Medical International Research spirolab III User Manual

spirolab III

User Manual Rev 1.6

Issued on 23/04/2007
Approved on 23/04/2007

User Manual

spirolab III – User Manual Code MIR 980067 REV 1.6 Page 1 / 77

Thank you for choosing a product from MIR
Medical International Research

The original packaging contains one of the following spirometers, complete with its standard
accessories:

PRODUCT without oximetry

option

Spirolab IIIbag
Spirolab IIIdevice

MiniFlowmeter sensor

Spirolab IIIUser Manual 980067 spirolabIII User Manual 980067
USB connection cable 532365 USB connection cable 532365

MiniFlowmeter to SpirolabIII

cable
1 power supply (220V) 920665 1 power supply (220V) 920665
CD winspiroPRO 920100 CD winspiroPRO 920100

1 Roll of thermal paper 910350 1 Roll of thermal paper 910350
1 nose clip 910320 1 nose clip 910320
2 paper mouthpieces 910300 2 paper mouthpieces 910300

2 disposable turbine sensors 910001 2 disposable turbine sensors 910001
1 reusable turbine sensor 910000 1 reusable turbine sensor 910000
1 spare fuse (internal) 2A 270464 1 spare fuse (internal) 2A 270464

1 spare fuse (internal) 4A 270468 1 spare fuse (internal) 4A 270468

OPTION CODE OPTION CODE

Serial/parallel printer converter 910110 Serial/parallel printer converter 910110
Connection cable RS 232, 9 pin

for PC

CODE PRODUCT with oximetry

option

672685
910551
910590

532370

671492 wrap finger sensor for oximetry

spirolabIII bag
spirolabIII device plus oxy

MiniFlowmeter sensor

MiniFlowmeter to SpirolabIII

cable

1 oximeter sensor 919010

over a long period
Connection cable RS232, 9

pin for PC

CODE

672685
910551
910590

532370

919001
671492

Before using your spirometer …

Please read this manual carefully, plus the labels and all of the information supplied
together with the product.

WARNING

Note that this symbol means: read the instructions carefully before use.

spirolab III – User Manual Code MIR 980067 REV 1.6 Page 2 / 77

Set up the device (date, time, language, predicted values, etc.) to your requirements as
described under Configuration Menu in this Manual.

Keep the original packaging!

In the event that your spirometer has a problem, always use the original packaging to return it
to your local distributor or to the manufacturer.

MIR has a policy of continuous product development and improvement, and the
manufacturer therefore reserves the right to modify and to update the information
contained in this User’s Manual as required. Any suggestions and or comments
regarding this product should be sent via email to: [e-mail]. Thank

you.
MIR accepts no responsibility for any loss or damage caused by the use of the
device due to the use of this Manual and/or due to an incorrect use of the product.
Note that due to printing limitations the screenshots shown in this manual may
differ from the display of the machine and/or from the keyboard graphics.

Copying this manual in whole or in part is strictly forbidden.

IMPORTANT NOTE

If the instrument is returned for repair it must be accompanied by a clear and detailed
explanation of the defect or problem found.

 the unit must be returned in its original packaging;
 transport costs must be prepaid.

Manufacturer’s address:

MIR srl: Via Del Maggiolino, 125
00155 Roma, Italy

Tel ++ 39 0622754777
Fax ++ 39 0622754785 e-mail: [e-mail]

spirolab III – User Manual Code MIR 980067 REV 1.6 Page 3 / 77

INDEX

INTRODUCTION.......................................................................................................................6

1 GENERAL INFORMATION...............................................................................................6

1.1 Intended use...............................................................................................................6

1.1.1 User Category...................................................................................................6

1.1.2 Ability and experience required.........................................................................6

1.1.3 Operating environment.....................................................................................7

1.1.4 Who can or must make the installation.............................................................7

1.1.5 Subject effect on the use of the device.............................................................7

1.1.6 Limitations of use - Contraindications...............................................................7

1.2 Important safety warnings ..........................................................................................8

1.2.1 Danger of cross-contamination .......................................................................10

1.2.2 Turbine............................................................................................................11

1.2.3 Mouthpiece .....................................................................................................11

1.2.4 Oximetry sensor..............................................................................................12

1.3 problems and unforseen errors................................................................................13

1.4 LABELS AND SYMBOLS .........................................................................................14

1.5 techical features of the spirometer...........................................................................16

1.6 technical specifications.............................................................................................17

1.6.1 Features of the spirometer..............................................................................17

1.6.2 Features of the oximeter.................................................................................18

2 PRODUCT DESCRIPTION.............................................................................................22

2.1 ILLUSTRATION OF Spirolab III................................................................................24

2.2 keyboard...................................................................................................................24

2.3 Charging the battery.................................................................................................25

2.4 Switching on the spirometer.....................................................................................26

2.5 Settings ....................................................................................................................26

2.5.1 Contrast settings.............................................................................................27

2.5.2 Loading the thermal paper..............................................................................27

2.5.3 Connecting the flow sensor.............................................................................28

2.5.4 Switching off the spirometer............................................................................28

2.5.5 Initial settings..................................................................................................29

2.5.6 Functioning of the spirometer .........................................................................35

2.5.7 New subject data entry ...................................................................................37

2.5.8 Modify subject data.........................................................................................38

2.6 Spirometry: fvc, vc/ivc, mvv......................................................................................38

2.6.1 Spirometry testing...........................................................................................39

2.6.2 Spirometry post - drug ....................................................................................40

2.7 Test quality control - spirometry...............................................................................42

2.8 Repeatability of the fvc test ......................................................................................43

2.9 Method of measurement and interpretation..............................................................43

2.10 Oximetry testing...................................................................................................44

2.10.1 Spot oximetry ..................................................................................................47

2.10.2 Sleep Oximetry................................................................................................48

2.10.3 Exsercise oximetry..........................................................................................49

2.10.4 Spot oximetry (MEMORIZED LIKE OXYTEST)...............................................50

2.11 File organization ..................................................................................................50

spirolab III – User Manual Code MIR 980067 REV 1.6 Page 4 / 77

2.12 Search and read tests in memory........................................................................51

2.12.1 Subject List by last name:...............................................................................51

2.12.2 Subject List by ID code...................................................................................52

2.12.3 Memory List ....................................................................................................52

2.13 View and print results ..........................................................................................52

3 DATA TRANSMISSION ..................................................................................................54

3.1 Data Transmission via Bluetooth to a cell phone .....................................................54

3.1.1 Preliminary operations....................................................................................54

3.1.2 Setting the Phone Number..............................................................................54

3.1.3 Data Transmission through Bluetooth.............................................................54

3.1.4 Data Transmission via Bluetooth for printing..................................................55

3.2 Connection to a pc ...................................................................................................55

3.2.1 Connection to a PC through a USB port.........................................................56

3.2.2 Connection to PC through RS 232 port. .........................................................56

3.3 Upgrade internal software ........................................................................................56

4 MAINTENANCE AND CLEANING ..................................................................................56

4.1 Cleaning the device..................................................................................................57

4.2 Cleaning the reusable turbine ..................................................................................57

4.3 Cleaning and disinfection of the oximetry sensor.....................................................59

5 PROBLEMS/CAUSES AND SOLUTIONS ......................................................................60

5 LIMITED WARRANTYCONDITIONS.............................................................................62

ANNEXES...............................................................................................................................64

Declaration of conformity....................................................................................................64

Example of oximetry test report ..........................................................................................65

Information for correct use in an electromagnetic environment..........................................66

N

spirolab III – User Manual Code MIR 980067 REV 1.6 Page 5 / 77

INTRODUCTION

The spirometers series MIR009 are sold with the spirolab IIItrademark.
spirolabIII is available with two different displays:

 Colour LCD display
 B/W LCD display

Unless otherwise specified, from this point onwards the term spirolab III is used to refer to
both models.

1 GENERAL INFORMATION

1.1 INTENDED USE

Spirolab III spirometer and pulse oximeter is intended to be used by either a physician,

respiratory therapist or technician.
The device is intended to test lung function and can make:

 spirometry testing in people of all ages, excluding infants and neonates
 oximetry testing in people of all ages.

It can be used in any setting.

1.1.1 User Category

spirolab III, spirometer + pulse oximeter calculates a series of parameters relating to
human respiratory function.

1.1.2 Ability and experience required

The correct use of the device, the interpretation of the results and the maintenance of the
device, with particular WARNING on cleaning operations (cross-contaminationrisk), all require
qualified personnel.

WARNING

MIR cannot be held responsible for any damage caused by the user of the device
failing to follow the instructions and warnings contained in this manual.
If the user of spirolab III is a person considered to be cognitively impaired, then the
operation of the device must be made under the supervision and responsibility of
whoever is legally charged with the supervision of this person.

spirolab III – User Manual Code MIR 980067 REV 1.6 Page 6 / 77

The spirolab III when used as a pulse oximeter is intended for spot-checking,
overnight sleep screening and/or continuous monitoring when attended by a
trained healthcare professional.

1.1.3 Operating environment

The device has been envisaged for use in a doctor’s office or in a hospital setting.
The information necessary for the proper use of the device in surrounding electromagnetic
environments (as required by EN 60601-1-2) is contained in the Annex.
The device is not intended for use in an operating theatre nor in the presence of inflammable

liquids or detergents, nor in the presence of inflammable anaesthetic gases (oxygen or
nitrogen).
The device is not designed to be used in direct air currents (e.g. wind), sources of heat or
cold, direct sun rays or other sources of light or energy, dust, sand or any other chemical
substances.

The user and/or the doctor are responsible for ensuring that the device is stored and used in
appropriate environmental conditions; in this regard reference is made to the specifics
described in paragraph 1.5 below.

WARNING

If the device is exposed to unsuitable environmental conditions, this could cause
the device to malfunction and to give incorrect results.

1.1.4 Who can or must make the installation

The device requires installation by qualified personnel. The user shall normally configure the
device accordingly.

1.1.5 Subject effect on the use of the device

A spirometry test should only be carried out when the subject is at rest and in good health,
and thus in a suitable condition for the test. A spirometry test requires the collaboration of the
subject, since the subject must make a complete forced expiration, in order to have a

meaningful test result.

1.1.6 Limitations of use - Contraindications

An analysis of the results of a spirometry test is not by itself sufficient to make a correct
diagnosis of the subject’s clinical condition. Test comments, a test interpretation and
suggested courses of treatment must be given by a doctor.

Any symptoms that the subject has at the time must be carefully considered before a
spirometry test is made. The user is responsible to assess both the mental and the physical
capacity of the subject to make a correct test and the user must also assess the degree of
collaboration for each test carried out.
A correct spirometry test requires the complete collaboration of the subject. The results

depend on the person’s capability to inspire and to expire all air completely and as fast as

spirolab III – User Manual Code MIR 980067 REV 1.6 Page 7 / 77

possible. If these fundamental conditions are not respected then the results obtained during
spirometry testing will not be accurate, and therefore the test results are "not acceptable".
The acceptability of a test is the responsibility of the user. Special WARNING should be

given to testing elderly subjects, children and handicapped people.
The device should never be used when it is possible or probable that the validity of the
results may be compromised due to any such external factors.

WARNING

The instrument must be used as described in the User’s Manual with particular
WARNING to the paragraph on Intended Use utilizing only original spare parts and
accessories as specified by the manufacturer may be used. Use of non original

parts such as the turbine sensor or other accessories may cause errors in
measurement and/or compromise the correct functioning of the device. Any use of
the device which differs from the original is to be considered improper and
therefore dangerous.

The spirolab III when used as a pulse oximeter has limited alarms, therefore the
device requires frequent display observation of SpO2 and pulse rate.

1.2 IMPORTANT SAFETY WARNINGS

spirolab III has been examined by an independent laboratory which has certified the
conformity of the device to the European Safety Standards EN 601-1 and guarantees the

EMC Requirements within the limits laid down in the European Standard EN 60601-1-2
spirolab III is constantly controlled during its production, therefore the product confirms to the

established security levels and quality standards laid down by the Council Directive
93/42/CEE for medical devices.

After removing the device from its packaging, check that there is no visible damage. In case
of damage do not use the device and return it to the manufacturer for repair.

WARNING

The safety and the correct performance of the device can only be assured if the
user of the device respects all of the relevant safety rules and regulations.
The manufacturer cannot be held responsible for damage caused by the failure of

the user to follow these instructions correctly.
In the event of any incident or accident of any kind resulting from the use of the
device, the user is required to inform the manufacturer without delay, this
procedure is laid down in article.9 of the European Regulations No. 46/1997, which
confirmed the CE Directive No. 93/42

Safety and correct functioning of the device are guaranteed only if the safety
standards in force are respected.

spirolab III – User Manual Code MIR 980067 REV 1.6 Page 8 / 77

Keep the instructions for use together with the warranty conditions for any future
reference or in case the device presents technical problems.

The manufacturer cannot be held responsible for damage caused by the failure of
the user to follow these instructions correctly, misuse of the device whether that
misuse is improper, incorrect and/or unreasonable, or when the device is

connected to an electrical outlet which does not conform to the safety regulations
in force.
The device and its accessories must be controlled before each and every use, so
that any malfunction and/or damage caused during transport and/or storage may be
detected.

Keep the device away from hot and/or cold sources.
The thermal paper used for printing is highly inflammable. Keep away from open
flames.

High-frequency emissions that are outside the limits expressed by the EN60601-1-2
may interfere with the correct functioning of the device. High frequency emissions

coming from other electrical or electronic devices can interfere with the functioning
of the device. For this reason certain minimum clearances (a few meters), should
be observed when high-frequency appliances such as TV, radio, cellular phones,
etc and other electronic units are operated in the same room.
When connecting the spirolab III to any other devices (PC, printer, modem etc.),
the user must guarantee that the required security level for subjects and/or users in
the same room are not in any way endangered by the connection.
If the PC and/or the printer connected to spirobank II come into contact with the

area containing patient data, ref. directive EN 60601-1-1, it is necessary that they
conform to the directive EN 60601-1.
The instrument may give inaccurate readings if operated in the presence of strong
electromagnetic sources, such as electrosurgical equipment, or in the presence of
computed tomography(CT) equipment.

If the device is not functioning properly, switch it off and consult the instruction
manual. After correctly following all the instructions, if the device does not function
correctly, call the manufacturer or an authorized service centre for assistance.

For any repairs call only certified service centres that are authorized by the
manufacturer, or directly call the manufacturer.

