2860-101, L3004A,
L3082A, L2889A, L3031A
September, 2008
E
Release of Volumetric Capnography
February 2010
F
Revised the manual to comply with the revised Medical Device Directive 2007/42/EC.
February 2010
G
Rebranded to the CareFusion style.
June 2010
H
Revised the Circuit Resistance Test regarding the use of ET tubes.
Added a bullet under Warnings: Routine assessment of oxygenation and ventilation should be
performed when a patient is receiving respiratory support.
January 2011
J
Changed the logo and company references to VIASYS.
January 2011
K
Changed the logo and company references to CareFusion.
June 2011
L
Added content for Volume Guarantee and Nasal Intermittent Mandatory Ventilation.
July 2011
M
Removed the first note from the section “Specific Controls” regarding the flow cycling of breaths.
February 2012
N
Updated Table E-2.
July 2012
P
Updated according to ECO 80620.
April 2014
R
Added the Manufacturer and EC REP symbols to the address information and added the
Attention symbol to all caution and warning statements to meet the requirements of
MDD 93/42/EEC as amended by 2007/47/EC Annex 1, Section 3.1.
Updated references to standards.
Changed all instances of “tracheal catheter” to “tracheal monitoring tube” and all instances of
esophageal catheter to “esophageal balloon.”
February 2016
T
Updated according to ECO 84941.
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Warranty
THE AVEA™ ventilator systems are warranted to be free from defects in material and workmanship and to meet the
published specifications for Two (2) years or 16,000 hours, whichever occurs first.
The liability of CareFusion (referred to as the Company) under this warranty is limited to replacing, repairing or issuing
credit, at the discretion of the Company, for parts that become defective or fail to meet published specifications during
the warranty period; the Company will not be liable under this warranty unless (A) the Company is promptly notified in
writing by Buyer upon discovery of defects or failure to meet published specifications; (B) the defective unit or part is
returned to the Company, transportation charges prepaid by Buyer; (C) the defective unit or part is received by the
Company for adjustment no later than four weeks following the last day of the warranty period; and (D) the Company’s
examination of such unit or part shall disclose, to its satisfaction, that such defects or failures have not been caused by
misuse, neglect, improper installation, unauthorized repair, alteration or accident.
Any authorization of the Company for repair or alteration by the Buyer must be in writing to prevent voiding the warranty.
In no event shall the Company be liable to the Buyer for loss of profits, loss of use, consequential damage or damages of
any kind based upon a claim for breach of warranty, other than the purchase price of any defective product covered
hereunder.
The Company warranties as herein and above set forth shall not be enlarged, diminished or affected by, and no
obligation or liability shall arise or grow out of the rendering of technical advice or service by the Company or its agents
in connection with the Buyer's order of the products furnished hereunder.
Limitation of Liabilities
This warranty does not cover normal maintenance such as cleaning, adjustment or lubrication and updating of
equipment parts. This warranty shall be void and shall not apply if the equipment is used with accessories or parts not
manufactured by the Company or authorized for use in writing by the Company or if the equipment is not maintained in
accordance with the prescribed schedule of maintenance.
The warranty stated above shall extend for a period of TWO (2) years from date of shipment or 16,000 hours of use,
whichever occurs first, with the following exceptions:
1.
Components for monitoring of physical variables such as temperature, pressure, oxygen, or flow are warranted
for ninety (90) days from date of receipt.
2.
Elastomeric components and other parts or components subject to deterioration, over which the Company has no
control, are warranted for sixty (60) days from date of receipt.
3.
Internal batteries are warranted for ninety (90) days from the date of receipt.
The foregoing is in lieu of any warranty, expressed or implied, including, without limitation, any warranty of
merchantability, except as to title, and can be amended only in writing by a duly authorized representative of the
Company.
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Contents
Revision History ....................................................................................................iii
Warranty
....................................................................................................... iv
Limitation of Liabilities .................................................................................... iv
Notices
...................................................................................................... viii
EMC Notice ................................................................................................... viii
MRI Notice ..................................................................................................... viii
Intended Use Notice ...................................................................................... viii
Regulatory Notice .......................................................................................... viii
Classification .................................................................................................. ix
Declaration of Conformity Notice .................................................................... ix
Safety Information ................................................................................................. x
Terms .............................................................................................................. x
Warnings ......................................................................................................... x
Cautions ......................................................................................................... xi
Equipment Symbols ............................................................................................ xiii
Chapter 1:
Introduction...................................................................................... 1
Chapter 2: Unpacking and Setup ...................................................................... 7
Ventilator Assembly and Physical Setup ......................................................... 7
Setting Up the Front of the Ventilator .............................................................. 9
Front Panel Connections ............................................................................... 17
Setting Up the Rear of the Ventilator ............................................................. 24
User Verification Test .................................................................................... 39
AVEA User Verification Test Checklist .......................................................... 46
AVEA Troubleshooting .................................................................................. 47
Chapter 3: Ventilator Operation ...................................................................... 51
Membrane Buttons and LEDs ....................................................................... 51
Patient Setup ................................................................................................. 59
Ventilation Setup ........................................................................................... 61
Setting the Ventilation Breath Type and Mode .............................................. 66
Volume Guarantee (VG) ................................................................................ 67
Primary Breath Controls ................................................................................ 90
Advanced Settings......................................................................................... 96
Independent Lung Ventilation (ILV) ............................................................. 104
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Chapter 4: Monitors, Displays and Maneuvers ..............................................105
Graphic Displays ..........................................................................................105
Digital Displays ............................................................................................124
Main Screen Displays ..................................................................................130
Chapter 5: Volumetric Capnography .............................................................133
Theory of Operation .....................................................................................133
Setup ...........................................................................................................134
Settings and Monitored Values ....................................................................137
Alarms ..........................................................................................................141
Maneuvers ...................................................................................................142
Zeroing the CAPNOSTAT 5 .........................................................................144
Checking the Accuracy of the CAPNOSTAT 5 ............................................146
Chapter 6: Infant Non-invasive Ventilation ....................................................149
Nasal CPAP (nCPAP) ..................................................................................149
Nasal Intermittent Mandatory Ventilation (nIMV) .........................................155
Chapter 7: Alarms and Indicators ..................................................................167
Status Indicators ..........................................................................................167
Messages ....................................................................................................169
Alarms ..........................................................................................................171
Alarm Controls .............................................................................................172
Alarm Types .................................................................................................173
Nasal CPAP / Nasal IMV Alarms .................................................................182
Volume Guarantee Alarms ...........................................................................185
Chapter 8: Maintenance and Cleaning ..........................................................187
Cleaning and Sterilization ............................................................................187
Recommended Periodic Maintenance .........................................................190
Battery Care .................................................................................................191
Fuses ...........................................................................................................194
Appendix A: Contact and Ordering Information ................................................197
How to Call for Service ................................................................................197
Ordering Parts..............................................................................................198
Appendix B: Specifications ...............................................................................201
Pneumatic Supply ........................................................................................201
Electrical Supply ..........................................................................................201
Data Input / Output.......................................................................................202
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Atmospheric and Environmental Specifications ........................................... 209
Physical Dimensions ................................................................................... 209
Accessories ................................................................................................. 209
Appendix C: Pneumatic Diagram ..................................................................... 211
Appendix D: Monitor Ranges and Accuracies .................................................. 213
Appendix E: Sensor Specifications and Circuit Resistance ............................. 217
VarFlex® Sensor Specifications .................................................................. 217
Hot Wire Flow Sensor Specifications........................................................... 218
Circuit Resistance Test................................................................................ 219
Volumetric Capnography Specifications ...................................................... 220
Appendix F: AVEA Message Bar Text ............................................................. 223
Appendix G: Advanced Pulmonary Mechanics Monitored Parameters ............ 225
Appendix H: Capnometry Troubleshooting ...................................................... 233
Appendix I: Volumetric CO2 Calculations....................................................... 235
Appendix J: Electromagnetic Declarations ...................................................... 239
Appendix K: Glossary ...................................................................................... 243
Index
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Notices
EMC Notice
This equipment generates, uses, and can radiate radio frequency (RF) energy. If this equipment is not installed and
used in accordance with the instructions in this manual, electromagnetic interference may result.
This equipment has been tested and found to comply with the limits of acceptance set forth in Standard EN 60601-1-2
for Medical Products. These limits provide reasonable protection against electromagnetic interference (EMC) when
operated in the intended use environments described in this manual.
This ventilator is also designed and manufactured to comply with the safety requirements of Standard EN 60601-1,
IEC 60601-2-12, CAN/CSA-C22.2 No. 601.1-M90, and UL 60601-1-1.
This ventilator can be affected by portable and mobile RF communications equipment.
This ventilator should not be stacked with other equipment.
The following cables were used in the evaluation of this ventilator.

15619 – Normally Open Patient Call Cable (Length – 1.7 meters)

15620 – Normally Closed Patient Call Cable (Length – 1.7 meters)

70600 – Cable, Communications (Length – 1 meter)

70693 – Cable, Communications (Length – 3 meters)

Standard Centronics Printer Cable (Length – 2 meters)

Standard SVGA Monitor Cable (Length – 2 meters)
Use of other cables may result in increased emissions or decreased immunity.
See Tables 201, 202, 203, and 205 for further information regarding the AVEA Ventilator and EMC.
MRI Notice
This equipment contains electromagnetic components whose operation can be affected by intense electromagnetic
fields.
Do not operate the ventilator in a MRI environment or in the vicinity of high-frequency surgical diathermy equipment,
defibrillators, or short-wave therapy equipment. Electromagnetic interference could disrupt the operation of the ventilator.
Intended Use Notice
The AVEA is intended to provide continuous respiratory support in an institutional health care environment (e.g.
hospitals). It may be used on neonatal through adult patients. It should only be operated by properly trained clinical
personnel, under the direction of a physician.
Regulatory Notice
Federal law restricts the sale of this device except by or on order of a physician.
The benefit of treatment with medical respiratory support devices outweighs the remote possibility of exposure to
phthalates.
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Classification
Type of Equipment:
Medical Equipment, Class 1 type B
Adult/Pediatric/Infant Lung Ventilator
Declaration of Conformity Notice
This medical equipment complies with the Medical Device Directive, 93/42/EEC, and the following Technical Standards,
to which Conformity is declared:
BS EN 60601-2-12:2006
EN 60601-1
EN 60601-1-1
EN 60601-1-2
ISO 13485
UL 60601-1
CAN / CSA C22.2 No. 601.1-M90
EU Notified Body:
BSI (Notified Body No. 0086)
Trade names:
AVEA ventilator systems
Manufactured by:
CareFusion
22745 Savi Ranch Parkway
Yorba Linda, California 92887–4668
USA
If you have a question regarding the Declaration of Conformity for this product, please contact CareFusion at one of the
numbers given in Appendix A.
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Safety Information
Please review the following safety information prior to operating the ventilator. Attempting to operate the
ventilator without fully understanding its features and functions may result in unsafe operating conditions.
Warnings and Cautions, which are general to the use of the ventilator under all circumstances, are included in this
section. Some Warnings and Cautions are also inserted within the manual where they are most meaningful.
Notes are also located throughout the manual to provide additional information related to specific features.
If you have a question regarding the installation, set up, operation, or maintenance of the ventilator, contact Customer
Care, as shown in Appendix A Contact and Ordering Information.
Terms
WARNINGS
identify conditions or practices that could result in serious adverse reactions or potential safety
hazards.
CAUTIONS
identify conditions or practices that could result in damage to the ventilator or other equipment.
NOTES
identify supplemental information to help you better understand how the ventilator works.
Warnings
Warnings and Cautions appear throughout this manual where they are relevant. The Warnings and Cautions
listed here apply generally any time you operate the ventilator.

The AVEA Ventilator is intended for use by a trained practitioner, under the direction of a qualified physician.

When the ventilator is connected to a patient, a trained health care professional should be in attendance at all times
to react to an alarm or other indications of a problem.

Alarm loudness must be set above ambient sound in order to be heard.

Always have an alternate means of ventilation available whenever the ventilator is in use.

The operator should not touch the electrical connectors of the ventilator or accessories, and the patient
simultaneously.

Due to possible explosion hazard, the ventilator should not be used in the presence of flammable anesthetics.

An audible alarm indicates an anomalous condition and should never go unheeded.

Anti-static or electrically conductive hoses or tubing should not be used within the patient circuit.

If a mechanical or electrical problem is recognized while operating the ventilator, the ventilator must be removed
from use and referred to qualified personnel for servicing. Using an inoperative ventilator may result in patient injury.

When a low gas supply alarm occurs, the oxygen concentration delivered to the patient will differ from that set on the
O2 control setting.

A source gas failure will change the FIO2 and may result in patient injury.

The functioning of this equipment may be adversely affected by the operation of other equipment nearby, such as
high frequency surgical (diathermy) equipment, defibrillators, short-wave therapy equipment, “walkie-talkies,” or
cellular phones.

Water in the air supply can cause malfunction of this equipment.
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
Do not block or restrict the Oxygen bleed port located on the instrument back panel. Equipment malfunction may
result.

Electric shock hazard - Do not remove any of the ventilator covers or panels. Refer all servicing to an authorized
CareFusion service technician.

A protective ground connection by way of the grounding conductor in the power cord is essential for safe operation.
Upon loss of protective ground, all conductive parts including knobs and controls that may appear to be insulated
can render an electric shock. To avoid electrical shock, plug the power cord into a properly wired receptacle, use
only the power cord supplied with the ventilator, and make sure the power cord is in good condition.

The AVEA is designed to ensure that the user and patient are not exposed to excessive leakage current per
applicable standards (UL 60601-1 and IEC60601-1). However, this cannot be guaranteed when external devices
are attached to the ventilator. In order to prevent the risk of excessive enclosure leakage current from external
equipment attached to the RS-232, printer and video ports, isolation of the protective earth paths must be provided
to ensure proper connection. This isolation should ensure that the cable shields are isolated at the peripheral end of
the cable. Only IEC 60950-1 or IEC 60601-1 certified external peripheral equipment shall be attached to the device.

Routine assessment of oxygenation and ventilation should be performed when a patient is receiving respiratory
support.

Delivered and monitored flow as well as pressure and volume settings and values are subject to device
accuracy specifications as described herein.

To avoid a potential safety hazard when operating two or more of the same or similar device in a single area, use
the same audible alarm characteristics.
Cautions
The following cautions apply any time you work with the ventilator.

Ensure that the voltage selection and installed fuses are set to match the voltage of the wall outlet, or damage may
result.

A battery that is fully drained (i.e. void of any charge) may cause damage to the ventilator and should be replaced.

All accessory equipment that is connected to the ventilator should comply with CSA/IEC 60601-1/UL 60601-1.

To avoid damage to the equipment, clean the air filter regularly.
The following cautions apply when cleaning the ventilator or when sterilizing ventilator accessories.

Do not sterilize the ventilator. The internal components are not compatible with sterilization techniques.

Do not gas sterilize or steam autoclave tubing adapters or connectors in place. The tubing will, over time, take the
shape of the adapter, causing poor connection and possible leaks.

DO NOT submerge the ventilator or pour cleaning liquids over or into the ventilator.

The patient-specific settings for the ventilator are stored in non-volatile memory every minute during use or each
time a setting is changed. This allows indefinite recovery of the settings even in the event of total power loss.
Exceptions would be any time the New Patient function is selected before ventilation or intentional clearing of the
memory, such as installing new software.
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

When the recommended breathing system is in use, and normal ventilation is compromised, resulting in the opening
of the safety valve, the inspiratory and expiratory gradient at the patient-connection port shall not be greater than
shown below:
5 LPM
30 LPM
60 LPM
Inspiratory
0.7 cmH2O
2.1 cmH2O
5.0 cmH2O
Expiratory
0.7 cmH2O
3.8 cmH2O
5.3 cmH2O
The use of any attachments or accessories placed in the breathing systems (circuit) may increase the pressure
gradient across the breathing system (resistance) for the patient.
Note:
Maximum Circuit Pressure Limit:
The ventilator has an independent mechanical pressure relief valve that limits the maximum pressure at the patient
wye to 125 cmH2O.
Safety Valve:
Under certain conditions, the safety valve automatically opens, which gives the patient the ability to spontaneously
breathe without having to draw a sub-ambient pressure to open the valve. Under this condition, the exhalation valve is
also de-energized and allows one-way breathing through the circuit to prevent the re-breathing of exhaled gasses.
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Equipment Symbols
The following symbols may be referenced on the ventilator or in accompanying documentation
Symbol
Source/Compliance
ISO 7010-W001
General warning
ISO 7000-0434A
Caution
Symbol #5016 IEC 60417
This symbol indicates a FUSE.
Symbol #5034 IEC 60417
Symbol #01-36 IEC 60878
Symbol #5035 IEC 60417
Symbol #01-37 IEC 60878
Symbol #5031 IEC 60417
Symbol #5019 IEC 60417
Symbol #01-20 IEC 60878
Symbol #5021 IEC 60417
Symbol # 01-24 IEC 60878
Symbol # 5333 IEC 60417
Symbol #02-03 IEC 60878
Symbol #5032 IEC 60417
This symbol indicates INPUT.
This symbol indicates OUTPUT
This symbol indicates DIRECT CURRENT (DC)
This symbol indicates protective EARTH (ground).
This symbol indicates the EQUIPOTENTIAL connection used to
connect various parts of the equipment or of a system to the same
potential, not necessarily being the earth (ground) potential (e.g., for
local bonding).
This symbol indicates TYPE B equipment, which indicates equipment
that provides a particular degree of protection against electric shock,
particularly with regards to allowable leakage current and reliability of
the protective earth connection.
Symbol #01-14 IEC 30878
This symbol is located on the rating plate. It indicates the equipment is
suitable for alternating current.
Symbol #5007 IEC 60417
Symbol #01-01 IEC 60878
Indicates ON (Power)
Symbol #5008 IEC 60417
Symbol #01-02 IEC 60878
Indicates OFF (Power)
Symbol #0651 ISO 7000
Horizontal return with line feed. Indicates ACCEPT entered values for
a specific field.
CareFusion Symbol
Indicates PATIENT EFFORT
CareFusion Respiratory
Care symbol
Indicates MANUAL BREATH
ACCEPT
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CANCEL
CareFusion Symbol
MAIN SCREEN
Symbol #417 IEC 5102
EVENT READY
CareFusion Symbol
MODE
CareFusion Symbol
ADVANCED SETTINGS
CareFusion Symbol
SET-UP for patient size selection
MDD Directive 93/42/EEC
CE Mark
Symbol #5307 IEC 60417
ALARM RESET
Symbol #5319 IEC 60417
ALARM SILENCE
CareFusion symbol
ADULT patient
CareFusion symbol
PEDIATRIC patient
CareFusion symbol
NEONATAL (Infant) patient
Graphical Symbol in
general use internationally
for “DO NOT”
CANCEL, i.e. do not accept entered values.
CareFusion symbol
Select DISPLAYED SCREEN function.
Symbol 5467 IEC 60417
FREEZE the current display.
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CareFusion symbol
Enable the ALARM LIMITS screen
CareFusion symbol
This symbol indicates a CONTROL LOCK.
CareFusion symbol
NEBULIZER port
CareFusion symbol
Increase OXYGEN
CareFusion symbol
PRINT SCREEN
CareFusion symbol
SUCTION port
CareFusion symbol
VARIABLE ORIFICE FLOW SENSOR connection
CareFusion symbol
HOT WIRE FLOW SENSOR connection
CareFusion symbol
ANALOG IN/OUT connection
CareFusion symbol
Display the MAIN SCREEN
CareFusion symbol
DO NOT BLOCK PORT
CareFusion symbol
EXTERNAL BATTERY connection
CareFusion symbol
Indicates GAS ID port
CareFusion symbol
OXYGEN SENSOR connection
CareFusion symbol
OVERPRESSURE relief
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CareFusion symbol
REMOTE NURSE CALL connection
CareFusion symbol
USER INTERFACE MONITOR connection
CareFusion symbol
This symbol indicates an INTERNAL BATTERY FUSE
CareFusion symbol
This symbol indicates ALARM LOUDNESS
CareFusion symbol
This symbol indicates that the AVEA is being powered by the
INTERNAL BATTERY only.
CareFusion symbol
This symbol indicates that the HELIOX configuration is in use.
CareFusion symbol
This symbol indicates the product contains phthalates.
Symbol #0434 IEC
TR60878
Indicates ATTENTION or CAUTION
Manufacturer
Indicates the medical device manufacturer, as defined in EU Directives
90/385/EEC, 93/42/EEC and 98/79/EC
Authorized representative in
the European Community
Indicates the authorized representative in the European Community
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Chapter 1: Introduction
The AVEA is a fourth generation, servo-controlled, software-driven ventilator. It has a dynamic range of breathing gas
delivery that provides for neonatal through adult patients. Its revolutionary user interface module (UIM) provides
maximum flexibility with simple operator interaction. It has a flat panel color LCD with real time graphic displays and
digital monitoring capabilities, a touch screen for easy interaction, membrane keys and a dial for changing settings and
operating parameters. A precision gas delivery engine with servo controlled active inhalation and exhalation improves
performance over previous generations.
The AVEA has been designed to function using most commonly available accessories. It is easy to clean and its design
does not allow liquids to pool on the casing, reducing the likelihood of fluid leakage into the body of the ventilator.
There are two models of AVEA: Comprehensive and Standard. The following table shows the standard and optional
functions available with each model.
Functions and Accessories
Modes
Proximal Hot Wire Flow Sensing
Synchronized Nebulizer
24 Hour Trending
Internal Battery
Full Color Graphics Display
Loops and Waveforms
Standard Cart
Proximal Variable Orifice flow sensing
Proximal Airway Pressure Monitoring
Tracheal Monitoring Tube
Esophageal Balloon
Internal Compressor
Heliox Delivery
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Optional Functions and Accessories
Operator's manual
Standard
Comprehensive
Custom Cart
Option
Included
External Battery (on custom cart only)
Option
Option
Gas Tank Holder (on either cart)
Option
Option
Internal Compressor
Option
Included
Pflex Maneuver
Option
Included
Heliox Delivery
Option
Included
nIMV/ Volume Guarantee
Option
Included
Volumetric Capnography
Option
Option
Some AVEA Features
Artificial Airway Compensation1
When Artificial Airway Compensation is turned on, the ventilator automatically calculates the pressure drop across the
endotracheal tube. The AVEA then adjusts the airway pressure to deliver the set inspiratory pressure to the distal
(carina) end of the endotracheal tube. This calculation takes into account flow, gas composition (Heliox or
Nitrogen/Oxygen), Fraction of Inspired Oxygen (FIO2), tube diameter, length, and pharyngeal curvature based on patient
size (Neonatal, Pediatric, Adult). This compensation only occurs during inspiration. Artificial Airway Compensation is
active in all Pressure Support and Flow Cycled Pressure Control Breaths.
WARNING
Activating of Artificial Airway Compensation while ventilating a patient will cause a sudden increase in the
peak airway pressures and a resultant increase in tidal volume. If you choose to activate Artificial Airway
Compensation while the patient is attached to the ventilator you will need to exercise caution to minimize the
risk of excessive tidal volume delivery.
Note:
Monitored airway pressures (inspiratory) will be higher than set values when Artificial Airway Compensation is active.
With an inspiratory pressure setting of zero, Artificial Airway Compensation will still provide an elevated airway pressure,
which will compensate for the resistance of the endotracheal tube.
When turned on the Artificial Airway Compensation indicator will appear in all modes of ventilation even though the
function may not be active (i.e.: Volume Controlled Breaths). This is to alert you to the fact that Artificial Airway
Compensation will become active if a Pressure Support or combination mode (e.g. Volume Control SIMV) is selected.
Range:
Off/On
Default:
Off
Available in all patient sizes
1
Estimation of Inspiratory Pressure Drop in Neonatal and Pediatric Endotracheal Tubes, by Perre-Henri Jarreau, American Physiological Society 1999
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Full range of Patient Size
You can select a patient size of Adult, Pediatric, or Neonate. Once the selection is made, the ventilator offers only those
parameters, which are available for your selected patient size.
For a complete listing of compatible circuits and accessories, see “Appendix E: Sensor and Circuit Specifications” on
page 217.
Non-Invasive Ventilation
The ventilator can perform non-invasive ventilation with a standard dual limb circuit. Leak compensation should be
turned on when using this feature. To turn leak compensation on, use the touch screen control displayed in the Ventilator
Set-Up Screen.
Note:
Noninvasive ventilation requires the use of a snug fitting mask with no bleed holes. Excessive leaks around the mask
may result in false triggering of the ventilator or assertion of disconnect alarms.
Leak Compensation
Leak Compensation is used to compensate for baseline leaks, which may occur at the patient mask interface or around
the patient’s endotracheal tube. It only provides baseline leak compensation and is not active during breath delivery.
During exhalation, PEEP is maintained by the cooperation of the Flow Control Valve (FCV) and the Exhalation Valve
(ExV). The ExV pressure servo is set to a target pressure of PEEP and the FCV pressure servo is set to a pressure
target of PEEP - 0.4 cmH2O. The ExV servo relieves when the pressure is above its target and the FCV supplies flow
when the pressure drops below its target up to a maximum flow rate for the patient size
Range:
Off/On
Default:
Off
Circuit Compliance Compensation
When Circuit Compliance is active, the volume of gas delivered during a volume controlled or targeted breath is
increased to include the set volume, plus the volume lost due to the compliance effect of the circuit. Circuit Compliance
is active for the set Tidal Volume during volume control ventilation, the Target Tidal Volume in PRVC mode and for
Machine Volume. It is only active in Adult and Pediatric applications.
Exhaled volume monitors for all modes and breath types are also adjusted for the compliance compensation
volume.
Range:
0.0 to 7.5 ml/cmH2O
Default:
0.0 ml/cmH2O
The ventilator automatically measures Circuit Compliance during the Extended Systems Test (EST). The value cannot
be entered manually.
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Note:
Although circuit compliance is displayed on the Setup screen it is not active for neonatal patients.
High circuit compliance with small tidal volumes may result in extended inspiratory times. This is a result of the delivery
of the circuit compliance volume at the set flow rate.
Setting extremely small delivered tidal volumes with Circuit Compliance Compensation not active and using a proximal
flow sensor may result in assertion of Patient Circuit Disconnect Alarms.
Humidification
You can select active or passive humidification (ON/active or OFF/passive). Active humidification assumes 99% RH;
passive assumes 60% RH when using an HME. This feature adjusts the BTPS correction factor to correct exhaled tidal
volumes.
Range:
Default:
Off/On
Active (ON)
Note:
Incorrect setting of the Humidification feature will affect monitored exhaled volume accuracy.
Heliox Delivery (Comprehensive only, option on Standard)
Using patented “Smart” connector technology, the Comprehensive model AVEA can deliver Heliox blended gas instead
of Medical air. By simply changing a connector on the back panel, the ventilator identifies the gas input and adjusts to
accommodate the change. All volumes (numeric and graphic) are automatically compensated for accurate display.
The clinical benefits of helium / oxygen gas are based on its significantly lower gas density when compared to nitrogen /
oxygen gas. This lower gas density allows the same volumetric (tidal volume) of gas to be delivered to the patient at a
significantly lower airway pressure. Additionally, the low-density properties of the gas allow it to diffuse past airway
obstructions or restrictions much easier than nitrogen / oxygen gas mixtures.
Note:
The Heliox “smart” connector is designed for use with an 80/20 Heliox tank only. Only a mixture of 20% oxygen and
80% Helium can be used as the Heliox gas supply.
If Heliox gas is connected this green icon displays in bottom right of the touch screen.
To set the Helium / Oxygen mixture during administration simply set the desired FIO2, the balance of the breathing gas is
Helium.
For example:
A set FIO2 of 35% will deliver a 65/35 Heliox mixture to the patient.
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WARNING
Connection of a gas supply at the Helium-Oxygen mixture inlet that does not contain 20% oxygen can cause
hypoxia or death.
Although an 80/20 mixture of Helium and Oxygen is marketed as medical gas, the Helium/Oxygen gas
mixture is not labeled for any specific medical use.
Note:
Hot wire flow sensors will not function with Heliox gas mixtures. During Heliox delivery, a variable orifice flow sensor
should be used for monitoring delivered volumes at the proximal airway.
Note:
Heated humidifier performance should be carefully monitored during Heliox therapy. Helium has significantly
greater thermal conductivity compared to nitrogen / oxygen gas mixtures and this could cause difficulty with some
heated humidification devices. A febrile patient may transfer heat via the gas column to a proximal temperature
sensor, which could affect the duty cycle of the humidifier and decrease output. This could cause desiccation of
secretions in the airway.
Alternately, in applications where a heated wire breathing circuit is used, this heat transfer from the patient may affect
the duty cycle of the heated wire circuit, which may result in increased condensation in the breathing circuit.
The relative settings of some types of humidifiers may need to be reduced to prevent overheating of the breathing gas.
Note:
The Oxygen alarm cannot be disabled during Heliox administration
Do not operate nebulizer while using heliox
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Chapter 2: Unpacking and Setup
Ventilator Assembly and Physical Setup
Unpacking the Ventilator
The AVEA is designed for simplicity of operation and set-up. It requires minimal assembly on site.
Items Required for Ventilator Setup
You will need the following to setup your AVEA ventilator:

Power Source. The ventilator operates from a standard 100, 110, 220, or 240 VAC power source or an optional
external 24VDC battery. There is an internal battery supplied with the ventilator, which will operate the ventilator for
short periods (see “Chapter 8: Maintenance and Cleaning”).
CAUTION
The ventilator should be connected to a mains AC power supply for at least 4 hours prior to switching to internal
battery power. For operation on external battery, the ventilator should be connected to a mains AC power supply for at
least 12 hours with the green LED lit to ensure a fully charged battery.

Pressurized Oxygen, Air or Heliox Gases. The compressed gas sources must provide clean, dry, medical grade
gas at a line pressure of 20 to 80 PSIG (1.4 to 5.6 bar).
Air or Heliox Supply
Pressure Range:
Temperature:
Minimum Flow:
Air Inlet fitting
Heliox Inlet fitting
20 to 80 psig (1.4 to 5.5 bar) (Supply Air)
20 to 80 psig (1.4 to 5.5 bar) (Supply Heliox - 80% / 20% Heliox Only)
3 to 10 psig (0.2 to 0.7 bar) (Compressor Air)
5 to 40°C (41 to 104°F)
80 L/min at 20 psig (1.4 bar)
CGA DISS-type body, No. 1160 (Air). NIST fitting per BS-5682:1984 (Air) also available.
CGA DISS-type body, No. 1180 (Heliox)
Note:
NIST fittings for air and oxygen are available from CareFusion upon request at the time of the order.
Oxygen Supply
Pressure Range:
Temperature:
Humidity:
Minimum Flow:
Inlet Fitting:
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20 to 80 psig (1.4 to 5.5 bar) (Supply Oxygen)
5 to 40º C (41 to 104º F)
Dew Point of gas should be 1.7º C (3º F) below the ambient temperature (minimum)
80 L/min at 20 psig (1.4 bar)
CGA DISS-type body, No. 1240. NIST fitting per BS-5682:1984 (O2) also available.
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Assembling the Ventilator
Assemble your AVEA ventilator’s wheeled base using the instructions included in the package. The ventilator body is
easily attached to the base by means of four thumbscrews. Reference the AVEA Service Manual Installation
Instructions for detailed directions (Figure 2–1).
Standard
Ventilator Base
Comprehensive
Ventilator Base
Figure 2–1: Basic and Comprehensive base attachment
CAUTION
The ventilator body and UIM weigh approximately 80 lbs. (36.4 kg) Employ safe lifting procedures when assembling
the ventilator.
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External battery option
If you have purchased the optional external battery pack, reference AVEA Service Manual, Installation Instructions.
Install your external batteries per the installation instructions enclosed with the cart accessories kit (P/N 11372).
Setting Up the Front of the Ventilator
Assembling the Exhalation Filter and Water Trap
To assemble and insert the exhalation filter and water trap do the following:
Screw the supplied water collection bottle
into the threaded cuff of the water trap.
Figure 2–2: Attaching the Collection Bottle to the Water Trap
Push the exhalation filter into the water trap assembly top as shown.
Locating Ridge for assembly
into cartridge
Figure 2–3: Attaching the Exhalation Filter
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Align the locating ridge on the water trap assembly with the slot in the exhalation filter cartridge (Figure 2–4).
Slot matches locating ridge
of water trap assembly
Figure 2–4: Exhalation Filter Cartridge Showing Locating Slot
Slide the water trap/exhalation filter assembly into the cartridge (Figure 2–5).
Figure 2–5: Exhalation Filter/Water Trap Assembly in Cartridge
Rotate the metal locking lever on the lower right of the ventilator body forward to
an open position.
Figure 2–6: Open locking lever
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Insert the completed cartridge assembly
into the ventilator body as shown. Make
sure it is completely seated in the well.
Figure 2–7: Insert exhalation filter
Note:
Placement of the exhalation filter/water trap assembly without the exhalation filter cartridge may cause misalignment of
the filter seal resulting in patient breathing circuit leaks.
Close the locking lever.
Figure 2–8: Close locking lever in place
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AVEA Disposable Expiratory Filter / Water Trap
User Instructions
Installation
Note:
The AVEA Disposable Expiratory Filter / Water Trap is supplied non-sterile. It can be used as an alternative for the
AVEA reusable filter assembly (reusable filter, a collector vial, a water trap, and a cartridge component). The AVEA
reusable filter assembly is not required when using the Disposable Expiratory Filter / Water Trap.
Figure 2–9: AVEA Disposable Expiratory Filter / Water Trap
1. Locate the metal locking lever on the front lower left side of the ventilator, then rotate the lever outwards to a fully
open position.
Figure 2–10: Inserting the Filter / Water Trap combination
2. Insert the AVEA Disposable Expiratory Filter into the filter cavity with the orientation as shown in Figure 2–
10. Make sure the filter is fully inserted into the filter cavity before closing the lever.
3. Close the locking lever completely to secure the filter in the ventilator well.
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Figure 2–11: Closing the locking lever
After you close the locking lever, the filter is ready for use.
Figure 2–12: Completed installation of Filter / Water Trap combination
WARNING
Incomplete insertion of the AVEA Disposable Expiratory Filter may cause misalignment of the filter seal,
which will result in patient circuit leakage.
Note:
The lever closes without great difficulty if the filter is fully inserted into the filter cavity.
WARNING
The locking lever must be closed completely to ensure that the filter is properly installed and
securely locked.
4. Drain Tube and Pinch Clamp. Inspect for any visible damage and make sure it is securely installed.
5. Periodically inspect the filter-vial water level and empty it before it reaches the maximum-level line.
6. To empty the fluid in the collection vial, press open the pinch clamp to empty contents of the collection vial into an
appropriate receptacle. Close and lock the pinch clamp when finished.
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Figure 2–13: Draining water trap
WARNING
The drain tube must be fully attached to the filter and the pinch clamp must be in the closed position.
Figure 2–14: Closed pinch clamp
Figure 2–15: Open pinch clamp
CLEANING:
Only the exterior of the filter can be cleaned. This is done by a gentle wipe down using only mild cleaning solutions that
are compatible with polystyrene plastic such as Isopropyl Alcohol or Chlorine Compounds. These cleaning solutions are
to be diluted by volume in water, with a recommended maximum concentration of 1:10.
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CAUTION
Do not attempt to clean the filter media. Do not attempt to sterilize or reuse the filter.
WARNING
To avoid increased filter flow resistance, do not immerse breathing circuit filters in liquid. To avoid a
reduction in filtration efficiency, do not attempt to scrub or touch the filter medium located inside the filter.
INSPECTION: Inspect for any visible damage to the plastic housing or the folded filter media before use. Discard if there
is any damage.
REPLACEMENT: AVEA Disposable Exhalation Filter, including the drain tube and the pinch clamp are single use items.
Replace with a new unused filter at each circuit change.
WARNING
Do not attempt to sterilize or reuse this filter.
Note:
Dispose used filters in accordance with your institution’s protocol. Sterilize before nondestructive disposal. Follow local
governing ordinances and recycling plans regarding disposal or recycling of medical device components
Additional Information:
Detailed information on the specifications of this assembly can be found in Appendix .B, Specifications
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Attaching the Patient Circuit
Adult Circuit using an Active
Humidifier
Using an active humidifier, the adult
patient circuit is set up as shown in Figure
2–16. Attach your humidifier to the upright
pole of the AVEA base. Adjust the height
of the humidifier and the length of the
humidifier tubing so that the tubing is
relatively straight with no occlusions.
For a complete listing of compatible
circuits and accessories, see “Appendix E:
Sensor and Circuit Specifications” on page
217.
Inspiratory
limb of Patient
Circuit
Figure 2–16: Adult Circuit with Active Humidifier
Adult Circuit without active humidifier
The setup for use with a passive humidifier or HME is
per Figure 2–17. The inspiratory limb of the patient
circuit connects directly to the gas output of the
ventilator. The passive humidification system should be
placed in-line in the patient circuit per the
manufacturer’s instructions.
Inspiratory Limb
of Patient Circuit
Figure 2–17: Adult Patient Circuit without active humidifier.
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Neonatal Patient Circuit
The Neonatal Patient Circuit is attached as
shown in Figure 2–18.
Inspiratory Limb
of Patient Circuit
Figure 2–18: Neonatal Patient Circuit
Front Panel Connections
Standard
Comprehensive
Figure 2–19: AVEA Front Panel Configurations Standard and Comprehensive
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Attaching Flow Sensors
The AVEA can accept either a hot wire or a variable orifice proximal flow sensor. These are in addition to the
instrument’s internal inspiratory flow sensor and heated expiratory flow sensor. Three proximal flow sensors are available
for the AVEA.
The standard Hot Wire flow sensor is suitable for neonatal and pediatric applications where the peak inspiratory flow rate
is less than 30 L/min. This flow sensor is not active in adult applications.
Hot Wire Flow Sensor
A Hot Wire flow sensor attaches to the receptacle
circled in light blue directly below the variable orifice
flow sensor connection on the front panel. The
receptacle is marked with the icon shown here.
Retractable plastic
collar
This is a locking connector. To attach, first pull back
the locking collar, then push firmly onto the
ventilator receptacle.
To disconnect, first retract the plastic collar then
firmly pull the connector away from the ventilator.
Do not pull up or down as this can damage the
connector.
Figure 2–20: Hot wire Flow Sensor Attachment
CAUTION
Flow sensors must be attached at both the patient wye and at the ventilator connection to ensure proper function of
the AVEA.
Note:
Hot wire flow sensors will not function with Heliox gas mixtures. During Heliox delivery, a variable orifice flow sensor
should be used for monitoring delivered volumes at the proximal airway.
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Hot Wire Flow Sensor Zero Procedure
It is recommended that this procedure is done when installing a new hot wire flow sensor and as a possible remedy to a
drifting waveform baseline.
The standard hot wire flow sensor is suitable for neonatal and pediatric applications where the peak inspiratory flow rate
is less than 30 L/min. This flow sensor is not active in adult applications. The following procedure describes how to reset
or re-zero the Hot Wire Sensor offset.
To reset or re-zero the Hot Wire Sensor offset:
1. Select Utility from the screens menu.
2. Select the Monitoring tab from the Utility screen
3. Press the Zero Sensor button under the Hot Wire Flow Sensor section.
4. Remove the hot wire flow sensor from the patient circuit.
5. Block both ends of the flow sensor with your gloved fingers so no flow occurs.
6. While holding the sensor steady (without movement), press the Continue button.
7. Wait for the Zero Sensor Completed message to appear.
8. Reinstall the hot wire flow sensor into the patient circuit.
9. If the flow sensor continues to drift or read inaccurately, repeat this procedure or replace the flow sensor.
Note:
The above steps must be executed in the proper sequence. If the test is repeated, only the last value measured is
saved. The saved value will then be applied to all future measurements of flow and volume that use this flow sensor.
This procedure will not “fail” but is limited on the offset amount it can correct for. If the hot wire flow sensor continues to
drift or read inaccurately after completing this procedure, the offset value is being limited and the sensor should be
cleaned or replaced.
Variable orifice flow sensors are also available on some AVEA models. The neonatal VarFlex flow sensor is compatible
in neonatal and pediatric applications where the peak inspiratory flow rate is less than 30L/min and is not active in adult
applications. For adult and large pediatric applications a Pediatric / Adult VarFlex flow sensor is available for use with
patients whose flow requirements fall within the range of 1.2 – 180 L/min.
Detailed information on the specifications of each flow sensor can be found in Appendix E: Sensor Specifications and
Circuit Resistance.
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Variable Orifice Flow Sensor
Variable Orifice sensors attach to the receptacle on the front panel of the ventilator circled in dark blue and marked with
the icon shown here.
This is a locking connector. To attach, first pull back the plastic locking collar, then push firmly onto the ventilator
receptacle. Then push the locking collar forward to lock the flow sensor in place.
Retractable plastic collar
Figure 2–21: Variable Orifice Flow Sensor Attachment
To disconnect, first retract the plastic collar then firmly pull the connector away from the ventilator. Do not pull up or
down as this can damage the connector.
CAUTION
Fully retract the plastic locking collar before attaching these connectors. Failure to do this can cause damage to the
connector.
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Attaching a Nebulizer
You can use an in-line nebulizer with the AVEA ventilator (see “Chapter 3: Ventilator Operation”). The nebulizer is
synchronized with inspiration, delivers gas at the set FIO2 and is active for 20 minutes. Attach the nebulizer tubing to the
fitting at the bottom of the front panel as shown here. The fitting is marked with the icon shown here.
Figure 2–22: Attaching nebulizer tubing
Note:
To use the internal nebulizer, the AVEA must be connected to a high-pressure air source. The nebulizer is not active
while the AVEA is operating on its internal compressor. The ventilator incorporates an internal pneumatic compressor,
which creates the drive pressure necessary to operate the nebulizer.
Note:
The nebulizer requires an inspiratory flow rate of at least 16 liters-per-minute to activate and is flow compensated to
maintain set tidal volumes.
CAUTION
When the internal nebulizer is used, the ventilator decreases the flow rate by 6 L/min to compensate for the nebulizer
output. However, since flow from the internal nebulizer can vary, using the internal nebulizer may impact the tidal
volumes delivered to the patient.
Note:
Do not operate the nebulizer while using Heliox.
Note:
An optional filter may be attached to the nebulizer port for filtration of the nebulizer gas flow.
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Attaching a Proximal Pressure Sensor
A proximal pressure sensor to monitor proximal airway pressure can be attached to the Comprehensive model of AVEA.
On the Comprehensive AVEA the connector is labeled as Aux as shown in Figure 2–23 and is circled in purple.
When active, this feature will display and alarm to proximal airway pressures.
Figure 2–23: Proximal pressure sensor connection on the Comprehensive AVEA
Note:
In applications which generate high resistances within the breathing system monitored, Proximal Airway Pressure may
be higher than set Inspiratory Pressure.
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(Comprehensive Model Only)
Esophageal Balloon
The connection intended for an esophageal balloon is circled in green at the top of the front panel as shown here. It is
identified with the legend PES.
Figure 2–24: Esophageal balloon connector
Note:
See “Chapter 4: Monitors, Displays and Maneuvers” for placement technique for esophageal balloons.
Tracheal Monitoring Tube
A tracheal monitoring tube attaches to the AVEA at the connection on the front panel marked as Aux. The connector is
shown in Figure 2–23.
Note:
See “Chapter 4: Monitors, Displays and Maneuvers” for the placement technique for tracheal monitoring tube.
WARNING
The AVEA is designed to ensure that the user and patient are not exposed to excessive leakage current per
applicable standards (UL 60601-1 and IEC60601-1). However, this cannot be guaranteed when external
devices are attached to the ventilator.
To prevent the risk of excessive enclosure leakage current from external equipment attached to the RS-232,
printer or video ports, the protective earth paths must be isolated to ensure proper connection.
This isolation should ensure that the cable shields are isolated at the peripheral end of the cable.
See “Appendix B: Specifications” on page 201 regarding connections and communications.
See “Appendix F: Tracheal Monitoring Tube Compatibility” on page 221 for compatibility information.
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Setting Up the Rear of the Ventilator
B
A
J
C
K
I
E
D
G
F
H
Figure 2–25: Rear panel
A
AC power module
H
Oxygen hose connection
B
UIM connection
I
External battery connector
C
Analog input/output/ILV
J
External battery fuse
D
Power ON/OFF Switch
K
Internal battery fuse
E
Nurse call system connection
F
Air/Heliox smart connector
G
Oxygen sensor
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Connecting the Oxygen Sensor
O2 Cell
The oxygen sensor cell is located on the rear panel, between the two gas fittings.
The oxygen sensor cable emerges from the rear panel directly above the sensor.
Carefully align and then gently push the connector onto the oxygen sensor until it
seats. When a good connection has been made, slide the protective cover down
and push over the sensor.
Figure 2–26: Connecting the O2 Sensor
Connecting Gas Fittings
The “Smart” Air Fitting
There are two gas connections on the rear
panel of the ventilator. The one on the left of
the panel is for attaching the Air or Heliox
gas source.
Collar
The smart connector fitting type shown here
is CGA DISS-type body No. 1160 for air with
an integral water trap/filter. To prevent the
entry of moisture into the ventilator from a
wall air source, the external water trap is
placed in-line between the air hose and the
“smart” air connector.
To attach, align the connector assembly
(Figure 2–27), seat gently onto the fitting and
screw down the fitting collar until finger tight.
Similar connectors for Air with NIST and
Air Liquide fittings are also available from
CareFusion.
“Smart” Connector
Figure 2–27: Attaching the Air “smart”
connector with water trap.
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The “Smart” Heliox Fitting
Operator's manual
Collar
A DISS-type, No. 1180 smart connector fitting is
also available for use with an 80/20 Heliox gas
mixture (Figure 2–28). Follow the instructions
contained with your Heliox kit to install the
tethered Heliox connector. This fitting has no
integral water trap/filter. All AVEA “Smart”
connectors with or without the integral water
trap/filter, attach in the same way. Align the
connector (Figure 2–27 and Figure 2–28), seat
gently onto the fitting and screw down the fitting
collar until finger tight.
Tether
Figure 2–28: Attaching the Tethered Heliox Connector
The AVEA “Smart” connectors signal to the ventilator which type of fitting is attached and therefore which gas controls to
initiate.
The fitting on the right of the panel is for attaching the Oxygen gas source. The O2 fitting type is CGA DISS type, No.
1240. (NIST or Air Liquide oxygen fittings are also available from CareFusion.)
Attaching the Gas Hoses
Oxygen Connection
Attach the Oxygen hose to the fitting on the right of the back panel
(Figure 2–29).
Figure 2–29: Connecting the O2 Hose
Heliox Connection
If you have the upgrade for Heliox delivery, attach the Heliox hose .to the tethered
“Smart” connector fitting on the left of the back panel as shown in Figure 2–30.
The air hose will not attach to the fitting designed for Heliox and vice versa.
Figure 2–30: Connecting the Heliox Hose
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WARNING
Allow 90 seconds for the accumulator to purge before initiating patient ventilation with Heliox gas.
WARNING
Connection of a gas supply at the Helium-Oxygen mixture inlet that does not contain 20% oxygen can cause
hypoxia or death.
Although an 80/20 mixture of Helium and Oxygen is marketed as medical grade gas, the Helium/Oxygen gas
mixture is not labeled for any specific medical use.
Attaching the Air Hose
Attach the Air supply hose to the “Smart” connector fitting with the
integral water trap/filter on the left of the back panel as shown in
Figure 2–31.
The fitting shown here is a DISS fitting. Fittings which accept NIST
and Air Liquide hoses are also available from CareFusion.
The air hose will not attach to the fitting designed for Heliox and vice
versa.
Figure 2–31: Attaching the Air Hose to the water trap/filter
Note:
The fitting for Air will not accept a Heliox connection and vice versa.
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Utilities Screens
Configuration Tab
Figure 2–32: Utilities Screen
Alarm Loudness.
To change alarm sound levels depress and hold the increase or decrease soft keys until the desired level is reached.
The “Alarm Test” banner will appear during the adjustment.
Enable / Disable O2 Alarm.
The High and Low oxygen alarms can be disabled in the event of a failure of the oxygen sensor while the ventilator is in
use. To disable the alarm depress the Enable / Disable O2 soft key, to re-enable depress the soft key again.
Note:
The oxygen alarms cannot be disabled while heliox is in use. Powering the ventilator off and back on again will
automatically re-enable the oxygen alarms.
WARNING
Although disabling the oxygen alarms will not affect oxygen titration an external analyzer should be placed
in line in the breathing circuit until the oxygen sensor has been replaced.
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Flow Correction
Flow Correction allows for flow correction to BTPS (Body Temperature Pressure Saturated or ATPD (Ambient
Temperature Pressure Dry). Default position is BTPS and should be used for all clinical applications.
ILV Mode

To enable Independent Lung Ventilation and define the Master and Slave ventilators, access the Utilities screen
from the screens menu (Figure 2–32). ILV requires the use of a specially configured accessory cable kit
(part number 16246), which is available from CareFusion.

