ResMed C16389 User Manual

RESMED

Proprietary Information, not to be reproduced or made available to third parties without prior consent from ResMed and not to be used in any unauthorised way. © ResMed Ltd. 2006

SPECIFICATION - PRINTED MATERIALS

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Date Document Prepared by Document Checked by

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VPAP Malibu User Guide USA Multilingual

1. ORACLE DESCRIPTION

VPAP Malibu User Gd USA ML

2. DETAILS

Cover

Dimensions: Trimmed to A5 Portrait (210 H x 148 W ± 2 mm)

Style: Covers printed one side only. Inside cover is blank.

Stock: 250gsm Chorus Silk

Colour of printing: 4 colour process

TEXT Dimensions: A5 Portrait (210 H x 148 W)mm ± 2mm

(Name)

Andrew Cheung or delegate

(refer to Change Note)

Style: Printed double-sided, bound and trimmed to make A5 portrait sized booklet.

80 gsm offset.

Colour of printing: Black.

Art Work: As shown on following pages. If re-typeset, the same styles and sizes must

be maintained.

Manufacturer: Small quantities may be printed in-house and large quantities externally.

3. RESMED QC INSPECTION

Refer to AU10006 - Printed Materials/Labels/CDs/Videos Section 19.1

VPAP Malibu™

User Guide

English • Français • Español • Português

Front Cover - User.qxp 30/11/2006 3:43 PM Page 1

Global leaders in sleep and respiratory medicine www.myresmed.com

268106/1

06 12

VPAP Malibu

User

AMER ML

Bleed this panel onto spine (if applicable) but NOT onto Front Cover

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VPAP Malibu™

User Guide 1

Guide Utilisateur 45

Guía del Usuario 93

EnglishFrançaisPortuguês Español

Manual do Usuário 141

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ResMed Ltd (Manufacturer) 1 Elizabeth Macarthur Drive Bella Vista NSW 2153 Australia ResMed Corp (US Designated Agent) 14040 Danielson Street Poway CA 92064-6857 USA ResMed (UK) Ltd (EU Authorized Representative) 65 Milton Park Abingdon Oxfordshire OX14 4RX UK ResMed Offices Australia, Austria, Brazil, Finland, France, Germany, Hong Kong, Japan, Malaysia, Netherlands,

New Zealand, Norway, Singapore, Spain, Sweden, Switzerland, UK, USA (see www.resmed.com for contact details).

Protected by patents: AU 691200, AU 697652, AU 699726, AU 702820, AU 709279, AU 713679, AU 724589, AU 764761, EP 0651971, EP 0661071, EP 0858352, EP 0920845, EP 0927538, EP 0934723, JP 3638613, US 4944310, US 5199424, US 5245995, US 5522382, US 5704345, US 6029665, US 6138675, US 6213119, US 6363933, US 6398739, US 6591834, US 6635021, US 6675797, US 6705315, US 6745768, US 6770037, US 6935337, US 7004908. Other patents pending. Protected by design registrations: AU 147283, AU 147336, CH 128709, CH 128710, DE 40202007.3, DE 40202020.0, ES 153514, ES 153515, FR 021396, FR 021397, GB 3001791, GB 3001819, JP 1164087, JP 1164265, SE 75599, SE 75600, US D467335, US D468011. Others pending.

Humidaire, Meridian, Mirage, Mirage Swift, Mirage Vista, SmartStart, ResLink, Ultra Mirage, VPAP and VPAP Malibu are trademarks of ResMed Ltd. Humidaire, Mirage, SmartStart, Vista and VPAP are registered in U.S. Patent and Trademark Office. SmartMedia is a registered trademark of Toshiba.

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VPAP Malibu™

User Guide

English

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Contents

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

Definitions 3 User/Owner Responsibility 3

Medical Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

What the VPAP™ Malibu Is Intended For 5 Tell Your Doctor If... 5 Warnings 5 Cautions 7

The VPAP Malibu System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

Mask 9 Supplemental Oxygen 11

Preparing for Use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13

Setting Up the VPAP Malibu 13

Operating Instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21

Starting Treatment 21 Stopping Treatment 23 Using the Mask-Fitting Feature 24 Using DC Power to Run the VPAP Malibu 25 Helpful Hints 25

Cleaning and Maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27

Daily 27 Weekly 27 Periodically 27 Replacing the Air Filter 28 Replacing the Antibacterial Filter 28 Servicing 28

Troubleshooting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31

Technical Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35

Limited Warranty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41

Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43

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Introduction

Definitions

This guide contains special terms and icons that appear in the margins to draw your attention to specific and important information.