Do not open or tamper with the device.
Always use and demand only original spare parts.
For the recycling of the SpirolabIII, the accessories, plastic consumable materials
(mouthpieces), and removable parts (for example the disposable turbine), use only

the appropriate containers or return all such parts to the dealer or to a recycling
centre. All applicable local regulations must be followed.
If any of these rules are not followed then MIR will decline all responsibility for any
direct or indirect damages, however caused.

spirolab III – User Manual Code MIR 980067 REV 1.6 Page 9 / 77

Use of non original parts such as the turbine flow sensor and other accessories
may cause errors in measurement and/or compromise the correct functioning of

the device and is therefore not permitted.
The installation must be carried out according to the manufacturer’s instructions.
An incorrect installation may cause damage to people, animals or things, in which
the manufacturer is not to be considered liable.

Modifications, adjustments, repairs, and reconfiguration must be carried out by the
manufacturer or authorised persons.
In case problems arise do not attempt to personally repair the device.
The setting of configuration parameters must be carried out by qualified personnel.
In any case the risks pertaining to incorrect settings do not constitute a danger for

the patient.
Inadequate respect to any of the above-mentioned points may compromise the
safety of the device.
Always respect the safety standards indicated for electrical devices, in particular:

 use only original accessories and spare parts
 do not immerse the device in anytype of liquid
 do not touch the device with wet or damp hands
 do not leave the device exposed to atmospheric conditions
 place the device on a stable and a level working surface for all maintenance

operations

 use of the device always requires full mental ability
 when unplugging the device, never pull the cable of the power supply or of the

device

 always place the device on a suitable rigid horizontal on a stable surface with

at least 30 cm (6 in) of space all around the device. The ventilation slots must
be free from any cover or obstruction of any kind. The ventilation slots are
located both behind and underneath the plastic outer casing of the device.

Before plugging in the charging unit, make sure that the electrical information on
the label of the charging unit corresponds to those of the electrical wiring of the
mains supply.
In case the plug of the charging unit supplied with the device is not compatible
with the electric socket of the mains supply, contact qualified personnel for the

substitution of the plug with a suitable one. Generally, it is not advisable to use
adapters and/or extension cables. If it is essential to use them, then only those
conform to the safety standards must be used, paying WARNING that they tolerate
the maximum limits which are indicated on adapters and extension cables.
Unplug the power supply cable when battery charging is not required.

Do not leave the device attached to the mains supplywhen not required.
In case of breakdown or damage of the charging unit, replace it only with the
manufacturer’s original spare parts.

spirolab III – User Manual Code MIR 980067 REV 1.6 Page 10 / 77

Use of an unsuitable power supply may change the performance of the device and
no longer guarantee the safetyconditions.

In order to avoid dangerous overheating we recommend to totally unwind the
power supplycable of the charging unit.
The maintenance operations detailed in this manual must be carried out precisely.
If these instructions are not followed this can cause measurement errors and/or

incorrect test interpretation.
Before doing any cleaning and/or maintenance operations always switch off the
device and unplug the power supply.
Keep the device out of reach of children and of any person with mental handicap.
When deciding to no longer use the device, it is recommended to dispose of it

according to the local regulations.
In order to avoid contamination of the environment provoked by disposing of the
spirometer, of its accessories, of plastic consumable materials or parts, follow all
local regulations.
Device lithium backup battery life is 10 years.

Do not use the device beyond the extimated life advised by the manufacturer.
The lithium battery is continuously monitored by the device; if the battery is
discharged, a warning message indicates that it must be replaced. Contact an
authorised service centre to change the battery.
If the LED of the lithium back-up battery flashes, the test data and spirometry

parameters in the memory, plus the device configuration then all information stored
may be cancelled automatically.
The batteries used for power supply and for data storage are both inside the
device. It is not permitted to open the device in order to replace them. This
procedure must be carried out only in an authorised service centre, authorized by

the manufacturer.
The maintenance operations detailed in this manual must be carried out to the
letter. If these instructions are not followed this can cause measurement errors
and/or an incorrect test interpretation.

1.2.1 Danger of cross-contamination

Two different types of turbine sensors can be used with the device, one is reusable and one
is single-patient disposable. A mouthpiece is required in order to connect a subject to the
spirometer. In order to avoid exposing the subject to the critical danger of cross-

contamination, the reusable flow sensor must always be cleaned before each spirometry test,
and always use a new disposable mouthpiece for each subject. The use of an anti bacterial
filter is at the discretion of the doctor. If a single-patient disposable turbine is used, then a
new one must be used for each patient.

1.2.2 Turbine

WARNING

spirolab III – User Manual Code MIR 980067 REV 1.6 Page 11 / 77

If you are going to perform the spirometry test with a “disposable”
turbine it is of vital importance to use a new turbine for each

patient. The characteristics, accuracy and the hygiene of the
disposable turbine can only be guaranteed if it has been conserved

Disposable

Turbine

Reusable

Turbine

For cleaning operations see § MAINTENANCE AND CLEANING in this Manual.
The following information applies to both types of turbine:

The turbine must never be held under a jet of water or air and must never come into contact
with high temperature fluids.

Do not allow dust or foreign bodies to enter the turbine sensor, in order to avoid incorrect
functioning and possible damage. The presence of any impurities such as hair, sputum,

threads etc. within the body of the turbine sensor may seriously compromise the accuracy of
the measurements.

beforehand in its original sealed packaging. The disposable turbine
is made of plastic and its disposal after use must adhere to the

local regulations and norms in force.

The correct functioning of the re-usable turbine can only be
guaranteed if it has been cleaned in the correct manner and is free

from foreign bodies, which could restrict its movement. If the
turbine has not been cleaned sufficiently this could cause cross­contamination from one patient to another. Periodic cleaning
should only be done when the instrument is for personal use and
will only be used by one patient. The cleaning of the turbine should

be performed according to the instructions contained in the User’s
Manual.

To avoid environmental contamination by cleaning waste products, the user must adhere to
all relevant regulations.

1.2.3 Mouthpiece

Any disposable mouthpieces included with the device are supplied
only as a guide to the correct type and dimensions of the mouthpiece
required for this device, they are clean but not sterile.
To purchase appropriate mouthpieces, generally either paper or

plastic, but in any case mono-use/disposable, we suggest that you
contact your local distributor who supplied the spirometer.

WARNING

spirolab III – User Manual Code MIR 980067 REV 1.6 Page 12 / 77

Use a bio-compatible mouthpiece to avoid any problems to the patient; unsuitable
materials could cause a bad functioning of the instrument, and therefore the test

results could be incorrect.

The user is responsible for obtaining the correct type of mouthpieces for the device. Those
required are a standard type with an outside diameter of 30 mm, they are commonly used

and in general easily procured.

WARNING

To avoid environmental contamination caused by the disposal of used
mouthpieces, the user must adhere to all relevant local regulations.

1.2.4 Oximetry sensor
The following oximetry sensors can be used with spirolabIII :

MANUFACTURER MANUFACTURER CODE DESCRIPTION

BCI 1300 adult sensor (disposable)
BCI 3026 wrap-around sensor for infants

BCI 3043 universal Y sensor
BCI 3078 ear sensor
BCI 3178 pediatric finger sensor, reusable
BCI 3444 adult sensor reusable (Comfort Clip)

BCI 3044 adult sensor, reusable, for finger

These sensors require the use of an extension cable cod. 919100 to be correctly connected
to the device.
The same sensors are also available with microconnector for the direct connection.

Prolonged use and/or the patient’s condition may require changing of the sensor site
periodically. Change sensor site and check skin integrity, circulatory status, and correct

alignment at least every 4 hours.

WARNING

Incorrectly applied sensors or damaged cables may cause inaccurate readings.
Using a damaged sensor may cause inaccurate readings, possibly resulting in
patient injury or death. Inspect each sensor before use.

If a sensor appears damaged then do not use it. Use another sensor or contact your
authorized repair centre for assistance.

Use only MIR sensors supplied with, or specifically intended for use with the

spirolabIII. Use of other types of sensors may cause inaccurate readings.

spirolab III – User Manual Code MIR 980067 REV 1.6 Page 13 / 77

Oximetry measurements may be inaccurate in the presence of high ambient light.
Shield the sensor area (with a surgical towel, for example) if necessary.

WARNING

Dyes introduced into the bloodstream, such as methylene blue, indocyanine green,
indigo carmine, patent blue V (PBV), and fluorescein may adversely affect the

accuracy of the oximetry reading.

Any condition that restricts blood flow, such as the use of a blood pressure cuff or
a device for systemic vascular resistance, may cause an inability to determine
accurate pulse rate and SpO2 readings.

Remove fingernail polish and/or false fingernails before applying SpO2 sensors.
Both may cause inaccurate oximetry measurement.

Significant levels of dysfunctional hemoglobins, such as carboxyhemoglobin or
methemoglobin, mayadversely affect the accuracy of the oximetry measurement.

Optical cross-talk can occur when two or more sensors are placed in close
proximity. Optical cross-talk may adversely affect the accuracy of the oximetry
readings. The danger can be eliminated by covering each site with opaque material.
Obstructions or dirt on the sensor’s emitter and/or detector may cause a sensor

failure or inaccurate readings. Make sure there are no obstructions and that the
sensor is clean.

Autoclaving and/or ethylene oxide sterilizing may cause sensor damage. Do not
attempt to sterilize the sensor.

Unplug the sensor from SpirolabIII before cleaning or disinfecting, to prevent
damaging the sensor or the device and to prevent safety hazards for the user.

Do not use the instrument in the presence of magnetic resonance imaging (MRI)
equipment. MRI equipment may cause an induced current to the oximetry sensor,

resulting in patient injury.

1.3 PROBLEMS AND UNFORSEEN ERRORS

In case of a problem, one of a series of messages will appear on the screen together with an
acoustic signal to indicate the nature of the problem.

Operation of the device beyond its declared life could provoke a loss of data in the memory
of the device (SRAM memory).

Errors in measurement or in interpretation can also be caused by:

spirolab III – User Manual Code MIR 980067 REV 1.6 Page 14 / 77

 use by non-qualified or non-trained personnel, lacking ability or experience
 user error
 use of the instrument outside the guidelines described in this User's Manual

 use of the instrument even when some operational anomalies are encountered
 non-authorised servicing of the instrument
 improper, incorrect and/or unreasonable use of the product

WARNING

Following the European Directive:

93/42/EEC for MEDICAL DEVICES
In the event of any accident caused by the device, the user must inform the
manufacturer without delay.

1.4 LABELS AND SYMBOLS

Identification label of the spirometer model SpirolabIII

For color display

The identification label located on the underside of the casing shows the product name, plus
the following:

 Manufacturer’s name and address
 Mark of conformity with the directive 93/42 EEC
 Serial number of the device

EC mark for medical devices.
This product is certified to conform to the requirements of the 93/42/EEC medical

0476

devices directive.

Electrical safety symbol. In accordance with IEC 60601-1, this product and its
component parts are of type BF and therefore protected against the dangers of
direct and indirect contact with electricity

Warning symbol for the connection of the power supply.
To charge the internal battery use only and exclusively the
original power supply (12 V - 1A DC) (MIR code 920665)

guaranteed and certified to the EN 60601-1 Safety
Standard.

For black and white

spirolab III – User Manual Code MIR 980067 REV 1.6 Page 15 / 77

Warning symbol for the turbine connector.
Use only and exclusively the original turbine flow sensor.

Warning symbol for the serial port. To connect other devices
such as PC or printer to the RS 232 serial port use only the
serial cable supplied by the manufacturer and observe the

safety regulations of EN 60601-1-1

Symbol laid down in the 2002/96/EEC requirements regarding the
disposal of electrical and electronic devices, (WEEE). At the end
of its useful life this device must not be thrown away with normal

domestic waste, instead it must be delivered to a WEEE
authorised collection centre.
An alternative is to return the device without charge to the dealer
or distributor, when it is replaced by another equivalent device.
Due to the materials used in the manufacturing of the device,

disposing it as a normal waste product could cause harm to the
environment and/or to health.
Failure to observe these regulations can lead to prosecution.

For connection to other devices such as PC or printer. Use only
the USB serial cable supplied by the manufacturer and observe

the safety regulations of IEC 60601-1-1.

Warning symbol for the SpO2 port for oximetry.

2

2

FCC ID:TUK-MIR009 Warning symbol for the FCC

spirolab III complies with Part 15 of the FCC Rules. The correct operation is subject to the
following conditions:

(1) this device must not cause harmful interference
(2) this device must accept any interference received, including interference that may cause
undesired operation.

Any modifications not expressly approved by this company could void the user's authority to
operate the device.

NOTE: This device has been tested and found to comply with the limits for a Class
B digital device, pursuant to Part 15 of the FCC Rules. These limits are designed to

spirolab III – User Manual Code MIR 980067 REV 1.6 Page 16 / 77

provide reasonable protection against harmful interference in a residential
installation. This equipment generates, uses and can radiate radio frequency
energy and, if not installed and used in accordance with the instructions, may
cause harmful interference to radio communications.
However, there is no guarantee that interference will not occur in a particular

installation. If this equipment does cause harmful interference to radio or television
reception, which can be determined by turning the equipment off and on, the user
is encouraged to try to correct the interference by one or more of the following
measures:

 Re-orient or relocate the receiving antenna
 Increase the distance between the equipment and receiver
 Connect the equipment to a wall socket which is on a different circuit from that

to which the receiver is connected.

 Consult the dealer or an experienced radio/TV technician for assistance.

1.5 TECHICAL FEATURES OF THE SPIROMETER

Memory capacity for over 6000

Memory

Interface RS232, USB, Bluetooth
Flow/volume measurement system
Measurement method Infrared interruption

Temperature sensor Semiconductor (0-45°C)
Power supply

Batteries charger

Communication port/interface
Wireless Communication

Dimensions
Weight

Volume range
Flow range

Volume accuracy
Flow accuracy ± 5% or 200 mL/s

Dynamic resistance at 12 L/s

spirometric tests. The precise number
depends on the individual configuration,
so it cannot be determined more closely

Bi-directional digital turbine

Rechargeable battery, Ni-MH, 6 elements

1.2V each, 4000 mAh
Output vonltage = 12 V, current = 1 A,

compliant with EN 60601-1.
Use exclusively battery charger provided
from manufacturer (MIR code 920665)
RS232, bidirectional and optoisolated to
4KV

Bluetooth
310x200x65mm

1.9 kg
10 L

16 L/s
± 3% or 50 mL

<0.5 cm H2O/L/s

spirolab III – User Manual Code MIR 980067 REV 1.6 Page 17 / 77

Type of electrical protection
Safety level for shock hazard

Protection against water ingress
Safety levels during use in presence of

inflammable anaesthetic gases or oxygen
or nitrogen

Conditions of use
Conditions of storage

Operating Conditions

Applied norms
Life expectancy

Storing of parameters, Flow/Volume and Volume/time curves. The number of tests cannot be
precisely defined as it depends on the set upmade by the individual user.