With both ventilators turned off, connect the ILV cable PN 16124 to the analog port of each ventilator.

Turn on the ventilator to be designated as the “Slave”.

Adjust all primary and advances settings as desired.

Power up the “Master” ventilator.

Select “Master” from the Utilities screen.

Adjust all primary and advanced settings as desired.

Connect the patient.
Note:
Ventilation will not begin until the Master ventilator has been turned on.
Each ventilator maintains independent settings for FIO2 during independent lung ventilation. Close monitoring of set
FIO2 on each ventilator is recommended.
Confirm alarm settings on each ventilator. Each ventilator will alarm independently based on alarm settings established
for that particular ventilator.
Apnea ventilation on the Slave ventilator is driven by the apnea ventilation rate of the Master ventilator only.
Should the ventilators become disconnected during ILV, only the Master ventilator will alarm for the ILV Disconnect
condition. The Slave ventilator will alarm for Apnea and begin apnea ventilation at its own active settings.
WARNING
DO NOT attempt to connect a standard DB-25 cable to this receptacle. This could cause damage to the
ventilator. A specially configured cable is required for ALL features associated with this connector. Contact
Technical Support.
Setting up Independent Lung Ventilation (ILV)
The AVEA has a 25 pin receptacle on the rear panel (Figure 2–33) to allow for Independent Lung Ventilation (ILV) .with
another AVEA. The output for ILV provides a 5VDC logic signal synchronized to the breath phase of the master
ventilator. Table 2–1 at the end of this section details the relevant pins for the signals carried by this connector.
Note:
This connector also carries the Analog Input and the Analog Output signals. Refer to Appendix B Specifications for
Analog Output Pressure (cmH2O/mv), flow ((ml/min)/mv) and Volume (ml/mv) conversions.
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ILV connector pin configuration
To connect two AVEA ventilators together for independent lung ventilation function, the cable must be wired so that the
ILV input (the slave) on one AVEA is connected to the ILV output (the master) on the other AVEA. As shown in Figure
2–33 below, the ILV slave is pin 18, and the ILV master is pin 6. In addition, at least one of the analog grounds (pins 5, 9,
10, 11, 12 or 13) must be connected. We recommend using a shielded cable.
For ILV operation:
Connect an analog ground on Vent 1 to analog ground on vent 2 (

Figure 2–34).

Connect Pin 6 on Vent 1(Master) to pin 18 on vent 2 (Slave).

Connect Pin 18 on Vent 1 to pin 6 on vent 2.
Slave
Master
Figure 2–33: ILV Connection Pin Configuration
Figure 2–34: Analog Ground Pins
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Note:
At least one analog ground is required for safe and accurate signal output and input. One analog ground is sufficient
for any and all of the other signals.
Selecting Language.
Touch the language box and use the data dial to select the desired language. Use the Accept key to accept the change.
All text displayed on the LCD screen will automatically be translated to the set language.
Note:
For ease of use all languages appear in their native text in the text selection box on the utilities screen.
Low Vte Alarm Sensitivity
Sets the number of consecutive breaths with an exhaled tidal volume below the Low Vte Alarm setting which are
required to sound the alarm. The default is 3 breaths; the range is 1-5 breaths.
Increase FIO2
Configures the step increase used during the increase oxygen maneuver. Sets the amount of oxygen the
ventilator will increase above the current set FIO2.
Example:
If the Increase FIO2 is set at 20%
AND
The set FIO2 is 40%
WHEN
The increase FIO2 Maneuver is activated the FIO2 will increase to 60% for two minutes
after which it will return to 40%.
The default setting for infants is 20% and 79% for Pediatric and Adult applications.
Note:
To achieve 100% delivered FIO2 during the Increase O2 maneuver set the Increase FIO2 setting to its maximum of 79%.
Note:
The settings will be reset to default values when New Patient is selected in the set up menu.
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Input/Output Tab
Figure 2–35: Utility Screen, Input / Output Tab
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Analog Input Configuration
Under the heading “Set Analog Input Scale” there are two buttons representing two possible voltage ranges.
If the full-scale output of the device you are interfacing with is less than 1 volt, select the 0-1 volt scale button.
If it is 5V or less, select the 0-5 volt range. Select the appropriate analog scale and press the ACCEPT key to enter the
configuration.
Analog Input is configured on the same connector as the ILV. The pin configuration for cables to use this feature is
shown in Figure 2–36 below. Pin configuration of the connector for attachment to your other device must be supplied by
the manufacturer of that device
WARNING
All applications using this connector require specially made cables. DO NOT connect a standard DB25 cable
to this receptacle. This could result in damage to the ventilator. Contact Technical Support at the numbers
given in Appendix A.
Analog Input Channel 1
Analog Input Channel 0
Figure 2–36: Analog Input connections
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Analog Outputs
Set Analog Output Type
The analog output flow signal can be selected between Wye Flow (calculated flow to the patient) or Machine Flow (the
flow measured by the inspiratory flow sensor within the ventilator).
Pressure, Flow, Volume, Breath Phase
Figure 2–37: Analog Outputs Pin configuration
The pin configuration for pressure, flow, volume and breath phase analog outputs is shown above. Refer to Appendix B
Specifications for Analog Output Pressure (cmH2O/mv), flow ((L/min)/mv) and Volume (ml/mv) conversions.
Figure 2–38: Analog Ground Pins **
Note:
At least one analog ground is required for safe and accurate signal output and input. One analog ground is sufficient
for any and all of the other signals.
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Table 2–1: ILV and Analog I/O pin configuration
PIN
1
FUNCTION
Analog Input Channel 0
14
Analog Input Channel 1
18
ILV In
6
ILV Out
20
Factory Use Only. DO NOT CONNECT.
22
Analog Output, PRESSURE
23
Analog Output, FLOW
24
Analog Output, VOLUME
25
Analog Output, BREATH PHASE
5, 9,10,11,12,13
Ground, Analog
Note: At least one analog ground is required for safe and accurate signal output and
input. One analog ground is sufficient for any and all of the other signals.
RS 232 Output
Sets the RS 232 output format for digital communications via the port labeled MIB.
The RS-232 output configuration provides the following setting choices:
Generic
Select 8, N, 1 and Baud Rates of: 9600, 2400, 4800, 9600, 19200, 38400, 57600 or 115200
or
Select CR/LF or CR Only
Figure 2–39: Utility Screen, Input / Output Tab, Generic RS-232 Output
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VueLink
RS-232 Output:
Select Off
Figure 2–40: Utility Screen, Input / Output Tab, Vuelink RS-232 Output
or
VOXP
Select VOXP and either 8,N,1 / 7,N, 1 / 7, E, 1 or 7, 0, 1 and Baud Rates of: 9600, 19200, 38400, 57600, 115200
Figure 2–41: Utility Screen, Input / Output Tab, VOXP RS-232 Output
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37
Nurse Call Connection
The AVEA can be connected to a remote nurse call system via the modular connector on the rear panel shown in Figure
2–25, E. The jack is configured to interface with normally closed (NC, open on alarm) or normally open (NO, closed on
alarm) signals. Cables for both systems are available from CareFusion.
Date/Time Tab
Figure 2–42: Utility Screen, Date / Time Tab
Setting the Date.
Using the touch turn touch technique use the data dial to set the correct month, day and year prior to use of the
ventilator.
Setting the Time.
Using the touch turn touch technique use the data dial to set the correct time in hours and minutes prior to use of the
ventilator.
Note:
After changing the date and/or time, cycle the ventilator off, then on and select “NEW PT” to ensure coordination of the
EVENTS and TRENDS with the new date/time set.
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Powering up the AVEA
To power up the ventilator, connect the power cord to a suitable AC power supply and turn on the power switch located
on the back panel of the ventilator as shown here.
ON
OFF
Figure 2–43: Power Switch
The power up/reboot time for this instrument is approximately 7 seconds.
WARNING
A protective ground connection by way of the grounding conductor in the power cord is essential for safe
operation. If the protective ground is lost, all conductive parts, including knobs and controls, which may
appear to be insulated, can render an electric shock. To avoid electrical shock, plug the power cord into a
properly wired receptacle, use only the power cord supplied with the ventilator, and make sure the power
cord is in good condition.
WARNING
If the integrity of the external power earth conductor arrangement is in doubt, unplug the ventilator from the
mains AC and operate it from its internal battery or the optional external battery.
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39
User Verification Test
WARNING
The User Verification Test should always be performed off patient.
The User Verification Test consists of the three following sub-tests and should be performed before connection to a new
patient.

The POST test:
The POST or Power On Self Test is transparent to the user and will only message if the ventilator encounters an
error. Normal ventilation commences at the culmination of the POST.
The Extended Systems Test (EST). During this test the ventilator will perform:

Patient circuit leak testing
Patient circuit compliance measurement
Two point calibration of the oxygen sensor
The Alarms Test consisting of verification for:

High Ppeak alarm
Ext High Ppeak Alarm
Low Ve alarm
High Ve alarm
High Vt alarm
Low O2 alarm
Low Vt alarm
High O2 alarm
Low Ppeak alarm
Loss of AC alarm
Circuit Disconnect
High Rate Alarm
Apnea Interval alarm
Low PEEP alarm
CAUTION
Although failure of any of the above tests will not prevent the ventilator from functioning, it should be checked to make
sure it is operating correctly before use on a patient.
The Power on Self Test (POST)
This test is run automatically and performs the following checks:

Processor Self Check

ROM Check Sum

RAM Test
The POST will also check the audible alarms and the LEDs at which time the audible alarm sounds and the LEDs on the
User Interface Module flash. Normal ventilation commences at the culmination of the POST.
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The Extended Systems Test (EST)
The EST function is accessed from the Setup screen as shown here. Press the SETUP membrane button to the lower
left of the UIM to open this screen.
Figure 2–44: Setup Screen
Press the EST touch screen button to select it.
A message will appear instructing you to remove the patient and
block the patient wye.
After confirming that the patient has been disconnected and the
circuit wye blocked press the Continue (Cont) button.
The ventilator will perform the EST and display a countdown clock.
During this test the ventilator will perform:

Patient circuit leak test

Patient circuit compliance measurement

Two point calibration of the oxygen sensor
The patient circuit compliance measurement and leak test are
performed simultaneously with the oxygen sensor calibration. The
maximum time for the EST is 90 seconds. To restart the EST at
any time select the Cancel button to return to the set up screen.
Figure 2.46a Remove Patient Instruction
Figure 2.46b In progress EST
After each test is complete the ventilator will display a “Passed” or
“Failed” message next to the corresponding test.
Once the test is complete press the continue button to return to the
set up screen.
Figure 2.46c Completed EST
Figure 2–45: EST Screens
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The “SET UP ACCEPT” key must be pressed in order for the AVEA to retain the circuit compliance measurement. At
this point, even after power cycling off, if “SAME PT” is selected, the circuit compliance measurement will continue to be
retained. If “NEW PT” is selected, the EST will be required to use this feature.
Note:
If you do not connect the ventilator to an oxygen supply, the O2 Sensor Calibration will immediately fail.
The Alarms Test
Note:
To ensure proper calibration of the oxygen sensor, you should always perform an EST prior to conducting Manual
Alarms Testing.
WARNING
User Verification Testing should always be done off patient.
CAUTION
Following each alarm verification test, ensure that the alarm limits are reset to the recommended levels shown in this
chapter before proceeding to the next test.
Test Setup Requirements:
Air Supply Pressure
O2 Supply Pressure
AC Line Voltage
Patient Circuit
Compliance
Resistance
Adult Setting
Pediatric Setting
Neonate Setting
> 30 psig (2.1 bar)
Same
Same
> 30 psig (2.1 bar)
Same
Same
115 + 10 VAC
Same
Same
6’ (2 m) Adult
6’ (2 m) Adult
Infant
20 ml/cmH2O
20 ml/cmH2O
N/A
5 cmH20/L/sec
5 cmH20/L/sec
N/A
To perform the Alarms Test on the AVEA ventilator using default settings, complete the following steps (A table
describing the default settings for Adult, Pediatric and Neonatal patient sizes is included at the end of the Alarms Test
section).
1. Make the appropriate connections for air and O2 gas supply. Connect the power cord to an appropriate AC outlet.
Attach an appropriate size patient circuit and test lung to the ventilator.
2. Power up the ventilator and select NEW PATIENT when the Patient Select Screen appears. Accept this selection by
pressing PATIENT ACCEPT. This will enable default settings for the Manual Alarms Test.
3. Select the appropriate patient size for your test (Adult, Pediatric or Neonate) from the Patient Size Select Screen.
Accept this selection by pressing SIZE ACCEPT. Set Humidifier Active off.
4. Make any desired changes or entries to the Ventilation Setup Screen and accept these by pressing SETUP
ACCEPT.
5. Press Alarm Limits button on the upper right of the user interface.
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6. Verify that no alarms are active and clear the alarm indicator by pressing the alarm reset button on the upper right of
the user interface.
7. Set the % O2 control to 100%. Disconnect the Oxygen sensor from the back panel of the ventilator and verify that
the Low O2 alarm activates. Return the O2 control setting to 21% with the sensor still disconnected from the rear
panel. Remove sensor from back panel. Provide blow-by to the sensor from an external oxygen flow meter. Verify
that the High O2 alarm activates. Return the % O2 to 21%, reconnect the Oxygen sensor to the back panel. Clear all
alarm messages by pressing the alarm reset button.
8. Set PEEP” to 0. Set Low PEEP alarm to 0. Disconnect the patient wye from the test lung. Verify that the Low Ppeak
alarm activates, followed by the Circuit Disconnect alarm. This second alarm should activate within 15 seconds or
one breath cycle. Reconnect the test lung to the circuit clear the alarm by pressing the reset button.
9. Disconnect the AC power cord from the wall outlet. Verify that the Loss of AC alarm activates. Reconnect the AC
power cord. Clear the alarm by pressing the reset button.
10. Occlude the exhalation exhaust port. Verify that the High Ppeak alarm activates, followed 5 seconds later by the
activation of the Ext High Peak Alarm.
11. Set the control setting for rate to 1 bpm. Verify that Apnea Interval alarm activates after the default setting of 20
seconds. Return the control setting to its default value and clear the alarm by pressing the reset button.
12. Set the Low PEEP alarm setting to a value above the default control setting for PEEP on your ventilator. Verify that
the Low PEEP alarm activates. Return the alarm setting to its default value and clear the alarm by pressing the reset
button.
13. Set the High Ppeak alarm setting to a value below the measured peak pressure or in neonatal ventilation, the default
control setting for Inspiratory Pressure on your ventilator. Verify that the High Ppeak alarm activates. Return the
alarm setting to its default value and clear the alarm by pressing the reset button.
14. Set the Low Ve alarm setting to a value above the measured Ve on your ventilator. Verify that the Low Ve alarm
activates. Return the alarm setting to its default value and clear the alarm by pressing the reset button.
15. Set the High Ve alarm setting to a value below the measured Ve on your ventilator. Verify that the High Ve alarm
activates. Return the alarm setting to its default value and clear the alarm by pressing the reset button.
16. Set the High Vt alarm setting to a value below the set Vt on your ventilator. Verify that the High Vt alarm activates.
Return the alarm setting to its default value and clear the alarm by pressing the reset button.
17. Set the Low Vt alarm setting to a value above the set Vt on your ventilator. Verify that the Low Vt alarm activates
after the number of breaths set in the Utility screen for VTE sensitivity. Return the alarm setting to its default value
and clear the alarm by pressing the reset button.
18. Set the High Rate alarm to a value below the default control setting for rate on your ventilator. Verify that the alarm
activates. Return the alarm to its default setting and clear the alarm by pressing the reset button.
19. Occlude the inspiratory limb of the patient circuit. Verity that the Circuit Occlusion alarm activates.
CAUTION
Although failure of any of the above tests will not prevent the ventilator from functioning, it should be checked to make
sure it is operating correctly before use on a patient.
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Default Settings for Adult, Pediatric and Neonate
The Default settings are the operational settings that take effect when you press the New Patient button on power up.
WARNING
Always check that the default values, including alarms, are appropriate prior to use on each patient and
adjust the setup as appropriate.
Ventilation Setup
ET tube Diameter
ET Tube Length
Artificial Airway
Compensation
Leak
Compensation
Circuit
Compliance
Compensation
(Circ Comp)
Humidification
Patient Weight
Adult Setting
Pediatric Setting
Neonate Setting
7.5 mm
30 cm
Off
5.5 mm
26 cm
Off
3.0 mm
15 cm
Off
Off
Off
Off
0.0 ml/cmH2O
0.0 ml/cmH2O
Active On
1 kg
Active On
1 kg
Active On
1 kg
Adult Setting
Pediatric Setting
Neonate Setting
Volume A/C
12 bpm
500 ml
Volume A/C
12 bpm
100 ml
TCPL A/C
20 bpm
2.0 ml
60 L/min
15 cmH2O
20 L/min
15 cmH2O
8 L/min
15 cmH2O
0.0 sec
0.0 sec
0.0 sec
1.0 sec
0.75 sec
0.35 sec
0 cmH2O
6 cmH2O
1.0 L/min
0 cmH2O
6 cmH2O
1.0 L/min
0 cmH2O
3 cmH2O
0.5 L/min
40%
40%
40%
0.0 ml/cmH2O
NOT active in
Neonates.
Primary Controls
Breath Type/Mode
Breath Rate (Rate)
Tidal Volume
(Volume)
Peak Flow
Inspiratory
Pressure (Insp
Pres)
Inspiratory Pause
(Insp Pause)
Inspiratory Time
(Insp Time)
PSV
PEEP
Inspiratory Flow
Trigger (Flow
Trig)
%O2
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Advanced Settings
Vsync
Vsync Rise
Sigh
Waveform
Bias Flow
Inspiratory
Pressure Trigger
(Pres Trig)
PSV Rise
PSV Cycle
PSV Tmax
Machine Volume
(Mach Vol)
Volume Limit
(Vol Limit)
Inspiratory Rise
(Insp Rise)
Flow Cycle
T High PSV
T High Sync
T Low Sync
Demand Flow
Adult Setting
0 (off)
5
0 (off)
1 (Dec)
2.0 L/min
3.0 cmH2O
Pediatric Setting
0 (off)
5
0 (off)
1 (Dec)
2.0 L/min
3.0 cmH2O
Neonate Setting
N/A
N/A
N/A
1 (Dec)
2.0 L/min
3.0 cmH2O
5
25%
5 sec
0L
5
25%
0.75 sec
0 ml
5
10%
0.35 sec
0 ml
2.50 L
500 ml
300.0 ml
5
5
5
0% (off)
Off
0%
0%
On
0% (off)
Off
0%
0%
On
0% (off)
N/A
N/A
N/A
On
Adult Setting
75 bpm
3.00 L
Pediatric Setting
75 bpm
1000 ml
Neonate Setting
75 bpm
300 ml
0.0 L
0.0 ml
0.0 ml
1.0 L
0.5 L
0.5 L
30.0 L/min
30.0 L/min
5.0 L/min
8 cmH2O
8 cmH2O
5 cmH2O
40 cmH2O
40 cmH2O
30 cmH2O
3 cmH2O
20 sec
3 cmH2O
20 sec
1 cmH2O
20 sec
Alarm Settings
High Rate
High Tidal Volume
(High Vt)
Low Tidal Volume
(Low Vt)
Low Exhaled
Minute Volume
(Low Ve)
High Exhaled
Minute Volume
(High Ve)
Low Inspiratory
Pressure (Low
Ppeak)
High Inspiratory
Pressure (High
Ppeak)
Low PEEP
Apnea Interval
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Chapter 2: Unpacking and Setup
Auxiliary Controls
Manual Breath
Suction
↑ O2
Nebulizer
Inspiratory Hold
(Insp Hold)
Expiratory Hold
(Exp Hold)
L2786 Version T
Adult Setting
----79%
-----
Pediatric Setting
----79%
Neonate Setting
----20%
---
---
---
---
---
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AVEA User Verification Test Checklist
Machine Serial Number:________________________________ Test Date: __________________
TEST
PASS
FAIL
Automated Tests
Power-on self test
Patient circuit leak test
Patient circuit compliance measurement
Two point calibration of the oxygen sensor
Manual Alarms Checks
High Rate Alarm
Low Vte Alarm
High Vte Alarm
Low Ve Alarm
High Ve Alarm
Low Ppeak Alarm
High Ppeak Alarm
Low PEEP Alarm
Apnea Interval Alarm
Extended High Ppeak Alarm
Circuit Disconnect Alarm
Circuit Occlusion Alarm
Loss of AC Alarm
High O2 Alarm
Low O2 Alarm
Signature of tester:_______________________________________________
Title___________________________________________________________
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AVEA Troubleshooting
Remove ventilator from patient with any potential problem
Symptom
Problem
Solution(s)
Will not pass EST - Fails Leak
Circuit wye not fully occluded
Ensure circuit wye is fully occluded
Leak in patient circuit
Check for leaks in circuit and reseat
circuit connections to ventilator.
Replace circuit if necessary.
Filter cartridge not properly seated Remove exhalation cartridge and
check condition of connections.
Reinstall and recheck. Replace if
necessary
Leak in exhalation corner
Replace exhalation diaphragm.
Will not pass EST - Fails O2
calibration
Connector on O2 sensor not
connected properly
Inlet gas pressure too low
Check sensor connection
Internal fault
Call Technical Service
Normal Condition when operating
on test lung.
Normal if readings are within
ventilator accuracy specifications
of +/-10%
Defective expiratory flow sensor
No action required
Verify inlet air and oxygen pressure
above 20psig
Defective O2 sensor
Replace O2 Sensor
No reading from proximal flow sensor Sensor / Patient size incompatible See the operators manual for
correct sensor/mode configurations
Sensor not connected
Ensure sensor properly connected
at both the patient wye and at the
ventilator.
Loose external connection
Check external connection
Defective sensor
Replace sensor
Vti > Vte when operating without
proximal flow sensors
Vte > Vti
Leak in patient circuit, water
collector or exhalation system
Normal if readings are within
ventilator accuracy specifications
of +/-10%
Defective expiratory flow sensor
Leak in patient circuit, water
collector or exhalation system
Internal fault
L2786 Version T
No action required if within
specification
Clean/replace expiratory flow
sensor
Verify with leak test
No action required if within
specification
Clean/replace expiratory flow
sensor
Verify with leak test
Call Technical Service
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Symptom
Problem
Solution(s)
Volume waveform above or below
baseline on patient with internal
sensor
Humidifier "Active on/off" set
incorrectly
Normal if readings are within
ventilator accuracy specifications
of +/-10%
Bad expiratory flow sensor
Set for "Active on” for humidifier,
"Active off" for “HME"
No action required if within
specification
Volumes become inaccurate over
time
Nebulizer output absent
Internal fault
Clean or replace expiratory flow
sensor
Call Technical Service
Foreign material on flow sensor
Clean/replace sensor
Internal fault
Call Technical Service
Ventilator running on compressor
Flow less than 15 L/min
Connect wall air
Increase flow if appropriate
Internal fault
Call Technical Service
FIO2 monitor inaccurate or reads "***" O2 sensor requires calibration
PEEP too high
O2 sensor at end of life
Exhalation filter cartridge clogged
or saturated
Defective exhalation diaphragm
Unit will not run on A/C power
Perform EST
Replace O2 Sensor
Replace cartridge
Change exhalation diaphragm
Blown fuse on power entry module Replace fuse
Power cord not connected to
mains power
Check connections
Unit will not run properly on battery
Battery not sufficiently charged
Improper charge level indicator Internal battery
Excessively discharged battery
Internal battery requires at least 4
hours to be fully charge. External
battery requires at least 12 hours
with green LED lit for a full charge.
Requires at least 4 hours for full
charge
Maintenance and testing required. Perform Internal Battery Charge
 The internal battery does not
Monitor Reset
operate for the specified time.
 The battery charge level indicator
LED is green, but the battery
operation time is less than
specified.
 The batteries do not appear to
maintain adequate charge.
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Symptom
Problem
Solution(s)
Improper charge level indicator External battery
Excessively discharged battery
Requires at least 12 hours for full
charge
Check connections
Loose connections
Decreased run time on battery
Battery not fully charged
Internal battery requires at least 4
hours for full charge. External
battery requires a minimum of 12
hours for a full charge.
Does not run on compressor
Defective battery
Internal fault
Call technical Service
Call Technical Service
Auto triggering
Improper sensitivity settings
Check flow and pressure trigger
settings
Circuit leaks
Perform EST and correct leaks as
required. Bias Flow should be set to
approximately 1.5 lm greater than
Flow Trigger setting.
Turn on Demand Flow
Call Technical Service
Reduce minute volume
Ensure proper connection
Vent INOP display
Low gas alarm on compressor
"Loss of gas" alarm
Device Error indicator
NCPAP Pressure Limit
L2786 Version T
Demand Flow turned off
System fault
Minute volume exceeds 40 L/min
Air/Heliox connector not properly
connected
Internal fault
Call Technical Service
Defective sensor
Replace sensor
Exhalation flow sensor not
connected
Check connections
O2 sensor connector not
connected
Defective O2 sensor
Check O2 sensor
Replace O2 sensor
Internal fault
Call Technical Service
Improper connection sequence
External battery connection should
be made with AC power
disconnected.
Occlusion of expiratory limb of
patient circuit.
Check expiratory limb for kinks
and/or water
Occluded expiratory filter
Replace expiratory filter
50
Symptom
Low NCPAP Pressure
High NCPAP Pressure
Circuit Disconnect
Inaccurate barometric pressure reading
Chapter 2: Unpacking and Setup
Operator's manual
Problem
Solution(s)
Circuit disconnect
Circuit leak
Patient interface leak
Check circuit
Check patient interface
Patient circuit occlusion
Water in circuit
Patient interaction
Check patient circuit
Check nasal prongs
Patient circuit disconnect
Check patient circuit
Barometer could require
calibration
Call CareFusion Technical Support.
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Chapter 3: Ventilator Operation
Membrane Buttons and LEDs
Figure 3.1a User Interface Module (International) Showing Button Icons
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Figure 3.1b User Interface Module (English) Showing Button Labels
Figure 3–1: User Interface Module
The Membrane buttons are the UIM controls, which surround the Touch Screen. Moving clockwise around the UIM from
the top right (see arrow), they are:
A.
Alarm Silence (LED)
Pressing this button will disable the audible portion of an alarm for 2 minutes (± 1 second) or until the Alarm Silence
button is pressed again. This button is not functional for a VENT INOP alarm.
Note:
Pressing the alarm silence button will not prevent the audible alarms sounding again later for certain alarm conditions.
B.
Alarm Reset
Cancels the visual indicator for alarms that are no longer active.
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C.
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53
Alarm Limits
Opens the alarm limits screen for data entry or adjustment. Toggles the screen on and off.
Note:
Pressing the Freeze button while the Alarm Limits window is open will automatically close the window and freeze the
graphics.
Caution
Do not adjust any of the Alarm Limit settings to an extreme value. Selecting an extreme value can
prevent the alarm thresholds from being reached.
D.
Manual Breath
Pressing this button during the expiration phase of a breath delivers a single mandatory breath at current ventilator
settings. No breath is delivered if the key is pressed during inspiration.
Note:
The Manual Breath button is not active in APRV / BIPHASIC.
E.
Suction (LED)
Pressing this button initiates a “Disconnect for Suction” maneuver.
The ventilator will:

Enable an “Increase % O2” maneuver for 2 minutes (see Increase O2 below).

While the circuit disconnect alarm is active, the ventilator will stop cycling and set a bias flow. The ventilator
will automatically detect the patient upon reconnection and resume normal ventilation.

Silences alarms for 120 seconds.
If the SUCTION key is pressed again during the 2 minutes that the “disconnect for suction” maneuver is active, the
maneuver will be cancelled.
F.
Increase O2
When this key is pressed, the ventilator increases the oxygen concentration delivered to the patient for 2 minutes. If the
 %O2 key is pressed again within this two-minute period, the maneuver is cancelled and the ventilator will return to prior
settings.
Defaults:
+20% Neonatal; 79% Adult/Pediatric
Adult/Pediatric:
79% above the set % O2
Neonate:
20% above the set % O2 or 100%, whichever is less
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To configure the Increase FIO2:
Access the Configuration tab on the Utilities Screen:
Increase FIO2:
Configures the step increase used during the increase oxygen maneuver. Sets the amount of oxygen the ventilator will
increase above the current set FIO2.
Example:
If the Increase FIO2 is set at 20%
AND
The set FIO2 is 40%
WHEN
The increase FIO2 Maneuver is activated the FIO2 will increase to 60% for two minutes after
which it will return to 40%.
The default setting for infants is 20% and 79% for Pediatric and Adult applications.
Note:
The settings will be reset to default values when New Patient is selected in the setup
Note:
To achieve 100% delivered FIO2 during the Increase O2 maneuver set the Increase FIO2 setting to its maximum of 79%.
WARNING
Heliox delivery will be interrupted for the time that either the “Suction” or the “Increase O2” buttons are
pressed during administration of Heliox. Tidal volume may be affected after the 2-minute “timeout” period,
or when the button is pressed, until the accumulator has been purged.
G. Data dial
Changes the values for a selected field on the touch screen.
H. Accept
Accepts data entered into a field on the touch screen.
I. Cancel
Cancels data entered into a field on the touch screen. The ventilator will continue to ventilate at current settings.
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J. Expiratory Hold
When the EXP HOLD button is pressed, at the start of the next breath interval the ventilator will not allow the patient to
inspire or exhale for a maximum of 20 seconds (adult/pediatric) for breath rates 20 and less, 25 seconds for breath rates
greater than 20, or 3 seconds (neonate). Expiratory Hold is NOT active in TCPL breaths.
K.
Inspiratory Hold (Manual)
When the INSP HOLD button is pressed, once the preset of a volume control or pressure control breath has been
delivered, the patient will not be allowed to exhale for a maximum of 3.0 seconds (± 0.1 second).
L. Nebulizer
The ventilator supplies blended gas to the nebulizer port at 10  1.5 psig (0.7 bar) when an in-line nebulizer is attached
and the Nebulizer key is pressed, provided that the calculated delivered flow is >15 L/min.
Delivery of the nebulized gas is synchronized with the inspiratory phase of a breath and lasts for 20 minutes. Press the
Nebulizer key a second time to end the treatment prior to the end of the 20-minute period.
CAUTION
Use of an external flow source to power the nebulizer is not recommended.
WARNING
Using the nebulizer may impact delivered tidal volumes.
Note:
Do not operate the nebulizer while using heliox
M.
Patient Size
The Patient Size Indicators for Adult, Pediatric, and Neonate at the bottom of the UIM show which
patient size is currently selected. These LED indicators have no associated membrane button on the
UIM.
Note:
The ventilator will not allow patient size changes when the active mode of ventilation is not available in the new patient
size selection. The ventilator will display a message instructing you to first change the ventilation mode. For example,
in neonatal ventilation with TCPL active, you cannot change to a pediatric or adult patient size without first changing
the mode to one available for those patients.
The ventilator will also not allow size changes if Machine Volume is active. A message displays indicating that
Machine Volume must first be turned off before making a patient size change.
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Panel Lock (LED)
The LOCK key disables all front panel and screen controls except MANUAL BREATH, Suction, %O2, ALARM RESET,
ALARM SILENCE, and LOCK.
O.
Print
The PRINT key outputs the contents of the currently displayed screen to a suitably connected parallel printer.
P.
Set-up
Opens the ventilator Setup screen.
Note:
Pressing the Set-Up button a second time before accepting Set-Up will close the window and restore the previous
settings. The Set-Up screen uses an on screen accept button. To change patient size without selecting new patient
requires that patient Set-Up be accepted after selecting patient size.
Q.
Advanced Settings (LED)
Opens the Advanced Settings screen for data entry or adjustment. Toggles the screen on and off.
Note:
Pressing the Freeze button while the Advanced Setting window is open will automatically close the window and freeze
the graphics.
R.
Mode
Opens the Mode Select screen for data entry or adjustment toggles the screen on or off. Pressing the Mode indicator at
the top of the touch screen will also access the screen.
Note:
Pressing the Mode button a second time before accepting the Mode will close the window and restore the previous
settings. The Mode screen uses an on screen accept button.
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Event
Records an event for future reference. Some events are recorded automatically others can be logged manually to
display in this screen. See “Chapter 4: Monitors, Displays and Maneuvers” for a full list of events.
T. Freeze
The FREEZE key freezes the current screen and suspends real-time update of screen data until pressed again. While
the screen is frozen, a scrollable cursor appears. The Data Dial can be used to scroll the cursor through data points on
waveform, loop or trend screens. To restore the screen to active press the Freeze button a second time.
Figure 3–2 shows a flow/volume loop in “freeze” mode. The cursors trace the “frozen” loop curve along an X-Y plot line.
The values along the curve of the loop are displayed as shown below.
Dashed
Cursor Line
Flag showing X
and Y values at
various points
along the loop
tracing
Flow/Volume
Loop Tracing
Cursor, currently
overlays the “X”
axis at Zero
Figure 3–2: Flow/Volume Loop in Freeze Mode
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Screens
Opens the Screen Selection box (Figure 3–3). You can also open this by pressing the Screen indicator in the top center
of the touch screen.
Note:
Pressing the Screens button a second time closes the window.
Figure 3–3: Screens Selection Box
V.
Main
Returns the display to the main screen.
W. Alarm Status LEDs
The Alarm status indicators at the top right of the UIM flash red or yellow to indicate a high or medium priority alarm (see
“Chapter 5: Volumetric Capnography”).
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Patient Select Screen
The Patient Select screen allows you to choose to resume ventilation of the current patient (RESUME CURRENT) or
select (NEW PATIENT) to reconfigure ventilator settings.
Figure 3–4: Patient Select Screen
If you press the Resume Current key, the ventilator begins ventilation at the most recent patient settings.
The New Patient key clears loops and trend buffers and resets all settings to default values.
Press Patient Accept to accept your selection.
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Patient Size Select Screen
The Patient Size Select screen appears as the first step of the new patient setup sequence.
Note:
The new patient size selection will not be active until the on screen SETUP ACCEPT button is pressed.
Figure 3–5: Patient Size Selection Screen
Note:
The ventilator will not allow patient size changes when the active mode of ventilation is not available in the new patient
size selection. The ventilator will display a message instructing you to first change the ventilation mode. For example,
in neonatal ventilation with TCPL active, you cannot change to a pediatric or adult patient size without first changing
the mode to one available for those patients.
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Ventilation Setup
Ventilation Setup Screen
Figure 3–6: Ventilation Setup Screen
In the Setup screen, controls are available to set the following:
Artificial Airway Compensation (AAC)
Range
ON/OFF
Default:
OFF
When Artificial Airway Compensation is turned on, the ventilator automatically calculates the pressure drop across the
endotracheal tube and adjusts the airway pressure to deliver the set inspiratory pressure to the distal (carina) end of the
endotracheal tube. This calculation takes into account flow, gas composition (Heliox or Nitrogen/Oxygen), Fraction of
Inspired Oxygen (FIO2), tube diameter, length, and pharyngeal curvature based on patient size (Neonatal, Pediatric,
Adult). This compensation only occurs during inspiration. Artificial Airway Compensation is active in all Pressure
Support and Flow Cycled Pressure Control Breaths.
Note:
Monitored airway pressures (inspiratory) will be higher than set values when Artificial Airway Compensation is active.
WARNING
Activation of Artificial Airway Compensation while ventilating a patient will cause a sudden increase in the
peak airway pressures and a resultant increase in tidal volume. Exercise caution when activating Artificial
Airway Compensation while the patient is attached to the ventilator to minimize the risk of excessive tidal
volume delivery.
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Even if inspiratory pressure is set at zero, Artificial Airway Compensation will still provide an elevated airway pressure to
compensate for the resistance of the endotracheal tube.
When turned on, the Artificial Airway Compensation (AAC) indicator will appear on the touch screen in all modes of
ventilation, even though Artificial Airway Compensation may not be active in the current mode (i.e. in volume controlled
breaths). This is to alert you to the fact that Artificial Airway Compensation is turned on and will become active if a
Pressure Support mode or a combination mode (i.e.: Volume Control SIMV) is selected.
Tube Diameter:
Range:
Default:
2.0 to 10.0 mm
7.5 mm
5.5 mm
3.0 mm
(Adult)
(Pediatric)
(Neonate)
Range:
2.0 to 30.0 cm
2.0 to 26.0 cm
2.0 to 15.0 cm
(Adult)
(Pediatric)
(Neonate)
Default:
30.0 cm
26.0 cm
15.0 cm
(Adult)
(Pediatric)
(Neonate)
Tube length:
Leak Compensation (LEAK COMP)
Range
ON/OFF.
Default:
OFF
During exhalation, PEEP is maintained by the cooperation of the Flow Control Valve (FCV) and the Exhalation Valve
(ExV). The ExV pressure servo is set to a target pressure of PEEP and the FCV pressure servo is set to a pressure
target of PEEP - 0.4 cmH2O. The ExV servo relieves when the pressure is above its target and the FCV supplies flow
when the pressure drops below its target up to a maximum flow rate for the patient size. It is not active during breath
delivery.
Note:
Leak compensation is not active in TCPL.
Circuit Compliance
When Circuit Compliance is active, the volume of gas delivered during a volume controlled or targeted breath is
increased to include the set volume plus the volume lost due to the compliance effect of the circuit.
Exhaled volume monitors, are adjusted for the compliance compensation volume in all modes of
ventilation.
Range:
0.0 to 7.5 ml/cmH2O
Default:
0.0 ml/cmH2O
Circuit compliance is measured automatically by the ventilator during an Extended Systems Test (EST). The value
cannot be entered manually.
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Note:
Circuit Compliance is active for set Tidal Volume in volume control ventilation, Target Tidal Volume in PRVC and
Machine Volume in Adult and Pediatric applications only. Although circuit compliance is displayed on the set up
screen it is not active for neonatal patients.
Humidifier
You can select active or passive humidification (ON/active or OFF/passive). Active humidification assumes 99% RH;
passive assumes 60% RH when using an HME. This feature adjusts the BTPS correction factor to correct exhaled tidal
volumes.
Range: Active ON/OFF
Default: Active ON
Note:
Incorrect setting of the Humidification feature will affect monitored exhaled volume accuracy
Patient Weight
Patient Weight can be set in the following ranges.
Adult
Pediatric
Neonate
1 to 300 Kg
1 to 75 Kg
0.1 to 16 Kg
Default:
1 Kg
Patient weight is a variable determined by the clinician and is used for the purpose of displaying monitored volume per
unit weight.
Identification
Patient ID. You may input a 24-character (two x 12-character), alphanumeric patient identification. To create a patient
ID, press the Touch Screen directly over the Patient IDENTIFICATION field.
A secondary screen appears showing the characters available for patient identification. Turn the data dial at the bottom
of the UIM (Figure 3–7) to scroll through the characters. Press the ACCEPT membrane key to accept each character
and build your Patient ID code. When the Patient ID code is complete, once again press the Touch Screen directly over
the Patient IDENTIFICATION field to accept the entire Patient ID code.
Check the rest of the screen parameters and if you are satisfied with the setup, press the SETUP ACCEPT button.
Figure 3–7: Data Dial, Accept and Cancel Button
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Note:
Primary breath controls active for the selected (highlighted) mode are visible at the bottom of the touch screen during
setup. The Advanced Settings dialog box and the Alarm Limits dialog box can also be opened during setup. All
controls are active and may be modified while in the Set Up screen.
Note:
The setup button is disabled during the Pflex, MIP/P100 and AutoPEEP maneuvers. It is active during an Esophageal
maneuver.
EST (Extended Systems Test)
From the Setup screen, press
the EST button.
Figure 3–8: Setup Screen, EST Button
A message will appear instructing you to remove the patient and block the patient wye. After confirming that the patient
is disconnected and the circuit wye blocked, press Continue (Cont).
The ventilator begins the EST and displays a countdown clock. During the EST the ventilator will perform:

A Patient circuit leak test.

