CareFusion AVEA Operating Instructions Manual

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.

© 2010–2011 CareFusion Corporation or one of its subsidiaries. All rights reserved. Avea
is a registered trademark of CareFusion Corporation or one of its subsidiaries. All other
trademarks are property of their respective owners.

USA

CareFusion
22745 Savi Ranch Parkway
Yorba Linda, California 92887-4668
USA

Authorized European Representative

CareFusion Germany 234 GmbH
Leibnizstrasse 7
97204 Hoechberg
Germany

800.231.2466 tel
+1.714.283.2228 tel

carefusion.com

Literature number: L2786 Revision M

+49.931.4972.0 tel

+49.931.4972.423 fax

L2786 Rev. M

AVEA ventilator systems iii

Date

Revision

Changes

September 2005

A

September, 2008

E

February 2010

F

February 2010

G

January 2011

J

January 2011

K

June 2011

L

July 2011

M

Revision History

Release

May 2006 B

December 2006 C

February 2007 D

June 2010 H

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

Updated the Primary Controls table

Added NCPAP to the troubleshooting table

Updated the Rate specification

Added the chapter “Infant NCPAP”

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

Release of Volumetric Capnography

Revised the manual to comply with the revised Medical Device Directive 2007/42/EC.

Rebranded to the CareFusion style.

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.

Changed the logo and company references to VIASYS.

Changed the logo and company references to CareFusion.

Added content for Volume Guarantee and Nasal Intermittent Mandatory Ventilation.

Removed the first note from the section “Specific Controls” regarding the flow cycling of breaths.

L2786 Rev. M

iv Operator's manual

Warranty

THE AVEA ventilator systems are warranted to be free from defects in material and workmanship and to meet the
published specifications for Two (2) years or 16,000 hours, whichever occurs first.

The liability of 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, 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.

L2786 Rev. M

AVEA ventilator systems v

Contents

Chapter 1: Introduction ................................................................................................................. 1

Chapter 2: Unpacking & Setup ..................................................................................................... 7

Ventilator Assembly & 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.................................................................................................. 45

AVEA Troubleshooting .......................................................................................................................... 46

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

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 ................................................................................................................................................. 170

Alarm Controls .................................................................................................................................... 171

Alarm Types ........................................................................................................................................ 172

Nasal CPAP / Nasal IMV Alarms ........................................................................................................ 181

Volume Guarantee Alarms ................................................................

Chapter 8: Maintenance and Cleaning ..................................................................................... 187

Cleaning and Sterilization ................................................................................................................... 187

Recommended Periodic Maintenance ................................................................................................ 190

Battery Care ........................................................................................................................................ 191

Fuses .................................................................................................................................................. 194

.................................................. 184

L2786 Rev. M

vi Operator's manual

Appendix A: Contact & 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

Atmospheric & Environmental Specifications ..................................................................................... 208

Physical Dimensions .......................................................................................................................... 209

Accessories ........................................................................................................................................ 209

Appendix C: Pneumatic Diagram ................................................................................................ 211

Appendix D: Monitor Ranges and Accuracies ........................................................................... 213

Appendix E: Sensor Specifications & Circuit Resistance......................................................... 217

VarFlex

Hot Wire Flow Sensor Specifications ................................................................................................. 218

Circuit Resistance Test ....................................................................................................................... 219

Volumetric Capnography Specifications ............................................................................................. 220

Appendix F: AVEA Message Bar Text ........................................................................................ 221

Appendix G: Advanced Pulmonary Mechanics Monitored Parameters ................................... 223

Appendix H: Capnometry Troubleshooting ................................................................................ 231

Appendix I: Volumetric CO

Appendix J: Electromagnetic Declarations ............................................................................... 237

Appendix K: Glossary .................................................................................................................. 241

®

Sensor Specifications .......................................................................................................... 217

Calculations ................................................................................. 233

2

L2786 Rev. M

AVEA ventilator systems vii

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 2601-1.

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.

L2786 Rev. M

viii Operator's manual

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 60601-1-2
ISO 13485

UL 60601-1

CAN / CSA C22.2 No. 601.1.12-94 (R99)

EU Notified Body:

BSI (Reg. 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.

L2786 Rev. M

AVEA ventilator systems ix

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 & 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 O

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.

2

• Water in the air supply can cause malfunction of this equipment.

• Do not block or restrict the Oxygen bleed port located on the instrument back panel. Equipment malfunction may result.

L2786 Rev. M

x Operator's manual

• 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 (UL2601 and IEC60601-1). However, this cannot be guaranteed when external devices are attached to the
ventilator. In order to prevent the risk of excessive enclosure leakage current from external equipment attached to the
RS-232, printer and video ports, isolation of the protective earth paths must be provided to ensure proper connection.
This isolation should ensure that the cable shields are isolated at the peripheral end of the cable.

• 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.

Cautions

The following cautions apply any time you work with the ventilator.

• Ensure that the voltage selection and installed fuses are set to match the voltage of the wall outlet, or damage may

result.

• A battery that is fully drained (i.e. void of any charge) may cause damage to the ventilator and should be replaced.

• All accessory equipment that is connected to the ventilator should comply with CSA/IEC601/UL2601.

• To avoid damage to the equipment, clean the air filter regularly.

The following cautions apply when cleaning the ventilator or when sterilizing ventilator accessories.

• Do not sterilize the ventilator. The internal components are not compatible with sterilization techniques.

• Do not gas sterilize or steam autoclave tubing adapters or connectors in place. The tubing will, over time, take the shape

of the adapter, causing poor connection and possible leaks.