WARNING

Alerts you to possible injury.

CAUTION

Explains special measures for the safe and effective use of the device.

Note: Is an informative or helpful note.

User/Owner Responsibility

The user or owner of this system shall have sole responsibility and liability for any injury to persons or damage to property resulting from:

• operation which is not in accordance with the operating instructions supplied

• maintenance or modifications carried out unless in accordance with

authorized instructions and by authorized persons.

Please read this guide carefully before use.

English

3Introduction

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Medical Information

What the VPAP Malibu™ Is Intended For

The VPAP Malibu is indicated for the treatment of adult patients with obstructive sleep apnea (OSA). It is intended for use in the hospital and home.

CAUTION (USA ONLY)

Federal law restricts this device to sale by or on the order of a physician.

Tell Your Doctor If...

You must tell your doctor if you have any of the following conditions, and CPAP (continuous positive airway pressure) or bilevel therapy must not be used:

• pneumothorax or pneumomediastinum

• severe heart failure, low blood pressure, or dehydration

• surgery to the brain, middle or inner ear, pituitary gland, or sinuses

• respiratory distress syndrome

• middle ear infection or perforated ear drum

• severe nosebleed.

Warnings

CPAP or bilevel therapy should be used with caution if you have any of the following conditions:

• respiratory failure

• cavities or cysts in the lung, or previous history of pneumothorax

• previous history of severe nosebleed

• sinus infection.

Tell your doctor if you have any of these conditions. Your doctor will advise you whether the likely benefits of CPAP or bilevel therapy outweigh the expected risks.

Special care should be exercised if you are dehydrated, or may become dehydrated, for example as a result of fluid restriction or diuretic therapy (including changes in therapy).

Discontinue therapy and seek medical advice if, during therapy or when you start therapy each night, you feel faint or light-headed.

The following are general warnings that pertain to your use of a VPAP Malibu unit. Specific warnings appear next to the relevant instructions in this guide.

English

5Medical Information

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WARNING

• This is NOT a life support device. It may stop operating with power failure

or if a fault occurs in the unit.

• The air flow for breathing produced by this device can be as much as 11

(6oC) higher than the temperature of the room. Caution should be exercised if the room temperature is warmer than 90oF (32oC).

• The VPAP Malibu unit should only be used with masks (and connectors)

recommended by ResMed, or by your physician or respiratory therapist. A mask should not be used unless the VPAP Malibu unit is turned on and operating properly. The vent hole or holes associated with the mask should never be blocked.

Explanation: The VPAP Malibu unit is intended to be used with special masks (or connectors) which have vent holes to allow continuous flow of air out of the mask. When the device is turned on and functioning properly, new air from the device flushes the exhaled air out through the mask vent holes. However, when the device is not operating, insufficient fresh air will be provided through the mask, and the exhaled air may be rebreathed. Rebreathing of exhaled air for longer than several minutes can, in some circumstances, lead to suffocation. This applies to most models of CPAP or bilevel devices.

• The VPAP Malibu unit should only be connected to the components,

humidifiers, or accessories specified in this guide. Connection of other items may result in injury, or damage to the VPAP Malibu unit.

• At low pressures, the flow through the exhalation ports of your mask may not

clear all exhaled gas from the tubing. Some rebreathing may occur.

• Explosion hazard—do not use in the vicinity of flammable anesthetics.

• If oxygen is used with this device, the oxygen flow must be turned off when

the device is not operating. Explanation of the warning: When the device is not in operation and the

oxygen flow is left on, oxygen delivered into the ventilator tubing may accumulate within the device enclosure. Oxygen accumulated in the device enclosure will create a risk of fire. This warning applies to most types of flow generators.

• Oxygen supports combustion. Oxygen should not be used while smoking or

in the presence of an open flame.

• Always ensure air flow is being generated by the device before the oxygen

supply is turned on.

• Always turn the oxygen supply off before stopping the air flow from the

device.

Note: At a fixed rate of supplemental oxygen flow, the inhaled oxygen concentration will vary, depending on where the oxygen is introduced, pressure settings, patient breathing pattern, mask selection, and leak rate. This applies to most types of CPAP machines.