A Patient circuit compliance measurement.

A two point calibration of the oxygen sensor
The patient circuit compliance measurement and leak
test are performed simultaneously with the oxygen
sensor calibration. The maximum time for the EST is 90
seconds. To restart the EST at any time, press Cancel to
return to the set up screen.
After each test is complete the ventilator will display a
“Passed” or “Failed” message next to the corresponding
test.
The “SET UP ACCEPT” key must be pressed in order for
the AVEA to retain the circuit compliance measurement.
At this point, even after power cycling off, if “SAME PT” is
selected, the circuit compliance measurement will
continue to be retained. If “NEW PT” is selected, the
EST will be required to use this feature.
Figure 3–9: Extended Systems Test Screens
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Once the test is complete, press Continue to return to the set up screen.
Note:
If the ventilator is NOT connected to an oxygen supply the O2 Sensor Calibration will immediately fail.
CAUTION
Although failure of any of the above tests will not prevent the ventilator from functioning, it should be checked to make
sure it is operating correctly before use on a patient.
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Setting the Ventilation Breath Type and Mode
To access the Mode selection options, press the Mode membrane button to the left of the LCD screen.
Figure 3–10: Adult and Pediatric Mode Select screen
Figure 3–11: Infant Mode Select screen
The choices displayed in the Mode Select screen are a combination of breath type and ventilation delivery mode (e.g. a
Volume limited breath with Assist /Control ventilation is shown as Volume A/C). APNEA Backup ventilation choices
appear when CPAP/PSV or APRV / BIPHASIC mode is selected. Apnea Backup is active in all Assist Control, SIMV,
APRV / BIPHASIC and CPAP/PSV modes.
Note:
When CPAP/PSV or APRV / BIPHASIC (Airway Pressure Release Ventilation) is selected, you MUST
1. Set the primary and advanced settings for CPAP/PSV or APRV / BIPHASIC
2
3
Select the breath type for APNEA backup mode by pressing the Apnea Settings key
Set the primary and advanced controls visible at the bottom of the touch screen, for the selected apnea breath
type before pressing the MODE ACCEPT button. The controls for the apnea breath type will not be visible once
the MODE ACCEPT button has been pressed. Only those controls that are active and required for CPAP/PSV or
APRV / BIPHASIC will remain. To review the Apnea backup settings press the Mode button at any time and select
APNEA Settings.
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Volume Guarantee (VG)
The Volume Guarantee function is available for the neonatal patient size setting only in PRESSURE and TCPL
ventilation modes in both the SIMV and Assist Control breath patterns. This function provides an additional operator
setting for target tidal volume. The control pressure for mandatory breaths will then be adjusted by the ventilator in order
to maintain the expired tidal volume close to the preset target volume.
Note:
Volume Guarantee is only available in the neonatal patient size setting and requires the use of a proximal flow sensor.
Refer to the AVEA operator’s manual for specific instructions on attaching proximal flow sensors.
Breath types
Volume Guarantee breath operation is as follows:
When Volume Guarantee is selected, the control Insp Pres will become an advanced setting, the Volume setting will be
displayed as a primary control, and the ventilator will deliver a test breath at the set Inspiratory Pressure setting.
The inspiratory pressure for subsequent breaths will be adjusted by the ventilator on a breath-to-breath basis. Pressure
will be adjusted separately for time-triggered breaths, patient-triggered breaths, apnea backup breaths and manual
breaths in order to maintain monitored expired tidal volume close to the set target.
Specific controls
Flow Cycle
The inspiratory phase of a TCPL Volume Guarantee breath will be terminated whenever the flow to the patient falls to
the operator-set percentage (Flow Cycle) of the peak flow.
When Volume Guarantee is active and Flow Cycle setting is greater than 0, the monitored leak percentage is averaged
over the previous 30 seconds and is added to the Flow Cycle setting (to the maximum setting for the Flow Cycle control
range) to determine the threshold for patient flow.
Flow Cycle is not available in Pressure Control when Volume Guarantee is active.
Note:
Flow cycling of a breath may cause the delivered volume to be reduced. Volume guarantee will attempt to compensate
by increasing delivered pressure up to 3 cmH2O below the high inspiratory-pressure limit. The Expiratory Volume alarm
will be activated if the expiratory volume falls below the alarm threshold.
Volume Limit
Volume Limit is not available for mandatory breaths when Volume Guarantee is active.
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Machine Volume
Machine Volume is not available when Volume Guarantee is active.
Volume Target
Default:
Monitored Expired Tidal Volume (if adding Volume Guarantee to the existing ventilation mode, and a
breath at the current set pressure has been delivered) or 2 mL (if no previous breath at the same
mode and pressure)
Resolution: 0.1 mL
Accuracy: ±(0.1 mL +10% setting)
Range: 2 to 300 mL (Pressure+VG modes)
2 to 100 mL (TCPL+VG)
Note:
Leaks greater than 30% may reduce the ability to achieve the desired Volume Target.
Note:
Due to the nature of the TCPL mode, delivered volume may be reduced if inspiratory time and/or flow are inadequate
to achieve the Volume Target. Volume guarantee will attempt to compensate by increasing delivered pressure up to
3 cmH2O below the high inspiratory-pressure limit. The Expiratory Volume alarm will be activated if the expiratory
volume falls below the alarm threshold.
Inspiratory Pressure
In VG, inspiratory pressure is no longer a primary control. The operator set Inspiratory Pressure is an advanced control
of Volume, and is used for test breaths and acts as a backup pressure setting during certain alarm conditions.
Range:
0 – 80 cmH2O
Default: The pressure setting of the Pressure or TCPL mode used before enabling VG.
WARNING
The Inspiratory Pressure setting in the Advanced Controls screen should be set at an appropriate level for
the patient to avoid under or over delivery of tidal volume during test breaths and certain alarm conditions.
Delivered Pressure
In volume guarantee ventilation the delivered pressure is not an operator setting, it is the pressure provided by the
ventilator to maintain the set volume.
Default: Inspiratory Pressure plus PEEP
Minimum: PEEP + 2 cmH2O
Maximum: High Peak Pressure –3 cmH2O
Note:
Breath to breath variation of delivered pressure will not be more than 3 cmH2O between successive breaths of the
same trigger type (time vs. patient triggered).
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Note:
Delivered Pressure will be limited when it reaches the High Pressure Limit setting of –3 cmH2O. When this occurs, the
message Volume Guarantee Pressure is Limited is displayed. The Low Vte or Low Ve alarms may occur.
Alarms and safety systems
Wye Sensor Disconnect
An audible/visual alarm will be activated, and FLOW SENSOR ERROR will be displayed when all of the following are
true: 1) neonatal flow sensor is in use; 2) volume guarantee function is enabled; and 3) monitored Vti drops below 20%
of the net delivered volume. In this case, the system will revert to the operator set Inspiratory Pressure.
Alarm delay: 3 breaths, or 10s if greater, or 30s if less
Alarm priority: Medium
WARNING
Disconnecting the proximal flow sensor or a Flow Sensor Error condition while Volume Guarantee is
active will cause the ventilator to deliver pressure ventilation at the set Inspiratory Pressure.
Low Ppeak
Range: 1 to 80 cmH2O
Default: 5 cmH2O
High Ppeak
Range: 10 to 85 cmH2O
Default: 30 cmH2O
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Low Expired Volume
An audible/visual alarm will be activated, and LOW Vte will be indicated whenever volume guarantee is active, and
monitored expiratory tidal volume is less than the set threshold from the volume target.
Volume threshold: 90% of Volume target
Alarm delay: 30s or 10 breaths (whichever is greater)
Alarm priority: Medium
Limit volume
All VG breaths will be cycled by volume if inspired volume exceeds a threshold based on the set Volume Target and the
leak (expressed as fraction), averaged over the previous 30 seconds.
The Volume Limit calculation varies with the degree of leak:
Mean Leak < 63%: Volume limit = (Volume Target x 1.3) x ((1.1 x Leak)+1)
Mean Leak >= 63%: Volume limit = Volume Target x 2.2
Alarm activation
During activation of the following alarms, delivered breaths are suspended and the VG control algorithm will be inactive.
Once the alarm condition is resolved, the VG control algorithm will reset, and test breaths will be delivered at the
operator set Inspiratory Pressure.
Circuit Disconnect
Safety Valve Open
Vent INOP
The VG control algorithm will reset to the operator set Inspiratory Pressure during the following alarm conditions and will
restart the VG control algorithm when the alarm condition is resolved.
Low Ppeak
Low PEEP
Flow sensor error
The VG control algorithm will be suspended if a Circuit Occlusion alarm is active. Once the condition is resolved, the VG
control algorithm will restart at the operator set Inspiratory Pressure.
Note:
Low Tidal Volume, High Tidal Volume and Low Vte Alarm Sensitivity settings are not applicable when Volume
Guarantee is active.
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Initiating Volume Guarantee
1.
To initiate Volume Guarantee select the Modes membrane button on the UIM or touch the screen area for the
Current Mode Display. The Mode Select box appears
2.
Select the desired mode (TCPL or Pressure) and also select Volume Guarantee.
Note:
Once Volume Guarantee is selected the Inspiratory Pressure primary control will automatically move to the Advanced
Settings window and the Volume primary control will appear in its place.
The current Monitored Expired Tidal Volume will be the default setting for Volume, if adding Volume Guarantee to
existing ventilation mode, and a breath at current set pressure has been delivered. In the absence of a previous breath
at the current inspiratory pressure setting, the default Volume will be 2mL.
3.
Set the available controls to the prescribed settings and select Mode Accept
WARNING
The Inspiratory Pressure setting in the Advanced Controls window should be set at an appropriate level for
the patient to avoid under or over delivery of tidal volume during test breaths or flow sensor disconnect.
WARNING
Disconnecting the proximal flow sensor or removing it from the circuit while Volume Guarantee is active will
cause the ventilator to deliver pressure ventilation at the set Inspiratory Pressure.
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Note:
Leaks greater than 99% will cause the VTe to display ***. Under this condition, the VG algorithm will not adjust
pressure, and ventilation will continue at the previous level.
Messages
AVEA message bar text
Cause
“Volume Guarantee Disabled”
On disconnect of proximal flow sensor when
Volume Guarantee is active, AAC inactive, if
flow sensor not reattached prior to alert box
closing.
“Volume Guarantee is only available in PRESSURE
and TCPL modes”
Selection of Volume Guarantee on the mode
screen when the primary mode selected is not
PRESSURE or TCPL.
Selection of a mode not PRESSURE or TCPL
when Volume Guarantee is already enabled.
“Set Vol Target will increase delivered press and vol”
Volume Target set more than 20% above
current setting.
“Set Vol Target will decrease delivered press and vol”
Volume Target set more than 20% below
current setting.
“High Ppeak Limit < PEEP + 7 cmH2O”
When Nasal CPAP / IMV mode is active and
breath rate is not ‘OFF’, attempt to set High
Ppeak alarm limit or nCPAP setting such that
High Ppeak alarm limit setting is less than
nCPAP +2 cmH2O.
“Volume Guarantee pressure is limited”
The pressure required to deliver the desired
tidal volume is greater than the High Ppeak
alarm limit of –3 cmH2O.
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Troubleshooting
Alarm
LOW Vte
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Medium
Possible causes
Actions
Inspiratory time or flow
inadequate in TCPL
Increase inspiratory time
and/or flow
Inspiratory time too short
due to flow cycling in TCPL.
Increase flow cycle setting
Delivered Pressure has
increased to its upper limit—
high pressure limit of –3
cmH2O
(±2 cmH2O)—due to
changes in ventilator
settings, resistance and/or
compliance.
Increase high pressure limit
or check patient condition
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Breath Types
This section contains a brief description of the breath types and ventilation mode combinations available for adult,
pediatric and neonatal patients.
There are two basic breath types:

Mandatory breaths (delivered according to set ventilator parameters)
and

Demand breaths (triggered by the patient)
All breaths are defined by four variables:




Trigger (initiates the breath),
Control (controls the delivery),
Cycle (primary breath termination), and
Limit (secondary breath termination).
Mandatory Breaths
Mandatory breaths can be triggered by the machine, the patient, or the operator. There are 4 mandatory breath types
delivered by the AVEA.
1. Volume breaths, which are:



Controlled by flow (inspiratory);
Limited by pre-set volume or maximum inspiratory pressure.
Cycled by volume, flow, and time.
Note:
The Volume Controlled breath is the default breath type for adult and pediatric patients.
The Intra-Breath Demand System in Volume Ventilation
AVEA features a unique intra-breath demand system in Volume Controlled ventilation, designed to provide
additional flow to the patient during periods of demand. AVEA measures the Peak Inspiratory Pressure (Ppeak)
every 2 milliseconds throughout the breath cycle and sets a “virtual” Pressure Support Target of the greater of:
PEEP + 2 cmH2O or Ppeak – 2 cmH2O.
The minimum “virtual” Pressure Support level is set PEEP + 2 cmH2O.
The maximum is 2 times the set PEEP.
Simultaneously, the ventilator monitors and compares the Ppeak measurement to its previous value. Should the
Ppeak decrease by the 2 cmH2O, the ventilator will recognize the patient demand and automatically “switch over” to
deliver a Pressure Support breath at the virtual Pressure Support Target. This allows flow to exceed the set Peak
Flow, thereby meeting the patient’s demand.
Once the set tidal volume has been delivered, the ventilator “looks” at the inspiratory flow. If the Peak Inspiratory
Flow is greater than set peak flow, the ventilator determines that the patient is continuing to demand flow and cycles
the breath when inspiratory flow falls to 25% of peak inspiratory flow. If the Peak inspiratory Flow is equal to the set
flow, the ventilator determines that there is no continued patient demand and ends the breath as a Volume Control
breath.
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Default is on. Can be turned off by accessing advanced setting of Peak Flow in Volume Controlled Ventilation.
2. Pressure breaths, which are:



Controlled by pressure (inspiratory + PEEP);
Limited by pressure (inspiratory + PEEP + margin);
Cycled by time or flow.
3. Time Cycled Pressure Limited (TCPL) breaths (available for neonatal patients only), which are:



Controlled by inspiratory flow;
Limited by pressure (inspiratory + PEEP);
Cycled by time, flow (inspiratory), or volume (Volume Limit).
Note:
TCPL breath type is only available for Neonates. This is the default breath type for neonate patients.
Note:
The ventilator will not allow the operator to set a Peak Inspiratory Pressure (Insp Pres or PSV + PEEP, or baseline
pressure in APRV / BiPhasic, greater than 90 cmH2O). The ventilator will deliver an on screen Pop-Up Message stating
that the Ppeak > 90 cmH2O. The operator must change the Inspiratory Pressure and or PEEP setting to limit the Ppeak
to less than or equal to 90 cmH2O.
WARNING
Total resistance of the inspiratory and expiratory limbs of the breathing circuit with accessories should not
exceed 4cmH2O at 5 L/min if inspiratory flows > 15 liters per minute are used in TCPL ventilation modes. For
instructions on how to perform a circuit resistance test (see “Appendix E: Sensor and Circuit
Specifications”).
4. Pressure Regulated Volume Control (PRVC) breaths are pressure breaths where the pressure level is
automatically modulated to achieve a preset volume. PRVC breaths are:



Controlled by pressure (inspiratory + PEEP) and volume;
Limited by pressure (inspiratory + PEEP + margin);
Cycled by time or flow.
PRVC breath operation is as follows:

When PRVC is selected, a decelerating flow, volume controlled test breath, to the set tidal volume with a 40 msec
pause, is delivered to the patient. The demand system is active during this test breath.

The ventilator sets the target pressure at the end inspiratory pressure of the test breath for the first pressure control
breath.

The next breath and all subsequent breaths are delivered as pressure control breaths. The inspiratory pressure is
based on the dynamic compliance of the previous breath and the set tidal volume.
Inspiratory pressure is adjusted automatically by the ventilator to maintain the target volume. The maximum step
change between two consecutive breaths is 3 cmH2O. The maximum tidal volume delivered in a single breath is
determined by the Volume Limit setting.
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The test breath sequence is initiated when any of the following occur:

Entering the Mode (PRVC)

Changing the set tidal volume while in PRVC

Reaching the Volume Limit setting

Delivered tidal volume > 1.5 times the set volume

Flow termination of the test breath

Exiting Standby

Activation of any of the following alarms
High Peak Pressure Alarm
Low Peak Pressure Alarm
Low PEEP Alarm
Patient Circuit Disconnect Alarm
I-Time Limit
I:E Limit
Note:
If flow cycling is active during a PRVC or Vsync breath flow cycling of the breath can only occur if the target tidal
volume has been delivered. This allows for expiratory synchrony while assuring delivered tidal volume.
Note:
Demand Flow is active for all mandatory breaths. The maximum peak inspiratory pressure achievable by the
ventilator is limited by the high peak pressure alarm setting.
Demand Breaths
All demand breaths are patient-triggered, controlled by pressure, and flow or time cycled. Demand breaths can be either
pressure supported (PSV) or spontaneous. All demand breaths are accompanied by the yellow patient demand
indicator, which flashes in the upper left of the screen.
1.
PSV (Pressure Support Ventilation)
A PSV breath is a demand breath in which the pressure level during inspiration is a preset PSV level plus PEEP.
The minimum pressure support level is PEEP + 2 cmH2O in adult and pediatric applications, independent of the set
PSV pressure level. In neonatal applications the minimum pressure support level is zero.
PSV breaths are:



Controlled by pressure (preset PSV level + PEEP);
Limited by pressure (preset PSV level + PEEP)
Cycled by time (PSV Tmax ) or flow (PSV Cycle).
Pressure Support is active when CPAP/PSV, SIMV or APRV/BiPhasic modes are selected
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Note:
The ventilator will not allow the operator to set a Peak Inspiratory Pressure (Insp Pres or PSV + PEEP, or baseline
pressure in APRV / BiPhasic, greater than 90 cmH2O). The ventilator will deliver an on screen Pop-Up Message stating
that the Ppeak > 90 cmH2O. The operator must change the Inspiratory Pressure and or PEEP setting to limit the Ppeak
to less than or equal to 90 cmH2O.
2.
Spontaneous breath
In adult and pediatric applications, a Spontaneous breath is a demand breath where the pressure level during
inspiration is preset at PEEP + 2 cmH2O.
In neonatal applications a Spontaneous breath is a demand breath delivered only at the preset PEEP.
Note:
IF PSV level is insufficient to meet patient demand, premature termination of the breath may occur with auto-triggering.
In these cases the PSV level should be increased slightly.
Figure 3–12: PSV Waveform
In Figure 3–12 breath number 1 represents the flow tracing which occurs when the PSV level is insufficient to meet the
patient demand. Breath two shows resolution after increasing the PSV level slightly. (Pressure tracing will show a similar
appearance).
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Ventilation Modes
Leak Compensation.
The ventilator incorporates a leak compensation system. This system compensates for baseline leaks at the patient interface. To activate leak compensation, use the touch screen control displayed in the Setup screen.
Assist Control Ventilation (A/C)
This is the default mode for all patient types. In Assist Control ventilation mode, all breaths initiated and delivered are
mandatory breaths. The initiation of a breath is triggered by one of the following:



Patient effort activates the inspiratory trigger mechanism,
The breath interval, as set by the RATE control, times out,
The operator presses the MANUAL BREATH key.
Initiation of a breath by any means resets the breath interval timing mechanism. It is possible for the patient to initiate
every breath if he/she is breathing faster than the preset breath rate. If the patient is not actively breathing, the ventilator
automatically delivers breaths at the preset interval (set breath rate).
Breath Interval
elapsed
PRESSURE
Breath Interval
elapsed
TIME
1
Mandatory Breath (Breath interval expired)
2
Mandatory Breath (Patient triggered)
Figure 3–13: Assist Control Ventilation Waveform
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Synchronized Intermittent Mandatory Ventilation (SIMV)
In SIMV mode, the ventilator can deliver both mandatory and demand breath types. Mandatory breaths are delivered
when the SIMV “time window” is open and one of the following occurs:
A patient effort is detected;

The breath interval has elapsed with no patient effort detected;

The MANUAL BREATH key has been pressed.
Pressure

Time
Assist Window Open
Patient triggered Volume breath
Pressure supported breath
Figure 3–14: SIMV Waveform
The breath interval is established by the preset breath rate. It resets as soon as the interval time determined by the set
breath rate has elapsed, or when the MANUAL BREATH key is pressed.
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Airway Pressure Release Ventilation (APRV / BIPHASIC)
APRV / BiPhasic is a Time Cycled Pressure mode in which the ventilator cycles between two different baseline
pressures based on time, which can be synchronized with patient effort. Controlled ventilation can be maintained by
timed cycling the transitions between baseline pressures. Additionally, pressure support can be added to improve
comfort for the spontaneous breathing patient.
In this mode, the patient is allowed to breathe spontaneously at two preset pressure levels. These are set using the
Pres High and Pres Low controls. The maximum duration at each pressure during time cycling is set with the Time
High and Time Low controls.
The operator can also adjust the length of the respective trigger (Sync) windows with the Time High and Time Low Sync
controls, which are advanced settings of Time High and Time Low. The Sync windows are adjustable from 0 to 50%, in
5% increments of set Time High and Time Low.
The ventilator synchronizes the change from Pressure Low to Pressure High with the detection of inspiratory flow or the
first inspiratory effort detected within the T Low Sync window. Transition from Pressure High to Pressure Low occurs
with the first end of inspiration detected after the T High Sync window opens.
Note:
Time High and Time Low are maximum time settings for a time-cycled transition. Actual times may vary depending on
the patient’s spontaneous breathing pattern and the Sync window setting.
Setting the Sync to 0% cycles the transition between pressure levels on time only and will not provide synchronization
with patient efforts.
The Manual Breath button is not active in APRV / BiPhasic.
The monitored PEEP in APRV/BIPHASIC is relative to the breath type. In the absence of spontaneous breathing, the
monitored PEEP will be the Pressure Low. In the presence of spontaneous breathing the monitored PEEP will reflect
the baseline pressure over which spontaneous breathing is occurred.
Adjustable PSV in APRV / BiPhasic
APRV / BiPhasic features adjustable PSV. The PSV is delivered above the current phase baseline pressure. PSV
breaths are available during Time High also, by activating T High PSV (an advanced setting of Time High). If T High
PSV is activated, during Time High, the ventilator will deliver the same PSV level for both Pressure Low and Pressure
High.
Note:
The ventilator will not allow the operator to set a Peak Inspiratory Pressure (Insp Pres or PSV + PEEP, or baseline
pressure in APRV / BiPhasic, greater than 90 cmH2O). The ventilator will deliver an on screen Pop-Up Message stating
that the Ppeak > 90 cmH2O. The operator must change the Inspiratory Pressure and or PEEP setting to limit the Ppeak
to less than or equal to 90 cmH2O. This 90 cmH2O limit warning is not active when T High PSV is OFF.
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Apnea Ventilation in APRV / BiPhasic
Apnea ventilation is available in APRV / BiPhasic. If the patient does not initiate a spontaneous effort, or the ventilator
does not time cycle between pressure levels before the apnea interval has elapsed, the ventilator will alarm for apnea
and begin apnea ventilation at the apnea ventilation settings. A spontaneous effort from the patient or a transition in
baseline pressure will reset the apnea alarm and timer and return the ventilator to APRV / BiPhasic ventilation.
Airway Pressure Release Ventilation
(APRV / BIPHASIC)
Pressure
Time High
Pressure High
Time Low
Pressure Low
Time
Demand Breath
Spontaneous Breath triggers change to Pressure High
Spontaneous Breath triggers change to Pressure Low
Figure 3–15: APRV / BIPHASIC Mode
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Pressure
Continuous Positive Airway Pressure (CPAP) Pressure Support Ventilation (PSV)
Time
Demand Breath
Figure 3–16: CPAP Waveform
In CPAP/PSV mode, all breaths are patient-initiated demand breaths unless the MANUAL BREATH key is pressed or
apnea backup ventilation is activated. When the MANUAL BREATH key is pressed, a single breath is delivered at the
currently selected apnea backup control settings.
Pressure Support is active in CPAP mode (see “Demand Breaths” on page 76).
CAUTION
When CPAP/PSV is selected, you must
1. Select the breath type for APNEA backup mode AND
2. Set the primary controls visible at the bottom of the touch screen, for the selected apnea breath type before
pressing the MODE ACCEPT button. The controls for the apnea breath type will not be visible once the
MODE ACCEPT button has been pressed. Only those controls that are active and required for CPAP/PSV will
remain. To review the settings for Apnea backup ventilation open the mode window, and select Apnea Settings
Note:
IF PSV level is insufficient to meet patient demand, premature termination of the breath may occur with auto-triggering.
In these cases the PSV level should be increased slightly.
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Figure 3–17: PSV Waveform
In Figure 3–17 breath number 1 represents the flow tracing which occurs when the PSV level is insufficient to meet the
patient demand. Breath two shows resolution after increasing the PSV level slightly. (Pressure tracing will show a similar
appearance).
Non-Invasive Ventilation
The ventilator can perform non-invasive ventilation with a standard dual limb circuit. Leak compensation should be
turned on when using this feature. To turn leak compensation on, use the touch screen control displayed in the Ventilator
Set-Up Screen. See Chapter 6 for Infant Non-invasive ventilation.
Note:
Noninvasive ventilation requires the use of a snug fitting mask with no bleed holes. Excessive leaks around the mask
may result in false triggering of the ventilator or assertion of disconnect alarms.
Apnea Backup Ventilation
Apnea Backup Ventilation is available in Assist Control, SIMV, CPAP/PSV and APRV / BIPHASIC modes.
Apnea Backup in Assist Control or SIMV
When in Assist Control or SIMV modes, the apnea backup rate is determined by the operator-set mandatory breath Rate
or the Apnea Interval setting (whichever provides the highest respiratory rate).
When the Apnea Interval setting (found in the Alarm Limits window) determines the backup rate, the ventilator will
continue to ventilate at this rate until the apnea has been resolved.
All other controls for apnea ventilation in Assist Control and SIMV are set when the primary control values for these
modes are selected.
Apnea ventilation will terminate when one of the following criteria are met:

The patient initiates a spontaneous breath

A manual breath is delivered

The mandatory respiratory rate is increased above the apnea interval setting.
Note:
The apnea interval timer is suspended during a Patient Circuit Disconnect Alarm.
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Apnea Backup in CPAP/PSV or APRV / BIPHASIC
When CPAP/PSV or APRV / BIPHASIC is selected, you MUST:
1. Set the primary and advanced settings for CPAP/PSV or APRV / BIPHASIC.
2. Select the breath type for APNEA backup mode (Volume or Pressure in adult and pediatric patients or Volume,
Pressure or TCPL in neonatal patients) by pressing the Apnea Settings key.
3. Set the primary and advanced controls appearing at the bottom of the touch screen, for the selected apnea breath
type before pressing the MODE ACCEPT button. The controls for apnea backup ventilation will not be visible
once the MODE ACCEPT button has been pressed. Only the controls that are active and required for
CPAP/PSV or APRV / BIPHASIC will remain.
See Figure 3–18 to Figure 3–21 for Apnea backup settings available in each mode.
Figure 3–18: Volume Apnea Backup settings for APRV / BIPHASIC Mode
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Figure 3–19: Pressure Apnea Backup settings for APRV / BIPHASIC Mode
Figure 3–20: Volume Apnea Backup settings for CPAP Mode
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Figure 3–21: Pressure Apnea Backup settings for CPAP Mode
Apnea ventilation will terminate when one of the following criteria are met:

The patient initiates a spontaneous breath

A manual breath is delivered

A timed transition between baseline pressures in APRV / BiPhasic
To review the Apnea backup settings press the Mode button at any time and select APNEA Settings.
Note:
When changing from a controlled mode of ventilation to CPAP/PSV or APRV / BIPHASIC, the default apnea settings
will be the same as those set in the controlled mode. If a New Patient is selected, the default apnea settings are the
same as the factory set default settings for each of the controlled modes.
Note:
The current set FIO2 is delivered during Apnea ventilation.
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Standby
To initiate Standby, press the Screens membrane button on the UIM identified by the icons shown here.
or
International
English
The Screen Select box appears (Figure 3–22).
Figure 3–22: Screen Select
Press STANDBY. The following message will display
Figure 3–23: Standby Message
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If you select “YES”, the ventilator will stop ventilating, the safety valve will close and the ventilator will supply 2 L/min of
gas continuously to the patient circuit and will display the message shown in Figure 3–24.
Figure 3–24: Standby Screen
To resume patient ventilation, press the Resume button. The ventilator will restart ventilation at the most recent settings.
Do not re-connect the patient to the ventilator until the RESUME button has been pressed and ventilation has restarted.
CAUTION
The 2 liters of bias flow, which is maintained during standby, is intended to reduce the risk of circuit overheating in the
event an active humidifier is in use and left on.
To ensure flow through the entire ventilator circuit, the patient wye should be plugged to direct flow down the expiratory
limb of the circuit. Failure to do this may result in damage to the ventilator circuit if the humidifier is left on. Consult the
circuit manufacturer to confirm that 2 L/min of flow is sufficient to prevent overheating.
Note:
Some alarms such as Loss A/C, Loss of O2, Loss of Air, Loss of Gas will be active in Standby.
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Available Breath Types and Modes by Patient Size
Adult and Pediatric Ventilation Modes
The following breath types and ventilation modes are available for Adult and Pediatric patients. When a mode is
selected, its description is displayed at the top left of the touch screen.
Table 3–1: Adult and Pediatric Displayed Modes
Displayed Mode
Volume A/C
Pressure A/C
Volume SIMV
Pressure SIMV
CPAP / PSV
PRVC A/C
PRVC SIMV
APRV / BIPHASIC
Description
Volume breath with Assist ventilation (Default for adult and pediatric patients)
Pressure breath with Assist ventilation
Volume breath with Synchronized Intermittent Mandatory Ventilation (SIMV) and an adjustable level of pressure
support for spontaneous breaths.
Pressure Breath with Synchronized Intermittent Mandatory Ventilation (SIMV) and an adjustable level of pressure
support for spontaneous breaths.
Continuous Positive Airway Pressure (Demand Breath) with Pressure Support Ventilation
Pressure Regulated Volume Controlled breath with Assist Ventilation
Pressure Regulated Volume Controlled breath with Synchronized Intermittent Mandatory Ventilation (SIMV) and an
adjustable level of pressure support for spontaneous breaths.
Spontaneous demand breath at two alternating baseline pressure levels or controlled ventilation cycled by time.
Neonatal Ventilation Modes
The following table shows the breath types and ventilation modes available for Neonatal patients
Table 3–2: Neonatal Displayed Modes
Displayed Mode
Volume A/C
Pressure A/C
Volume SIMV
Pressure SIMV
Description
Volume breath with Assist ventilation (Default for adult and pediatric patients).
Pressure breath with Assist ventilation.
Volume breath with Synchronized Intermittent Mandatory Ventilation (SIMV) and an adjustable level of
pressure support for spontaneous breaths.
Pressure Breath with Synchronized Intermittent Mandatory Ventilation (SIMV) and an adjustable level of
pressure support for spontaneous breaths.
TCPL A/C
TCPL SIMV
Time Cycled Pressure Limited breath with Assist ventilation (Default for neonatal patients).
CPAP / PSV
Nasal CPAP / IMV
Pressure A/C + VG
Continuous Positive Airway Pressure (Demand Breath) with Pressure Support Ventilation.
Time Cycled Pressure Limited breath with SIMV and an adjustable level of pressure support for spontaneous
breaths.
Continuous Positive Airway Pressure (Demand Breath) with or without Intermittent Mandatory Ventilation.
Pressure Breaths with Assist ventilation (Assist Control) with an adjustable volume target (Volume
Guarantee).
Pressure SIMV + VG
Pressure Breaths with Synchronized Intermittent Mandatory Ventilation (SIMV) and an adjustable volume
target.
Pressure TCPL + VG
Pressure Breaths with Synchronized Intermittent Mandatory Ventilation (SIMV) and an adjustable volume
target.
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Primary Breath Controls
The Primary Breath Controls are the operator set controls, which directly affect the way a breath is delivered to your
patient. They are displayed along the bottom of the AVEA LCD touch screen. Only the active controls for the selected
mode of ventilation will be displayed.
Table 3–3: Primary Breath Controls
Displayed
Control
bpm
Rate
ml
Volume
cmH2O
Insp Pres
Description
Range
Accuracy
Breath rate shown in Breaths
per Minute
1 to 150 bpm (Neo / Pediatric)
1 to 120 bpm (Adult)
± 1 bpm
Tidal Volume in milliliters
0.10 to 2.50 L (Adult)
25 to 500 ml (Pediatric)
2.0 to 300 ml (Neonate)
± (0.2 ml + 10% of setting)
Inspiratory Pressure in
centimeters of water pressure
0 to 90 cmH2O (Adult/Pediatric)
0 to 80 cmH2O (Neonate)
Adult/Pediatric: ±4cmH2O +5%
Neonate: ±3 cmH2O +2.5%
(measured at the patient wye, end inspiratory pressure
after 0.3 seconds)
L/min
Peak Flow
Peak Inspiratory Flow in Liters
per Minute
3 to 150 L/min (Adult)
1 to 75 L/min (Pediatric)
0.4 to 30.0 L/min (Neonate)
 10% of setting or  (0.2 L/min + 10% of setting),
whichever is greater
sec
Insp Time
Inspiratory Time in Seconds
0.20 to 5.00 sec
(Adult/Pediatric)
0.15 to 3.00 sec (Neonate)
± 0.10 sec
sec
Insp Pause
Sets an inspiratory pause which
will be in effect for each Volume
breath delivered
0.0 to 3.0 sec
± 0.10 sec
cmH2O
PSV
Pressure Support in centimeters
of water pressure
0 to 90 cmH2O (Adult/Pediatric)
0 to 80 cmH2O (Neonate)
± 3 cmH2O or ± 10% whichever is greater
cmH2O
PEEP
Positive end expiratory pressure
in centimeters of water pressure
0 to 50 cmH2O
 2 cmH2O or  5% of setting, whichever is greater
Sets inspiratory flow trigger
point in liters per minute
0.1 to 20.0 L/min
+ 1.0 /  2.0 L/min ( for PEEP < 30 cmH2O)
L/min
Flow Trig
+ 2.0 /  3.0 L/min ( for PEEP > 30 cmH2O)
 (0.2 L/min + 10% of setting) (Wye flow sensor only)
Controls the percentage of
oxygen in the delivered gas.
21% to 100%
 3% O2
cmH2O
Pres High
In APRV / BIPHASIC mode,
controls the baseline pressure
achieved during Time High.
0 to 90 cm H2O
± 3 cmH2O
sec
Time High
In APRV / BIPHASIC mode sets
the minimum time for which the
high-pressure setting is
maintained.
0.20 to 30.0 sec
± 0.1 sec
sec
Time Low
In APRV / BIPHASIC mode sets
the minimum time for which the
low pressure setting is
maintained.
0.20 to 30.0 sec
 0.1 sec
cmH2O
Pres Low
In APRV / BIPHASIC mode
controls the baseline pressure
achieved during Time Low.
0 to 45 cmH2O
 2 cmH2O or  5% of setting, whichever is greater
%
%O2
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To activate a primary control, press the touch screen directly over the control. The control highlights (changes color)
indicating that it is active.
Figure 3–25: Highlighted Control
To modify the settings for the highlighted control, turn the data dial below the touch screen (Figure 3–26). Turning in a
clockwise direction increases the selected value, turning counterclockwise decreases it.
Figure 3–26: Data dial.
To accept the displayed value, either press the touch screen directly over the highlighted control or press the ACCEPT
membrane button to the left of the data dial. The control color will change back to normal and the ventilator will begin
operating with the new setting. If you press the CANCEL button or do not actively accept the new setting within 15
seconds, ventilation will continue at the previous settings.
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Descriptions of Primary Breath Controls
Breath Rate (Rate)
The breath rate control sets the breath interval. Its function is dependent upon the selected mode of ventilation and it has
different effects on the breath cycle, depending on which mode is selected.
Range:
1 to 150 bpm (Neonate / Pediatric)
1 to 120 bpm (Adult)
Breath Interval: (60/Rate) sec.
Defaults:
12 bpm
(Adult)
12 bpm
(Pediatric)
20 bpm
(Neonate)
Tidal Volume (Volume)
A volume breath delivers a predetermined volume of gas to the patient. Tidal Volume, together with the Insp Flow, and
Waveform settings determine how the volume breath is delivered.
Range:
0.10 to 2.50 L
(Adult)
25 to 500 ml
(Pediatric)
2.0 to 300 ml
(Neonate)
Defaults:
0.50 L
(Adult)
100 ml
(Pediatric)
2.0 ml
(Neonate)
Sigh:
1.5 x Volume
(Adult/Pediatric only)
Note:
When operated from the internal compressor, the maximum Tidal Volume that the ventilator can achieve is 2.0 L.
The maximum minute volume that the ventilator is capable of delivering using wall gas supply is at least 60L and using
internal compressor is 40L.
Inspiratory Pressure (Insp Pres)
During a mandatory pressure breath, the ventilator controls the inspiratory pressure in the circuit. For Pressure and
TCPL breaths, the pressure achieved is a combination of the preset Insp. Pres. level plus PEEP.
Range:
0 to 90 cmH2O (Adult/Pediatric)
0 to 80 cmH2O (Neonate)
Maximum Flow: > 200 L/min
(Adult)
< 120 L/min
(Pediatric)
< 50 L/min
(Neonate)
Default:
15 cmH2O
Note:
The ventilator will not allow the operator to set a Peak Inspiratory Pressure (Insp Pres or PSV + PEEP, or baseline
pressure in APRV / BiPhasic, greater than 90 cmH2O). The ventilator will deliver an on screen Pop-Up Message stating
that the Ppeak > 90 cmH2O. The operator must change the Inspiratory Pressure and or PEEP setting to limit the Ppeak
to less than or equal to 90 cmH2O.
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Peak Flow
Peak flow is the flow delivered by the ventilator during the inspiratory phase of a mandatory volume or TCPL breath.
Range:
Defaults:
3 to 150 L/min
(Adult)
1 to 75 L/min
(Pediatric)
0.4 to 30.0 L/min
(Neonate)
60 L/min
(Adult)
20 L/min
(Pediatric)
8.0 L/min
(Neonate)
Inspiratory Time (I-Time)
The I-Time control sets the inspiratory time cycle variable for all mandatory pressure, TCPL or PRVC breaths.
Range:
0.20 to 5.00 seconds
0.15 to 3.00 seconds
(Adult/Pediatric)
(Neonate)
Default:
1.0 second
0.75 seconds
0.35 second
(Adult)
(Pediatric)
(Neonate)
Note:
If the preset I-Time is greater than actual I- Time (as determined by Vt, FP, and the waveform), an Inspiratory Pause time
equal to the preset I-Time minus the actual I- Time is added to the breath.
Inspiratory Pause (Insp Pause)
Sets an Inspiratory Pause, which will be in effect for each volume breath delivered.
A preset inspiratory pause will be delivered with each volume breath.
Range:
Default:
0.00 to 3.00 seconds
0.00 second
PSV (Pressure Support)
The PSV control sets the pressure in the circuit during a pressure supported breath.
Range:
0 to 90 cmH2O
(Adult/Pediatric)
0 to 80 cmH2O
(Neonate)
Maximum Flow: > 200 L/min
(Adult)
< 120 L/min
(Pediatric)
< 50 L/min
(Neonate)
Default:
0 cmH2O
Note:
The ventilator will not allow the operator to set a Peak Inspiratory Pressure (Insp Pres or PSV + PEEP, or baseline
pressure in APRV / BiPhasic, greater than 90 cmH2O). The ventilator will deliver an on screen Pop-Up Message stating
that the Ppeak > 90 cmH2O. The operator must change the Inspiratory Pressure and or PEEP setting to limit the Ppeak
to less than or equal to 90 cmH2O.
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Note:
In adult and pediatric ventilation, a minimum of 2 cmH2O of PSV above PEEP is applied even when the control is set to
zero.
Note:
IF PSV level is insufficient to meet patient demand, premature termination of the breath may occur with autotriggering. In these cases the PSV level should be increased slightly.
Figure 3–27: PSV Waveform
In Figure 3–27 breath number 1 represents the flow tracing which occurs when the PSV level is insufficient to meet the
patient demand. Breath two shows resolution after increasing the PSV level slightly. (Pressure tracing will show a similar
appearance).
Note:
Monitored airway pressures (inspiratory) will be higher than set when AAC is active. With an inspiratory pressure
setting of zero, AAC will still provide an elevated airway pressure, to compensate for the resistance of the endotracheal
tube.
Positive End Expiratory Pressure (PEEP)
PEEP is the pressure that is maintained in the patient circuit at the end of exhalation.
Range:
0 to 50 cmH2O
Defaults:
6 cmH2O
3 cmH2O
(Adult/Pediatric)
(Neonate)
Note:
The ventilator will not allow the operator to set a Peak Inspiratory Pressure (Insp Pres or PSV + PEEP, or baseline
pressure in APRV / BiPhasic, greater than 90 cmH2O). The ventilator will deliver an on screen Pop-Up Message stating
that the Ppeak > 90 cmH2O. The operator must change the Inspiratory Pressure and or PEEP setting to limit the Ppeak
to less than or equal to 90 cmH2O.
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Note:
The ventilator may assert a circuit occlusion alarm in conditions when measured PEEP is significantly greater than
operator set PEEP.
Inspiratory Flow Trigger (Flow Trig)
The inspiratory trigger mechanism* is activated when the Net Flow becomes greater than the Inspiratory Flow Trigger
setting. Net Flow is defined as [Delivered Flow  Exhaled Flow] (or Wye Inspiratory Flow when using a wye flow
sensor). When the Inspiratory Flow Trigger is enabled, a low level of Bias Flow is delivered to the patient circuit during
the exhalation phase of the breath.
Range:
0.1 to 20.0 L/min
Defaults:
1.0 L/min
0.5 L/min
(Adult/Pediatric)
(Neonate)
*See also “Pres Trig” on 101.
CAUTION
If a proximal flow sensor is used it must be attached at both the patient wye and at the ventilator connection to
ensure proper function of the AVEA.
Note:
To ensure adequate bias flow for inspiratory triggering the bias flow setting should be at least 0.5 liters per minute
greater than the flow trigger threshold.
%O2
The % O2 control sets the percentage of oxygen in the delivered gas.
Range:
21 to 100%
Default:
40%
Note:
During Heliox administration the %O2 control sets the percent of Oxygen in the delivered gas. The balance of the
delivered gas is Helium.
Pressure High (Pres High)
This control is only available in APRV / BIPHASIC Mode. It controls the baseline pressure achieved during Time High.
Range: 0 to 90 cmH2O
Default: 15 cmH2O
Time High
Available in APRV / BIPHASIC mode only, this control sets the maximum time for which the Pressure High setting is
maintained.
Range: 0.2 to 30 seconds
Default: 4 seconds
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Time Low
In APRV / BIPHASIC mode, this control sets the maximum time for which the Pressure Low setting is maintained.
Range: 0.2 to 30 seconds
Default: 2 second
Pressure Low
In APRV / BIPHASIC Mode, this control sets the baseline pressure achieved during Time Low.
Range: 0 to 45 cmH2O
Default: 6 cmH2O
Advanced Settings
When the mode and the primary breath controls have been set, you can further refine delivery of the breath by accessing
the Advanced Settings.
Accessing the Advanced Settings
To access the advanced settings group, press the ADV
SETTINGS membrane button located to the left of the touch
screen between the Mode and the Set-up buttons. The LED
indicator on the button illuminates and the Advanced Settings
screen appears. When you select a primary control by pressing
and highlighting the control at the bottom of the touch screen,
the available advanced settings for that selected control appear
in the advanced settings screen.
Figure 3–28: Advanced Settings
membrane button
Primary Controls, which feature an advanced setting, will display a
yellow triangle to the right of the control name.
Figure 3–29: Advanced Settings indicator
Note:
Not every primary control will have an associated advanced setting.
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Table 3–4: Controls and Advanced Settings Associated with Breath Type and Mode
BREATH
TYPE
AND MODE
PRIMARY
CONTROLS
VOL A/C
VOL SIMV
PRES
A/C
PRES
SIMV
PRVC A/C
PRVC
SIMV
RATE
bpm
*
*
*
*
*
VOLUME
ml
*
*
*
INSP PRES
cmH2O
PEAK FLOW
L/min
*
*
PSV
cmH2O
PEEP
cmH2O
FLOW TRIG
L/min
% OXYGEN
%O2
PRES HIGH
cmH2O
TIME HIGH
sec
TIME LOW
sec
PRES LOW
cmH2O
ADVANCED
SETTINGS
AVAILABLE
WITHIN EACH
MODE
*
* Apnea
* Apnea
*
* Apnea
* Apnea
* Apnea
*
*
*
*
*
*
*
*
*
*
*
TCPL A/C
TCPL
SIMV
*
*
* Apnea
*
*
* Apnea
* Apnea
*
*
* Apnea
* Apnea
*
*
* Apnea
* Apnea
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
Mode
Mode
Mode
Mode
*
*
*
Mode
Mode
*
*
*
*
*
*
*
Vsync*,
Vsync*,
Mach
Mach vol,
Vsync
Vsync rise*,
vol,
Vol limit,
rise*,
Sigh,**
Vol limit,
Insp rise,
Sigh,**
Waveform,
Insp rise,
Flow
Waveform,
Vol. Limit,
Flow
cycle,
Bias flow,
PSV rise,
cycle,
PSV rise,
Pres trig
PSV cycle,
Bias
PSV cycle,
PSV Tmax,
flow,
PSV
Vol limit
Bias flow,
Pres trig
Tmax,
(when
Pres trig,
Bias flow,
Vsync =
Flow
Pres trig
ON), Flow
Cycle*,
Cycle*,
Demand
Demand
Flow
Flow
* Available only with Vsync activated for adult or pediatric patients only.
** Available for adult and pediatric patients only.
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BIPHASIC
*
INSP TIME
sec
INSP PAUSE
sec
CPAP/PSV
*
*
*
*
*
*
*
Mode
Mode
Mode
Mode
Mode
Mode
*
Insp rise,
Bias flow,
Pres trig
Vol Limit,
Flow
Cycle
Vol limit,
PSV rise,
PSV cycle,
PSV
Tmax,
Bias flow,
Pres trig,
Flow
Cycle
Vol limit,
PSV rise,
PSV cycle,
PSV Tmax,
Bias flow,
Pres trig
Vol limit,
PSV rise,
PSV cycle,
PSV
Tmax,
Bias flow,
Pres trig
T High
Sync
T High
PSV
T Low
Sync
Vol limit,
Flow
cycle,
Bias flow,
Pres trig
Vol limit,
Flow
cycle,
PSV rise,
PSV
cycle,
PSV
Tmax,
Bias flow,
Pres trig
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Advanced Settings Characteristics and Ranges
Volume Limit (Vol Limit)
The Vol Limit setting sets the volume limit for a Pressure Limited breath. When the volume delivered to the patient
meets or exceeds the preset Vol Limit, the inspiratory phase of the breath is terminated.
Range:
Normal:
0.10 to 2.50 L
25 to 750 ml
2.0 to 300.0 ml
(Adult)
(Pediatric)
(Neonate)
Defaults:
2.50 L
500 ml
300 ml
(Adult)
(Pediatric)
(Neonate)
The Vol Limit setting sets the volume limit for a Pressure limited breath. When the volume delivered to the patient meets
or exceeds the preset Vol Limit, the inspiratory phase of the breath is terminated.
Volume Limit is active for Pressure, PRVC / Vsync, TCPL, and PSV breaths only. In neonatal applications Volume Limit
requires the use of a wye flow sensor. Whenever a proximal flow sensor is used (Neonatal, Pediatric or Adult
applications) the Volume Limit is activated by the inspiratory tidal volume measured by the wye flow sensor. In adult and
pediatric applications where no wye flow sensor is used Volume Limit is determined by the calculated inspiratory wye
flow. When the volume limit threshold has been reached the ventilator alarm status indicator will change to yellow and
display the words Volume Limit. The alarm status indicator cannot be reset until the ventilator has delivered a breath,
which does not meet the volume limit threshold. To reset the alarm status window use the alarm-reset button.
CAUTION
If a proximal flow sensor is used it must be attached at both the patient wye and at the ventilator connection to
ensure proper function of the AVEA.
Note:
Excessive inspiratory flow rates or highly compliant ventilator circuits may allow delivery of a tidal volume that exceeds
the volume limit setting. This is due to the ventilator circuit recoiling and providing additional tidal volume to the
patient. Delivered tidal volumes should be closely monitored to ensure Volume Limit accuracy.
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Machine Volume (Mach Vol)
The Machine Volume control sets the minimum tidal volume delivered from the ventilator when the control is activated in a
pressure control breath. This control is always used with the time cycling criterion in pressure control ventilation. Machine
volume is circuit compliance compensated in adult and pediatric applications.
Range:
Normal:
0.10 to 2.50 L
25 to 500 ml
2.0 to 300.0 ml
(Adult)
(Pediatric)
(Neonate)
Defaults:
0L
0 ml
0 ml
(Adult)
(Pediatric)
(Neonate)
Once you set the machine volume, the ventilator calculates the decelerating inspiratory flow required to deliver the
Machine Volume in the set inspiratory time. When a Pressure Control breath is delivered and Peak Flow decelerates to
this calculated peak inspiratory flow, if the Machine Volume has not been met the ventilator will automatically transition to
a continuous flow until the Machine Volume has been delivered. Once the set Machine Volume has been delivered the
ventilator will cycle into exhalation. When the Machine Volume is met or exceeded during delivery of the pressure
control breath, the ventilator will complete the breath as a normal Pressure Control breath.
During this transition in flow, the Inspiratory Time will remain constant and the Peak Inspiratory Pressure will increase to
reach the set Machine Volume. The maximum Peak Inspiratory Pressure is determined by the High Peak Pressure
alarm setting.
Note:
Pmax is disabled when Machine Volume is set. In the event Flow Cycling is active in Pressure Control the ventilator
will not Flow Cycle until the Machine Volume has been met. Machine Volume must be set to zero to change patient
size.
To set Machine Volume in adult and pediatric applications (with circuit compliance compensation active) simply set the
minimum desired tidal volume.
In neonatal applications with proximal flow sensor in use:

