VIASYS AVEA User Manual

Operator’s Manual

AVEA

Ventilator Systems

L2786 Rev. D

ii AVEA Ventilator Systems

This page intentionally left blank.

L2786

Operator’s Manual iii

Revision History

Date Revision Pages Changes

September 2005 A All Release

May 2006 B

December 2006 C

February 2007 D 4-7 Updated the figure and added a description of the

4-25 Added a note regarding the date and time

1-1, 1-4, 2-7, 2-10 Removed references to the Plus model
2-12 Removed “non-operational” from figure 2-19
3-16, 3-18, 3-21, 3-33,

3-34, 3-35,
5-3 Added Ppeak to the list of alert messages
2-31 Updated the Primary Controls table
2-36 Added NCPAP to the troubleshooting table
3-33 Updated the Rate specification
5-1 to 5-7 Added the chapter “Infant NCPAP”

Added a note regarding the setting of Peak
Inspiratory Pressure

balloon size and type selection

L2786

iv AVEA Ventilator Systems

Warranty

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

The liability of VIASYS Respiratory Care Inc. (referred to as the Company) under this warranty is limited to replacing,
repairing or issuing credit, at the discretion of the Company, for parts that become defective or fail to meet published
specifications during the warranty period; the Company will not be liable under this warranty unless (A) the Company is
promptly notified in writing by Buyer upon discovery of defects or failure to meet published specifications; (B) the
defective unit or part is returned to the Company, transportation charg es p repaid by Buyer; (C) the defective unit or part
is received by the Company for adjustment no later than four weeks following the last day of the warranty period; and (D)
the Company’s examination of such unit or part shall disclose, to its satisfaction, that such defects or failures have not
been caused by misuse, neglect, improper installation, unauth orized repair, alteration or accident.

Any authorization of the Company for repair or alteration by the Buyer must be in writing to prevent voiding the warranty.
In no event shall the Company be liable to the Buyer for loss of profits, loss of use, consequential damage or damages of
any kind based upon a claim for breach of w arranty, other than the purchase price of any def ective product covered
hereunder.

The Company warranties as herein and above set forth shall not be enlarged, diminished or affected by, and no
obligation or liability shall arise or grow out of the rendering of technical advice or service by the Company or its agents
in connection with the Buyer's order of the products furnis hed hereunder.

Limitation of Liabilities

This warranty does not cover normal maintenance suc h as cleaning, adjustment or lubrication and updat ing of
equipment parts. This warranty shall be void and shall not apply if the equipment is used with accessories or parts not
manufactured by the Company or authorized for use in writing by the Company or if the equipment is not maintained in
accordance with the prescribed schedule of maintenance.

The warranty stated above shall extend for a perio d of TWO (2) years from date of shipment or 16,000 hours of use,
whichever occurs first, with the following exceptions:

1. Components for monitoring of physical variab les such as temperature, pressure, or flow are warranted for ninety
(90) days from date of receipt.

2. Elastomeric components and other parts or components subject to deterioration, over which the Company has no
control, are warranted for sixty (60) days from date of receipt.

3. Internal batteries are warranted for ninety (90) d ays fro m the date of receipt.

The foregoing is in lieu of any warranty, expressed or implied, including, without limitation, any warranty of
merchantability, except as to title, and can be amended only in writing by a duly authorized represent ative of the
Company.

L2786

Operator’s Manual v

Contents

Revision History........................................................................................................iii

Warranty ....................................................................................................................iv

Notices......................................................................................................................vii

Safety Information ....................................................................................................ix

Equipment Symbols .................................................................................................xi

Chapter 1 Introduction.........................................................................................1-1

Some AVEA Features ..................................................................................................................1-2

Chapter 2 Unpacking & Setup.............................................................................2-1

Ventilator Assembly & Physical Setup.......................................................................................2-1

Setting Up the Front of the Ventilator ........................................................................................2-3

Front Panel Connections.............................................................................................................2-7

Setting Up the Rear of the Ventilator........................................................................................2-14

User Verification Test................................................................................................................2-26

AVEA User Verification Test Checklist ....................................................................................2-33

AVEA Troubleshooting..............................................................................................................2-34

Chapter 3 Ventilator Operation...........................................................................3-1

Membrane Buttons and LEDs.....................................................................................................3-1

Patient Setup................................................................................................................................3-9

Ventilation Setup........................................................................................................................3-10

Setting the Ventilation Breath Type and Mode........................................................................3-14

Primary Breath Controls............................................................................................................3-31

Advanced Settings.....................................................................................................................3-37

Independent Lung Ventilation (ILV)..........................................................................................3-44

Chapter 4 Monitors, Displays and Maneuvers..................................................4-1

Graphic Displays..........................................................................................................................4-1

Digital Displays ..........................................................................................................................4-20

Main Screen Displays................................................................................................................4-26

Chapter 5 Infant NCPAP......................................................................................5-1

Overview.......................................................................................................................................5-1

Circuit Compatibility....................................................................................................................5-1

General Specifications ................................................................................................................5-1

Initiating Nasal CPAP...................................................................................................................5-3

Monitors........................................................................................................................................5-5

Graphics........................................................................................................................................5-6

L2786

vi AVEA Ventilator Systems

Chapter 6 Alarms and Indicators........................................................................6-1

Status Indicators.......................................................................................................................... 6-1

Messages...................................................................................................................................... 6-3

Alarms...........................................................................................................................................6-4

Alarm Controls............................................................................................................................. 6-5

Alarm Types.................................................................................................................................6-6

Chapter 7 Maintenance and Cleaning................................................................7-1

Cleaning & Sterilization............................................................................................................... 7-1

Disposable Parts.......................................................................................................................... 7-2

Other Accessories.............................................................................................................. ......... 7-2

Recommended Periodic Maintenance....................................................................................... 7-3

Battery Care................................................................................................................................. 7-4

Fuses............................................................................................................................................ 7-6

Appendix A Contact & Ordering Information...................................................A-1

How to Call for Service................................................................................................................A-1

Ordering Parts..............................................................................................................................A-2

Appendix B Specifications.................................................................................B-1

Pneumatic Supply........................................................................................................................B-1

Electrical Supply..........................................................................................................................B-1

Data Input / Output ......................................................................................................................B-2

Atmospheric & Environmental Specifications..........................................................................B-5

Physical Dimensions...................................................................................................................B-5

Accessories..................................................................................................................................B-6

Appendix C Pneumatic Diagram.......................................................................C-1

Gas Delivery Engine....................................................................................................................C-1

Appendix D Monitor Ranges and Accuracies..................................................D-1

Appendix E Sensor Specifications & Circuit Resistance ............................... E-1

VarFlex® Sensor Specifications.................................................................................................E-1

Hot Wire Flow Sensor Specifications ........................................................................................E-2

Circuit Resistance (per EN794 –1)..............................................................................................E-2

Appendix F AVEA Message Bar Text.................................................................F-1

Appendix G Adjusting Barometric Pressure for Altitude ...............................G-1

Appendix H Advanced Pulmonary Mechanics Monitored Parameters..........H-1

Appendix I Glossary.............................................................................................I-1

Index ...........................................................................................................................3

L2786

Operator’s Manual vii

Notices

Copyright Notice

Copyright© 2005 VIASYS Respiratory Care Inc, California.
This work is protected under Title 17 of the U.S. Code an d is the sole property of the Company. No part of this document

may be copied or otherwise reproduced, or stored in any electronic information retrieval system, except as specifically
permitted under U.S. Copyright law, without the prior written consent of the Company. For more information, contact:

USA

European Authorized Representative

VIASYS Respiratory Care Inc.
22745 Savi Ranch Parkway
Yorba Linda, California 92887-4645
Telephone: [phone]
[phone]
Fax: [phone]

www.viasyshealthcare.com

VIASYS Healthcare GmbH
Leibnizstrasse 7
97204 Hoechberg
Germany
Telephone: [phone]
Fax: [phone]

Trademark Notices

AVEA® is a registered trademark of VIASYS Respiratory Care Inc. in the U.S. and some other countries. All other brand
names and product names mentioned i n this manual are trademarks, registered trademar ks, or trade names of their
respective holders.

EMC Notice

This equipment generates, uses, and can radiate radio frequency energy. If not installed and used in accordance with
the instructions in this manual, electromagnetic interference may result. The equipment has been tested and found to
comply with the limits set forth in EN60601- 1-2 for Medical Products. These limits provide reasonable protection against
electromagnetic interference when operated in the intended use environments (e.g. hospitals) described in this manual.

This ventilator is also designed and manufact ured to comply with the following standards EN 60601-1, IEC 601-2-12, EN
60601-1-2, EN 794-1, CAN/CSA-C22.2 No. 60 1.1-M90, and UL 2601-1.

MRI Notice

This equipment contains electromagnetic components whose operation can be affected by intense electromagnetic
fields.

Do not operate the ventilator in a MRI environme nt or in the vicinity of high-frequency surgical diathermy equipme nt,
defibrillators, or short-wave therapy equipment. Electromagnetic interference could disrupt the operation of the ventilator.

Intended Use Notice

The AVEA ventilator systems are designed to provide ventilator support for the critical care management of infant,
pediatric or adult patients with compromised lung function. They are intended to provide continuous respiratory support
in an institutional health care environment (e.g. a hospital). They should only be operated by properly trained clinical

personnel, under the direction of a physician.

L2786

viii AVEA Ventilator Systems

Regulatory Notice

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

Classification

Type of Equipment: Medical Equipment, Class 1 type B

Adult/Pediatric/Infant Lung Ventilator

Declaration of Conformity Notice

This medical equipment complies with the Medical Device Directive, 93/42/EEC, and the
following Technical Standards, to which Conformity is declared:

EN 794-1
EN 60601-1
EN 60601-1-2
ISO 13485

EU Notified Body:

BSI (Reg. No. 0086)
Trade names:
AVEA ventilator systems

Manufactured by:

VIASYS Respiratory Care Inc.
1100 Bird Center Drive
Palm Springs, CA 92262-8099
U.S.A.

