Respironics Respironics_V60_Ventilator_User_Manual_ Model AF Series Lab Ovens Operating Manual

User Manual

For Technical Support and Customer Service, contact:

USA and Canada: 1-800-722-9377
International: www.philips.com.
Select your location to access contact information.

Manufacturer

Respironics California, LLC
2271 Cosmos Court
Carlsbad, CA 92011
USA

Email and web addresses

[e-mail]
[e-mail]
www.philips.com/healthcare

Authorized European representative

Respironics Deutschland GmbH&Co. KG
Gewerbestrasse 17
82211 Herrsching
Germany
[phone]

EC REP

Australian sponsor

Philips Electronics Australia Ltd
65 Epping Road
North Ryde, NSW 2113
Australia

You can find the most current version of this user manual here:
http://www.philips.com/hrcmanuals

Table of contents

1. Warnings, cautions, and notes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-1

Definitions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-1

General. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-1

Preparing for ventilation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-3

Operation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-6

Operation in high flow therapy (HFT) . . . . . . . . . . . . . . . . . . . . . . . . . . 1-6

Alarms and messages. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-7

Care and maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-7

First-time installation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-8

Communications interface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-8

Diagnostic mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-9

2. Symbols . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-1

3. General information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-1

Intended use. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-1

Contraindications. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-1

About CO

Potential side effects . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-2

General description . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-2

Physical description. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-4

About the optional backup battery . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-9

About the graphical user interface . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-11

Starting up the ventilator . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-13

Shutting down the ventilator . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-13

Training . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-13

rebreathing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-2

2

Patient circuits, masks/patient interfaces, and accessories . . . . . . . 3-4

Ventilator unit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-6

Navigating the graphical user interface . . . . . . . . . . . . . . . . . . . . 3-12

4. Principles of operation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-1

System operational overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-1

Pneumatic system operation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-2

Breath delivery characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-2

Control variable . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-2

Triggering, cycling, and leak adaptation . . . . . . . . . . . . . . . . . . . . 4-2

Baseline pressure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-2

Pressure rise time . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-3

Negative pressures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-3

Oxygen concentration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-3

Auto-Trak Sensitivity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-3

Triggering . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-3

Cycling . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-3

Leak adaptation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-5

Auto-Trak+ (optional) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-6

iii

High flow therapy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-6

Ventilation modes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-7

CPAP mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-8

PCV mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-9

S/T mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-10

AVAPS mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-11

PPV mode (optional) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-13

Oxygen mixing. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-16

5. Setting up the ventilator for use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-1

Connecting oxygen. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-1

Installing an oxygen analyzer/monitor. . . . . . . . . . . . . . . . . . . . . . . . . . . 5-1

Connecting to AC power . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-2

Installing the patient circuit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-3

Connecting external devices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-6

Before placing a patient on the ventilator. . . . . . . . . . . . . . . . . . . . . . . . 5-7

Verify ventilator operation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-7

Running alarm tests. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-8

Preparation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-8

High Inspiratory Pressure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-8

Low Tidal Volume . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-8

Patient Disconnect . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-9

Patient Circuit Occluded . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-9

Using the ventilator for intra-hospital transport . . . . . . . . . . . . . . . . . . . 5-10

Storing the ventilator between patient use . . . . . . . . . . . . . . . . . . . . . . 5-11

6. Operation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-1

Changing the mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-2

Changing control settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-3

Making batch setting changes . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-3

Changing individual ventilator settings . . . . . . . . . . . . . . . . . . . . . . 6-4

Using the Ramp Time function . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-5

Using the 100% O

Using PPV. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-7

About Max V and Max P alarms and alarm limits . . . . . . . . . . . . . . . 6-7

Guidelines for using PPV . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-9

Changing alarm settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-12

Selecting the mask and exhalation port . . . . . . . . . . . . . . . . . . . . . . . . 6-12

Running the exhalation port test . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-16

Procedure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-16

Troubleshooting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-17

Other functions: the Menu window . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-17

Brightness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-17

Loudness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-17

Mask/Port . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-17

Vent Info (ventilator information) . . . . . . . . . . . . . . . . . . . . . . . . . 6-18

Screen Lock . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-18

Auto-Trak+ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-18

Standby . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-19

Help function . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-21

Table of modes and control settings . . . . . . . . . . . . . . . . . . . . . . . . . . 6-22

function . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-5

2

iv

7. High flow therapy. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-1

Circuit setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-1

High flow nasal cannula setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-1

Connecting to a circuit with an FEP (filter exhalation port) installed . . 7-2

Connecting directly to a 22 mm circuit . . . . . . . . . . . . . . . . . . . . . 7-2

Changing from an NIV mode to high flow therapy . . . . . . . . . . . . . . . . . 7-3

Viewing and pausing the HFT graph. . . . . . . . . . . . . . . . . . . . . . . . . . . 7-4

Changing from high flow therapy to an NIV mode . . . . . . . . . . . . . . . . . 7-4

HFT alarms and messages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-5

8. Patient monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-1

Display conventions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-1

Table of monitored parameters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-2

Scaling the waveform axes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-2

Freezing and unfreezing waveforms . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-3

9. Alarms and messages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-1

Responding to alarms. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-1

Setting alarm loudness. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-4

Silencing alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-5

Resetting alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-5

Manually resetting alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-5

Clearing autoreset alarms from the Alarms list . . . . . . . . . . . . . . . . 9-5

Hiding/displaying alarm messages . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-6

Alarms and other messages. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-6

10. Care and maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-1

Exterior and touchscreen cleaning . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-1

Approved cleaning agents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-2

Cleaning instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-2

Exterior and touchscreen disinfection . . . . . . . . . . . . . . . . . . . . . . . . 10-2

Approved disinfecting agents . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-3

Disinfection instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-3

Bacteria filter, patient circuit, and other accessories . . . . . . . . . . . . . . 10-3

Preventive maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-4

Replacing the air inlet filter . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-5

Cleaning or replacing the cooling fan filter . . . . . . . . . . . . . . . . . 10-6

Removing and replacing the battery . . . . . . . . . . . . . . . . . . . . . . 10-7

Disposal . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-7

Storage between patient use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-7

Service and repairs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-7

Repacking and shipping . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-8

11. Technical specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-1

Control settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-1

Patient data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-3

Alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-4

Menu window settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-4

Diagnostic mode functions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-5

v

Physical characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-5

Environmental specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-6

Pneumatic specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-6

Electrical specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-7

Accessory requirements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-7

Other specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-7

A. First-time installation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-1

Unpacking and inspection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-1

Mounting the ventilator . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-2

Installing the optional battery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-3

Installing oxygen inlet connector and AC power cord . . . . . . . . . . . . . . . . A-6

Installing the oxygen manifold kit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-8

Verifying ventilator operation and audible alarm . . . . . . . . . . . . . . . . . . . A-8

Configuration and screen calibration . . . . . . . . . . . . . . . . . . . . . . . . . . . A-8

B. Communications interface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B-1

RS-232 serial and analog I/O port . . . . . . . . . . . . . . . . . . . . . . . . . . . . B-2

Pinout of connector . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B-2

Communications protocol . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B-4

Commands and transmission conventions . . . . . . . . . . . . . . . . . . . B-4

Using Philips IntelliBridge or VueLink . . . . . . . . . . . . . . . . . . . . . . . . B-15

Using Philips monitors and the IntelliBridge Open Interface . . . . . B-15

Using Philips monitors and the VueLink Open Interface . . . . . . . . B-15

Data display . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B-16

Remote alarm port. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B-19

C. Parts and accessories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . C-1

Masks. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . C-1

HFT interfaces. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . C-2

Exhalation ports. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . C-2

O

analyzer/monitor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . C-2

2

Patient breathing circuits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . C-3

Humidification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . C-3

Bacteria filter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . C-4

Operator maintenance parts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . C-4

Other parts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . C-5

D. Regulatory compliance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . D-1

Electromagnetic compatibility (EMC). . . . . . . . . . . . . . . . . . . . . . . . . . D-1

Electromagnetic compatibility declaration . . . . . . . . . . . . . . . . . . . . . . D-1

Electromagnetic emissions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . D-1

Electromagnetic immunity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . D-2

WEEE recycling directive . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . D-5

Safety. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . D-5

vi

E. Diagnostic mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . E-1

Entering the diagnostic mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . E-1

System settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . E-3

Language . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . E-4

Date/Time . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . E-6

Pressure Units . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . E-7

Restore Default Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . E-8

Software Options . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . E-9

Baud Rate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . E-10

Alarm Volume Escalation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . E-11

Service . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . E-12

Significant Event Log . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . E-12

Touchscreen calibration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . E-14

Exiting the diagnostic mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . E-14

Glossary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Glossary-1

Index. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Index-1

vii

(This page is intentionally blank.)

viii

Chapter 1. Warnings, cautions, and notes

Before using the Respironics V60/V60 Plus Ventilator on a patient, familiarize
yourself with this user manual, particularly the safety considerations listed. Be
aware, however, that this manual is a reference only. It is not intended to
supersede your institution’s protocol regarding the safe use of assisted
ventilation.

Definitions WARNING: Alerts the user to the possibility of injury, death, or other serious adverse

reactions associated with the use or misuse of the device.

CAUTION: Alerts the user to the possibility of a problem with the device

associated with its use or misuse, such as device malfunction, device
failure, damage to the device, or damage to other property.

NOTE: Emphasizes information of particular importance.

General WARNING: An alternative means of ventilation shall be available whenever the

ventilator is in use. If a fault is detected in the ventilator, disconnect the
patient from it and immediately start ventilation with such a device. The
ventilator must be removed from clinical use and serviced by authorized
service personnel.

WARNING: Use the Respironics V60/V60 Plus Ventilator on spontaneously breathing

patients only. It is an assist ventilator and is intended to augment the
ventilation of a spontaneously breathing patient. It is not intended to
provide the total ventilatory requirements of the patient.

WARNING: We do not recommend you use the Respironics V60/V60 Plus Ventilator

on patients who require ventilation at predetermined tidal volumes. The
ventilator provides continuous positive airway pressure (CPAP) and
positive pressure ventilation (S/T, PCV, and AVAPS, and PPV) and is
indicated for assisted ventilation only. These modes do not provide
ventilation with guaranteed tidal volume delivery.

1-1

Warnings, cautions, and notes

WARNING: We do not recommend you use AVAPS on patients who require rapid and

frequent IPAP adjustments to maintain a consistent tidal volume. AVAPS, a
volume targeted mode, changes the IPAP setting in order to achieve the
target tidal volume. During AVAPS setup, there may be a period of time
before the target tidal volume is achieved. AVAPS is ideal for more
stabilized patients.

WARNING: To reduce the risk of CO

rebreathing, make sure EPAP pressures and

2

exhalation times are sufficient to clear all exhaled gas through the
exhalation port. In noninvasive ventilation continuous air flow through the
port flushes exhaled gases from the circuit. The ability to completely
exhaust exhaled gas from the circuit depends on the EPAP setting and I:E
ratio. Higher tidal volumes further increase the volume of CO

rebreathed

2

by the patient.

WARNING: To reduce the risk of CO

rebreathing, monitor the patient for changes in

2

respiratory status at the start of ventilation and with each change in
ventilator settings, circuit configuration, or patient condition. Pay
attention to ventilator alarms that warn of increased CO

rebreathing risk.

2

WARNING: To ensure accuracy of oxygen administration and to monitor for the

presence of contamination (incorrect gas connected), use an external
oxygen monitor to verify the oxygen concentration in the delivered gas.

WARNING: To reduce the risk of fire, use the ventilator in well-ventilated areas away

from flammable anesthetics. Do not use in a hyperbaric chamber or other
similarly oxygen-enriched environments. Do not use near an open flame.

WARNING: To reduce the risk of electric shock from liquid entering the device, do

not put a container filled with a liquid on the ventilator.

WARNING: To reduce patient risk of oxygen toxicity, keep free-flowing oxygen away

from air inlet of ventilator.

WARNING: The nurse call/remote alarm should be considered a backup to the

ventilator’s primary alarm system.

WARNING: To ensure that the alarm will be heard, make sure the alarm loudness is

adequate and avoid blocking the alarm speakers beneath the ventilator.
WARNING: Do not leave the ventilator unattended when stationed on an incline.
WARNING: The V60/V60 Plus Ventilator may cause radio interference or may disrupt

the operation of nearby equipment. It may be necessary to take mitigation

measures, such as re-orienting or relocating the ventilator or shielding

the location.
WARNING: Use of non-approved accessories, transducers or cables may increase

EMC emissions or decrease the EMC immunity performance of the

equipment.

CAUTION: Federal law (USA) restricts this device to sale by or on the order of a

physician.
CAUTION: The Respironics V60/V60 Plus Ventilator is designed to operate in the

temperature range of 5 to 40 ºC (41 to 104 ºF). To minimize the risk

of overheating the device, do not operate adjacent to heaters or other

heat sources.
NOTE: The displays shown in this manual may not exactly match what you

see on your own ventilator.

1-2

Warnings, cautions, and notes

NOTE: Pressures are indicated on the ventilator in cmH2O. Millibars and

hectopascals (hPa) are used by some institutions instead. Since
1 millibar equals 1 hPa, which equals 1.016 cmH
be used interchangeably.

NOTE: The ventilator is not intended for use as an ambulance transport

ventilator or as an Automatic Transport Ventilator as described by the
American Hospital Association and referenced by the FDA. It is
intended to allow the patient to be transported within the hospital
setting using a cart to move the ventilator.

NOTE: When attachments or other components or subassemblies are added

to the ventilator breathing system, the pressure gradient across the
ventilator breathing system, measured with respect to the ventilator
outlet, may increase.

NOTE: To ensure the correct performance of the ventilator and the accuracy

of patient data, use only Respironics-approved accessories with the
ventilator. See Appendix C, “Parts and accessories”.

NOTE: This Respironics V60/V60 Plus Ventilator and its recommended

accessories that have patient contact are not made with natural
rubber latex.

NOTE: If an alarm persists for no apparent reason, discontinue ventilator use

and contact Philips.