• DO NOT submerge the ventilator or pour cleaning liquids over or into the ventilator.

L2786 Rev. M

AVEA ventilator systems xi

Symbol

Source/Compliance

Meaning

Symbol #01-37 IEC 60878

local bonding).

Symbol #01-14 IEC 30878

ACCEPT

Equipment Symbols

The following symbols may be referenced on the ventilator or in accompanying documentation

Symbol #03-02 IEC 60878 Indicates ATTENTION, consult ACCOMPANYING DOCUMENTS

Symbol #5016 IEC 60417

Symbol #5034 IEC 60417

This symbol indicates a FUSE.

This symbol indicates INPUT.

Symbol #01-36 IEC 60878

Symbol #5035 IEC 60417

This symbol indicates OUTPUT

Symbol #5031 IEC 60417

Symbol #5019 IEC 60417

This symbol indicates DIRECT CURRENT (DC)

This symbol indicates protective EARTH (ground).

Symbol #01-20 IEC 60878

This symbol indicates the EQUIPOTENTIAL connection used to

Symbol #5021 IEC 60417

Symbol # 01-24 IEC 60878

connect various parts of the equipment or of a system to the same
potential, not necessarily being the earth (ground) potential (e.g., for

This symbol indicates TYPE B equipment, which indicates equipment

Symbol # 5333 IEC 60417

Symbol #02-03 IEC 60878

Symbol #5032 IEC 60417

Symbol #5007 IEC 60417
Symbol #01-01 IEC 60878

that provides a particular degree of protection against electric shock,
particularly with regards to allowable leakage current and reliability of
the protective earth connection.

This symbol is located on the rating plate. It indicates the equipment is
suitable for alternating current.

Indicates ON (Power)

Symbol #5008 IEC 60417
Symbol #01-02 IEC 60878

Symbol #0651 ISO 7000

CareFusion Symbol

CareFusion Respiratory
Care symbol

L2786 Rev. M

Indicates OFF (Power)

Horizontal return with line feed. Indicates ACCEPT entered values for
a specific field.

Indicates PATIENT EFFORT

Indicates MANUAL BREATH

xii Operator's manual

CareFusion Symbol

Symbol #417 IEC 5102

CareFusion Symbol

CareFusion Symbol

CareFusion Symbol

MDD Directive 93/42/EEC

Symbol #5307 IEC 60417

MAIN SCREEN

EVENT READY

MODE

ADVANCED SETTINGS

SET-UP for patient size selection

CE Mark

ALARM RESET

CANCEL

Symbol #5319 IEC 60417

CareFusion symbol

CareFusion symbol

CareFusion symbol

Graphical Symbol in
general use internationally
for “DO NOT”

CareFusion symbol

Symbol 5467 IEC 60417

ALARM SILENCE

ADULT patient

PEDIATRIC patient

NEONATAL (Infant) patient

CANCEL, i.e. do not accept entered values.

Select DISPLAYED SCREEN function.

FREEZE the current display.

L2786 Rev. M

AVEA ventilator systems xiii

CareFusion symbol

CareFusion symbol

CareFusion symbol

CareFusion symbol

CareFusion symbol

CareFusion symbol

CareFusion symbol

Enable the ALARM LIMITS screen

This symbol indicates a CONTROL LOCK.

NEBULIZER port

Increase OXYGEN

PRINT SCREEN

SUCTION port

VARIABLE ORIFICE FLOW SENSOR connection

CareFusion symbol

CareFusion symbol

CareFusion symbol

CareFusion symbol

CareFusion symbol

CareFusion symbol

CareFusion symbol

HOT WIRE FLOW SENSOR connection

ANALOG IN/OUT connection

Display the MAIN SCREEN

DO NOT BLOCK PORT

EXTERNAL BATTERY connection

Indicates GAS ID port

OXYGEN SENSOR connection

L2786 Rev. M

xiv Operator's manual

CareFusion symbol

CareFusion symbol

CareFusion symbol

CareFusion symbol

CareFusion symbol

CareFusion symbol

OVERPRESSURE relief

REMOTE NURSE CALL connection

USER INTERFACE MONITOR connection

This symbol indicates an INTERNAL BATTERY FUSE

This symbol indicates ALARM LOUDNESS

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.

L2786 Rev. M

AVEA ventilator systems 1

All

All

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 & Accessories Standard Comprehensive

Modes

Proximal Hot Wire Flow Sensing

Synchronized Nebulizer

24 Hour Trending

Internal Battery

Full Color Graphics Display

Loops and Waveforms

Standard Cart

Proximal Variable Orifice flow sensing

Proximal Airway Pressure Monitoring

Tracheal Catheter

Esophageal Balloon

Internal Compressor

Heliox Delivery

L2786 Rev. M

2 Chapter 1: Introduction Operator's manual

Optional Functions & Accessories

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

nCPAP

Option

Included

V

Option

Option

CO

2

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 (F
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.

IO

), tube diameter, length, and pharyngeal curvature based on patient

2

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

L2786 Rev. M

AVEA ventilator systems Chapter 1: Introduction 3

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.

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:

Non invasive 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 cmH
when the pressure drops below its target up to a maximum flow rate for the patient size

Range: Off/On

Default: Off

O. The ExV servo relieves when the pressure is above its target and the FCV supplies flow

2

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/cmH

Default: 0.0 ml/cmH

The ventilator automatically measures Circuit Compliance during the Extended Systems Test (EST). The value cannot
be entered manually.

O

2

O

2

L2786 Rev. M

4 Chapter 1: Introduction Operator's manual

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: Off/On
Default: 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.