If you have a question regarding the Declaration of Conformity for this product, please contact VIASYS Respiratory Care
Inc. at one of the numbers given in Appendix A.

L2786

Operator’s Manual ix

Safety Information

Please review the following safety information prior to operating the ventilator. Attempting to operate the

ventilator without fully understanding its features and functions may result in unsafe operat ing conditions.
Warnings and Cautions, which are general t o the use of the ventilator under all circumstanc es, are included in this

section. Some Warnings and Cautions are al so inserted within the manual where they are most meaningful.
Notes are also located throughout the manual to provide additional information related to specific features.
If you have a question regarding the installation, set up, operation, or maintenance of the ventilator, contact VIASYS

Respiratory Care Inc., Customer Care, as shown in Appendix A Contact & Ordering Information.

Terms

WARNINGS identify conditions or practices that could result in serious adverse reactions or potenti al safety

hazards.

CAUTIONS identify conditions or practices that could result in damage to the ventilator or other equipment.
NOTES identify supplemental information to help you better understand how the ventilator works.

Warnings

Warnings and Cautions appear throughout this manual where they are relevant. The Warnings and Cautions
listed here apply generally any time you operate the ventilator.

The AVEA Ventilator is intended for use by a train ed practitioner, under the direction of a qualified physician.
When the ventilator is connected to a patient, a trained health care professional should be in att en da nce at all times

to react to an alarm or other indications of a problem.
Alarm loudness must be set above ambient sound in order to be heard.
Always have an alternate means of ventilation available whenever the v entilator is in use.
The operator should not touch the electrical con nectors of the ventilator or accessories, and the patient

simultaneously.
Due to possible explosion hazard, the ventilator should not be used in the presence of flammab le anesthetics.
An audible alarm indicates an anom alous condition and should never go unheeded.
Anti-static or electrically conductive hoses or tubing should not be used within the patient circuit.
If a mechanical or electrical problem is recognized while operating the ventilator, the v entilator must be removed

from use and referred to qualified personnel for servicing. Using an inoperative ventilator may result in patient

injury.
When a low gas supply alarm occurs, the oxygen concentration delivered to the patient will differ from that set on the

2 control setting.

O
A source gas failure will change the F

IO2 and may result in patient injury.

The functioning of this equipment may be adversely affected by the operation of other equipment nearby, such as

high frequency surgical (diathermy) equipment, defibrillators, short-wave therapy equipment, “walkie-talki es,” or

cellular phones.
Water in the air supply can cause malfunction of this equip m ent.

L2786

x AVEA Ventilator Systems

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

result.

Electric shock hazard - Do not remove any of the ventilator covers or panels. Refer all servicing to an authorized

VIASYS Respiratory Care service technician.

A protective ground connection by way of the grounding conductor in the power cord is es sential for safe operation.

Upon loss of protective ground, all conductive p arts in cluding knobs and controls that may appear to be
insulated can render an electric shock. To avoid electrical shock, plug the power cord into a properly wired
receptacle, use only the power cord supplied with the ventilator, and make sure the power cord is in good
condition.

The AVEA is designed to ensure that the user and patient are not exposed to excessive leakage curr ent per

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

Cautions

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

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

result.
A battery that is fully drained (i.e. void of any charge) may cause damage to the ventilator and should be replaced.
All accessory equipment that is connected to the ventilator should comply with CSA/IEC601/UL2601.
To avoid damage to the equipment, clean the air filter regularly.

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

Do not sterilize the ventilator. The internal co mponents are not compatible with sterilization techniques.
Do not gas sterilize or steam autoclave tubing adapters or connectors in place. The tubing will, over time, take the

shape of the adapter, causing poor connection and possible leaks.
DO NOT submerge the ventilator or pour cleaning liquids over or into the ventilator.

L2786

Operator’s Manual xi

Equipment Symbols

The following symbols may be reference d o n the ventilator or in accompanying documentation

Symbol Source/Compliance Meaning

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

Symbol #5016 IEC 60417
Symbol #5034 IEC 60417

Symbol #01-36 IEC 60878
Symbol #5035 IEC 60417
Symbol #01-37 IEC 60878

This symbol indicates a FUSE.

This symbol indicates INPUT.

This symbol indicates OUTPUT

ACCEPT

Symbol #5031 IEC 60417
Symbol #5019 IEC 60417

Symbol #01-20 IEC 60878

Symbol #5021 IEC 60417
Symbol # 01-24 IEC 60878

Symbol # 5333 IEC 60417
Symbol #02-03 IEC 60878

Symbol #5032 IEC 60417
Symbol #01-14 IEC 30878

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

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

Symbol #0651 ISO 7000

This symbol indicates DIRECT CURRENT (DC)

This symbol indicates protective EARTH (ground).

This symbol indicates the EQUIPOTENTIAL connection used to
connect various parts of the equipment or of a system to the same
potential, not necessarily being the earth (ground) potential (e.g., for
local bonding).

This symbol indicates TYPE B equipment, which indicates equipment
that provides a particular degree of protection against electric shock,
particularly with regards to allowable leakage current and reliability of
the protective earth connection.

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

Indicates ON (Power)

Indicates OFF (Power)

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

VIASYS Respiratory Care
Symbol

Indicates PATIENT EFFORT

VIASYS Respiratory Care
symbol

Indicates MANUAL BREATH

L2786

xii AVEA Ventilator Systems

VIASYS Respiratory Care
Symbol

MAIN SCREEN

Symbol #417 IEC 5102

EVENT READY

VIASYS Respiratory Care
Symbol

VIASYS Respiratory Care
Symbol

MODE

ADVANCED SETTINGS

VIASYS Respiratory Care
Symbol

SET-UP for patient size selection

MDD Directive 93/42/EEC

CE Mark

Symbol #5307 IEC 60417

ALARM RESET

CANCEL

Symbol #5319 IEC 60417

VIASYS Respiratory Care
symbol

VIASYS Respiratory Care
symbol

VIASYS Respiratory Care
symbol

Graphical Symbol in
general use internationally
for “DO NOT”

VIASYS Respiratory Care
symbol

Symbol 5467 IEC 60417

ALARM SILENCE

ADULT patient

PEDIATRIC patient

NEONATAL (Infant) patient

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

Select DISPLAYED SCREEN function.

FREEZE the current display.

L2786

Operator’s Manual xiii

VIASYS Respiratory Care
symbol

VIASYS Respiratory Care
symbol

VIASYS Respiratory Care
symbol

VIASYS Respiratory Care
symbol

VIASYS Respiratory Care
symbol

VIASYS Respiratory Care
symbol

VIASYS Respiratory Care
symbol

Enable the ALARM LIMITS screen

This symbol indicates a CONTROL LOCK.

NEBULIZER port

Increase OXYGEN

PRINT SCREEN

SUCTION port

VARIABLE ORIFICE FLOW SENSOR connection

VIASYS Respiratory Care
symbol

VIASYS Respiratory Care
symbol

VIASYS Respiratory Care
symbol

VIASYS Respiratory Care
symbol

VIASYS Respiratory Care
symbol

VIASYS Respiratory Care
symbol

VIASYS Respiratory Care
symbol

HOT WIRE FLOW SENSOR connection

ANALOG IN/OUT connection

Display the MAIN SCREEN

DO NOT BLOCK PORT

EXTERNAL BATTERY connection

Indicates GAS ID port

OXYGEN SENSOR connection

L2786

xiv AVEA Ventilator Systems

VIASYS Respiratory Care
symbol

OVERPRESSURE relief

VIASYS Respiratory Care
symbol

REMOTE NURSE CALL connection

VIASYS Respiratory Care
symbol

USER INTERFACE MONITOR connection

VIASYS Respiratory Care
Symbol

VIASYS Respiratory Care
Symbol

This symbol indicates an INTERNAL BATTERY FUSE

This symbol indicates ALARM LOUDNESS

VIASYS Respiratory Care
Symbol

This symbol indicates that the AVEA is being powered by the
INTERNAL BATTERY only.

VIASYS Respiratory Care
Symbol

This symbol indicates that the HELIOX configuration is in use.

L2786

Operator’s Manual 1-1

Chapter 1 Introduction

The AVEA is a fourth generation, servo-controlled, software-driven ventilator. It has a dynamic range of breathing gas
delivery that provides for neonatal through adult patients. Its revolutionary user interface module (UIM) provides
maximum flexibility with simple operator interaction. It has a flat panel color LCD with real time graphic displays and
digital monitoring capabilities, a touch scr een for easy interaction, membrane keys and a dial for c hanging settings and
operating parameters. A precision gas delivery engine with servo controlled active inhalation and exhalation improves
performance over previous generations.

The AVEA has been designed to function using most commonly available accessories. It is easy to clean and its design
does not allow liquids to pool on the casing, reducing the likelihood of fluid leakage into the body of the ventilator.

There are two models of AVEA: Comprehensive and Standard. The following table shows the standard and optional
functions available with each model.