Display:

spirolabIII B/W: Graphic LCD passive type FSTN 320x240 Pixel
spirolabIII colour: Graphic LCD 16 colour passive type FSTN320x240 Pixel

Keyboard:

Silicon rubber keyboard
07 Hardware function keys, with symbols
15 Software function keys, with symbols
05 Arrow keys with symbols (right, left, up, down, enter)
02 Gender identification with appropriate symbols
10 Number keys
29 International alphabet keys.

Class II device
Type BF Apparatus

IPX0
Apparatus not suitable

Apparatus for continuous use
Temperature: MIN -20 °C, MAX + 60 °C

Humidity: MIN 10% RH; MAX 95%RH
Temperature: MIN + 10 °C, MAX + 40

°C
Humidity: MIN 10% RH,MAX 95%RH

Electrical Safety Standard EN 60601
Electro Magnetic Compatibility EN 60601

About 10 years.

WARNING

This device is a Class IIa medical device, according to the European Directive
93/42/EEC, annez IX, rule 10.

1.6 TECHNICAL SPECIFICATIONS

1.6.1 Features of the spirometer

spirolab III – User Manual Code MIR 980067 REV 1.6 Page 18 / 77

Measured parameters:

SYMBOL DESCRIPTION Units

*FVC Best FVC L
*FEV1 Best FEV1 L
*PEF Best PEF L/s

*FEV1/FVC Best FEV1/FVC
FVC Forced Vital Capacity L
FEV1 Volume expired in the 1stsecond of the test L

FEV1/FVC FEV1/FVC x 100 %
FEV1/VC FEV1 / best between EVC and IVC x 100 %
PEF Peak expiratory flow L/s

FEF2575 Average flow between 25% and 75% of the FVC L/s
FEF25 Forced Expiratory Flow at 25% of FVC L/s
FEF50 Forced Expiratory Flow at 50% of FVC L/s

FEF75 Forced Expiratory Flow at 75% of FVC L/s
FEV3 Volume expired in the initial 3 seconds of the test L
FEV3/FVC FEV3/FVC x 100 %

FEV6 Volume expired in the initial 6 seconds of the test L
FEV1/FEV6 FEV1/FEV6 x 100 %
FET Forced expiratory time s

VEXT Extrapolated volume mL
FIVC Forced inspiratory volume L
FIV1 Volume inspired in the 1stsecond of the test L
FIV1/FIVC FIV1/FIVC x 100 %

PIF Peak inspiratory flow L/s
MVVcal Maximum voluntary ventilation calculated from the FEV1 L/s
VC Slow vital capacity (expiratory) L

ELA Estimated lung age years
IVC Slow inspiratory vital capacity L
IC Inspiratory capacity (maxbetween EVC and IVC - ERV) L

ERV Expiratory reserve volume L
TV Current volume L
VE Ventilation per minute, at rest L/min

RR Respiratory frequency Breath/min
tI Average time of inspiration, at rest s
tE Average time of expiration, at rest s

TV/tI Average flow of inspiration, at rest L/min
tI/Ttot tE/(tI+tE) /
MVV Maximum voluntary ventilation L/min

*= best values

1.6.2 Features of the oximeter

spirolab III – User Manual Code MIR 980067 REV 1.6 Page 19 / 77

Measurement method:
Range of measurement %SpO2:

Red and infrared absorption
0 – 99% (with 1% increments)

%SpO2accuracy: 2% between 70-99% SpO2
Average number of heart beats for the %SpO

calculation:
Range of measurement of cardiac pulse:

2

8 beats
30 – 254 BPM (with 1 BPM

increments)

Accuracy of cardiac pulse: 2 BPM or 2%
Average interval for the calculation of cardiac
pulse:

8 seconds

Signal quality indication: 0 - 8 segments on display

Definitions:

Desaturation Event
Total Pulse rate Variation

Desaturation events SpO2 fall >= 4% in a limited period of 8-40 sec
and successive rise > = 2% within a total period of 150 sec.

Pulse rate rise >= 10 BPM in limited period of 8-40 sec and
successive fall >=8 BPM during a total period of 150 sec.

Parameters measured during sleep oximetry:

SYMBOL DESCRIPTION Units

SpO2 Baseline SpO2 Average in first three minutes %
SpO2 Min SpO2 Minimum during analysis period %

SpO2 Max SpO2 Maximum during analysis period %
SpO2 Mean SpO2 Average during analysis period %

BPM Baseline Average pulse frequency in the first 3 minutes BPM
BPM Min

BPM Max
BPM Mean

Minimum pulse frequency during the analysis
period

Maximum pulse frequency during the analysis
period

Average pulse frequency during the analysis
period

BPM
BPM
BPM

Recording time Total time measure of SpO2 hh:mm:ss
Analysis Time Total time of analysis hh:mm:ss

T90 Time passed with SpO2 < 90 % % hh:mm:ss
T89 Time passed with SpO2 < 89 % % hh:mm:ss
T88 Time passed with SpO2 < 88 % % hh:mm:ss

T87 Time passed with SpO2 < 87 % % hh:mm:ss
N SpO2. Events <89% Fall of SpO2 below 89% for at least 20 seconds \

Index (12ses)

Index of SpO2 fluctuation calculated in intervals
of 12 sec.

\

T< 40 BPM Time passed with pulse frequency < 40 BPM % hh:mm:ss
T> 120 BPM Time passed with pulse frequency > 120 BPM % hh:mm:ss
Bradycar. Events < 40

BPM

Bradycardia events during the entire analysis
period

\

spirolab III – User Manual Code MIR 980067 REV 1.6 Page 20 / 77

Tachycar. Events>120
BPM

Total Desat. Events
ODI Desaturation events per hour of analysis 1/h

Mean Duration Average duration of desaturation events s
Longest Duration Longest duration of desaturation events s
Desaturation Peak Minimum Sp02 during desaturation events %

Mean Desaturation Average duration of desaturation events %
Mean Drop SpO2

Max Drop SpO2
N. Pulse Variations

Pulse Index Variation of pulse frequency by hour of analysis 1/h
NOD 4%

NOD 89%

NOD 90%

=DELTA

Parameters measured during exercisetest:

SYMBOL DESCRIPTION Units

SpO2 Baseline SpO2 average before exercise %
SpO2 End SpO2 after exercise %
SpO2 Min SpO2 minimum during exercise %
SpO2 Max SpO2 maximum during exercise %

SpO2 Mean SpO2 average during exercise %
BPM Baseline Average pulse frequency before exercise BPM
BPM End Pulse frequency after exercise BPM

BPM Min Pulse frequency minimum during exercise BPM
BPM Max Pulse frequency maximum during exercise BPM
BPM Mean Pulse frequency average during exercise BPM

T90 Time passed with SpO2 < 90 % % hh:mm:ss
T89 Time passed with SpO2 < 89 % % hh:mm:ss
T88 Time passed with SpO2 < 88 % % hh:mm:ss

T87 Time passed with SpO2 < 87 % % hh:mm:ss
T2 [SpO2≥2%]

T4 [SpO2 ≥4%]

Tachycardia events during the entire analysis
period

Desaturation events during the entire analysis
period

Average SpO2 fall with respect to baseline,
during the desaturation events

Maximum fall of SpO2 with respect of baseline,
during the desaturation events

Variation of pulse frequency events during the
entire analysis period

Time passed with SpO2 < 4 % with respect to
SpO2 base for continual periods above 5

minutes
Time passed with SpO2 < 89 % for continued

periods above 5 minutes
Time passed with SpO2 < 90 % for continued

periods above 5 minutes with minimum value <
86 % (Nadir)

Time passed during exercise test with SpO2 < 2
% with respect to SpO2 base

Time passed during SpO2 exercise test < 4 %
with respect to SpO2 base

\

\

%
%
\

\ hh:mm:ss

\ hh:mm:ss

\ hh:mm:ss

hh:mm:ss
hh:mm:ss

spirolab III – User Manual Code MIR 980067 REV 1.6 Page 21 / 77

T< 40 BPM Time passed with pulse frequency < 40 BPM hh:mm:ss
T> 120 BPM Time passed with pulse frequency > 120 BPM hh:mm:ss

Bradycar. Events < 40
BPM

Tachycar. Events>120
BPM

Recording Time Total time measure of SpO2 hh:mm:ss
Analysis Time Total time of analysis hh:mm:ss

Baseline Time Duration of baseline phase hh:mm:ss
Exercise Time Duration of exercise phase hh:mm:ss

Recovery Time
DYSPNEA Baseline Variation in grade of dyspnea during Baseline \

DYSPNEA End Final grade of dyspnea \
DYSPNEA CHG Variation in grade of dyspnea during exercise \
FATIGUE Baseline Variation in grade of fatigue duringBaseline \

FATIGUE End Final grade of fatigue \
Fatigue CHG Variations in level of fatigue during exercise \

Bradycardia events during the entire period of
analysis

Tachycardia events during the entire period of
analysis

Time for SpO2 value 99% of the average base
value calculated during the initial phase of the
test.

\
\

hh:mm:ss

=DELTA
Parameters required for exercise test:

SYMBOL DESCRIPTION Units

Baseline DYSPNEA Grade of dyspnea before exercise \
Final DYSPNEA Grade of dyspnea after exercise \

Baseline FATIGUE Level of fatigue before exercise \
Final FATIGUE Level of fatigue after exercise \

Parameters measured with SpO2 Analysis:

SYMBOL DESCRIPTION Units

SpO2 Baseline SpO2 Average in first three minutes %
SpO2 Min SpO2 Minimum during analysis period %

SpO2 Max SpO2 Maximum during analysis period %
SpO2 Mean SpO2 Average during analysis period %
BPM Baseline Average pulse frequency in the first 3 minutes BPM

BPM Min
BPM Max

BPM Mean
Recording time Total time measure of SpO2 hh:mm:ss

Analysis Time Total time of analysis hh:mm:ss
T90 Time passed with SpO2 < 90 % % hh:mm:ss

Minimum pulse frequency during the analysis
period

Maximum pulse frequency during the analysis
period

Average pulse frequency during the analysis
period

BPM
BPM
BPM

spirolab III – User Manual Code MIR 980067 REV 1.6 Page 22 / 77

T89 Time passed with SpO2 < 89 % % hh:mm:ss
T88 Time passed with SpO2 < 88 % % hh:mm:ss

T87 Time passed with SpO2 < 87 % % hh:mm:ss
N. SpO2 Events < 89%

Index (12sec)
T< 40 BPM Time passed with pulse frequency < 40 BPM % hh:mm:ss

T> 120 BPM Time passed with pulse frequency > 120 BPM % hh:mm:ss
Bradycar. Events < 40

BPM
Tachycar. Events>120

BPM

=DELTA

Fall of SpO2 below 89 % for at least 20
seconds

Index of SpO2 fluctuation calculated in intervals
of 12 seconds

Bradycardia events during the entire analysis
period

Tachycardia events during the entire analysis
period

\
\

\
\

Acoustic signals for oximetry:

 Beep with frequency of the cardiac pulse
 Continuous beep in the case of either %SpO2or cardiac pulse going outside of the

programmed alarm levels

 Continuous beep during oximetry measurement in the case of low battery level
 If the patient’s finger is not inserted correctly or the connecter is not properly attached

there will be an intermittent beeping sound for 10 seconds

 If the test has been interrupted due to low battery power an intermittent beeping will be

heard for 10 seconds when the device is switched on again

The specifications for both the oximetry and for the cardiac pulse are the same, regardless of
which of the above mentioned oximetry sensors is used.

2 PRODUCT DESCRIPTION

SpirolabIII is a spirometer with an optional pulse oximetry module that facilitates the total
valuation of lung function. It is a powerful and compact measurement device intended for use

by a physician (respiratory specialist), and which is capable of calculating more than 30
spirometric parameters.

SpirolabIII is able to make FVC, VC, IVC, MVV and breathing profile tests, as well as the
saturation of oxygen in the blood and the heart beat.
It can operate in stand alone mode, and it can be connected to a PC or to a printer using any
one of several available methods: RS232, USB, Bluetooth.
It calculates an index of test acceptability (test quality control) and a measure of

reproducibility; It also gives functional interpretation with 11 possible levels following the
latest ATS (American Thoracic Society) classification; it has an internal memory sufficient for

over 6000 spirometry tests or for 1000 hours (or 40 days) of oximetry monitoring.

spirolab III – User Manual Code MIR 980067 REV 1.6 Page 23 / 77

The main spirometric parameters are measured and displayed and all data with Flow/Volume
and Volume/time curves can be printed out in seconds by the built-in thermal printer. The
Flow/Volume curve is shown in real time on the display.

Each test can be repeated as required. The best parameters are always available for quick
viewing or printing. The normal (predicted) values can be selected from five different authors.
In general, within the European Union the ERS (European Respiratory Society) predicted
values are used.

The device also calculates the response to drug administration, i.e., the percentage change
between spirometry results obtained before and after the subject takes a drug) and the
results of a bronchial challenge test or a bronchodilation test. A comparison of data is made
between POST (after-drug) and PRE (before drug administration).

The flow and volume measurement sensor is a digital turbine, based on the infrared
interruption principal. This principal ensures the accuracy and the reproducibility of the
measurements without requiring a periodic calibration.
The main features of this kind of sensor are listed below:

Accurate measurement even at very low flow rates (end of expiration)
Not influenced by gas humidity nor density
Shockproof and unbreakable
Inexpensive to replace

The turbine flow measurement sensor is available both in reusable and in single-patient
disposable versions.

REUSABLE TURBINE DISPOSABLE TURBINE

The following precautions must be observed to ensure that the characteristics of the turbine
remain unaltered over time:

For the disposable turbine: must always be substituted between patients.
For the reusable turbine: always clean the turbine between patients, to ensure the

maximum level of hygiene and safety for the patient.