NOTE: If you detect any unexplained changes in the performance or visual

displays of the ventilator, discontinue ventilator use and contact
Philips.

NOTE: The Respironics V60/V60 Plus Ventilator does not support automatic

record keeping.

NOTE: All ventilator mode and alarm settings, alarm messages and

significant events are retained and automatically logged, even when
power is lost.

O, the units may

2

Preparing for ventilation

1-3

WARNING: Connect the ventilator only to an appropriate medical-grade oxygen

source.

WARNING: To reduce the risk of hypoxia, connect only oxygen to the high-pressure

connector at the rear of the ventilator.

WARNING: To reduce the risk of fire, do not use a high-pressure oxygen hose that is

worn or contaminated with combustible materials like grease or oil.

WARNING: The Respironics V60/V60 Plus Ventilator is designed to use ambient air

and high pressure 100% oxygen. No other gases should be used.
WARNING: Do not use the ventilator with helium or mixtures with helium.
WARNING: Do not use the ventilator with nitric oxide.
WARNING: To prevent possible asphyxia and to reduce the risk of CO

take these precautions with respect to mask and exhalation port use:

- Use only an oro-nasal mask with an anti-asphyxia valve or a nasal
mask for noninvasive ventilation.

rebreathing,

2

Warnings, cautions, and notes

- Do not occlude the exhalation port.

- Turn on the ventilator and verify that the port is operational before
application. Pressurized gas from the ventilator should cause a
continuous flow of air to exhaust from the leak port, flushing exhaled
gas from the circuit.

- Never leave the mask on the patient while the ventilator is not
operating. When the ventilator is not operating, the exhalation port
does not allow sufficient exhaust to eliminate CO
Substantial CO

rebreathing may occur.

2

from the circuit.

2

WARNING: The patient’s exhaled volume can differ from the measured exhaled

volume due to leaks around the mask during noninvasive ventilation.

WARNING: To ensure normal air circulation and exchange, do not cover or block the

ports on the ventilator. Do not block the air inlet panel on the right side of
the ventilator.

WARNING: Do not cover or position the ventilator so as to adversely affect its

operation or performance. Use the V60/V60 Plus in an upright position
that does not block the air inlet.

WARNING: To reduce the risk of the device overheating and possible burn injury, do

not block the fan intake at the rear of the ventilator.

WARNING: To prevent possible patient injury and possible water damage to the

ventilator, make sure the humidifier is set appropriately.

WARNING: When using a humidifier, always use either a circuit with a water trap or a

heated wire circuit to minimize patient risk from condensate in the
circuit.

WARNING: To prevent the possibility of inadequate humidification, pay close

attention to the humidifier’s functioning when operating the ventilator at
an ambient temperature > 30 ºC (86 ºF). The ventilator warms the air
delivered to the patient above ambient temperature, which may impair the
humidifier’s performance.

WARNING: To reduce the risk that the patient will aspirate condensed water from the

breathing circuit, position any humidifier lower than both the ventilator
and the patient.

WARNING: To prevent possible patient injury and equipment damage, do not turn the

humidifier on until the gas flow has started and is regulated. Starting the
heater or leaving it on without gas flow for prolonged periods may result
in heat build-up, causing a bolus of hot air to be delivered to the patient.
Circuit tubing may melt under these conditions. Turn the heater power
switch off before stopping gas flow.

WARNING: To reduce the risk of fire, use only patient circuits intended for use in

oxygen-enriched environments. Do not use antistatic or electrically
conductive tubing.

WARNING: To prevent patient or ventilator contamination, always use a main flow

bacteria filter on the patient gas outlet port. Filters not approved by
Respironics may degrade system performance.

WARNING: During ventilation, patient exhalate is released into room air. Use of a

patient circuit with a filter on its exhalation port is recommended.

WARNING: To reduce the risk of bacterial contamination or damage, handle bacteria

filters with care.

1-4

Warnings, cautions, and notes

WARNING: Any additional accessories in the patient circuit may substantially

increase flow resistance and impair ventilation.

WARNING: Avoid adding resistive circuit components on the patient side of the

proximal pressure line. Such components may defeat the disconnect
alarm.

WARNING: To reduce the risk of strangulation from patient tubing, use a tubing

support arm and secure the proximal pressure line with clips.

WARNING: To reduce the risk of electric shock, connect the ventilator to an AC

supply mains with protective earth only.

WARNING: Do not use extension cords, adapters, or power cords with the ventilator

that are not approved by Respironics.

WARNING: To prevent unintentional disconnection of the power cord, always use the

correct, Philips-supplied power cord and lock it into place with the power
cord retainer before you switch the ventilator on. The retainer is designed
to hold the connector end of the Philips-supplied cord securely in place.

WARNING: The V60/V60 Plus Ventilator should not be positioned in a way that makes

it difficult to disconnect from mains power if necessary. Disconnect from
supply mains by removing the power cord from the wall outlet.

WARNING: To reduce the risk of electric shock, regularly inspect the AC power cord

and verify that it is not frayed or cracked.

WARNING: To reduce the risk of strangulation, route the power cord to avoid

entanglement.

WARNING: To reduce the risk of power failure to the ventilator, pay close attention to

the battery’s charge level. The battery’s operation time is approximate and
is affected by ventilator settings, discharge and recharge cycles, battery
age, and ambient temperature. Battery charge is reduced at low ambient
temperatures or in situations where the alarm is continuously sounding.

WARNING: Always check the status of the oxygen cylinders before using the

ventilator during transport.

WARNING: Provide external oxygen monitoring to minimize patient risk in case of O

supply loss or ventilator failure.

WARNING: To ensure the ventilator’s safe operation, always verify ventilator

operation as described in “Verify ventilator operation” on page 5-7 before
using the ventilator on a patient. If the ventilator fails any tests, remove it
from clinical use immediately. Do not use the ventilator until necessary
repairs are completed and all tests have passed.

WARNING: To prevent possible patient injury due to nonannunciating alarms, verify

the operation of any remote alarm device before use.

WARNING: To prevent possible patient injury, always return alarm settings to

hospital-standard values after verifying ventilator operation.

WARNING: Manufacturer default settings are not appropriate for all patients. Prior to

using the ventilator, verify that the current alarm settings or defaults are
appropriate for each particular patient.

CAUTION: To prevent possible damage to the ventilator, ensure that the

connection to the oxygen supply is clean and unlubricated, and that
there is no water in the oxygen supply gas.

2

1-5

Warnings, cautions, and notes

CAUTION: For 120 V equipment, grounding reliability can only be achieved

when it is connected to an equivalent receptacle marked “hospital
only” or “hospital grade.”

CAUTION: Oxygen hose configurations using SIS connectors generate higher

resistance to flow. Therefore, a minimum supply pressure of 53 psig
is recommended when adding supplemental O
adapters such as the O2 transport manifold.

accessories with SIS

2

Operation WARNING: To prevent possible patient injury, avoid setting alarm limits to extreme

values, which can render the alarm system useless.

WARNING: PPV limits are not intended to be the primary ventilator alarms and should

not be substituted for the alarms found in the Alarm Settings window.

WARNING: To prevent the delivery of excessive pressure or volume, set the PPV

limits appropriately. Delivery of excessive pressure or volume can occur
from a sudden increase in mask leak, inappropriate settings, or a plugged
or kinked proximal pressure line. Conversely, insufficient treatment may
result if limits are set too low.

WARNING: Nebulization or humidification can increase the resistance of breathing

system filters. When using a nebulizer or humidifier, monitor the
breathing system filter frequently for increased resistance and blockage.

WARNING: Using a jet nebulizer can cause inadvertent alarms and affect the

accuracy of delivered FiO
pneumatic nebulizers to 10 L/min or use a vibrating mesh nebulizer.

. To reduce patient risk, limit the flow of

2

Operation in high flow therapy (HFT)

WARNING: When transitioning from a high flow therapy interface to an NIV mask,

ensure that an exhalation port is placed in the circuit and is unobstructed
to reduce the risk of CO

WARNING: When transitioning from ventilation to high flow therapy, remove the NIV

mask and use only a Philips-approved high flow patient interface to
minimize pressure build-up and patient discomfort.

WARNING: When transitioning from high flow therapy to ventilation, remove the nasal

cannula as these are restrictive and may defeat alarms such as patient
disconnect. Using a nasal cannula in an NIV mode may lead to
hypercarbia due to the inability to provide pressure support.

WARNING: Patient alarms are not available during high flow therapy (HFT) as the

therapy uses an open system. A nasal cannula occupies only a portion of
the nares and patients can breathe through their mouth, which prevents
estimation of patient parameters such as tidal volume, respiratory rate,
pressure, and minute ventilation. Provide external monitoring, including
oximetry, to inform the clinician of a change in the patient's condition.

rebreathing.

2

1-6

Warnings, cautions, and notes

WARNING: During high flow therapy (HFT), verify that an occlusive patient interface

is not being used. Occlusive patient interfaces include a cannula fully
sealed within the nares, an NIV mask, or a direct connection to a
tracheostomy tube or endotracheal tube. Remove any occlusive interface
immediately as this may expose the patient to unintended high pressures.

Alarms and messages WARNING: If AC power fails and the backup battery is not installed or is depleted, an

audible and visual alarm annunciates for at least 2 minutes. Immediately
discontinue ventilator use and secure an alternative means of ventilation.
As in most ventilators with passive exhalation ports, when power is lost,
sufficient air is not provided through the circuit and exhaled air may be
rebreathed.

Care and maintenance

WARNING: To reduce the risk of electric shock, power down the ventilator and

disconnect it from AC power before cleaning, disinfecting, or servicing it.

WARNING: To prevent patient or ventilator contamination, inspect and replace the

main flow bacteria filter between patients and at regular intervals (or as
stated by the manufacturer).

WARNING: To prevent possible patient injury, inspect and verify the proper operation

of the exhalation port regularly during use.

WARNING: To reduce the risk of fire, explosion, leakage, or other hazard, take these

precautions with respect to the battery:

- Do not attempt to disassemble, open, drop, crush, bend or deform,
insert foreign objects into, puncture, or shred the battery pack; modify
or remanufacture it; immerse or expose it to water or other liquids;
expose it to fire, excessive heat (including soldering irons); or put it in
a microwave oven.

- Replace the battery only with another battery specified by the
manufacturer.

- Follow all instructions for proper use of the battery.

- Do not short-circuit the battery or allow metallic or conductive objects
to contact the battery connector housing.

- Use the battery with the Respironics V60/V60 Plus Ventilator only.

WARNING: Modification of the V60/V60 Plus Ventilator and associated equipment is

not permitted and may compromise ventilator operation and patient
safety. Service should only be performed by qualified service personnel.

WARNING: This product consists of devices that may contain mercury, which must be

recycled or disposed of in accordance with local, state, or federal laws.
(Within this system, the backlight lamps in the monitor display contain
mercury.)

CAUTION: Do not attempt to sterilize or autoclave the ventilator.
CAUTION: To prevent possible damage to the ventilator, use only those cleaning

and disinfecting agents listed in this manual.

1-7

Warnings, cautions, and notes

CAUTION: To prevent possible damage to the ventilator, do not drip or spray any

liquids directly onto any surface including the front panel,
touchscreen, and navigation ring.

CAUTION: Never clean or disinfect the touchscreen with an abrasive brush or

device, since this will cause irreparable damage.

CAUTION: To avoid introducing foreign matter into the ventilator and to ensure

proper system performance, change the air inlet filter at regular
intervals (or as stipulated by your institution).

CAUTION: To ensure proper system performance, use a Respironics-approved air

inlet filter.

CAUTION: Because some environments cause a quicker collection of lint and dust

than others, inspect the filters more often when needed. The air inlet
filter should be replaced; the cooling fan filter should be cleaned.

CAUTION: To prevent possible damage to the ventilator, always ship it with the

original packing material. If the original material is not available,
contact Philips to order replacements.

First-time installation WARNING: Never attempt to disconnect or connect the battery during operation.

CAUTION: To prevent possible damage to the ventilator, always secure it to its

stand or securely place it on a flat, stable surface that is free of dirt
and debris. Do not use the ventilator adjacent to, or stack it with,
other equipment.

Communications interface

WARNING: Connect to the ventilator only items that are specified as part of or

compatible with the ventilator system. Additional equipment connected to
medical electrical equipment must comply with the respective IEC or ISO
standards. Furthermore, all configurations shall comply with the
requirements for medical electrical systems (see IEC 60601-1-1 or
clause 16 of edition 3 of IEC 60601-1, respectively). Anybody connecting
additional equipment to medical electrical equipment configures a
medical system and is therefore responsible for ensuring that the system
complies with the requirements for medical electrical systems. Also be
aware that local laws may take priority over the above mentioned
requirements. If in doubt, consult Philips.

WARNING: The USB port is not currently available for use. DO NOT connect or attempt

to power any equipment from the USB port.

WARNING: It is the responsibility of the end user to validate the compatibility and use

of information transmitted from the ventilator to the device to be
connected to the ventilator.

WARNING: The data provided through the communications interface is for reference

only. Decisions for patient care should be based on the clinician’s
observations of the patient.

1-8

Warnings, cautions, and notes

WARNING: To prevent possible patient injury due to nonannunciating alarms, verify

the operation of any remote alarm device before use.

WARNING: To ensure the functionality of the remote alarm, connect only Respironics-

approved cables to the remote alarm port.

CAUTION: The remote alarm port is intended to connect only to an SELV (safety

extra-low voltage and ungrounded system with basic insulation to
ground), in accordance with IEC 60601-1. To prevent damage to the
remote alarm, make sure the signal input does not exceed the
maximum rating of 24 VAC or 36 VDC at 500 mA with a minimum
current of 1 mA.

Diagnostic mode WARNING: To prevent possible patient injury, do not enter the diagnostic mode while

a patient is connected to the ventilator. Verify that the patient is
disconnected before proceeding.

1-9

Warnings, cautions, and notes

(This page is intentionally blank.)

1-10

Chapter 2. Symbols

Refer to these tables to interpret symbols used on the ventilator labels and
packaging and on the ventilator screen. To interpret symbols pertaining to
accessories, refer to their instructions for use.