Functions & Accessories Standard Comprehensive

Modes
Proximal Hot Wire Flow Sensing

Synchronized Nebulizer
24 Hour Trending
Internal Battery
Full Color Graphics Display
Loops and Waveforms
Standard Cart
Proximal Variable Orifice flow sensing
Proximal Airway Pressure Monitoring
Tracheal Catheter
Esophageal Balloon
Internal Compressor
Heliox Delivery

Optional Functions & Accessories

All All

Custom Cart Option Included
External Battery (on custom cart only) Option Option
Gas Tank Holder (on either cart) Option Option
Internal Compressor Option Included

Heliox Delivery Option Included

L2786

1-2 Chapter 1 Introduction AVEA Ventilator Systems

Some AVEA Features

Artificial Airway Compensation1

When Artificial Airway Compensation is turned on, the ventilator automatically calculates the pres sure drop across the
endotracheal tube, then adjusts the airway pressure to deliver the set inspiratory pressure to the distal (carina) end of the
endotracheal tube. This calculation takes into account flow, gas composition (Heliox or Nitrogen/Oxygen), Fraction of
Inspired Oxygen (FiO2), tube diameter, length, and pharyngeal curvature based on patient size (Neonatal, Pediatric,
Adult). This compensation only occurs during inspiration. Artificial Airway Compensation is active in all Pressure
Support and Flow Cycled Pressure Control Breaths.

WARNING

Activating of Artificial Airway Compensation while ventilating a patient will cause a sudden increase in the peak
airway pressures and a resultant increase in tidal volume. If you choose to activate Artificial Airway
Compensation while the patient is attached to the ventilator you will need to exercise caution to minimize the
risk of excessive tidal volume delivery.

Note:

Monitored airway pressures (inspiratory) will be higher than set values when Artificial Airway Compensation is active.

With an inspiratory pressure setting of zero, Artificial Airway Compensation will still provide an elevated airway pressure,
which will compensate for the resistance of the endotracheal tube.

When turned on the Artificial Airway Compensation indicator will appear in all modes of ventilation even though the
function may not be active (i.e.: Volume Controlled Breaths). This is to alert you to the fact that Artificial Airway
Compensation will become active if a Pressure Support or combination mode (e.g. Volume Control SIMV) is selected.

Range: Off/On
Default: Off
Available in all patient sizes

Full range of Patient Size

You can select a patient size of Adult, Pediat ric, or Neonate. Once the selection is made, the ventilator offers only those
parameters, which are available for your sel ected patient size.

Non-Invasive Ventilation

The ventilator can perform non-invasive ventilation with a standard dual limb circuit. Leak compensation should be
turned on when using this feature. To turn leak compensation on, use the touch screen control displayed in the Ventilator
Set-Up Screen.

NOTE

Non invasive ventilation requires the use of a snug fitting mask with no bleed holes. Excessive leaks around the mask
may result in false triggering of the ventilator or assertion of disconnect alarms.

1

Estimation of Inspiratory Pressure Drop in Neonatal and Pediatric Endotracheal Tubes, by Perre-Henri Jarreau, American Physiological Society 1999

L2786

Operator’s Manual Chapter 1 Introduction 1-3

Leak Compensation

Leak Compensation is used to compensate for baseline leaks, which may occur at the patient mask interface or around
the patient’s endotracheal tube. It only provides baseline leak compensation and is not a c tive during breath delivery.

During exhalation, PEEP is maintained by the cooperation of the Flow Control Valve (FCV) and the Exh alation Valve
(ExV). The ExV pressure servo is set to a target pressure of PEEP and the FCV pressure servo is set to a pressure
target of PEEP - 0.4 cmH
when the pressure drops below its target up to a maximum flow rate for the patient size

Range: Off/On
Default: Off

2O. The ExV servo relieves when the pressure is above its target and the FCV supplies flow

Circuit Compliance Compensation

When Circuit Compliance is active, the volume of gas delivered during a volume controlled or targeted breath is
increased to include the set volume, plus the volume lost due to the compliance effect of the circuit. Circuit Compliance
is active for the set Tidal Volume during volume control ventilation, the Target Tidal Volume in PRVC mode and for
Machine Volume. It is only active in Adult and Pediatric applications.

Exhaled volume monitors for all modes and breath types are also adjusted for the compliance compensation
volume.

Range: 0.0 to 7.5 ml/cmH
Default: 0.0 ml/cmH
The ventilator automatically measur es Circuit Compliance during the Extended System s Test (EST). It can also be

entered manually.

Note:

Although circuit compliance is displaye d on the Setup screen it is not active for neonatal patients..
High circuit compliance with small tidal volumes may result in extended inspiratory times. This is a result of the delivery

of the circuit compliance volume at the set flow rate.
Setting extremely small delivered tidal volumes with Circuit Compliance Compensation not active and using a proximal

flow sensor may result in assertion of Patient Circuit Disconnect Alarms.

Humidification

You can select active or passive humidificati on (ON/active or OFF/passive). Active humidification assu mes 99% RH;
passive assumes 60% RH when using an H ME. This feature adjusts the BTPS correction factor to correct exhaled tid al
volumes.

Range: Off/On
Default: Active (ON)

2O

2O

Note:

Incorrect setting of the Humidification feature will affect monitored exhaled volume accuracy.

L2786

1-4 Chapter 1 Introduction AVEA Ventilator Systems

Heliox Delivery (Comprehensive only, option on Standard)

Using patented “Smart” connector technology, the Comprehensive model AVEA can deliver Heliox blended gas instead
of Medical air. By simply changing a connector on the back panel, the ventilator identifies the gas input and ad justs to
accommodate the change. All volumes (numeric and graphic) are automatically compen sated for accurate display.

The clinical benefits of helium / oxygen gas a r e based on its significantly lower gas density wh en compared to nitrogen /
oxygen gas. This lower gas density allows the same volumetric (tidal v ol ume) of gas to be delivered to the patient at a
significantly lower airway pressure. Additionally, the low-density properties of the gas allow it to diffuse past airway
obstructions or restrictions much easier than nitrogen / oxyg en gas mixtures.

Note

The Heliox “smart” connector is designed for use with an 80/20 Heliox tank only. Only a mixture of 20% oxygen and
80% Helium can be used as the Heliox gas supply.

If Heliox gas is connected this green icon displays in bottom right of the touch screen.

To set the Helium / Oxygen mixture during administration si mply set the desired FiO2, the balance of the breathing gas is
Helium.

For example:

A set FiO2 of 35% will deliver a 65/35 Heliox mixture to the patient.

WARNING

Connection of a gas supply at the Helium-Oxygen mixture inlet that does not contain 20% oxygen can cause
hypoxia or death.

Although an 80/20 mixture of Helium and Oxygen is marketed as medical gas, the Helium/Oxygen gas mixture is
not labeled for any specific medical use.

Note

Hot wire flow sensors will not function with Heliox gas mixtures. During Heliox delivery, a variable orifice flow sensor
should be used for monitoring delivered volumes at the proximal airway.

L2786

Operator’s Manual Chapter 1 Introduction 1-5

Note

Heated humidifier performance should be carefully monitored during Heliox therapy. Helium has significantly

greater thermal conductivity compared to nitrogen / oxygen gas mixtures and this could cause diffic ulty with some heated
humidification devices. A febrile patient may transfer heat via the gas column to a proximal temperature sensor, which
could affect the duty cycle of the humidifier and decrease output. This could cause desiccation of secretions in the
airway.

Alternately, in applications where a heated wire breathing circuit is used, this heat transfer from the patient may affect
the duty cycle of the heated wire circuit, which may result in increased condensation in the breathing circuit.

The relative settings of some types of humidifiers may need to be reduced to prevent overheating of the breathing gas.

Note

The Oxygen alarm cannot be disabled during Heliox administration
Do not operate nebulizer while us ing heliox

L2786

1-6 Chapter 1 Introduction AVEA Ventilator Systems

This page intentionally left blank.

L2786

Operator’s Manual 2-1

Chapter 2 Unpacking & Setup

Ventilator Assembly & Physical Setup

Unpacking the Ventilator

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

Items Required for Ventilator Setup

You will need the following to setup your AVEA ventilator:

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

external 24VDC battery. There is an internal battery supplied with the ventilator, which will operate the
ventilator for short periods (see Chapter 6, Maintenance & Cleaning)

CAUTION

The ventilator should be connected to a mains AC power supply for at least 4 hours prior to switching to internal battery
power. For operation on external battery the ventilator s ho uld be connected to a mains AC power supply for at least 12
hours with green LED lot to insure a fully charged battery.

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

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

Air or Heliox Supply

Pressure Range: 20 to 80 psig (1.4 to 5.5 bar) (Supply Air)
20 to 80 psig (1.4 to 5.5 bar) (Supply Heliox - 80% / 20% Heliox Only)
3 to 10 psig (0.2 to 0.7 bar) (Compressor Air)
Temperature: 5 to 40°C (41 to 104°F)
Minimum Flow: 80 L/min at 20 psig (1.4 bar)
Air Inlet fitting CGA DISS-type body, No. 1160 (Air). NIST fitting per BS-5682:1984 (Air) also availabl e.
Heliox Inlet fitting CGA DISS-type body, No. 1180 (Heliox)

Note

NIST fittings for Air and Oxygen are available from VIASYS, upon request at time of order.

Oxygen Supply

Pressure Range: 20 to 80 psig (1.4 to 5.5 bar) (Supply Oxygen)
Temperature: 5 to 40º C (41 to 104º
Humidity: Dew Point of gas should be 1.7º
Minimum Flow: 80 L/min at 20 psig (1.4 bar)
Inlet Fitting: CGA DISS-type body, No. 1240. NIST fitting per BS-5682:1984 (O2) also ava il ab le.

F)

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

L2786

2-2 Chapter 2 Unpacking & Setup AVEA Ventilator Systems

Assembling the Ventilator

Assemble your AVEA ventilator’s wheeled base using the instructions included in the package. The ventilator body is
easily attached to the base by means of four thumbscr ews. Reference Installation Instructions L2353 for detailed
directions. See figure 2.1.