For a correct interpretation of a spirometry test, the measured values must be compared
either with the so-called normal or predicted values which are calculated from the
anthropometric details of the patient or, alternatively, with the personal best values from the

clinical history of the subject.
The personal best values can vary considerably from the predicted values, which are taken
from “healthy” subjects.

spirolab III – User Manual Code MIR 980067 REV 1.6 Page 24 / 77

SpirolabIII is supplied with an RS-232 optoisolated serial communication port, which

guarantees excellent electrical protection (> 4 KV) both for the health care worker and for the
subject, in compliance with the most strict European safety standards (EN 60601-1).
The Bluetooth connection system can be used to connect the device directly to a printer (the
Bluetooth system must be installed and enabled on the printer as well).

SpirolabIII can also be connected to a PC (or to another computerised system) to configure
the system. All spirometric test results plus the related subject details stored inside the
device can be transferred from the device to the PC and then viewed within the winspiroPRO

PC software (Flow/volume curves, spirometry parameters, plus optional oximetry
parameters).
The connection to the PC can be made in the following ways:

through the RS232 port or
through the USB port

The internal software (or firmware) of the device can be upgraded quickly and simply from a
PC.
For upgrading the system consult the manufacturer or an authorized representative.

spirolab III gives an automatic interpretation of each spirometry test carried out, and assigns
a “traffic light” feedback (green, yellow or red) to each test or series of tests. The set up of the

traffic light settings is made by the doctor responsible for the system configuration.

Oximetry function

The oximetry sensor has two light emitting diodes (LEDs), one emits in the visible spectrum
and one infrared. Both lights then pass through the finger and are “read” by the receiver. As
these lights pass through the finger, a proportion of the light is absorbed by the blood and by

the soft tissue, in function of the concentration of heamoglobin. The quantity of light
absorbed, at each frequency, depends on the degree of oxygenation of the haemoglobin
inside the soft tissue.
This measurement principal ensures accuracy and reproducibility, without requiring regular
calibration.

The oximetry sensor can be disinfected with isopropilic alcohol for more information see
paragraph 4.3.

The operating battery is a 3.6V lithium battery.

spirolab III – User Manual Code MIR 980067 REV 1.6 Page 25 / 77

2.1 ILLUSTRATION OF SPIROLAB III

1. MiniFlowmeter sensor

2. Thermal paper container

3. Flow sensor compartment

4. Display

5. Keyboard

6. Oximeter sensor

2.2 KEYBOARD

4

4

1

1

5

2

2

5

3

3

6

6

SYMBOL DESCRIPTION

On/Off
Adjust contrast, press several times as required

Adjust brightness, press several times as required
Advance the printer paper
Self-check key

spirolab III – User Manual Code MIR 980067 REV 1.6 Page 26 / 77

...

Cancel the current operation
Select configuration menu

Correction key/cancel last data inserted
Information about options
View data in memory
Enter/modify patient data

View best test
View last test
View last oximetry test
Make POST test

Make oximetry test
Print
Make FVC test

Make VC test
Make MVV test

Number keys
Specifies female sex

Specifies male sex
Confirm last operation. This key is the ENTER key

Move cursor

2.3 CHARGING THE BATTERY

WARNING

spirolab III is powered onlyby the internal batteries; the battery charger is used only
to charge the internal batteries. In the charging phase the device can be used only

after the internal batteries have recovered a minimum charge level.

spirolab III – User Manual Code MIR 980067 REV 1.6 Page 27 / 77

WARNING

For charging internal battery of spirolab III use exclusively the battery charger
provided with the device (MIR code 920665)

Make sure that the electrical information on the label of the charging unit corresponds to that
of the power source.

Plug the power supply into an electrical outlet.
Plug the power supply jack into the socket on the back of the device.

Do not use the power supply if it is wet or damp.

Green LED

POWER ON

The charging process has several phrases which are indicated by two LEDs, green and
orange (as shown above).

 Immediately after connecting the power supply, the orange LED starts to flash.
 After a few seconds the orange LED stops flashing and remains lit.
 For about 10 minutes the charging is partial while device automatically checks the

battery condition.

 After about 10 minutes the charging starts and proceeds to a full charge.
 When charging is completed, the orange LED turns off and the green LED lights up.

WARNING

It is possible that during battery charging there may be a slight increase of a few
degrees in the temperature of the power supply. Always place the device on a
suitable rigid horizontal on a stable surface with at least 30 cm (6 in) of space all

around the device. The ventilation slots must be free from any cover or obstruction
of any kind, they are located both behind and underneath the plastic outer casing of
the device.

Orange LED

Battery charging

Green LED

Battery charged

2.4 SWITCHING ON THE SPIROMETER

First check that all the accessory items are in good condition.

spirolab III – User Manual Code MIR 980067 REV 1.6 Page 28 / 77

Before using the device proceed with the cleaning operations, as described in the
MAINTENANCE AND CLEANING section.

Lift the LCD display, release the catch.
Press the red on/off key on the upper left corner of the keyboard. When the device is on,

the green led on the right hand side of the on/off key will light up.

WARNING

When the device is connected to a PC via a USB cable then it will automatically
power on, as the power supply is internal.

2.5 SETTINGS
Backlight settings

To adjust the brightness of the display back light use the double key . Press several
times as required, on the left to diminish the brightness or on the right to increase it.

2.5.1 Contrast settings

To adjust the display contrast , to account for the angle of vision and the surrounding lighting,
use the double key . Press several times as required, on the left to diminish the

contrast or on the right to increase it.

2.5.2 Loading the thermal paper

Open the lid of the thermal paper compartment and remove it from the device; remove the
paper roll holder.

Insert the new roll of paper onto the paper roll holder.

WARNING

The thermal paper must be inserted as shown in this picture, paying WARNING to
the position of the paper holder roll pins inside the guides and to the direction of
the roll, so that printing occurs on the correct side of the thermal paper. Note that

the thermal paper cannot be printed on both sides but only on the one face-up of
the paper roll.

spirolab III – User Manual Code MIR 980067 REV 1.6 Page 29 / 77

Guide to the correct positioning of the paper
roll holder

Push the paper into the slot located under the
traction reel (black rubber reel).
A sensor (as indicated in the image) detects
the paper and automatically advances it.
This image shows the position of the paper in

relation to the traction reel. The paper must
advance through the slot in the compartment
when it is closed; close the lid of the
compartment.
If necessary make the paper advance

manually by pressing

WARNING
To avoid damage to the printer and/or defects in printing, it is recommended to use

thermal paper with 112 mm width size. The sensibility of the thermal paper must be
suitable for printers with a printing speed of 50 mm/s. This type of paper is easy to
find at most medical device dealers.

spirolab III – User Manual Code MIR 980067 REV 1.6 Page 30 / 77

2.5.3 Connecting the flow
sensor

The flow sensor is made up of the
elements shown in the following
illustration.

Before carrying out a spirometry
test, verify that there are no foreign

bodies present inside the flow
sensor.

Connect the connection cable to
the Miniflowmeter until hearing the

‘click’ which indicates that it has
been correctly inserted. Connect

the other end to the spirolab III as
shown in the image; again the
‘click’ will indicate the correct
insertion.

Make sure that a new disposable mouthpiece has been correctly inserted in the turbine
(mouthpiece holder).

WARNING

Follow carefully all of the instructions given in the various paragraphs of this
manual, to ensure that all of the functions operate correctly.

Remove the used mouthpiece and dispose of it after
finishing the spirometry testing.
When the flow sensor head is not in use, we
recommend that it is kept in its compartment.
Press lightly on the connector to detach the flow sensor

turbine from the socket on the left hand side of the
device and proceed with the cleaning operations as
outlined in the MAINTENANCE CLEANING section of
the manual.

Miniflowmeter Turbine Mouthpiece

2.5.4 Switching off the spirometer

The device has an auto power-off system for reducing batteryconsumption. This feature can be
set up from the menu by selecting one of the following 3 options: 6, 60 or 240 minutes; the
device will automatically switch off upon reaching the pre-set time, when no activity has been
made for that time.

spirolab III – User Manual Code MIR 980067 REV 1.6 Page 31 / 77

If instead the device remains switched on when all operations are complete, switch it off
manually by pressing . When the device is switched off, the green (LED) indicator on the

right hand side of the on/off key should also be off.
When the battery does not need charging then be sure to detach the power supply from the
power supply socket on the back of the device and remove the charger from the mains
supply.

2.5.5 Initial settings

WARNING

The sections of this Manual contained in a frame correspond to the wording shown
on the screen of the device.

spirolab III allows for the personalised setting of certain parameters through the
Configuration Menu.

To access the configuration menu, with the device switched on, press which contains
the following list:

 Delete data in memory
 Print last calibration
 Turbine calibration
 Printout header text
 Change Date/Time
 Choose operating language
 Choose predicted values

 Setup parameters/printout
 Bluetooth settings
 Oximetry settings
 Incentive
 Turbine type
 Standard
 Date format
 Units format
 Auto power-off

Select the required option using or , until the  symbol on the left of the screen is
alongside your selection; then press to access the option.

Use this key to recall the Configuration Menu, to set-up and/or to change

certain main functions of the device.

spirolab III – User Manual Code MIR 980067 REV 1.6 Page 32 / 77

Delete data in memory

To delete all the data in memory.
The display will show:

WARNING! ALL SPIROMETRY TESTS IN

Use to quit without deleting the test
data.

The password is: 122333
After deleting the data in memory, the display shows:

MEMORY WILL BE DELETED.

TO PROCEED INSERT PASSWORD

DELETE DATA IN MEMORY

( )

If the password is entered incorrectly, the
display shows:

PASSWORD INCORRECT

ENTER to Retry

ESC to Quit

Press to repeat the procedure.

Test data has been DELETED!

Available memory is: 100%

PRESS ANY KEY TO EXIT

Print last calibration

To print the turbine calibration coefficient currently in use plus the date of the last calibration
made.

Turbine calibration

WARNING

The turbine flow sensor does not require calibration but needs only regular
cleaning. If a calibration must be made then the following guidelines must be
carefully noted.
Only the reusable turbine can be calibrated.

NOTE

spirolab III – User Manual Code MIR 980067 REV 1.6 Page 33 / 77

Each time a calibration is made, the new correction factor is algebraically added to
the previous correction factors. Therefore, before making a new calibration, make

sure to delete the actual calibration in use as described above.
For an accurate and reliable calibration the syringe volume must be at least 3 L.

To modify the calibration of the turbine based on the
FVC values (for the expiratory phase) and FIVC (for

the inspiratory phase), measured during a test made
with a calibration syringe.

From configuration menu choosing “turbine
calibration”, on the display appears the following
informations.

The values “last FVC” and “last FIVC” are retailed to
the last calibration. The values under the “ERR”

SYRINGE VOLUME cL: 300

SYRINGE VOLUME cL: 300

OLD CALIBRATION

OLD CALIBRATION

FVC 300 0

FVC 300 0
FIVC 300 0

FIVC 300 0

NEW CALIBRATION

NEW CALIBRATION

FVC

FVC
FIVC

FIVC

BTPS %ERR

BTPS %ERR

ATP

ATP

column indicate the actual correction. They are set

%ERR = TOTAL ERROR

on 0 for default.

%ERR = TOTAL ERROR
BTPS = Measure condition

BTPS = Measure condition
ATP = Conversion from BTPS

ATP = Conversion from BTPS

If FVC and FIVC =0 then

If FVC and FIVC =0 then

use factorycalibration

use factorycalibration

ESC to Quit

ESC to Quit

WARNING

ATP stands for Ambient Temperature and Pressure which indicates that the
measurement conditions are ambient temperature and pressure.
BTPS stands for Body Temperature and Pressure Saturated which represents a
world standard reference condition for the measurement of spirometric parameters.
All spirometric parameters are calculated at body temperature (37 °C) and pressure

saturated.

In line with the publication "STANDARDISED LUNG FUNCTION TESTING" of the
European Respiratory Society (Vol 6, Supplement 16, March 1993), the air expired

from the mouth is at a temperature of circa 33/34 °C.
The expired flow and volume, to be converted back to BTPS conditions (37 °C),
must be increased by 2.6% - this is derived from the BTPS factor of 1.026 at a
temperature of 33°C, which represents a correction of 2.6%. In practice the BTPS
factor for the expired flow and volumes is therefore constant and equal to 1.026.

For the inspired volumes and flows, the BTPS factor depends instead upon the
ambient temperature, as the inspired air is at ambient temperature.
For instance, at an ambient temperature of 20°C with relative humidity at 50%, the
BTPS factor is 1.102, a correction of +10.2%.

spirolab III – User Manual Code MIR 980067 REV 1.6 Page 34 / 77

The correction of the inspired volumes and flows is made automatically, as the
device has an internal temperature sensor; all parameters are thus reported at

BTPS.

To make the calibration:
1 - Insert the volume in cL of the calibration syringe in use (e.g. for a 3L syringe, insert 300

cL).
2 - Insert both the FVC and FIVC values, obtained by the measurement made with the
calibration syringe, in the New FVC and New FIVC field. Use vertical scrolls to select the
value to be modified (SIRIN, New FVC, New FIVC).
Use numeric keys to modify the parameter value selected.

If the calculated correction factors are acceptable (<20%), they are displayed beside the New
FVC and New FIVC parameters.

Press ESC to return to the configuration Menu without entering the correction.
If the FVC and FIVC values produce a correction factor that is >20%, the FVC and FIVC
values will not be accepted. This means that the system cannot correct for such a large
calibration error. The following message appears:

WARNING ! ERROR toohigh

In this case:

- Check the correct functioning of the spirolab III with a new turbine and/or

- Clean the turbine.
To erase the calibration in use and reset to the factory calibration, input 0 in the New FVC
and New FIVC fields.
Then press to return to the Configuration Menu.

WARNING

With the new calibration, the correction factors are algebraically added to the
previous correction factor(s).
Before to begin a new calibration set the two values FVC and FIVC at 0, then repeat
the calibration procedure.

If a 3L syringe is used to make the calibration and if the spirometer is calibrated
correctly then the FVC (syringe) value will be:

3.00 (FVC) x 1.026 (BTPS) = 3.08 L (FVC at BTPS).
If the ambient temperature is 20°C, the FIVC (syringe) value will be:

3.00 (FIVC) x 1.102 (BTPS) = 3.31 L (FIVC at BTPS).
The user must be aware that the volume of the syringe shown by the machine is

converted to BTPS conditions, so that the "increase" of the results with respect to
the expected values does not constitute an error.

spirolab III – User Manual Code MIR 980067 REV 1.6 Page 35 / 77

For instance, if the calibration procedure is carried out with measured data:
20 ° C, FVC = 3.08, FIVC = 3.30

the spirometer is perfectly calibrated and the relative correction factors are null. No
calibration is required!
This does not represent an error, but is a logical consequence of the above detailed
explanation.