IO

To set the Helium / Oxygen mixture during administration simply set the desired F
Helium.

For example:

IO

A set F

of 35% will deliver a 65/35 Heliox mixture to the patient.

2

, the balance of the breathing gas is

2

L2786 Rev. M

AVEA ventilator systems Chapter 1: Introduction 5

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

L2786 Rev. M

6 Chapter 1: Introduction Operator's manual

This page intentionally left blank.

L2786 Rev. M

AVEA ventilator systems 7

Chapter 2: Unpacking and Setup

Ventilator Assembly & Physical Setup

Unpacking the Ventilator

The AVEA is designed for simplicity of operation and set-up. It requires minimal assembly on site.

Items Required for Ventilator Setup

You will need the following to setup your AVEA ventilator:

• Power Source. The ventilator operates from a standard 100, 110, 220, or 240 VAC power source or an optional external

24VDC battery. There is an internal battery supplied with the ventilator, which will operate the ventilator for short periods
(see “Chapter 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 green LED lot to insure a fully charged battery.

• Pressurized Oxygen, Air or Heliox Gases. The compressed gas sources must provide clean, dry, medical grade gas

at a line pressure of 20 to 80 PSIG (1.4 to 5.6 bar).

Air or Heliox Supply

Pressure Range: 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 40°C (41 to 104°F)
Minimum Flow: 80 L/min at 20 psig (1.4 bar)
Air Inlet fitting CGA DISS-type body, No. 1160 (Air). NIST fitting per BS-5682:1984 (Air) also available.
Heliox Inlet fitting 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: 20 to 80 psig (1.4 to 5.5 bar) (Supply Oxygen)
Temperature: 5 to 40º C (41 to 104º
Humidity: Dew Point of gas should be 1.7º
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 (O

F)

C (3º F) below the ambient temperature (minimum)

) also available.

2

L2786 Rev. M

8 Chapter 2: Unpacking and Setup Operator's manual

Standard

Comprehensive

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).

Ventilator Base

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.

L2786 Rev. M

AVEA ventilator systems Chapter 2: Unpacking and Setup 9

Locating Ridge for assembly

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.

into cartridge

Figure 2–3: Attaching the Exhalation Filter

Figure 2–2: Attaching the Collection Bottle to the Water Trap

Push the exhalation filter into the water trap assembly top as shown.

L2786 Rev. M

10 Chapter 2: Unpacking and Setup Operator's manual

Slot matches locating ridge

Align the locating ridge on the water trap assembly with the slot in the exhalation filter cartridge (Figure 2–4).

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

L2786 Rev. M

AVEA ventilator systems Chapter 2: Unpacking and Setup 11

Rotate the metal locking lever on the lower right of the ventilator body
forward to an open position.

Figure 2–6: Open locking lever

Insert the completed cartridge assembly
into the ventilator body as shown. Make
sure it is completely seated in the well.

Figure 2–7: 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

L2786 Rev. M

12 Chapter 2: Unpacking and Setup Operator's manual

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.

L2786 Rev. M

AVEA ventilator systems Chapter 2: Unpacking and Setup 13

3. Close the locking lever completely to secure the filter in the ventilator well.

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.

L2786 Rev. M

14 Chapter 2: Unpacking and Setup Operator's manual

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.

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

L2786 Rev. M

AVEA ventilator systems Chapter 2: Unpacking and Setup 15

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.

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

L2786 Rev. M

16 Chapter 2: Unpacking and Setup Operator's manual

Inspiratory
Inspiratory Limb

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.

limb of Patient
Circuit

Figure 2–16: Adult Circuit with Active Humidifier

Adult Circuit without active humidifier

of Patient Circuit

Figure 2–17: Adult Patient 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.

L2786 Rev. M

AVEA ventilator systems Chapter 2: Unpacking and Setup 17

Inspiratory Limb

Comprehensive

Neonatal Patient Circuit

The Neonatal Patient Circuit is attached as
shown in Figure 2–18.

of Patient Circuit

Figure 2–18: Neonatal Patient Circuit

Front Panel Connections

Standard

Figure 2–19: AVEA Front Panel Configurations Standard & Comprehensive

L2786 Rev. M

18 Chapter 2: Unpacking and Setup Operator's manual

Retractable plastic

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.

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

collar

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.

L2786 Rev. M

AVEA ventilator systems Chapter 2: Unpacking and Setup 19

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.

L2786 Rev. M

20 Chapter 2: Unpacking and Setup Operator's manual

Retractable plastic collar

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.

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.

L2786 Rev. M

AVEA ventilator systems Chapter 2: Unpacking and Setup 21

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 F
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

IO

and is active for 20 minutes. Attach the nebulizer tubing to the

2

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.

L2786 Rev. M

22 Chapter 2: Unpacking and Setup Operator's manual

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 & 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.

L2786 Rev. M

AVEA ventilator systems Chapter 2: Unpacking and Setup 23

(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 P

Figure 2–24: Esophageal balloon connector

.

ES

Note:

See “Chapter 4: Monitors, Displays and Maneuvers” for placement technique for esophageal balloons.

Tracheal Catheter

A tracheal catheter will attach to the AVEA at the connection on the front panel marked as Aux. The connector is shown
in Figure 2–23.

Note:

See “Chapter 4: Monitors, Displays and Maneuvers” for placement technique for tracheal catheters.

WARNING

The AVEA is designed to ensure that the user and patient are not exposed to excessive leakage current per
applicable standards (UL2601 and IEC60601-1). However, this cannot be guaranteed when external devices
are attached to the ventilator.