Standard
Ventilator Base

Figure 2.1 Basic and Comprehensive base attachment

Comprehensive
Ventilator Base

CAUTION

The ventilator body and UIM weigh approximately 80 lbs. ( 36.4 kg) Employ safe lifting procedures when assembling the
ventilator.

L2786

Operator’s Manual Chapter 2 Unpacking & Setup 2-3

External battery option

If you have purchased the optional external battery pack, the dr op
cable should be fed up the central pole of the base and out through
the cord routing well shown in figure 2.2 prior to attaching the base
to the ventilator body. Install your external batteries per the
installation instructions enclosed with the cart accessories kit (P/N

11372). Reference Installation Instructions L2353 for detailed
directions.

When the cord is in place, use the handles on e ach side of the
ventilator body to maneuver and align it with the thumbscrews on
the base (see figure 2.1). Tighten the thumbscrews.

Figure 2.2 External Battery Routing

Setting Up the Front of the Ventilator

Assembling the Exhalation Filter and Water Trap

To assemble and insert the exhalation filter and water trap do the following:

Screw the supplied water collection bottle
into the threaded cuff of the water trap.

Figure 2.3 Attaching the Collection Bottle to the Water Trap

L2786

2-4 Chapter 2 Unpacking & Setup AVEA Ventilator Systems

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

Figure 2.4 Attaching the Exhalation Filter.

Locating Ridge for assembly
into cartridge

Align the locating ridge on the water trap assemb ly with the slot in the exhalation filter
cartridge (see fig 2.5).

Slide the water trap/exhalation filter assembly into the cartridge (see fig 2.6)

Figure 2.6 Exhalation Filter/Water Trap Assembly in Cartridge

Slot matches
locating ridge of
water trap
assembly

Figure 2.5 Exhalation Filter Cartridge Showing Locating Slot

L2786

Operator’s Manual Chapter 2 Unpacking & Setup 2-5

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

Figure 2.7 Open locking lever

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

Figure 2.8 Insert exhalation filter

Note

Placement of the exhalation filter/water trap assembly without the exhalation filter cartridge may cause misalignment of
the filter seal resulting in patient breathing circuit leaks.

Close the locking lever.

Figure 2.9 Close locking lever in place

L2786

2-6 Chapter 2 Unpacking & Setup AVEA Ventilator Systems

Attaching the Patient Circuit

Adult Circuit using an Active
Humidifier

Using an active humidifier, the adult patient
circuit is set up as shown in figure 2.10.
Attach your humidifier to the upright pole of
the AVEA base. Adjust the height of the
humidifier and the length of the humidifier
tubing so that the tubing is relatively
straight with no occlusions.

Inspiratory
limb of Patient
Circuit

Figure 2.10 Adult Circuit with Active Humidifier

Adult Circuit without active humidifier

Inspiratory Limb
of Patient Circuit

Figure 2.11 Adult Patient Circuit without active humidifier.

The setup for use with a passive humidifier or HME is
per figure 2.11. The inspiratory limb of the patient c ircu it
connects directly to the gas output of the ventilator. The
passive humidification system should be placed in-line
in the patient circuit per the manufacturer’s instructions.

L2786

Operator’s Manual Chapter 2 Unpacking & Setup 2-7

Neonatal Patient Circuit

The Neonatal Patient Circuit is attached as
shown in figure 2.12.

Inspiratory Limb
of Patient Circuit

Figure 2.12 Neonatal Patient Circuit

Front Panel Connections

Standard

Figure 2.13 AVEA Front Panel Configurations

Comprehensive

Standard & Comprehensive

L2786

2-8 Chapter 2 Unpacking & Setup AVEA Ventilator Systems

Attaching Flow Sensors

The AVEA can accept either a hot wire or a variable orifice proximal flow sensor. These are in addition to the
instrument’s internal inspiratory flow sensor and heated expiratory flow sensor. Three proximal flow sensors are available
for the AVEA.

The standard Hot Wire flow sensor is suitable for neonatal and pediatric applications where the peak inspiratory flow rate
is less than 30 L/min. This flow sensor is not active in adult applications.

Hot Wire Flow Sensor

A Hot Wire flow sensor attaches to the receptacle
circled in light blue directly below the variable orifice
flow sensor connection on the front pane l. The
receptacle is marked with the icon shown here.

This is a locking connector. To attach, first pull back
the locking collar, then push firmly onto the ventilator
receptacle.

To disconnect, first retract the plastic collar then
firmly pull the connector away from the ventilator.
Do not pull up or down as this can damage the
connector

Retractable plastic
collar

Figure 2.14 Hot wire Flow Sensor Attachment

Note

Hot wire flow sensors will not function with Heliox gas mixtures. During Heliox delivery, a variable orifice flow sensor
should be used for monitoring delivered volumes at the proximal airway.

Variable orifice flow sensors are also available on some AVEA models. The neonatal VarFlex flow sen sor is compatible
in neonatal and pediatric applications where the peak inspiratory flow rate is less than 30L/min and is not active in adult
applications. For adult and large pediatric applications a Pediatric / Adult VarFlex flow sensor is available for use with
patients whose flow requirements fall within the range of 1.2 – 180 L/min.

Detailed information on the specifications of each flow sensor can be found in Appendix E: Sensor Specifications and
Circuit Resistance.

L2786

Operator’s Manual Chapter 2 Unpacking & Setup 2-9

Variable Orifice Flow Sensor

Figure 2.15 Variable Orifice
Flow Sensor Attachment

Retractable
Plastic Collar

Variable Orifice sensors attach to the receptacle on the front panel of the
ventilator circled in dark blue and marked with the icon shown here.

This is a locking connector. To attach, first pull back the plastic locking collar,

then push firmly onto the ventilator receptacl e. Then push the locking collar
forward to lock the flow sensor in place.

To disconnect, first retract the plastic collar then firmly pull the connector away
from the ventilator. Do not pull up or down as this can damage the connector.

CAUTION

Fully retract the plastic locking collar before attaching these connectors. Failure to do this can cause damage to the
connector.

Attaching a Nebulizer

You can use an in-line nebulizer with the AVEA ventilator
(see Chapter 3, Ventilator Operation). The nebulizer is
synchronized with inspiration, delivers gas at the set
FiO2/FiHe and is active for 20 minutes. Attach the
nebulizer tubing to the fitting at the bottom of the front
panel as shown here. The fitting is marked with the icon
shown here.

Note

To use the internal nebulizer, the AVEA must be connected to a high-pressure air source. The nebulizer is not active
while the AVEA is operating on its intern al compressor. The ventilator incorporates an internal pneumatic compressor,
which creates the drive pressure nec essary to operate the nebulizer.

Figure 2.16 Attaching nebulizer tubing

L2786

2-10 Chapter 2 Unpacking & Setup AVEA Ventilator Systems

Note

The nebulizer requires an inspiratory flow rate of at lea st 15 liters per minute to activate and is flow compensated to
maintain set tidal volumes.

CAUTION

When the internal nebulizer is used, the ventilator decreases the flow rate by 6 L/min to compensate for the ne bu lizer
output. However, since flow from the internal ne bulizer can vary, using the internal nebuliz er may impact the tidal
volumes delivered to the patient.

Note

Do not operate the nebulizer while using Heliox

Attaching a Proximal Pressure Sensor

A proximal pressure sensor to monitor proximal airway pressure can be attached to the Comprehensive model of AVEA.
On the Comprehensive AVEA the connector is labeled as Aux as shown in figure 2.17.

When active, this feature will display & alarm to proximal airway pressures.

Figure 2.17 Proximal pressure sensor connection on the Comprehensive AVEA

Note

In applications which generate high re sistances within the breathing system mon itored, Proximal Airway Pressure may
be higher than set Inspiratory Pressure.

L2786

Operator’s Manual Chapter 2 Unpacking & Setup 2-11

(Comprehensive Model Only)
Esophageal Balloon

The connection intended for an esophageal balloon is circled in
green at the top of the front panel as shown here. It is id entified
with the legend P

.

ES

Figure 2.18 Esophageal balloon connector

Note

See chapter 4 for placement technique for esophageal balloons.

Tracheal Catheter

A tracheal catheter will attach to the AVEA at the connection on the front panel marked as Aux. The connector is shown
in figure 2.18.

Note

See chapter 4 for placement techniq ue for tracheal catheters.

L2786

2-12 Chapter 2 Unpacking & Setup AVEA Ventilator Systems

Other Connections

WARNING

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

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

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

RS-232 Connections

The RS-232 #1 connection is used for AVEA feature upgrades, which are performed by a VIASYS certified technician
only, and communications. The communications protocol is described in document L2317 AVEA Communications
Protocol.

WARNING

The RS-232 #2 port connection is non-functional. Do not use.

Figure 2.19 Connections beneath the UIM screen

L2786

Operator’s Manual Chapter 2 Unpacking & Setup 2-13

Printer Connector

The AVEA has a standard 25 pin female Centronics p ara llel printer port for interfacing to an external print er.

SVGA Connector

A SVGA output connector is provided to enable real time di splay of the screen from a separate external display device
such as an LCD projector or remote monitor. This output can be switched on and off on the utilities screen.

Medical Information Buss (MIB) Connector

IEEE 1073 Medical Information Buss connection.
This communication port is used for all serial comm unication from the AVEA. Please contact your VIASYS Sales

Specialist for available applications an d kits.