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Warnings Related to Treatment

WARNING

• If you stop your CPAP or bilevel treatment, your sleep apnea will return

immediately.

• Always consult your clinician if you expect to be in a situation where you

cannot use your VPAP Malibu unit.

• If you are admitted to a hospital or prescribed any other form of medical

treatment, always inform the medical staff that you are being treated with CPAP or bilevel. It is also important to contact the clinician who is treating you for sleep apnea.

• If you experience an infection of the upper respiratory tract, middle ear, or

sinuses, contact your clinician before continuing your CPAP or bilevel treatment. You may be advised to stop treatment until the infection has cleared. If you continue with treatment during an infection, be sure to clean your mask and tubing after every use.

Cautions

The following are general cautions. Specific cautions appear next to the relevant instructions in this guide.

English

CAUTION

• Do not open the VPAP Malibu case. There are no user serviceable parts

inside. Repairs and internal servicing should only be performed by an authorized service agent.

Possible Side Effects

The VPAP Malibu flow generator is designed to help you have a good night’s sleep. However, you need to be aware of possible problems that may arise during CPAP or bilevel treatment.

WARNING

Consult your clinician immediately if you experience any of the following symptoms during your CPAP or bilevel treatment:

• headache

• middle ear or sinus discomfort

• dryness of the nose, mouth, or throat

• feeling bloated due to air swallowing

• air continually leaking out of the mouth while sleeping

• recurrence of any sleep apnea symptoms while on CPAP or bilevel.

Skin irritation may occur from sensitivity to the mask materials or from excessively tight headgear straps. A correctly fitted mask and appropriately adjusted straps will often prevent skin irritation. If problems persist, contact your clinician for advice.

7Medical Information

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The VPAP Malibu System

Please identify and familiarize yourself with the following components of the VPAP Malibu system:

VPAP Malibu Unit

Front View

LCD screen

Control panel

English

Rear View

Filter cover

AC power switch

Removable front cap

Carry bag

Air outlet

Air tubing 6’6" (2 m)

Power

sockets

Power cord

Auxiliar y

port

communications

Power cord clip

Mask

You will also need a ResMed mask system (supplied separately). The following ResMed mask systems are recommended for use with the VPAP Malibu:

Nasal Masks

• Meridian™ Nasal Mask

• Mirage Vista™ Nasal Mask

• Ultra Mirage™ Nasal Mask

• Ultra Mirage II Nasal Mask.

Nasal Pillow System

• Mirage Swift™ Nasal Pillows System.

Full Face Masks

• Ultra Mirage Full Face Mask.

Notes:

• ResMed devices have been designed and manufactured to provide optimum

performance using ResMed vented mask systems. Other mask systems may be used, however performance and data outputs may be affected.

Serial

port

9The VPAP Malibu System

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• In VSet mode, only ResMed masks are compatible for use with the

VPAP Malibu.

• Your clinician needs to set up your VPAP Malibu for use with your particular

mask.

Humidifier

A humidifier may be required if you are experiencing dryness of the nose, throat, or mouth. The VPAP Malibu is compatible for use with the following humidifier.

HumidAire 2i™ heated humidifier

Please refer to the relevant clinician’s guide for details.

WARNING

Only the HumidAire 2i is compatible for use with the VPAP Malibu. Please refer to Warnings on page 6.

Accessories

The following accessories are available for use with the VPAP Malibu:

VPAP Malibu Accessories

• Hypoallergenic air filter (not shown)

Air tubing 9’9" (3 m)

Antibacterial air filter

Note: ResMed recommends the following tubing products for use with the VPAP Malibu: 3 m air tubing, gray (PN: 14980); 2 m air tubing, gray (PN: 14948); disposable air tubing, clear (PN: 14912).

DC-24/30 Converter

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Supplemental Oxygen

The VPAP Malibu is designed to be compatible with the use of low flow oxygen therapy provided from an external source and supplied at a fixed rate of up to 15 L/min (S mode, CPAP mode) or 5 L/min (VSet mode). At a fixed flow rate of supplemental oxygen flow, the inhaled oxygen concentration will vary,depending on the pressure settings, patient breathing pattern,mask selection,and the leak rate. This warning applies to most types of CPAP machines.