Printer header text

To insert a header that will be printed at the
beginning of each spirometry report (see image).

PRINTER HEADER TEXT

PRINTER HEADER TEXT

INSERT YOUR PRINTE HEADING,

INSERT YOUR PRINTE HEADING,

USING UP TO 40 CHARACTERS

USING UP TO 40 CHARACTERS

Change DATE/TIME

To change the date and time.
The time is shown in the 24 hour format.

¦

¦

Select language

To change the language used for displaying
messages on the screen and the printouts.

ESC to Quit

ESC to Quit

Select predicted values

To select one of the standards available for the calculation of the predicted values. The
parameters are organized in the following way:

REFERENCE ADULTS CHILDREN

1 ERS Knudson
2 Knudson Knudson
3 Morris/Bass Knudson
4 ERS Zapletal

5 MC-Barcelona Zapletal

Select with the numeric keys the reference number, automatically the chosen values will set
and the display shows the configuration menu.

Select printout

To enable or disable the printout of spirometry parameters; in addition this menu allows to
set-up, enable or disable the printout of the F/V and V/t curves.

Bluetooth settings

Select this function and the following menu is shown:

spirolab III – User Manual Code MIR 980067 REV 1.6 Page 36 / 77

Search Device
Options PRINTER
Options PHONE

Remote line Number

Search Device

Select the required option with  and confirm with ; spirolab III begins to search for
Bluetooth active devices; when one or more active devices are found then a list is shown,

select a device and push to define the device (with vertical scroll) as a printer or as a
phone (use PRINTER or PHONE); select one of the two options and push , otherwise

push to return to the Bluetooth options. If the device is already present in the chosen
list a warning message will be shown on the display; push a key to turn to the devices list.

Options PRINTER

To control the devices memorized within the “printers list”. Enter the list with and having
selected a device it is possible:

to set the device as default, identified with a yellow point near the device name (so spirolab

IIIwill automatically connect to this)

to delete the device from the list (spirolab III asks for a confirmation by pressing ,

otherwise press to return to the Bluetooth options and not delete the device from
the list).

If no devices are shown then a message advises the user to search for active devices; press

to start the search or to return to the Bluetooth settings.

Options PHONE

To control the devices memorized in the “printers list”. Enter the list with and having
selected a device it is possible:

to set the device as default, identified with a yellow point near the device name (and

spirolabIII will automatically connect to this)

to delete the device from the list (spirolab III asks for a confirmation by pressing ,

otherwise press to return to the Bluetooth options and not delete the device from
the list).

Even if the list is empty, a search can be made for active devices as previously described.

Remote line Number

spirolab III – User Manual Code MIR 980067 REV 1.6 Page 37 / 77

Enter the menu with then it is possible to insert the telephone number that spirolab III
will use to connect to a Bluetooth telephone. Insert the required number using the numeric

keyboard and then press .

Oximetry settings

This function permits the following kinds of setting up :

 reference values for Sp02 and BPM; if, during a test, these values go below the minimum

or above the maximum values in the set up an acoustic alarm will ring to alert the user

 activation/disactivation of the acoustic alarm
 set the sampling time (2 or 4 seconds) of oximetry values during a test

The cursor at the beginning will rest on the minimum Sp02 value, use the numeric keys to
select the desired value, then the cursor automatically pass to the next value; if a value must

not be modified press ; once the four values have been set up you can then, if required,
activate or disactivate the acoustic alarm by pressing key 1 for OFF and key 2 for ON. To

confirm the selection press . Then is possible to set the sampling time: press key 2 to set 2
sec or press key 4 to set 4 sec. Pressing the configuration menu is displayed.

Incentive

spirolab III has a pediatric incentive program which can be useful to help a child (or an older
person) make a correct spirometry test. The incentive is a hidden image, directly connected
to the signal coming from the MiniFlowmeter so the harder the expiration then the further the

“curtain” moves away, revealing the image and thus helping the patient to obtain the best
possible result.
When the pediatric incentive is selected, a warning message is shown asking for the age of
the patient. Set the correct value, the configuration menu is then shown.
Given that the FVC test requires collaboration that is difficult to obtain in children under the

age of 4, then if an age of 4 or below is selected then spirolab III automatically shows the
incentive during the FVC test.

Turbine setup

Select the type of turbine to be used for testing, either single-patient disposable or reusable.
To select the correct option, follow the steps as described previously selecting the required

item and press v to change the option.

Standard

To select one of the available standards: ATS/ERS or NANHES III, press .

DATE format: dd/mm/yy

To select the required format, toggles between dd/mm/yy or mm/dd/yy or yy/mm/dd or vice
versa.

Press to toggle.

spirolab III – User Manual Code MIR 980067 REV 1.6 Page 38 / 77

UNITS format: cm, kg

To change the units format from cm, kg to in, lb (inches and pounds) or vice versa.
Press to toggle.

Auto power-off: 6 min

To change the wait-time for auto power off to 6 min, 60 min or after 240 min.
Press to toggle.

2.5.6 Functioning of the spirometer

spirolab III performs the following
measurements:

The valuation and interpretation of test
results are given by comparing the
measured parameters with specific
‘normal’ spirometry values (known as

predicted values) which are calculated
from subject data: age, height, weight, sex and ethnic group.

For the calculation of the predicted values, there are several different sets available both for
adults and for children.

Forced Vital Capacity
Slow Vital Capacity

Maximum Voluntary Ventilation
SpO2/BPM

For adults ERS (European Respiratory Society)

“ Knudson
“ Morris/Bass
“ Multicentrico Barcellona

For children Knudson

“ Zapletal

After each test session the results are compared to the selected predicted values and the
percentage ratio between measured and predicted is shown for each parameter.

% Predicted =

The test can be repeated more than once and the best result is memorized in order to be
recalled from the spirolab III’s memory.

The best test result is determined following the ATS/ERS standards.
In practice, the best test is the one having the highest sum of FVC+FEV1.
All tests are analyzed by applying the quality criteria (quality control), following the ATS

standards. In addition, the reproducibility of the FEV1, FVC and PEF parameters are also
calculated.
It is possible to perform POST drug testing, in this case the test results are compared to a
test made prior to the administration of drugs (PRE-test).

spirolab III displays and prints the Flow/Volume and the Volume/time curves
superimposed, with PRE and POST parameter comparison and percentage of change:

Measured

Predicted

x 100

spirolab III – User Manual Code MIR 980067 REV 1.6 Page 39 / 77

% PRE =

Value POST

Value PRE

x 100

After switching on the device, the main screen will
show a summary of the current patient data.
Some values shown are as follows:

v. x.y

Indicates the version of the software (firmware) inside
the spirometer. In case of technical problems always
note this version number.

DATE AND TIME

The current date and time, which can be modified from
the Configuration Menu.

Spirolab III VER v. x.y

Spirolab III VER v. x.y

DATE 23/05/06 TIME 12:44:00

DATE 23/05/06 TIME 12:44:00

FILE N° 1

FILE N° 1

MEMORY 0% 100%

MEMORY 0% 100%

LAST NAME

LAST NAME
FIRST NAME

FIRST NAME
#ID

#ID
BIRTH DATE 0/ 0/ 0

BIRTH DATE 0/ 0/ 0
HEIGHT cm 0 AGE 0

HEIGHT cm 0 AGE 0
WEIGHT kg 0 SEX ?

WEIGHT kg 0 SEX ?
ETHNIC G. Caucasico

ETHNIC G. Caucasico

TYPE OF TURBINE REUSABLE

TYPE OF TURBINE REUSABLE
STANDARD IN USE ATS/ERS

STANDARD IN USE ATS/ERS
BTPS 1.087

BTPS 1.087

CHOOSE ANY FUNCTION

CHOOSE ANY FUNCTION

PRE

The first test for each new subject is a PRE type, i.e. without drug administration.
For the POST test i.e. after the administration of drugs, see Paragraph 2.6.2 POST in this
Manual.

FILE

spirolab III assigns a progressive number to each new PRE, POST or SpO2/BPM oximetry
test.

LAST NAME AND NAME

Are displayed data of the last patient inserted

#ID

Indicates the subject number or identification code which is inserted by the user.

TYPE OF TURBINE
STANDARD IN USE
BTPS (Body Temperature Pressure Saturated)

2.5.7 New subject data entry

spirolab III – User Manual Code MIR 980067 REV 1.6 Page 40 / 77

Press .
The lower part of the screen will show the following message:

CHANGE   NEW

Use or to modify patient data of patient displayed, otherwise insert new details.

SUBJECT NAME AND SURNAME

Use or to modify data of a patient already inserted, or to enter the details of a new
patient.
Enter the required information using the cursor positioned on the subject’s surname. Use

to go to the next entry.

All data entered must be confirmed with or cancelled with . To modify a number
after it has been entered use ; to return the cursor to the area required, to enter the
correct numerical value and go to the next entry press .

#ID

Insert the patient ID code: this code is alphanumerical and can be a maximum combination of
16 characters; this code enables the quick recall of any patient data when required.

Recall a subject from memory and press the #ID key to create a new test session with the
anthropometric details of the same subject. This avoids having to reinsert all of the data of
that patient.
If the ID code inserted already exists in memory then the following message appears:

WARNING! #ID ALREADY ASSIGNED

CONFIRM ID CODE OR MODIFY

The user may either exit, enter a new ID code, or continue by using the patient file in
memory.
Press to confirm the code; press one of the arrow key to modify.

DATE OF BIRTH

Insert patient data with the numeric keys; spirolab III automatically calculates the patient
age which is then shown in the space “AGE”. Insert the other data using .

HEIGHT

Enter the subject’s height (in cm or in inches, according to the current configuration), using
the numeric keyboard. Go to next entry using .

WEIGHT

spirolab III – User Manual Code MIR 980067 REV 1.6 Page 41 / 77

Enter the subject’s weight (in Kg or Pounds, according to the current configuration), using
the numeric keyboard. Go to next entry using .

SEX

Select gender using the keyboard, for male and for female.

ETHNIC GROUP

A list of possible ethnic groups appear, enter the number corresponding to the required
ethnical group. Press 0 for no conversion factor.

By matching a subject to an ethnic group, the predicted values for that subject are then
modified by a percentage determined by the ERS and published in: THE EUROPEAN
RESPIRATORY JOURNAL Volume 6, Supplement 16 March 1993, Standardized Lung
Function Testing § 5.3.

WARNING

By entering the number 0 (zero), no ethnic correction will be made to the
calculation of the predicted values. It is possible to enter ethnic group no. 10, and

to define a correction percentage of the predicted values between 50% and 200% of
the predicted values in use.

WARNING

Note the settings pre-defined within the configuration menu when inserting patient
data, in particular re date format, weight and height.

2.5.8 Modify subject data

To modify subject data press and then .
AIl data not to be modified must be confirmed by pressing .

2.6 SPIROMETRY: FVC, VC/IVC, MVV

All subject data must be entered before carrying out a spirometry test.
The test can be made from the main screen or from any display that shows a previous test
result (last test, best test or test in memory).

Select the spirometry test:

To make the FVC test
To make the VC/IVC and ventilatory profile tests

spirolab III – User Manual Code MIR 980067 REV 1.6 Page 42 / 77

To make the MVV test.

When a test is being performed the display will show the real time Flow/Volume curve or the
Volume/time curve (if the pediatric incentive is set, then the volume/time curve is displayed.).

The test must begin within 30 seconds of pressing the start key, otherwise the test is
interrupted and the device returns to the main screen.

2.6.1 Spirometry testing

Insert a new mouthpiece into the MiniFlowMeter mouthpiece holder.
Fit the nose clip onto the nose of the subject, to ensure that air cannot escape through the

nostrils.
The subject must insert the mouthpiece well into the mouth, it should be inserted at least 2
cm beyond the front teeth and held between the teeth, closing the lips to ensure that air
cannot escape from the sides of the mouth.

Breathe as directed according to the test to be undertaken, details follow.
Make the test in either a standing or a sitting position. During total expiration (slowly or
forced) lean forward to help the expiratory action with a compression of the abdomen.

FVC

If required (this part is optional), before the test make several breaths at rest. When ready,
inspire slowly as much air as possible (opening the arms helps) and then expire all of the air

as fast as possible. Then, without removing the mouthpiece from the mouth, finish the test by
inspiring again as fast and as completely as possible.
This final inspiration is not necessary in the case that the inspiratory parameters (FIVC, FIV1,
FIV1%, PIF) are not required.
The cycle can be repeated several times, without removing the mouthpiece, in which case

SpirolabIII will automatically select and show the best test and measured parameters. To
end test press or just wait for 3 seconds after the last volume cycle, the test

terminates automatically.

WARNING

In the case of an FVC test, after making at least two valid tests, the reproducibility
of the parameters FVC, FEV1, and PEF is also shown.

VC/IVC andVentilatory Profile tests

It is possible (optional) to begin the test by making several complete breaths at rest. After
three or four similar breaths, a message (VC/IVC) on the display will indicate that the
ventilatory profile has been measured and you can now proceed to carry out the VC or IVC
test.

VC test: When the message VC/IVC appears, inspire slowly as much air as possible into the
lungs and then expire slowly as much air as possible.

spirolab III – User Manual Code MIR 980067 REV 1.6 Page 43 / 77

IVC test: When the message VC/IVC appears, expire slowly as much air as possible and
then inspire slowly as much air as possible.

To end the test press or wait 3 seconds after the last volume cycle.
If you make the test without the ventilatory profile (respiratory function at rest) then the

measured parameter will be only VC or IVC. Instead, by carrying out several complete
breaths at rest, then in addition all measured parameters of the ventilatory profile will be

given.
During the test the volume/time curve is displayed.

MVV

Start the test by carrying out a series of forced inspirations and expirations with the maximum
possible amplitude. The suggested frequency is 30 breaths/min. The test will terminate

automatically after 12 seconds.
To end test press or wait 3 seconds after the last volume cycle.

At the end of any test, the related curves and the main measured parameters are shown.
After viewing the curves, press to view the remaining test parameters, plus the predicted

values and the percentage ratio between the measured value and the predicted value.
During the test the volume/time curve is displayed.