L2786

2-14 Chapter 2 Unpacking & Setup AVEA Ventilator Systems

Setting Up the Rear of the Ventilator

A

B

C

J

I

E

D

G

F

H

Figure 2.20 Rear panel

A – AC power module H – Oxygen hose connection
B – UIM connection I – External battery connector
C – Analog input/output/ILV J – External battery fuse
D - Power ON/OFF Switch
E – Nurse call system connection
F – Air smart connector
G – Oxygen sensor

L2786

Operator’s Manual Chapter 2 Unpacking & Setup 2-15

r

Connecting the Oxygen Sensor

O2 Cell

Figure 2.21 Connecting the O

2 Sensor

Connecting Gas Fittings

The “Smart” Air Fitting

There are two gas connections on the rear
panel of the ventilator. The one on the left of
the panel is for attaching the Air or Heliox
gas source.

The oxygen sensor cell is located on the rear panel, between the two gas fittings.
The oxygen sensor cable emerges from the rear panel directly above the sensor.
Carefully align and then gently push the connector onto the oxygen sensor until it
seats. When a good connection has been made, slide the protective cover down
and push over the sensor.

Colla

The smart connector fitting type shown here
is CGA DISS-type body No. 1160 for air with
an integral water trap/filter. To prevent the
entry of moisture into the ventilator from a
wall air source, the external water trap is
placed in-line between the air hose and the
“smart” air connector.

To attach, align the connector assembly (see
figure 2.22), seat gently onto the fitting and

“Smart” Connector

screw down the fitting collar until finger tight.
Similar connectors for Air with NIST and

Air Liquide fittings are also available from VIASYS.

Figure 2.22 Attaching the Air “smart”

connector with water trap.

L2786

2-16 Chapter 2 Unpacking & Setup AVEA Ventilator Systems

The “Smart” Heliox Fitting

A DISS-type, No. 1180 smart connector fitting is
also available for use with an 80/20 Heliox gas
mixture (see figure 2.23). Follow the instructions
contained with your Heliox kit to instal l the
tethered Heliox connector. This fitting has no
integral water trap/filter. All AVEA “Smart”
connectors with or without the integral water
trap/filter, attach in the same way. Align the
connector (see figures 2.22 and 2.23), seat gently
onto the fitting and screw down the fitting collar
until finger tight.

Figure 2.23 Attaching the Tethered Heliox Connector

The AVEA “Smart” connectors signal to the ventilator which type of fitting is attached and therefore which gas controls to
initiate.

The fitting on the right of the panel is for attaching the Oxygen g as source. The O2 fitting type is CGA DISS type, No.

1240. (NIST or Air Liquide oxygen fittings are al so available from VIASYS)

Tether

Attaching the Gas Hoses

Oxygen Connection

Attach the Oxygen hose to the fitting on the right of the back panel
(see figure 2.24).

Heliox Connection

Figure 2.25 Connecting the Heliox Hose

Figure 2.24 Connecting the O2 Hose

If you have the upgrade for Heliox delivery, attach the Heliox hose .to the tethered
“Smart” connector fitting on the left of the back panel as shown in figure 2.25.

The air hose will not attach to the fitting designed for Heliox and vice versa.

L2786

Operator’s Manual Chapter 2 Unpacking & Setup 2-17

WARNING

Allow 90 seconds for the accumulator to purge before initiating patient ventilation with Heliox gas.

WARNING

Connection of a gas supply at the Helium-Oxygen mixture inlet that does not contain 20% oxygen can cause
hypoxia or death.

Although an 80/20 mixture of Helium and Oxygen is marketed as medical grade gas, the Helium/Oxygen gas
mixture is not labeled for any specific medical use.

Attaching the Air Hose

Attach the Air supply hose to the “Smart” connector fitting with the
integral water trap/filter on the left of the back panel as shown in figure

2.26.
The fitting shown here is a DISS fitting. Fittings which accept NIST

and Air Liquide hoses are also available from VIASYS.
The air hose will not attach to the fitting designed for Heliox and vice

versa.

Figure 2.26 Attaching the Air Hose to the water trap/filter

Note

The fitting for Air will not accept a Heliox connection and vice versa.

L2786

2-18 Chapter 2 Unpacking & Setup AVEA Ventilator Systems

Utilities Screens

Configuration Tab

Figure 2.27 Utilities Screen

Alarm Loudness.

To change alarm sound levels depress a nd hold the increase or decrease soft keys unt il the desired level is reached.
The “Alarm Test” banner will appear during the adjustment.

Enable / Disable O2 Alarm.

The High and Low oxygen alarms can be di sabled in the event of a failure of the oxygen sensor w hile the ventilator is in
use. To disable the alarm depress the Enable / Disable O2 soft key, to re-enable depress the soft key aga in.

NOTE

The oxygen alarms cannot be disabled whil e heliox is in use. Powering the ventilator off and back on again will
automatically re-enable the oxygen alarms.

WARNING

Although disabling the oxygen alarms will not effect oxygen titration an external analyzer should be placed in
line in the breathing circuit until the oxygen sensor has been replaced.

L2786

Operator’s Manual Chapter 2 Unpacking & Setup 2-19

Flow Correction

Allows for flow correction to BTPS (Body Temperature Pressure Saturated or ATPD (Ambient Temperature
Pressure Dry). Default position is BTPS and should be used for all clinical applications.

ILV Mode

To enable Independent Lung Ventilation and define the Master and Slave ventilators, access the Utilities screen from the
screens menu (see figure 2.30). ILV requires the use of a specially configured accessory cable kit, which is

available from VIASYS (Part Number 16246).

With both ventilators turned off, connect the ILV cable PN 16124 to the analog port of each ventilator. Turn on the
ventilator to be designated as the “Slave”. Adjust all primary and advanc es settin gs as desired.

Next, power up the “Master” ventilator. Select “Master” from the Utilities screen. Adjust all primary an d advanced settings
as desired.

Connect the patient.

Note

Ventilation will not begin until the Master ventilator has been turned on.
Each ventilator maintains independent settings for FiO2 during independent lung ventilation. Close monitoring of set
FiO2 on each ventilator is recommended.
Confirm alarm settings on each ventilator. Each ventilator will alarm independently based on alarm settings established
for that particular ventilator.
Apnea ventilation on the Slave ventilator is driven by the apnea ventilation rate of the Master ventilator only.
Should the ventilators become disconnected during ILV, only the Master ventilator will alarm for the ILV Disconnect
condition. The Slave ventilator will alarm for Apnea and begin apnea ventilation at its own activ e settings.

WARNING

DO NOT attempt to connect a standard DB-25 cable to this receptacle. This could cause damage to the
ventilator. A specially configured cable is required for ALL features associated with this connector. Contact
VIASYS Tech Support.

Setting up Independent Lung Ventilation (ILV)

The AVEA has a 25 pin receptacle on the rear p anel (see figure 2.20) to allow for Independent Lung Ventilation (ILV)
.with another AVEA. The output for ILV provides a 5VDC logic signal sy nchronized to the breath phase of the master
ventilator. Table 2.3 at the end of this section details the relevant pins for the signals carried by this connector.

Note

This connector also carries the Analog Input and the Analog Output signals. Refer to Appendix B Specifications for
Analog Output Pressure (cmH2O/mv), flow ((ml/min)/mv) and Volume (ml/mv) conversions.

ILV connector pin configuration

To connect two AVEA ventilators together for independent lung ventilation function, the cable must be wired so that the
ILV input (the slave) on one AVEA is connected to the ILV output (the master) on the other AVEA. As shown in figure

2.27 below, the ILV slave is pin 18, and the ILV master is pin 6. In ad dition, at least one of the analog grounds (pins 5, 9,
10, 11, 12 or 13) must be connected. We recommend using a shielded cable.

L2786

2-20 Chapter 2 Unpacking & Setup AVEA Ventilator Systems

For ILV operation:

Connect an analog ground on Vent 1 to analog ground on vent 2 (See figure 2.28).
Connect Pin 6 on Vent 1(Master) to pin 18 on vent 2 (Slave).
Connect Pin 18 on Vent 1 to pin 6 on vent 2.

Figure 2.28 ILV Connection Pin Configuration

Slave

Master

Figure 2.29 Analog Ground Pins

L2786

Operator’s Manual Chapter 2 Unpacking & Setup 2-21

Note

At least one analog ground is required for safe and accurate signal output and input. One analog gro und is sufficient for
any and all of the other signals.

Selecting Language .

Touch the language box and use the data dial to select the desired language. Use the Accept key to accept the change.
All text displayed on the LCD screen will automatically be translated to the set language.

Note

For ease of use all languages appear in their native text in the text selection box on the utilities screen.

Low Vte Alarm Sensitivity

Sets the number of consecutive breaths with an exhaled tidal volume below the Low Vte Alarm setting which are
required to sound the alarm. The default is 3 breaths; the range is 1-5 breaths.

Increase FiO2

Configures the step increase used during the increase oxygen maneuver. Sets the amount of oxygen the

ventilator will increase above the current set FiO2.
Example: If the Increase FiO2 is set at 20%
AND
The set FiO2 is 40%
WHEN

The increase FiO2 Maneuver is activated the FiO2 will increase to 60% for two
minutes after which it will return to 40%.

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

Note

To achieve 100% delivered FiO2 during the Increas e O2 maneuver set the Increase FiO2 setting to its maximum of 79%.

Note

The settings will be reset to default values when New Patient is selected in the set up menu.

Setting the Barometric Pressure.

Using the touch turn touch technique use the data d ial to set the correct barometric pressure for the current altitude.

L2786

2-22 Chapter 2 Unpacking & Setup AVEA Ventilator Systems

Note

Failure to properly set the barometric pressu re can affect accuracy of some of the instruments monitoring systems. See
Appendix G for Barometric Pressure / Altitude conversion chart.