?

Table 2-1: Symbols used on ventilator labels and packaging

Symbol Description

Warning: Risk of explosion. Do not use in the presence of flammable an­esthetics.

Attention, consult the accompanying documents.

Read the user manual before using the ventilator.

(Blue) It is mandatory for the operator to consult the accompanying docu­ments.

Protective earth (ground)

Type B applied part, which is equipment that provides a particular degree
of protection against electric shock, particularly in regard to allowable
leakage current and of the protective earth connection

Requires alternating current (AC)

Degree of fluid ingress protection provided by the enclosure (drip-proof)

Caution: Federal law restricts this device to sale by or on the order of a

physician

Alarm and remote alarm

Two states of control: ON and Shutdown

Battery

European Conformity. Symbol is on rear panel of ventilator.

2-1

Symbols

EC REP

Table 2-1: Symbols used on ventilator labels and packaging (continued)

Symbol Description

Brazilian Conformity. Certification by INMETRO (National Institute of Me­trology, Standardization and Industrial Quality)/SGS (Societe Generale de
Surveillance).

EurAsian Conformity mark - EAC

Date of manufacture

Manufacturer

EC representative

Serial number

Order number

Lot or batch number

Model number

Use by date

RS-232 serial input/output

USB port

Oxygen

(Yellow) Warning

Ethernet connection

2-2

Table 2-1: Symbols used on ventilator labels and packaging (continued)

(On power cord)

Symbol Description

Accept button on the navigation ring

Adjustment direction on the navigation ring

Canadian Standards Association approval

Do not disassemble. Refer to authorized service personnel.

Product must be disposed of in accordance with the WEEE directive.

Symbols

Noninvasive ventilation (patient with mask)

Invasive ventilation (intubated patient)

Do not block the cooling fan Inlet (at the rear of the ventilator).

No pushing. Do not push on the ventilator screen. Tipping hazard.

Total mass (weight) of the ventilator, ventilator stand, and standard setup.
See page 11-5 for more information.

Hospital-grade

2-3

Symbols

廢電池請回收

Table 2-1: Symbols used on ventilator labels and packaging (continued)

Symbol Description

Recycle

Recycle (Taiwan)

RoHS (China). Administrative Measure on the Control of Pollution Caused
by Electronic Information Products. Contains RoHS substances with 50
years environmentally friendly use period (EFUP).

uR UL recognition symbol

Direct current (DC). Symbol is on backup battery.

Rechargeable battery. Symbol is on backup battery.

Lithium-ion battery. Battery must be recycled or disposed of properly.
Symbol is on backup battery.

Atmospheric pressure limitation. Indicates the acceptable upper and low­er limits of atmospheric pressure for transport and storage.

Humidity limitation. Indicates the acceptable upper and lower limits of
relative humidity for transport and storage.

Temperature limit. Indicates the maximum and minimum temperature
limits at which the item shall be stored or transported.

Battery option

C-Flex feature

AVAPS mode (included)

2-4

Table 2-1: Symbols used on ventilator labels and packaging (continued)

Symbol Description

PPV software option

Auto-Trak+ software option

High flow therapy

Note: 3.00 software and above. HFT is optional for model V60 and
included with model V60 Plus.

Table 2-2: Symbols used on graphical user interface

Symbol Description

Alarm (audible)

Symbols

Alarm is silenced

High priority alarm

Low priority alarm

Alarm reset

Informational message

Alarm message is displayed. Touch to hide alarm messages.

Alarm message is hidden. Touch to display alarm messages.

Do not use an NIV mask during high flow therapy (3.00 software and
above, and V60 Plus).

2-5

Symbols

Table 2-2: Symbols used on graphical user interface (continued)

Symbol Description

Increase and decrease (adjustment arrow) buttons. Adjusts a setting or
selects a value.

Accept button. Accepts set values.

Cancel button. Cancels set values.

+2:00 minutes button. Adds two minutes to 100% O

Ventilator is powered by AC power and the optional battery is installed.

Ventilator is powered by AC power and the optional battery is not in­stalled.

Ventilator is powered by the battery. This symbol shows the approximate
battery time remaining in hours and minutes, and it shows the capacity
graphically.

Help button. Touch to display onscreen help information.

Vertical autoscale button. Autoscales the Y axis of the graphs to fit the
data currently displayed.

delivery.

2

Pause button. Freezes waveforms in the Waveform window.

Pause in progress

Resume button. Resumes all waveform graphs from a paused state.

2-6

Table 2-2: Symbols used on graphical user interface (continued)

Symbol Description

Time base adjust button. Rescales the X axis of the graph display data at
3, 6, 12, and 24 second increments.

Symbols

V

E

V

T

T

I/TTOT

Estimated minute ventilation

Estimated exhaled tidal volume
Duty cycle. Inspiratory time divided by total cycle time.
No valid data to display

Data is under range

Data is over range

Pressure, centimeters of water

Flow, liters per minute. BTPS compensated.

Volume, milliliters

User-set Ramp Time. Ramp graphic fills in as Ramp Time progresses.

Ramp Time is OFF (no ramp time set).

Intentional leak. The number corresponds to the leak symbol printed on
Philips Respironics masks.

2-7

Symbols

(This page is intentionally blank.)

2-8

Chapter 3. General information

This manual covers the Respironics V60 and V60 Plus Ventilator
configurations. Both share the same platform. The V60 Plus Ventilator comes
standard with High Flow Therapy (HFT). The V60 Ventilator can be field­upgraded with HFT, subject to local regulations. For a full list of features,
modes, and options, see "General description" on page 3-2.

NOTE: The 3.00 software upgrade, which permits the activation of HFT, and

the V60 Plus Ventilator are not available in all countries

NOTE: .

Intended use The Respironics V60/V60 Plus Ventilator is an assist ventilator and is intended

to augment patient breathing. It is intended for spontaneously breathing
individuals who require mechanical ventilation: patients with respiratory
failure, chronic respiratory insufficiency, or obstructive sleep apnea in a
hospital or other institutional settings under the direction of a physician.

The ventilator is intended to support pediatric patients weighing 20 kg (44 lb)
or greater to adult patients. It is also intended for intubated patients meeting
the same selection criteria as the noninvasive applications. The ventilator is
intended to be used by qualified medical professionals, such as physicians,
nurses, and respiratory therapists. The ventilator is intended to be used only
with various combinations of Respironics-recommended patient circuits,
interfaces (masks), humidifiers, and other accessories.

Contraindications The Respironics V60/V60 Plus Ventilator is contraindicated for patients with

any of the following conditions:

• Lack of spontaneous respiratory drive

• Inability to maintain a patent airway or adequately clear secretions

• At risk for aspiration of gastric contents

• Acute sinusitis or otitis media

• Hypotension

• Untreated pertussis

• Epistaxis (nosebleed)

3-1

General information

Model
number

About CO2 rebreathing

As with mask ventilation in general, patient CO2 rebreathing may occur under
some circumstances. Follow these guidelines to minimize the potential for CO
rebreathing. If rebreathing is a significant concern for a particular patient and
these guidelines are not sufficient to acceptably reduce the potential for CO
rebreathing, consider an alternative means of ventilation.

• Increase EPAP to decrease the potential for CO
pressures produce more flow through the exhalation port, which helps
to purge all CO

• Be aware that the potential for CO
inspiratory time increases. A longer inspiratory time decreases
exhalation time, allowing less CO
the next cycle. In such circumstances, higher tidal volumes further
increase the volume of CO

from the circuit to prevent rebreathing.

2

rebreathing increases as

2

to be purged from the circuit before

2

rebreathed by the patient.

2

rebreathing. Higher

2

Potential side effects Advise the patient to immediately report any unusual chest discomfort,

shortness of breath, or severe headache. Other potential side effects of
noninvasive positive pressure ventilation include: ear discomfort,
conjunctivitis, skin abrasions due to mask/patient interface, and gastric
distention (aerophagia). If skin irritation or breakdown develops from the use of
the mask, refer to the accompanying mask instructions for appropriate action.

2

2

General description The Respironics V60/V60 Plus Ventilator (Figure 3-1) is a microprocessor-

controlled, bilevel positive airway pressure (BiPAP) ventilatory assist system
that provides noninvasive positive pressure ventilation (NPPV) and invasive
ventilatory support for spontaneously breathing adult and pediatric patients.

Figure 3-1: Respironics V60 Ventilator shown

Ventilation modes. The ventilator offers a range of conventional pressure
modes, CPAP (continuous positive airway pressure), PCV (pressure-controlled
ventilation), and S/T (spontaneous/timed). The volume-targeted AVAPS
(average volume-assured pressure support) mode combines the attributes of
pressure-controlled and volume-targeted ventilation. The optional PPV mode
provides pressure ventilation in proportion to the patient’s efforts.

3-2

General information

Modes, therapies and features. Table 3-1 shows which modes, therapies and

features are included or optional for the V60 and V60 Plus models.

Table 3-1: V60 and V60 Plus comparison

Ventilator Model

V60 Included Optional Optional Optional Included

V60 Plus Included Optional Included Optional Included

Modes Therapy Features

AVAPS PPV HFT Auto-Trak+ C-Flex

High flow therapy (HFT). High flow therapy provides a set flow of mixed air and

oxygen. Flow and O

percentage settings are selected by the clinician. HFT is

2

available for 3.00 software and above, as well as for the V60 Plus.

Auto-Trak Sensitivity allows the ventilator to automatically compensate for
intentional and unintentional leaks by maintaining a stable baseline and
adjusting trigger and cycle thresholds for optimum patient-to-ventilator
synchrony. The optional Auto-Trak+ feature lets you further adjust the level of
Auto-Trak Sensitivity.

User interface. The ventilator’s ergonomic design, including a 12.1-inch (31­cm) color touchscreen, a navigation ring, and key panel, lets you easily access
ventilator settings and monitored parameters.

Monitoring. The ventilator displays monitored parameters as numbers and as
real-time waveforms (curves or scalars).

Alarms. The ventilator’s operator-adjustable and nonadjustable alarms help
ensure the patient’s safety.

Power and gas supplies. The ventilator uses as its primary power source AC mains.
An optional internal backup battery powers the ventilator typically for 6 hours.

The ventilator uses high-pressure oxygen. An integral blower pressurizes gas for
delivery to the patient.

NOTE: Oxygen delivered through the compressed gas hose and blower is

used as fresh gas.

Mounting. The ventilator can be mounted to a stand. When equipped with the
optional cylinder holder, the stand can accommodate two E-size oxygen
cylinders. An oxygen manifold kit is available, which allows two oxygen
cylinders and one wall oxygen supply line to be used as inputs to the ventilator.

Communications interface. The ventilator can output data through the RS-232
serial port upon receiving a command from a host computer or bedside
monitoring system. The ventilator is equipped with a remote alarm/nurse call
connection to activate alarms remotely.

Upgradability via Respi-Link

remote diagnostic system. The Respi-Link interface

permits software upgrade and remote troubleshooting of the ventilator through
the RS-232 port.

3-3

General information

Oxygen
monitor

Humidifier

Oxygen

cylinder

Patient circuit

Mask

Bacteria filter

Physical description Patient circuits, masks/patient interfaces, and accessories

Figure 3-2 shows the Respironics V60/V60 Plus Ventilator with its patient
circuit and accessories. Table 3-2 on page 3-5 lists recommended patient
circuits, masks/patient interfaces, and other accessories for use with the
ventilator. Appendix C provides ordering information for parts and accessories.

Figure 3-2: Respironics V60/V60 Plus Ventilator with accessories

3-4

General information

Table 3-2: Recommended parts and accessories

Part Use...

Patient circuit Single-limb patient circuit intended for

noninvasive ventilation, invasive
ventilation, or high flow therapy (if
applicable). Use a circuit listed in
Appendix C.

WARNING:
During ventilation, patient exhalate is

released into room air. Use of a patient
circuit with a filter on its exhalation port is
recommended.

Patient interface (noninvasive or invasive) • Respironics masks listed in Appendix C

• Invasive interface (tracheostomy or ET
tube)

Patient interface (HFT) Nasal high flow cannula and tracheostomy

interface listed in Appendix C.
(For use with 3.00 software and above, as
well as V60 Plus.)

Exhalation port Philips Respironics exhalation port listed in

Appendix C. Contact your Philips
representative.

Inspiratory filter Main flow (inspiratory) bacteria filter listed

in Appendix C

Humidifier • Fisher & Paykel

• Fisher & Paykel

Oxygen analyzer/monitor • Analytical Industries AII-2000M oxygen

analyzer/monitor*

*NOTE: Contact Philips representative for
availability outside the U.S.

Nebulizer • Vibrating mesh nebulizer, such as the

Aerogen

• Jet nebulizer with low drive flow
requirements (< 10 L/min)

MR850
MR290 chamber

3-5

General information

1

6

5

4

2

3

Key panel

789

Ventilator unit

Figure 3-3 through Figure 3-5 show the controls, indicators, and other
important parts of the ventilator unit.

Figure 3-3: Front view

Number Description

1 Graphical user interface. Color LCD (liquid crystal display) with touchscreen.

2 Navigation ring. Lets you adjust values and navigate the graphical user interface

by rotating the finger on its touchpad.

3 Accept button. Activates selections.

4 Proximal pressure port. Connection for tubing that monitors patient pressure in

5 Ventilator outlet (To patient) port. Main connection for the patient circuit.

6 Alarm speakers (beneath ventilator)

7 Alarm LED. Flashes during a high-priority alarm. On continuously during a

8 Battery (charged) LED. Flashes when battery is charging. On continuously when

9 ON/Shutdown key with LED. Turns on AC power and initiates ventilator shutdown.

the patient circuit.

Delivers air and oxygen in prescribed pressures to the patient.

ventilator inoperative condition.

battery is charged. Off when ventilator is running on battery or when the
ventilator is off and AC power is not connected.

LED is continuously on when AC power is connected.