To prevent the risk of excessive enclosure leakage current from external equipment attached to the RS-232,
printer or video ports, the protective earth paths must be isolated to ensure proper connection.

This isolation should ensure that the cable shields are isolated at the peripheral end of the cable.

See “Appendix B: Specifications” regarding connections and communications.

L2786 Rev. M

24 Chapter 2: Unpacking and Setup Operator's manual

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

B

A C E J I D H F G

K

Setting Up the Rear of the Ventilator

Figure 2–25: Rear panel

L2786 Rev. M

AVEA ventilator systems Chapter 2: Unpacking and Setup 25

O2 Cell

“Smart” Connector
Collar

Connecting the Oxygen Sensor

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.

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.

Figure 2–27: Attaching the Air “smart”
connector with water trap.

L2786 Rev. M

26 Chapter 2: Unpacking and Setup Operator's manual

Tether

The “Smart” Heliox Fitting

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.

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 O

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).

Heliox Connection

Figure 2–30: Connecting the Heliox Hose

fitting type is CGA DISS type, No.

2

Figure 2–29: Connecting the O2 Hose

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.

L2786 Rev. M

AVEA ventilator systems Chapter 2: Unpacking and Setup 27

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.

L2786 Rev. M

28 Chapter 2: Unpacking and Setup Operator's manual

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 O

soft key, to re-enable depress the soft key again.

2

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.

L2786 Rev. M

AVEA ventilator systems Chapter 2: Unpacking and Setup 29

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 F
F

IO

on each ventilator is recommended.

2

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.

IO

during independent lung ventilation. Close monitoring of set

2

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 (cmH

O/mv), flow ((ml/min)/mv) and Volume (ml/mv) conversions.

2

L2786 Rev. M

30 Chapter 2: Unpacking and Setup Operator's manual

Slave

Master

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.

Figure 2–33: ILV Connection Pin Configuration

Figure 2–34: Analog Ground Pins

L2786 Rev. M

AVEA ventilator systems Chapter 2: Unpacking and Setup 31

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

FIO

ventilator will increase above the current set

Example: If the Increase

FIO

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.

.

2

is set at 20%

2

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.

L2786 Rev. M

32 Chapter 2: Unpacking and Setup Operator's manual

Input/Output Tab

Figure 2–35: Utility Screen, Input / Output Tab

L2786 Rev. M

AVEA ventilator systems Chapter 2: Unpacking and Setup 33

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.

Figure 2–36: Analog Input connections

L2786 Rev. M

34 Chapter 2: Unpacking and Setup Operator's manual

Pressure, Flow, Volume, Breath Phase

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).

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 (cmH

O/mv), flow ((L/min)/mv) and Volume (ml/mv) conversions.

2

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.

L2786 Rev. M

AVEA ventilator systems Chapter 2: Unpacking and Setup 35

PIN

FUNCTION

Table 2–1: ILV and Analog I/O pin configuration

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.

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

L2786 Rev. M

36 Chapter 2: Unpacking and Setup Operator's manual

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

L2786 Rev. M

AVEA ventilator systems Chapter 2: Unpacking and Setup 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.

L2786 Rev. M

38 Chapter 2: Unpacking and Setup Operator's manual

ON

OFF

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.

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.

L2786 Rev. M

AVEA ventilator systems Chapter 2: Unpacking and Setup 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 High O2 alarm
Ext High Ppeak Alarm Low Ppeak alarm
Low Ve alarm Loss of AC alarm
High Ve alarm Circuit Disconnect
High Vt alarm High Rate Alarm
Low O
Low Vt alarm Low PEEP alarm

alarm Apnea Interval alarm

2

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.

L2786 Rev. M

40 Chapter 2: Unpacking and Setup Operator's manual

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.

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 2.46a Remove Patient Instruction

Figure 2.46b In progress EST

L2786 Rev. M

Figure 2.46c Completed EST

Figure 2–45: EST Screens

AVEA ventilator systems Chapter 2: Unpacking and Setup 41

Adult Setting

Pediatric Setting

Neonate Setting

Air Supply Pressure

O2 Supply Pressure

AC Line Voltage

Patient Circuit

Compliance

Resistance

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:

> 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 O
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.

gas supply. Connect the power cord to an appropriate AC outlet. Attach

2

L2786 Rev. M

42 Chapter 2: Unpacking and Setup Operator's manual

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 % O
Low O
Remove sensor from back panel. Provide blow-by to the sensor from an external oxygen flow meter. Verify that the High
O

alarm activates. Return the % O2 to 21%, reconnect the Oxygen sensor to the back panel. Clear all alarm messages

2

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.

control to 100%. Disconnect the Oxygen sensor from the back panel of the ventilator and verify that the

2

alarm activates. Return the O2 control setting to 21% with the sensor still disconnected from the rear panel.

2

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.