Input/Output Tab

Analog Input Configuration

Under the heading “Set Analog Input Scale” there are two buttons representing two possible voltage r anges.
If the full-scale output of the device you are interfacing with is less than 1 volt, select the 0-1 volt scale button.
If it is 5V or less, select the 0-5 volt range. Select the appropriate anal og scale and press the “ACCEPT” key to enter the

configuration.
Analog Input is configured on the same connector as the ILV. The pin c onfiguration for cables to use this feature is

shown in figure 2.29 below. Pin configuration of the connector for attachment to your other device must be supplied by
the manufacturer of that device

WARNING

All applications using this connector require specially made cables. DO NOT connect a standard DB25 cable to
this receptacle. This could result in damage to the ventilator. Contact VIASYS Respiratory Care technical
support at the numbers given in Appendix A.

L2786

Operator’s Manual Chapter 2 Unpacking & Setup 2-23

Figure 2.30 Analog Input connections

Analog Outputs

Set Analog Output Type

The analog output flow signal can be selected between Wye Flow (calculated flow to the patient) or Machine Flow (the

flow measured by the inspiratory flow sensor within the ventilator).

Pressure, Flow, Volume, Breath Phase

Figure 2.32 Analog Outputs Pin configuration

The pin configuration for pressure, flow, volume and breath phase analog outputs is shown above. Refer to Appendix B

Specifications for Analog Output Pressure (cmH2O/mv), flow ((L/min)/mv) and Volume (ml/mv) conversions.

L2786

2-24 Chapter 2 Unpacking & Setup AVEA Ventilator Systems

Figure 2.33 Analog Ground Pins **

Note

At least one analog ground is required for safe and accurate signal output and input. One analog gro und is sufficient for
any and all of the other signals.

Table 2.3 ILV and Analog I/O pin configuration

PIN FUNCTION

1 Analog Input Channel 0
14 Analog Input Channel 1
18 ILV In
6 ILV Out
20 Factory Use Only. DO NOT CONNECT.
22 Analog Output, PRESSURE
23 Analog Output, FLOW
24 Analog Output, VOLUM E
25 Analog Output, BREATH PHASE
5, 9,10,11,12,13 Ground, Analog (see Note)

Video Output

Enables or disables the real time video output via the SVGA connector on the bottom of the UIM. Default position is off.

RS 232 Output

Sets the RS 232 output format for digital communications via the port labeled MIB.

Nurse Call Connection

The AVEA can be connected to a remote nurse call system via the modular connector on the rear panel shown in figure

2.20, E. The jack is configured to interface with normally closed (NC, open on alarm) or normally open (NO, closed on
alarm) signals. Cables for both systems are available from VIASYS Respiratory Care Inc.

L2786

Operator’s Manual Chapter 2 Unpacking & Setup 2-25

Date/Time Tab

Setting the Date.

Using the touch turn touch technique use the data dial to set the correct month, day and year prior to use of the

ventilator.

Setting the Time.

Using the touch turn touch technique use the d ata d ial to set the correct time in hours and minutes prior to use of the

ventilator.

Note

After changing the date and/or time, cycle the ventilator off, then on and select “NEW PT” to ensure coordination of the

EVENTS and TRENDS with the new date/time set.

L2786

2-26 Chapter 2 Unpacking & Setup AVEA Ventilator Systems

Powering up the AVEA

To power up the ventilator, connect the power cord to a suitable AC power supply and turn on the power switch located
on the back panel of the ventilator as shown here.

ON

Figure 2.34 Power Switch

The power up/reboot time for this instrument is approximately 7 seconds.

OFF

WARNING

A protective ground connection by way of the grounding conductor in the power cord is essential for safe
operation. If the protective ground is lost, all conductive parts, including knobs and controls, which may appear
to be insulated, can render an electric shock. To avoid electrical shock, plug the power cord into a properly
wired receptacle, use only the power cord supplied with the ventilator, and make sure the power cord is in good
condition.

WARNING

If the integrity of the external power earth conductor arrangement is in doubt, unplug the ventilator from the
mains AC and operate it from its internal battery or the optional external battery.

User Verification Test

WARNING

The User Verification Test should always be performed off patient.

The User Verification Test consists of the three following s ub-tests and should be performed before connection to a new
patient.

The POST test:

The POST or Power On Self Test is transparent to the user and will o nly message if the ventilator encounters
an error. Normal ventilation commences at the culmination of the POST.

L2786

Operator’s Manual Chapter 2 Unpacking & Setup 2-27

The Extended Systems Test (EST). During this test the ventilator will perform:

Patient circuit leak testing
Patient circuit compliance measurement
Two point calibration of the oxygen sensor

The Alarms Test consisting of verification for:

High Ppeak alarm High O
High Ppeak, Sust Low Ppeak alarm
Low Ve alarm Loss of AC alarm
High Ve alarm Circuit Disconnect
High Vt alarm High Rate Alarm
Low O
Low Vt alarm Low PEEP alarm

alarm Apnea Interval alarm

2

CAUTION

Although failure of any of the above tests will not prevent the ventilator from functioning, it should be checked to ma ke

sure it is operating correctly before use on a patient.

The Power on Self Test (POST)

This test is run automatically and performs the following checks:

Processor Self Check
ROM Check Sum
RAM Test

alarm

2

The POST will also check the audible alarms and the LEDs at which time the audible a larm sounds and the LEDs on the

User Interface Module flash. Normal ventilation commences at the culmination of the POST.

The Extended Systems Test (EST)

The EST function is accessed from the Setup screen as shown here. Press the SETUP membrane button to the lower

left of the UIM to open this screen.

L2786

2-28 Chapter 2 Unpacking & Setup AVEA Ventilator Systems

Press the EST touch screen icon to highlight.
A message will appear instructing you to remove

the patient and block the patient wye.
After confirming that the patient has been

disconnected and the circuit wye blocked press the
Continue (Cont) button.

The ventilator will perform the EST and display a
countdown clock.

During this test the ventilator will perform:

• Patient circuit leak test

• Patient circuit compliance measurement

• Two point calibration of the oxygen sensor

The patient circuit compliance measurement and
leak test are performed simultaneously with the
oxygen sensor calibration. The maximum time for
the EST is 90 seconds. To restart the EST at any
time select the Cancel button to return to the set up
screen.

After each test is complete the ventilator will
display a “Passed” or “Failed” message next to the
corresponding test.

Once the test is complete press the continue
button to return to the set up screen.

The “SET UP ACCEPT” key must be pressed in order for t he AVEA to retain the circuit compliance measurement. At
this point, even after power cycling off, if “SAME PT” is selected, the circuit compliance measurement will continue to be
retained. If “NEW PT” is selected, the EST will be required to use this feature.

Note

If you do not connect the ventilator to an oxygen supply, the O2 Sensor Calibration will immediately fail.

L2786

Operator’s Manual Chapter 2 Unpacking & Setup 2-29

The Alarms Test

Note:

To ensure proper calibration of the oxygen sensor, you should always perform an EST prior to conducting Manual

Alarms Testing.

WARNING

User Verification Testing should always be done off patient.

CAUTION

Following each alarm verification test, ensure that the alarm limits are reset to the recommended levels shown in this

chapter before proceeding to the next test.

Test Setup Requirements:

Adult Setting Pediatric Setting Neonate Setting
Air Supply Pressure
O2 Supply Pressure
AC Line Voltage
Patient Circuit
Compliance
Resistance

> 30 psig (2.1 bar) Same Same
> 30 psig (2.1 bar) Same Same
115 + 10 VAC Same Same
6’ (2 m) Adult 6’ (2 m) Adult Infant
20 ml/cmH2O 20 ml/cmH2O N/A
5 cmH20/L/sec 5 cmH20/L/sec N/A

To perform the Alarms Test on the AVEA ventilator using default settings, complete the following steps (A table

describing the default settings for Adult, Pediatric and Neonatal patient sizes is included at the end of the Alarms Test

section).

1. Make the appropriate connections for air an d O2 gas supply. Connect the power cord to an appropriate AC outlet. Attach
an appropriate size patient circuit an d test lung to the ventilator.

2. Power up the ventilator and select NEW PATIENT when the Patient Se lect Screen appears. Accept this selection by
pressing PATIENT ACCEPT. This will enable default settings for the Manual Alarms Test.

3. Select the appropriate patient size for your test (Adult, Pediatric or Neonate) from the Patient Size Select Screen.
Accept this selection by pressing SIZE ACCEPT. Set Humidifier Active off.

4. Make any desired changes or entries to the Ventilation Setup Screen and accept these by pressing SETUP ACCEPT.

5. Press Alarm Limits button on the upper right of the user interface.

6. Verify that no alarms are active and clear the alarm indicator by pressing the alarm reset button on the upper ri ght of the
user interface.

7. Set the % O2 control to 100%. Disconnect the Oxygen sens or from the back panel of the ventilator and verify that the
Low O
Remove sensor from back panel. Provide blow-by to the s ensor from an external oxygen flow meter. Verify that the High

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

2

L2786

2-30 Chapter 2 Unpacking & Setup AVEA Ventilator Systems

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

8. Set PEEP” to 0. Set Low PEEP alarm to 0. Disconnect the patient wye from the test lung. Verify that the Low Ppeak
alarm activates, followed by the Circuit Disconn ect a larm. This second alarm should activate after the default setting of
20 seconds for the apnea interval has elapsed. Reconnect the test lung to the circuit clear the alarm by pressing the
reset button.

9. Disconnect the AC power cord from the wall outlet. Verify that the Loss of AC alarm activates. Reconnect the AC power
cord. Clear the alarm by pressing the reset button.

10. Occlude the exhalation exhaust port. Verify that the High Ppeak alarm activates, followed 5 seconds later by the
activation of the High Ppeak, Sust. alarm.

11. Set the control setting for rate to 1 bpm. Verify that Apnea Interval alarm activates after the default setting of 20 seconds.
Return the control setting to its default value an d clear the alarm by pressing the reset button.