WARNING

• If oxygen is used with this device, the oxygen flow must be turned off

when the device is not operating. Explanation: When the device is not in operation, and the oxygen flow is left on, oxygen delivered into the ventilator tubing may accumulate within the device enclosure and create a risk of fire.

• Always begin VPAP Malibu therapy before the oxygen supply is turned

on.

• Always turn the oxygen supply off before stopping VPAP Malibu

therapy.

• Oxygen supports combustion. Oxygen should not be used while

smoking or in the presence of an open flame.

English

11The VPAP Malibu System

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Preparing for Use

Setting Up the VPAP Malibu

WARNING

• Do not connect any device (other than the ResLink™ module) to the

auxiliary port. Although your health care provider may connect specially designed devices to the auxiliary port of the VPAP Malibu unit, connection of other devices could result in injury to persons, or damage to the unit.

• In the clinical environment any PC that is used with the VPAP Malibu

system must be at least 5’ (1.5 m) away from, or at least 8’ (2.5 m) above the patient. It must also comply with IEC 60950 or equivalent.

Note: The air filter cover protects the device in the event of accidental liquid spillage onto the device. Ensure that the air filter and air filter cover are fitted at all times.

1 Place the VPAP Malibu unit on a flat surface near the head of your bed. If the unit

is placed on the floor, ensure that the area is free from dust and clear of bedding, clothes, or any other objects that could block the air inlet.

CAUTION

Be careful not to place the device where it can be bumped or where someone is likely to trip over the power cord.

Connect the power cord:

There are two sockets at the rear of the flow generator—the top one for an AC (standard mains electricity) and the lower one for a DC power cord (see “Using DC Power to Run the VPAP Malibu” on page 25). ResMed recommends using the AC power cord supplied with the unit.

The customized ResMed power cord can be held in place with the locking clips. To insert the locking clip, pinch the free ends together and fit the pins into the

holes on both sides of the socket. Insert the power cord into the socket. Push the locking clip down so that the groove holds the power cord in place. Plug one

English

13Preparing for Use

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end of the power cord into the power socket at the rear of the unit, and the other end into a power outlet.

CAUTION

Do not connect both AC and DC power cords to the VPAP Malibu at the same time.

WARNING

Make sure the power cord and plug are in good condition and the equipment is not damaged.

Connect one end of the air tubing firmly onto the air outlet of the unit.

AC power switch

Locking clip

AC power cord

WARNING

Only ResMed air tubing should be used with your flow generator. A different type of air tubing may alter the pressure you actually receive reducing the effectiveness of your treatment.

Assemble your mask system according to the mask user instructions.

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Connect your mask system to the free end of the air tubing.

The VPAP Malibu is now ready for use. To start treatment, see “Operating Instructions” on page 21.

English

15Preparing for Use

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Humidifier Use

WARNING

The VPAP Malibu is not compatible with external humidifiers.

HumidAire 2i

The HumidAire 2i attaches to the front of the VPAP Malibu to provide heated humidification. No other accessories are required for its use. The VPAP Malibu automatically detects the presence of the HumidAire 2i. No menu changes are required. Please refer to the relevant user manual for details.

WARNING

• Make sure that the power cord and plug are in good condition and the

equipment is not damaged.

• Make sure that the water chamber is empty and thoroughly dried before

transporting the HumidAire 2i.

• When using the carry bag, always separate the VPAP Malibu unit and the

Humidaire 2i before placing in their respective compartments.

The VPAP Malibu is now ready for use. To start treatment, see “Operating Instructions” on page 21.

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Features of the VPAP Malibu

LCD Screen and Keypad

The control panel of the VPAP Malibu includes an LCD screen and keypad.

LCD screen

English

Left key

Up/down key

The VPAP Malibu keypad has the following keys:

Key Function

Front

• Starts or stops treatment.

• Extended hold for at least 3 seconds starts the Mask-Fitting

Start/Stop

Mask-fit

feature.

Up/Down

• Allows you to scroll through the VPAP Malibu menus, submenus, and setting options.

Left

• Performs the function indicated by the guiding text displayed above it on the LCD screen. Guiding text includes menu, enter, change, and apply.

Right

• Performs the function indicated by the guiding text displayed above it on the LCD screen. Guiding text includes exit and cancel

Start/Stop

Right key

sk-fit

Keypad

Front key

To assist you in adjusting the VPAP Malibu, the keypad and LCD are equipped with a backlight. The LCD backlight comes on when the unit is turned on or when you press a key, and turns off after two minutes. The keypad backlight is on at all times when the VPAP Malibu is powered.