3-6

Number Description

1
2

General information

Figure 3-4: Side view

1 Ventilation vents. Allow intake of air for delivery to the patient.

2 Air inlet filter (under side panel). Filters the air for delivery to the patient.

3-7

General information

83

1

7 3 6 5 4 3 2

9

Figure 3-5: Rear view

Number Description

1 Backup battery (compartment under side panel). Optional, 6-hour backup

battery.

2 Remote alarm/nurse call connector

3 Reserved for future use

4 Power cord retainer

5 Power cord

6 RS-232 serial and analog I/O connector (female DB-25). Connects to hospital

information systems and other serial devices, and functions as an interface
for analog signals. Connects Respi-Link
for software updates.

7 Cooling fan filter

8 High-pressure oxygen inlet connector

9 Option labels

remote diagnostic system gateway

3-8

General information

About the optional backup battery

WARNING: To reduce the risk of power failure to the ventilator, pay close attention to

the battery’s charge level. The battery’s operation time is approximate and
is affected by ventilator settings, discharge and recharge cycles, battery
age, and ambient temperature. Battery charge is reduced at low ambient
temperatures or in situations where the alarm is continuously sounding.

NOTE: The backup batteries are intended for short-term use only. They are

not intended to be a primary power source.

NOTE: We recommend that the ventilator’s batteries be fully charged before

you ventilate a patient. If the batteries are not fully charged and AC
power fails, always pay close attention to the level of battery charge.

NOTE: A new backup battery should be installed and charged within one year

of the date of manufacture identified on the battery and on the
shipping box.

The optional internal backup battery protects the ventilator from low, or failure
of, AC (mains) power. If AC power fails, the ventilator automatically switches to
operation on backup battery with no interruption in ventilation. The battery
powers the ventilator until AC power is again adequate or until the battery is
depleted. The battery powers the ventilator typically for 6 hours.

As a safeguard, the ventilator provides a low battery alarm. It also has a
capacitor-driven backup alarm that sounds for at least 2 minutes when battery
power is completely lost.

The ventilator charges the battery whenever the ventilator is connected to AC,
with or without the ventilator switched on. The Battery (charged) LED flashes
to show that the battery is being charged.

Check the battery charge level before putting a patient on the ventilator and
before unplugging the ventilator for transport or other purposes. The power
source symbol at the bottom right-hand corner of the screen shows the power
source in use and, if the ventilator is running on battery, the level of battery
charge (Figure 3-6). If the battery is not fully charged, recharge it by
connecting the ventilator to AC power for a minimum of 5 hours. Pressing the
Help button shows you the time remaining until the battery is full. If the
battery is not fully charged after this time, have the ventilator serviced.

3-9

General information

ON/Shutdown LED

On continuously: AC
power is connected

Battery (charged) LED

Flashes: Battery is charging
On continuously: Battery is charged

(90 to 100%)
Off: Ventilator is running on battery,

or the ventilator is off and AC power
is not connected

Power source symbol

The ventilator is powered by AC
and the battery is installed.

The ventilator is powered by AC
and the battery is not installed.

The ventilator is powered by the
battery. This symbol shows the
approximate battery time
remaining in hours and minutes,
and it shows the capacity
graphically.

Figure 3-6: Power indicators

3-10

General information

15

Window/window tabs

(see page 6-1)

Help button
(see page 6-21)

Waveforms window

(see page 8-1)

Patient data window

(see page 8-1)

Power symbols

(see page 5-2)

Alarm status bar

(see page 9-2)

Compressed waveforms window with Alarms/
Messages list
(see page 9-2)

100% O

2

button

(see page 6-5)

About the graphical user interface

Through the graphical user interface (Figure 3-7) you make ventilator settings
and view ventilator and patient data. During ventilation, the upper screen
displays alarms and patient data. The middle screen displays real-time
waveforms and alarm and informational messages. The lower screen lets you
access modes and other ventilator settings, display help information, and see
the power status.

Figure 3-7: Parts of graphical user interface

3-11

General information

Adjustment
arrow button

Slider flag

Setting range scale

Proposed value

Navigating the graphical user interface

Select a function by touching the desired tab or button on the touchscreen.
Use this as the primary method to control the ventilator.

You can use the navigation ring as an alternative to the following touchscreen
functions:

Touchscreen equivalent Navigation ring equivalent

Touch increase button (adjustment
arrow). Press and hold for faster
adjustments.

Touch decrease button (adjustment
arrow). Press and hold for faster
adjustments.

* Available in Revision 2.30 software and above.

*

*

Touch Accept button
(applies selection)

Touch and rotate finger clockwise to
increase value or move cursor forward

Touch and rotate finger
counterclockwise to decrease value or
move cursor backward

Press Accept (checkmark)
button (applies selection)

After making selections and adjusting values, accept selections by pressing the
circular Accept button (the checkmark) in the middle of the navigation ring to
accept and apply the change.

To open a window, touch the window tab.

To cancel a function and close the window, either select Cancel or touch another

window tab.

To adjust a parameter, select the value with the navigation ring or touch the
arrow button. Each touch changes the value in single increments or, for
parameters with wide ranges, press and hold the arrow key to make faster
changes. The slider flag moves along the setting range scale. Select Accept to
apply.

The navigation ring also lets you adjust the position of the cursor in the
waveforms window while the screen is frozen. See Freezing and unfreezing
waveforms on page 8-3 for more information.

3-12

General information

Starting up the ventilator

Shutting down the ventilator

NOTE: Upon power-on the ventilator automatically runs a test of the backup

audible alarm followed by the primary audible alarm. You should hear
a high-pitched tone, followed by a beep. If you do not hear all of these
sounds, discontinue use of the ventilator and have it serviced.

1. Power on the ventilator with the ON/Shutdown key.

2. Verify the ventilator operation, as described on page 5-7.

Shut down the ventilator as follows:

1. Press and release the ON/Shutdown key. The Shutdown window opens.

2. Select Ventilator Shutdown. The ventilator shuts down.

NOTE: Improper shutdown may cause a Power has been restored message the

next time the ventilator is turned on.

NOTE: If the screen is blank and the dialogue box cannot be displayed, shut

down the ventilator by pressing the ON/Shutdown key, then the Accept
button on the navigation ring.

Training Product training is available. Contact your local Philips sales representative or

Philips Customer Support for assistance. Call 1-800-225-0230 for ordering
and 1-800-722-9377 for service.

3-13

General information

(This page is intentionally blank.)

3-14

Chapter 4. Principles of operation

System operational overview

The Respironics V60/V60 Plus Ventilator is a microprocessor-controlled
pneumatic system that delivers a mixture of air and oxygen. It is powered by
AC with optional battery backup to protect against power failure or unstable
power and to facilitate intrahospital transport. The ventilator’s pneumatics
deliver gas and its electrical systems control pneumatics, monitor the patient,
and distribute power.

The user provides inputs to the ventilator through a touchscreen, keys, and a
navigation ring. These inputs become instructions for the pneumatics to
deliver a precisely controlled gas mixture to the patient. Pressure and flow
sensors provide feedback, which is used to adjust gas delivery to the patient.
Monitored data based on sensor inputs is also displayed by the graphical user
interface.

The ventilator’s gas delivery and monitoring functions are cross-checked. This
cross-checking helps prevent simultaneous failure of these two main functions
and minimizes the possible hazards of system failure.

A comprehensive system of visual and audible alarms helps ensure the
patient’s safety. Clinical alarms can indicate an abnormal physiological
condition. Technical alarms, triggered by the ventilator’s self-tests, can
indicate a hardware or software failure. In the case of some technical alarms,
limited ventilation is provided to give the user time for corrective actions.
When a condition is critical enough to possibly compromise safe ventilation,
the ventilator is placed into the ventilator inoperative state, in which oxygen
flow and blower operation are disabled.

The ventilator has several means to ensure that safe patient or respiratory
pressures are maintained. The maximum working pressure is ensured by the
high inspiratory pressure (HIP) alarm limit. If the set high pressure limit is
reached, the ventilator cycles into exhalation.

4-1

Principles of operation

Respironics V60/V60 Plus Ventilator

Blower

High-

pressure

oxygen

Ambient

air

Proximal (patient)

pressure

Ventilator outlet

(machine)

pressure

Air flow

sensor

Mixer

Propor-

tioning

valve

O2 flow

sensor

Air inlet

filter

Main flow

filter

Patient

Exhalation

port

O2 pressure

Pneumatic system operation

Figure 4-1: Respironics V60/V60 Plus Ventilator gas delivery system

The ventilator uses ambient air and high-pressure oxygen (Figure 4-1). Air
enters through an inlet filter. Oxygen enters though a high-pressure inlet, and a
proportioning valve provides the operator-set concentration. The system mixes
the air and oxygen, pressurizes it in the blower, and then regulates it to the
user-set pressure. To do this, the ventilator compares the proximal (patient)
pressure measurement with the ventilator outlet (machine) pressure, and
adjusts the machine pressure to compensate for the pressure drop across the
inspiratory filter, patient circuit, and humidifier. This helps ensure accurate
and responsive pressure delivery and leak compensation.

The ventilator delivers gas to the patient through a main flow (inspiratory)
bacteria filter, a single-limb patient breathing circuit, a humidification device
(optional) and a patient interface such as a mask or ET tube. A pressure tap
proximal to the patient is used to monitor patient pressure. The exhalation port
continually exhausts gas from the circuit during inspiration and exhalation to
minimize rebreathing and ensure CO

removal.

2

Breath delivery characteristics

Control variable

Breaths delivered by the Respironics V60/V60 Plus Ventilator are pressure
controlled. In the AVAPS mode, the ventilator’s applied pressure is
automatically adjusted over a period of time to maintain a target tidal volume.

Triggering, cycling, and leak adaptation

Unlike other ventilators, the Respironics V60/V60 Plus Ventilator does not
require you to set triggering and cycling sensitivity or to adjust baseline
flow.The ventilator’s unique Auto-Trak Sensitivity algorithm adjusts these
automatically; see “Auto-Trak Sensitivity” on page 4-3.

Baseline pressure

4-2

A positive baseline pressure (EPAP or CPAP) may be set for all breaths in all modes.

Principles of operation

Pressure rise time

The operator-set Rise Time defines the time required for inspiratory pressure to
rise to the set (target) pressure.

Negative pressures

There are no negative pressures generated during exhalation.

Oxygen concentration

The Respironics V60/V60 Plus Ventilator incorporates an oxygen mixer. Oxygen
concentration can be set in all modes.

Auto-Trak Sensitivity An important characteristic of the Respironics V60/V60 Plus Ventilator is its

ability to recognize and compensate for intentional and unintentional leaks in
the system, and to automatically adjust its triggering and cycling algorithms to
maintain optimum performance in the presence of leaks. This is called Auto­Trak Sensitivity. The following subsections describe this function in detail.

Triggering

Breaths are patient (flow) triggered in all modes, typically when patient effort
causes a certain volume of gas to accumulate above
method). An inspiration is also triggered when the patient inspiratory
distorts the expiratory flow waveform sufficiently (shape signal method; see
page 4-4).

baseline flow (volume

effort

Cycling

Cycling to exhalation occurs in these cases:

• Patient expiratory
sufficiently (shape signal method). See “Shape signal method of
cycling and triggering.” on page 4-4.

• Patient flow reaches the spontaneous exhalation threshold (SET). See
“SET method of cycling.” on page 4-4.

• After 3 seconds at the IPAP level (timed backup safety mechanism)

• When a flow reversal occurs, typically due to a mask or mouth leak

effort distorts the inspiratory flow waveform

4-3

Principles of operation

Estimated

patient flow

Shape

signal

Cycle to exhalation
crossover point

Trigger to
inspiration
crossover point

Spontaneous
exhalation threshold

Shape signal method of cycling and triggering. The shape signal or “shadow
trigger” method uses a mathematical model derived from the flow signal. A
new flow signal (shape signal) is generated by offsetting the signal from the
actual flow and delaying it (Figure 4-2). This intentional delay causes the flow
shape signal to be slightly behind the patient’s flow signal. If there is a sudden
change in patient flow, the patient’s flow signal crosses the shape signal; this
results in a trigger or a cycle. As a result, a sudden decrease in expiratory flow
from an inspiratory effort will cross the shape signal and create a signal for
ventilator triggering.

Figure 4-2: Shape signal

SET method of cycling. Patient flow reaches the spontaneous exhalation
threshold (SET); see Figure 4-3. The SET represents the intersection of the
flow waveform and a line of a given slope. SET is updated each breath.

Figure 4-3: Spontaneous exhalation threshold (SET)

4-4

Principles of operation

Flow

TIME

Original
baseline

Inspiration

Spontaneous
trigger

Cycle to
exhalation

End exhalation

Adjustment
of baseline

New

baseline

Patient

flow

Additional
leak

Leak adaptation

Noninvasive ventilation in particular may involve considerable leakage around
the mask or through the mouth. Some leakage is known or intentional: it is a
characteristic of the mask/patient interface design. So that it can accurately
adjust its baseline flow, the ventilator has you enter the intentional leakage
value specific to the mask/patient interface (“Selecting the mask and
exhalation port” on page 6-12). Other leakage is unpredictable or
unintentional, and it changes as the patient’s breathing pattern changes.

To maintain prescribed pressures in the presence of leakage, the ventilator
adjusts its baseline flow. Because the unintentional part of the leakage may
constantly change, the ventilator recalculates the baseline flow each breath at
the end of exhalation. The ventilator uses two main mechanisms to update its
baseline flow: expiratory flow adjustment and tidal volume adjustment.

Expiratory flow adjustment. Every breath, at end-exhalation, the ventilator
updates its flow baseline. At end-exhalation patient flow is assumed to be zero,
so any difference between actual patient flow and the original baseline flow
indicates a change in leakage. Figure 4-4 shows how the ventilator adjusts the
baseline.

Figure 4-4: Expiratory flow adjustment

4-5

Principles of operation

Additional leak
introduced

New baseline

Volume adjustment

Flow

Volume

Tidal volume adjustment. Every breath, the ventilator compares the inspiratory
and expiratory tidal volumes. Any difference is assumed to be due to an
unintentional circuit leak. The ventilator adjusts the baseline to reduce this
tidal volume difference for the next breath. Figure 4-5 shows how the
ventilator adjusts the baseline.