12. Set the Low PEEP alarm setting to a value above the default control setting for PEEP on your ventilator. Verify that the
Low PEEP alarm activates. Return the alarm setting to its default value and clear the alarm by pressing the reset button.

13. Set the High Ppeak alarm setting to a value below the measured peak pressure or in neonatal ventilation, the default
control setting for Inspiratory Pressure on your ventilator. Verify that the High Ppeak alarm activates. Return the alarm
setting to its default value and clear the alarm by pressi ng the reset button.

14. Set the Low Ve alarm setting to a value above the measured Ve on your ventilator. Verify that the Low Ve alarm
activates. Return the alarm setting to its default value an d clear the alarm by pressing the reset button.

15. Set the High Ve alarm setting to a value below the measured Ve on your ventilator. Verify that the High Ve alarm
activates. Return the alarm setting to its default value an d clear the alarm by pressing the reset button.

16. Set the High Vt alarm setting to a value below the set Vt on your ventilator. Verify that the High Vt alarm activates.
Return the alarm setting to its default value and clear the alarm by pressing the reset button.

17. Set the Low Vt alarm setting to a value above the set Vt on your ventilator. Verify that the Low Vt alarm activates. Return
the alarm setting to its default value and clear the alarm by pressing the reset button.

18. Set the High Rate alarm to a value below the default control setting for rate on your ventilator. Verify that the alarm
activates. Return the alarm to its default setting and clear the alarm by pressing the reset button.

19. Occlude the inspiratory limb of the patient circuit. Verity that the Circuit Occlusion alarm .activates.

CAUTION

Although failure of any of the above tests will not prevent the ventilator from functioning, it should be checked to ma ke
sure it is operating correctly before use on a patient.

L2786

Operator’s Manual Chapter 2 Unpacking & Setup 2-31

Default Settings for Adult, Pediatric and Neonate

The Default settings are the operational settings that take effect when you press the “New Patient” button on power up.

Ventilation Setup:

ET tube Diameter
ET Tube Length
Artificial Airway
Compensation
Leak
Compensation
Circuit
Compliance
Compensation
(Circ Comp)
Humidification
Patient Weight

Primary Controls:

Breath Type/Mode
Breath Rate (Rate)
Tidal Volume
(Volume)
Peak Flow
Inspiratory
Pressure (Insp
Pres)
Inspiratory Pause
(Insp Pause)
Inspiratory Time
(Insp Time)
PSV
PEEP
Inspiratory Flow
Trigger (Flow
Trig)
%O2

Adult Setting Pediatric Setting Neonate Setting

7.5 mm 5.5 mm 3.0 mm
30 cm 26 cm 15 cm

Off Off Off
Off Off Off

0.0 ml/cmH2O 0.0 ml/cmH2O 0.0 ml/cmH
NOT active in
Neonates.

Active On Active On Active On

1 kg 1 kg 1 kg

Adult Setting Pediatric Setting Neonate Setting

Volume A/C Volume A/C TCPL A/C

12 bpm 12 bpm 20 bpm

500 ml 100 ml 2.0 ml

60 L/min 20 L/min 8 L/min

15 cmH

0.0 sec 0.0 sec 0.0 sec

1.0 sec 0.75 sec 0.35 sec

0 cmH
6 cmH

1.0 L/min 1.0 L/min 0.5 L/min

O 15 cmH2O 15 cmH2O

2

O 0 cmH2O 0 cmH2O

2

O 6 cmH2O 3 cmH2O

2

40% 40% 40%

2

O

Advanced Settings:

Adult Setting Pediatric Setting Neonate Setting
Vsync
Vsync Rise
Sigh
Waveform
Bias Flow
Inspiratory
Pressure Trigger
(Pres Trig)
PSV Rise
PSV Cycle

L2786

0 (off) 0 (off) N/A

5 5 N/A

0 (off) 0 (off) N/A

1 (Dec) 1 (Dec) 1 (Dec)

2.0 L/min 2.0 L/min 2.0 L/min

3.0 cmH

O 3.0 cmH2O 3.0 cmH2O

2

5 5 5

25% 25% 10%

2-32 Chapter 2 Unpacking & Setup AVEA Ventilator Systems

Adult Setting Pediatric Setting Neonate Setting
PSV Tmax
Machine Volume
(Mach Vol)
Volume Limit
(Vol Limit)
Inspiratory Rise
(Insp Rise)
Flow Cycle
T High PSV
T High Sync
T Low Sync
Demand Flow

Alarm Settings:

Adult Setting Pediatric Setting Neonate Setting
High Rate
High Tidal Volume
(High Vt)
Low Tidal Volume
(Low Vt)
Low Exhaled
Minute Volume
(Low Ve)
High Exhaled
Minute Volume
(High Ve)
Low Inspiratory
Pressure (Low
Ppeak)
High Inspiratory
Pressure (High
Ppeak)
Low PEEP
Apnea Interval

5 sec 0.75 sec 0.35 sec

0 L 0 ml 0 ml

2.50 L 500 ml 300.0 ml
5 5 5

0% (off) 0% (off) 0% (off)

Off Off N/A
0% 0% N/A
0% 0% N/A

On On On

75 bpm 75 bpm 75 bpm

3.00 L 1000 ml 300 ml

0.0 L 0.0 ml 0.0 ml

1.0 L 0.5 L 0.5 L

30.0 L/min 30.0 L/min 5.0 L/min

8 cmH

40 cmH

3 cmH

O 8 cmH2O 5 cmH2O

2

O 40 cmH2O 30 cmH2O

2

O 3 cmH2O 1 cmH2O

2

20 sec 20 sec 20 se c

Auxiliary Controls:

Adult Setting Pediatric Setting Neonate Setting
Manual Breath --- --- ---

Suction

↑ O2
Nebulizer ---
Inspiratory Hold (Insp
Hold)
Expiratory Hold (Exp
Hold)

L2786

--- --- ---

79% 79% 20%

--- --- ---

--- --- ---

Operator’s Manual Chapter 2 Unpacking & Setup 2-33

AVEA User Verification Test Checklist

Machine Serial Number:________________________________ Test Date: __________________

TEST

Automated Tests

Power-on self test
Patient circuit leak test
Patient circuit compliance measurement
Two point calibration of the oxygen sensor

Manual Alarms Checks

High Rate Alarm
Low Vte Alarm
High Vte Alarm
Low Ve Alarm
High Ve Alarm
Low Ppeak Alarm
High Ppeak Alarm
Low PEEP Alarm
Apnea Interval Alarm
Extended High Ppeak Alarm
Circuit Disconnect Alarm
Circuit Occlusion Alarm
Loss of AC Alarm
High O2 Alarm
Low O2 Alarm

PASS FAIL

Signature of tester:_______________________________________________

Title___________________________________________________________

L2786

2-34 Chapter 2 Unpacking & Setup AVEA Ventilator Systems

AVEA Troubleshooting

Remove ventilator from patient with any potential problem

Symptom Problem Solution(s)

Will not pass EST - Fails Leak Circuit wye not fully occluded Ensure circuit wye is fully occluded

Leak in patient circuit Check for leaks in circuit and reseat

circuit connections to ventilator.
Replace circuit if necessary.

Filter cartridge not properly seated Remove exhalation cartridge and

check condition of connections.
Reinstall and recheck. Replace if
necessary

Leak in exhalation corner Replace exhalation diaphragm.

Will not pass EST - Fails O2
calibration

No reading from proximal flow sensor Sensor / Patient size incompatible See operators manual for correct

Vti > Vte when operating without
proximal flow sensors

Vte > Vti Normal if readings are within

Connector on O2 sensor not
connected properly

Inlet gas pressure too low Verify inlet air and oxygen pressure

Defective O2 sensor Replace O2 Sensor

Sensor not connected Ensure sensor properly connected
Loose external connection Check external connection

Defective sensor Replace sensor

Internal fault Call Technical Service

Normal Condition when operating
on test lung.

Normal if readings are within
ventilator accuracy specifications
of +/-10%
Defective expiratory flow sensor Clean/replace expiratory flow

Leak in patient circuit, water
collector or exhalation system

ventilator accuracy specifications
of +/-10%

Defective expiratory flow sensor Clean/replace expiratory flow

Leak in patient circuit, water

collector or exhalation system

Internal fault Call Technical Service

Check sensor connection

above 20psig

sensor/mode configurations

No action required

No action required if within
specification

sensor
Verify with leak test

No action required if within
specification

sensor
Verify with leak test

Volume waveform above or below
baseline on patient with internal
sensor

L2786

Humidifier "Active on/off" set
incorrectly

Set for "Active on” for humidifier,
"Active off" for “HME"

Operator’s Manual Chapter 2 Unpacking & Setup 2-35

Symptom Problem Solution(s)

Normal if readings are within

ventilator accuracy specifications
of +/-10%

Bad expiratory flow sensor Clean or replace expiratory flow

Internal fault Call Technical Service

Volumes become inaccurate over
time

Nebulizer output absent Ventilator running on compressor Connect wall air

FiO2 monitor inaccurate or reads "***" O2 sensor requires calibration Perform EST
PEEP too high Exhalation filter cartridge clogged

Foreign material on flow sensor Clean/replace sensor

Internal fault Call Technical Service

Flow less than 15 L/min Increase flow if appropriate

Internal fault Call Technical Service

O2 sensor at end of life Replace O2 Sensor

or saturated

No action required if within
specification

sensor

Replace cartridge

Defective exhalation diaphragm Change exhalation diaphragm

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

Power cord not connected to

mains power

Unit will not run properly on battery Battery not sufficiently charged Internal battery may require up to 4

Improper charge level indicator ­Internal battery

Improper charge level indicator ­External battery

Decreased run time on battery Battery not fully charged Internal battery may require up to 4

Excessively discharged battery Requires up to 4 hours for full

Excessively discharged battery Requires up to 12 hours for full

Loose connections Check connections

Defective battery Call technical Service

Check connections

hours for full charge. External
battery may require up to 12 hours
with green LED lit for a full charge.

charge

charge

hours for full charge. External
battery may require up to 12 hours
for a full charge.