17Preparing for Use

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Using the Menus

The VPAP Malibu unit provides a set of functions which are arranged in menus and submenus. Via the LCD screen, the menus and submenus allow you to view and change the settings for a particular function. You can access the menus regardless of whether the VPAP Malibu is in standby mode or delivering therapy.

After the Welcome screen appears and device self-checks are complete, you will see either the Ramp screen (S mode and CPAP mode) or the Settling screen (VSet mode).

Ramp Screen

(S mode, CPAP mode) If your clinician has set a maximum ramp time, the Ramp screen is displayed after the Welcome screen. On the Ramp screen, you can immediately set a ramp time. Ramp time is the period during which the pressure increases from a low pressure to the prescribed treatment pressure. See “Ramp Time” on page 23.

Ramp time can be altered in five minute increments (from OFF to a maximum ramp time set by your clinician) by the using the Up/Down key.

Settling Screen

(VSet mode) If your clinician has set a maximum settling time, the Settling screen is displayed after the Welcome screen. On the Settling screen, you can immediately set a settling time. Settling time is the period for which the VPAP Malibu remains at Minimum Pressure, before increasing pressure in response to events. See “Settling Time” on page 23.

Settling time can be altered in five minute increments (from OFF to a maximum settling time set by your clinician) by the using the Up/Down key.

Menus

The menu allows you to view details about the time used and the current software version of your VPAP Malibu. The Used (time) screen displays the total number of hours for which you have used the device since it was last reset by the clinician. It also displays the number of days the VPAP Malibu was used out of the total number of days available for use. The SW screen displays the current software version that is installed in your VPAP Malibu.

Figure 1 summarizes the VPAP Malibu standard menu series.

• To access the VPAP Malibu menus:

Press the Left key (menu) while the VPAP Malibu (or Ramp or Settling) screen is displayed.

• To scroll through items within the menu:

Press the Up/Down key

• To exit out of the menu:

Press the Right key (exit)

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VSet mode S mode & CPAP mode

SETTLE: 20min

EXHALATION: MED

change exit

USED: 0000hrs 000/000days exit

SX3650201

SW:

exit

RAMP: 30min

Figure 1: VPAP Malibu Menu Series

Notes:

• The Settling and Ramp screens are only available if Max Settle or Max Ramp has been set by a clinician.

• The Exhalation screen is only available if enabled by a clinician.

Menus with a Humidifier

If the HumidAire 2i is connected to the VPAP Malibu, and treatment has not commenced, the VPAP Malibu will display one of the following screens:

Prior to starting treatment:

VPAP Malibu

menu warmup

RAMP : 20min

menu warmup

SETTLE : 20min

menu warmup

English

Max Ramp set to 0 CPAP and S modes VSet mode

Max Settle set to 0

After starting treatment:

VPAP Malibu

Note: The VPAP Malibu screen displays for three seconds, then defaults to the treatment screens (see “Starting Treatment” on page 19).

Figure 2: Menu display with humidifier

19Preparing for Use

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Menus with a ResLink and Oximeter

If your clinician has recommended that you use a ResLink module, and the ResLink and an oximeter are connected to the VPAP Malibu, then display of SpO

(oxygen saturation) and HR (heart rate) takes priority. If treatment has not

commenced, the VPAP Malibu will display one of the following screens, whether a humidifier is connected or not:

Prior to starting treatment:

SpO2 : 98%

menu HR : 60

RAMP: 20min 98%

menu HR: 60

SETTLE: 20min 98%

menu HR: 60

Max Ramp off Max Ramp set Max Settle set

or to non-zero value to non-zero value

Max Settle off

Figure 3: Menu display with ResLink and oximeter

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Operating Instructions

Starting Treatment

The VPAP Malibu unit should be assembled beside your bed with the air tubing and mask system connected. See “Setting Up the VPAP Malibu” on page 13.

1 Turn the main power switch at the back of the unit to on (I).

AC power switch

When the VPAP Malibu is turned on, a welcome message is displayed on the LCD screen. The VPAP Malibu (or Ramp or Settling) screen then appears.

Note: If you have the HumidAire 2i attached, please refer to the relevant user manual for operating instructions.