2.6.2 Spirometry post - drug

WARNING

To carry out a POST test it is necessary to have carried out at least one PRE FVC
type test on the patient on the same day; it is not possible to do a POST test on the
PRE VC or MVV tests; it is however possible to do a POST VC or MVV test if the
archive already contains at least one PRE test carried out on the same day.

1stcase: current patient data

To perform a POST test on the current subject after completing e PRE test, follow these
instructions:

Press to activate the POST phase. On the bottom of display it is shown the following
message:

ENTER to make POST test

It is possible to carry out the POST test using one of the three tests available. Selected the
test, in the lower part of display it is possible to define the dose administer to the patient
before the test; the value can be inserted with numeric keys.

spirolab III – User Manual Code MIR 980067 REV 1.6 Page 44 / 77

2ndcase: subject file

To perform a POST test on a patient already in memory, firstly “recall from memory” the
relavant PRE test spirometry parameters from the same subject file.

Press ; select using one of the research metods the PRE file. Confirm with . Press

to set a new test with the same patient. Press to activate the POST phase.
When the POST phase is activated, the patient data are shown and “POST” appears under
file number.

WARNING

In the POST phase the FVC, VC and MVV tests can be performed.

In the POST phase, having selected one of these three tests or , the
administered drug dose must be entered.

Whenever the test is repeated using the same dose, the best test related to the dose used is
saved.
When the dose is changed, then a new record is made with a progressive FILE number. For
example, if three tests are made on a subject at different doses, then three different records
(POST tests) are saved for that subject.

Afterwards the separate best POST tests can be viewed.
The subject code in the POST test is the same as for the related PRE test.
The results allow the confrontation of the spirometry parameters calculated in the POST test
against the best results obtained in the PRE test already present in the patient archive for

that session* (*session refers to tests carried out on that day). It is not possible therefore to
carryout a POST test on a patient if the patient archive only contains PRE tests carried out
only on previous days.
When the results are displayed it is possible to see the variation between the PRE and POST
values (shown in column headed CHG)

In the POST phase, the measured result is compared to the values of the related PRE test.
The Flow/Volume curves of the PRE test and related POST test are shownsuperimposed.

After the two curves, the measured parameters (POST), the related PRE values and the
percentage variations between POST and PRE are also shown.
To make the results shown easier to understand a traffic light system has been used with the
following icons and/or as per the criteria below:

  significant broncodilatation with FEV1 POST ≥80% of predicted
  significant broncodilatation with FEV1 POST < 80% of predicted
  no significant broncodilatation

WARNING

spirolab III – User Manual Code MIR 980067 REV 1.6 Page 45 / 77

In the POST phase no test interpretation is given, the test quality control messages
are shown.

The POST test is available both in main display with the characteristics of the patient and in
visualization of previous test ( or ) in this manner is easy to set post

phase. Visualizing the data stored the active keys are:

 ;
 #ID (for a new spirometric test with patient selected)

 (for a POST test)
 (print out of the selected test)

 and for display
 to go to the archivi menu.

 (key for generic stop)
 1, 2, 3 (if there are made more than one test).

Physiological test (placebo)

It is common practise prior to a POST test to carry out a test using physiological solution in
place of a drug, to examine the subject’s response to such a stimulus.
If the subject is healthy then the reaction to a placebo is almost zero, but in the case of

hypersensitivity even this stimulus can have some effect.
In the physiological test the amount of the dose to enter is zero and it is still possible to
compare the POST results with those of the PRE test.
The POST phase will show a coloured string highlighting the words POST FILE No. and
DOSE.

WARNING

The POST test can be based only on a PRE test made in the same day; it is not
possible make a POST test referred to a PRE test made in the previous days.

WARNING

To end the POST phase and make new PRE tests, press and then .

2.7 TEST QUALITY CONTROL - SPIROMETRY

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Through a mathematical analysis (quality control) which is applied to certain calculated
indices and parameters, the spirolab III produces a series of comments, helpful for

understanding the reliability of the test made.

ERROR IN Vext and PEFT

If the extrapolated volume Vext is greater than 500 mL or more than 5% of the FVC,or if the
PEFT (time to peak flow) is greater than 200 ms, this message is shown:

Repeat test and blow faster

FLOW DROP 50%

If the flow rate falls (>50%) and then rises again during the 1stsecond of a forced expiry, this
message is shown:

Repeat and avoid coughing

FET ERROR
If the FET is less than the minimum (3 seconds), this message is shown:

Expiry time insufficient

FLOW ERROR

If the last point of the F/V curve is greater than 200 mL/s, this indicates that the expiration
was not complete and thus this message is shown:

Blow out all air in lungs

2.8 REPEATABILITY OF THE FVC TEST

Following the international ATS and ERS standards, it is recommended to repeat each FVC
test at least 3 times to ensure the reliability of the spirometry test results. The device helps
the user through the reproducibility control check.

Between tests, the repeatabilityof the following parameters is calculated:
PEF repeatable when the difference between the two largest PEF is ≤0.67 L/s;

VC repeatable when the difference between the two largest VC is ≤150 mL;

If FVC is > 1.0 L then:
FEV1 repeatable when the difference between the two largest FEV1 is ≤150 mL;
FVC repeatable when the difference between the two largest FVC is ≤150 mL;

if FVC is ≤1.0 L then:
FEV1 repeatable when the difference between the two largest FEV1 is ≤100 mL;
FVC repeatable when the difference between the two largest FVC is ≤100 mL;

2.9 METHOD OF MEASUREMENT AND INTERPRETATION

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The device uses the infrared interruption principle of measurement, with two sets of
optoelectronic transmitters and receivers. A pair of deflectors positioned at the entry and at
the exit of the turbine tube generates a vortex in the passing air, around the axis of the

sensor. A rotor with a speed of rotation directly proportional to the air flow then interrupts
the infrared beams and generates a digital signal. The measurement of the air volume that
passes through the tube is proportional to the interruption of the infrared rays.
This measurement principle guarantees stability, reproducibility and reliability over a long
period of time, and the measurement is not affected by gas density, humidity or pressure.

WARNING

The measurement of the air volume that passes through the tube is proportional to
the interruption of the infrared rays.

The cleaning of the turbine flow sensor is very simple, and is essential for the protection of
the subject from possible infections. For cleaning operations see Chapter 4 of this Manual.

No calibration of the turbine is required, but it is good practice to make a calibration check by
following the simple instructions contained in the relevant paragraph in the maintenance
section of this manual.

Method of test interpretation

Following each FVC test, the device carries out a quality control check to verify the
acceptability of the test made and, if possible, compares the main measured parameters
FEV1, FEV1% and FVC with the respective predicted values. It also calculates a series of
indices, based on the following criteria:

index %=

The interpretation of these indices %, according to the ATS standards, generates a series of
messages which correspond to possible levels of obstruction or restriction plus one level of
normal spirometry, as shown in the following table:

normal
mild
moderate
moderately severe
severe

very severe

If it is not possible to make the calculations for lack of data, the interpretation is not valid and
this message appears:

WARNING

measured values

predicted values

 green
 green-yellow
 yellow
 yellow-red
 red

 violet

NOT VALID

x 100

spirolab III – User Manual Code MIR 980067 REV 1.6 Page 48 / 77

The interpretation during a test session for each subject always refers to the best
test results made by that subject.

2.10 OXIMETRY TESTING

spirolab III can carry out different types of oximetry tests, which are described in the
following paragraphs.

WARNING

If spirolab IIIhas been purchased without the oximetry option, then only spirometry
tests can be made. If the oximetry option is purchased afterwards, then contact the

service centre or the manufacturer to enable the function.
If during the oximetry testing the SpO2 blood pulse rate goes below the lower

threshold or goes over the upper threshold, spirolab III will ‘beep’ while this
situation persists. This option can be switched off during sleep tests.

The values shown are the default settings.

WARNING

Note: the sensor described below is for illustration purposes only. spirolab III is
enabled for the use of any of the sensors described in the previous Paragraph

1.2.4. MIR does not recommend the use of a specific type of senor; this decision is
made by the doctor.

During the oximetry test spirolab III cannot be switched off, to switch off the device
it is necessary to interrupt the test in progress, this avoids unwanted interruptions

which could compromise the accuracy of the data obtained.

For the non-invasive measurement of the SpO2oxygen saturation and blood pulse rate utilize
the re-usable finger sensor. This sensor is recommended for patients weighing > 20 Kg with

limited activity.
spirolabIII memorises the two oximetry values every 2 or 4 seconds.

Carry out an oximetry test as follows:

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 Connect the sensor to the instrument: insert

the connector with the arrow (printed on the
connector) face-up, as shown:

 Choose a high perfusion site, which is

easily adaptable to the sensor.

 Insert finger into the sensor until the finger

touches the end of the probe. Ensure that
the bottom part of the finger completely
covers the detector. If the finger is not able
to be correctly positioned, use another
finger. 

 Position the sensor so that the cable is

underneath the palm of the hand. This
enables the light source to remain on the
fingernail and the detector on the bottom
part of the finger. From the main screen

press to access the test menu.

 Select required test using the vertical scroll

arrow.

If this message appears:

OXIMETRY NOT DETECTED

then your instrument does not include an oximeter.
If this message appears:

OXIMETRY DISABLED

the function has not been enabled. In this case contact a service centre or the manufacturer.

WARNING

Before starting the test check to see that the battery is fully charged, if it is low the
following message will be shown:

Batteries are low and may not be sufficient for an oximetry test.

In this case select ESC to exit the test, by pressing any key you can continue with
the test already set up.

If the test is interrupted, due to low battery charge, the following message will
appear on the display when the device is switched on again:

The last oximetry test was interrupted before being properly completed

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A beeping sound will be simultaneously heard for 10 seconds.
Afterwhich the spirolab IIImain screen will appear.

The oximetry tests that can be performed by Spirolab III
are:

1. SPOT OXIMETRY

2. SLEEP OXIMETRY

3. EXSERCISE OXIMETRY

4. SPOT OXIMETRY (MEMORIZED LIKE OXYTEST)

Choose required test pushing corresponding number on
numeric key board.

During the test the display shows the informations like in the following image
The number of blocks shown next to the SpO2 value are proportional to the signal quality
(maximum 8 blocks). Position the finger within the sensor in order to maximise the signal
strength.

WARNING

In order not to compromise the reproducibility of the measurements and the
integrity of the sensor, avoid twisting the sensor cable and handle with due care
when using, connecting, disconnecting and when placing the finger into it.

During the first few seconds of the test the device searches for the best signal, after which
the timer re-sets to zero and spirolab III starts to memorise the data.

For each type of test, if the sensor has not been correctly inserted, after a few seconds the
following message will appear:

Connect sensor

Contemporaneously spirolabIII emits a beepfor 10seconds.

If the sensor has been inserted but the finger is not inserted correctly, the following message
will appear:

Insert fingher

Contemporaneously spirolabIII emits a beep for 10 seconds.

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If the sensor correctly receives the signal, after a few seconds the device starts to ‘beep’ and
the values will be displayed on the screen.
For all oximtery tests alarms can be set up in the case that the critical values are exceeded

as described in paragraph 2.5.5. In the case that the alarm is activated during the test, the

symbol on the display will be seen and this can be activated/disactivated by pressing

to disactivate, and to activate.

For further information on the correct set up for this function please refer to paragraph 2.5.5.

2.10.1 Spot oximetry

WARNING

The sensor described below is for illustration purposes only spirolab III is enabled
for the use of any of the sensors described in §1.2.4. MIR does not recommend the
use of a specific type of senor; any decision in made by the individual doctor.

To perform a non-invasive continuous monitoring of arterial oxygen saturation, it is
recommended to use the reusable "wrap" sensor. The use of this sensor is indicated for
patients weighing more than 30 Kg and contraindicated for patients with allergy to adhesive
tape.

WARNING

The materials used for manufacturing the sensor are NATURAL LATEX PROTEIN
free. The materials used for the sensor are subject to biocompatibility tests.

Adult Single Patient Sensor –Instructions for Use

WARNING

This sensor is contraindicated for use on patients who exhibit allergic reactions to
the adhesive tape. Do not reuse. One use on one patient.

 Choose an application site on the patient’s finger or

toe where the light source will be directly over and in­line with the detector. The preferred sites are the
forefinger or smaller thumb.

 Remove nail polish or artificial fingernails

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 Place the patient’s digit in the sensor nail-side up,

lining up the digit’s pad over the detector. The
sensor’s positioning line runs across the mid axis of
the fingertip

 Wrap the bottom adhesive around the digit, being

careful not to cover the nail.

 Fold the sensor’s top over the digit, making sure the

light source is directly over and in-line with the
detector. Wrap the adhesive around the finger or toe
to secure the sensor. Route the cable along the palm

or the bottom of the foot, and secure with adhesive
tape if necessary.

Connect the sensor to the instrument: insert the connector with the arrow on the connector
face-up and control the correct functioning according to the previous instructions.

WARNING

Do not twist unnecessarily or use excessive force when using, connecting,
disconnecting, or storing the sensor.
An over-tight sensor can produce inaccurate saturation measurements. Therefore
avoid over tightening the adhesive tape.
It is recommended to fasten the cable to the wrist with a bandage.

Making a Test

Select “Oximetry (SpO2/BPM)” from the oximetry tests list pressing 1 on the numeric key.
The display shows: “Oximetry (SpO2/BPM)”. The test duration is unlimited and the aim is to
record variations of the oximetry values during a period as decided by the doctor.
If the finger is removed from the sensor during the test, the following message will appear:

Please, wait for signal

The data shown during the test are:

 Spo2
 Quality of signal received
 BPM

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 Test time extension
 Time curve of the two parameters (SpO2 and BPM)
 Test type in esecution

 Possible warning message

To end test, press
To print data see Paragraph 3.1.2; see example of the test printout report attached to this

Manual.

2.10.2 Sleep Oximetry

To chose this test press 2 on numeric key.
This test records the variations in the patient’s parameters overnight.

After approximately 5 minutes spirolab III will go to standby i.e., it stops beeping and the
display turns off. The led signal remains on. To control the correct functioning while on

standby, press , after 5 minutes spirolab III will automatically return to standby. If there is
no signal while on standby the device will automatically exit this phase and a warning
message will appear (sensor unplugged or finger not detected correctly).
The data shown are the same as described in the preceding test, except for information on

this present phase, which is not envisaged for this test.
The data shown are the same described previously.
After the required time the test can be interrupted as previously described.
Results can be printed as described in Paragraphs 2.13 and 3.1.2; see example of the test
printout report attached to this Manual.