Figure 4-5: Tidal volume adjustment

Auto-Trak+ (optional) The Auto-Trak+ option for the Respironics V60/V60 Plus Ventilator lets you

further adjust the level of Auto-Trak Sensitivity, a feature that recognizes and
compensates for intentional and unintentional leaks. This algorithm has
multiple breath trigger and cycle thresholds. When you adjust Auto-Trak+
settings, you adjust these multiple trigger and/or cycle thresholds
simultaneously, retaining all the auto-adaptive features of Auto-Trak
Sensitivity.

The Normal Auto-Trak settings work well for most patients. Pediatric patients,
however, may benefit from more sensitive trigger settings, while some adult
patients may benefit from more or less sensitive cycle settings.

High flow therapy High flow therapy (HFT) enables delivery of a humidified gas mixture at an

operator-set flow rate via a nasal cannula interface or tracheal adapter. The
principle mechanism of action for high flow therapy is delivering a known FiO
at a flow rate equal to or greater than the patient's peak flow, thus minimizing
dilution of the gas.

HFT provides blended gas to the patient at a targeted flow. Both O

2

concentration and flow are set by the clinician. Heated humidification is
recommended during high flow therapy.

2

4-6

Principles of operation

High flow therapy (HFT) controls flow instead of pressure and is accessed only
while in Standby mode. Patient alarms are not available during high flow
therapy. This therapy is not considered a breath delivery mode.

Available for 3.00 software and above, as well as the V60 Plus.

Ventilation modes The Respironics V60/V60 Plus Ventilator operates in the following ventilation

modes:

• CPAP (continuous positive airway pressure) mode

• S/T (spontaneous/timed) mode

• PCV (pressure-controlled ventilation) mode

• AVAPS (average volume-assured pressure support) mode

• PPV (proportional pressure ventilation) mode (optional)

Table 4-1 summarizes the characteristics of these modes. Note that on the
ventilator, the Timed breath indicator means the breath is ventilator triggered,
while the Spont breath indicator means the breath is patient triggered.

Table 4-1: Characteristics of Respironics V60/V60 Plus ventilation modes

Timed breaths Spont breaths

Mode

CPAP N/A N/A N/A Auto-Trak Pressure Auto-Trak

PCV Time Pressure Time Auto-Trak Pressure Time

S/T Time Pressure Time Auto-Trak Pressure Auto-Trak

AVAPS Time Pressure Time Auto-Trak Pressure Auto-Trak

PPV Time Pressure Time Auto-Trak Pressure Auto-Trak

* A trigger variable starts inspiration.
† A limit variable can reach and maintain a preset level before inspiration ends but it does not

end inspiration.

‡ A cycle variable is a measured parameter used to end inspiration.

Trigger

*

Limit

†

Cycle

‡

Trigger Limit Cycle

4-7

Principles of operation

Volume Flow

Pressure

CPAP

I E

Time

CPAP mode

In the CPAP (continuous positive airway pressure) mode, the ventilator
functions as a demand flow system, with the patient triggering all breaths and
determining their timing, pressure, and size. You set no triggering or cycling
sensitivities: the patient triggers and cycles based on the ventilator’s Auto-Trak
Sensitivity algorithms. The control settings active in the CPAP mode are shown
in Figure 4-6. Figure 4-7 shows CPAP mode waveforms.

The C-Flex feature setting enhances traditional CPAP by reducing the pressure
at the beginning of exhalation – a time when patients may be uncomfortable
with CPAP – and returning it to the set CPAP level before the end of exhalation.

Figure 4-6: CPAP controls

Figure 4-7: CPAP waveforms

4-8

Principles of operation

Pressure

EPAP

IPAP

I-Time

1/Rate

Machine-triggered
(Timed) breath

Rise

Time

Patient-triggered
(Spont) breath

PCV mode

The PCV (pressure-controlled ventilation) mode delivers pressure-controlled
breaths, either triggered by the ventilator (Timed) or the patient (Spont). The
control settings active in the PCV mode are shown in Figure 4-8. The IPAP
setting defines the applied inspiratory pressure for all breaths. If the patient
fails to trigger a breath through Auto-Trak within the interval determined by the
rate setting, the ventilator triggers a mandatory breath. The I-Time setting is
the cycle criterion for all breaths. Figure 4-9 shows a PCV mode pressure
waveform.

Figure 4-8: PCV controls

Figure 4-9: PCV pressure waveform

4-9

Principles of operation

Pressure

EPAP

IPAP

I-Time

1/Rate

Patient-triggered (Spont)

spontaneous breath with

pressure support

Mandatory
(Timed) breath

Time

Rise

S/T mode

The S/T (spontaneous/timed) mode guarantees breath delivery at the user-set
rate. It delivers pressure-controlled, time-cycled mandatory and pressure­supported spontaneous breaths, all at the IPAP pressure level. If the patient
fails to trigger a breath within the interval determined by the Rate setting, the
ventilator triggers a mandatory breath with the set I-Time. You set no patient
triggering or cycling sensitivities: the patient triggers and cycles based on the
ventilator’s Auto-Trak Sensitivity algorithms. The control settings active in the
S/T mode are shown in Figure 4-10. Figure 4-11 shows an S/T mode pressure
waveform.

Figure 4-10: S/T controls

Figure 4-11: S/T pressure waveform

4-10

Principles of operation

AVAPS mode

NOTE: When you adjust AVAPS minimum and maximum pressures,

remember that IPAP is adjusted to meet the target value. If the
calculated target pressure is outside of the minimum and maximum
pressure range, the target volume will not be achieved.

Unlike most pressure modes, the AVAPS (average volume-assured pressure
support) mode delivers a target tidal volume. It achieves the target volume by
regulating the pressure applied following an initial pressure ramp-up. The
AVAPS mode delivers time-cycled mandatory breaths and pressure-supported
spontaneous breaths.

If the patient fails to trigger a breath within the interval determined by the
Rate control, the ventilator triggers a mandatory breath with the set I-Time.
Mandatory and spontaneous breaths are delivered at a pressure that is
continually adjusted over a period of time to achieve the volume target, V
Min P and Max P define the minimum and maximum pressures that can be
applied. You set no patient triggering or cycling sensitivities: the patient
triggers and cycles based on the ventilator’s Auto-Trak Sensitivity algorithms.

.

T

At start-up, AVAPS applies an inspiratory pressure equal to one of the
following, whichever is greater:

• EPAP + (target volume / 60 ml/cmH

• EPAP + 8 cmH

O

2

O)

2

•Pmin

The control settings active in the AVAPS mode are shown in Figure 4-12.
Figure 4-13 shows AVAPS mode waveforms.

Figure 4-12: AVAPS controls

4-11

Principles of operation

Volume Flow

Pressure

Max P

Min P

V

T

EPAP

1/Rate

I-Time

Mandatory (Timed)

breath

Patient-triggered (Spont)
spontaneous breath

Rise

Time

Figure 4-13: AVAPS waveforms

4-12

Principles of operation

PPV mode (optional)

The PPV (proportional pressure ventilation) mode provides patient-triggered
breaths that deliver pressure in proportion to patient effort. Additionally a user­settable backup rate activates machine-triggered, pressure-limited, and time­cycled breaths in the case of apnea. In the PPV mode, patient effort
determines the pressure, flow, and tidal volume delivered by the ventilator. The
ventilator responds to patient effort, allowing the patient to determine when to
start and end a breath.Additionally flow and pressure change based on the
patient’s efforts throughout inspiration.

The physics behind PPV. Two forces oppose ventilation, resistance and
elastance.

Resistance is the impedance to air movement in the airways:

Pressure/Flow = Resistance

Airway resistance in healthy adults ranges from approximately 0.5 to

2.5 cmH

Elastance is the elastic opposition to ventilation or the tendency of the lungs to
resist inflation (elastance is the reciprocal of compliance):

O/L/s.

2

Pressure/Volume = 1/Compliance = Elastance

The compliance of lungs and chest wall for a healthy adult is approximately

0.1 L/cmH

O, resulting in an elastance value of 10 cmH2O/L.

2

The inspiratory muscles, therefore, must generate force to overcome the
resistance and elastance of the respiratory system. The proximal airway
pressure is the net result of this contraction of these muscles: it is the force of
the inspiratory muscle contraction minus both the pressure needed to generate
air flow (overcome respiratory system resistance) and the pressure generated to
inflate the lungs (overcome respiratory system elastance).

PPV is based on the equation of motion:

Pressure = Volume x Elastance + Flow x Resistance

where Pressure is the sum of patient effort (P

) and the ventilator-

muscle

generated pressure.

How PPV works. The delivery of a PPV breath is controlled by the maximum
elastance (volume) assist (Max E), maximum resistance (flow) assist (Max R),
and PPV % settings. The actual delivered assistance to overcome elastance is
the product of PPV % and Max E. The actual delivered assistance to overcome
resistance is the product of PPV % and Max R. In general, Max E should be set
relative to the respiratory elastance and Max R should be set relative to the
respiratory resistance, although you do not need to know the actual value of
either to apply PPV. You adjust assist levels to optimize patient comfort. The
resultant pressure support delivered in the PPV mode is the resistance assist
times patient flow plus the elastance assist times the patient volume. The end

4-13

Principles of operation

result is that the level of pressure support is controlled by the inspiratory effort
of the patient. Because the patient completely controls ventilatory output,

1

PPV may significantly improve patient-ventilator synchrony and ultimately,
patient comfort.

The PPV backup rate ensures that the patient receives a minimum number of
breaths per minute if the spontaneous breathing rate falls below the Rate
setting. If the patient fails to trigger a breath within the interval determined by
the Rate control, the ventilator triggers a Timed (backup) breath with the set
I-Time, Rise, and IPAP settings.

The control settings active in the PPV mode are shown in Figure 4-14.

Figure 4-14: PPV controls

Figure 4-15 shows PPV mode waveforms. Note how volume and pressure
increase as does the ventilatory demand of the patient. Max V (PPV maximum
volume limit) and Max P (PPV maximum pressure limit) are used to prevent the
delivery of excessive pressure or volume. More information about these limits
is provided in “About Max V and Max P alarms and alarm limits” on page 6-7.

1 Marantz, S., Patrick, W., Webster, K., et al. “Response of ventilator-dependent

patients to different levels of proportional assist.” Journal of Applied Physiology, Vol.
80: 397-403, 1996.

4-14

Principles of operation

VolumeFlowPressure

Max V

Increase in patient demand

Time

Max P

EPAP

Figure 4-15: PPV waveforms

4-15

Principles of operation

40

45

50

55

60

65

70

75

80

85

90

95

100

130 140 150 160 170 180 190 200 210 220 230 240

Total Ventilator Flow L/min

O2% Concentration

Assumptions: At an O2 setting of 100% and an oxygen supply with a 50 psig inlet pressure capable
of delivering up to160 L/min.

Total ventilator flow (L/min)

Oxygen concentration (%)

Oxygen mixing The ventilator’s oxygen mixer regulates and proportions oxygen into the air

from the blower according to the O
±5% of the set value up to the maximum oxygen flow available. The ventilator
can deliver up to 240 L/min of air/oxygen mix to assist in managing
uncontrolled leaks during noninvasive ventilation.

Many hospital oxygen supply systems, however, cannot meet such high flow
demands. Under extraordinary conditions (high O
or high patient demand) where demand exceeds available oxygen system flow,
the ventilator provides additional air flow from the blower to ensure the target
pressure is met. Under such conditions, the accuracy of delivered oxygen may
be affected. Figure 4-16 shows the effect on the delivered oxygen
concentration as the maximum oxygen system flow is exceeded. This graph
assumes a continuous flow demand. Normally the higher “peak” flow is only
needed during inspiration, so this is a worst case scenario.

setting. The delivered oxygen accuracy is

2

setting plus high leak, and/

2

4-16

Figure 4-16: O

2

concentration as a function of total ventilator flow

Chapter 5. Setting up the ventilator for use

Set up the ventilator for each patient use as described in this chapter. For first­time installation, refer to Appendix A. For use with high flow therapy (HFT), set
up the ventilator as described in this chapter, then refer to Chapter 7, High
flow therapy.

Connecting oxygen WARNING: Connect the ventilator only to an appropriate medical-grade oxygen

source.

WARNING: To ensure accuracy of oxygen administration and to monitor for the

presence of contamination (incorrect gas connected), use an external
oxygen monitor to verify the oxygen concentration in the delivered gas.

WARNING: To reduce the risk of fire, do not use a high-pressure oxygen hose that is

worn or contaminated with combustible materials like grease or oil.

WARNING: To reduce the risk of hypoxia, connect only oxygen to the high-pressure

connector at the rear of the ventilator.

WARNING: To reduce patient risk of oxygen toxicity, keep free-flowing oxygen away

from air inlet of ventilator.

CAUTION: To prevent possible damage to the ventilator, ensure that the

connection to the oxygen supply is clean and unlubricated, and that
there is no water in the oxygen supply gas.

Installing an oxygen analyzer/monitor

Connect the oxygen hose to an appropriate high-pressure oxygen source.

Use of SIS connectors and supplemental oxygen accessories such as the O
manifold requires higher oxygen supply pressures. Consult Table 11-9 on
page 11-6 for appropriate oxygen pressure ranges.

Install an Analytical 2000M oxygen analyzer/monitor, or the equivalent, and
follow the manufacturer’s instructions for setup and calibration.

5-1

2

Setting up the ventilator for use

Connecting to AC power

WARNING: To reduce the risk of electric shock, connect the ventilator to an AC

supply mains with protective earth only.

WARNING: Do not use extension cords, adapters, or power cords with the ventilator

that are not approved by Respironics.

WARNING: To prevent unintentional disconnection of the power cord, always use the

correct, Philips-supplied power cord and lock it into place with the power
cord retainer before you switch the ventilator on. The retainer is designed
to hold the connector end of the Philips-supplied cord securely in place.

WARNING: To reduce the risk of electric shock, regularly inspect the AC power cord

and verify that it is not frayed or cracked.