Fit your mask as described in the mask user instructions.

Lie down and arrange the air tubing so that it is free to move if you turn in your

sleep.

CAUTION

• Do not leave long lengths of air tubing around the top of your bed. It

could twist around your head or neck while you are sleeping.

• Make sure the area around the flow generator is dry and clean. It should

also be clear of bedding, clothes, and other potential blockages.

English

To start treatment, simply breathe into the mask (see “SmartStart™/SmartStop”

on page 23). Air will begin flowing slowly and will build up to full operating pressure in about

10 to 15 seconds.

Note: If the VPAP Malibu does not start automatically, you can also press the Front key.

21Operating Instructions

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CPAP mode S mode VSet mode

(First screens only display if Ramp or Settling are selected)

Mode/Ramping Indicator

CPAP pressure

C:RAMP 8.0

A> exit

CPAP 15.0

A>>> exit

Pressure Graph

Apnea Indicator

Minute ventilation (L/min)

Breath/phase/expiration

Average inspiration time

Note: (Set) values are those selected by the clinician.

(last 5 breaths)

Oxygen saturation (%)

Heart rate (BPM)

Mode/Ramping Indicator

S:RAMP 8.0-11.0

S>>>> PS 3.0

Mode

Trigger Indicator

Leak

SPONT: 8.0-11.0

S>>>> PS 3.0

LK: 24L/min RR: 12

MV: 12.0 VT:1000

S**TiMn TiMx 4.0

Ti 2.1s 1: 1.6

SpO2 : 12%

HR : 57 exit

(Set) EPAP pressure

(Set) IPAP pressure

Pressure Support

Respiratory rate (bpm) Tidal volume (mL)

(Top row: VSet and S mode only) Ti Max setting (sec) Average I:E ratio (last 5 breaths)

Mode/Settling Indicator

EPAP

IPAP

VS:SETL 8.0-11.0

A>>>> PS 3.0

(Set) PS

VSET 8.0-11.0

A>>>> PS 3.0

Apnea Indicator

(This screen only displays if ResLink and an oximeter are connected)

The treatment screens contain the following information: Treatment mode: Mode of treatment set by your clinician. Options are: CPAP,

S and VSet. Ramping indicator: (CPAP mode, S mode) Appears if the VPAP Malibu is in

ramp mode. This disappears once the ramp time has elapsed. Settling indicator: (VSet mode) Appears if the VPAP Malibu is in settling mode.

This disappears once the settling time has elapsed. Set pressure(s): In CPAP mode, this displays the set treatment pressure

(centimeters of water). In S mode, it displays exhalation and inhalation pressures (centimeters of water). In VSet mode, it displays the AutoSet pressure (mean mid-point pressure between inhalation and exhalation).

Trigger indicator: (S mode) How the VPAP Malibu changes the pressure when you are inhaling. "S" (Spontaneous) indicates a patient triggered change.

Apnea indicator: (CPAP mode, VSet mode) Visual indicator that displays an "A" to indicate an apnea is occurring.

Pressure bar graph: Graphical display of the changing pressure. Leak: Current mask leak (liters per minute). Respiratory rate: Number of breaths per minute.

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Minute ventilation: Volume of air inhaled per minute (liters per minute). Tidal volume: Volume of air inhaled per breath (milliliters per breath). Breath/phase/expiration: This screen item displays in the format: breath type/

phase display/expiration type as shown below (eg, S**TiMn):

Breath type: S=spontaneous Phase display: **=inspiration, (blank)=expiration Expiration type:

TiMn=expiration triggered at completion of minimum inspiration-hold time TiMx=expiration triggered at completion of maximum inspiration-hold time C=expiration triggered spontaneously within TiMin and TiMax

Oxygen saturation: The saturation of blood hemoglobin (%). Heart rate: The number of hearts beats in a 60-second time frame (beats per

minute).

Ramp Time

(S mode, CPAP mode) Ramp time is a feature which can be enabled by your clinician. If you have difficulty falling asleep with full pressure, select a ramp time. The airflow will start very gently while you fall asleep. The pressure will slowly increase to full operating pressure over the selected ramp time. The clinician has set a maximum ramp time; you may select any value up to the maximum.