2.10.3 Exsercise oximetry

This test is made up of 3 phases:

 Baseline (initial rest)
 Exercise
 Recovery

Baseline (initial rest)

The data shown are the same described previously.
The duration of the test is minimum 2 minutes, then this message appears:

pass to EXERCISE phase

press 1 to pass to the following phase. If the phase lasts for more than 6 minutes then
spirolabIII will emit a ‘beep’ as a reminder to pass to the exercise phase.

Exercise Phase

At the beginning of this phase the timer is reset to zero, to give an accurate control of the
duration of each single phase. The data on the display is the same as shown before.

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The duration of this phase is minimum 2 minutes, this message will appear:

pass to RECOVERY phase

press 2 for a few seconds to pass to the recovery phase. If this phase lasts for more than 6
minutes then spirolab III will emit a ‘beep’ after which the device passes to the initial phase

and the timer is re-set to zero.

Recovery Phase

The user can decide freely on the duration of this phase, the duration is not suggested (at the
beginning of the phase the timer re-sets to zero).

To end test press .
At the end of the test the data required for the calculation of the parameters must be inserted;

more specifically:

 Baseline DYSPNEA
 Final DYSPNEA

 Baseline FATIGUE
 Final FATIGUE

These follow the Borg scale and can
have the following values: 0, 0.5, 1, 2, 3,
4, 5, 6, 7, 8, 9, 10.

The Borg scale coefficients represent the
following severity values:

Use and to enter data; use or to go back or pass to next data.
Exercise test data results are given in the following screen, and can be printed as described

in Paragraphs 2.13 and 3.1.2. if the test results are printed, the test printout will only show the
exercise test results; an example of a test printout report is attached.

Press to end the test at any moment.
At the end of the test are shown calculated and inserted data with more than one display.

Use or to read the various data.

WARNING

One of the parameters calculated by the Spirolab III during an oximetry test is the
so-called Recovery Time. The Recovery Time is defined as the time taken for the

SCALE SEVERITY

0 None

0.5 Very Very Slight (Just Noticeable)
1 Very Slight

2 Slight
3 Moderate
4 Some What Severe

5 Severe
6 “
7 Very Severe

8 “
9 Very Very Severe (Almost Maximum)

10 Maximum

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SpO2 value to return to at least 99% of the average base value calculated during the
initial phase of the test.

2.10.4 Spot oximetry (MEMORIZED LIKE OXYTEST)

This test is the same described in 2.10.1; the only difference is that the test is without subject
data; in the archive the test is memorized with the name: “OXYTEST”. The parameters

calculated are like in spot oximetry (see 2.10.1).

2.11 FILE ORGANIZATION

The memory of the spirometer is a ‘string’ of memory areas called records, each of which
contain information regarding a single test session.

More specifically, each record is made up as follows:

 Demographic details of the subject
 Date, time and ambient temperature at the time of the FVC test
 Reproducibility and quality control test information
 Parameters stored with the FVCtest:

o FVC, FEV1, PEF, FEF75, FEF2575, FET, *PEF, *FVC, *FEV1, FEV1%, FEV6,

FEV6%, FEV3, FEV3%, FEV1/FEV6%, FEF25, FEF50, Vext, FIVC, FIV1, FIV1%,
PIF, FEV1/VC

 Parameters stored with the VC test:

o VC, IVC, EVC,* (EVC or IVC), ERV, IC, TV, VE, fr, ti, te, TV/ti, te/tt

 Parameters stored with the MVV test:

o MVV

 Points of the expiratory part and (if present) the inspiratory part of the Flow/Volume

curves, plus the points of the Volume/time curve.

 Parameters stored with the SpO2 test (in relation with the test recorded, see also

paragraph 1.6.2):

WARNING

All of the parameters are always stored even if not all of the tests were performed
(in this case the results of those parameters are stored as zero). The symbol *

indicates the best result of that subject.

Spirometry results can be recalled from the memory.
To access the database, press . The results of the selected test can be printed by

pressing after visualization on display.

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2.12 SEARCH AND READ TESTS IN MEMORY

FIND AND READ TESTS IN MEMORY

FIND AND READ TESTS IN MEMORY

Press to access menu, from where to view all

test data stored in the memory of the device.
The research can be made in three different

manners:

 Subject list by last name
 Subject list by ID code
 List by date

 Memory list

Using and , select the method with , then press .

From this display it is also possible make the archive transmission with Bluetooth connection,
using a cell phone (please see paragraph 3.1).

2.12.1 Subject List bylast name:

This message appears:

INSERT LAST NAME OR THE FIRST

LETTERS OF LAST NAME TO FIND
ALL MATCHING FILES IN MEMORY

 Subject List by LastName

 Subject List by LastName

Subject Listby ID code

Subject Listby ID code
List bydate

List bydate
MemoryList

MemoryList
Bluetooth transmission

Bluetooth transmission

CHOOSE ANY FUNCTION

CHOOSE ANY FUNCTION

Use keyboard to enter subject surname or first letters. All corresponding surnames found in
memory will then be listed.
The first column on the right will show the file numbers corresponding to the tests made, use

numeric keyboard to enter required test, press to viewrelated values.

Print selected test results, using the internal printer, by pressing , pressing twice
the data are print on the external printer via Bluetooth system.

2.12.2 Subject List byID code

The following message appears:

ENTER ID# CODE,

OR PARTIAL TO SEARCH

MATCHING FILES

Enter subject ID# and press to view the list containing all file linked with the patient.

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The data can be printed like described previously.

2.12.3 Memory List

FILE NAME DATE TIME TEST

FILE NAME DATE TIME TEST

MEMORY LIST

MEMORY LIST

The screen will show the complete test memory list.
Indicate FILE No. to view corresponding spirometry

test results and press .
The data can be printed like described previously.
The data shown can be printed individually or in
group; it is possible to print a sequence of tests
(pressing the keys of the first and the last)

otherwise a single test pressing the number on
numeric keys, then press .

Read file N. 0

Read file N. 0

2.13 VIEW AND PRINT RESULTS

WARNING

During a test session the device will automatically memorize up to 8 FVC tests.
Press to view the results arranged in 8 sections on the screen. Each of the 8

tests can be viewed and printed. These tests are numbered from 1 to 8, where test
1 represents the best test and 8 represents the worst test. The last test made is
always highlighted in green.

During the test session press (which recalls the best test), the device will
always show the graphs and results of the 3 best tests. Each of the 3 tests can be

viewed and printed.
At the end of the test session, when either a new subject is inserted or you pass to
the POST phase, the 3 best tests corresponding to the previous session are
automatically saved on file. These can be successively recalled from memory and
viewed or printed either together or separately.

From the main screen it is possible to re-examine and to print all the spirometry
parameters.

Generates the Flow/Volume curves of the best test.

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Generates the Flow/Volume curves of the last test.

WARNING

All tests results saved on file can be recalled, viewed and printed.

The data stored in the memory are those of the best tests. The current test can be printed by
pressing . To print a test saved on file after recalling it press . To interrupt

printing press .
The printout report includes a header line with the date, time, the BTPS value at the time of

the test, patient details, the FILE No., any pre-set ethnic correction factor and the predicted
value set used.
There follow the Flow/Volume and Volume/time curves, which relate to either the last or best
test performed.

Press from the main screen to print the best test results of the day relative to the
displayed patient.

To print the last test press while viewing the last test.
Lastly, the measured parameters and spirometry test interpretation are shown.

In the case of a PRE test, the following are shown:
Predicted calculated predicted values

PRE measured value before drug administration
%Predicted values percentage value against predicted values

In the case of a POST test then the graph will show the two curves superimposed and in
addition to the above-mentioned parameters, the following values:

POST measured value after drug administration
%CHG % variation (+/-) between POST and PRE.

From the measured parameter’s screen ( or key, or recalled from memory) the
subject’s name, date and time of test is shown on the bottom of the screen.

3 DATATRANSMISSION

spirolab III includes a “Bluetooth” wireless data transmission system. This connection is via
radio and allows the transferring of all the data in memory for two different operations:

transfer to a cell phone, which then transmits the data to a PC by modem;
transfer to a Bluetooth-enabled printer.

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The following paragraphs contain in-depth information on these two procedures.

3.1 DATATRANSMISSION VIA BLUETOOTH TO A CELL PHONE

spirolab III can be connected to a cell phone with this system installed. The transmission of
data with this technology allows the transfer of all data in memory of the spirolab III.

The sequence of operations to follow is describedbelow.

3.1.1 Preliminary operations
WARNING

The transmission of data through a Bluetooth connection requires the phone
number of the unit where the data shall be transferred (the doctor’s office,
telemedicine service, etc.). The phone number is set up from the Configuration
Menu (see Paragraph 2.5.5). A device must also be setup for the connection; ; refer
to Paragraph 2.5.5 for further details.

3.1.2 Setting the Phone Number

 With spirolab IIIswitched on, press .
 Use vertical scroll key to select “Bluetoothsettings” then press .
 Use vertical scroll key to select “insert telephon number” then press .
 Enter the number with the numerical keyboard, and again press ; the Bluetooth Menu

will appear.

 Use to return to the main screen.

3.1.3 Data Transmission through Bluetooth

 From the main screen press
 Use vertical scroll keys to select “Bluetooth transmission”and press
 it is described the transmission way and, if correct, it is required to confirm it with “OK” to

activate the connection to the device choosen as default in the configuration menu.

 when the request is from mobile phone, type the code shown on the screen (relative to

the device’s Serial Number reported on the back label of spirolab III)

 are executed all the next connection steps.
 When the connection is active, data are transmitted from the selected modem
 At the end of the transfer data process the following message “Connection Completed” is

shown.

The screen will show the following information:
 The device used for the connection;

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 The pre-set phone number.
 The preset PIN (corresponding to the serial number of the device).

To interrupt data transmission during the Bluetooth connection press to end the
connection and to return to the main screen.
Where no device has been setup for data transmission, a message will appear on the display
to start searching for enabled devices. After setting the device the connection will start up
automatically.

3.1.4 Data Transmission via Bluetooth for printing
WARNING

Printing of data from the patient management function is enabled only if the printer
has a Bluetooth connection; alternatively a USB key can be installed on the printer

in order to enable a Bluetooth connection.

The Bluetooth system enables spirolab III to transfer test data directly to a printer with
Bluetooth. The sequence of activities to be followed is:

 When the test is finished or searched in the archive press twice
 spirolabIII will carry out the phases of connection.
 At the end of the transmission spirolab III will show the message “CONNECTION

COMPLETED”, returning automatically to the main screen

Previous tests stored on file can also be printed. Use the procedure described in Paragraph

2.11 to print required tests. When the required test is shown on the display, press twice

To interrupt data transmission during Bluetooth connection press to end the
connection and to return to the main screen.
Where no printer has been set up, a message will appear to search for devices. After the
device has been set up it will automatically be enabled for printing.

When searching for Bluetooth enabled devices, spirolab III will check the address of that
device and where a previously registered device has changed name, it will be automatically
updated.

3.2 CONNECTION TO A PC

spirolab III can be connected to a PC and perform tests online. Two connection types are
used: USB port or RS 232 port.

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3.2.1 Connection to a PC through a USB port
WARNING

Before connecting spirolab III to a PC via the USB port, the winspiroPRO software
must be installed to interface with the device.
Prior to initiating the following procedure it is important to know the version of the

operating system on the PC (from Control Panel click on “System”, and here the
operating system installed on the PC can be checked).

To make the connection insert the mini USB
connector supplied with spirolab III as shown in

the picture and attach the other connector to the
USB port of the PC.
When initally making a connection, the PC will,
depending on the version of the operating

system, either make an automatic driver
installation or request some information. To avoid
errors in this phase please read the winspiroPRO
User Manual very carefully.

3.2.2 Connection to PC through RS 232 port.

spirolab III can be connected to a PC through a
RS 232 serial port. This leaves the USB port
free. The picture shows the RS 232 connector

attached to spirolab III.
For the correct management of the device see
the software manual.

3.3 UPGRADE INTERNAL SOFTWARE

spirolab III can be upgraded when connected to a PC (via USB or RS232). Upgrades can be
downloaded by registering on www.spirometry.com. For further information on upgrading

software see the “winspiroPRO” software manual.

4 MAINTENANCE AND CLEANING

spirolab III is an instrument that requires very limited maintenance. The operations to perform
periodically are:

 Cleaning and controlling of the reusable turbine.
 Changing the disposable turbine at each test.

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 Cleaning of the oximetrysensor (for reusable sensors).

 Changing the adhesive tape of the oximetrywrap sensor.

 Changing the battery.

The maintenance operations described in the User’s Manual must be carried out carefully.
Failing to observe the instructions may cause errors in measurement or in the interpretation

of measured values.
Modifications, adjustments, repairs, and reconfiguration must be carried out by the
manufacturer or by authorised persons.
In case problems arise, never attempt to repair the unit.
The setting of the configuration parameters must be carried out by qualified personnel. In any

case, the risks from an incorrect setting do not constitute a danger for the patient.
The device is supplied with an internal lithium battery used to back-up the RAM; the average
battery life is approximately 10 years. If this message appears:

WARNING ! Replace the internal lithium battery

Contact a service centre or the manufacturer for battery replacement.

4.1 CLEANING THE DEVICE

Clean the device with a damp cloth. Make sure to dry it afterwards.

WARNING

Do not wet or immerse the device or power supply in any liquids.
Do not use any abrasive materials to clean the device.

4.2 CLEANING THE REUSABLE TURBINE

The turbine utilized with spirolabIII is of one of two categories: disposable or reusable. These
guarantee precise measurements and have the advantage of requiring no periodic
calibration. In order to maintain these characteristics, a simple cleaning is required prior to

each use (onlyfor the reusable turbine).
Cleaning of the disposable turbine is not required as it is supplied already clean in a sealed
plastic bag. It must be disposed of after use.

The maintenance operations to perform are cleaning and controlling of the turbine.

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WARNING

It is good practice to control
from time to time that dirt or

foreign bodies such as
threads or hair are not
deposited inside the turbine.
Any such deposit could brake
or block the blade of the

turbine and thus compromise
the measurement accuracy.

To clean the reusable turbine,
remove it from its compartment in

the MiniFlowmeter by turning it anti­clockwise and pressing lightly. It
can be helpful to push it gently from

underneath with one finger.
Immerse the turbine in a cold detergent solution and move it within the liquid to remove any
impurities which may be deposited inside. Leave the turbine immersed for the time specified
in the instructions of the solution.