Adjust the peak inspiratory pressure to reach the desired tidal volume.

Select Vdel as one of the monitored parameters. Read the Vdel (uncorrected Tidal Volume delivered from the
machine) during a pressure control breath.

Set the Machine volume to or slightly below the Vdel measurement. This will set the machine volume to a level
that will provide more consistent tidal volume delivery in the case of slight decreases in lung compliance.
CAUTION
If a proximal flow sensor is used it must be attached at both the patient wye and at the ventilator connection to
ensure proper function of the AVEA.
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Note:
To protect against larger changes in lung compliance, the machine volume should be set higher and Volume Limit
should be added.
Insp Rise
The Inspiratory Rise setting controls the slope of the pressure rise during a mandatory breath. This control is a relative
control with fast being a setting of 1, and slow a setting of 9.
Range:
1 to 9
Default:
5
The Inspiratory Rise control is not active for TCPL breaths.
Flow Cycle
The flow cycle setting sets the percentage of the peak inspiratory flow (Peak Flow), at which the inspiratory phase of a
Pressure Control, TCPL or PRVC/Vsync breath is terminated.
Range:
0 (Off) to 45%
Default:
0% (Off)
Flow cycling is active for Pressure, PRVC/Vsync or TCPL breaths only.
Note:
If flow cycling is active during a PRVC or Vsync breath flow cycling of the breath can only occur if the target tidal
volume has been delivered. This allows for expiratory synchrony while assuring delivered tidal volume.
Note:
If Flow Cycling is active during a pressure control breath, monitored airway pressures (inspiratory) will be higher than
set when AAC is active. In pediatric and adult ventilation with an inspiratory pressure setting of zero AAC will still
provide an elevated airway pressure, which will compensate for the resistance of the endotracheal tube.
Waveform
During the delivery of a volume breath, flow can be delivered in one of two user selectable waveforms: square wave or
decelerating wave. The default waveform is Decelerating Wave.
Square Wave (Sq)
With this waveform selected, the ventilator delivers gas at the set peak flow for the duration of the inspiration.
Decelerating Wave (Dec)
With this waveform selected, the ventilator delivers gas starting at the peak flow and decreasing until the flow
reaches 50% of the set peak flow.
Demand Flow
Enables and disables the Intra-Breath Demand system in volume controlled ventilation. The default position is on.
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Note:
Should the patient’s inspiratory demand be sustained beyond the controlled inspiratory time plus the minimum
expiratory time with the demand system turned off, auto-triggering or double triggering may occur. This is the result
of the patient demanding more flow than available resulting in a breath trigger after the minimum expiratory time. This
may be resolved by increasing the inspiratory flow rate to meet the patients demand or turning the demand system
back on.
Sigh
The ventilator delivers sigh volume breaths when this setting is ON. A sigh volume breath is delivered every 100th breath
in place of the next normal volume breath.
Range:
Off, On (every 100 breaths)
Sigh Volume:
1.5 times set tidal volume
Sigh Breath Interval (sec):
Set Normal Breath Interval x 2 (Assist mode) or
set Normal Breath Interval (SIMV mode)
Default:
Off
Sigh breaths are only available for Volume breaths in Assist and SIMV modes for adult and pediatric patients.
Bias Flow
The Bias Flow control sets the background flow available between breaths. Additionally, this control establishes the base
flow that is used for flow triggering.
Range:
Defaults:
0.4 to 5.0 L/min
2.0 L/min
Note:
To ensure adequate bias flow for inspiratory triggering the bias flow setting should be at least 0.5 liters per minute
greater than the flow trigger threshold. Consult the ventilator circuit manufacturer to ensure that bias flow setting is
sufficient to prevent overheating of the ventilator circuit.
Pres Trig
Sets the level below PEEP at which the inspiratory trigger mechanism is activated. When the pressure in the patient
circuit falls below PEEP by the set pressure trigger level, the ventilator will cycle to inspiration.
Range:
Default:
0.1 to 20.0 cmH2O
3.0 cmH2O
Vsync
Vsync breaths are:

Controlled by pressure (inspiratory + PEEP) and volume;

Limited by pressure (inspiratory + PEEP + margin);

Cycled by time. Inspiratory time in Vsync is determined indirectly by setting the peak inspiratory flow. The set
inspiratory time is displayed in the message bar.
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Vsync breath operation is as follows:
When Vsync is selected, a decelerating flow, volume test breath to the set tidal volume with a 40 msec pause is
delivered to the patient. The ventilator sets the target pressure at the end inspiratory pressure of the test breath or the
first pressure control breath. The next breath and all subsequent breaths are delivered as pressure control breaths.
Inspiratory pressure is adjusted automatically, based on the dynamic compliance of the previous breath, to maintain the
target volume. The maximum step change between two consecutive breaths is 3 cmH2O. The maximum tidal volume
delivered in a single breath is determined by the Volume Limit setting.
This test breath sequence is initiated when any of the following occur:







Entering the Mode (Vsync)
Changing the set tidal volume while in Vsync
Reaching the Volume Limit setting
Delivered tidal volume > 1.5 times the set volume
Flow termination of the test breath
Exiting Standby
Activation of any of the following alarms
-
High Peak Pressure Alarm
Low Peak Alarm
Low PEEP Alarm
Patient Circuit Disconnect Alarm
I-Time Limit
I:E Limit
Vsync is only available for adult and pediatric patients.
Note:
If flow cycling is active during a PRVC or Vsync breath flow cycling of the breath can only occur if the target tidal
volume has been delivered. This allows for expiratory synchrony while assuring delivered tidal volume.
Note:
The Peak Flow control sets the flow rate, which is used by the ventilator for the test breath only. The ventilator uses
the Peak Flow setting and Inspiratory Pause to determine the maximum inspiratory time during Vsync ventilation.
Vsync Rise
With Vsync active, this control sets the slope of the pressure rise during the volume breath. It is a relative control ranging
from fast (1) to slow (9).
Range:
1 to 9
Default:
5
PSV Rise
This control sets the slope of the pressure rise during a pressure-supported breath. It is a relative control with a range
from fast (1) to slow (9).
Range:
1 to 9
Default:
5
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PSV Cycle
Sets the percentage of peak inspiratory flow at which the inspiratory phase of a PSV breath is terminated.
Range:
5 to 45%
Default:
25% (Adult/Pediatric)
10% (Neonate)
PSV Tmax
Controls the maximum inspiratory time of a pressure-supported breath.
Range:
0.20 to 5.00 seconds (Adult/Pediatric)
0.15 to 3.00 (Neonate)
Default:
5.00 seconds (Adult)
0.75 seconds (Pediatric)
0.35 seconds (Neonate)
T High Sync
T High Sync establishes the length of respective trigger (Sync) window while in Time High. Transition from Pressure
High to Pressure Low occurs with the first end of inspiration detected after the T High Sync window opens.
Range:
0-50% in 5% increments of set T High.
Default:
Adult and Pediatric: 0%
Infant:
Not Applicable
T High PSV
Pressure Support breaths are available during Time High in APRV / BiPhasic by activating T High PSV. If T High PSV is
activated, during Time High, the ventilator will deliver the same PSV level for both Pressure Low and Pressure High.
Range (Pressure Support):
Adult and Pediatric 0-90 CcmH2O
Infant:
Not Applicable
Not to exceed a PIP > 90 cmH2O.
Default:
Adult and Pediatric: Off
Infant: Not Applicable
T Low Sync
T Low Sync establishes the length of respective trigger (Sync) window while in Time Low. The ventilator synchronizes
the change from Pressure Low to Pressure High with the detection of inspiratory flow or the first inspiratory effort
detected within the T Low Sync window.
Range:
0-50% in 5% increments of set T Low.
Default:
Adult and Pediatric: 0%
Infant:
Not Applicable
Note:
PSV Rise, PSV Cycle and PSV Tmax are active even if the PSV level is set to Zero
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Independent Lung Ventilation (ILV)
Independent lung ventilation allows 2 ventilators to be synchronized to the same breath rate (the rate control set on the
master ventilator), while all other primary and advanced controls for each ventilator can be set independently. Master
and slave ventilators need not operate in the same mode during ILV.
The AVEA offers a port to allow Independent Lung Ventilation (ILV). This connection is located on the rear panel (, C).
The output provides a 5 VDC logic signal, synchronized to the breath phase of the master ventilator.
A specially configured accessory cable kit (part number 16246), available from CareFusion, is required to
implement ILV.
WARNING
Do NOT attempt to connect a standard DB-25 cable to this receptacle. This could cause damage to the
ventilator. A specially configured cable is required for ALL features associated with this connector. Contact
Technical Support.
To enable Independent Lung Ventilation, refer to Chapter 2, Ventilator Setup, Independent Lung Ventilation (ILV).
Note:
During ILV, the alarm limits for each ventilator should be set to appropriate levels for each ventilator to ensure
appropriate patient protection. Confirm apnea timer settings and apnea ventilation settings for the Slave ventilator.
These settings will be used in the event of a loss of signal from the Master ventilator.
WARNING
Since the master ventilator controls the breath rate for both ventilators, care should be taken when setting
the other independent breath controls for the slave ventilator, to ensure sufficient time is allowed for
exhalation to occur.
CAUTION
If the cable connecting the master and slave ventilators becomes detached, the slave ventilator will alarm for loss of
signal. In this event, only the master ventilator will continue to provide ventilation at the current settings. The slave
ventilator will begin apnea ventilation after its apnea timer has elapsed at its current apnea ventilation settings.
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Graphic Displays
Graphics Colors
Graphic displays on AVEA may appear as red, blue, yellow, green or purple tracings. These colors may provide useful
information to the operator about breath delivery and are consistent between both waveform and loop graphic
displays.
A RED tracing indicates the inspiratory portion of a mandatory breath. A YELLOW tracing indicates the inspiratory
portion of an assisted or spontaneous breath (patient assisted or spontaneous breaths are also denoted with a yellow
demand indicator that appears in the left hand corner of the mode indicator). BLUE tracings represent the expiratory
phase of a mandatory, assisted or spontaneous breath. A GREEN tracing during the expiratory phase of a single breath
indicates that a purge of the expiratory flow sensor or the wye flow sensor (if attached) has occurred. A PURPLE tracing
indicates safety state, which occurs when the safety valve is open.
Waveforms
Three waveforms can be selected and simultaneously displayed on the MAIN screen as shown in Figure 4–1.
Note:
Waveforms are circuit compliance compensated for pediatric and adult patient sizes.
Waveform
Heading
Display
Figure 4–1: Waveform Graphs Displayed on the Main Screen
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When you press and highlight the waveform heading display on the touch screen a scrollable menu appears showing the
choice of waveforms (Figure 4–2).
Waveform
Selection Menu
Highlighted
Waveform
Heading
Y-axis of
graph
X axis of
graph
Figure 4–2: Waveform Selection
To scroll through the waveform choices, turn the data dial under the touch screen. To make your selection, touch the
touch screen menu again or press the Accept membrane button shown here next to the data dial.
Figure 4–3: Data dial
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Each waveform is continuously updated unless the PRINT or FREEZE membrane button is pressed.
The PRINT button transfers data to a connected parallel printer.
The FREEZE button freezes the current screen and suspends the screen update until pressed a second time.
Table 4–1: Waveform Choices
Heading Display
Waveform Shown
Paw (cm H2O)
Airway Pressure
Pinsp (cmH20)
Airway Pressure at Machine Outlet
Pes (cmH2O)
Esophageal Pressure
Ptr (cmH2O)
Tracheal Pressure
Ptp (cmH20)
Transpulmonary Pressure
Flow(L/min)
Flow
Vt (ml)
Airway Tidal Volume
Fexp
Finsp
Expiratory flow
Inspiratory Flow
PCO2
CO2 value through the respiratory cycle
Analog 0
Based on analog input scale
Analog 1
Based on analog input scale
PCO2
CO2 level through respiratory cycle
Axis Ranges
The scale (vertical axis) and sweep speed (horizontal axis) of the displayed graphs are also modifiable using the touch
screen. To change the displayed range, press either axis of the displayed graph to highlight it. The highlighted axis can
then be modified using the data dial below the touch screen (Figure 4–3). To accept the change, touch the highlighted
axis again or press Accept.
Time Ranges
0 to 6 seconds
0 to 12 seconds
0 to 30 seconds
0 to 60 seconds
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Loops
Accessing the Loops Screen
To access the loops screen press the screens
membrane button to the left of the touch screen on
the UIM. The button is labeled with the icons shown
here.
or
International
English
Select LOOP from the options that appear.
Figure 4–4: Screen Selection
Choice of Loops
The ventilator displays 2 loops in real time, selected from the following.

Vt-Flow
Flow / Volume Loop. Inspiratory flow / Volume. If proximal flow sensor is used values are
based on proximal flow sensor measurements.
Available for all patients.

PAW - Vt
Airway Pressure / Volume loop. Active for all patients.

PES - Vt
Esophageal Pressure vs. Volume loop. This requires the use of an optional esophageal
balloon and is active for adult and pediatric patients only.

PTR - Vt
Tracheal Pressure vs. Volume loop. This requires the use of an optional tracheal monitoring
tube and is active for adult and pediatric patients only.

PINSP – Vt
Inspiratory Pressure vs. Volume loop.

PTp – Vt
Transpulmonary vs. Volume. This requires the use of an optional esophageal balloon and is
active for adult and pediatric patients only.