WARNING: To reduce the risk of strangulation, route the power cord to avoid

entanglement.

CAUTION: For 120 V equipment, grounding reliability can only be achieved

when it is connected to an equivalent receptacle marked “hospital
only” or “hospital grade.”

Plug the power cord into a grounded outlet that supplies AC power between
100 and 240 V, 50/60 Hz.

Always check the reliability of the AC outlet. If you are using a 120 V outlet,
make sure that it is hospital grade.

5-2

Setting up the ventilator for use

Installing the patient circuit

WARNING: To reduce the risk of strangulation from patient tubing, use a tubing

support arm and secure the proximal pressure line with clips.

WARNING: To prevent possible patient injury and possible water damage to the

ventilator, make sure the humidifier is set appropriately.

WARNING: To prevent possible patient injury and equipment damage, do not turn the

humidifier on until the gas flow has started and is regulated. Starting the
heater or leaving it on without gas flow for prolonged periods may result
in heat build-up, causing a bolus of hot air to be delivered to the patient.
Circuit tubing may melt under these conditions. Turn the heater power
switch off before stopping gas flow.

WARNING: To reduce the risk that the patient will aspirate condensed water from the

breathing circuit, position any humidifier lower than both the ventilator
and the patient.

WARNING: To reduce the risk of fire, use only patient circuits intended for use in

oxygen-enriched environments. Do not use antistatic or electrically
conductive tubing.

WARNING: To prevent patient or ventilator contamination, always use a main flow

bacteria filter on the patient gas outlet port. Filters not approved by
Respironics may degrade system performance.

WARNING: During ventilation, patient exhalate is released into room air. Use of a

patient circuit with a filter on its exhalation port is recommended.

WARNING: To reduce the risk of bacterial contamination or damage, handle bacteria

filters with care.

WARNING: Any additional accessories in the patient circuit may substantially

increase flow resistance and impair ventilation.

WARNING: Avoid adding resistive circuit components on the patient side of the

proximal pressure line. Such components may defeat the disconnect
alarm.

NOTE: Bacteria filter must be installed onto gas outlet.
NOTE: Under extreme conditions and a missing, ruptured, or defective

bacteria filter, the entire gas pathway can become contaminated with
bodily fluids or exhaled gas.

Install the patient circuit as shown in this section. For a list of compatible
parts and accessories offered by Philips, see “Parts and accessories” on
page C-1.

Assemble the patient circuit, including the main flow (inspiratory) bacteria
filter, proximal pressure line, oxygen sensor tee, and if desired, humidifier and
nebulizer. Figure 5-2 and Figure 5-3 show circuit configurations for
noninvasive and invasive ventilation. Follow the manufacturers’ instructions for
use for the individual parts.

NOTE: If you are using a jet nebulizer, use the lowest possible flow rate

recommended by the manufacturer. The flow rate must not exceed
10 L/min.

5-3

Setting up the ventilator for use

Proximal pressure line

Ventilator
outlet

Bacteria filter

Proximal
pressure
port

Humidifier

Oxygen sensor tee

NOTE: This circuit setup is recommended for noninvasive ventilation. It is

also recommended for high flow therapy when using the AC611 FEP
Connect to block the exhalation port.

Figure 5-1: Noninvasive patient circuit, with heated-wire and humidification

5-4

Setting up the ventilator for use

Proximal pressure line

Ventilator
outlet

Bacteria filter

Proximal
pressure
port

Oxygen sensor tee

NOTE: This circuit setup is recommended for noninvasive ventilation.

Figure 5-2: Noninvasive patient circuit, without humidification

5-5

Setting up the ventilator for use

Ventilator
outlet

Proximal pressure line

Water trap

Humidifier

Proximal filter

Bacteria filter

Proximal
pressure
port

Oxygen sensor tee

NOTE: This circuit setup is recommended for both noninvasive and invasive

ventilation.

Connecting external devices

Figure 5-3: Invasive patient circuit, with humidification

Connect the ventilator to a remote alarm (nurse call) device and a patient
monitor or other external device, if applicable.

The Respironics V60/V60 Plus Ventilator can communicate with a Philips
patient monitor using the IntelliBridge Open Interface. See “Using Philips
monitors and the IntelliBridge Open Interface” on page B-15. The ventilator
also supports the VueLink Open Interface. VueLink has been replaced by
IntelliBridge, but information is included in this manual for backwards
compatibility. See “Using Philips monitors and the VueLink Open Interface*”
on page B-15.

For more information about connecting with non-Philips systems, contact your
Philips representative.

5-6

Setting up the ventilator for use

Before placing a patient on the ventilator

WARNING: Always verify ventilator operation before placing the patient on a

ventilator. If the ventilator fails any verification steps, remove it from
clinical use immediately. Do not use the ventilator until necessary repairs
are completed and the ventilator passes verification.

WARNING: To reduce the risk of power failure to the ventilator, pay close attention to

the battery’s charge level. The battery’s operation time is approximate and
is affected by ventilator settings, discharge and recharge cycles, battery
age, and ambient temperature. Battery charge is reduced at low ambient
temperatures or in situations where the alarm is continuously sounding.

NOTE: If the ventilator has a backup battery, the battery must be adequately

charged to verify operation. Recharge as necessary before verifying
operation.

NOTE: The backup batteries are intended for short-term use only. They are

not intended to be a primary power source.

NOTE: We recommend that the ventilator’s batteries be fully charged before

you ventilate a patient. If the batteries are not fully charged and AC
power fails, always pay close attention to the level of battery charge.

Verify ventilator operation

1. Power on the ventilator. The ventilator automatically runs a test of the

backup audible alarm followed by the primary audible alarm. Verify that
you hear a high-pitched tone, followed by a beep.

2. Create a patient alarm, such as a disconnect alarm.

a. VERIFY that the proper alarm is annunciated (audio, visual,

flashing, and alarm LED).

b. VERIFY that the volume setting is adequate for the environment in

which it will be used.

c. VERIFY remote alarm setup, if applicable.

3. Resolve the alarm condition and manually reset the alarm.

4. If the backup battery is installed, disconnect the ventilator from AC
power while the ventilator is running. If the backup battery is not
installed, go to step 5.

a. VERIFY that the ventilator switches over to battery power (battery

symbol in right-hand corner of screen is displayed).

b. VERIFY that the audible alarm sounds intermittently.

5. Reconnect the ventilator to AC power.

5-7

Setting up the ventilator for use

V

•

Running alarm tests The ventilator performs a self-check during start-up and continuously during

operation. Alarm functionality is verified by this self-check. You may also want
to run alarm tests, which demonstrate the alarms’ operation.

WARNING: To prevent possible patient injury, always return alarm settings to

hospital-standard values after verifying ventilator operation.

Preparation

1. Set the ventilator up as for normal ventilation, complete with
breathing circuit (PN 582073 or the equivalent) and a 1-liter test lung
assembly (PN 1021671).

2. Set the mode to S/T and make the following control settings: Rate:
4 BPM, IPAP: 10 cmH
Ramp: Off, O

: 21%.

2

3. Make the following alarm settings: Hi Rate: 90 BPM, Lo Rate: 1 BPM,
Hi V

: 2000 mL, Lo VT: OFF, HIP: 50 cmH2O, LIP: OFF, Lo E: OFF,

T

LIP T: 5 secs.

O, EPAP: 6 cmH2O, I-Time: 1 sec, Rise: 1,

2

High Inspiratory Pressure

1. Lower the HIP alarm limit to 8 cmH2O.

2. VERIFY that the High Inspiratory Pressure alarm is activated, the
ventilator cycles into exhalation, and pressure falls to 6 cmH
EPAP level).

3. Raise the HIP alarm limit to 15 cmH

O.

2

Low Tidal Volume

1. Raise the Lo VT alarm setting above the displayed, measured VT.

2. VERIFY that the Low Tidal Volume alarm is activated.

3. Turn the Lo V

4. VERIFY that the alarm resets.

alarm setting OFF.

T

O (the

2

5-8

Setting up the ventilator for use

Patient Disconnect

1. Disconnect the test lung.

2. VERIFY that the Patient Disconnect alarm is activated.

3. Reconnect the test lung.

4. VERIFY that the alarm resets and that the ventilator automatically

resumes ventilation.

Patient Circuit Occluded

1. Disconnect the patient circuit (including bacteria filter) from the

ventilator outlet, and block the ventilator outlet.

2. VERIFY that the Patient Circuit Occluded alarm is activated.

3. Unblock the outlet, and reconnect the circuit.

4. VERIFY that the alarm resets.

5-9

Setting up the ventilator for use

Using the ventilator for intra-hospital transport

WARNING: Always check the status of the oxygen cylinders before using the

ventilator during transport.

WARNING: To reduce the risk of power failure to the ventilator, pay close attention to

the battery’s charge level. The battery’s operation time is approximate and
is affected by ventilator settings, discharge and recharge cycles, battery
age, and ambient temperature. Battery charge is reduced at low ambient
temperatures or in situations where the alarm is continuously sounding.

WARNING: The V60/V60 Plus Ventilator requires a pressurized oxygen supply that

provides a minimum flow of 175 SLPM. Do not use any devices such as
valves, hoses, Grab n' Go regulators or other brands of combined cylinder/
regulators that limit supply of oxygen flow below 175 SLPM.

WARNING: Do not leave the ventilator unattended when stationed on an incline.

Do the following to conserve oxygen during transport with the ventilator.

• Make sure all cylinders are full (13,790 kPa/2000 psig or more).

• Make sure the cylinder regulators are turned off while the ventilator is
connected to wall oxygen.

• Never turn the cylinder regulator on until you are ready to begin
transport.

• Only turn one cylinder regulator on at a time. If you turn on both
cylinders, they may become depleted simultaneously, leaving you with
no backup oxygen.

• Whenever possible, reduce the O

• Minimize all inadvertent leaks. Tighten masks prior to transport, and
loosen up when patient is back on wall oxygen.

setting before transport.

2

• Avoid using masks that have an exhalation port built into the mask
when there is already an exhalation port in the circuit.

• Be aware that oxygen is more rapidly depleted at higher leak rates (see
Figure 5-4).

5-10

Setting up the ventilator for use

Leak of 50 L/min

a. VT = 500 mL, Rate = 40 BPM, EPAP = 6 cmH2O, IPAP = 18 cmH2O

Leak of 10 L/min
Leak of 20 L/min
Leak of 30 L/min
Leak of 40 L/min

FIO

2

(%)

0

10

20

30

40

50

60

70

80

90

Duration (min)

30 35 40 45 50 55 60 65 70 75 80 85 90 95 100

b. VT = 500 mL, Rate = 20 BPM, EPAP = 6 cmH2O, IPAP = 18 cmH2O

20

40

60

80

100

120

140

0

Duration (min)

Leak of 10 L/min

Leak of 20 L/min

Leak of 30 L/min
Leak of 40 L/min
Leak of 50 L/min

30 35 40 45 50 55 60 65 70 75 80 85 90 95 100

FIO2 (%)

Storing the ventilator between patient use

Figure 5-4: Duration of cylinder oxygen (13,790 kPa/2000 psig) at various

leak rates

See “Storage between patient use” on page 10-7 for information about storing
the ventilator.

5-11

Setting up the ventilator for use

(This page is intentionally blank.)

5-12

Chapter 6. Operation

page 6-3 page 6-12 page 6-2 page 6-17 page 6-19 page 6-21

WARNING: To ensure the ventilator’s safe operation, always verify ventilator

operation as described in “Verify ventilator operation” on page 5-7 before
using the ventilator on a patient. If the ventilator fails any tests, remove it
from clinical use immediately. Do not use the ventilator until necessary
repairs are completed and all tests have passed.

NOTE: Before operation, prepare the ventilator as instructed in Chapter 5.

After power-on, the ventilator starts up in the mode and with the settings that
were active before last power down. Check these settings and adjust as
required. You must be familiar with using the touchscreen and navigation ring
to select, adjust, activate, and confirm parameters. For details, see “Before
placing a patient on the ventilator” on page 5-7.

Access the ventilator setting windows from the tabs at the bottom of the
screen.

6-1

Operation

Active
mode

Changing the mode The active ventilation mode is displayed in the bottom, left-hand corner of the

screen. Change the mode as follows. For details on modes, see “Ventilation
modes” on page 4-7.

1. Open the Modes window.

2. Select the desired mode.

3. Adjust settings as desired (see “Changing individual ventilator
settings” on page 6-4). Newly adjusted setting values are shown in
yellow.

4. Select Activate Mode to apply.

6-2

Operation

Active
mode

Changing control settings

Table 6-3 on page 6-22 is an alphabetical list of the control settings with their
ranges. Table 11-2 on page 11-2 shows the control settings applicable to the
different modes. For more information on control settings as they apply in the
different ventilation modes, see “Ventilation modes” on page 4-7.

Making batch setting changes

NOTE: During a batch setting change, you cannot change the Ramp Time

setting when a ramp is active.

This process applies to ventilation settings only, not to alarm settings.

1. Open the Modes window.

2. Select the active mode.

3. Adjust settings as desired (see “Changing individual ventilator

settings” on page 6-4). Newly adjusted setting values are shown in
yellow.

4. Select Activate Batch Change to apply.

6-3

Operation

Adjustment
arrow button

Current

settings area

Setting range scale

Additional

information

Proposed value

Changing individual ventilator settings

You can make ventilator settings from the Settings window.

1. Open the Settings window.

2. Select the desired setting. As an example we will show the IPAP
adjustment.

3. The setting window opens. Adjust the setting. Select Accept to apply.

6-4

Operation

Ramp
status
Bar

Using the Ramp Time function

The Ramp Time function helps your patient adapt to ventilation by gradually
increasing inspiratory and expiratory pressure (IPAP and EPAP/CPAP) from
subtherapeutic to user-set pressures over a user-set interval. Table 6-3 on
page 6-22 describes this function’s principles of operation.

Follow these instructions to use the Ramp Time function:

1. Select the Ramp Time button in the Settings window.

The ramp starts. As the ramp progresses, the Ramp Time button
graphic fills in.

2. To change the ramp interval or to end the ramp, select the Ramp Time

button again. The Ramp in Progress window opens.