L2786 Rev. M

AVEA ventilator systems Chapter 2: Unpacking and Setup 43

Adult Setting

Pediatric Setting

Neonate Setting

ET tube Diameter

7.5 mm

5.5 mm

3.0 mm

ET Tube Length

30 cm

26 cm

15 cm

Artificial Airway
Compensation

Leak
Compensation

Off

Off

Off

Circuit

(Circ Comp)

Humidification

Active On

Active On

Active On

Patient Weight

1 kg

1 kg

1 kg

Adult Setting

Pediatric Setting

Neonate Setting

Breath Type/Mode

Volume A/C

Volume A/C

TCPL A/C

Breath Rate (Rate)

12 bpm

12 bpm

20 bpm

Tidal Volume
(Volume)

Peak Flow

60 L/min

20 L/min

8 L/min

Inspiratory

Pres)

Inspiratory Pause
(Insp Pause)

0.0 sec

0.0 sec

0.0 sec

Inspiratory Time
(Insp Time)

PSV

PEEP

Inspiratory Flow

Trig)

1.0 L/min

1.0 L/min

0.5 L/min

%O2

40%

40%

40%

Adult Setting

Pediatric Setting

Neonate Setting

Vsync

0 (off)

0 (off)

N/A

Vsync Rise

5 5 N/A

Sigh

0 (off)

0 (off)

N/A

Waveform

1 (Dec)

1 (Dec)

1 (Dec)

Bias Flow

2.0 L/min

2.0 L/min

2.0 L/min

Inspiratory

(Pres Trig)

PSV Rise

5 5 5

PSV Cycle

25%

25%

10%

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.

Ventilation Setup

Off Off Off

0.0 ml/cmH2O 0.0 ml/cmH2O 0.0 ml/cmH2O

Compliance
Compensation

Primary Controls

NOT active in
Neonates.

Pressure (Insp

Trigger (Flow

Advanced Settings

Pressure Trigger

500 ml 100 ml 2.0 ml

15 cmH2O 15 cmH2O 15 cmH2O

1.0 sec 0.75 sec 0.35 sec

0 cmH2O 0 cmH2O 0 cmH2O
6 cmH2O 6 cmH2O 3 cmH2O

3.0 cmH2O 3.0 cmH2O 3.0 cmH2O

L2786 Rev. M

44 Chapter 2: Unpacking and Setup Operator's manual

Adult Setting

Pediatric Setting

Neonate Setting

PSV Tmax

5 sec

0.75 sec

0.35 sec

Machine Volume
(Mach Vol)

0 L

0 ml

0 ml

(Vol Limit)

Inspiratory Rise
(Insp Rise)

5 5 5

Flow Cycle

0% (off)

0% (off)

0% (off)

T High PSV

Off

Off

N/A

T High Sync

0%

0%

N/A

T Low Sync

0%

0%

N/A

Demand Flow

On

On

On

Adult Setting

Pediatric Setting

Neonate Setting

High Rate

75 bpm

75 bpm

75 bpm

High Tidal Volume
(High Vt)

3.00 L

1000 ml

300 ml

Low Tidal Volume
(Low Vt)

0.0 L

0.0 ml

0.0 ml

Low Exhaled

(Low Ve)

1.0 L

0.5 L

0.5 L

High Exhaled

(High Ve)

30.0 L/min

30.0 L/min

5.0 L/min

Low Inspiratory

Ppeak)

High Inspiratory

Ppeak)

Low PEEP

Apnea Interval

20 sec

20 sec

20 sec

Adult Setting

Pediatric Setting

Neonate Setting

Manual Breath

---

---

---

Suction

---

---

---

↑ O2

79%

79%

20%

Nebulizer

---

Inspiratory Hold
(Insp Hold)

---

---

---

Expiratory Hold
(Exp Hold)

---

---

---

Volume Limit

Alarm Settings

Minute Volume

Minute Volume

Pressure (Low

2.50 L 500 ml 300.0 ml

8 cmH2O 8 cmH2O 5 cmH2O

40 cmH2O 40 cmH2O 30 cmH2O

Pressure (High

3 cmH2O 3 cmH2O 1 cmH2O

Auxiliary Controls

L2786 Rev. M

AVEA ventilator systems Chapter 2: Unpacking and Setup 45

TEST

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

High O2 Alarm

Low O2 Alarm

AVEA User Verification Test Checklist

Machine Serial Number:________________________________ Test Date: __________________

PASS FAIL

Loss of AC Alarm

Signature of tester:_______________________________________________

Title___________________________________________________________

L2786 Rev. M

46 Chapter 2: Unpacking and Setup Operator's manual

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

Replace circuit if necessary.

Filter cartridge not properly seated

Remove exhalation cartridge and

necessary

Leak in exhalation corner

Replace exhalation diaphragm.

Will not pass EST - Fails O2

Connector on O2 sensor not

Check sensor connection
Defective O2 sensor

Replace O2 Sensor

No reading from proximal flow sensor

Sensor / Patient size incompatible

See the operators manual for

Sensor not connected

Ensure sensor properly connected

ventilator.

Loose external connection

Check external connection

Defective sensor

Replace sensor

Internal fault

Call Technical Service

Vti > Vte when operating without

Normal Condition when operating

No action required

Normal if readings are within

of +/-10%

No action required if within
Defective expiratory flow sensor

Clean/replace expiratory flow
sensor

Leak in patient circuit, water

Verify with leak test

Vte > Vti

Normal if readings are within

No action required if within
Leak in patient circuit, water

Verify with leak test

AVEA Troubleshooting

Remove ventilator from patient with any potential problem

circuit connections to ventilator.

check condition of connections.
Reinstall and recheck. Replace if

calibration

proximal flow sensors

connected properly

Inlet gas pressure too low Verify inlet air and oxygen pressure

above 20psig

correct sensor/mode configurations

at both the patient wye and at the

on test lung.

ventilator accuracy specifications

collector or exhalation system

specification

L2786 Rev. M

ventilator accuracy specifications
of +/-10%

Defective expiratory flow sensor Clean/replace expiratory flow

collector or exhalation system

Internal fault Call Technical Service

specification

sensor

AVEA ventilator systems Chapter 2: Unpacking and Setup 47

Symptom

Problem

Solution(s)