PCO2/Vte
Exhaled CO2 vs. Exhaled Vt
Note:
Loops are circuit compliance compensated for pediatric and adult patient sizes.
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Using the Freeze Button to Compare Loops
You can freeze the Loops screen and select a reference loop for
comparison. When real-time data refreshing resumes (by
pressing the Freeze button again), the selected loop will remain
in the background behind the real time graphic.
To create a reference loop refer to Figure 4–6, Figure 4–7, and
Figure 4–8 and do the following.
Figure 4–5: Frozen Flow / Volume Loop
Saving a loop
Press the Freeze button to freeze the loop you wish to use as a
reference then press the Save Loop touch screen display in the
right hand bar, beneath the frozen graphic display (Figure 4–6).
Figure 4–6: Reference Loop ON/OFF button (OFF)
This puts the selected loop into memory and places a time
reference into a field in the left hand bar beneath the graphics
display as shown in Figure 4–7. A total of four (4) loops can
be saved at one time. When the fifth loop is saved, the oldest
loop is removed.
Figure 4–7: Saved Loops Display
Creating a reference loop
Press the touch screen directly over the touch screen field
in the left bar which represents the saved loop you wish to
use as a reference. The field will highlight (Figure 4–7).
Press the “Ref Loop ON/OFF” field on the right hand bar
(Figure 4–6 and Figure 4–8) to turn the reference loop on.
Figure 4–8: Reference Loop ON/OFF button (ON)
When you press the Freeze button again, the reference loop remains visible in the background, while the active display
places current loops in real time over the top of it.
To turn off the reference loop, freeze the screen again and press the Ref Loop On/Off toggle button shown in Figure 4–8.
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Maneuvers
Figure 4–9: Maneuver Selection
The AVEA is capable of performing various respiratory mechanics maneuvers. These maneuvers can be accessed from the
screens menu and selecting the Maneuvers screen. Depending on the model, the following maneuvers may be available:
Esophageal, MIP / P100, Inflection Point (Pflex), and AutoPEEPAW. Each maneuver screen includes all controls, monitors, and
waveform or loop graphics pertinent to the selected maneuver.
Note:
Maneuvers are not available for Neonate patients. Some alarms may be disabled during a maneuver.
Note:
The initiation of an AutoPEEP or Pflex maneuver will terminate Apnea ventilation.
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Esophageal Maneuver Screen
Figure 4–10: Esophageal Maneuver Settings
Controls
Figure 4–11: Select Esophageal Balloon Size and Type
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Selecting Balloon Size and Type
Upon connection of the Balloon Extension Tubing the ventilator will display the Esophageal Balloon Size and
Type dialogue box. You must select the size and type of balloon you intend to use before you will be able to
conduct the Balloon Test.
Note:
Disconnecting the Balloon Extension Tubing will require you to select balloon size and type and repeat the
balloon test procedure.
In order to change balloon size or type you must disconnect and re-connect the balloon extension tubing to
open the Esophageal Balloon Size and Type dialogue box.
Selecting a balloon size and type other than the one to be used can result in failure of the balloon test.
Balloon Leak / Size Test
The Balloon Test verifies the integrity and size of the esophageal balloon. The ventilator will display a Pass or
Fail message in the message bar at the bottom of the screen.
If the Balloon Test is not passed all connections should be checked to ensure they are secure and balloon
integrity should be evaluated.
Note:
The Balloon Test must be performed without the balloon in the patient
Balloon Fill Start / Stop
When the Start key is actuated, the ventilator delivers the volume specified below into the
esophageal balloon before esophageal pressure measurement commences.
Adult balloon:
0.5 to 2.5 mL
Pediatric balloon:
0.5 to 1.25 mL
The ventilator will evacuate and refill the balloon every 30 minutes to maintain measurement
accuracy.
When the Stop key is actuated, the ventilator evacuates the balloon prior to removal of the
esophageal balloon from the patient.
Note:
Do Not inflate the balloon until after it has been placed in the patient. The balloon should be evacuated prior to
removal from patient.
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Chest wall Compliance (CCW)
The preset Chest wall Compliance (CCW) is used by the ventilator to calculate work of
breathing.
Range:
0 to 300 mL/cmH2O
Resolution:
1 mL/cmH2O
Default:
200 mL/cmH2O
Alarms
All currently available alarms are active during the Esophageal maneuver.
To Perform Esophageal Maneuvers
Esophageal measurements require the use of an esophageal balloon, which can be purchased from CareFusion.
From the Maneuvers Screen menu select Esophageal
Before placing the balloon in the patient a balloon test should be performed. Connect the esophageal balloon
extension tubing to the EPM panel on the AVEA as described in Chapter 2. Remove the new esophageal balloon from
its package and connect it to the pinned connector on the patient end of the extension tubing.
Allow the balloon to hang freely and not contact any surfaces and press the Balloon Test soft key on the maneuver
screen. The ventilator will perform a leak test by evacuating the balloon, filling it to the proper specification, measuring
the balloon pressure and finally evacuating the balloon. A message will appear on the message bar after the test stating
Pass or Fail.
In the event that the balloon does not pass the leak test, inspect the balloon for damage and replace if necessary. If no
damage is present on the balloon check all connectors on the balloon and extension tubing and repeat the test.
Note:
Disconnecting the balloon after passing a balloon test will require that the test be repeated.
Once the balloon has passed the leak test it is ready for placement in the patient. Proper placement of the balloon is
imperative for accurate measurements. During insertion the waveform produced can provide information to confirm
proper placement. An approximate level of placement can be made by measuring the distance from the tip of the nose
to the bottom of the earlobe and then from the earlobe to the distal tip of the xiphoid process.
1. The esophageal pressure waveform correlates to the airway pressure in that they become positive during a
positive pressure breath and negative during a spontaneous breath.
2. The esophageal tracing may show small cardiac oscillations reflective of cardiac activity.
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3. Once placed using the above criteria appropriate balloon location can be confirmed by performing an
occlusion technique. This requires that the airway be occluded and the esophageal and airway pressures
compared for similarity.
After the balloon has been inserted and turned on, the ventilator will fill the balloon to the appropriate level and begin
monitoring data. The ventilator will automatically evacuate and refill the balloon every thirty minutes to ensure accuracy
of monitored values.
WARNING
Esophageal balloon placement should only be conducted in patients under the direction of a physician who
has assessed the patients for contraindications to the use of esophageal balloons.
WARNING
Incorrect placement of an esophageal balloon can affect the accuracy of monitored values.
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MIP / P100 Maneuver Screen
Figure 4–12: MIP Maneuver Settings
The MIP (Maximum Inspiratory Pressure) / P100 maneuver measures the negative deflection in the pressure tracing
during the patient’s active effort to demand a breath. During the maneuver, the inspiratory flow valve remains
closed and no inspiratory flow is delivered. The MIP is an indication of the maximum negative pressure that the
patient can draw, while P100 is an indication of the pressure drop that occurs during the first 100 milliseconds of the
breath.
Controls
Duration
The preset Duration shall determine the maximum amount of time that the maneuver will last.
Normal ventilation will be suspended for the duration of the maneuver and will resume after
the duration has timed out.
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5.0 to 30.0 seconds
Default:
10 seconds
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Sensitivity
The maneuver sensitivity establishes the level below PEEP that the airway pressure must
drop, which determines the onset of a patient effort. This allows the clinician to set the
maneuver appropriate to patient ability.
Range:
0.1 to 5.0 cmH2O
Resolution:
0.1 cmH2O
Default:
3.0 cmH2O
Note:
Excessively high setting of the maneuver sensitivity can affect the accuracy of timing for P100 determination.
Start / Stop
The maneuver begins when the START key is actuated. The maneuver will be immediately
terminated should the operator activate the STOP key and normal ventilation will resume.
Note:
If the Start key is activated during a mandatory inspiratory breath the maneuver will not commence until the ventilator
cycles into exhalation and the minimum expiratory time of 150 msec has elapsed.
Alarms
All currently available alarms shall be active during the MIP / P100 maneuver except Apnea Interval and
Low PEEP.
To Perform a MIP / P100 Maneuver:
The MIP / P100 maneuver allows the measurement of the Maximum Inspiratory Pressure (MIP) achieved by the patient
during an expiratory hold maneuver. The ventilator can also measure the P100 value which is the maximum inspiratory
pressure achieved in the first 100 milliseconds of the maneuver.
From the Maneuvers Screen select MIP P100
The MIP maneuver screen allows the operator to set:
Duration – This is the time period that ventilation is suspended to conduct the maneuver. Once the Start button is
depressed normal ventilation will be suspended until the Duration time period has elapsed or the operator presses the
Stop button.
Sensitivity – This sets the sensitivity threshold that the ventilator uses to begin the timer for the P100 maneuver. The
default position is 3 cmH2O but can be adjusted by the operator to ensure accuracy in patients with minimal inspiratory
effort.
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Note: The maneuver sensitivity setting is used for the maneuver only and does not affect trigger sensitivity.
Start / Stop – Starts and Stops the maneuver.
WARNING
Normal ventilation is suspended for the duration of the maneuver. The patient should be evaluated for
contraindications prior to executing the maneuver. The patient should be directly monitored by trained
medical personnel during the maneuver.
To execute a MIP / P100 maneuver set the Duration and Sensitivity controls to the desired level. Press the Start soft key
on the maneuver screen. The ventilator will close the inspiratory and expiratory valves and begin monitoring. At the
completion of the maneuver the ventilator will display the MIP and P100 values in their respective windows on the
maneuver screen. The MIP and P100 will also be available as trended data on the Trends screen. The maneuver can
be aborted at any time by pressing the Stop soft key.
Inflection Point (Pflex) Maneuver Screen
Figure 4–13: Pflex Maneuver Settings
The Inflection point (Pflex) maneuver is performed on patients during mandatory ventilation. The upper and lower
inflection points are automatically indicated on the inspiratory portion of a Pressure/Volume (PAW / Vol) Loop.
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Note:
Normal ventilation shall be suspended for the duration of the maneuver. The maneuver will be aborted if a patient effort
is detected and the message bar will indicate a message stating that patient effort was detected.
Controls
Tidal Volume (Volume)
This is the volume of gas delivered to the patient during the maneuver.
Range:
0.10 to 2.50 L (Adult)
25 to 500 mL (Pediatric)
Resolution:
0.01 L
1 mL
(Adult)
(Pediatric)
Default:
0.25 L
25 mL
(Adult)
(Pediatric)
Peak Flow
Sets the Peak Flow used for the maneuver.
Note: A square wave flow pattern is used for the maneuver.
Range:
0.5 to 5.0 LPM
Resolution:
0.1 LPM
Default:
1.0 LPM
Maneuver PEEP (PEEP)
The Maneuver PEEP determines the baseline pressure at which the maneuver begins.
Note: The Maneuver PEEP can be set independent of the PEEP used during normal
ventilation.
Range:
0 to 50 cmH2O
Resolution:
1 cmH2O
Default:
0 cmH2O
PEEP Equilibration Time (PEEP Teq)
The PEEP Equilibration Time determines the amount of time allowed for equilibration of the
airway pressure before slow flow commences. Upon activation of the maneuver the ventilator
will set PEEP to the Maneuver PEEP level for the PEEP Equilibration Time prior to beginning
the slow flow maneuver.
Range:
0.0 to 30.0 seconds
Resolution:
0.1 second
Default:
1.0 second
Sensitivity
The preset Sensitivity establishes the level below the peak airway pressure that the pressure
must drop to abort the Pflex maneuver.
Note: The Pflex maneuver will be terminated if a leak greater than 100% is present.
Range:
0.1 to 5.0 cmH2O
Resolution:
0.1 cmH2O
Default:
3.0 cmH2O
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Start / Stop
The maneuver shall begin when the START key is actuated. The maneuver shall be
immediately terminated when the STOP key is actuated, a patient effort is detected or the
maneuver tidal volume has been delivered and normal ventilation will resume.
Note:
The initiation of a Pflex Maneuver is delayed by two factors. The total delay is equal to 25% of the breath interval plus
the PEEP Equilibration time set. The PEEP Equilibration time has a range of 0–30 seconds. If the mandatory breath
rate is 10 bpm, the breath interval is therefore 6 seconds and the delay to initiate Pflex is 1.5 seconds plus the PEEP
equilibration time set. At the default PEEP Equilibration time of 1 second, the total delay is 2.5 seconds in this example.
If the mandatory breath rate is set to 1 bpm, the breath interval is 60 seconds and the delay to initiate Pflex in this
worst-case scenario is 15 seconds, plus the PEEP Equilibration time.
Upper Pflex and Lower Pflex determination
Once the maneuver tidal volume has been delivered the ventilator will cycle into exhalation. At the end
of exhalation, the PAW / Vol loop will freeze automatically, the upper and lower inflection points, as well as
the delta Pflex volume, will be calculated and displayed. The ventilator will return to normal ventilation at
the current ventilator settings.
The user can, should they choose to do so, override the Pflex values by moving the Pflex indicators to a
new point along the PV loop and pressing the appropriate set key. The corresponding Pflex values and
delta Pflex volume change to represent values based on the current position of the indicators. The
ventilator will store up to four PV loops and their respective inflection points simultaneously.
Note:
Once the values have been redefined by the operator the original values cannot be restored.
Alarms
All currently available alarms shall be active during a Pflex maneuver except Apnea Interval and I-Time Limit.
To Perform a Pflex Maneuver
The Pflex maneuver allows the clinician to determine opening pressures of the lung during a slow flow volume controlled
breath. Because this maneuver is performed at a slow inspiratory flow rate the effects of respiratory system resistance
are minimized.
Note:
Performance of the Pflex maneuver requires a passive patient. In the event that a patient effort is detected the
ventilator will abort the maneuver and deliver a patient effort detected message while simultaneously returning to
normal ventilation at the current settings.
From the Maneuvers Screen select Pflex
The Pflex maneuver screen allows the operator to set:
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Tidal Volume (Vt) – This is the tidal volume delivered to the patient during the maneuver. This setting has no effect on
the settings during normal ventilation and can be set to any tidal volume desired independent of the current mode of
ventilation.
Note:
The Tidal Volume setting during a Pflex maneuver is not circuit compliance compensated.
Flow – This setting is adjustable from 0.5 to 5 l/min and controls the inspiratory flow used to deliver the maneuver tidal
volume.
PEEP – The is the PEEP used for the Slow Flow Maneuver. The operator can select any PEEP level independent of the
control PEEP used during controlled ventilation.
PEEPTeq – This control sets the equilibration at the Maneuver PEEP after which the Slow Flow Maneuver begins.
Sensitivity – This sets the sensitivity threshold that the ventilator uses to detect patient effort during the Slow Flow
Maneuver. The default position is 3 cmH2O but can be adjusted by the operator to ensure accurate sensitivity in all
applications.
Start / Stop – Starts and Stops the maneuver.
Note:
All maneuver control settings are independent of control settings in normal ventilation.
WARNING
Normal ventilation is suspended for the duration of the maneuver. The patient should be evaluated for
contraindications prior to executing the maneuver. The patient should be directly monitored by trained
medical personnel during the maneuver.
To execute a Pflex maneuver set the Tidal Volume, Flow, Maneuver PEEP, PEEP Equilibration time and Sensitivity.
Press the Start soft key on the maneuver screen. The ventilator will suspend normal ventilation and begin delivering the
Maneuver Tidal Volume at the set Flow. The corresponding Pressure / Volume curve will be drawn by the ventilator as
the volume is delivered to the patient. Once complete the ventilator will automatically resume normal ventilation and
Freeze the graphics display. The maneuver can be aborted at any time by pressing the Stop soft key. If at any time
during the maneuver the ventilator detects a patient effort, the ventilator will cycle into exhalation and normal ventilation
will resume.
The measured Pflex, Pflex Lwr, Pflex Upr and Vdelta will be displayed, if they can be determined. At this point the
operator can choose to accept the inflection points as determined by the ventilator or the operator can choose to set the
inflection points manually.
To set the inflection points manually simply scroll the cursor to the desired position with the Data Dial and press the Set
Pflex Lwr or Set Pflex Upr softkey. The Vdelta will be automatically recalculated.
The measured data can be saved by pressing the Save Loop softkey. Up to four loops may be saved, when a fifth loop
is saved the oldest loop and data will be erased.
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Note:
If the loop and corresponding data are not saved by the operator, the data will be erased after exiting the maneuver
screen.
AutoPEEP Maneuver Screen
Figure 4–14: AutoPEEP Maneuver Settings
AutoPEEP is the airway pressure at the end of exhalation immediately prior to the beginning of the next mandatory
inspiration. During the execution of this maneuver the ventilator will execute an expiratory hold in which both the
inspiratory and expiratory valves will be closed. The ventilator will establish the AutoPEEP measurement when the
system pressure reaches equilibration, at the next mandatory breath interval or 5 seconds whichever is shorter.
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Controls
Sensitivity
The preset Sensitivity establishes the level that the airway pressure must drop below PEEP to
abort the AutoPEEP maneuver.
Range:
0.1 to 5.0 cmH2O
Resolution:
0.1 cmH2O
Default:
3.0 cmH2O
Start / Stop
The maneuver begins when the START key is actuated and the ventilator is in exhalation.
The maneuver will stop immediately when the STOP key is activated, the maneuver is
completed or a patient effort is detected and normal ventilation will resume.
Note:
The maneuver will be aborted if a patient effort is detected and the message bar will indicate a message stating that
patient effort was detected.
Alarms
All currently available alarms shall be active during the AutoPEEP maneuver.
To Perform an AutoPEEP Maneuver
The AutoPEEP maneuver allows the measurement of PEEP generated within the breathing system (patient and circuit)
during an expiratory hold maneuver. This maneuver requires a passive patient.
From the Maneuvers Screen select AutoPEEP
The AutoPEEP maneuver screen allows the operator to set:
Sensitivity – This sets the sensitivity threshold that the ventilator uses to detect patient effort during the AutoPEEP
Maneuver. The default position is 3 cmH2O but can be adjusted by the operator to ensure accurate sensitivity in all
applications.
Start / Stop – Starts and Stops the maneuver.
To execute an AutoPEEP maneuver the operator sets the Sensitivity appropriate for the patient and presses the Start
softkey. The ventilator will then close the inspiratory and expiratory valves and allow the pressure to equilibrate between
the patient and the breathing circuit. At the completion of the maneuver the ventilator will display the AutoPEEP and
dAutoPEEP values in their respective windows on the maneuver screen. The AutoPEEP and dAutoPEEP will also be
available as trended data on the Trends screen. The maneuver can be aborted at any time by pressing the Stop soft
key.
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Note:
The AutoPEEP value will be set at the next mandatory breath interval or 5 seconds whichever is sooner.
Capnometry Screen
Figure 4–15: Capnometry Screen in Maneuvers Selection
Note:
See “Chapter 5: Volumetric Capnography”.
Tracheal Monitoring Tube Placement
Some advanced mechanics measurements on the AVEA require the use of a tracheal monitoring tube. To ensure
accuracy of measurements and to minimize risk of adverse events the tracheal monitoring tube should be placed in the
endotracheal tube and not extend beyond the tip.
To ensure proper placement, measure the length of the endotracheal tube, and its associated adapters. Insert the
tracheal monitoring tube into the endotracheal tube to a distance not greater than this measurement.
WARNING
Inserting the tracheal monitoring tube beyond the tip of the endotracheal tube may cause irritation and
inflammation of the trachea and airways or produce vagal responses in some patients.
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Digital Displays
The Monitor Screen
To access the monitor screen press the Screens
membrane button to the left of the touch screen on the
UIM. The button is labeled with the icon shown here.
or
International
English
Select MONITOR from the selection box that appears.
Figure 4–16: Screen Selection
The monitor screen can display a total of 15 different monitored values simultaneously. Monitor Displays are updated at
the start of the next inspiration or every 10 seconds, whichever occurs first. Each value can be independently selected
from the available choices (see Table 4–2).
1. Use the touch screen to select and highlight the monitor you wish to set.
2. Turn the data dial beneath the touch screen to scroll through the menu choices.
3. To accept your selection, either touch the highlighted display or press the accept button adjacent to the data dial
(Figure 4–17).
Figure 4–17: The Monitor Screen
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Table 4–2: Monitored Values Menu Choices
For a full description of the specifications and calculation of monitored displays (see “Appendix D: Monitor Ranges and
Accuracies”).
Note:
Depending on the model and options, not all of the following displays may be available.
Display
ml
Vte
ml/kg
Vte/kg
ml
Vti
ml
Vti/kg
ml
Spon Vte
ml/Kg
Spon Vte/Kg
ml
Mand Vte
ml/kg
Mand Vte/Kg
Value
Expired tidal volume
Expired tidal volume adjusted for patient weight
Inspired tidal volume
Inspired tidal volume adjusted for patient weight
Spontaneous tidal volume exhaled
Spontaneous tidal volume adjusted for patient weight exhaled
Mandatory tidal volume exhaled
Mandatory tidal volume adjusted for patient weight exhaled
Vdel
This is the uncorrected tidal volume measured by the inspiratory flow sensor inside the ventilator.
Leak
Percent leakage
L
Total Ve
Minute Volume
ml/kg
Total Ve/kg
L
Spon Ve
ml/kg
Spon Ve/kg
bpm
Rate
Minute volume adjusted for patient weight
Spontaneous minute volume
Spontaneous minute volume adjusted for patient weight
Total Breath Rate (spontaneous and mandatory)
bpm
Spon Rate
Spontaneous breath rate
bpm
Mand Rate
Mandatory Breath Rate
sec
Ti
Inspiratory time
sec
Te
Expiratory Time
I:E
Inspiratory/expiratory ratio
B2/Min/L
f/Vt
Rapid shallow breathing index
cmH2O
Ppeak
Peak inspiratory pressure
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Value
cmH2O
Pmean
Mean inspiratory pressure
cmH2O
Pplat
Plateau pressure
Ptp Plat
The ventilator is capable of calculating and displaying the Transpulmonary pressure during an inspiratory hold, which is the
difference between the airway plateau pressure (Pplat aw) and the corresponding esophageal pressure.
cmH2O
PEEP
Positive end expiratory pressure
Pbaro
Barometric pressure
psig
Air Inlet
Air inlet pressure
psig
O2 Inlet
Oxygen inlet pressure
%
FIO2
Percentage of oxygen
ml/cmH2O
Cdyn
Dynamic compliance
ml/cmH2O
Cdyn/Kg
Dynamic compliance adjusted for patient weight
ml/cmH2O
Cstat
Respiratory system compliance (Static compliance)
ml/cmH2O
Cstat/Kg
Respiratory system compliance adjusted for patient weight (Static compliance
C20/C
F/Vt
cmH2O/LPS
Rrs
Ratio of the dynamic compliance during the last 20% of inspiration (C20) to the total dynamic compliance (C).
Rapid Shallow Breathing Index (f / Vt) which is the spontaneous breath rate per tidal volume
Respiratory system resistance
L/min
PIFR
Peak Inspiratory flow rate
L/min
PEFR
Peak Expiratory flow rate
RRS
Respiratory System Resistance (RRS), is the total resistance during the inspiratory phase of a breath
RPEAK
Peak Expiratory Resistance (RPEAK) is defined as the resistance at the time of the Peak Expiratory Flow (PEFR).
RIMP
Imposed Resistance (RIMP), is the airway resistance between the wye of the patient circuit and the tracheal sensor
RLUNG
Lung Resistance (RLUNG), is the ratio of the tracheal pressure differential to the inspiratory flow 12 ms prior to the end of inspiration
PIFR
The actual peak inspiratory flow rate for the inspiratory phase of a breath.
PEFR
The actual peak expiratory flow rate for the expiratory phase of a breath.
dPAW
Delta Airway Pressure (dPAW), is the difference between peak airway pressure and baseline airway pressure.
dPES
Delta Esophageal Pressure (dPES), is the difference between peak esophageal pressure and baseline esophageal pressure
WOBP
Patient Work of Breathing (WOBP), normalized to the total inspiratory tidal volume
WOBI
Imposed Work of Breathing (WOBI), is defined as the work performed by the patient to breathe spontaneously through the
breathing apparatus, i.e. the E.T. tube, the breathing circuit, and the demand flow system.
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Display
Value
WOBV
Ventilator Work of Breathing (WOBV), is the summation of airway pressure minus the baseline airway pressure times the change in
tidal volume to the patient during inspiration, and normalized to the total inspiratory tidal volume
AutoPEEP
AutoPEEP, is the airway pressure at the end of an expiratory hold maneuver.
dAutoPEEP
Delta AutoPEEP (dAutoPEEP), is the difference between airway pressure at the end of an expiratory hold maneuver and the airway
pressure at the start of the next scheduled breath after the expiratory hold maneuver
Ptp PEEP
Transpulmonary pressure, AutoPEEP (PtpPEEP) is the difference between the corresponding airway and the esophageal pressures
at the end of the expiratory hold during an AutoPEEP maneuver.
AutoPEEPES
CCW
CLUNG
Ptp Plat
AutoPEEPES is the difference between esophageal pressure measured at the end of exhalation minus the esophageal pressure
measured at the start of a patient-initiated breath and the sensitivity of the ventilator’s demand system
Chest wall Compliance (CCW), is the ratio of the tidal volume (exhaled) to the Delta Esophageal Pressure (dPES).
Lung Compliance (CLUNG), is the ratio of the tidal volume (exhaled) to the delta transpulmonary pressure
Transpulmonary pressure during an inspiratory hold
MIP
Maximum Inspiratory Pressure is the maximum negative airway pressure that is achieved by the patient, during an expiratory hold
maneuver
P100
Respiratory Drive (P100), is the negative pressure that occurs 100 ms after an inspiratory effort has been detected
nCPAP
Mean airway pressure while in nCPAP mode
CPAP Flow
Mean inspiratory flow while in nCPAP mode
EtCO2
Peak expired CO2 as measured and reported by the CO2 sensor in the aiway. EtCO2 is measured for each breath. Display is either
a breath-by-breath or averaged measurement.
VCO2
The amount of CO2 eliminated every minute. This is calculated over each minute and then averaged over the set VCO2 averaging
time.
VtCO2
The amount of CO2 exhaled per breath. It is measured for each breath and then averaged over the set VCO2 averaging time.
Vdana
The volume of dead space in the patient’s airway. Anatomical dead space is measured for each breath. This value is averaged
over the set VCO2 averaging time.
Vdana/Vt
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Events
Pressing the EVENT membrane button to the left of the
touch screen opens a scrollable menu of event markers that
are placed in the trend buffer along with the 66 monitored
parameters. To select an event use the data dial to scroll
the event menu and highlight the desired event. Press the
ACCEPT button adjacent to the data dial to place the event
in the trend buffer. Events will appear on the data
spreadsheet in green text with an asterisk next to the time
code (see “Trends” below).
Figure 4–18: The Events menu
Selectable events include:
Event
Abbreviation
Blood Gas
BG
Chest X-ray
CXR
Diagnostic (Dx) Procedure
Dx
Feeding
Feed
Intubation
ETT
Therapeutic (Rx) Procedure
Rx
Suction
Sxn
The following events are automatically recorded in the event log:
Event
Abbreviation
Change a primary or advanced control setting
Stgs
Powering the ventilator on
Pon
Powering the ventilator off
Poff
Entering Standby
eSby
exiting Standby
xSby
Activation of the nebulizer
Neb
Activation of the expiratory hold
eHold
Activation of the inspiratory hold
iHold
A manual breath
Man
Activation of the suction button
Sxn
Activation of the increase O2 button
IncO2
Activation of New Patient
NwPt
Involuntary Power Loss and Recovery
Prec
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Trends
The monitored parameters described in the previous section are trended as one minute averaged values over a running
24-hour period. Trend data is accessed by pressing the screen button on the membrane panel to the left of the touch
screen or by pressing the screen indicator in the top center portion of the touch screen display. The screen menu will
appear. Press the TREND button on the screen menu to open the trends screen.
Figure 4–19: The Trends Window
Note:
If left open the Trends Window will update every 10 minutes.
Four histograms and a spreadsheet are displayed on the touch screen. Each histogram and column on the spreadsheet
can be configured from the list of monitored parameters as well as events. Touch the title bar of any histogram or the
heading of any column to open a scrollable menu. Move through the list by turning the data dial. Highlight the item to be
displayed and press the highlighted display or the ACCEPT button above the data dial to accept the new item for display.
Histograms can be scaled by touching either axis. With the axis highlighted, use the data dial to adjust the scale. Touch
the axis again or press the ACCEPT button to accept the change.
To look at histogram or spreadsheet trends over time, press the FREEZE button and use the data dial to move the
cursor through the time line. The time line is shown as yellow text on the spreadsheet. Event markers appear in green
text.
Note:
Changing the date / time back on the instrument’s internal clock erases stored trend data.
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Main Screen Displays
Calculated I:E Ratio
The AVEA displays the calculated I:E Ratio (Calc I:E) based on the set breath rate, set tidal volume, and set peak flow
for Volume breaths, or the set breath rate and set inspiratory time for Pressure, TCPL, and PRVC breaths. The display
is located next to the Calculated Minute Volume display at the bottom left of the Main screen. This display is updated
while the data dial is being rotated when changing any of the primary patient settings that affect these displays in order
to view the Calculated I:E Ratio that results when the setting change is accepted, before accepting that change. This
display reverts to the previously established values if the setting change is cancelled or times out.
Figure 4–20: Calculated I:E Ratio Display
Range:
1:99.9 to 99.9:1
Limitations: For Volume breaths, the calculated I:E Ratio shall only change if the set tidal volume, set breath rate,
or set peak flow is changed. For Pressure, TCPL, PRVC, breaths, the calculated I:E Ratio shall only
change if the set breath rate or set inspiratory time is changed.
Note:
Calculated I:E ratio is not active in APRV / BIPHASIC mode
Calculated Minute Volume (Calc Ve)
The ventilator displays the Calculated Minute Volume at the bottom left of the Main screen as follows:
Calc Ve = [(Set tidal volume)  (Set breath rate)]
This display is updated while the data dial is being rotated when changing any of the primary patient settings that affect
these displays in order to view the Calculated Ve that results when the setting change is accepted, before accepting that
change. This display reverts to the previously established values if the setting change is cancelled or times out.
Limitation:
For Volume breaths only. The Calc Ve display only changes if the set tidal volume or set breath rate is
changed.
Calculated Time High and Time Low Min / Max
The AVEA displays the calculated minimum and maximum Time High and Time Low in APRV / BiPhasic ventilation. The
display is located immediately under the Time High and Time Low primary controls on the main screen.
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Calculated Time High: Time Low Ratio
The AVEA displays the calculated ratio corresponding to the ratio ot Time High divided by Time Low in APRV / BiPhasic
ventilation. The display is located between the displays of Time High and Time Low (where the minimums and maximums are
displayed) and below the display of the Pressure High setting. This ratio is presented similarly to an I:E Ratio, but it is actually a
Time High :Time Low Ratio. The ratio is displayed in the same format as an I:E Ratio with the same rules for
transitioning from ratios less than one to ratios greater than one (1:1.1 to 1.1:1). This display is also
updated dynamically while the data dial is being rotated when changing any of the patient settings that
affect this display. This display also reverts to the previously established ratio if the setting change is
cancelled or times out.
Min
Max
Min
Max
Figure 4–21: Calculated T High / T Low
Note:
Time High and Time Low are maximum time settings for a time-cycled transition. Actual times may vary depending on
the patient’s spontaneous breathing pattern and the Sync window setting.
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Main Screen Monitors
Five monitored parameters are continuously displayed to the left of the graphic displays. These are selected in the same
way as the displays on the Monitors screen.
1. Use the touch screen to select and highlight the monitor you wish to set.
2. Turn the data dial beneath the touch screen to scroll through the menu choices.
3. To accept your selection, either touch the highlighted display or press the accept button adjacent to the data dial.
Highlighted
Parameter
Selection Menu
for Monitored
Parameter
Figure 4–22: Selectable Monitored Parameters Displayed on the Main Screen
Note:
The main screen monitored parameters may be different than the monitored parameters on the loops or trends
screens.
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Introduction
The Volumetric Capnography, Vco2 Option for AVEA adds new monitoring and advanced calculation features. The
option requires purchase of the sensor and a software activation. In addition to traditional ETCO2 and capnography,
there are features that assist the clinician with patient evaluation.
Warnings
Periodically check the CO2 sensor for excessive moisture or secretion build up.
Volumetric capnography measurements require accurate measurement of delivered volumes. For this reason, a proximal
flow sensor or circuit compliance compensation must be used. Furthermore, when circuit compliance compensation is
used, and if the circuit compliance changes, volumetric accuracy will be altered.
A system leak, such as that caused by un-cuffed endotracheal tubes may affect flow-related readings. These include
flow, pressure, dead space, CO2 production, and other respiratory mechanics parameters.
Nitrous oxide, excessive levels of oxygen, helium, and halogenated hydrocarbons can influence the CO2 measurements.
The AVEA compensates for oxygen and helium gas automatically.
Do not use CO2 measurements as the sole basis for changing ventilation parameters without reference to clinical
condition and independent monitors such as blood gas. CO2 measurements may be inaccurate in the presence of a
breathing circuit leak, secretions, or sensor malfunction.
Do not position the CO2 sensor or cable in any manner that may cause entanglement, strangulation, or accidental selfextubation. Use clips as appropriate to secure the sensor cable to the breathing circuit.
Do not use EtCO2 as basis for changing ventilation parameters without reference to clinical condition and independent
monitors such as blood gas.
Cautions
The CAPNOSTAT® 5 contains no user serviceable parts.
Do not use damaged sensors or cables.
Do not sterilize or immerse sensors, except as directed in this manual.
Do not apply excessive tension to any sensor cable.
It is recommended that the CO2 sensor be removed from the circuit whenever an aerosolized medication is delivered.
This is due to the increased viscosity of the medications, which may contaminate the sensor windows, causing the
sensor to fail prematurely or to display incorrect data.
Theory of Operation
The CAPNOSTAT® 5 measures CO2 by using the infrared absorption technique, which has endured and evolved in the
clinical setting for over the past two decades and remains the most popular and versatile technique. The principle is
based on the fact that CO2 molecules absorb infrared (IR) light energy of specific wavelengths with the amount of energy
absorbed being directly related to the CO2 concentration. When an IR beam is passed through a gas sample containing
CO2, the electronic signal from the photo detector (which measures the remaining light energy) can be obtained. This
signal is then compared to the energy of the IR source and calibrated to accurately reflect CO2 concentration in the
sample.
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Setup
1. Attach the end of the CO2 sensor cable to the connection on the bottom of the AVEA UIM labeled EtCO2.
EtCO2 Connection
Figure 5–1: Bottom of AVEA UIM
Note:
Only capnography cables supplied by CareFusion are compatible with the AVEA.
WARNING
Route the sensor cable so as to avoid risk of patient entanglement or accidental extubation. Clips are
available to secure the cable to the breathing circuit as appropriate.
2. Access the setup and utilities controls by pressing the Screens button, selecting Utility, and selecting the Monitoring
tab.
Screens softkey
Figure 5–2: Screens soft key
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3. Enable CO2 Monitoring by touching the Enable/Disable button.
Figure 5–3: Monitoring Tab, Utility Screen
Note:
Capnography requires either a proximal flow sensor or circuit compliance compensation to be active.
If CO2 monitoring is enabled but a proximal flow sensor or circuit compliance compensation is not active, an alert dialog
box appears.
Figure 5–4: Vco2 Alert Dialog
4. If volumetric capnography is required, add a proximal flow sensor or enable circuit compliance compensation (or do
both), and then re-enable CO2 monitoring as described above; otherwise, only the PCO2 waveform and End-tidal
CO2 monitor are available.
5. Remove the appropriate airway adapter from its packaging and make sure it is undamaged and ready to use.
6. Insert the airway adapter into the CO2 sensor. The adapter clicks into place when properly inserted.
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Figure 5.5a Adult / Pediatric Adapter
Figure 5.5b Pediatric / Neonatal Adapter
Figure 5–5: Airway adaptors
7. Perform the “sensor zero” procedure by following the instructions in the section “Zeroing the CAPNOSTAT 5” on
page 144. The zeroing procedure must also be performed when switching between disposable and reusable airway
adapters.
8. After the sensor is successfully zeroed, place the airway adapter and sensor into the ventilator circuit between the
wye and endotracheal tube (and any adapters) as shown in the preceding illustration.
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Settings and Monitored Values
Settings
The setup and utilities controls are accessed by pressing the Screens button, selecting Utility, and selecting the
Monitoring tab.
Figure 5–6: Monitoring Tab in Utility Screen
Capnography – Enable / Disable
When CO2 monitoring is enabled, all CO2 monitoring and alarm functions are also enabled. When CO2 Monitoring is
disabled all CO2 monitoring and alarm functions are disabled.
Range: Enable or Disable
Default: Disable
EtCO2 Averaging
EtCO2 is measured for each breath. You can select the number of breaths over which the displayed EtCO2 is averaged.
Range: 1 or 8 breath(s)
Default: 8 breaths
VCO2 Averaging
VCO2 is updated at one minute intervals. You select the time over which the displayed VCO2 is averaged. Also averaged
over this time period are Vd, Vd/Vt, VtCO2 and VA.
Range: 3, 6, 9 or 12 minutes
Default: 6 minutes
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Zero CO2
This control initiates the sensor zero procedure. This procedure needs to be done only when you switch airway adapter
types (disposable or reusable) and as part of the calibration check. See the section “Zeroing the CAPNOSTAT 5” on
page 144.
Note:
The CO2 Zero and calibration-check controls are available only when CO2 is enabled and a sensor has been
connected and has completed initialization. This initialization may take up to five seconds.
Calibration Check
This control provides access to a calibration-check procedure. This procedure needs to be done only during the yearly,
preventative maintenance procedure. See the section “Checking the Accuracy of the CAPNOSTAT 5” on page 146.
Monitored Values
End Tidal CO2 (EtCO2)
The patient’s peak expired CO2 as measured and reported by the CO2 sensor in the airway. EtCO2 is measured for each
breath. The display is either a breath-by-breath measurement or an averaged measurement.
Range: 0 – 150 mmHg (0 – 20.0 kPa)
Resolution: 0.1 mmHg (0.01 kPa) or three significant digits (whichever is greater)
Accuracy:
± 2 mmHg for 0 – 40 mmHg
± 5% of reading for 41 – 70 mmHg
± 8% of reading for 71 – 100 mmHg
± 10% of reading for 101 – 150 mmHg
Note:
The minimum differential between inspired and expired CO2 must be 5 mmHg (0.7kPa) or greater.
WARNING
Do not use EtCO2 as basis for changing ventilation parameters without reference to clinical condition and
independent monitors such as blood gas.
CO2 Elimination (VCO2)
The amount of CO2 eliminated every minute. This is calculated over each minute, and then averaged over the set VCO2
averaging time.
Range: 0 – 999 mL/min
Resolution: 0.1 mL or three significant digits (whichever is greater)
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CO2 (VtCO2)
The amount of CO2 exhaled per breath. VtCO2 is measured for each breath and then averaged over the set VCO2
Averaging time.
Range: 0 – 299 mL
Resolution: 0.1 mL or three significant digits (whichever is greater)
Anatomical Dead Space (Vd ana)
Volume of dead space in the patient’s airway. Anatomical dead space is measured for each breath. This value is
averaged over the set VCO2 averaging time.
Range: 0 – 999 mL
Resolution: 0.1 mL or three significant digits (whichever is greater)
Anatomical Dead Space / Tidal Volume Ratio (Vd / Vt ana)
Vd / Vt ana is averaged over the set VCO2 averaging time.
Range: 0 – 99%
Resolution: 1%
Note:
VCO2 , VtCO2, Vd ana and Vd/Vt ana require flow to be measured by a proximal flow sensor at the wye, or circuit
compliance compensation to be active. If a proximal flow sensor or circuit compliance compensation are not used, the
AVEA displays *** in those fields.
Note:
An arterial blood gas sample is required to calculate VA, Vd phy, Vd/Vt phy, Vd alv, OI, and P/F. These values are
available at the Capnography Maneuver screen.
Alveolar Ventilation (VA)
Alveolar Ventilation is the volume of gas participating in gas exchange per minute.
Range: 0 – 99.9 L/min
Resolution: 0.01 L/min or three significant digits (whichever is greater)
Physiologic Dead Space (Vd phy)
Range: 0 – 999 mL
Resolution: 0.1 mL or three significant digits (whichever is greater)
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Physiologic Dead Space / Tidal Volume Ratio (Vd / Vt phy)
Range: 0 – 99%
Resolution: 1%
Alveolar Dead Space (Vd alv)
Range: 0 – 999 mL
Resolution: 0.1 mL or three significant digits (whichever is greater)
Oxygenation Index (OI)
Oxygenation index is a dimensionless number often used to assess the “pressure cost” of oxygenation.
OI Range: 0 – 200 (when PAO2 is entered in mmHg); OI Range: 0 – 1500 (when PAO2 is entered in kPa)
Resolution: 0.1 or three significant digits (whichever is greater)
PaO2 / FIO2 Ratio (P/F)
The PAO2 / FIO2 ratio is a simple assessment of gas exchange.
Range: 0 – 800 (PAO2 entered in mmHg) 0 – 106 (PAO2 entered in kPa)
Resolution: 0.1 or three significant digits (whichever is greater)
Waveforms and Loops
PCO2 wave (capnogram)
Displays the CO2 value through the respiratory cycle as measured and reported by the CO2 sensor at the wye.
Maximum range: 0 – 150 mmHg (0 – 20 kPa)
PCO2 / Vte loop
Displays the patient’s exhaled CO2 value on the vertical axis and exhaled Vt on the horizontal axis. During the inspiratory
phase, both values will be set to zero.
Maximum range (CO2): 0 – 150 mmHg (0 – 20 kPa)
Maximum range (Vte): 0 – 2.5 liters
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Alarms
Figure 5–7: Capnometry Alarms
High EtCO2
Creates a low-priority alarm if the monitored EtCO2 exceeds this setting (see the previous figure).
Range: 6 to 150 mmHg (0.8 – 20 kPa) or Off
Resolution: 1 mmHg (0.1 kPa)
Default: 60 mmHg (8 kPa)
Note:
The High EtCO2 alarm must be set at least 5 mmHg (0.7 kPa) above the Low EtCO2 alarm setting.
Low EtCO2
Creates a low-priority alarm if the monitored EtCO2 does not exceed the setting (see the previous figure).
Range: 1 – 145 mmHg (0.1 – 19.3 kPa) or Off
Resolution: 1 mmHg (0.1 kPa)
Default: 30 mmHg (4 kPa)
Note:
The Low EtCO2 alarm must be set at least 5 mmHg (0.7 kPa) below the High EtCO2 alarm setting.
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Maneuvers
Several additional physiologic parameters (Vd/Vt phy, Vd phy, Vd alv, VA, OI and PF) may be calculated by obtaining
PaCO2 and PAO2 values at the same time as exhaled CO2 and volume measurements.
1. Immediately before drawing an arterial blood sample, press the Event button and select Arterial Blood Gas.
Event Softkey
Figure 5–8: Event Softkey
Volume and CO2 data from the preceding period (set VCO2 Averaging time) are stored.
WARNING
The patient’s cardio-respiratory status should be stable before performing the capnography calculations to
ensure the most accurate results.
Note:
If you do not create an Arterial Blood Gas event, no data are stored and no calculations can be performed.
2. After analyzing the arterial sample, press the Screens button, select Maneuvers, and then select Capnometry to
display the Capnometry Maneuver screen.
This screen displays data from the last five maneuvers and includes the following:

Capnometric data in the digital displays

Capnogram

Date and time of the arterial blood gas event
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Date and time of the arterial blood
gas event
Figure 5–9: Capnometry in Maneuver Screen
When you exit the maneuver screen, the digital displays and waveform return to the original settings.
3. Enter PAO2 and/or PaCO2 values using the data dial by touching the appropriate control.
PAO2 input range: 0-750 mmHg
PaCO2 input range: 0-250 mmHg
Note:
If you only enter a PCO2 value, OI and P/F ratio will not be calculated. Likewise, if you only enter a PAO2 value, the OI
and P/F ratio will be the ONLY calculations performed. If you do not enter any arterial blood gas values, or you failed to
create an Arterial Blood Gas event, a warning dialog box displays.
4. After you enter the arterial blood gas values, press Calculate.
The screen displays the calculated parameters.
5. Ensure the arterial blood gas values are correct and press Accept.
If you need to make a change, press Cancel and reenter the blood gas values. Once accepted, the new calculations
populate the last row on the capnometry maneuver screen.
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Zeroing the CAPNOSTAT 5
The CAPNOSTAT 5 must be zeroed when it is connected to the AVEA and monitoring is started. It must also be zeroed
to adjust the sensor to the optical characteristics when you change airway adapter types (single patient use or reusable).
WARNING
Failure to correctly zero the CAPNOSTAT 5 may result in incorrect data being displayed. The airway adapter
and CO2 sensor must not be attached to the patient circuit during the zero procedure.
WARNING
The airway adapter and CO2 sensor must not be attached to the patient circuit during the zero procedure.
Note:
The Capnostat must be at operating temperature to be zeroed. If required, the AVEA will wait up to 120 seconds for
the sensor to warm up. While the zero procedure is in process, all CO2 alarms are turned off. The alarms resume when
the procedure is complete.
1. Attach the end of the CO2 sensor cable to the connection on the bottom of the AVEA UIM.
Figure 5–10: Bottom of AVEA UIM
2. Attach the CO2 sensor to the airway adapter.
3. Access the Capnography Utilities by depressing the Screens soft button, selecting Utility and selecting the
Monitoring tab.
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Figure 5–11: Zero CO2 Sensor message
4. Ensure that CO2 Monitoring is enabled.
5. Press Zero CO2 and press Continue.
6. If the sensor is ready to zero, a message “Zeroing CO2 Sensor…” is displayed and a 30 second countdown timer
starts.
Note:
If the message “CO2 Sensor not ready to zero…” is displayed after pressing Continue, a 120 second countdown time
starts. The sensor will not be ready to zero if it is not up to its operating temperature, if it detects breaths, or if there is a
sensor malfunction. When the sensor becomes ready to zero, “Zeroing CO2 Sensor…” is displayed and a 30 second
countdown timer will start.
7. When the sensor is zeroed, “Zero CO2 PASS” is displayed.
When the CO2 sensor sends a Zero Failed message, the timer stops, and a message Zero CO2 FAIL appears.
When the countdown timer reaches zero without the CO2 sensor returning a Zero pass or fail, the message Zero CO2
TIMEOUT displays. Note that in this event, the actual operation of zeroing the sensor may subsequently continue to
completion. If this should occur before activation of the Exit control, the message is replaced by Zero CO2 PASS or Zero
CO2 FAIL, as appropriate.
8. Press Exit to close the message.
It is possible to close the CO2 Zero Popup while the zero procedure is in progress to provide access to other ventilator
functions. In this event, zeroing may then succeed or fail. In the event of failure, the alarm message CO2 Zero Required
displays.
While CO2 Zeroing is in progress, all CO2 alarms are disabled. These alarms are re-enabled and all CO2 monitors are
restarted upon completion of the zeroing procedure.
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Checking the Accuracy of the CAPNOSTAT 5
The accuracy of the CAPNOSTAT 5 sensor should be compared against a calibration gas every twelve months.
1.
Attach the end of the CO2 sensor cable to the connection on the bottom of the AVEA UIM.
Figure 5–12: Bottom of UIM
2. Attach the CO2 sensor to the airway adapter.
3. Access the Capnography Utilities by depressing the Screens button, selecting Utility, and the selecting the
Monitoring tab.
Screens softkey
Figure 5–13: Screens Softkey
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Monitoring tab
Figure 5–14: Configuration Tab in Utility Screen
4. Follow the procedure “Zeroing the CAPNOSTAT 5” on page 144. Press Continue when the procedure is complete.
5. Press Calibration Check and then Continue.
6. Set the gas temperature setting to that of the calibration gas (typically room temperature).
Figure 5–15: CO2 Calibration Message
7. Attach a regulated, flowing gas mixture of 5% CO2 (± 0.03%) balance nitrogen (N2) to the airway adapter. Set the
flow rate of the calibration gas to 2 – 5 liters per minute.
8. Allow 10 seconds for the reading to stabilize. The expected reading is 5% ± 0.26%.
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Note:
While the Calibration Check routine is in process, all CO2 alarms are suspended. The alarms resume when the
procedure is complete.
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Nasal CPAP (nCPAP)
Overview
Infant Nasal CPAP is a spontaneous mode of ventilation. In this mode, no mechanical positive pressure breaths are
delivered and no inspiratory triggers are required. A patient spontaneously breathes at an elevated baseline pressure
level called the “nCPAP level.”
Note:
Nasal CPAP is an available option in the Infant Mode Select Screen only.
Circuit Compatibility
AVEA nCPAP utilizes standard two-limbed neonate patient circuits and nasal prongs for the patient interface.
The following nasal CPAP prongs have been approved for use:

HUDSON Infant Nasal CPAP Cannula: Sizes 0 through 4
Hudson RCI, Research Triangle NC

INCA® Infant Nasal Cannula: Sizes 7.5F, 9F, 10.5F, 12F, 15F
CooperSurgical, Inc., Trumbull CONN

NEOTECH™ Binasal Airway: Sizes 3.0 mm, 3.5 mm, 4.0 mm
NEOTECH Products, Inc., Valencia CA

NEOTECH™ RAM cannula: Sizes preemie, newborn and infant

Fisher & Paykel Healthcare Limited nasal interfaces: Sizes 3520, 4030, 4540, and 5040

ARGYLE® Infant Nasal Cannula: Sizes Extra-small, Small, Large
Sherwood Medical; St. Louis MO
General Specifications
nCPAP Level
Range
2 to 10 cmH2O
Resolution
1 cmH2O
Default
5 cmH2O
Accuracy
 2 cmH2O
nCPAP Flow
Flow delivery is under software control and limited to a maximum of 15LPM.
Advanced Settings
There are no advanced settings for the primary settings in Nasal CPAP.
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Alarms
Sound levels (measured at three meters in front of the AVEA ventilator):
 Lowest Alarm Level – 55 dBA.
 Highest Alarm Level – 75 dBA.
The Alarms Settings Screen does not open in Nasal CPAP.
Existing machine alarms and safety systems will be maintained. During nCPAP support, certain alarms will be
suspended.
Alarms suspended during nCPAP
Time Based Alarms
High Rate
I-Time Limit
I:E Limit
Apnea Interval
Volume Based Alarms
High Ve
High Vt
Low Vte
Low Ve
Volume Limit
Pressure Alarms
High Ppeak
Ext High Peak Alarm
Low PEEP
Low Ppeak
Occlusion
Alarms added during nCPAP
High nCPAP Pressure
A high priority audible/visual alarm is activated whenever the nCPAP Pressure exceeds the threshold for a period greater
than 15 seconds.
Alarm threshold is automatically updated on acceptance of control setting.
Threshold:
Set nCPAP level + 3 cmH2O or Pressure Limit
Low nCPAP Pressure
A high priority audible/visual alarm is activated whenever the nCPAP Pressure falls below the threshold for a period
greater than 15 seconds.
Alarm threshold is automatically updated on acceptance of control setting.
Threshold:
Set nCPAP level -2 cmH2O (If nCPAP setting  3 cmH2O)
Set nCPAP level -1 cmH2O (if nCPAP setting < 3 cmH2O)
nCPAP Pressure Limit
A high priority audible/visual alarm will be activated if the nasal CPAP pressure exceeds 11 cmH2O for 3 seconds. Upon
activation of the alarm, the safety valve will open to ambient. The alarm will deactivate and the safety valve will close
when the nCPAP pressure falls below 4.5 cmH2O.
Initiating Nasal CPAP
1. To initiate Nasal CPAP, touch the Modes membrane button on the UIM or touch the screen area for the Current Mode
Display. The Mode Select box appears
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Figure 6–1: Mode selection
2. Touch Nasal CPAP. The following message appears.
Figure 6–2: Calibration Required Message
3. Disconnect the Nasal CPAP device from the patient and disconnect the expiratory limb of the circuit at the patient wye.
(Figure 6–3)
Figure 6–3: Disconnect Point for Calibration
Do not disconnect the Nasal CPAP device at the wye and leave the prongs open to ambient.
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4. Touch Continue; the following message appears.
Figure 6–4: Calibration Progress Message
If calibration is successful, the following message appears.
Figure 6–5: Calibration Successfully Completed Screen
Note:
If the calibration test fails, check the following:

Ensure the patient was disconnected during the calibration.

Ensure the circuit connections are secure.

Ensure there was no movement of the circuit during the calibration.

Ensure the prongs are open during the test.
 Ensure the expiratory limb of the circuit was disconnected before starting the calibration.
If failure of the calibration persists after checking all of the above, remove the ventilator from service and have it checked by
a qualified technician.
5. Reconnect the expiratory limb of the circuit at the patient wye.
6. Connect the Nasal CPAP device to the patient and touch Continue. The patient will be supported initially by the default value
of 2 cmH2O of continuous positive airway pressure.
7. Set the prescribed level for nCPAP Pressure and/or FIO2 by touching the primary control, turning the Data Dial until the
desired value is displayed and by either touching the primary control again or by touching the ACCEPT membrane key
adjacent to the Data Dial to activate the new setting.
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Note:
Low Nasal CPAP Pressure and High Nasal CPAP Pressure Alarm Thresholds are updated automatically when a new
value is accepted in the nCPAP Primary Control.
Figure 6–6: nCPAP Primary Controls and Alarm Threshold Indicators
CAUTION
Apnea back-up ventilation is suspended during nCPAP.
AVEA continually displays the following message during nCPAP administration.
Figure 6–7: Caution Message Display
Monitors
In Nasal CPAP, all existing monitors will be suspended, except:

Air Inlet Pressure (Air Inlet)

Oxygen Inlet (O2 Inlet)

Gas Composition Monitor (FIO2)

Percent Leak
The following monitors have been added for Nasal CPAP:

nCPAP level (mean airway pressure)
Range:
0 to 120 cmH2O
Resolution: 1 cmH2O
Accuracy:

3.5% of reading or 2 cmH2O, whichever is greater
CPAP Flow (mean inspiratory flow)
Range:
0–300 LPM
Resolution: 0.1 LPM
Accuracy:
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Graphics
All existing waves will be maintained except for the volume (Vt) wave will be selectable with no functionality and the
loops selection button will be disabled.
Displayed Waves

Net Flow (Flow)
Range:

Minimum:
-2 to +2 LPM
Maximum:
-300 to +300 LPM
Default:
-40 to +40 LPM
Inspiratory Flow / CPAP Flow (Finsp)
Range:



Minimum:
-2 to +2 LPM
Maximum:
-300 to +300 LPM
Default:
-20 to +20 LPM
Expiratory Flow (Fexp)
Minimum:
-2 to +2 LPM
Maximum:
-300 to +300 LPM
Airway Pressure / CPAP Level (Paw)
Minimum:
-1 to +2 cmH2O
Maximum:
-60 to +120 cmH2O
Default:
-20 to +40 cmH2O
Inspiratory Pressure (PINSP)
Minimum:
-1 to +2 cmH2O
Maximum:
-60 to +120 cmH2O
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Nasal Intermittent Mandatory Ventilation (nIMV)
Nasal CPAP is a spontaneous mode of ventilation. In this mode, no mechanical positive pressure breaths are delivered.
Nasal IMV is a time-triggered, time-cycled mode of pressure control ventilation provided via nasal prongs. This is an
enhancement to the nasal CPAP mode. When a rate is set greater than zero, time-triggered, time-cycled mandatory
breaths are delivered. Each breath comprises an inspiratory phase, during which the delivered pressure is increased
from baseline (PEEP) to PEEP + Inspiratory Pressure, and an expiratory phase, during which the delivered pressure is
returned to PEEP.
Nasal IMV breaths are:

Controlled by pressure

Limited by pressure

Cycled by time
Note:
Nasal CPAP/IMV is only available in the neonatal patient size setting.
Circuit compatibility
This mode utilizes standard two-limbed infant/neonatal patient circuits and nasal prongs for the patient interface.
The following nasal CPAP prongs have been approved for use:

HUDSON Infant Nasal CPAP Cannula: Sizes 0 through 4
Hudson RCI, Research Triangle NC

INCA® Infant Nasal Cannula: Sizes 7.5F, 9F, 10.5F, 12F, 15F
Cooper Surgical, Inc., Trumbull CONN

NEOTECH Binasal Airway: Sizes 3.0 mm, 3.5 mm, 4.0 mm
NEOTECH Products, Inc., Valencia CA

ARGYLE® Infant Nasal Cannula: Sizes Extra-small, Small, Large
Sherwood Medical; St. Louis MO
General specifications
nCPAP Level
Range: 2 to 10 cmH2O
Resolution: 1 cmH2O
Default: 5 cmH2O
Accuracy: ±2 cmH2O
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Insp Press
Range: 0 to 30 cmH2O
Resolution: 1 cmH2O
Default: 5 cmH2O
Accuracy: ±2 cmH2O
Insp Rise
Range: 1 to 9
(relative control with fast being a setting of 1, and slow a setting of 9)
Default: 5
Note:
Inspiratory Rise is only available when the Rate is set.
Insp Time
Range: 0.15 to 3.0 seconds
Default: 0.35 seconds
Rate
Range: Off, 1 to 80 bpm
Default: Off (nCPAP only)
nCPAP Flow
Flow delivery is under software control and limited to a maximum of 15 LPM.
Advanced Settings
Note:
There are no advanced settings for the primary settings when the Rate is set to Off.
Alarms
Note:
The Alarms Settings window is not available in this mode when the Rate is set to Off. Existing machine alarms and
safety systems will be maintained. During nCPAP support with Rate set to Off, certain alarms will be suspended.
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Alarms suspended during nCPAP with Rate set to off
Time-based alarms
High Rate
I-Time Limit
I:E Limit
Apnea Interval
Volume-based alarms
High Ve
High Vt
Low Vte
Low Ve
Volume Limit
Pressure alarms
High Ppeak
Ext High Peak Alarm
Low PEEP
Low Ppeak
Occlusion
Low Ppeak
Range: 1 to 40 cmH2O (Neonate setting – nCPAP / IMV)
Default: 7 cmH2O
Note:
Not available in nasal CPAP mode unless Rate of one or greater is set.
Alarm threshold setting changes during nCPAP / IMV will not be retained for other ventilation modes following exiting
from nasal CPAP mode.
High Ppeak
Range: 2 to 45 cmH2O (Neonate setting – nCPAP / IMV)
Default: 20 cmH2O
Note:
Not available in nasal CPAP mode unless a Rate of one or greater is set.
Alarm threshold setting changes during nCPAP / IMV will not be retained for other ventilation modes following exiting
from nasal CPAP mode.
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nCPAP/IMV Disconnect Sensitivity
In nCPAP/IMV, patient circuit disconnect is based on characterization of the nasal prongs, carried out during the nCPAP
breathing circuit characterization.
In nCPAP/IMV, the CIRCUIT DISCONNECT alarm is based on leak flow during exhalation (periods of baseline
pressure). The circuit characterization provides a value for leak flow with the prongs removed from the nose. An alarm
will be indicated if, the leak flow exceeds an operator set percentage of this characterized leak flow. This alarm will
activate within 15 seconds of disconnect.
Range: 20 – 95 %
Resolution: 5%
Default: 95 %
The Disconnect Sensitivity setting banner appears in the message bar. The current measured leak is displayed on the
left side of the banner and the Disconnect Sensitivity setting is displayed on the right. The background colors illustrate
leak in blue relative to the Disconnect Sensitivity setting.
Following completion of Nasal CPAP / IMV characterization procedure, note the measured leak percentage. While the
nasal prongs are still disconnected, set the Disconnect Sensitivity slightly below the measured leak percentage. This will
help with proper disconnect detection, especially when using small prongs.
Note:
The Disconnect Sensitivity alarm is only available when a Rate of one or greater is set.
If the measured leak is within 5% of the Disconnect Sensitivity setting, the measured leak value will be displayed in RED
alerting the operator to an impending alarm.
When the Circuit Disconnect alarm is asserted, the Disconnect Sensitivity setting banner background will display the leak
level above the Disconnect Sensitivity setting in RED until the alarm situation is resolved.
Note:
The Leak % monitor is not available in nCPAP/nIMV.
WARNING
Under certain conditions, such as small prongs and/or high respiratory rates, the Circuit Disconnect Alarm
may not recognize that the prongs have been dislodged from the nares during nCPAP or nIMV. Ensure
proper physiologic monitoring is used.
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High nCPAP pressure
A high priority audible/visual alarm will be activated whenever the nCPAP exceeds the high airway pressure threshold for
a period greater than 15 seconds.
Threshold: Set CPAP Level + 3 cmH2O
Tolerance: ± 0.5 cmH2O
Note:
Threshold is automatically updated upon acceptance of a change in the nCPAP control setting.
Low nCPAP Pressure
A high priority audible/visual alarm will be activated whenever the nCPAP pressure falls below the low airway pressure
threshold for a period greater than 15 seconds.
Threshold:
Set nCPAP Level - 2 cmH2O (if set nCPAP ≥ 3 cmH2O)
Set nCPAP Level - 1 cmH2O (if set nCPAP < 3 cmH2O)
Tolerance:
± 0.5 cmH2O
Note:
Threshold is automatically updated upon acceptance of a change in the nCPAP control setting.
nCPAP Pressure Limit
A high priority audible/visual alarm will be activated whenever the nCPAP pressure is greater than airway pressure limit
for 3 seconds. The alarm will deactivate when the nCPAP pressure drops below 4.5 cmH2O.
Pressure Limit: 11 cmH2O (nCPAP only, rate set to off)
Set CPAP Level + Inspiratory Pressure + 3 cmH2O (nCPAP / IMV, rate not zero)
Tolerance: + 0.5 cmH2O
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Initiating Nasal CPAP / NIMV
1. To initiate Nasal CPAP, select the Modes membrane button on the UIM, or touch the screen area for the Current
Mode Display. The Mode Select box appears.
2.
Select Nasal CPAP/nIMV. The following message appears.
3.
Disconnect the Nasal CPAP device from the patient and disconnect the expiratory limb of the circuit at the patient
wye.
Do not disconnect the Nasal CPAP device at the wye and leave the prongs open to ambient.
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Touch Continue; the following message appears.
If the calibration is successful, the following message appears.
Note:
If the calibration test fails, check the following:
 Ensure the patient was disconnected during the calibration.
 Ensure the circuit connections are secure.
 Ensure there was no movement of the circuit during the calibration.
 Ensure the prongs are open during the test.
 Ensure the expiratory limb of the circuit was disconnected before starting the calibration.
If failure of the calibration persists after checking all of the above, remove the ventilator from service and have it
checked by a qualified technician.
5.
Leave the patient disconnected and reconnect the expiratory limb of the circuit at the patient wye.
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6.
Select Continue; the following message appears
7.
If characterization is successful the following message appears
8.
Select Continue.
9.
Set the prescribed level for nCPAP Pressure and/or FIO2 by touching the primary control, turning the Data Dial until
the desired value is displayed and by either touching the primary control again or by touching the ACCEPT
membrane key adjacent to the Data Dial to activate the new setting. If NIMV is prescribed, set the prescribed level
for Inspiratory Pressure, Inspiratory Time and Rate as well.
10. Connect the Nasal CPAP device to the patient.
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Monitors
In Nasal CPAP, all existing monitors will be suspended, except:

Air Inlet Pressure (Air Inlet)

Oxygen Inlet (O2 Inlet)

Gas Composition Monitor (FIO2)
The following monitors are only available when the Rate is set to one or greater:

Total Breath Rate

Mandatory Breath Rate

Inspiratory Time

Exhalation Time

I:E Ratio

Peak Inspiratory Pressure

Mean Airway Pressure

PEEP
Nasal CPAP specific monitors
In nCPAP/IMV and when a rate of one or greater is set, the nCPAP level is calculated only over those periods when
control pressure is equal to the nCPAP setting (exhalation, following the end of the pressure decay as determined by
inspiratory rise control).

nCPAP level
Range: 0 to 120 cmH2O
Resolution: 1 cmH2O
Accuracy: 3.5% of reading or 2 cmH2O, whichever is greater

CPAP Flow (mean inspiratory flow)
Range: 0–300 LPM
Resolution: 0.1 LPM
Accuracy: 10%
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Graphics
All existing waveforms will be maintained, except for the volume (Vt) waveform. The volume waveform will be selectable
with no functionality, and the loops selection button will be disabled.
Displayed waveforms

Net Flow (Flow)
Range:
Minimum: -2 to +2 LPM
Maximum: -300 to +300 LPM
Default: -40 to +40 LPM

Inspiratory Flow / CPAP Flow (Finsp)
Range:
Minimum: -2 to +2 LPM
Maximum: -300 to +300 LPM
Default: -20 to +20 LPM

Expiratory Flow (Fexp)
Minimum: -2 to +2 LPM
Maximum: -300 to +300 LPM

Airway Pressure / CPAP Level (Paw)
Minimum: -1 to +2 cmH2O
Maximum: -60 to +120 cmH2O
Default: -20 to +40 cmH2O

Inspiratory Pressure (PINSP)
Minimum: -1 to +2 cmH2O
Maximum: -60 to +120 cmH2O
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Messages
AVEA message bar text
Cause
Characterization is Required in Nasal CPAP.
Mode Key pressed when nasal CPAP characterization
is in progress.
No Advanced Settings in Nasal CPAP.
Advanced Settings Screen Button was pressed with
Breath Rate off
No Alarm Limits in Nasal CPAP.
Alarm Limits Screen Button was pressed with Breath
Rate off
No Manual Breath in Nasal CPAP.
Manual Breath Button was pressed.
Nasal CPAP / IMV mode: I:E ratio not in range
I:E ratio exceeds I:E ratio limit. The setting will not be
accepted.
No Proximal Flow Sensing in nCPAP.
On detection of a Proximal Flow Sensor in Nasal CPAP
Mode.
Troubleshooting
Alarm
Priority
Possible causes
Actions
NCPAP Pressure
Limit
High
Occlusion of expiratory limb of
patient circuit.
Occluded expiratory filter
Check expiratory limb for kinks
and/or water
Replace expiratory filter
Low NCPAP
Pressure
High
Circuit disconnect
Circuit leak
Patient interface leak
Check circuit
Check the nasal prongs
High NCPAP
Pressure
High
Patient circuit occlusion
Water in circuit
Patient interaction
Check patient circuit
Check nasal prongs
LOW PPEAK
High
Partial or complete disconnect
Circuit leak
Patient interface leak
Check patient circuit
Check nasal prongs
HIGH PPEAK
High
Partial or complete occlusion of
circuit
Water in circuit
Patient cough / sneeze
Check patient circuit
Check nasal prongs
Circuit Disconnect
High
Patient circuit disconnect
Check patient circuit
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Status Indicators
The ventilator displays the following status indicators.
Note:
For optimal awareness of an alarm state, the ideal operator position is one meter in front of the AVEA screen at an
angle subtended by 30 degrees from the screen midpoint horizontal and normal to the screen plane.
Compressor Active
If the internal compressor is active, the Compressor Active icon shown here will display at the bottom of the touch
screen with no accompanying tone.
Heliox Source Connected
If Heliox gas is connected this green icon displays in bottom right of the touch screen.
Mains/Battery Indicators
There are visual status indicators on the ventilator front panel for the mains power and the internal and external batteries
(Figure 7–1).
The sequence in which the power sources are used by the ventilator is:

Mains AC Power

External Battery (if installed)

Internal Battery
Power On Indicator
The green Power On indicator lights up whenever the power switch is on ( I ) and power is being supplied from any of the
available power sources (AC, external battery, or internal battery).
On battery indicator while operating on internal or external battery, a battery icon will blink in the lower right hand corner
of the display.
AC Power Indicator
The green AC indicator is on whenever the ventilator is connected to AC power. It displays whether the power switch
is on ( I ) or off (O).
Operating On Battery Indicator
When operating on battery power (Internal or External) a yellow blinking battery indicator will appear in the lower right
hand corner of the LCD screen.
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External Battery Power Indicator
The EXT indicator above the battery status indicators is lit whenever the external battery is providing the primary source
of power for the ventilator.
Internal Battery Power Indicator
The INT indicator above the battery status indicators is lit whenever the internal battery is providing the primary source of
power for the ventilator.
Battery Status Indicators
The battery status indicator shown in Figure 7–1 for the INTernal or optional EXTernal battery will illuminate
incrementally depending on the available charge remaining in the battery.
Note:
If the ventilator is plugged into the mains power supply and no battery status light is illuminated for the internal battery
or optional external battery (if equipped), the battery should be checked and/or replaced. Replacement of the Internal
battery must be done by a CareFusion trained technician.
LED Indicator
Internal Battery (NiMH)
External Battery (SLA)
GREEN
At least 90% charge remaining
At least 80% charge remaining
YELLOW
Between 30% and 90% remaining
Between 20% and 80% remaining
RED
Less than 30% charge remaining
Less than 20% charge remaining
Note:
When approximately 2 minutes of battery charge remain the ventilator will initiate a non-cancelable alarm. The
ventilator should be immediately connected to an appropriate AC power source.
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AC indicator
Green
Yellow
Red
Figure 7–1: Front Panel Display Area. Comprehensive model shown.
Messages
The AVEA displays messages in one of two ways.

In a “Popup” message box

In the Message bar at the bottom right of the touch screen
Alert Messages that require an acknowledgement from the user, appear in a “pop-up” message box with an “OK” or
“Continue” button. When you press the acknowledgement button, the message disappears and the ventilator continues
normal functioning.
“Popup” Alert Messages
These messages will require you to press a button to clear the “Popup” box.

Can't change Mode to APRV / BiPhasic when ILV is active.

Can't set Pres Low higher than Pres High.

Can't set Pres High lower than Pres Low.

Stored Settings and Configuration Data lost.

Settings restored to defaults. Check Barometric Pressure setting

Stored Settings lost. Settings restored to defaults.

Stored Configuration Data lost. Check Barometric Pressure setting

Can't change size to PED or ADULT when Mode is TCPL.

Can't change size to NEO when Mode is PRVC.
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
Can't change size to NEO when Mode is APRV / BiPhasic.

Can't change patient size when Machine Volume is active.

ILV is not available when Mode is APRV / BiPhasic.

Can't disable O2 Alarms when Heliox is in use.

Ppeak > 90cmH2O

Barometric pressure calibration invalid. Call service representative. Using 760mmHg.
Operator's manual
The Message Bar
Messages not requiring acknowledgement or response appear in the Message Bar located at the bottom right of the
touch screen. A complete list of text, with explanations, for those messages that appear in the message bar, is provided
in Appendix F.
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Alarms
WARNING
To avoid a potential safety hazard when operating two or more of the same or similar device in a single area,
use the same audible alarm characteristics.
Alarm Categories
AVEA ventilator alarms are grouped into three categories:
High priority (warning)
This category of alarm requires immediate action. For a high priority alarm, the alarm indicator is RED and the alarm icon
flashes at a rate of 2 Hz (fast). A high priority alarm sounds a series of five tones, three low and two high, repeated at
intervals of 6 seconds.
Medium priority (caution)
A medium priority alarm displays a yellow indicator and the alarm icon flashes at ½ Hz (slow). A medium priority alarm
sounds three tones, all at the same pitch, repeated at intervals of 20 seconds.
Low priority (advisory)
A low priority alarm (or advisory) displays a yellow indicator and the alarm icon does not flash.
A low priority alarm sounds a single tone, which is not repeated
There are visual displays for all categories of alarms. A text message appears in the indicator at the upper right of the
touch screen.
The alarm icons flash until the cause of the alarm is no longer present. Both high and medium priority alarms that have
been resolved will appear as a solid yellow message indicator with no icon displayed until the Alarm Reset button is
pressed. (See Table 7–1 on page 179 for alarm messages.)
Multiple alarms can be displayed simultaneously. If 2 or more alarms are current, a white triangle appears on the right of
the alarm indicator/message. Touching the screen over the triangle will open a drop down box for display of up to nine
alarm messages. In the event that there are more than nine active or resolved alarms available for display, the nine
highest priority alarms will be displayed.
To close the drop down box and display a single alarm message, touch the triangle again.
Alarm messages are prioritized in order of appearance, the highest priority alarm is always displayed in the top position
of the alarm indicator display.
The alarm indicator is solid green with no message when no alarms are currently active.
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Backup Alarm (advisory)
A continuous tone alarm sounds when a vent-inop occurs and the Back Up Alarm electronics detects the primary alarm
is not functioning.
Alarm Controls
Setting an Alarm Limit
To set the limits for each alarm, press the red Alarm
LIMITS membrane button on the right of the user
interface marked with the icon shown here.
The Alarm Limits screen will appear (Figure 7–2). To set the limits for an alarm, press the touch screen immediately over
the alarm control. The control will highlight (change color) on the screen.
Caution
Do not adjust any of the Alarm Limit settings to an extreme value. Selecting an extreme value can
prevent the alarm thresholds from being reached.
Figure 7–2: Alarm Limits Screen
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Figure 7–3: Control Knob and Accept / Cancel Softkeys
With the control selected, rotate the large data dial below the touch screen until the control reaches the setting you
require. To accept the new setting, either press the touch screen over the control again or press the ACCEPT button.
Note:
Red indicators appearing on the primary controls display the relative alarm settings of any associated alarm.
Alarm Silence
You can disable the audible alarm for 2 minutes  1 second by pressing the Alarm Silence key. Pressing the Alarm
Silence key again before the 2-minute period is up will cancel the “silence”. This feature is functional for all alarms, with
the exception of the “Vent Inop” alarm, which cannot be silenced.
Note:
The activation of the auditory alarm silence button will not prevent the subsequent activation of auditory alarm signals
for certain alarm conditions.
Alarm Reset
The Alarm Reset button deactivates visual indicators for alarms that are no longer active.
Alarm Types
Machine Alarms
Safety Valve Open
This is a high priority audible/visual alarm. SAFETY VALVE OPEN is displayed, and a high priority tone sounds
whenever the Safety Valve is open.
Ventilator Inoperative
This is a high priority audible/visual alarm. VENT INOP is displayed if the ventilator fails due to a non-recoverable
condition, such as loss of power or supply gases. A high priority tone sounds. The safety valve opens, indicated by a
SAFETY VALVE OPEN alarm message, and the patient is allowed to breathe room air.
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Note:
PEEP is not maintained during a VENT INOP or a SAFETY VALVE OPEN alarm condition. When the ventilator safety
valve is open the ventilator graphics will indicate a safety state by displaying the color purple.
Not Ventilating
This is a high priority audible/visual alarm. NOT VENTILATING is displayed if the internal blended system pressure
drops below 1 psi for greater than about 12 seconds. The time delay on this alarm allows a transient drop in pressure
due to high patient demand. This alarm is triggered when there is a component failure that is preventing ventilation from
occurring. The Safety Valve is normally held physically closed by this system pressure, and therefore the safety valve
should be open if there is no system pressure at this location to keep the Safety Valve closed. This alarm is
differentiated from “Safety Valve Open”, as the software is not driving the Safety Valve to an open state, and the
software cannot determine the physical state of the Safety Valve. This is a local alarm only and is not transmitted via
any communication protocol, however other alarms should always be active and transmitted; the primary purpose of this
new alarm message is to provide clarification and differentiation from “Circuit Disconnect” to alert the operator that there
is a potential machine fault.
The first thing the operator should check for is a compressed gas source. If the “Not Ventilating” message is displayed
without an accompanying “Loss of Gas” alarm, the unit should be removed from service.
Fan Failure
This is a low priority audible/visual alarm. FAN FAILURE is displayed and low priority tone sounds, whenever the
circulating fan at the rear of the ventilator cabinet stops rotating.
Circuit Disconnect Alarm
This is a high priority audible / visual alarm. The ventilator will sound a disconnect alarm when total expiratory flow,
inclusive of bias flow is less than 10% of total inspiratory flow, inclusive of bias flow for 5 seconds. Additionally, in
neonatal applications when a proximal flow sensor is used the circuit disconnect is sounded when the Percent Leak
((Vti – Vte) /Vti) is greater than 95% for three consecutive breaths.
If “Loss of Gas” or “Not Ventilating” alarms are active in addition to a “Circuit Disconnect” alarm, the trigger for these
alarms is a loss of system pressure, not a circuit leak or circuit disconnect. See “Loss of Gas Supply” on page 175 and
“Not Ventilating” on page 174 for details and resolution of these conditions.
Note:
While the circuit disconnect alarm is active, the ventilator will stop cycling and set a bias flow. The ventilator will
automatically detect the patient upon reconnection and resume normal ventilation.
The apnea interval timer is suspended during a Patient Circuit Disconnect Alarm.
Setting extremely small delivered tidal volumes with Circuit Compliance Compensation not active and using a proximal
flow sensor may result in assertion of Patient Circuit Disconnect Alarms.
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Gas Supply Indicators and Alarms
Loss of Air
This is a high priority audible/visual alarm. LOSS, AIR is displayed and a high priority tone sounds. This alarm is
triggered if the wall air supply to the ventilator drops below 18.0 psig (1.2 bar), and the ventilator does not have a
functional internal compressor or the compressor output is insufficient to meet instrument demand. The patient
continues to be ventilated by the oxygen supply only.
Loss of O2
This is a high priority audible/visual alarm. LOSS, O2 is displayed and a high priority tone sounds. This alarm is
triggered if the oxygen supply to the ventilator drops below 18.0 psig (1.2 bar) and the % O2 control is set >21%. The
patient continues be ventilated by the air supply (wall air or internal compressor) only.
Loss of Gas Supply
This is a high priority audible/visual alarm. LOSS, GAS SUPPLY is displayed and a high priority tone sounds. This
alarm is triggered if the ventilator loses all sources of gas (wall air, internal compressor if present, and wall oxygen). The
safety valve opens, indicated by a SAFETY VALVE OPEN visual display, and the patient is allowed to breathe room air.
Note:
PEEP is not maintained during a LOSS, GAS SUPPLY alarm condition. When the ventilator safety valve is open the
ventilator graphics will indicate a safety state by displaying the color purple.
Loss of Heliox
This is a high priority audible/visual alarm. LOSS, HELIOX is displayed and a high priority tone sounds. The alarm is
triggered if Heliox is being used and the Heliox supply to the ventilator drops below 18.0 psig (1.2 bar). The patient
continues to be ventilated by the oxygen supply only.
Pressure Alarms
Low Peak Pressure
This is a high priority audible/visual alarm. LOW PPEAK is displayed and a high priority tone sounds, whenever the peak
inspiratory pressure for a given breath is less than the preset threshold for Low PPEAK.
Range:
3 to 99 cmH2O
Defaults:
8 cmH2O (Adult/Pediatric)
5 cmH2O (Neonate)
Limitations:
Not active for spontaneous breaths.
High Peak Pressure
This is a high priority audible/visual alarm. HIGH PPEAK is displayed and a high priority tone sounds whenever the preset
High PPEAK threshold is exceeded. Inspiration is terminated and circuit pressure is allowed to return to the current set
baseline pressure + 5 cmH2O. Circuit pressure must return to baseline +5 cmH2O before the next breath can be
delivered.
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Normal High PPEAK Alarm
Alarms if the inspiratory pressure in the patient circuit exceeds the set High PPEAK alarm threshold during the
inspiratory phase of a breath, except during sigh breath cycles.
Range:
Defaults:
10 to 105 cmH2O
(Adult/Pediatric)
10 to 85 cmH2O
(Neonate)
40 cmH2O (Adult/Pediatric)
30 cmH2O (Neonate)
Not active for Sigh Breaths

Sigh High PPEAK Alarm
Alarms if the inspiratory pressure in the patient circuit exceeds the Sigh High PPEAK alarm threshold during a
sigh breath cycle.
Range:
1.5 x (Normal High PPEAK), up to a maximum of 105 cmH2O
Active only for Sigh Breaths.
Note:
Maximum Circuit Pressure Limit:
The ventilator has an independent mechanical pressure relief valve, which limits the maximum pressure at the patient
wye to 125 cmH2O.
Extended High Peak Pressure
This is a high priority audible/visual alarm. EXT HIGH PPEAK, is displayed and a high priority tone sounds if the High PPEAK
alarm remains active for more than 5 seconds, (i.e. the circuit pressure does not return to PEEP + 5 cmH2O within 5
seconds). No breaths are delivered during this alarm condition. The Safety and Exhalation valves open allowing the
patient to breathe from room air and the Safety Valve alarm activates. Bias flow is suspended while this alarm is active.
PEEP may not be maintained. This alarm remains active (flashing) until the condition causing it has been resolved.
Low PEEP
This is a high priority audible/visual alarm. LOW PEEP is displayed and a high priority tone sounds if the baseline
pressure (PEEP) is less than the Low PEEP alarm threshold for a period greater than 0.25 ± 0.05 seconds.
Range:
0 to 60 cmH2O
Defaults:
3 cmH2O
(Adult/Pediatric)
1 cmH2O
(Neonate)
The alarm is off if set to zero.
Circuit Occlusion Alarm
This is a high priority audible/visual alarm. CIRCUIT OCCLUSION is displayed and a high priority tone sounds whenever
the inspiratory or expiratory limb of the patient circuit becomes sufficiently occluded to trigger the alarm. An inspiratory
limb occlusion is unlikely to cause any pressure increase at the patient and will simply result in the termination of the
breath.
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The system is designed to prevent an expiratory limb occlusion from causing an increase in patient pressure measured
at the distal end of the ET tube beyond the following limits:

For Neonates: 5 cmH2O or 15% (whichever is greater) above the target pressure

For Adults/Pediatrics: 10 cmH2O or 15% (whichever is greater) above the target pressure
Bias flow is suspended while the alarm is active, and the alarm is deactivated when the occlusion is removed.
Note:
High patient-circuit resistance may cause false circuit-occlusion alarms. False circuit-occlusion alarms may also occur
when peak inspiratory flow exceeds 150 L/min for adult, 75 L/min for pediatrics, and 30 L/min for neonates. For the
recommended test for neonatal-circuit resistance, refer to “Appendix E: Sensor and Circuit Specifications” on page 217.
The alarm is not active in nCPAP mode.
Note:
The ventilator may assert a circuit occlusion alarm in conditions when measured PEEP is significantly greater than
operator set PEEP.
Volume Alarms
Low Exhaled Minute Volume (Low Ve)
This is a high priority audible/visual alarm. LOW MINUTE VOLUME is displayed and a high priority tone sounds
whenever the monitored exhaled minute volume is less than the Low Exhaled Minute Volume threshold setting.
Range:
Off (indicated by 0), 1 to 50 L
(Adult)
Off (indicated by 0), 0.1 to 30.0 L
(Pediatric)
Off (indicated by 0), 0.01 to 5.00 L (Neonate)
Defaults:
1.00 Liter (Adults)
0.50 Liter (Pediatrics)
0.05 Liter (Neonate)
High Exhaled Minute Volume (High Ve)
This is a medium priority audible/visual alarm. HIGH MINUTE VOLUME is displayed and a medium priority tone sounds
whenever the monitored exhaled minute volume is greater than the High Exhaled Minute Volume threshold setting.
Range:
Defaults:
0 to 75 L
(Adult)
0.0 to 30.0 L
(Pediatric)
0.00 to 5.00 L
(Neonate)
30.0 L
(Adult/Pediatric)
5.00 L
(Neonate)
Low Exhaled Tidal Volume (Low Vt)
A high priority audible/visual alarm shall be activated, and LOW TIDAL VOLUME shall be indicated, whenever the
absolute monitored exhaled tidal volume does not exceed the Low Tidal Volume alarm threshold setting for the Low Vte
Sensitivity setting.
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Range:
Operator's manual
Off (indicated by 0.00) to 3.00 L (Adult)
Off (indicated by 0) to 1000 mL (Pediatric)
Off (indicated by 0.0) to 300.0 mL (Neonate)
Resolution: 0.01 L (Adult)
1 mL (Pediatric)
0.1 mL (Neonate)
Accuracy:
 0.01 L of monitored exhaled tidal volume (Adult)
 1 mL of monitored exhaled tidal volume (Pediatric)
 0.1 mL of monitored exhaled tidal volume (Neonate)
Defaults:
0.00 L (Adult)
0 mL (Pediatric)
0.0 mL (Neonate)
Note:
The Low Exhaled Tidal Volume alarm will assert on a single occurrence of a low exhaled volume. In patients who have
variable tidal volumes, the Low Exhaled Tidal Volume alarm may be turned off (default) and the Low Exhaled Minute
Volume alarm can be used to avoid nuisance alarms.
High Tidal Volume (High Vt)
This is a low priority audible/visual alarm.. HIGH Vt is displayed and a low priority tone sounds if the absolute monitored
exhaled tidal volume is greater than the High Tidal Volume threshold setting.
Range:
0.10 to 3.00 L (Adult)
25 to 1000 ml (Pediatric)
2.0 to 300.0 ml (Neonate)
Defaults:
3.00 L (Adult)
1000 ml (Pediatric)
300.0 ml (Neonate)
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Rate/Time Alarms
Apnea Interval
This is a high priority audible/visual alarm. APNEA INTERVAL is displayed and a high priority tone sounds if the
ventilator does not detect a breath initiation (by any means) within the preset period of time. Apnea ventilation will begin
when this alarm is activated.
Range:
6 to 60 seconds
Default:
20 seconds
High Rate
This is a medium priority audible/visual alarm. HIGH RATE is displayed and a medium priority tone sounds if the
monitored total breath rate exceeds the alarm setting.
Range:
1 to 200 bpm
Default:
75 bpm
Maximum Inspiratory Time Limit (Max I-Time)
This is a low priority audible/visual alarm. I-TIME LIMIT is displayed and a low priority tone sounds if the inspiratory time
for any breath exceeds the maximum set inspiratory time plus pause time. Maximum inspiratory time is 5.0 seconds for
adult/pediatric, and 3.0 seconds for neonate. The inspiratory phase of the breath is terminated when this alarm
activates.
I:E Ratio Limit (I:E Limit)
This is a low priority audible/visual alarm. I:E LIMIT is displayed and a low priority tone sounds, if the I:E Ratio for a
mandatory breath exceeds 4:1. The inspiratory phase of the breath is terminated when this alarm activates.
This alarm is not active in APRV / BIPHASIC mode.
O2 Alarms
Low O2% (Low FIO2)
This is a high priority audible/visual alarm. LOW FIO2 is displayed and a high priority tone sounds if the monitored
Delivered O2% falls below the set FIO2 minus 6% or 18% FIO2, whichever is greater.
High O2% (High FIO2)
This is a high priority audible/visual alarm. HIGH FIO2 is displayed and a high priority tone sounds if the monitored
Delivered O2% rises above the set FIO2 + 6%.
Table 7–1: Alarm Conditions
Message
Alarm Condition
Range
Priority
SAFETY VALVE
OPEN
Safety valve is open
N/A
High
VENT INOP
Ventilator failure due to a recoverable or non-recoverable
condition. The safety valve opens, indicated by a SAFETY VALVE
message, and the patient is allowed to breathe room air. PEEP is
not maintained
N/A
High
LOSS, AIR
Wall air drops below 18.0 psig (1.2 bar) and no functional
compressor is installed or the compressor output is insufficient to
meet instrument demand. Patient will continue to be ventilated by
O2 supply only.
N/A
High
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Message
Alarm Condition
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Range
Priority
LOSS, O2
Oxygen supply to the ventilator drops below 18.0 psig (1.2 bar)
and the %O2 is set to > 21%. Patient will continue to be ventilated
by the air supply only
N/A
High
LOSS, HELIOX
The alarm is triggered if heliox is being used and the heliox gas
supply to the ventilator drops below 18.0 psig (1.2 bar). The
patient continues to be ventilated by the oxygen supply only.
N/A
High
LOSS, GAS
SUPPLY
All sources of gas fail; wall air, internal compressor (if installed)
and oxygen. The safety valve opens, indicated by a SAFETY
VALVE OPEN message, and the patient is allowed to breathe
room air. PEEP is not maintained.
N/A
High
NOT
VENTILATING
The internal blended gas pressure is below 1 psi for greater than
about 12 seconds, indicating there is no ventilation occurring.
The safety valve should be open in this condition, as there is no
pressure to keep the safety valve closed. This alarm is only a
monitor of this pressure level and does not change the “state” of
the ventilator. The condition is recoverable if pressure is restored.
Pressure < 1psi for > 12 seconds
High
LOW PPEAK
The peak inspiratory pressure for a breath is less than the set
LOW PPEAK. Not active for spontaneous breaths.
3 to 99 cmH2O
Default 3 cmH2O
High
HIGH PPEAK
Peak inspiratory pressure is greater than the set HIGH PPEAK.
Inspiration is terminated and the circuit pressure is allowed to
return to baseline pressure + 5 ± 1.5 cmH2O before the next
breath is delivered.
Normal Breath Range:
Adult:
10 to 105 cmH2O
Default: 40 cmH2O
Pediatric:
10 to 85 cmH2O
Default: 40 cmH2O
Neonate:
Default: 30 cmH2O
Sigh Breath Range:
1.5 x set normal HIGH PPEAK
Only active for sigh breaths
High
EXT HIGH PPEAK
Activates whenever the HIGH PPEAK alarm has been active for
more than 5 seconds (i.e. If the circuit pressure fails to return to
PEEP + 5 cmH2O within 5 seconds). The safety and exhalation
valves open and no breaths are delivered. The SAFETY VALVE
OPEN alarm activates. Bias flow is suspended while this alarm is
active. PEEP may not be maintained. This alarm will remain
active until the condition is resolved.
N/A
High
LOW PEEP
Baseline pressure (Positive End Expiratory Pressure) is less than
the set LOW PEEP alarm threshold for a period greater than 0.25
± 0.05 seconds. This alarm is OFF if set to zero.
0 to 60 cmH2O
Defaults:
3 cmH2O (Adult/Pediatric)
1 cmH2O (Neonate)
High
LOW Ve
Monitored exhaled minute volume (Ve) is less than the set LOW
Ve alarm threshold.
OFF (0), 1 to 50 L (Adult)
OFF (0), 0.1 to 30 L (Pediatric)
OFF (0), 0.01 to 5.00 L (Neonate)
Default OFF
Medium
HIGH Ve
Monitored exhaled minute volume (Ve) is greater than the set
HIGH Ve alarm threshold.
0 to 75 L (Adult)
0.0 to 30.0 L (Pediatric)
0.00 to 5.00 L (Neonate)
Defaults:
30.0 L (Adult/Pediatric)
5.00 (Neonate)
Medium
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Alarm Condition
Range
Priority
HIGH Vt
The absolute monitored exhaled tidal volume is greater than the
set HIGH Vt alarm threshold.
0.10 to 3.00 L (Adult)
25 to 1000 ml (Pediatric)
2.0 to 300.0 ml (Neonate)
Defaults:
3.00 L (Adult)
1000 ml (Pediatric)
300.0 ml (Neonate)
Visual
Alert
Low Vt
The absolute monitored exhaled tidal volume does not exceed the
Low Tidal Volume alarm threshold setting
Off to 3.00 L (Adult)
Off to 1000 mL (Pediatric)
Off to 300.0 mL (Neonate)
High
APNEA
INTERVAL
Active in A/C, SIMV, APRV / BIPHASIC and CPAP/PSV modes if
the ventilator does not detect a breath within the preset APNEA
time interval.
6 to 60 seconds
Default 20 seconds
High
HIGH RATE
The monitored total breath rate exceeds the set alarm RATE.
1 to 200 bpm
Default: 75 bpm
Medium
I-TIME LIMIT
The inspiratory time for a breath exceeds the set MAX I-TIME
plus pause time, which is 5.0 seconds for adult/pediatric patients
and 3.0 seconds for neonatal patients.
N/A
Low
I:E LIMIT
The inspiratory: expiratory ratio for a mandatory breath exceeds
4:1. The inspiratory phase of the breath is terminated.
Not active in APRV / BIPHASIC mode.
Low
LOW FIO2
Delivered oxygen percentage falls below the set FIO2 minus 6% or
18% FIO2., whichever is greater.
N/A
High
HIGH FIO2
Delivered oxygen percentage rises above the set FIO2 plus 6%
N/A
High
CIRCUIT
DISCONNECT
A high priority audible/visual alarm is activated, and CIRCUIT
DISCONNECT displayed, whenever the patient circuit becomes
disconnected from the ventilator or patient.
N/A
High
LOW BATTERY
A high priority audible/visual alarm is activated, and LOW
BATTERY displayed, whenever the internal battery has been
depleted to a level that provides a minimum of two minutes of
safe operation.
N/A
High
LOSS, AC
POWER
A high priority audible/visual alarm is, and LOSS, AC POWER
displayed, whenever the power switch is on and AC power has
been removed from the ventilator (i.e. power cord disconnect or
loss of supply power).
N/A
High
ILV
DISCONNECT
A high priority audible/visual alarm is activated, and ILV
DISCONNECT displayed, whenever the master ventilator
becomes disconnected from the slave ventilator during ILV.
N/A
High
INVALID GAS ID
A medium priority audible/visual alarm shall be activated, and
INVALID GAS I.D. shall be indicated whenever a defective gas
I.D. connector is installed in the ventilator. When a defective Gas
I.D. connector is detected, the gas corrections default to air.
N/A
Medium
FAN FAILURE
A low priority audible/visual alarm is activated, and FAN FAILURE
indicated, whenever the fan has stopped rotating.
N/A
Low
High EtCO2
Low priority alarm if monitored EtCO2 exceeds the alarm
threshold setting.
6 – 150 mmHg or off
Default: 60 mmHg
Low
Low EtCO2
Low priority alarm if monitored EtCO2 does not exceed the alarm
threshold setting.
1 – 145 mmHg or off
Default: 30 mmHg
Low
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Nasal CPAP / Nasal IMV Alarms
Note:
The Alarms Settings window is not available in this mode when the Rate is set to Off. Existing machine alarms and
safety systems will be maintained. During nCPAP support with Rate set to Off, certain alarms will be suspended.
Alarms suspended during nCPAP with Rate set to off
Time-based alarms
High Rate
I-Time Limit
I:E Limit
Apnea Interval
Volume-based alarms
High Ve
High Vt
Low Vte
Low Ve
Volume Limit
Pressure alarms
High Ppeak
Ext High Peak Alarm
Low PEEP
Low Ppeak
Occlusion
Low Ppeak
Range: 1 to 40 cmH2O (Neonate setting – nCPAP / IMV)
Default: 7 cmH2O
Note:
Not available in nasal CPAP mode unless Rate of one or greater is set.
Alarm threshold setting changes during nCPAP / IMV will not be retained for other ventilation modes following exiting
from nasal CPAP mode.
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High Ppeak
Range: 2 to 45 cmH2O (Neonate setting – nCPAP / IMV)
Default: 20 cmH2O
Note:
Not available in nasal CPAP mode unless a Rate of one or greater is set.
Alarm threshold setting changes during nCPAP / IMV will not be retained for other ventilation modes following exiting
from nasal CPAP mode.
nCPAP/IMV Disconnect Sensitivity
In nCPAP/IMV, patient circuit disconnect is based on characterization of the nasal prongs, carried out during the nCPAP
breathing circuit characterization.
In nCPAP/IMV, the CIRCUIT DISCONNECT alarm is based on leak flow during exhalation (periods of baseline
pressure). The circuit characterization provides a value for leak flow with the prongs removed from the nose. An alarm
will be indicated if, the leak flow exceeds an operator set percentage of this characterized leak flow. This alarm will
activate within 15 seconds of disconnect.
Range: 20 – 95 %
Resolution: 5%
Default: 95 %
The Disconnect Sensitivity setting banner appears in the message bar. The current measured leak is displayed on the
left side of the banner and the Disconnect Sensitivity setting is displayed on the right. The background colors illustrate
leak in blue relative to the Disconnect Sensitivity setting.
Following completion of Nasal CPAP / IMV characterization procedure, note the measured leak percentage. While the
nasal prongs are still disconnected, set the Disconnect Sensitivity slightly below the measured leak percentage. This will
help with proper disconnect detection, especially when using small prongs.
Note:
The Disconnect Sensitivity alarm is only available when a Rate of one or greater is set.
If the measured leak is within 5% of the Disconnect Sensitivity setting, the measured leak value will be displayed in RED
alerting the operator to an impending alarm.
When the Circuit Disconnect alarm is asserted, the Disconnect Sensitivity setting banner background will display the leak
level above the Disconnect Sensitivity setting in RED until the alarm situation is resolved.
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WARNING
Under certain conditions, such as small prongs and high respiratory rates, the Circuit Disconnect Alarm may
not recognize that the prongs have been dislodged from the nares. Ensure proper physiologic monitoring is
used.
High nCPAP pressure
A high priority audible/visual alarm will be activated whenever the nCPAP exceeds the high airway pressure threshold for
a period greater than 15 seconds.
Threshold: Set CPAP Level + 3 cmH2O
Tolerance: ± 0.5 cmH2O
Note:
Threshold is automatically updated upon acceptance of a change in the nCPAP control setting.
Low nCPAP Pressure
A high priority audible/visual alarm will be activated whenever the nCPAP pressure falls below the low airway pressure
threshold for a period greater than 15 seconds.
Threshold:
Set CPAP Level - 2 cmH2O (if set CPAP ≥ 3 cmH2O)
Set CPAP Level - 1 cmH2O (if set CPAP < 3 cmH2O)
Tolerance:
± 0.5 cmH2O
Note:
Threshold is automatically updated upon acceptance of a change in the nCPAP control setting.
nCPAP Pressure Limit
A high priority audible/visual alarm will be activated whenever the nCPAP pressure is greater than airway pressure limit
for 3 seconds. The alarm will deactivate when the nCPAP pressure drops below 4.5 cmH2O.
Pressure Limit: 11 cmH2O (nCPAP only, rate set to off)
Set CPAP Level + Inspiratory Pressure + 3 cmH2O (nCPAP / IMV, rate not zero)
Tolerance: + 0.5 cmH2O
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Volume Guarantee Alarms
Wye Sensor Disconnect
An audible/visual alarm will be activated, and FLOW SENSOR ERROR will be displayed when all of the following are
true: 1) neonatal flow sensor is in use; 2) volume guarantee function is enabled; and 3) monitored Vti drops below 20%
of the net delivered volume. In this case, the system will revert to the operator set Inspiratory Pressure.
Alarm delay: 3 breaths, or 10s if greater, or 30s if less
Alarm priority: Medium
WARNING
Disconnecting the proximal flow sensor or removing it from the circuit while Volume Guarantee is active will
cause the ventilator to deliver pressure ventilation at the set Inspiratory Pressure.
Low Ppeak
Range: 1 to 80 cmH2O
Default: 5 cmH2O
High Ppeak
Range: 10 to 85 cmH2O
Default: 30 cmH2O
Low Expired Volume
An audible/visual alarm will be activated, and LOW Vte will be indicated whenever volume guarantee is active, and
monitored expiratory tidal volume is less than the set threshold from the volume target.
Volume threshold: 90% of Volume target
Alarm delay: 30s or 10 breaths (whichever is greater)
Alarm priority: Medium
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Limit volume
All VG breaths will be cycled by volume if inspired volume exceeds a threshold based on the set Volume Target and the
leak (expressed as fraction), averaged over the previous 30 seconds.
The Volume Limit calculation varies with the degree of leak:
Mean Leak < 63%: Volume limit = (Volume Target x 1.3) x ((1.1 x Leak)+1)
Mean Leak >= 63%: Volume limit = Volume Target x 2.2
Note:
Test breaths in TCPL may be subject to the non-adjustable volume limit.
Alarm activation
Throughout activation of the following alarms, delivered breaths are disabled and the VG control algorithm will be
inactive; on deactivation the VG control algorithm will reset, with ‘test breaths’ delivered at the operator set Insp Pres.
Circuit Disconnect
Safety Valve Open
Vent INOP
The system will reset to operator-prescribed pressure during the period of activation of the following alarm conditions,
and will restart the tidal volume targeting algorithm on deactivation:
Low Ppeak
Low PEEP
Flow sensor error
Note:
Low Tidal Volume, High Tidal Volume and Low Vte Alarm Sensitivity settings are not applicable when Volume
Guarantee is active.
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Cleaning and Sterilization
The AVEA is designed for easy maintenance. All exposed parts of the ventilator are corrosion resistant.
CAUTION
DO NOT submerge the ventilator or pour cleaning liquids over or into the ventilator.
DO NOT sterilize the ventilator. The internal components are not compatible with sterilization techniques.
DO NOT gas sterilize or steam autoclave adapters or connectors while attached to the tubing. The tubing will, over
time, take the shape of the adapter, causing poor connection and possible leaks.
To minimize cleaning and replacement frequency, the AVEA design places the exhalation manifold, flow sensor and
diaphragm behind the exhalation filter and water trap.
Limitations on Reprocessing
There are instructions supplied by other manufacturers for individual parts and accessories that are included with the
ventilator. Follow those directions for processing between patients.
Instructions
Point of Use: Follow your institutions procedures for removing material from a patient area for processing.
Preparation for Decontamination: There are no special requirements regarding Preparation for Decontamination for
these parts.
Automated Cleaning: Follow cleaning instructions below. No specific automatic cleaning devices have been validated.
Manual Cleaning:
Cleaning External Surfaces: All external surfaces of the ventilator (the Exhalation cartridge included), can be wiped
clean with one of the following: Isopropyl Alcohol or Chlorine Compounds with a maximum concentration of 1:10.
Cleaning Accessories and Parts: ONLY the following three parts are cleanable using an enzyme pre-soaking solution:
The Water Trap (PN 50000-40035), the Infant Hot Wire Flow sensor (PN 16465) and the Water Collection Jar (PN
33985)
1. Prepare an enzyme based pre-soaking solution such as Klenzyme® (made by Steris Corporation, Mentor, OH) or
equivalent in accordance with manufacturer's instructions, using sterile distilled water at 20-30 degrees Celsius (6886 degrees Fahrenheit)
2. Immerse the part to be cleaned in the prepared solution for 2-5 minutes, making sure that all lumens and air pockets
are completely filled with the solution, and agitate periodically.
3. Remove the part from the solution after 2-5 minutes and rinse immediately by immersing in at least 1 gallon of sterile
distilled water at 20-30 degrees Celsius (68-86 degrees Fahrenheit). Leave the part in the rinsing bath for at least 1
minute agitating periodically to ensure thorough rinsing.
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4. Visually inspect the part after removing it from the rinse to ensure that no debris remains on the part.
5. Repeat the cleaning method if necessary.
Cleaning the outside of the Capnometry sensor and cable:
1. Use a cloth dampened with 70% isopropyl alcohol, 10% bleach solution, disinfectant spray cleaner such as Steris
Coverage® SprayHB, ammonia, or mild soap.
2. Wipe surfaces with a clean, water-dampened cloth before use. Ensure that the sensor is clean and dry before use.
Maintenance, Inspection and Testing:
An Extended System Test (EST) should be performed every time when cleaned components are re-assembled for use,
to check for leaks.
Packaging:
Follow your institution’s guidelines for packaging of material for sterilization.
Sterilization:
Only the following parts can be steam sterilized (autoclave): The Water Trap (PN 50000-40035), the Infant Hot Wire
Flow Sensor (PN 16465), and Water Collection Jar (PN 33985).
Steam sterilization (autoclave): maximum temperature 138 degrees Celsius (280 degrees Fahrenheit), minimum
temperature 132 degrees Celsius (270 degrees Fahrenheit) for a maximum of 18 minutes and a minimum of 15 minutes
(30 cycles maximum number for any of these parts).
Vacuum Steam Cycle: 3 pre-condition pulses (vacuum pulses). Sterilizer vacuum target set to 10-26 psig. Dwell at 132 138 degrees Celsius (270 to 280 degrees Fahrenheit) for 4 to 8 minutes duration. (50 cycles maximum for the hot-wire
infant flow sensor and 25 cycles maximum for the water trap/water collection jar.
Drying following steam cycle:
Minimum dry time: 15 minutes
The Infant Hot Wire Flow Sensor (part no. 16465) may also be cold sterilized using a 2.4% glutaraldehyde solution.
Storage:
Temperature: -20 to 60 degrees Celsius (-4 to 140 degrees Fahrenheit)
Humidity: 0 to 95% Relative Humidity non-condensing.
Pall Microbial Filter
The non-disposable exhalation filter (part number 33987) has been validated by Pall Medical of Ann Arbor, MI, USA for
the following sterilization method:

Autoclave at maximum temperature of 132 degrees Celsius (270 degrees Fahrenheit) for 15 minutes

25 cycle maximum
For further information please contact Pall Medical.
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Capnometry Airway Adapters
Reusable Adapters
Clean reusable adapters by rinsing them in warm soapy water followed by soaking them in a liquid disinfectant such as
70% isopropyl alcohol, 10% bleach solution, 2.4% glutaraldehyde solution such as Cidex®, Steris System1® or
ammonia. Rinse with sterile water and dry before use.
The adapter may also be disinfected using one of the following methods:

Steam autoclave the adapter (adult adapter only).