Using the 100% O2 function

3. To end the ramp and apply the full IPAP and EPAP/CPAP immediately,

select End Ramp.

4. To end the ramp and start a new one, select Start New Ramp. The Ramp

Time setting window opens again so that you can set up a new ramp.

NOTE: The 100% O2 feature is available in Revision 2.30 software and

above.

The 100% O2 function delivers 100% oxygen to the patient. It is available
during Screen Lock status.

Follow these instructions to use the 100% O

1. Select the 100% O2 button in the main GUI window.

6-5

function:

2

Operation

2. The ventilator delivers 100% oxygen for two minutes. A countdown
timer displays.

While 100% oxygen delivery is active, you can press the +2:00 button
to add two minutes more. Press Cancel to stop.

6-6

Operation

Using PPV

Follow these instructions to set up the ventilator in the PPV mode, referring to
Figure 6-3. For principles of operation, see “PPV mode (optional)” on page 4-13.

1. Open the PPV Settings window.

2. Set EPAP, O

, alarm limits, and backup settings to appropriate values.

2

The HIP alarm limit should be greater than Max P. See “Principles of
operation” on page 4-1 for a detailed explanation of these settings.

3. Set the Max V and Max P limits.

4. Set alarm limits to appropriate values. The HIP alarm limit should be

greater than the Max P.

About Max V and Max P alarms and alarm limits

Max V (PPV maximum volume limit) and Max P (PPV maximum pressure limit)

are used to prevent the delivery of excessive pressure or volume.

WARNING: PPV limits are not intended to be the primary ventilator alarms and should

not be substituted for the alarms found in the Alarm Settings window.

WARNING: To prevent the delivery of excessive pressure or volume, set the PPV

limits appropriately. Delivery of excessive pressure or volume can occur
from a sudden increase in mask leak, inappropriate settings, or a plugged
or kinked proximal pressure line. Conversely, insufficient treatment may
result if limits are set too low.

When the Max V (PPV maximum volume limit) is reached, the breath is
terminated and a message is displayed. After the limit is reached in three
consecutive breaths, the audible alarm sounds. A PPV waveform with Max V is
shown in Figure 6-1.

6-7

Operation

VolumeFlow

Max V

VT ≥ Max V

Inspiration terminated

Sudden increase

in flow

Time

Pressure

EPAP

Max P

Sudden increase

in target pressure

Pressure limited Exhalation cycled by patient

Figure 6-1: PPV waveform – Max V limit

When the Max P (PPV maximum pressure limit) is reached, pressure is limited
but the breath is not terminated, and a message is displayed. After the limit is
reached in three consecutive breaths, the audible alarm sounds. A PPV
waveform with Max P is shown in Figure 6-2.

Figure 6-2: PPV waveform – Max P limit

Frequent annunciation of one or both alarms typically indicates improved
patient status. It may, however, indicate that the patient is more actively
breathing, possibly due to agitation or a change in the patient’s level of
sedation. It may also indicate an increase in leakage.

The V

(estimated exhaled tidal volume) measurement may remain below the

T

set Max V limit even though the inspired volume exceeds Max V. This results
from variable leakage, which reduces the exhaled volume in relation to the
inspired volume.

6-8

Operation

Guidelines for using PPV

NOTE: The guidelines below are based on recommendations by

clinicians. They do not replace the clinical judgment of a
physician and should not, on their own, be used for clinical
decision making.

Determining Max R and Max E settings

It is recommended you set Max R (flow assist) and Max E (volume assist) to
initial values and then titrate them based on the patient’s disease process:

• Obstructive disease (COPD, asthma): Focus on Max R. Overcoming

increased resistance is typically the emphasis, not volume delivery.

• Restrictive disease (neuromuscular, chest-wall deformities, obesity
hypoventilation): Focus on Max E. Maintaining sufficient volume is
typically the emphasis, not overcoming increased resistance.

• Mixed disease processes affecting both resistance and elastance:
Titrate both Max R and Max E settings.

6-9

Operation

Suggested titration procedure Follow this procedure to titrate settings to

optimize patient comfort while avoiding overassisting. See also the flow chart
in Figure 6-3.

NOTE: You may also need to adjust

you do for the other PPV settings described below. Mask leakage,
especially a sudden increase, is interpreted as patient effort by the
ventilator and assisted accordingly; this may necessitate lowering the

PPV %

setting. However, the best solution is to maintain a minimal leak.

PPV %

according to patient response, as

1. Set EPAP, O2, alarm limits, and backup settings to appropriate values.
The HIP alarm limit should be greater than Max P.

Suggested starting settings:
EPAP 4 cmH

O

2

Current setting or per prescription

Max P 25 cmH

*

O

2

O

2

Max V 1000 to 1500 mL
PPV % 80 to 100%
Max E 5 cmH
Max R 2 cmH
All other backup settings

Per usual protocol

O/L

2

O/L/s

2

and alarms

* Consider higher EPAP settings for COPD patients to treat autoPEEP as evidenced by

missed triggers

2. Adjust Max E:
a. Evaluate the patient. Check whether any of these conditions is

true:

• The patient says they are getting too much air, pressure, or
volume

• The patient is using accessory muscles to actively stop
inspiration

•The Max V or Max P limit is reached

• The mask leak has suddenly increased

b. If none is true, increase Max E in increments of 2 cmH

O/L while

2

continuing to evaluate the patient’s response.

c. If any is true, decrease Max E by 2 cmH

O/L, and re-evaluate.

2

Repeat to optimize patient comfort.

3. Repeat the process above adjusting Max R, increasing and decreasing

in increments of 1 cmH

O/L/s to optimize patient comfort.

2

4. Repeat adjustment for Max E as needed.

5. Adjust PPV % downward as tolerated.

6-10

Start

Make initial settings:

EPAP: 4 cmH

2

O

O

2

: Current setting or per prescription

Max P: 25 cmH

2

O

Max V: 1000 to 1500 mL
PPV %: 80 to 100%
Max E: 5 cmH

2

O/L

Max R: 2 cmH

2

O/L/s

HIP: > Max P
Other settings: Per usual protocol

Yes

No

Is the patient using

accessory muscles to ac-

tively stop inspiration

?

Was the Max V or Max P

limit reached

?

Has the mask leak suddenly

increased?

No

No

No

Increase Max E by

2 cmH

2

O/L

Yes

Yes

Yes

No

Does the patient say the air

is coming too fast

?

Is the patient using

accessory muscles to ac-

tively stop inspiration

?

Was the Max V or Max P

limit reached

?

Has the mask leak suddenly

increased?

No

No

Increase Max R by

1 cmH

2

O/L/s

Reduce Max R by 1 cmH2O/L/s for

patient comfort

Yes

Yes

Yes

Yes

No

End

Titrate PPV % downward as tolerated

Does the patient say they

are getting too much air,

pressure, or volume

?

Reduce Max E

by 2 cmH

2

O/L for patient comfort

Max E

titration

Repeat Max E titration as needed

Max R

titration

Operation

Figure 6-3: PPV initial setup

6-11

Operation

Changing alarm settings

WARNING: To prevent possible patient injury, avoid setting alarm limits to extreme

values, which can render the alarm system useless.

Some ventilator alarm settings are operator adjustable. You can adjust these at
any time. Table 6-4 on page 6-25 lists the alarm settings and their ranges.

Review and adjust the alarm settings as follows:

1. Open the Alarm Settings window.

2. Select the desired setting, adjust it, and select Accept to apply.

The ventilator annunciates an alarm when a monitored value goes out of the
range bounded by the alarm limits.

Selecting the mask and exhalation port

To be able to display full leakage data plus accurate tidal and minute volumes,
the ventilator must know the intentional leak characteristics of the specific
mask/patient interface and exhalation port.

After power-on, the Messages list displays the current mask and port settings
for 5 minutes.

Change these settings as follows:

1. Open the Menu window.

2. Select Mask/Port.

6-12

3. Select the desired mask/patient interface type (Table 6-1). Select

Accept to apply.

For information concerning mask/port leak characteristics, see the
instructions provided with each mask/port. See Appendix C for a list of
masks, circuits, and related components used with the ventilator.

Operation

6-13

Operation

Table 6-1: Mask/patient interface selections

Mask/patient interface type

ET/Trach ET or tracheostomy tube

Leak 1 Mask with minimal intentional leak characteristics. Enter

Leak 2 Mask with medium intentional leak characteristics. Enter

Leak 3 AP111

Leak 4 Reserved for future use

Other Mask not manufactured by Philips Respironics

*

Description

Leak 1 for any of these Philips Respironics masks:

• Contour Deluxe nasal mask

• PerformaTrak mask

• AF421, AF531, AF541, AF811 (EE)

Leak 2 for this mask:

• Philips Respironics PerforMax oro-nasal mask [EE]

• AF421, AF531, AF541 (EE)

NOTE: If you select Other, the ventilator displays

Tot.Leak rather than Pt. Leak.

* A leak symbol is printed on Respironics masks.

4. Select the desired exhalation port type (Table 6-2). Select Accept to

apply.

If you select an exhalation port that is not compatible with the
selected mask, Not allowed with current mask is displayed.

NOTE: In ventilation modes, ET/tracheostomy tubes and most Philips

Respironics masks require the use of an exhalation port. If you
selected ET/Trach or Leak 1 as a mask/patient interface, you may not
select None as an exhalation port.

6-14

Port type

Operation

Table 6-2: Exhalation port selections

Exhalation port test
recommended?

DEP

Philips Respironics Disposable Exhalation
Port

Whisper Swivel

Philips Respironics Whisper Swivel

PEV

Philips Respironics Plateau Exhalation Valve

Other

Exhalation port not supplied by Philips
Respironics.

None

No inline circuit exhalation port

NOTE: If you select None, refer to the manufacturer’s

instructions to make sure the mask selected contains an
exhalation port.

No

No

Yes

Yes

No

5. Run the exhalation port test if indicated in the table (see “Running
the exhalation port test” on page 6-16 for instructions).

CAUTION: If you selected PEV or Other as an exhalation port, you must run an

exhalation port test.

NOTE: If the exhalation port test is not run or if it fails, the intentional leak is

unknown. Tot.Leak rather than Pt. Leak is displayed in the patient data
window.

6-15

Operation

Progress

bar

Running the exhalation port test

The exhalation port test is required and its window is automatically displayed
when PEV or Other is selected.

Procedure

Run the test as follows:

1. Disconnect the patient circuit from the mask/patient interface.

2. Occlude the circuit outlet. Select Start Test.

3. Wait while the test runs.

4. Verify that Test Passed is displayed.

6-16

Operation

5. Reconnect the patient circuit to the mask/interface.

6. Select Start Ventilation to initiate ventilation.

Troubleshooting

If Test Failed is displayed, check for leaks in the patient circuit, and install an
exhalation device with lower leak characteristics. Repeat test. If the exhalation
port test fails again, the intentional leak is unknown and Tot.Leak rather than

Pt. Leak is displayed in the patient data window.

Other functions: the Menu window

From the Menu window you can adjust user preferences.

Brightness

Use Brightness to adjust the screen for optimum daytime or nighttime viewing.

Loudness

Use Loudness to adjust the volume of the alarm and touchscreen audible
feedback. You will hear audible feedback as you go through the selections.

The Alarm Volume Escalation status is also displayed on this screen. See “Alarm
Volume Escalation” on page E-11 for more information.

Mask/Port

See “Selecting the mask and exhalation port” on page 6-12.

6-17

Operation

Vent Info (ventilator information)

The Ventilator Information window displays software version and other
information specific to your ventilator.

Screen Lock

Screen Lock deactivates all buttons and tabs on the touchscreen except Alarm
Silence, Alarm Reset, the Alarm/Message button, and Help. Tabs are grayed out

as in this example.

This message bar is displayed at the top of the screen:

To unlock the screen, press the Accept button in the center of the navigation
ring.

NOTE: If Screen Lock is active, the touchscreen remains locked even if an

alarm becomes active.

Auto-Trak+

The Normal Auto-Trak settings work well for most patients. Pediatric patients,
however, may benefit from more sensitive trigger settings, while some adult
patients may benefit from more or less sensitive cycle settings.

Changing Auto-Trak+ settings

1. Select Auto-Trak+ from the Menu window.

6-18

Operation

Proposed value

Auto-Trak+
active

2. Select the desired adjustment. As an example, the E-Cycle adjustment
is shown below.

3. The setting window opens. Adjust the setting, referring to the
pressure-time graphic which represents the effect on I-Time. Select
Accept to apply.

When Auto-Trak+ is active (when either Trigger or E-Cycle is set to a value other
than Normal), the ventilator setting window displays Auto-Trak+.

Additionally, after power-on the Messages list displays the Auto-Trak+ settings
for 5 minutes.

Standby Standby lets you safely suspend ventilation to temporarily disconnect the

patient from the ventilator or to set up the ventilator before connecting the
patient. Alarms are disabled during standby.

You can also change ventilator settings and most menu functions during
standby. The settings changes are effective when you exit standby. Enter
standby as follows:

6-19

Operation

1. Select Standby. The Entering Standby window opens.

NOTE: Remove the mask/patient interface in order to enter standby. The

ventilator will not enter standby with a patient connected. If the
patient is not disconnected, the ventilator continues breath delivery
while waiting for the patient to be disconnected. The standby mode
request cancels in 60 seconds if the patient remains connected.

NOTE: Standby mode disables alarms and should be used when the patient

is disconnected.

2. Disconnect the patient from the ventilator now. The ventilator enters

standby and displays the Standby screen.

6-20

3. To resume ventilation, reconnect the patient. When the ventilator

Help

message

senses a patient breathing effort, ventilation automatically resumes in
the previous mode.

NOTE: You can also manually resume ventilation with the Restart Mode

button.

Help function Select the help button to display additional information.