Volume waveform above or below

Humidifier "Active on/off" set

Set for "Active on” for humidifier,

Normal if readings are within

of +/-10%

No action required if within
Bad expiratory flow sensor

Clean or replace expiratory flow
sensor

Internal fault

Call Technical Service

Internal fault

Call Technical Service

Nebulizer output absent

Ventilator running on compressor

Connect wall air

Flow less than 15 L/min

Increase flow if appropriate

Internal fault

Call Technical Service

F

O2 sensor requires calibration

Perform EST

O2 sensor at end of life

Replace O2 Sensor

PEEP too high

Exhalation filter cartridge clogged

Replace cartridge

Defective exhalation diaphragm

Change exhalation diaphragm

Power cord not connected to

Check connections

Unit will not run properly on battery

Battery not sufficiently charged

Internal battery requires at least 4

with green LED lit for a full charge.

Improper charge level indicator -

Excessively discharged battery

Requires at least 4 hours for full

maintain adequate charge.

Maintenance and testing required.

Perform Internal Battery Charge

baseline on patient with internal
sensor

Volumes become inaccurate over
time

IO

monitor inaccurate or reads "***"

2

incorrectly

ventilator accuracy specifications

"Active off" for “HME"

specification

Foreign material on flow sensor Clean/replace sensor

or saturated

Unit will not run on A/C power Blown fuse on power entry module Replace fuse

Internal battery

• The internal battery does not

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

L2786 Rev. M

mains power

hours to be fully charge. External
battery requires at least 12 hours

charge

Monitor Reset

48 Chapter 2: Unpacking and Setup Operator's manual

Symptom

Problem

Solution(s)

Improper charge level indicator -

Excessively discharged battery

Requires at least 12 hours for full
charge

Loose connections

Check connections

Decreased run time on battery
Battery not fully charged

Internal battery requires at least 4

Defective battery

Call technical Service

Does not run on compressor

Internal fault

Call Technical Service

Auto triggering

Improper sensitivity settings

Check flow and pressure trigger

Circuit leaks

Perform EST and correct leaks as

Flow Trigger setting.

Demand Flow turned off

Turn on Demand Flow

Vent INOP display

System fault

Call Technical Service

Low gas alarm on compressor

Minute volume exceeds 40 L/min

Reduce minute volume

"Loss of gas" alarm

Air/Heliox connector not properly

Insure proper connection
Internal fault

Call Technical Service

Exhalation flow sensor not

Check connections
O2 sensor connector not

Check O2 sensor

Internal fault

Call Technical Service
disconnected.

NCPAP Pressure Limit

Occluded expiratory filter

Replace expiratory filter

External battery

hours for full charge. External
battery requires a minimum of 12
hours for a full charge.

settings

required. Bias Flow should be set to
approximately 1.5 lm greater than

connected

Device Error indicator Defective sensor Replace sensor

connected

connected

Defective O2 sensor Replace O2 sensor

Improper connection sequence External battery connection should

be made with AC power

Occlusion of expiratory limb of
patient circuit.

Check expiratory limb for kinks
and/or water

L2786 Rev. M

AVEA ventilator systems Chapter 2: Unpacking and Setup 49

Symptom

Problem

Solution(s)

Low NCPAP Pressure

High NCPAP Pressure

Circuit Disconnect

Inaccurate barometric pressure reading

Circuit disconnect

Circuit leak

Patient interface leak

Patient circuit occlusion

Water in circuit

Patient interaction

Patient circuit disconnect Check patient circuit

Barometer could require
calibration

Check circuit

Check patient interface

Check patient circuit

Check nasal prongs

Call CareFusion Technical Support.

L2786 Rev. M

50 Chapter 2: Unpacking and Setup Operator's manual

This page intentionally left blank

L2786 Rev. M

AVEA ventilator systems 51

Chapter 3: Ventilator Operation

Membrane Buttons and LEDs

Figure 3.1a User Interface Module (International) Showing Button Icons

L2786 Rev. M

52 Chapter 3: Ventilator Operation Operator's manual

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.

L2786 Rev. M

AVEA ventilator systems Chapter 3: Ventilator Operation 53

C. Alarm Limits

Opens the alarm limits screen for data entry or adjustment. Toggles the screen on and off.

Note:

Pressing the Freeze button while the Alarm Limits window is open will automatically close the window and freeze the
graphics.

D. Manual Breath

Pressing this button during the expiration phase of a breath delivers a single mandatory breath at current ventilator
settings. No breath is delivered if the key is pressed during inspiration.

Note:

The Manual Breath button is not active in APRV / BIPHASIC.

E. Suction (LED)

Pressing this button initiates a “Disconnect for Suction” maneuver.

The ventilator will:

• Enable an “Increase % O2” maneuver for 2 minutes (see Increase O2 below).

• 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 % O

Neonate: 20% above the set % O

2

or 100%, whichever is less

2

L2786 Rev. M

54 Chapter 3: Ventilator Operation Operator's manual

IO

To configure the Increase F

Access the Configuration tab on the Utilities Screen:

Increase F

Configures the step increase
increase above the current set

Example: If the Increase F

AND

The set F

WHEN

The default setting for infants is 20% and 79% for Pediatric and Adult applications.

IO

:

2

:

2

used during the increase oxygen maneuver. Sets the amount of oxygen the ventilator will

FIO2.

IO

is set at 20%

2

IO

is 40%

2

The increase F
which it will return to 40%.

IO

Maneuver is activated the FIO2 will increase to 60% for two minutes after

2

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.