Immerse and soak the adapter in 2.4% glutaraldehyde solution such as Cidex for 10 hours.

Immerse and soak the adapter in 0.26% paracetic acid solution such as Perasafe® for 10 minutes.

Use Cidex OPA (follow manufacturer’s instructions for use).
Before reusing the adapter, ensure the windows are dry and free of residue, and that the adapter has not been damaged
during the cleaning/disinfecting process.
Disposable Adapters
Treat all single-patient use adapters in accordance with institutional protocol for single patient use items.
Additional Information
The following are considered disposable parts and, therefore, CareFusion does not recommend a method of cleaning
or sterilization:

Disposable Variable Orifice Flow Sensors (PN 50000-40038 and PN 50000-40031)

Tracheal Adapters (PN 50000-40034)

5 FrenchTube Set (PN 10635)

Extension Tubes (PN 50000-09910 and PN 50000-09920 )

Esophageal Balloons (PN 7003401 and PN 7003100)

Nasogastric Pressure Monitoring Tubes (PN 7003300 and PN 7003402)

Esophageal Pressure Monitoring Tube Set (PN 7003503)

AVEA Disposable Water Trap (PN 11556)

AVEA Disposable Expiratory Filter/Water Trap assembly (PN 11590)

Capnography single patient use airway adapters (PN 16605 and PN 16606)
The instructions provided above have been validated by the manufacturer of the medical device. It remains the
responsibility of the processor to ensure that the reprocessing as actually performed using equipment, materials and
personnel in the reprocessing facility achieve the desired result. This normally requires validation and routine monitoring
of the process.
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Recommended Periodic Maintenance
CareFusion is committed to product support. If you have any questions concerning your ventilator’s operation or
maintenance contact your product support representative as shown in Appendix A, Contact Information.
The batteries should undergo discharge/charge cycling quarterly (every three months).
A Preventive Maintenance service should be performed on your AVEA ventilator once per year. Call CareFusion,
Customer Care, at the number given in Appendix A to arrange for a qualified Service Technician to perform this.
WARNING
Electric shock hazard - Do not remove any of the ventilator covers or panels. Refer all servicing to a service
technician authorized by CareFusion.
The annual maintenance will include the following.
Replacement of:

The Air inlet Filter

The Oxygen Inlet Filter

The Compressor Inlet Filter (on compressor equipped models)

The Compressor Outlet Filter (on compressor equipped models)

The Exhalation Diaphragm.
At this time the following maintenance will be performed:

Removal and replacement of the above items

Verification that the following transducers are within calibration specifications:

Air

O2

Blended Gas

Expiratory

Inspiratory

Exhaled Flow delta

Wye flow delta

Auxiliary

Esophageal

Replacement of the O2 Sensor

Verification Testing to confirm the ventilator is functioning within optimum parameters.

Screen Calibration

Calibration of the Capnostat

Battery Performance Verification
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Every two years the following is recommended to be replaced:

Internal Batteries

External Batteries
AVEA Maintenance should only be performed by a trained and authorized service technician. CareFusion will make
available to qualified technicians, service manuals, which include such items as circuit diagrams, component parts lists,
calibration instructions and other information to assist in repair of those parts of the ventilator designated by the
manufacturer as repairable items.
WARNING
If a mechanical or electrical problem is recognized while operating the ventilator, the ventilator must be
removed from use and referred to qualified personnel for servicing.
Using an inoperative ventilator may result in patient injury.
Battery Care
The AVEA has an internal, Nickel Metal Hydride battery pack that will provide power
backup for short periods in the event that the mains power supply is lost (Figure 8–1).
Under normal operating conditions and when fully charged, the internal battery is capable
of powering the ventilator alone for 1 hour or the ventilator and compressor for 30
minutes.
Figure 8–1: Internal Battery Pack
Note:
The internal battery is intended only for short duration backup in the event of disruptions in line power. The internal
battery provides 30 minutes of battery power for the ventilator and compressor nominally. The recharging cycle for this
battery can be 4 hours or more depending on the state of discharge. Should you wish to perform intra-facility transport
of patients you should equip your instruments with the optional external battery. The addition of the external battery will
extend the time period to 2 hours for ventilator and compressor.
CareFusion recommends that when used in transport situations the expected transport time should not be greater than
50% of the usable battery life. This provides a safety margin in the event of schedule delays or premature consumption
of the battery power. Should the expected transport time be delayed beyond this, a dedicated transport system should
be considered. As with any patient transport, suitable manual ventilation backup should be available.
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CAUTION
Prior to operating on battery power, the internal (and external if connected) battery indicator(s) should be green. The
ventilator should be connected to a mains AC power supply until the battery indicator(s) show green prior to operating
on battery power.
An optional sealed lead-acid (SLA) external battery pack is also available. This can significantly extend the operating
period of the ventilator when it is not connected to an AC source. Under normal operating conditions, fully charged
external and internal batteries combined are capable of powering the ventilator and compressor for a period equal to or
greater than 2 hours, and the ventilator on wall air for a period equal to or greater than 4 hours.
Both battery types are re-chargeable and require some maintenance when installed.
The internal battery should be discharged and recharged approximately once every three months.
The external battery should be discharged and recharged approximately once every twelve months.
The Battery Status Indicators on the front panel enable you to monitor the battery charge remaining (see “Chapter 7:
Alarms and Indicators”).
CAUTION
Should your internal battery require replacement, contact your CareFusion representative. Do NOT attempt to replace
the battery yourself. The battery should only be replaced by a qualified technician.
Precedence of power use
The sequence in which the power sources are used by the ventilator is:
1. AC
2. External Battery (if installed)
3. Internal Battery
CAUTION
Do not store the ventilator in hot areas for prolonged periods of time. Temperatures above 80°F (27 °C) can shorten
battery life. Failing to charge the ventilator while in storage may also shorten battery life.
CAUTION
When the integrity of the external power ground conductor arrangement is in doubt, operate the ventilator from its
internal battery or the optional external battery.
Note: Refer to the Service Manual for battery maintenance and testing procedures.
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Battery Status
Battery status indicators showing the state of charge of the internal and external batteries appear on the front panel of
the ventilator (Figure 8–2).
Green
Yellow
Red
Figure 8–2: Front Panel Display Area. Comprehensive model shown.
If the battery charge is allowed to drop below the low range of the battery monitor, a battery status indicator LED may no
longer be displayed. The unit should be plugged into the AC power supply to allow the batteries to re-charge. When the
battery voltage becomes large enough to power the battery monitor, the battery status indicators will display.
Failure to charge
If the internal batteries do not show significant recharge after being reconnected to an AC power source for four hours
contact your technical support representative as shown in Appendix A to arrange for replacement. Total time to recharge
depends on the extent of battery depletion and ventilator usage while charging is taking place.
Note:
The batteries in a ventilator that is not in use and not connected to AC, will continue to slowly discharge. A fully
charged battery may reach a deep discharge state due to self-discharge. However, even with a fully charged battery, if
the ventilator is unplugged from AC for more than 4 hours, the internal battery status indicator will display red indicating
a low battery condition. In this condition the ventilator should be plugged into an AC outlet for 10-12 minutes to restore
the battery to the correct charge state.
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Fuses
The AVEA has the following replaceable fuses associated with internal DC, external DC and AC power sources.
WARNING
Do not remove or replace fuses or perform any maintenance tasks on the ventilator while your patient is
connected. Always perform these tasks “off patient”.
Battery Fuses
The internal and optional external battery fuses are 10A, 250V (5 x 20 mm) fast blow type.
The fuse for the optional external battery is located on the back panel next to the external battery connector and is
replaceable. The fuse for the internal battery is located to the right of the UIM connection. To remove fuses, carefully
unscrew with a flat blade screwdriver and pull out the fuse holder.
External Battery Fuse Holder
External Battery Connector
Figure 8–3: External Battery Connector and Fuse
WARNING
To avoid fire hazard, use only the fuse specified in the ventilator’s parts list or one that is identical in type,
voltage rating, and current rating to the existing fuse.
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Mains Fuses
The main AC power fuses are housed within the power entry module located on the back panel. They are slow blowtype. Check that the correct voltage for your mains supply is showing through the window in the power entry module.
Table 8–1: Mains fuses
Line Voltage
Fuse
Amperage
100/120VAC
250V 6.35 x 31.75mm
3.2A
230/240VAC
250v 6.35 x 31.75mm
1.5A
Replacing a Mains Electrical Fuse
WARNING
Ensure that the mains power cord is unplugged before attempting to remove or replaces fuses.
To replace mains electrical fuses:
1. Unplug the ventilator from the mains AC power source and unplug the power cord from the power entry module on
the rear of the ventilator.
2. Using a small flat blade screwdriver, pry open the cover of the power entry module.
3. Carefully ease the red fuse holder out of the power entry module.
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4. The fuse holder contains two fuses, 3.1 amps (for 100/120 volt lines) and 2.0 amps (for 230/240 volt lines) as shown
in Table 8–1.
5. Replace the failed fuse in the fuse holder with a fuse whose type, voltage rating, and current rating is identical to the
fuses supplied from the factory.
6. Carefully replace the red fuse holder into the power entry module. Check to ensure that the correct line voltage is
uppermost as you re-insert the fuse holder into the power entry module.
7. Close the power entry module cover and check to make sure that the correct voltage is displayed through the
window.
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Appendix A: Contact and Ordering Information
How to Call for Service
To get help on performing any of the preventive maintenance routines, or to request service on your ventilator, contact
CareFusion:
Technical and Clinical Support
Hours: 6:30 AM to 4:30 PM (PST) Monday through Friday
Phone: (800) 231-2466
Fax:
(714) 283-8471
After hours service:
Phone:(800) 231-2466 from within the US and select option 2.
CareFusion Customer Care Helpline
Hours:
24 hours, seven days a week
Phone: (800) 231-2466 from within the United States
Online service for warranty replacements parts can be found at
carefusion.com
Select “Warranty Form” from the choices on the left of the screen.
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Ordering Parts
To obtain AVEA Ventilator parts, contact CareFusion customer service at:
Hours:
7:00 Am to 4:30 PM (PST)
Monday through Friday
Phone:
(800) 328-4139
(760) 778-7200
Fax:
(760) 778-7274
Accessories
Neonatal Accessories
CareFusion Part
Number
50000-40038
51000-40098
Description
Quantity
Neonatal disposable flow sensor
10
Neonatal disposable flow sensor
1
External Battery Option
To add the external battery option to your AVEA, you will need to order the following parts:
CareFusion Part
Number
33977
Description
Quantity
External Battery Tray Assembly
1
16217
External Battery Wire Harness
1
16179
AVEA External Battery
2
Other Replacement Parts and Accessories
CareFusion Part
Number
Description
71667
Internal/External Battery Fuse
71612
100/120 VAC Mains Power Supply Fuse
56000-20064
230/240 VAC Mains Power Supply Fuse
33978
51000-40640
Gas Tank Rack Assembly
Filter Cartridge
11590
Disposable Expiratory Filter/Water Trap (case of 12)
11556
Disposable Water Trap (case of 12)
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Appendix A: Contact and Ordering Information
Advanced Physiologic Monitoring Parts and Accessories
CareFusion Part Number
Description
10635
5 French Tube Set, Single-patient Use (10 pack)
50000-40040
AVEA VarFlex Tracheal Pressure Monitor Extension Tubing, Box of 10
50000-40034
AVEA Adaptor, Tracheal Pressure Monitoring Tube Set, 5 Fr, Box of 10
7003100
AVEA Esophageal Pressure Monitoring Tube set, 8 Fr, Adult Box of 10
7003401
AVEA Esophageal Pressure Monitoring Tube Set,6 Fr, Pediatric Box of 10
50000-09920
AVEA Extension Esophageal Pressure Monitoring Tube, Box of 10
50000-09960
Single-use Extension Esophageal Pressure Monitoring Tube Set
7003300
AVEA Nasogastric Pressure Monitoring Tube Set, 16 Fr, Adult Box of 10
7003402
AVEA Nasogastric Pressure Monitoring Tube Set, 7 Fr Pediatric Box of 10
Capnography Parts and Accessories
CareFusion Part Number
27695-001
Description
Reusable CO2 Sensor (box of 1)
16605
Single-Patient Use Adult/Pediatric Airway Adapters (box of 10)
16606
Single-Patient Use Neonatal Airway Adapters (box of 10)
16607
Reusable Adult/Pediatric Airway Adapter (box of 1)
16608
Reusable Neonatal Airway Adapter (box of 1)
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Appendix B: Specifications
Pneumatic Supply
Air or Heliox Supply
Pressure Range:
20 to 80 psig (1.4 to 5.5 bar)
(Supply Air)
20 to 80 psig (1.4 to 5.5 bar)
(Supply Heliox – 80% / 20% Heliox only)
3 to 10 psig (0.2 to 0.7 bar)
(Compressor Air)
Temperature:
5 to 40º C (41 to 104º F)
Humidity:
Dew Point of gas should be 1.7º C (3º F) below the ambient temperature (minimum)
Minimum Flow:
80 L/min at 20 psig (1.4 bar)
Air Inlet Fitting:
CGA DISS-type body, No. 1160. NIST fitting per BS-5682:1984 (Air) also available.
Heliox Inlet Fitting: CGA DISS-type body, No. 1180. NIST fitting per BS-5682:1984 (Heliox) also available.
Oxygen Supply
Pressure Range:
20 to 80 psig (1.4 to 5.5 bar)
(Supply Oxygen)
Temperature:
5 to 40º C (41 to 104º F)
Humidity:
Dew Point of gas should be 1.7º C (3º F) below the ambient temperature (minimum)
Minimum Flow:
80 L/min at 20 psig (1.4 bar)
Inlet Fitting:
CGA DISS-type body, No. 1240. NIST fitting per BS-5682:1984 (O2) also available.
Electrical Supply
AC Power Supply
The ventilator operates within specification when connected to the following AC power supplies:
Nominal
Voltage Range
Frequency Range
100 VAC
(85 to 110 VAC)
47 to 65 Hz
120 VAC
(102 to 132 VAC)
55 to 65 Hz
230 VAC
(196 TO 253 VAC)
47 to 65 Hz
240 VAC
(204 TO 264 VAC)
47 to 65 Hz
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DC Power Supply
The ventilator can also operate from a 24 VDC power source (internal or external battery).
Internal Battery:
The Internal Battery requires a minimum charge time of 4 hours to achieve a full charge. Under normal operating
conditions, the internal battery is capable of powering the ventilator alone for 1 hour and powering the ventilator and
compressor for 30 minutes when fully charged. The ventilator should be connected to a main A/C supply and charged for
at least 4 hours prior to switching to battery power.
External Battery: 22.0 to 26.4 VDC
Under normal operating conditions, fully charged external and internal batteries combined are capable of powering the
ventilator and compressor for a period of time equal to or greater than 2 hours and the ventilator alone for a period of
time equal to or greater than 7 hours. With a discharged battery the ventilator should be connected to a main AC supply
and charged for at least 12 hours to ensure a full charge.
Data Input / Output
Independent Lung Ventilation (ILV)
The ventilator provides an output (master) and an input (slave) for synchronization of ventilators. The output supplies a
5 VDC logic signal synchronized to the breath phase of the master via a 25-pin connector on the rear of the ventilator.
The pin configuration for this connector is as follows:
PIN
FUNCTION
1
Analog Input Channel 0
14
Analog Input Channel 1
18
ILV In
6
ILV Out
20
Factory Use Only, DO NOT CONNECT
22
Analog Output, PRESSURE
23
Analog Output, FLOW
24
Analog Output, VOLUME
25
Analog Output, BREATH PHASE
5,9,10,11,12,13
Ground, Analog
Note:
At least one analog ground is required for safe and accurate signal output and input.. One analog ground is sufficient
for any and all of the other signals.
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Analog Inputs
The ventilator provides 2 programmable channels for analog signal inputs as shown above. Each channel is scalable for
the input ranges specified.
Ranges:
0 to 1 VDC
0 to 5 VDC
0 to 10 VDC
Resolution: 0.25 mV
(for 0 to 1 VDC)
1.37 mV
(for 0 to 5 VDC)
2.5 mV
(for 0 to 10 VDC)
Analog Outputs
The ventilator provides 4 signals to the analog output connector:
1. Airway Pressure, PAW:
Range:
-60 to 140 cmH2O
Scale:
1 cmH2O/25 mV
Accuracy:
± 50 mV or ± 5% of reading, whichever is greater
Zero Offset: 1.5 VDC at 0 cmH2O
2. Flow
Inspiratory/Expiratory:
When selected, the ventilator provides a continuous analog voltage representative of inspiratory flow minus
expiratory flow.
Range:
-300 to 200 L/min (Adult)
-120 to 80 L/min (Pediatric)
-60 to 40 L/min (Neonate)
Scale Factor: 1 L/min / 10 mV (Adult)
1 L/min / 25 mV (Pediatric)
1 L/min / 50 mV (Neonate)
Accuracy:
± 10% of reading or ± 30 mV, whichever is greater
Zero Offset: 3.0 VDC at 0 L/min
Machine:
When selected, the ventilator provides a continuous analog voltage representative of machine delivered flow.
Range:
0 to 200 L/min (Adult)
0 to 100 L/min (Pediatric)
0 to 50 L/min (Neonate)
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Scale Factor: 1 L/min / 25 mV (Adult)
1 L/min / 50 mV (Pediatric)
1 L/min / 100 mV (Neonate)
Accuracy:
± 10% of reading or ± 30 mV, whichever is greater
Zero Offset: None
3. Volume
Range:
-1.00 to 4.00 L (Adult)
-200 to 800 ml (Pediatric)
-100 to 400 ml (Neonate)
Scale Factor: 1 L / V (Adult)
1 ml / 5 mV (Pediatric)
1 ml / 10 mV (Neonate)
Accuracy:
 10% of reading or  30 mV, whichever is greater
Zero Offset: 1.000 VDC
4. Breath Phase
The ventilator provides a continuous analog voltage representative of breath phase (Inspiration = 5 VDC, Expiration
= 0 VDC).
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Digital Communication
RS 232 Output
Sets the RS 232 output format for digital communications via the port labeled MIB.
The RS-232 output configuration provides the following setting choices:
Generic
This interface is available in AVEA software versions 3.3 and greater. The AVEA GSP Interface Kit is part number 16375 and
includes a CAT–5 cable and a 9-pin adaptor.
Select 8, N, 1 and Baud Rates of: 9600, 2400, 4800, 9600, 19200, 38400, 57600 or 115200
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or
Select CR/LF or CR Only
VueLink
AVEA software versions 3.1 and greater can be interfaced with the Phillips Vue–Link system. The part number of the Vue-Link
CAT–5 serial cable and adaptor is 16337.
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VOXP (Ventilator Open XML Protocol)
AVEA software versions 3.7 and greater support VOXP. The AVEA VOXP Interface kit is part number 16375 and includes a
CAT–5 cable and a 9-pin adaptor.
Select either 8,N,1 / 7,N, 1 / 7, E, 1 or 7, 0, 1 and Baud Rates of: 9600, 19200, 38400, 57600, 115200
The ventilator has two RS-232 ports installed for bi-directional communication of data: RS-232 Ch1 is currently used for
software updates as well as data communications to external systems.
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VOXP Communications Requirements
Communication is established between a ventilator and an external system with a properly configured set of system-level
items from physical cables, adapters, and communication parameters to application protocols. A detailed description of
the interface is available in a separate specification, Consolidated VOXP Specification, part number L3058, Revision A,
or later.
To ensure proper operation of the ventilator, there is an important limitation to the implementation of the interface with
external devices. Waveforms should not be selected at baud rate settings less than 57600, and no more than 3
waveforms should be selected at baud rates of 57600 and higher. Waveform transmission requires high speed
communications, and problems can occur if waveforms are requested at lower baud rates, or if too many waveforms are
requested at high baud rates.
WARNING
To ensure proper operation of the ventilator, external device communications using waveforms must follow
the recommendations in Consolidated VOXP Specification, part number L3058, Revision A, or later. The MIB
port must be connected to a device that meets the IEC60601–1 standard.
Printer
The ventilator has a standard 25-pin female Centronics parallel printer port for interfacing to an external printer.
Remote Nurse Call
The ventilator has a modular jack configured to interface with external systems that are either wired for normally open
(N.O., close on alarm) or normally closed (N.C., open on alarm) signals.
In the active state, the remote alarm can sink 1.0 A.
Video Output
The ventilator provides a video output connector, which allows for interfacing to an externally located 256-color, 800 x
600, SVGA monitor. The Video Output is always enabled.
Alarm Loudness
Volume Control Level
Alarm Loudness
Maximum
Not greater than 75 dB
Minimum
Greater than 47 dB
Language Support
The list of selectable languages on the AVEA are English, Chinese, Czech, Dutch, French, German, Greek, Hungarian, Italian,
Japanese, Polish, Portuguese, Russian, Spanish, and Turkish.
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Atmospheric and Environmental Specifications
Temperature and Humidity
Storage
Temperature:
20 to 60º C (4 to 140º F)
Humidity:
Operating
0 to 95% RH non-condensing
Temperature:
5 to 40º C (41 to 104º F)
Humidity:
0 to 95% RH non-condensing
Barometric Pressure
Barometric pressure is measured by an internal barometer automatically. This data is displayed as a monitor value on
the setup screen.
Range: 760 to 545 mmHg
Physical Dimensions
Overall Size
Ventilator
17” W x 16” D x 10.5” H or (43.2 cm X 40.6 cm X 26.7 cm)
UIM
16.25” W x 2.5” D x 13.75” H (41.3 cm X 6.4 cm X 34.9 cm)
Weight
Ventilator w/ UIM no compressor
< 73 lbs. (33.1 kg)
Ventilator w/UIM and Compressor < 80 lbs (36.3 kg)
Accessories
Pall Microbial Filter
Resistance
The exhalation filter supplied with your AVEA ventilator is manufactured by Pall Medical of Ann Arbor, MI, USA. The
published maximum resistance of this filter is 4cmH2O at 100 L/min for the 725 filter.
Compliance
The compliance for the filter is < 0.4 ml/cmH2O.
Materials
Materials used in the construction of the filter have passed USP Class VI 121° C Plastic and Cytotoxicity test.
For further information please contact Pall Medical.
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Water Trap
Resistance
The resistance of the internal exhalation water trap assembly including the collection bottle is < 0.5 cmH2O at 50 L/min.
Compliance
The compliance of the internal exhalation water trap assembly including the collection bottle is < 0.2 ml/cmH2O.
AVEA Disposable Expiratory Filter / Water Trap
SPECIFICATIONS
Viral and Bacterial Filtration Efficiency (VFE and
BFE):
Greater than 99.999%
Particle Filtration Efficiency (PFE):
99.97% of 0.3 Tm nominal particle size at 60 L/min flow
Inlet Connector:
22 mm male with a 15 mm female conical connector
Outlet Connector:
22 mm male with a non-standard size female conical connector
Resistance to Flow:
Less than 1.0 cmH2O at 60 L/min when new
Flow leakage:
Less than 0.01 L/min at 140 cmH2O internal pressure
Size:
9.7 cm diameter, 33 cm tall (3.8 inches diameter, 13 inches tall)
Plastic material:
Polystyrene
Internal volume:
Approximately 500 mL
Compliance:
Less than 0.5 mL/cmH2O
Condensate Water Trap capacity:
Approximately 130 mL (up to Maximum Fill Line)
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Appendix C: Pneumatic Diagram
Gas Delivery Engine
The Gas Delivery Engine receives and conditions supplied Oxygen and Air from external and/or internal (compressor) sources. It
then mixes the gas to the concentration required and delivers the desired flow, or pressure to the patient.
The Gas Delivery Engine begins with the Inlet Pneumatics. The Inlet Pneumatics accepts clean O2, or Air; it provides extra
filtration and regulates air and O2 gas before entering the Oxygen Blender. The Oxygen Blender mixes the gases to the desired
concentration before reaching the Flow Control Valve. The Flow Control Valve controls the flow rate of the gas mixture to the
patient. Between the Oxygen Blender and Flow Control Valve, the Accumulator System is installed to provide peak flow capacity.
The Flow Sensor provides information about the actual inspiratory flow for closed loop servo control. The gas is then delivered to
the patient through the Safety/Relief Valve and Outlet Manifold.
Compressor
Flow
(Optional)
Air
Oxygen
Inlet
Pneumatics
Oxygen
Blender
Figure C1 Gas Delivery Engine
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Accumulator
System
Flow Control
Valve
Flow Sensor
Safety/Relief
Valve &
Manifold
Patient
Flow
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Appendix D: Monitor Ranges and Accuracies
DISPLAY
DESCRIPTION
RANGE
ACCURACY
VOLUME MONITORS
The volume measured during the inspiratory phase of the breath is accumulated as the inspired tidal volume, and the volume
measured during the exhalation phase is accumulated as the exhaled tidal volume. This volume does not include the volume
delivered by the Circuit Compliance Compensation function for volume breaths.
Vte
Exhaled tidal volume. Exhaled volume readings are
measured by the expiratory flow sensor. This
reading may be affected by the humidifier setting in
the ventilator. When using a proximal flow sensor,
the VTe is measured as the expiratory flow goes
away from the patient at the point of insertion of the
sensor (between the patient interface and the wye)
0 to 4 L
Exhaled tidal volume adjusted for patient weight
0 to 4 ml/kg
Inspired tidal volume. VTi is measured by the
inspiratory flow sensor inside the ventilator and
reflects the volume without compensating for tubing
compliance. It is a calculation of the difference
between the flow delivered and the flow exhaled
during inspiration. When using a proximal flow
sensor, the VTi is measured as the inspiratory flow
(translated into volume) goes to the patient at the
point of insertion of the sensor (between the patient
interface and the wye).
0 to 4 L
Inspired tidal volume adjusted for patient weight
0 to 4 ml/kg
Spontaneous tidal volume. A zero (0) Spont Vt
indicates the most recent breath was not a
spontaneous breath. It is an instantaneous value.
0 to 4 L
Spon Vt/kg
Spontaneous tidal volume adjusted for patient
weight
0 to 4 ml/kg
Mand Vt
Mandatory tidal volume. Displayed as a rolling
average of either 8 breaths or one minute,
whichever occurs first.
0 to 4 L
(± 20ml + 10% of reading)-Adult machine
sensor
(± 1 ml + 10% of reading)-Neonate wye
sensor
Vte/kg
Vti
Vti/kg
Spon Vt
(± 20ml + 10% of reading)-Adult machine
sensor
(± 1 ml + 10% of reading)-Neonate wye
sensor
(± 20ml + 10% of reading)-Adult machine
sensor
(± 1 ml + 10% of reading)-Neonate wye
sensor
(± 20ml + 10% of reading)-Adult machine
sensor
(± 1 ml + 10% of reading)-Neonate wye
sensor
Mand Vt/kg
Mandatory tidal volume adjusted for patient weight
0 to 4 ml/kg
Derived
Vdel
Total delivered machine volume measured by the
ventilator’s inspiratory flow sensor. This value will
be greater than the VTi if tubing compliance
compensation is active.
0 to 4L
(± 20ml + 10% of reading)-
% Leak
Percent leakage. The difference between the
inspired and exhaled tidal volumes in terms of %
difference.
Derived
Derived
Minute Volume. Volume of gas exhaled by the
patient during the last minute.
0 to 99.9 L
Derived
Minute volume adjusted for patient weight
0 to 999 ml/kg
Derived
Spontaneous minute volume.
0 to 99.9L
Derived
Spontaneous minute volume adjusted for patient
weight
0 to 999ml/kg
Derived
Breath Rate.
0 to 200 bpm
± 3% or ± 2 bpm whichever is greater
Spontaneous breath rate. Reflects spontaneous
rate for the last minute.
0 to 200 bpm
± 3% or ± 2 bpm whichever is greater
Ve
Ve/kg
Spon Ve
Spon Ve/kg
RATE/TIME MONITORS
Rate
Spon Rate
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DISPLAY
DESCRIPTION
RANGE
Ti
Inspiratory time.
0.00 to 99.99
sec
± 0.03 sec
Te
Exhalation Time.
0.00 to 99.99
sec
± 0.03 sec
I:E
Inspiratory/expiratory ratio
Note: Not active for demand breaths.
1:99.9 to
99.9:1
Derived from accuracies for monitored Ti
and Te
Description
Range
Accuracy
Rapid shallow breathing index.
0 to 500
b2/min/L
Derived from accuracies for spontaneous
breath rate and spontaneous minute
volume
Display
f/Vt
ACCURACY
PRESSURE MONITORS
Ppeak
Peak inspiratory pressure.
Not active with spontaneous breaths
0 to 120
cmH2O
 3.5% of reading or  2 cmH2O,
whichever is greater
Pmean
Mean airway pressure.
0 to 120
cmH2O
 3.5% of reading or  2 cmH2O,
whichever is greater
Pplat
Plateau pressure. If no plateau occurs, then the
monitor displays * * *
0 to 120
cmH2O
 3.5% of reading or  2 cmH2O,
whichever is greater
PEEP
Positive end expiratory pressure.
0 to 60 cmH2O
 3.5% of reading or  2 cmH2O,
whichever is greater
Air Inlet
Air inlet gas supply pressure.
0 to 80 psig
 5 psig (1.4 – 5.5 bar)
O2 Inlet
Oxygen inlet gas supply pressure.
0 to 80 psig
 5 psig (1.4 - 5.5 bar)
Pbaro
Barometric pressure
760 to 545
mmHg or 101
to 72.7 kPA
 2% of full scale
0 to 100%
 3%
0 to 300
ml/cmH2O
Derived
GAS COMPOSITION MONITORS
FIO2
Delivered percent O2.
MECHANICS
Cdyn
Dynamic Compliance (CDYN and CDYN / Kg),
absolute and normalized to patient weight.
Cdyn/Kg
Cstat
Cstat/Kg
0.00 to 5.00
ml/cmH2Okg
Respiratory System Compliance (CRS), (a.k.a.
Static Compliance CSTAT), absolute and normalized
to patient weight.
Note: This requires an Inspiratory Hold maneuver.
0 to 300
ml/cmH2O
Derived
0.00 to 5.00
ml/cmH2Okg
Rrs
Respiratory system resistance.
Note: Calculation is performed during an Inspiratory
Hold maneuver.
0 to 100
cmH2O/L/sec
Derived
PIFR
Peak Inspiratory flow rate.
0 to 300 L/min
(All patients)
 10% of setting or  (0.2 L/min + 10%
of setting), whichever is greater
PEFR
Peak Expiratory flow rate.
0 to 300 L/min
(All patients)
 10% of setting or  (0.2 L/min + 10%
of setting), whichever is greater
Ccw
The ratio of the tidal volume (exhaled) to the Delta
Esophageal Pressure (dPES). Requires an
esophageal balloon.
0 to 300
mL/cmH2O
+ 10%
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Display
Appendix D: Monitor Ranges and Accuracies
Description
Range
Accuracy
CLUNG
The ratio of the tidal volume (exhaled) to the delta
transpulmonary pressure. The delta
transpulmonary pressure is the difference between
the airway plateau pressure (during an inspiratory
pause) and esophageal pressure (at the time the
airway plateau pressure is measured) minus the
difference between the airway and esophageal
baseline pressures. Requires an inspiratory hold
and esophageal balloon.
0 to 300
mL/cmH2O
+ 10%
C20 / C
The ratio of the dynamic compliance during the last
20% of inspiration (C20) to the total dynamic
compliance (C).
0.00 to 5.00
+ 10%
Display
Description
Range
Accuracy
RRS
The total resistance during the inspiratory phase of
a breath. Respiratory System Resistance is the
ratio of the airway pressure differential (peak –
plateau) to the inspiratory flow 12 ms prior to the
end of inspiration. Requires an inspiratory hold.
0 to 100
cmH2O/L/sec
+ 10%
RPEAK
The Peak Expiratory Resistance (RPEAK), is defined
as the resistance at the time of the Peak Expiratory
Flow (PEFR).
0.0 to 100.0
cmH2O/L/sec
+ 10%
RIMP
The airway resistance between the wye of the
patient circuit and the tracheal sensor. Requires an
inspiratory hold and tracheal monitoring tube.
0.0 to 100.0
cmH2O/L/sec
+ 10%
RLUNG
The ratio of the tracheal pressure differential (peak
– plateau) to the inspiratory flow 12 ms prior to the
end of inspiration. Requires an inspiratory hold and
tracheal monitoring tube.
0.0 to 100.0
cmH2O/L/sec
+ 10%
dPAW
The difference between peak airway pressure
(PPEAK AW) and baseline airway pressure (PEEPAW).
120 to 120
cmH2O
+ 2 cm H2O or + 5% whichever is greater
dPES
The difference between peak esophageal pressure
(PPEAK ES) and baseline esophageal pressure
(PEEPES).
120 to 120
cmH2O
+ 2 cm H2O or + 5% whichever is greater
AutoPEEP
The airway pressure at the end of an expiratory
hold maneuver. Requires a passive patient.
0 to 50 cmH2O
+ 2 cm H2O or + 5% whichever is greater
dAutoPEEP
The difference between airway pressure at the end
of an expiratory hold maneuver and the airway
pressure at the start of the next scheduled breath
after the expiratory hold maneuver. Requires a
passive patient.
0 to 50 cmH2O
+ 2 cm H2O or + 5% whichever is greater
AutoPEEPES
The difference between esophageal pressure
measured at the end of exhalation (PEEPES) minus
the esophageal pressure measured at the start of a
patient-initiated breath (PES start) and the sensitivity
of the ventilator’s demand system. The sensitivity
of the ventilator’s demand system is the difference
between the baseline airway pressure (PEEPAW)
and the airway pressure when the patient initiates a
breath (PAW start). Requires an esophageal balloon.
0 to 50 cmH2O
+ 2 cm H2O or + 5% whichever is greater
Ptp Plat
Transpulmonary pressure during an inspiratory
hold, which is the difference between the airway
plateau pressure (PPLAT AW) and the corresponding
esophageal pressure. Requires an inspiratory hold
and esophageal balloon.
60 to 120
cmH2O
+ 2 cm H2O or + 5% whichever is greater
L2786 Version T
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216
Appendix D: Monitor Ranges and Accuracies
Operator's manual
Display
Description
Range
Accuracy
Ptp PEEP
The difference between the corresponding airway
and esophageal pressures at the end of the
expiratory hold during an AutoPEEP maneuver.
Requires an inspiratory hold and esophageal
balloon.
60 to 120
cmH2O
 2 cmH2O or  5%, whichever is greater
MIP
The maximum negative airway pressure that is
achieved by the patient, during an expiratory hold
maneuver.
60 to 120
cmH2O
 2 cmH2O or  5%, whichever is greater
P100
The negative pressure that occurs 100 ms after an
inspiratory effort has been detected.
60 to 120
cmH2O
 2 cmH2O or  5%, whichever is greater
Description
Range
Accuracy
WOBV
The summation of airway pressure (PAW) minus the
baseline airway pressure (PEEPAW) times the
change in tidal volume to the patient (V) during
inspiration, and normalized to the total inspiratory
tidal volume (Vti).
0.00 to 20.00
Joules/L
+ 10%
WOBP
Patient Work of Breathing (WOBP), normalized to
the total inspiratory tidal volume. Patient work of
breathing is defined as the summation of two work
components: work of the lung and work of the chest
wall. Requires an esophageal balloon.
0.00 to 20.00
Joules/L
+ 10%
WOBI
The work performed by the patient to breathe
spontaneously through the breathing apparatus, i.e.
the E.T. tube, the breathing circuit, and the demand
flow system. Requires a tracheal monitoring tube.
0.00 to 20.00
Joules/L
+ 10%
Display
Note:
Monitored values are displayed as BTPS
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AVEA ventilator systems
Appendix E: Sensor and Circuit Specifications
VarFlex® Sensor Specifications
Table E.1 Varflex Flow Sensor Specifications
Sensor
Infant 15 mm
Adult 15 mm
Part Number
Type
Circuit Location
Performance Specifications
Flow Range
Diff Pres Range
Accuracy*
Resistance
Dead Space
Freq. Response**
Airway Pres Range
Calibration (EEPROM)
Linearity
Operating Temperature
7002500
Single Use
Wye
7002300
Single Use
Wye
0.024 to 30 L/min
± 5.72 cmH2O
± (0.012 L/min + 5% or reading
4.5 cmH2O @ 30 L/min
0.7 ml installed
17 Hz
-140 to 140 cmH2O
29 Point Curve
< 1% between points
5° to 40° C
41° to 104° F
1.2 to 180 L/min
± 5.72 cmH2O
± (0.1 L/min + 5% or reading
2.4 cmH2O @ 60 L/min
9.6 ml installed
26 Hz
-140 to 140 cmH2O
29 Point Curve
< 1% between points
5° to 40° C
41° to 104° F
1.36 in (3.5 cm)
15 mm OD
15 mm OD
48 in (121.9 cm)
Bicore Proprietary
22 g (0.7 oz)
Single Patient Use
NA
Sensor – Lexan
Flap – Mylar
Tubing – PVC
Connector - ABS
2.45 in (6.2 cm)
15 mm OD
15 mm OD
73 in (185.4 cm)
Bicore Proprietary
31 g (1.0 oz)
Single Patient Use
NA
Sensor – Lexan
Flap – Mylar
Tubing – PVC
Connector - ABS
Physical Specifications
Sensor Length
Diameter Insp (Vent Side)
Diameter Exp (Patient)
Tube Length
Connector
Weight
Service Life
Sterilization
Material
L/min: Dry air at 77° F (25° C) and 14.7 psig barometric pressure.
* Includes ± 1% for linearity and hysteresis with no zero drift for the pressure transducer and ± 2 % for temperature and
humidity variations.
The sensor must be corrected for barometric pressure, and oxygen concentration.
** Frequency Response is signal attenuation to 0.707 input and assumes 100 Hz sample rate.
L2786 Version T
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Appendix E: Sensor and Circuit Specifications
Operator's manual
Hot Wire Flow Sensor Specifications
Table E-2 Hot wire sensor specifications
Part Number
Type:
Circuit Location:
Performance Specifications
Flow Range:
Vol. Accuracy:
Flow Resistance:
Dead Space:
Freq. Response*:
Calibration:
Linearity:
Operating Temperature:
Physical Specifications
Sensor length
Diameter Insp (Vent Side)
Diameter Exp (Patient Side)
Tube length
Connector
Weight
Service Life
Sterilization
Materials
16465
Multiple use heated wire
Wye
0 (+/- 0.002) to 30 L/min
+/-10%
6 cmH2O @ 20 L/min
0.8 mL
16 Hz
36 point curve
< 2%
5 to 40oC
1.68”
15 mm OD
15 mm OD
N/A
Pin and Socket type
< 10g (not including wire)
25 cycles
Steam Autoclave
Sensor - Delrin
Wire – Platinum
Screen – Stainless Steel 304 or 316
Pin – PhBz, gold over nickel plated
Spacer - Delrin
L2786 Version T
AVEA ventilator systems
Appendix E: Sensor and Circuit Specifications
219
Circuit Resistance Test
The resistance of a neonatal patient circuit should be tested for proper functionality of the ventilator for neonatal patient
size applications. Excessive circuit resistance under these circumstances may result in triggering a Circuit Occlusion
Alarm.
This resistance test applies to all neonatal applications except nCPAP.
1. To measure the resistance of the breathing circuit, set-up the system as follows:
Mode
TCPL AC
Flow Correction
ATPD (Set in utility screen, configuration tab)
Rate
4
Inspiratory Pressure
10 cmH2O
Peak Flow
15 L/min
Inspiratory Time
3.0 sec
PEEP
0 cmH2O
Flow Trigger
20 L/min
Pressure trigger
20 cmH2O
% O2
21 % (no Heliox)
Bias Flow
2 L/min
Humidifier
Dry chamber inline, humidifier power off
Patient circuit
Clean and dry
Expiratory Filter
Installed, clean and dry
Test Lung
Not used, block the wye
2. Select waveforms Pinsp and Paw.
3. With the patient wye blocked, allow a TCPL breath to occur, and then press the FREEZE key and scroll the Cursor
Line with the data dial until it is positioned in the middle of the inspiration portion of the breath.
4. Read the pressure from the Pinsp and Paw waveforms from the Cursor Line data.
5. Subtract Paw from Pinsp. Pinsp – Paw = X cmH2O
6. The resulting pressure difference (X cmH2O) must not exceed 3.1cmH2O at a flow of 15 L/min, and there must not
have been an occlusion alarm active for that breath.
7. Reset the “Flow Correction” setting in the Utility screen to “BTPS” (normal setting for patient use).
Note:
We do not recommend using a neonatal circuit in a pediatric patient size application.
Circuit Compatibility
The following circuits have been validated for use with the AVEA ventilator:
 Fisher & Paykel Healthcare- RT240, RT131, RT136, and RT236
 AirLife- RT110, RT500, RT509, RT4851
 Hudson- 780-36, 780-10, 780-24
L2786 Version T
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Appendix E: Sensor and Circuit Specifications
Operator's manual
Volumetric Capnography Specifications
Sensors
Sensor Type
Sensor Physical Characteristics
Sensor Compatibility
Mainstream, non-dispersive infrared single-beam optics, dual wavelengths. No
moving parts
Weight: 25 g (78 g with standard cable and connectors)
Size: 33 mm x 43 mm x 23 mm. Cable length: 3 m
The CareFusion Capnostat 5 is interchangeable between CareFusion equipment
only.
CO2 Measurement
CO2 Measurement range
CO2 Measurement Accuracy
CO2 Resolution
CO2 Stability
Gas Composition Compensation
Airway Adapters
Adult/Pediatric
Single Patient Use
Infant /Pediatric
Single Patient Use
Adult/Pediatric
Reusable
Infant /Pediatric
Reusable
0 – 150 mmHg (0 – 20 kPa)
± 2 mmHg for 0-40 mmHg
± 5% of reading for 41-70 mmHg
± 8% of reading for 71-100 mmHg
± 10% of reading for 101-150 mmHg
1 mmHg
< 0.8 mmHg over four hours
Oxygen and Helium gas composition. Automatic compensation
For use with endotracheal tube greater than 4mm ID
Dead space: 5 mL
Weight: 7.7 g
Color: Clear
For use with endotracheal tube less than or equal to 4mm ID
Dead space: < 1 mL
Weight: 9.1 g
Color: Purple
For use with endotracheal tube greater than 4mm ID
Dead space: 5 mL
Weight: 12 g
Color: Black
For use with endotracheal tube less than or equal to 4mm ID
Dead space: < 1 mL
Weight: 14.9 g
Color: Red
All components are Latex free
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AVEA ventilator systems
Appendix F: Tracheal Monitoring Tube Compatibility
The AVEA tracheal monitoring functions have been validated for use with the French feeding tube. The following 5 French feed
tubes have been validated by CareFusion for the purpose of tracheal pressure monitoring.
Brand
Part Number
CareFusion Part Number
Covidien
8888260802
10635 (10 pack)
Pacific Hospital Supply Company,
LTD (PAHSCO)
I05501
N/A
WARNING
Radiographic verification of pressure monitoring position is strongly recommended.
WARNING
Using of a monitoring tube with dimensions other than those provided may affect accuracy of measurement
of the tracheal pressure.
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Appendix F: Tracheal Monitoring Tube Compatibility
Operator's manual
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AVEA ventilator systems
Appendix G: AVEA Message Bar Text
AVEA MESSAGE BAR TEXT
"Confirm Apnea Settings."
"Proximal Flow Sensor required."
"Bias Flow insufficient to allow Flow
Trigger."
"Heliox concentration will change."
"Nebulizer not available."
"Confirm inspiratory pressure settings."
"Settings restored to defaults."
"Compliance Compensation not active for
NEO."
"Minimum 0.2 sec Inspiratory Time."
"Maximum 4:1 I:E Ratio."
"Maximum 3 sec Inspiratory Time."
"Maximum 5 sec Inspiratory Time."
"Invalid Calibration"
"Error saving Serial/Model Number"
Clear Messages
"FCV Characterization in progress."
"FCV Characterization complete."
"FCV Characterization failed."
Installed Software Version
Current Time, Date, and Runtime Hours
“DPRAM Comm. Error, Ctrl"
"Printing."
"Printer Out of Paper."
"Printer Offline."
"Printer Error."
L2786 Version T
CAUSE
Selection of CPAP/PSV or APRV on Mode Select popup when
active.
Acceptance of Volume Limit setting when
Size is NEO, Volume Limit is active, and no Wye Flow Sensor
connected (Varflex or Hotwire).
Acceptance of Bias Flow setting or Flow Trigger setting when
Flow Trigger < (Bias Flow + 0.5 lpm).
Acceptance of % O2 setting when Heliox is being used.
Acceptance of Peak Flow setting < 15 lpm when Nebulizer is
active or on pressing of Nebulizer membrane key when Peak Flow
setting < 15 lpm
Selection of Volume Limit control when Volume Limit active (i. e.,
not at default / highest value for patient size).
Patient Accept when New Patient selected.
Size Accept when Size is NEO, and Circ Comp setting is nonzero.
Acceptance of any combination of settings that will produce an ITime of less than 0.2 seconds.
Acceptance of any combination of settings that will produce an I:E
Ratio of 4:1 or greater.
Acceptance of any combination of settings when size is NEO that
will produce an I-Time of greater than 3 seconds.
Acceptance of any combination of settings when size is PED or
ADULT that will produce an I-Time of greater than 5 seconds.
Service State Only:
Validation failure, while calibration dialog box is active for selected
device.
Service State Only:
On accept of Serial Number or Model Number Change.
Service State Only:
Validation success, while calibration dialog box is active for
selected device.
Service State Only:
On start of Flow Control Valve characterization procedure.
Service State Only:
On successful completion of Flow Control Valve characterization
procedure.
Service State Only:
Unsuccessful completion of Flow Control Valve characterization
procedure. Validation failure characterization and tuning data.
Power Up
Main key pressed.
Loss of Communication with Control microprocessor
Print Screen button was pressed; commenced sending screen
data to printer.
Print Screen button was pressed, printer reported it is out of
paper.
Print Screen button was pressed; printer is not available.
Print Screen button was pressed; printer reported an error
condition.
224
Appendix G: AVEA Message Bar Text
AVEA MESSAGE BAR TEXT
"Printer Ready."
"Printer Busy."
"Volume Limit disabled."
"Proximal Flow Sensor disconnected."
"Flow sensor is not Heliox-compatible."
"Proximal Airway Line disconnected."
"Proximal Flow Sensor conflict.
"Esophageal monitoring not available."
"Tracheal monitoring not available."
"Flow Sensor Error."
"Wye Sensor Error."
"Device Error."
"Esophageal Balloon Leak Test Failed."
“Stopped: Patient Effort Detected”
Operator's manual
CAUSE
Sending screen data to printer has completed.
Print Screen button was pressed, device has not completed
sending data from previous activation.
On disconnect of WFS (Neo or Hotwire) when Size is NEO and
Volume Limit is active.
On disconnect of WFS, any type.
On connect of Hotwire WFS when Heliox is active.
On disconnect of Proximal Pressure connection.
On simultaneous connect of Hotwire and VarFlex WFS.
On connect of Esophageal Balloon when size is NEO.
On connect of Tracheal Monitoring Tube when size is NEO.
On power up, failure to validate any internal flow sensor.
On connect and failure to validate any proximal flow sensor.
On detection of a fault classified as “Device Error”
On failure of Esophageal Balloon leak test.
Upon detecting Patient effort in maneuvers which require a
passive patient
“Proximal Flow Sensor Ready”
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AVEA ventilator systems
Appendix H: Advanced Pulmonary Mechanics Monitored
Parameters
Rapid Shallow Breathing Index (f / Vt)
The ventilator is capable of displaying the calculated value for Rapid Shallow Breathing Index (f / Vt),
which is the spontaneous breath rate per tidal volume, and is based on the following formula:
f / Vt = f 2 / Ve , where f = spontaneous breath rate (BPM) and
Ve = spontaneous minute ventilation in LPM
Range:
0 to 500 b2/min/L
Resolution:
1 b2/min/L
Chest wall Compliance (CCW)
Chest wall Compliance (CCW), is the ratio of the tidal volume (exhaled) to the Delta Esophageal Pressure
(dPES).
CCW =
Vte
dPES
Range:
0 to 300 mL/cmH2O
Resolution:
1 mL/cmH2O
Note:
Requires an esophageal balloon.
Accuracy:
± 10%
Lung Compliance (CLUNG)
Lung Compliance (CLUNG), is the ratio of the tidal volume (exhaled) to the delta transpulmonary pressure.
The delta transpulmonary pressure is the difference between the airway plateau pressure (during an
inspiratory pause) and esophageal pressure (at the time the airway plateau pressure is measured) minus
the difference between the airway and esophageal baseline pressures.
CLUNG =
Vte
, where dPPLAT TP = (PPLAT AW  PES)  (PEEPAW  PEEPES)
dPPLAT TP
Range:
0 to 300 mL/cmH2O
Resolution:
1 mL/cmH2O
Note:
Requires an Inspiratory Hold maneuver and an esophageal balloon.
Accuracy: ±10%
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Appendix H: Advanced Pulmonary Mechanics Monitored Parameters
Operator's manual
Compliance Ratio (C20 / C)
Compliance Ratio (C20 / C), is the ratio of the dynamic compliance during the last 20% of inspiration (C20)
to the total dynamic compliance (C).
Range:
0.00 to 5.00
Resolution:
0.01
Accuracy: ± 10%
Respiratory System Resistance (RRS)
Respiratory System Resistance (RRS), is the total resistance during the inspiratory phase of a breath.
Respiratory System Resistance is the ratio of the airway pressure differential (peak – plateau) to the
inspiratory flow 12 ms prior to the end of inspiration.
Range:
0 to 100 cmH2O/L/sec
Resolution:
0.1 cmH2O/L/sec
Limitation:
Active for volume breaths only.
Note:
Requires an Inspiratory Hold maneuver.
Accuracy:
± 10%
Peak Expiratory Resistance (RPEAK)
The ventilator shall be capable of calculating and displaying the Peak Expiratory Resistance (RPEAK),
which is defined as the resistance at the time of the Peak Expiratory Flow (PEFR).
RPEAK =
PPEFR
PEFR
Range:
0.0 to 100.0 cmH2O/L/sec
Resolution:
0.1 cmH2O/L/sec
Accuracy:  10%
L2786 Version T
AVEA ventilator systems
Appendix H: Advanced Pulmonary Mechanics Monitored Parameters
227
Imposed Resistance (RIMP)
Imposed Resistance (RIMP), is the airway resistance between the wye of the patient circuit and the
tracheal sensor.
Range:
0.0 to 100.0 cmH2O/L/sec
Resolution:
0.1 cmH2O/L/sec
Note:
Requires an Inspiratory Hold maneuver and a tracheal monitoring tube.
Accuracy:
± 10%
Lung Resistance (RLUNG)
Lung Resistance (RLUNG), is the ratio of the tracheal pressure differential (peak – plateau) to the
inspiratory flow 12 ms prior to the end of inspiration.
Range:
0.0 to 100.0 cmH2O/L/sec
Resolution:
0.1 cmH2O/L/sec
Note:
Requires an Inspiratory Hold maneuver and a tracheal monitoring tube.
Accuracy:
± 10%
Peak Inspiratory Flow Rate (PIFR)
The ventilator is capable of monitoring and displaying the actual peak inspiratory flow rate for the
inspiratory phase of a breath.
Range:
0 to 300 LPM
(All patients)
Resolution:
1 LPM
0.1 LPM
(Adult/Pediatric)
(Neonate)
Accuracy:
± 10%
Peak Expiratory Flow Rate (PEFR)
The ventilator is capable of monitoring and displaying the actual peak expiratory flow rate for the
expiratory phase of a breath.
L2786 Version T
Range:
0 to 300 LPM
(All patients)
Resolution:
1 LPM
0.1 LPM
(Adult/Pediatric)
(Neonate)
Accuracy:
± 10%
228
Appendix H: Advanced Pulmonary Mechanics Monitored Parameters
Operator's manual
Delta Airway Pressure (dPAW)
Delta Airway Pressure (dPAW), which is the difference between peak airway pressure (PPEAK
baseline airway pressure (PEEPAW).
AW)
and
dPAW = PPEAK AW  PEEPAW
Range:
120 to 120 cmH2O
Resolution:
1 cmH2O
Accuracy:
± 2cmH20 or ± 5%, whichever is greater
Delta Esophageal Pressure (dPES)
Delta Esophageal Pressure (dPES), is the difference between peak esophageal pressure (PPEAK ES) and
baseline esophageal pressure (PEEPES).
dPES = PPEAK ES  PEEPES
Range:
120 to 120 cmH2O
Resolution:
1 cmH2O
Accuracy:
± 2cmH20 or ± 5%, whichever is greater
AutoPEEPAW
AutoPEEPaw, is the airway pressure at the end of an expiratory hold maneuver.
Range:
0 to 50 cmH2O
Resolution:
1 cmH2O
Accuracy:
± 2cmH20 or ± 5%, whichever is greater
Note:
Requires a passive patient.
L2786 Version T
AVEA ventilator systems
Appendix H: Advanced Pulmonary Mechanics Monitored Parameters
229
Delta AutoPEEPAW (dAutoPEEPAW)
Delta AutoPEEPAW (dAutoPEEPAW), is the difference between airway pressure at the end of an
expiratory hold maneuver and the airway pressure at the start of the next scheduled breath after the
expiratory hold maneuver.
Range:
0 to 50 cmH2O
Resolution:
1 cmH2O
Note:
Requires a passive patient.
Accuracy: ± 2cmH20 or ± 5%, whichever is greater
AutoPEEPES
AutoPEEPES is defined as the difference between esophageal pressure measured at the end of
exhalation (PEEPES) minus the esophageal pressure measured at the start of a patient-initiated breath
(PES start) and the sensitivity of the ventilator’s demand system. The sensitivity of the ventilator’s demand
system is the difference between the baseline airway pressure (PEEPAW) and the airway pressure when
the patient initiates a breath (PAW start).
AutoPEEPES = (PEEPES  PES start)  (PEEPAW  PAW start)
Range:
0 to 50 cmH2O
Resolution:
1 cmH2O
Note:
Requires an esophageal balloon.
Accuracy:
± 2cmH20 or ± 5%, whichever is greater
Transpulmonary Pressure, Plateau (Ptp Plat)
The ventilator is capable of calculating and displaying the Transpulmonary pressure during an inspiratory
hold, which is the difference between the airway plateau pressure (PPLAT AW) and the corresponding
esophageal pressure.
PtpPlat = PPLAT AW  PES
Range:
60 to 120 cmH2O
Resolution:
1 cmH2O
Accuracy:
± 2cmH20 or ± 5%, whichever is greater
Note:
Requires an inspiratory hold and an esophageal balloon.
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230
Appendix H: Advanced Pulmonary Mechanics Monitored Parameters
Operator's manual
Transpulmonary Pressure, AutoPEEP (Ptp PEEP)
Transpulmonary pressure, AutoPEEP (PtpPEEP) is the difference between the corresponding airway and
esophageal pressures at the end of the expiratory hold during an AutoPEEP maneuver.
PtpPEEP = PAW  PES (at the end of an expiratory hold)
Range:
60 to 120 cmH2O
Resolution:
1 cmH2O
Accuracy:
 2 cmH2O or  5%, whichever is greater
Note:
Requires an expiratory hold and an esophageal balloon.
Maximum Inspiratory Pressure (MIP)
Maximum Inspiratory Pressure (MIP), is the maximum negative airway pressure that is achieved by the
patient, during an expiratory hold maneuver.
Range:
60 to 120 cmH2O
Resolution:
1 cmH2O
Accuracy:
± 2cmH20 or ± 5%, whichever is greater
Respiratory Drive (P100)
Respiratory Drive (P100), is the negative pressure that occurs 100 ms after an inspiratory effort has been
detected.
P100 = Pend 100  PEEPAW
Range:
60 to 120 cmH2O
Resolution:
1 cmH2O
Accuracy:
± 2cmH20 or ± 5%, whichever is greater
L2786 Version T
AVEA ventilator systems
Appendix H: Advanced Pulmonary Mechanics Monitored Parameters
231
Ventilator Work of Breathing (WOBV)
Ventilator Work of Breathing (WOBV), is defined as the summation of airway pressure (PAW) minus the
baseline airway pressure (PEEPAW) times the change in tidal volume to the patient (V) during
inspiration, and normalized to the total inspiratory tidal volume (Vti).
If PAW > PEEPAW ,
 (P
AW
WOBV =
 PEEPAW )V
Insp
Vti
Range:
0.00 to 20.00 Joules/L
Resolution:
0.01 Joules/L
Accuracy:
± 10%
Patient Work of Breathing (WOBP) (Normalized to Delivered Tidal Volume)
Patient Work of Breathing (WOBP), normalized to the total inspiratory tidal volume. Patient work of
breathing is defined as the summation of two work components: work of the lung and work of the chest
wall.
WOBP = WOBLUNG + WOBCW
Tiend
where WOBLUNG =
 (PEEP
ES
 PES )V
(if PEEPES > PES and V > 0)
Testart
and WOBCW =
VP 2
(if PEEPES > PES)
2CCW
Work of the lung (WOBLUNG) is calculated using esophageal pressure when the baseline esophageal
pressure (PEEPES) is greater than the esophageal pressure (PES), indicating patient effort.
Work of the chest wall (WOBCW) for a spontaneously breathing patient is calculated using only the portion
of the total tidal volume delivered due to a patient effort (VP) and the chest wall compliance (CCW).
Range:
Resolution:
Accuracy:
0.00 to 20.00 Joules/L
0.01 Joules/L
± 10%
Note:
Requires an esophageal balloon.
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Appendix H: Advanced Pulmonary Mechanics Monitored Parameters
Operator's manual
Imposed Work of Breathing (WOBI)
Imposed Work of Breathing (WOBI), is defined as the work performed by the patient to breathe
spontaneously through the breathing apparatus; that is, the E.T. tube, the breathing circuit, and the
demand flow system.
Imposed work is assessed by integrating the change in tracheal pressure and tidal volume, and
normalizing the integrated value to the total inspiratory tidal volume (Vti). (Requires the use of an optional
tracheal monitoring tube.) Based on the following formula:
WOBI =
 PEEP
Vti
AW
0
 PTR  *
dV
,
dt
where PEEPAW = airway baseline pressure
PTR = tracheal pressure
Vti = inspired tidal volume
Range:
Resolution:
Accuracy:
0.00 to 20.00 Joules/L
0.01 Joules/L
± 10%
Note:
Requires a tracheal monitoring tube.
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AVEA ventilator systems
Appendix I: Capnometry Troubleshooting
Error Message
Corrective Action
CO2 Communication Error
Medium-priority alarm. Ensure the sensor is properly plugged in. Reinsert the
sensor if necessary. If the error persists, call technical support.
Medium-priority alarm. Ensure the sensor is properly plugged in. Reinsert the
sensor if necessary. If the error persists, call technical support.
Medium-priority alarm. Ensure the sensor is not exposed to extreme
temperatures, such as temperatures produced by lamps. If the error persists, call
technical support.
Medium-priority alarm. Check airway adapter and clean if needed. If the error
persists, perform an adapter zero procedure.
Medium-priority alarm when the CO2 measured by the sensor exceeds 150 mmHg
(20.0 kPa). If the error persists, perform a zero procedure.
Medium-priority alarm. Check the airway adapter and clean it if needed. If the
error persists, perform an adapter zero procedure.
Medium-priority alarm. No breaths are being detected by the CAPNOSTAT 5.
Ensure spontaneous or mechanical breaths are being delivered to the patient.
Confirm that the airway adapter is placed in the airway between any connector(s)
and the circuit wye and that the sensor is firmly attached to the adapter.
CO2 Sensor Faulty
CO2 Sensor Over Temp
CO2 Zero Required
CO2 Out of Range
Check CO2 Airway Adapter
Invalid EtCO2
L2786 Version T
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Appendix I: Capnometry Troubleshooting
Operator's manual
This page intentionally left blank
L2786 Version T
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235
Appendix J: Volumetric CO2 Calculations
Note:
The AVEA assumes all gas passing through the sensor to be at BTPS (except during calibration check). Barometric
pressure (PBar) is measured with an integrated barometric pressure sensor. Gas composition must be known by the
CO2 sensor and algorithms to ensure accurate reporting of PCO2. The AVEA internally reports delivered gas
composition data.
PCO2
Partial pressure of carbon dioxide in the inhaled and exhaled gas measured continuously and
reported by the CO2 sensor at the wye. This is displayed graphically as the capnogram
waveform.
EtCO2
Peak partial pressure of carbon dioxide in exhaled gas reported by the CO2 sensor at the wye.
This is calculated for each breath and then averaged as specified by setup control EtCO2
Averaging.
FCO2
Fraction of carbon dioxide in the inhaled and exhaled gas measured continuously and reported
by the CO2 sensor at the wye. This value is used in the VCO2 and dead space calculations but
is not displayed.
VCO2
Minute volume of exhaled CO2. It is measured continuously and averaged over a userselectable time (VCO2 Average: 3, 6, 9, 12 minutes).
is the flow at the wye, and is measured or calculated.
VtCO2
Tidal volume of exhaled CO2. It is measured over the period of each breath and averaged over
a user-selectable time (VCO2 Average: 3, 6, 9, 12 minutes).
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Appendix J: Volumetric CO2 Calculations
Operator's manual
FeCO2
Percentage of carbon dioxide in the exhaled gas reported by the CO2 sensor at the wye. This
value is used in the dead space calculations but is not displayed.
PeCO2
Mean exhaled partial pressure of carbon dioxide in the exhaled gas reported by the CO2
sensor at the wye. This value is used in the dead space calculations but is not displayed.
Physiologic Dead Space (Vd phy)
Comprises anatomic dead space (see below) as well as the volume of the respiratory zone
(respiratory bronchioles, alveolar ducts and alveoli) not participating in gas exchange. The
classic Bohr-Enghoff2 equation is used to calculate physiologic dead space. This method uses
arterial CO2 (PaCO2) as an estimator for alveolar CO2 (PACO2).
Physiologic Dead Space / Tidal volume ratio (Vd phy / Vt)
Used to calculate the ratio of the tidal volume not participating in gas exchange (wasted
ventilation).
2
Enghoff H: Volumen inefficax: Bemerkungen zur Frage des schadlichen Raumes. Upsalla Lakareforen Forhandl, 1938;
44:191-218.
L2786 Version T
AVEA ventilator systems
Appendix J: Volumetric CO2 Calculations
237
Anatomic Dead Space (Vd ana)
Total volume of the conducting airways from the nose to the level of the terminal bronchioles
(areas that do not participate in gas exchange). Anatomic dead space also includes any
mechanical dead spaces added to the ventilator circuit between the CO2 sensor and the
patient.
At end of each exhalation, calculation is carried out equivalent to the graphical method defined
by Fowler 3. The fraction of CO2 in the exhaled gas is considered as a function of volume
exhaled.
Using Fowler’s nomenclature, phase I is the initial exhaled volume with constant FCO2. FCO2
during phase I is calculated as FI. Phase III is the linear part of the capnogram associated with
exhalation of gas from the lung gas exchange units. This is calculated using linear regression
over that part of the capnogram representing 30 to 70% of exhaled CO2. The slope of phase III
is calculated as m, with offset at the FCO2 axis FO.
Shaded areas x and y are equal.
The volume above the capnogram and below the regression line through phase III is
calculated as A.
Anatomical dead space is defined as that point on the volume axis at which the volumes
shaded below and above the curve are equal. This is calculated using an algebraic method4
This parameter is calculated for each breath and then averaged over the same period as
VCO2.
If either phase I or phase III is ill-defined, based on variation of slope, then anatomical dead
space is not calculated and this parameter is displayed as ‘***’.
3. Fowler W S, Lung Function Studies II: The Respiratory Dead Space, Am J Physiol 1948; 154: 405-416
4
Heller H, Könen-Bergmann M, Schuster K D, An Algebraic Solution to Dead Space Determination According to Fowler’s
Graphical Method, Comput Biomed Res 1999; 32: 161-167
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Appendix J: Volumetric CO2 Calculations
Operator's manual
Anatomic Dead Space / Tidal volume Ratio (Vd ana / Vt)
Anatomic dead space / Tidal volume ratio is used to calculate the ratio of the tidal volume not
participating in gas exchange (wasted ventilation). This is calculated on a breath to breath
basis. Vd phy / Vt is probably more clinically relevant, but requires an arterial blood sample to
be accurate.
Alveolar Dead Space
Alveolar dead space is (mathematically) the difference between physiological dead space and
anatomical dead space. It represents the volume of the respiratory zone that is from ventilation
of relatively under-perfused or non-perfused alveoli.
Alveolar Ventilation (VA)
The minute volume of fresh gas that participates in gas exchange.
Oxygenation Index (OI)
Oxygenation index is a dimensionless number often used to assess the “pressure cost” of
oxygenation. This parameter is calculated from the FIO2 mean airway pressure and an arterial
blood oxygen measurement entered by the clinician.
PAO2 / FIO2 Ratio (P/F)
The PAO2 / FIO2 ratio is a simple assessment of gas exchange. This parameter is calculated
from the FIO2 monitor value and an arterial blood oxygen measurement entered by the clinician.
Note:
Because PAO2 may be entered in either mmHg or kPa, the normal range for parameters OI and
P/F differ depending on the setting of the CO2 units control.
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AVEA ventilator systems
Appendix K: Electromagnetic Declarations
60601-1-2 IEC:2001 (E) Table 201
Guidance and manufacturer’s declaration – electromagnetic emissions
The AVEA Ventilator is intended for use in the electromagnetic environment specified below. The customer or the user of the AVEA
Ventilator should ensure that it is used in such an environment.
Emissions test
Compliance
Electromagnetic environment - guidance
RF emissions
CISPR 11
Group 1
RF emissions
CISPR 11
Class B
Harmonic emissions
Class A
IEC 61000-3-3
Voltage Fluctuation/
Flicker emissions
IEC 61000-3-3
L2786 Version T
Complies
The AVEA Ventilator 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.
The AVEA Ventilator is suitable for use in all establishments, including domestic
establishments and those directly connected to the public low-voltage power supply
that supplies buildings used for domestic purposes.
240
Appendix K: Electromagnetic Declarations
Operator's manual
60601-1-2 IEC:2001 (E) Table 202
Guidance and manufacturer’s declaration - electromagnetic immunity
The AVEA Ventilator is intended for use in the electromagnetic environment specified below. The customer or the user of the AVEA
Ventilator should ensure that it is used in such an environment.
Immunity Test
IEC 60601
Compliance level
Electromagnetic environment - guidance
Test level
Electrostatic discharge
(ESD)
± 6 kV contact
± 6 kV contact
IEC 61000-4-2
± 8 kV air
± 8 kV air
Electrical fast
transient/burst
± 6 kV for power supply
lines
± 6 kV for power supply
lines
IEC 61000-4-4
± 1 kV for input/output lines
± 1 kV for input/output lines
Surge
± 1 kV differential mode
± 1 kV differential mode
IEC 61000-4-5
± 2 kV common mode
± 2 kV common mode
Voltage dips, short
interruptions and voltage
variations on power
supply input lines
<5 % UT
(>95% dip in UT)
for 0,5 cycle
<5 % UT
(>95% dip in UT)
for 0,5 cycle
40 % UT
(60 % dip in UT)
for 5 cycles
40 % UT
(60 % dip in UT)
for 5 cycles
70 % UT
(30 % dip in UT)
for 25 cycle
70 % UT
(30 % dip in UT)
for 25 cycle
<5 % UT
(>95% dip in UT)
for 5 seconds
<5 % UT
(>95% dip in UT)
for 5 seconds
IEC 61000-4-11
Power frequency (50/60
Hz) magnetic field
3 A/m
3 A/m
IEC 61000-4-8
NOTE UT is the a.c. mains voltage prior to application of the test level.
Floors should be wood, concrete, or ceramic
tile. If floors are covered with synthetic material,
the relative humidity should be at least 30%.
Mains power quality should be that of a typical
commercial or hospital environment.
Mains power quality should be that of a typical
commercial or hospital environment.
Mains power quality should be that of a typical
commercial or hospital environment.
Compliance is dependent on the operator
following recommended charging and
maintenance of the installed battery backup.
Power frequency magnetic fields should be at
level characteristic of a typical location in a
typical commercial or hospital environment.
L2786 Version T
AVEA ventilator systems
Appendix K: Electromagnetic Declarations
241
60601-1-2 IEC:2001 (E) Table 203
Guidance and manufacturer’s declaration - electromagnetic immunity
The AVEA Ventilator is intended for use in the electromagnetic environment specified below. The customer or the user of the AVEA
Ventilator should ensure that it is used in such an environment
Immunity Test
IEC 60601
Compliance level
Electromagnetic environment - guidance
Test level
Portable and mobile RF communications equipment should
be used no closer to any part of the AVEA Ventilator,
including cables, than the recommended separation distance
calculated from the equation applicable to the frequency of
the transmitter.
Recommended separation distance
Conducted RF
IEC 61000-4-6
Radiated RF
IEC 61000-4-3
3 Vrms
150 kHz to 80 MHz
outside ISM bandsa
3V
10 Vrms
150 kHz to 80 MHz
In ISM bandsa
10 V
10 V/m
80 MHz to 2,5 GHz
10 V/m
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 metres (m).b
Field strengths from fixed RF transmitters, as determined by
an electromagnetic site survey,c should be less than the
compliance level in each frequency range.d
Interference may occur in the vicinity of equipment marked
with the following symbol:
NOTE 1 At 80 MHz and 800 MHz, the higher frequency range applies.
NOTE 2 These guidelines may not apply in all situations. Electromagnetic propagation is affected by absorbtion and reflection from structures, objects
and people.
a
b
c
d
The ISM (industrial, scientific, and medicinal) bands between 150 kHz and 80 MHz are 6,765 MHz to 6,795 MHz; 13,553 MHz to
13,567 MHz; 26,957 MHz to 27, 283 MHz; and 40,66 MHz to 40,70 MHz.
The compliance levels in the ISM frequency bands between 150 kHz and 80 MHz and in the frequency range 80 MHz to 2,5 GHz are
intended to decrease the likelihood that mobile/portable communications equipment could cause interference if it is inadvertently
brought into patient areas. For this reason, an additional factor of 10/3 is used in calculating the recommended separation distance for
transmitters in these frequency ranges.
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 FR transmitters, an electromagnetic site survey should be considered. If the measured field strength in the
location in which the AVEA Ventilator is used exceeds the applicable RF compliance level above, the AVEA Ventilator should be
observed to verify normal operation. If abnormal performance is observed, additional measures may be necessary, such as reorienting
or relocating the AVEA Ventilator.
Over the frequency range 150 kHz to 80 MHz, field strengths should be less than 3 V/m.
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Appendix K: Electromagnetic Declarations
Operator's manual
60601-1-2 IEC:2001 (E) Table 205
Recommended separation distance between
portable and mobile RF communications equipment and the AVEA Ventilator
The AVEA Ventilator is intended for use in an electromagnetic environment in which radiated RF disturbances are controlled. The customer
or the user of the AVEA Ventilator can help prevent electromagnetic interference by maintaining a minimum distance between portable and
mobile RF communications equipment (transmitters) and the AVEA Ventilator as recommended below, according to the maximum output
power of the communications equipment.
Separation distance according to frequency of transmitter
m
Rated maximum output
150 kHz to 80 MHz
150 kHz to 80 MHz in
80 MHz to 800 MHz
80 MHz to 800 MHz
power of transmitter
outside ISM bands
ISM bands
W
0,01
0,1
1
10
100
0.12
0.37
1.16
3.67
11.60
0.12
0.38
1.20
3.79
12.00
0.12
0.38
1.20
3.79
12.00
0.23
0.73
2.30
7.27
23.00
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.
NOTE 1 At 80 MHz and 800 MHz, the separation distance of the higher frequency range applies.
NOTE 2 The ISM (industrial, scientific, and medical) bands between 150 kHz and 80 MHz are 6,765 MHz to 6,795 MHz;13,553 MHz to 13,567 MHz;
26,957 MHz to 27,283 MHz; and 40,66 MHz to 40,70 MHz.
NOTE 3 An additional factor of 10/3 is used in calculating the recommended separation distance for transmitters in the ISM frequency bands between 150
kHz and 80 MHz and in the frequency range 80 MHz to 2,5 GHz to decrease the likelihood that mobile/portable communications equipment could cause
interference if it is inadvertently brought into patient areas.
NOTE 4 These guidelines may not apply in all situations. Electromagnetic propagation is affected by absorption and reflection from structures, objects and
people.
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AVEA ventilator systems
Appendix L: Glossary
Breath Interval
Preset
Trigger
BTPS
ATPD
Demand Flow
AC
Bias Flow
bpm
Breath Period
Breath Rate
BTPD
Button
cmH2O
Controls
Event
Flow
Indicators
L
LED
L/min
Mode
Monitored Parameter
O2
Patient Breathing
Circuit
Paw
PEEP
Ppeak
L2786 Version T
Elapsed time from the start of one breath to the start of
the next.
An operator set ventilator parameter.
Value at which the ventilator initiates delivery of a breath
as a result of measured patient effort.
Body Temperature at Ambient Pressure, Saturated.
Ambient Temperature, Ambient Pressure, Dry.
The flow generated by the ventilator to meet the patient’s
flow demand in order to maintain PEEP at the preset
level.
Alternating Current (mains electricity).
Flow through the patient breathing circuit during the
expiratory phase. This flow is used for flow triggering.
Breaths per minute.
The length of time between machine-initiated breaths.
Depends on the Breath Rate setting.
The number of breaths delivered in a minute.
Body Temperature at Ambient Pressure, Dry
A push button switch used to toggle a function on or off.
Centimeters of water pressure.
Any button, switch, or knob that allows you to modify the
ventilator’s behavior.
The occurrence or activation of certain controls or
functions of the ventilator or a patient care activity, which
can be stored in the trend buffer.
The rate at which gas is delivered. Measured in liters per
minute (L/min).
A visual element showing operational status.
Liters. A unit of volume.
Light Emitting Diode
Liters per minute. A unit of flow.
An operating state of the ventilator that determines the
allowable breath types.
A measured value displayed in the monitor window.
Oxygen
The tubing that provides the ventilatory interface between
the patient and ventilator.
Airway Pressure. Measured in cmH2O.
Positive End Expiratory Pressure. Pressure maintained in
the circuit at the end of exhalation.
Peak Inspiratory Pressure. Shows the highest circuit
pressure to occur during inspiration. The display is
updated at the end of inspiration. Ppeak is not updated for
spontaneous breaths.
244
Appendix L: Glossary
Pplat
PSIG
Sigh Breath
WOB
Operator's manual
Plateau Pressure. Measured during an Inspiratory Hold
maneuver or during zero flow in a pressure control breath.
Used to calculate Static Compliance (Cstat).
Pounds per square inch gauge. 1 PSIG = .07bar
A Volume Controlled machine breath having a tidal
volume equal to one-and-a-half times (150%) of the
current tidal volume setting.
Patient Work of Breathing i.e. a measure of Patient Effort.
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AVEA ventilator systems
Index
A access the advanced settings group · 96
active humidifier · 16
adult patient circuit · 16
advanced settings · 96
accessing the screen ∙ 96 advanced settings indicator ∙ 96 bias flow ∙ 101 flow cycle ∙ 100 insp rise ∙ 100 machine volume ∙ 99 pres trig ∙ 101 PSV cycle ∙ 103 PSV rise ∙ 102 PSV Tmax ∙ 103 sigh ∙ 101 volume limit ∙ 98 Vsync ∙ 102 Vsync rise ∙ 102 waveform ∙ 100 air inlet pressure · 126, 216
air supply · 7
alarm conditions · 179
alarm indicator · 171
alarm indicators · 58
alarm limits · 172
alarm loudness · 28
alarm reset button · 173
alarm silence · 173
alarm types · 173
alarms · 171
apnea interval ∙ 179 extended high peak pressure ∙ 176 fan failure ∙ 174 high exhaled minute volume ∙ 177 high O2 percent ∙ 179 high peak pressure, normal ∙ 175 high peak pressure, sigh ∙ 176 high priority ∙ 171 high rate ∙ 179 high tidal volume ∙ 178 IE ratio ∙ 179 loss of air ∙ 175 loss of gas supply ∙ 175 loss of O2 ∙ 175 low exhaled minute volume ∙ 177 low O2 percent ∙ 179 low peak pressure ∙ 175 low PEEP ∙ 176 low priority ∙ 171 maximum inspiratory time ∙ 179 medium priority ∙ 171 safety valve open ∙ 173 vent inop ∙ 173 L2786 Version T
annual maintenance · 191
apnea backup
CPAP or APRV / BIPHASIC ∙ 84 apnea back-up ventilation · 66
Artificial Airway Compensation · 61
assemble and insert the exhalation filter and water trap · 9
assembly on site · 7
assist control ventilation mode · 78
attaching the flow sensors · 18
B Backup Alarm · 172
base flow · 101
battery cord · 9
battery pack · 192, 193
external ∙ 193 battery replacement · 193
battery status indicator · 168
battery status indicators · 194
bias flow · 95, 101, 245
breath interval · 55, 78, 79, 92
breath interval timing mechanism · 78
breath rate · 78, 79, 92, 125, 130, 179, 181, 215
breath type and delivery mode · 66
breath types · 74, 79, 245
breath types and modes by patient size
adult and pediatric ∙ 89 breaths, defined by four variables · 74
C calculated IE Ratio · 130
calculated minute volume · 130
cautions · xiii
choice of waveforms · 106
circuit compliance · 3, 62
circuit compliance compensation · 3, 62
Circuit Occlusion Alarm · 42
cleaning and sterilization
accessories and parts ∙ 187 external surfaces ∙ 187 colors on waveform display · 105
compliance effect of the circuit · 3, 62
compressed gas sources · 7
connecting the O2 sensor · 25
contacting the manufacturer · 199
control knob · 106, 107, 124, 132, 173
controls associated with each breath type and mode · 97
cord routing · 9
CPAP/PSV mode · 66, 76, 82
customer service · 200
246
Index
Operator's manual
D I data dial · 91
default mode for all patient types · 78
demand breaths · 76
disable the audible alarm · 173
displayed value · 91
dynamic compliance · 126, 216
independent lung ventilation · 29, 30, 104
indicators · 167
external battery ∙ 167 internal battery ∙ 167 mains AC ∙ 167 inhaled tidal volume · 215
adjusted for ideal body weight ∙ 215 insp pause · 90
insp pres · 90
insp rise · 100
insp time · 90
inspiratory pause · 93
inspiratory pressure · 92
inspiratory time · 93, 125, 216
Inspiratory/Expiratory ratio · 125, 216
inspired tidal volume · 125
adjusted for patient weight ∙ 125 internal battery · 38, 193
E electromagnetic components · x
Enable/Disable O2 Alarms · 28
esophageal balloon · 23
connection ∙ 23 event log · 128
event markers · 128
events · 128
events automatically recorded · 128
exhalation filter · 9, 10, 11, 187
exhaled tidal volume · 215
adjusted for ideal body weight ∙ 215 expiratory Time · 125, 216
expired tidal volume · 125
adjusted for patient weight ∙ 125 external battery · 38, 193
external water trap · 25
F flashing alarms · 171
flow cycle · 100
flow trig · 90
freezing a loop · 109
freezing the loops screen · 109
fuses · 196
L leak compensation · 62
loops
colors ∙ 105 comparing loops ∙ 109 freezing a loop ∙ 109 reference ∙ 109 reference loops ∙ 109 saving a loops ∙ 109 selection ∙ 108 loops in real time · 108
loops screen · 108
low priority alarm · 171
M G gas line pressure · 7
gas sources · 7
air supply ∙ 7 oxygen supply ∙ 7 graphs · 107
H Heliox connection · 26
heliox delivery · 4
high priority alarm · 171
hot wire sensor · 18
humidification · 4, 16, 63
mach vol · 99
main screen monitors · 132
mandatory breath · 74
mandatory tidal volume · 125, 215
adjusted for patient weight ∙ 125, 215 mean inspiratory pressure · 126, 216
medium priority alarm · 58, 171
membrane button
expiratory hold ∙ 55 membrane buttons
accept button ∙ 54 advanced settings ∙ 56 alarm limits ∙ 53 alarm reset ∙ 52 alarm silence ∙ 52 cancel ∙ 54 freeze ∙ 57 increase O2 ∙ 53 inspiratory hold ∙ 55 L2786 Version T
AVEA ventilator systems
main ∙ 58 manual breath ∙ 53 mode ∙ 56 nebulizer ∙ 55 panel lock ∙ 56 print ∙ 56 screens ∙ 58 setup ∙ 56 suction ∙ 53 membrane buttons and LEDs · 52
minute volume · 125, 215
adjusted for patient weight ∙ 125, 215 monitor screen · 124
monitored values · 124
monitored values choices · 125
multiple alarms · 171
N nebulizer · 21, 55
neonatal patient circuit · 17
new patient key · 59
NIST fittings · 25
O O2 percentage · 90
optional external battery · 9
ordering parts · 199
oxygen inlet pressure · 126, 216
oxygen sensor · 24
cable ∙ 25 cell ∙ 25 oxygen supply · 7
P passive humidifier or HME · 16
patient effort · 78, 79, 245
patient ID · 63
patient select screen · 59
patient size · 3
patient size indicators · 55
patient size select screen · 60
patient-triggered breaths · 76
peak Expiratory flow rate · 126, 216
peak flow · 90
peak Inspiratory flow rate · 126, 216
peak inspiratory pressure · 125, 216
PEEP · 75, 76, 90, 92, 94, 101, 126, 174, 175, 176, 179,
180, 216, 245
percent leakage · 125, 215
percentage of oxygen · 126, 216
plateau pressure · 126, 216
positive end expiratory pressure · 94, 126, 216
power cord · 38
power on indicator · 167
L2786 Version T
Index
247
power source · 7
pres high · 90, 95
pres low · 90
pres trig · 101
pressure breaths · 75, 155
pressure high control · 95
pressure low control · 96
pressure regulated volume control breaths · 75
pressure support ventilation · 82
preventive maintenance · 191
primary breath controls · 90, 92
breath rate ∙ 92 flow trigger ∙ 95 inspiratory pause ∙ 93 inspiratory pressure ∙ 92 inspiratory time ∙ 93 PEEP ∙ 94 pressure high ∙ 95 pressure low ∙ 96 pressure support ∙ 93 tidal volume ∙ 92 time high ∙ 95 time low ∙ 96 printing · 107
protective ground connection · 38
PSV · 90
PSV breath · 76
PSV control · 93
PSV cycle · 76, 103
PSV rise · 102
PSV Tmax · 76, 103
R rapid shallow breathing index · 125, 216
rate · 90
rear panel diagram · 24
reference loop · 109
remote nurse call system · 37
replaceable fuses · 195
respiratory system resistance · 126, 216
resume button · 88
resume current key · 59
S safety information · xii
save loop button · 109
saving a loop · 109
scaling histograms · 129
screen select box · 87
screens
mode selection ∙ 66 patient select ∙ 59 patient size ∙ 60 ventilation setup ∙ 61 sequence in which the power sources are used · 193
service calls · 199
248
Setting Date · 37
setting the breath type and ventilation mode · 66
Setting the Language · 31
Setting the Time · 37
setting up your AVEA ventilator · 7
sigh · 101, 176, 180
sigh volume breaths · 101
SIMV mode · 79
smart connectors
attachment ∙ 26 smart Heliox connectors · 26
specifications
accessories ∙ 211 atmospheric and environmental ∙ 211 data input and output ∙ 205 electrical ∙ 203 physical dimensions ∙ 211 pneumatic ∙ 203 spontaneous breath · 77
spontaneous breath rate · 125, 215
spontaneous minute volume · 125, 215
adjusted for patient weight ∙ 125, 215 spontaneous tidal volume · 125, 215
adjusted for ideal body weight ∙ 215 adjusted for patient weight ∙ 125 standby mode · 87
static compliance · 126, 216
status indicators · 167
symbols · xv
synchronized intermittent mandatory ventilation · 79
T tidal volume · 92
time cycled pressure limited breaths · 75
time high · 90, 95
control ∙ 95 time low · 90, 96
control ∙ 96 Index
Operator's manual
tracheal monitoring tube · 23
trended data · 129
histograms ∙ 129 spreadsheet ∙ 129 trends screen · 129
V variable orifice sensor · 20
ventilation modes · 78
ventilator specifications · 203
ventilator synchronization · 29
visual alarm display · 171
volume breaths · 74
volume limit · 75, 98
Vsync · 102
pressure control breaths ∙ 102 volume test breath ∙ 102 Vsync rise · 102
Vt · 90
W warnings · xii
warranty · vi
water collection bottle · 9
water trap · 9, 10, 187
waveform · 93, 100, 106, 107, 132
choices ∙ 107 waveforms
colors ∙ 105 freeze ∙ 107 freezing ∙ 105 main screen ∙ 105 menu ∙ 106 printing ∙ 107 L2786 Version T
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