Help messages are displayed:

Operation

6-21

Operation

Pressure relief

Must be less than
or equal to IPAP

EPAP IPAP

Must be greater
than or equal to
EPAP

EPAP IPAP

Table of modes and control settings

Table 6-3: Modes and control settings with ranges

Setting Description Range

Modes

Modes Ventilation mode AVAPS, CPAP,

S/T, PCV
Optional: PPV

Control settings

C-Flex Enhances traditional CPAP by reducing the

pressure at the beginning of exhalation––a
time when patients may be uncomfortable
with CPAP––and returning it to the set CPAP
pressure before the end of exhalation. The
amount of pressure relief is determined by
the C-Flex setting and the expiratory flow.
The higher the setting number (1, 2 or 3)
and the greater the expiratory flow, the
greater the pressure relief (during the active
part of exhalation only).

Applies in CPAP mode only.

CPAP Continuous positive airway pressure. The baseline pressure applied during the expiratory

phase.
Applies in CPAP mode only.

E-Cycle
(optional)

EPAP Expiratory positive airway pressure. The

Expiratory Cycle Sensitivity. Auto-Trak+ employs several algorithms to determine the point
at which the ventilator cycles into exhalation. This setting adjusts all algorithms
simultaneously. At the lowest setting (-2), inspiration terminates later, resulting in the
longest inspiratory time. At the highest setting (+6), inspiration terminates earlier,
resulting in the shortest inspiratory time. Normal is the Auto-Trak setting used when Auto­Trak+ is not enabled.

Applies only when the optional Auto-Trak+ feature is installed.

application and maintenance of pressure
above atmospheric at the airway throughout
the expiratory phase of positive-pressure
mechanical ventilation.

OFF, 1 to 3

4 to 25 cmH

-2, -1, Normal,
+1 to +6

4 to 25 cmH

2

2

O

O

IPAP Inspiratory positive airway pressure. The

application and maintenance of pressure
above atmospheric at the airway throughout
the inspiration phase of positive-pressure
mechanical ventilation.

6-22

4 to 40 cmH

O

2

Table 6-3: Modes and control settings with ranges (continued)

Shows where I:E
ratio becomes
inverse

Resulting I:E
ratio

Setting Description Range

Operation

I-Time
(Inspiratory

Time to deliver the required gas. Inverse
ratio ventilation is not allowed.

Time)

Max E The maximum elastance (volume assist) value used by the PPV mode to overcome the

elastance of the patient's lungs. See also PPV % setting.
Applies in PPV mode only.

Max P (AVAPS

The maximum pressure to be applied.
Maximum IPAP
Pressure)

NOTE: When you adjust the AVAPS minimum and maximum pressures, remember that

IPAP is adjusted to meet the target value. If the calculated target pressure is
outside of the minimum and maximum pressure range, the target volume will
not be achieved.

Applies in AVAPS mode only.

Max P (PPV
Maximum
Pressure Limit)

The maximum pressure to be applied. When the limit is reached, the ventilator limits the

pressure and displays a PPV Max P alarm message. If the condition persists for three

consecutive PPV inspirations, an audible alarm also sounds.

Applies in PPV mode only.

0.30 to

3.00 secs

0 to
100 cmH

6 to 40 cmH

2

O/L

2

5 to 40 cmH2O

O

WARNING: PPV limits are not intended to be the primary ventilator alarms and should not be

WARNING: To prevent the delivery of excessive pressure or volume, set the PPV limits appropriately.

substituted for the alarms found in the Alarm Settings window.

Delivery of excessive pressure or volume can occur from a sudden increase in mask leak,
inappropriate settings, or a plugged or kinked proximal pressure line. Conversely,
insufficient treatment may result if limits are set too low.

Max R The maximum resistance (flow assist) value used by the PPV mode to overcome

pulmonary resistance. See also PPV % setting.

Applies in PPV mode only.

Max V (PPV
Maximum
Volume Limit)

The maximum volume to be delivered. When the limit is reached, the ventilator terminates

the breath and displays a PPV Max V alarm message. If the condition persists for three

consecutive PPV inspirations, an audible alarm also sounds.

Applies in PPV mode only.

WARNING: PPV limits are not intended to be the primary ventilator alarms and should not be

substituted for the alarms found in the Alarm Settings window.

WARNING: To prevent the delivery of excessive pressure or volume, set the PPV limits appropriately.

Delivery of excessive pressure or volume can occur from a sudden increase in mask leak,
inappropriate settings, or a plugged or kinked proximal pressure line. Conversely,
insufficient treatment may result if limits are set too low.

0 to 50 cmH
L/s

200 to
3500 mL

O/

2

6-23

Operation

Max E and Max R are multiplied by PPV %
to obtain the applied Elastance assist and
Resistance assist values. Here a Max R

setting of 4 cmH

2

O/L/s and a PPV %

setting of 30% yield a Resistance assist
value of 1.2 cmH

2

O/L/s.

PPV %

Initial CPAP/EPAP

CPAP/EPAP 4 cmH2O+

2

-------------------------------------------------------------=

Initial IPAP Initial EPAP

IPAP EPAP–()

2

-------------------------------------------

+=

Ramp duration

Ramp

start

pressures

Ramp
end
pressures

Shows where I:E ratio
becomes inverse

Resulting I:E
ratio

Proposed rise slope in
relation to EPAP and IPAP

Table 6-3: Modes and control settings with ranges (continued)

Setting Description Range

Min P (AVAPS

The minimum pressure to be applied.
Minimum IPAP
Pressure)

NOTE: When you adjust the AVAPS minimum and maximum pressures, remember that

IPAP is adjusted to meet the target value. If the calculated target pressure is
outside of the minimum and maximum pressure range, the target volume will
not be achieved.

Applies in AVAPS mode only.

O

2

Oxygen concentration to be delivered. 21 to 100%

PPV % Percentage of PPV assist or gain. This gain

is applied to the Max E and Max R settings,

yielding the applied Elastance and

Resistance assist values.

Applies in PPV mode only.

Ramp Time An interval during which time the ventilator

linearly increases pressure, helping to

reduce patient

anxiety.

5 to 30 cmH

0 to 100%

OFF, 5 to 45
min

O

2

Rate
(Respiratory
Rate)

Respiratory frequency or number of breaths

per minute.

Inverse ratio ventilation is not allowed.

Rise (Rise Time) Speed with which inspiratory pressure rises

to the set (target) pressure.

If the Rise Time is insufficient to reach the

target IPAP pressure, adjust the Rise Time

or I-Time setting.

6-24

4 to 60 BPM

1 to 5 (1 is
fastest)

Table 6-3: Modes and control settings with ranges (continued)

HIP
alarm

LIP
alarm

IPAP

EPAP

Setting Description Range

Operation

Trigger
(optional)

V

(AVAPS

T

Target Tidal
Volume)

Trigger Sensitivity. Auto-Trak+ employs several algorithms to determine the point at which
the inspiration begins. The larger the value, the more sensitive the trigger (that is, the
patient can trigger inspiration with less effort). Normal is the Auto-Trak setting used when
Auto-Trak+ is not enabled.

Applies only when the optional Auto-Trak+ feature is installed.

Target tidal volume to be delivered during inspiration. The ventilator meets this target by
adjusting the inspiratory pressure with each breath.

Applies in AVAPS mode only.

Table 6-4: Alarm settings

Setting Description Range

Hi Rate (High Rate Alarm) High total breath rate. 5 to 90 BPM

Lo Rate (Low Rate Alarm) Low total breath rate. 1 to 89 BPM

NOTE: In non-CPAP modes, the Low Rate Alarm is

essentially off if set below the Respiratory Rate
setting.

Hi V

(High Tidal Volume

T

Alarm)

High exhaled tidal volume. 200 to 3500 mL

Normal, +1 to
+7

200 to
2000 mL

Lo V

(Low Tidal Volume

T

Alarm)

HIP (High Inspiratory
Pressure Alarm)

LIP (Low Inspiratory
Pressure Alarm)

Low exhaled tidal volume. OFF to 1500 mL

High pressure at the patient

5 to 50 cmH

O

2

airway.

Low pressure at the patient

OFF to 40 cmH

O

2

airway.

NOTE: In the S/T and PCV modes, the LIP alarm should

be set 3-5 cmH

O below the IPAP level. When

2

set in this manner, the alarm works in
conjunction with the LIP T alarm to indicate if
there is a failure to trigger between the two
pressure levels. It will also alert the clinician to
pressure degradation due to excessive leaks. See
figure below.

6-25

Operation

V

•

Table 6-4: Alarm settings (continued)

Setting Description Range

LIP T (Low Inspiratory
Pressure Delay Time)

Lo

(Low Minute

E

Ventilation Alarm)

The interval from the
detection of low inspiratory
pressure until the alarm
becomes active.

Low expiratory minute
volume.

5 to 60 secs

OFF to 99.0 L/min

6-26

Chapter 7. High flow therapy

The high flow therapy (HFT) feature is available for 3.00 software and above,
as well as V60 Plus. HFT is accessed from the Standby mode. For more
information, see “Standby” on page 6-19.

For principles of operation, see “High flow therapy” on page 4-6.

WARNING: When transitioning from a high flow therapy interface to an NIV mask,

ensure that an exhalation port is placed in the circuit and is unobstructed
to reduce the risk of CO2 rebreathing.

WARNING: When transitioning from ventilation to high flow therapy, remove the NIV

mask and use only a Philips-approved high flow patient interface to
minimize pressure build-up and patient discomfort.

WARNING: When transitioning from high flow therapy to ventilation, remove the nasal

cannula as these are restrictive and may defeat alarms such as patient
disconnect. Using a nasal cannula in an NIV mode may lead to
hypercarbia due to the inability to provide pressure support.

WARNING: Patient alarms are not available during high flow therapy (HFT) as the

therapy uses an open system. A nasal cannula occupies only a portion of
the nares and patients can breathe through their mouth, which prevents
estimation of patient parameters such as tidal volume, respiratory rate,
pressure, and minute ventilation. Provide external monitoring, including
oximetry, to inform the clinician of a change in the patient's condition.

WARNING: During high flow therapy (HFT), verify that an occlusive patient interface

is not being used. Occlusive patient interfaces include a cannula fully
sealed within the nares, an NIV mask, or a direct connection to a
tracheostomy tube or endotracheal tube. Remove any occlusive interface
immediately as this may expose the patient to unintended high pressures.

NOTE: High flow therapy (HFT) is accessed only from the Standby window.

Standby mode cannot be entered if a nasal cannula is connected to
the circuit.

Circuit setup See “Installing the patient circuit” on page 5-3 for circuit configuration.

High flow nasal cannula setup

Use either the AC611 with FEP Connector (Figure 7-1) or the AC611 22 mm
(Figure 7-2), which connects directly to the patient circuit.

7-1

High flow therapy

FEP

FEP Connect

DEP/FEP

22 mm connector

Connecting to a circuit with an FEP (filter exhalation port) installed

Insert the AC611 FEP Connect into the FEP, making sure the perforations in
the port are completely blocked.

Figure 7-1: High flow nasal cannula using the FEP Connect

Connecting directly to a 22 mm circuit

Remove the DEP/FEP. Connect the high flow nasal cannula with 22 mm
connector directly to the circuit.

Figure 7-2: High flow nasal cannula, 22 mm connection

7-2

High flow therapy

Changing from an NIV mode to high flow therapy

Follow these instructions to use the V60/V60 Plus Ventilator for high flow
therapy (HFT).

1. Select Standby. The Entering Standby window opens.

2. Remove the patient mask or ET interface to enter Standby.

3. Install a Philips-approved nasal cannula (Figure 7-1 and Figure 7-2
above) or a high flow tracheostomy interface on the patient circuit.

4. Select HFT.

5. From the Active Mode window, you can adjust Flow and O

%.

2

6. Press Start HFT.

7. The High Flow Therapy Active message is displayed during HFT.

8. Apply the HFT interface to the patient.

7-3

High flow therapy

9. Note the low priority alarm stating that patient alarms are disabled
during HFT. Press alarm reset to confirm this message.

Viewing and pausing the HFT graph

Changing from high flow therapy to an NIV mode

A flow graph is displayed during high flow therapy. Press the Pause button to
view an event.

1. Verify that the nasal cannula is removed from the patient and
disconnected from patient circuit.

2. Select Standby to open the Standby window.

3. Press the Enter Standby button.

4. In the Select Therapy window, press Ventilation.

5. Replace the high flow patient interface with a Philips-approved NIV
mask.

7-4

High flow therapy

6. Review patient settings and alarms.

7. Install the appropriate interface on the patient.

8. Verify that the ventilator detects the patient's breath to activate

ventilation, or press the Start Mode button.

HFT alarms and messages

Table 7-1 is a list of alarms and other messages displayed by the ventilator,
along with descriptions, suggested corrective actions, and other information.
The ID (identifier) listed with the priority type is the priority number of the
alarm. This priority number determines the order of alarm message display.
Unless otherwise indicated, alarms listed as autoresettable are reset when the
alarm condition is removed.

Table 7-1: HFT Alarm and other messages: summary and troubleshooting

Message Description Corrective Action

Cannot Reach Target
Flow

Patient alarms are
disabled during HFT

Displays when HFT (high
flow therapy) is active.
Indicates that flow target is
not achieved.

Displays when HFT (high
flow therapy) is active.
Patient alarms are not
available in this therapy.

Check the patient. Check
that the nasal cannula size
is appropriate for the flow
setting. Check that an
occlusive interface is NOT in
use (a cannula fully sealed
within the nares, an NIV
mask or direct connection to
an ETT/trach). Check for an
occlusion, kink or liquid in
the patient circuit.

Manually reset to confirm
and clear the audible alarm.

Priority
type (ID)

Low
(66)

Low/
Infor­mation
(68)

Manually
resettable

No Yes Yes

Yes No Yes

Autore­settable

Silence­able

Patient Circuit
Occluded

Displays when HFT (high
flow therapy) is active. Gas
flow to the patient is
obstructed.

Check the patient. Check
that an occlusive interface is
NOT in use (a cannula fully
sealed within the nares, an
NIV mask or direct connect
to an ETT/trach). Check for
an occlusion, kink or liquid
in the patient circuit. If
problem persists, provide
alternative ventilation.

7-5

High
(67)

No Yes Yes

High flow therapy

(This page is intentionally blank.)

7-6