L2786 Rev. M

AVEA ventilator systems Chapter 3: Ventilator Operation 55

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 >

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.

15 L/min.

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.

L2786 Rev. M

56 Chapter 3: Ventilator Operation Operator's manual

N. Panel Lock (LED)

The LOCK key disables all front panel and screen controls except MANUAL BREATH, Suction,↑ %O2, ALARM RESET,
ALARM SILENCE, and LOCK.

O. Print

The PRINT key outputs the contents of the currently displayed screen to a suitably connected parallel printer.

P. Set-up

Opens the ventilator Setup screen.

Note:

Pressing the Set-Up button a second time before accepting Set-Up will close the window and restore the previous
settings. The Set-Up screen uses an on screen accept button. To change patient size without selecting new patient
requires that patient Set-Up be accepted after selecting patient size.

Q. Advanced Settings (LED)

Opens the Advanced Settings screen for data entry or adjustment. Toggles the screen on & off.

Note:

Pressing the Freeze button while the Advanced Setting window is open will automatically close the window and freeze
the graphics.

R. Mode

Opens the Mode Select screen for data entry or adjustment toggles the screen on or off. Pressing the Mode indicator at
the top of the touch screen will also access the screen.

Note:

Pressing the Mode button a second time before accepting the Mode will close the window and restore the previous
settings. The Mode screen uses an on screen accept button.

S. Event

Records an event for future reference. Some events are recorded automatically others can be logged manually to
display in this screen. See “Chapter 4: Monitors, Displays and Maneuvers” for a full list of events.

L2786 Rev. M

AVEA ventilator systems Chapter 3: Ventilator Operation 57

Dashed
Cursor Line

Flag showing X

Flow/Volume

Cursor, currently

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.

and Y values at
various points
along the loop
tracing

Loop Tracing

Figure 3–2: Flow/Volume Loop in Freeze Mode

overlays the “X”
axis at Zero

L2786 Rev. M

58 Chapter 3: Ventilator Operation Operator's manual

U. 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”).

L2786 Rev. M

AVEA ventilator systems Chapter 3: Ventilator Operation 59

Patient Setup

Patient Select Screen

The Patient Select screen allows you to choose to resume ventilation of the current patient (RESUME CURRENT) or
select (NEW PATIENT) to reconfigure ventilator settings.

Figure 3–4: Patient Select Screen

If you press the Resume Current key, the ventilator begins ventilation at the most recent patient settings.

The New Patient key clears loops and trend buffers and resets all settings to default values.

Press Patient Accept to accept your selection.

L2786 Rev. M

60 Chapter 3: Ventilator Operation Operator's manual

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.

L2786 Rev. M

AVEA ventilator systems Chapter 3: Ventilator Operation 61

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 (F
Adult). This compensation only occurs during inspiration. Artificial Airway Compensation is active in all Pressure
Support and Flow Cycled Pressure Control Breaths.

IO

), tube diameter, length, and pharyngeal curvature based on patient size (Neonatal, Pediatric,

2

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.

L2786 Rev. M

62 Chapter 3: Ventilator Operation Operator's manual

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: 2.0 to 10.0 mm
Default: 7.5 mm (Adult)

5.5 mm (Pediatric)

3.0 mm (Neonate)

Tube length:

Range: 2.0 to 30.0 cm (Adult)

2.0 to 26.0 cm (Pediatric)

2.0 to 15.0 cm (Neonate)

Default: 30.0 cm (Adult)

26.0 cm (Pediatric)

15.0 cm (Neonate)

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 cmH
when the pressure drops below its target up to a maximum flow rate for the patient size. It is not active during breath
delivery.

O. The ExV servo relieves when the pressure is above its target and the FCV supplies flow

2

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/cmH

Circuit compliance is measured automatically by the ventilator during an Extended Systems Test (EST). The value
cannot be entered manually.

O

2

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.

L2786 Rev. M

AVEA ventilator systems Chapter 3: Ventilator Operation 63

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 1 to 300 Kg
Pediatric 1 to 75 Kg
Neonate 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 & Cancel Button

Note:

Primary breath controls active for the selected (highlighted) mode are visible at the bottom of the touch screen during
setup. The Advanced Settings dialog box and the Alarm Limits dialog box can also be opened during setup. All
controls are active and may be modified while in the Set Up screen.

L2786 Rev. M

64 Chapter 3: Ventilator Operation Operator's manual

From the Setup screen, press
the EST button.

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)

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

Once the test is complete, press Continue to return to the set up screen.

L2786 Rev. M

AVEA ventilator systems Chapter 3: Ventilator Operation 65

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.

L2786 Rev. M

66 Chapter 3: Ventilator Operation Operator's manual

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 Select the breath type for APNEA backup mode by pressing the Apnea Settings key
3 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.

L2786 Rev. M

AVEA ventilator systems Chapter 3: Ventilator Operation 67

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
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

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.

®

operator’s manual for specific instructions on attaching proximal flow sensors.

will then be adjusted by the ventilator in order

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 cmH
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.

O below the high inspiratory-pressure limit. The Expiratory Volume alarm

2

L2786 Rev. M

68 Chapter 3: Ventilator Operation Operator's manual

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 cmH

O below the high inspiratory-pressure limit. The Expiratory Volume alarm will be activated if the expiratory

2

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 cmH

Default: The pressure setting of the Pressure or TCPL mode used before enabling VG.

O

2

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 cmH

Maximum: High Peak Pressure –3 cmH

O

2

O

2

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).