English

Settling Time

(VSet mode) Settling time is a feature which can be enabled by your clinician. If you have difficulty falling asleep with the VPAP Malibu operating, select a settling time. The airflow will remain at Minimum Pressure for the period of time that you set, giving you time to fall asleep. After this time, the VPAP Malibu will be able to increase pressure in response to events

The clinician will set a maximum settling time; you may select any value up to the maximum.

SmartStart™/SmartStop

The VPAP Malibu has a function SmartStart which starts therapy automatically when you breathe into the mask. If SmartStop is enabled, therapy will automatically stop when you take your mask off. This means you do not have to press the Front key to begin or end treatment.

Note: SmartStop will not work if:

• you have selected FULL FACE for your mask type.

• your clinician has enabled Mask Alarm.

Stopping Treatment

To stop treatment at any time, simply remove your mask and treatment will end (if your clinician has enabled SmartStop).

or remove your mask and press the Front key.

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Using the Mask-Fitting Feature

The VPAP Malibu Mask-Fitting feature can be used to help you fit your mask properly. The mask-fitting feature delivers air pressure for a three-minute period, prior to starting treatment, for checking and adjusting your mask fit to minimize leaks. If a Ramp time (S mode, CPAP mode) or Settling time (VSet mode) is selected, this allows you to adjust the mask at a pressure closer to the prescribed pressure. To use the mask-fitting feature:

1 Fit your mask as described in the user instructions.

Hold down the Front key for at least three seconds until air pressure delivery

starts. The following display will appear on the LCD screen indicating that the Mask-

Fitting feature is in operation. The flow generator will ramp to the Mask-Fit pressure and will remain at this pressure for three minutes. A Mask-Fit star rating is also displayed. See “Definitions of Mask-Fit Star Rating” on page 25.

Mask Fit excelnt

Notes:

• The Mask-Fit star rating display disappears after three minutes.

• Mask-Fit is accessible when the LCD shows the VPAP Malibu screen. It is

also accessible from the Ramp screen or Settling screen (these are only displayed if a maximum ramp or settling time has been set).

• In S and CPAP modes the Mask-Fit pressure is the set treatment pressure or

10 cm H20, whichever is greater.

• In VSet mode, the mask-fit pressure is 10 cm H

• Mask Alarm and SmartStop functions are disabled while using Mask Fit.

Adjust your mask, mask cushion, and headgear until you have a secure and

comfortable fit. Once you have a secure and comfortable fit, check your Mask-Fit star rating on

the LCD screen. Definitions of the Mask-Fit star ratings are presented in Table 1.

Note: If there is another person nearby to check your Mask-Fit star rating, you can adjust your mask, mask cushion, and headgear while lying down.

After three minutes, treatment will begin.

• If you do not wish to wait three minutes, hold down the Front key for at

least three seconds and treatment will begin immediately.

• If you press the Front key for less than three seconds, the unit will return

to standby mode (the VPAP Malibu, Ramp or Settling screen is displayed).

*****

Mask-Fit Star rating

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Table 1: Definitions of Mask-Fit Star Rating

Star rating Definition

***** Excellent

****- Very good

***- - Good

**- - - Adjust mask

*- - - - Adjust mask

HIGH LEAK Adjust mask

Using DC Power to Run the VPAP Malibu

The VPAP Malibu can be run on DC in the case of power failure. ResMed supplies separately a converter that allows a 12V or 24V battery to be connected to the DC input of the VPAP Malibu. When using DC, power is turned on and off via the switch on the connector to the power source, not the power switch at the back of the VPAP Malibu. The DC converter is a separate accessory that can be purchased through your ResMed distributor.

The humidifier heater will be automatically disabled when the VPAP Malibu is operating from the DC supply.

Power consumption of the VPAP Malibu varies with treatment settings. Adequate battery type and size is required before operation on DC, and it is recommended that you contact ResMed’s Technical Services division or ResMed's website for information on your specific application.

CAUTION

• The VPAP Malibu uses 24V DC power. Only connect the VPAP Malibu to

DC power using the ResMed DC-24/30 Converter specified for this application.

• Do not connect both AC and DC power cords to the VPAP Malibu at the

same time.

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Helpful Hints

Starting Out

Mouth Leaks

When using a nasal mask, try to keep your mouth closed during treatment. Air leaks from your mouth can decrease the effectiveness of your treatment. If mouth leaks are a problem, a full face mask or chin strap may help. Contact your clinician or equipment supplier for further details.

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