WARNING

To avoid causing irreparable damage, never clean the turbine by placing it under a
direct jet of water or any other liquid. Where no cleaning solutions are available, it
is indispensable to clean the turbine in clean water.
Do not sterilize in an autoclave. This operation would cause irreparable damage to
the turbine.

Miniflowmeter Turbine Mouthpiece

Rinse the turbine by immerging it in clean water (not hot).
Shake off the excess water from the turbine and leave it to dry, standing it vertically on a dry

surface.
To ensure that the turbine is functioning correctly before replacing it inside the instrument it is
good practice to make a visual check of the rotation blade. Placing the turbine tube
horizontally and moving it gently from left to right and vice versa, the rotation blade (rotor)
must rotate freely. Otherwise, accurate measurement is no longer guaranteed, so the turbine

must be replaced.
Once the turbine has been cleaned, insert the turbine tube in its place following the
instructions indicated by the “lock “ symbol printed on the MiniFlowmeter.
To insert the turbine correctly, push it and then turn it clockwise until reaching the stop, which
ensures that the tube has been blocked inside the casing.

Verify the free movement of the turbine:

 Switch on spirolabIII as if to make a spirometry test (for example FVC).

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 Hold the MiniFlowmeter in one hand and move it gently from side to side, so that air

passes through the turbine.

 If the rotor within the turbine is turning correctly, then you will hear a beep that indicates

that the turbine is moving within the specific low flow range.

 If moving the turbine from side to side at a constant velocity, regular beeps or no beeps

at all are heard, then proceed with the cleaning of the turbine.

WARNING

If the disposable turbine is used, do not clean it but replace it after each test.
To avoid environmental contamination caused by the disposal of the cleaning
solutions, the user must follow all local regulations.

4.3 CLEANING AND DISINFECTION OF THE OXIMETRY SENSOR

WARNING

Do not sterilize by irradiation, steam, or, ethylene oxide. Do not immerse in liquids.
Before cleaning or disinfecting the sensor, unplug it from the monitor.

CAUTION

Before cleaning or disinfecting the sensor, unplug it from the device

Clean the sensor with a soft cloth moistened with water or a mild soap solution. To disinfect
the sensor, rub with isopropylic alcohol. Allow the sensor to dry completely after cleaning.

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5 PROBLEMS/CAUSES AND SOLUTIONS

The device does not switch on

Press firmly on the on key.
The internal battery may be discharged.
Make sure that the power supply cable of the charging unit is connected to the spirometer

and that the plug is inserted correctly into the mains outlet, then proceed with charging.

The LCD does not display

Using the two keys which regulate the brightness and the contrast of the display.

The battery charging is not working correctly

The device is protected thermically. In case the power supply of the battery reaching a high
temperature then a thermal protection intervenes and prevents the charging.
This thermo protector can intervene if:

 the device has operated beyond the functioning limits indicated in this manual;
 the device is operated near a heat source, or in ambients with a temperature either too

high or too low.

Disconnect the power supply and let it cool down before continuing with charging.

The lithium battery for the data memory indicates discharged

If the internal lithium battery is discharged, the spirometry parameters in the memory and
other configuration data may be cancelled automatically.

Contact an authorized service centre to replace it.

The printer does not print

The thermal paper may have run out, otherwise may be inserted in the wrong way.
Check the correct position of the thermal paper, if necessary insert a new roll of thermal

paper.

The printer is in thermal protection

The printer is also protected thermically. In case the printer reaches elevated temperatures
then a thermal protection intervenes and blocks the functioning of the printer.
A message on the display appears to signal the protection.
Let the printer cool down before turning on the device again.

The printer makes noises

Make sure there is a sufficient quantity of thermal paper.
Make sure that the thermal paper and the thermal paper holder are positioned correctly.
Make sure that the thermal paper container lid is in the correct position.

The device does not measure

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Make sure that the turbine’s cable is connected to the spirometer and that the plug is
inserted properly in the appropriate connector.
Make sure that the turbine is inserted correctly into the MiniFlowmeter.

The device does not measure correctly

Make sure the turbine is inserted correctly in the MiniFlowmeter. Verify the free movement
of the turbine as illustrated in Paragraph 4.2.

WARNING

In case the device does not resume correct functioning in spite of the
controls made, contact the manufacturer or an authorized service centre.

WARNING

Before contacting the centre for technical assistance, please download the
archive from the device on to the PC using the Winspiro PRO software.
This procedure is necessary as the data could be lost whilst repairing the

device and could also be of a confidential nature and therefore subject to
laws on data privacy.

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5 LIMITED WARRANTY CONDITIONS

This MIR product together with its standard accessories is guaranteed for a period of ONE
YEAR from the date of purchase. In the case of any warranty claims the relevant sales

invoice (or another proof of purchase document) must be submitted to MIR.
The instrument must be checked at the time of purchase, or upon delivery, and any claims

must be made within 8 days in writing to the manufacturer.
This warranty covers the repair or the replacement (at the discretion of the manufacturer) of

the product or of the defective parts without charge for the parts or for the labour.
All batteries and other consumable parts are specifically excluded from the terms of this

guarantee.
The instrument must be returned to the authorized service centre for repair within 8 days

from when the defect is detected.
This warranty is not valid, at the discretion of the manufacturer, in the following cases:

 If the fault is due to an improper installation or operation of the machine, or if the

installation does not conform to the current safety norms in the country of installation.

 If the product is utilized differently from the use described in the User’s Manual

(improper, incorrect and/or unreasonable use, etc.).

 If any alteration, adjustment, modification or repair has been carried out by personnel

not authorised by MIR or by the user.

 If the fault is caused by lack of or incorrect routine maintenance of the machine.
 If the machine has been dropped, damaged or subjected to physical or electrical stress.
 If the fault is caused by the mains or by another product to which the instrument has

been connected.

 If the serial number of the instrument is missing, tampered with and/or not clearly legible.
This warranty does not cover any liability for damage, caused directly or indirectly, of any

kind whatsoever for persons or things for the period in which the device is not in use.
The repair or replacement described in this warranty is supplied for goods returned at the

customers’ expense to our certified service centres. For details of these centres please
contact your local supplier of the spirometer or contact the manufacturer directly.

The customer is liable for all repairs not included under the terms of this guarantee.
The customer is responsible for all transportation charges.

Any instrument or accessory returned must be accompanied by a clear and detailed
explanation of the defect or problem found. If units are to be returned to the manufacturer

then written or verbal permission must be received before any instruments are returned to
MIR.

spirolab III – User Manual Code MIR 980067 REV 1.6 Page 68 / 77

MIR - Medical International Research reserves the right to modify the instrument if required,
and a description of any modification made will be sent along with the returned goods.

spirolab III – User Manual Code MIR 980067 REV 1.6 Page 69 / 77

ANNEXES

DECLARATION OF CONFORMITY

MEDICAL INTERNATIONAL RESEARCH
Via del Maggiolino, 125 00155 -Roma - ITALIA

srl

Declaration of EC Conformity

Quality Management System according to the requirements of Annex II of the Medical
Device Directive 93/42/EEC.

Notified body CERMET N° 0476 - Certificate of Conformity N° MED

– 9826

MIR srl Medical International Research declares that the Device subject of this declaration together with
its standard accessories conforms to the requirements of the Council Directive 93/42/EEC

Annex I.

Device Description Spirometer
Device name spirolab III

Classification IIa
This device is marked with

Any modifications to the Device which are not authorised by us will invalidate this declaration.

Roma 01/ 09 / 2006

Signature: Signature:

Simon Fowler Carmine Cerullo
Sales Manager Quality Manager

spirolab III – User Manual Code MIR 980067 REV 1.6 Page 70 / 77

EXAMPLE OF OXIMETRY TEST REPORT

spirolab III – User Manual Code MIR 980067 REV 1.6 Page 71 / 77

INFORMATION FOR CORRECT USE IN AN ELECTROMAGNETIC ENVIRONMENT

Guidance and manufacturer’s declaration – electromagnetic emissions

The spirolab III is intended for use in the electromagnetic environment specified
below.

The customer or the user of the spirolab III should assure that it is used in such an
environment.

Emissions test Compliance Electromagnetic

environment – guidance

RF emissions
CISPR 11

RF emissions
CISPR 11

Harmonic emissions
IEC 61000-3-2

Voltage fluctuations/
flicker emissions

Group 2 The spirolab III must emit

electromagnetic energy to
perform its indended

function. Nearby electronic
equipment can be affected.

Class B The spirolab III is suitable

for use in all
establishments,

including domestic
establishments and those

directly
connected to the public

low-voltage power supply
network that supplies
buildings used for

domestic
purposes.

Class D
Complies

IEC 61000-3-3

spirolab III – User Manual Code MIR 980067 REV 1.6 Page 72 / 77

Guidance and manufacturer’s declaration – electromagnetic immunity

The spirolab III is intended for use in the electromagnetic environment specified
below.

The customer or the user of the spirolab III should assure that it is used in such an
environment.

Immunity test IEC 60601

test level

Electrostatic
discharge (ESD)

IEC 61000-4-2

Electrical fast
transient/burst

IEC 61000-4-4
Surge

IEC 61000-4-5

Voltage dips,
short

interruptions and
voltage variations
on power supply

input lines
IEC 61000-4-11

± 6 kV contact
± 8 kV air

±1 kV for
input/output

lines

± 1 kV
differential
mode

± 2 kV common
mode

<5 % UT
(>95 % dip in

UT)
for 0,5 cycle

40 % UT
(60 % dip in

UT)
for 5 cycles

70 % UT
(30 % dip in

UT)
for 25 cycles

Compliance
level

± 6 kV contact
± 8 kV air

±1 kV for
input/output

lines

±1 kV differential
mode

± 2 kV common
mode

<5 % UT
(>95 % dip in UT)

for 0,5 cycle
40 % UT

(60 % dip in UT)
for 5 cycles

70 % UT
(30 % dip in UT)
for 25 cycles

<5 % UT
(>95 % dip in UT)

for 5 sec

Electromagnetic
environment –
guidance

Floors should be wood,
concrete or ceramic tile.

If floors are covered with
synthetic material, the

relative humidity should
be at least 30 %.

Mains power quality
should be that of a

typical commercial or
hospital

environment.
Mains power quality

should be that of a
typical commercial or

hospital environment.

spirolab III – User Manual Code MIR 980067 REV 1.6 Page 73 / 77

<5 % UT
(>95 % dip in

UT)
for 5 sec

Power frequency
(50/60 Hz)

magnetic field
IEC 61000-4-8

NOTE UT is the a.c. mains voltage prior to application of the test level.

3 A/m 3 A/m Power frequency

magnetic fields should
be at levels characteristic

of a typical location in a
typical commercial or

hospital environment.

spirolab III – User Manual Code MIR 980067 REV 1.6 Page 74 / 77

Guidance and manufacturer’s declaration – electromagnetic immunity

The spirolab III is intended for use in the electromagnetic environment specified below.
The customer or the user of the spirolab III should assure that it is used in such an

environment.

Immunity test IEC 60601

test level

Compliance level Electromagnetic

environment – guidance

Portable and mobile RF
communications equipment

should be used no closer to
any part of the spirolab III,
including cables, than the

recommended separation
distance calculated from

the equation applicable to
the frequency of the
transmitter.

Recommended separation
distance

Conducted RF
IEC 61000-4-6

Radiated RF
IEC 61000-4-3

spirolab III – User Manual Code MIR 980067 REV 1.6 Page 75 / 77

3 Vrms
150 kHz to 80

MHz

3 V/m
80 MHz to 2,5

GHz

[3 ] V

[3 ] V/m

d=[ 3.5 ] √P

3

d=[ 3.5 ] √P 80 MHz to 800

GHz

3

d=[ 7 ] √P 800 MHz to 2,5

GHz

3

where P is the maximum
output power rating of the

transmitter in watts (W)
according to the transmitter

manufacturer and d is the
recommended separation

distance in metres (m).
Field strengths from fixed RF

transmitters, as determined
by an electromagnetic site

survey, should be less than
the compliance level in each

frequency range.b
Interference may occur in the

vicinity of equipment marked
with the following symbol:

NOTE 1 At 80 MHz and 800 MHz, the higher frequencyrange applies.
NOTE 2 These guidelines may not apply in all situations. Electromagnetic propagation

is affected by absorption and reflection from structures, objects and people.
a Field strengths from fixed transmitters, such as base stations for radio
(cellular/cordless) telephones and land mobile radios, amateur radio, AM and FM radio

broadcast and TV broadcast cannot be predicted theoretically with accuracy. To assess
the electromagnetic environment due to fixed RF transmitters, an electromagnetic site

survey should be considered. If the measured field strength in the location in which the

spirolab III is used exceeds the applicable RF compliance level above, the spirolab III

should be observed to verify normal operation. If abnormal performance is observed,
additional measures may be necessary, such as reorienting or relocating the spirolab

III.

b Over the frequency range 150 kHz to 80 MHz, field strengths should be less than [3]
V/m.

spirolab III – User Manual Code MIR 980067 REV 1.6 Page 76 / 77

Recommended separation distances between

portable and mobile RF communications equipment and the Spirloab III

The spirolab III is intended for use in an electromagnetic environment in which radiated
RF disturbances are controlled. The customer or the user of the spirolab III can help

prevent electromagnetic interference by maintaining a minimum distance between
portable and mobile RF communications equipment (transmitters) and the spirolab III as
recommended below, according to the maximum output power of the communications

equipment.

Separation distance according to frequency of transmitter

mRated maximum

output

150 kHz to 80 MHz

80 MHz to 800 MHz

800 MHz to 2,5 GHz
power of
transmitter

d=[ 3.5 ] √P

V

1

d=[ 3.5 ] √P

E

1

d=[ 7 ] √P

E

1

W

0.01 0.12 0.24 0.24

0.1 0.37 0.37 0.74
1 1.17 1.17 2.34

10 5.28 5.28 1.056

100 11.66 11.66 23.32

For transmitters rated at a maximum output power not listed above, the recommended
separation distanced in metres (m) can be estimated using the equation applicable to the

frequency of the transmitter, where P is the maximum output power rating of the
transmitter in watts (W) according to thetransmitter manufacturer.

NOTE 1 At 80 MHz and 800 MHz, the separation distance for the higher frequency range
applies.

NOTE 2 These guidelines may not apply in all situations. Electromagnetic propagation is
affected byabsorption and reflection from structures, objects and people.

spirolab III – User Manual Code MIR 980067 REV 1.6 Page 77 / 77