L2786 Rev. M

AVEA ventilator systems Chapter 3: Ventilator Operation 69

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

L2786 Rev. M

70 Chapter 3: Ventilator Operation Operator's manual

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.

L2786 Rev. M

AVEA ventilator systems Chapter 3: Ventilator Operation 71

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.

L2786 Rev. M

72 Chapter 3: Ventilator Operation Operator's manual

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

“Volume Guarantee Disabled” On disconnect of proximal flow sensor when

“Volume Guarantee is only available in PRESSURE
and TCPL modes”

“Set Vol Target will increase delivered press and vol” Volume Target set more than 20% above

“Set Vol Target will decrease delivered press and vol” Volume Target set more than 20% below

“High Ppeak Limit < PEEP + 7 cmH2O” When Nasal CPAP / IMV mode is active and

“Volume Guarantee pressure is limited” The pressure required to deliver the desired

AVEA® message bar text Cause

Volume Guarantee is active, AAC inactive, if
flow sensor not reattached prior to alert box
closing.

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.

current setting.

current setting.

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 cmH

tidal volume is greater than the High Ppeak
alarm limit of –3 cmH

2

O.

2

O.

L2786 Rev. M

AVEA ventilator systems Chapter 3: Ventilator Operation 73

Troubleshooting

Alarm Priority Possible causes Actions

LOW Vte Medium Inspiratory time or flow

inadequate in TCPL

Inspiratory time too short
due to flow cycling in TCPL.

Delivered Pressure has
increased to its upper limit—
high pressure limit of –3

O

cmH

2

(±2 cmH
changes in ventilator
settings, resistance and/or
compliance.

O)—due to

2

Increase inspiratory time
and/or flow

Increase flow cycle setting

Increase high pressure limit
or check patient condition

L2786 Rev. M

74 Chapter 3: Ventilator Operation Operator's manual

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 cmH

The minimum “virtual” Pressure Support level is set PEEP + 2 cmH

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 cmH
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.

O or Ppeak – 2 cmH2O.

2

O, the ventilator will recognize the patient demand and automatically “switch over” to

2

2

O.

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.

L2786 Rev. M

AVEA ventilator systems Chapter 3: Ventilator Operation 75

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 cmH
that the Ppeak > 90 cmH
to less than or equal to 90 cmH

O. The operator must change the Inspiratory Pressure and or PEEP setting to limit the Ppeak

2

O.

2

O). The ventilator will deliver an on screen Pop-Up Message stating

2

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 Specifications & Circuit
Resistance”).

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 cmH
determined by the Volume Limit setting.

O. The maximum tidal volume delivered in a single breath is

2

L2786 Rev. M

76 Chapter 3: Ventilator Operation Operator's manual

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 cmH
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 T

max ) or flow (PSV Cycle).

O in adult and pediatric applications, independent of the set

2

Pressure Support is active when CPAP/PSV, SIMV or APRV/BiPhasic modes are selected

L2786 Rev. M

AVEA ventilator systems Chapter 3: Ventilator Operation 77

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 cmH
that the Ppeak > 90 cmH
to less than or equal to 90 cmH

O. The operator must change the Inspiratory Pressure and or PEEP setting to limit the Ppeak

2

O.

2

O). The ventilator will deliver an on screen Pop-Up Message stating

2

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 cmH

In neonatal applications a Spontaneous breath is a demand breath delivered only at the preset PEEP.

O.

2

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).

L2786 Rev. M

78 Chapter 3: Ventilator Operation Operator's manual

Breath Interval
elapsed

Breath Interval
elapsed

TIME

PRESSURE

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).

1 Mandatory Breath (Breath interval expired)

2 Mandatory Breath (Patient triggered)

Figure 3–13: Assist Control Ventilation Waveform

L2786 Rev. M

AVEA ventilator systems Chapter 3: Ventilator Operation 79

Pressure

Time

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

• A patient effort is detected;

• The breath interval has elapsed with no patient effort detected;

• The MANUAL BREATH key has been pressed.

one of the following occurs:

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.

L2786 Rev. M

80 Chapter 3: Ventilator Operation Operator's manual

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 cmH
that the Ppeak > 90 cmH
to less than or equal to 90 cmH

O. The operator must change the Inspiratory Pressure and or PEEP setting to limit the Ppeak

2

O. This 90 cmH2O limit warning is not active when T High PSV is OFF.

2

O). The ventilator will deliver an on screen Pop-Up Message stating

2

L2786 Rev. M

AVEA ventilator systems Chapter 3: Ventilator Operation 81

Time

Pressure

Demand Breath

Time High

Time Low

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 High

Pressure Low

Spontaneous Breath triggers change to Pressure High
Spontaneous Breath triggers change to Pressure Low

Figure 3–15: APRV / BIPHASIC Mode

L2786 Rev. M

82 Chapter 3: Ventilator Operation Operator's manual

Pressure

Time

Demand Breath

Continuous Positive Airway Pressure (CPAP) Pressure Support Ventilation (PSV)

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.

L2786 Rev. M

AVEA ventilator systems Chapter 3: Ventilator Operation 83

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:

Non invasive 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.

L2786 Rev. M

84 Chapter 3: Ventilator Operation Operator's manual

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

L2786 Rev. M

AVEA ventilator systems Chapter 3: Ventilator Operation 85

Figure 3–19: Pressure Apnea Backup settings for APRV / BIPHASIC Mode

Figure 3–20: Volume Apnea Backup settings for CPAP Mode

L2786 Rev. M

86 Chapter 3: Ventilator Operation Operator's manual

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.

L2786 Rev. M