L2786

2-36 Chapter 2 Unpacking & Setup AVEA Ventilator Systems

Symptom Problem Solution(s)

Does not run on compressor Internal fault Call Technical Service

Auto cycling Improper sensitivity settings Check flow and pressure trigger

settings

Circuit leaks Perform EST and correct leaks as

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

Demand Flow turned off Turn on Demand Flow
Vent INOP display System fault Call Technical Service
Low gas alarm on compressor Minute volume exceeds 40 L/min Reduce minute volume
"Loss of gas" alarm Air/Heliox connector not properly

connected

Internal fault Call Technical Service

Device Error indicator Defective sensor Replace sensor

Insure proper connection

NCPAP Pressure Limit

Low NCPAP Pressure

High NCPAP Pressure

Circuit Disconnect

Exhalation flow sensor not

connected

O2 sensor connector not

connected

Defective O2 sensor Replace O2 sensor

Internal fault Call Technical Service

Improper connection sequence External battery connection should

Occlusion of expiratory limb of

patient circuit.

Occluded expiratory filter

Circuit disconnect

Circuit leak

Patient interface leak

Patient circuit occlusion

Water in circuit

Patient interaction

Patient circuit disconnect Check patient circuit

Check connections

Check O2 sensor

be made with AC power
disconnected.

Check expiratory limb for kinks
and/or water

Replace expiratory filter

Check circuit
Check patient interface

Check patient circuit
Check nasal prongs

L2786

Operator’s Manual 3-1

Chapter 3 Ventilator Operation

Membrane Buttons and LEDs

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

L2786

3-2 Chapter 3 Ventilator Operation AVEA Ventilator Systems

Figure 3.1b User Interface Module (English) Showing Button Labels

The Membrane buttons are the UIM controls, which surround the Touch Screen. Moving clockwise around the UIM from
the top right (see arrow), they are:

A. Alarm Silence (LED)

Pressing this button will disable the audible p ortion of an alarm for 2 minutes (± 1 second) or until the Alarm Silence
button is pressed again. This button is not functional for a VENT INOP alarm.

Note

Pressing the alarm silence button will not prevent the audible alarms sounding again later for certain alarm conditions.

B. Alarm Reset

Cancels the visual indicator for alarms that are no lo nger active.

L2786

Operator’s Manual Chapter 3 Ventilator Operation 3-3

C. Alarm Limits

Opens the alarm limits screen for data entry or adjustment. Toggl es th e screen on and off.

Note:

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

D. Manual Breath

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

Note

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

E. Suction (LED)

Pressing this button initiates a “Disconnect for Suction” maneuver.
The ventilator will:

Enable an “Increase % O
While the circuit disconnect alarm is active, the vent ilator will stop cycling and set a bias flow. The venti lator will

automatically detect the patient upon reconnecti on and resume normal ventilation.
Silences alarms for 120 seconds.

If the SUCTION key is pressed again during the 2 minutes that the “disconnect for suction” maneuver is active, the
maneuver will be cancelled.

2” maneuver for 2 minutes (see Increase O2 below).

F. Increase O2

When this key is pressed, the ventilator increases the oxygen concentration delivered to the patient for 2 minutes. If the
↑ %O

key is pressed again within this two-minute period, the maneuver is cancelled and the ventilator will return to prior

2

settings.

Defaults: +20% Neonatal; 79% Adult/Pediatric
Adult/Pediatric: 79% above the set % O
Neonate: 20% above the set % O

To configure the Increase FiO2:

Access the Configuration tab on the Utilities Screen:

2

or 100%, whichever is less

2

L2786

3-4 Chapter 3 Ventilator Operation AVEA Ventilator Systems

Increase FiO2:

Configures the step increase

increase above the current set FiO2
Example: If the Increase FiO2 is set at 20%
AND
The set FiO2 is 40%
WHEN

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

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

.

The increase FiO2 Maneuver is activated the FiO2 will increase to 60% for two minutes after
which it will return to 40%.

Note

The settings will be reset to default values when New Patient is selected in the setup

Note

To achieve 100% delivered FiO2 during the Increas e O2 maneuver set the Increase FiO2 setting to its maximum of

79%.

WARNING

Heliox delivery will be interrupted for the time that either the “Suction” or the “Increase O2” buttons are pressed

during administration of Heliox. Tidal volume may be affected after the 2-minute “timeout” period, or when the

button is pressed, until the accumulator has been purged.

G. Data dial

Changes the values for a selected field on the tou ch screen.

H. Accept

Accepts data entered into a field on the touch screen.

I. Cancel

Cancels data entered into a field on the touch screen. The ventilator will continue to ventilate at current settings.

J. Expiratory Hold

When the EXP HOLD button is pressed, at the start of the next breath interval the ve ntilator will not allow the patient to

inspire or exhale for a maximum of 20 seconds (adult/pediatric) or 3 seconds (neonate). Expiratory Hold is NOT active

in TCPL breaths.

L2786

Operator’s Manual Chapter 3 Ventilator Operation 3-5

K. Inspiratory Hold (Manual)

When the INSP HOLD button is pressed, once the preset of a volume control or pressure control breath has been
delivered, the patient will not be allowed to exha le for a maximum of 3.0 seconds (± 0.1 second).

L. Nebulizer

The ventilator supplies blended gas to the nebulizer port at 10 ± 1.5 psig (0.7 bar) when an in-line nebulizer is attached
and the Nebulizer key is pressed, provided that the calculated delivered flow is >

Delivery of the nebulized gas is synchronize d with the inspiratory phase of a breath and lasts for 20 minutes. Press the
Nebulizer key a second time to end the treatment prior to the end of the 20-minute period.

15 L/min.

CAUTION

Use of an external flow source to power the nebulizer is not recommended.

WARNING

Using the nebulizer may impact delivered tidal volumes.

Note

Do not operate the nebulizer while using heliox

L2786

3-6 Chapter 3 Ventilator Operation AVEA Ventilator Systems

M. Patient Size

The Patient Size Indicators for Adult, Pediatric, and Neonate at the bottom of the UIM show which
patient size is currently selected. These LED indicators have no associated membrane button on the
UIM.

Note

The ventilator will not allow patient size chang es when the active mode of ventilation is not av ailable in the new patient

size selection. The ventilator will display a message instructing you to first change the ventilation mode. For example, in

neonatal ventilation with TCPL active, you cannot change to a pediatric or adult patient size without first changing the

mode to one available for those patients.

The ventilator will also not allow size changes if Machine Volume is active. A message displays indicating that Machine

Volume must first be turned off before making a patient size change.

N. Panel Lock (LED)

The LOCK key disables all front panel and screen contr ols except MANUAL BREATH, Suction,↑ %O2, ALARM RESET,

ALARM SILENCE, and LOCK.

O. Print

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

P. Set-up

Opens the ventilator Setup screen.

Note

Pressing the Set-Up button a second time before accepting Set-Up will close the window and restor e the previous

settings. The Set-Up screen uses an on screen accept button. To change patient size without selecting new patient

requires that patient Set-Up be accepted after selecting patient size.

Q. Advanced Settings (LED)

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

Note

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

the graphics.

L2786

Operator’s Manual Chapter 3 Ventilator Operation 3-7

R. Mode

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

Note

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

S. Event

Records an event for future reference. Some Events are recorded automatically others can be l ogged manually to
display in this screen. See Chapter 4, Monitors and Displays, for a full list of Events.

T. Freeze

The FREEZE key freezes the current screen and suspends real-time update of screen data until pressed again. While
the screen is frozen, a scrollable cursor appears. The Data Dial can be used to scroll the cursor through data points on
waveform, loop or trend screens. To restore the screen to active press the Freeze button a second time.

Figure 3.2 shows a flow/volume loop in “freeze” mode. The cursors trace the “frozen” loop curve along an X-Y plot line.
The values along the curve of the loop are displayed as shown below.

Flag showing X
and Y values at
various points

Dashed
Cursor Line

Flow/Volume
Loop Tracing

Figure 3.2 Flow/Volume Loop in Freeze Mode

along the loop
tracing

Cursor, currently
overlays the “X”
axis at Zero

L2786

3-8 Chapter 3 Ventilator Operation AVEA Ventilator Systems

U. Screens

Opens the Screen Selection box. See figure 3.3. You can also open this by pressing the Screen indicator in the top

center of the touch screen.

Note

Pressing the Screens button a second time closes the window.

V. Main

Returns the display to the main screen.

W. Alarm Status LEDs

The Alarm status indicators at the top right of the UIM flash red or yellow to indicate a high or medium priority alarm (See

chapter 5 Alarms and Indicators).

Figure 3.3 Screens Selection Box.

L2786

Operator’s Manual Chapter 3 Ventilator Operation 3-9

Patient Setup

Patient Select Screen

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

Figure 3.4 Patient Select Screen

If you press the Resume Current key, the ventilator begins ventilation at the most recent patient settings.
The New Patient key clears loops and trend buffers and resets all settings to default values.
Press Patient Accept to accept your selection.

Patient Size Select Screen

The Patient Size Select screen appears as the first step of the new
patient setup sequence.

Press the Size Accept button to accept your choices. The ventilator
Setup screen is revealed as the Patient Size Select scre en closes (see
Fig. 3.5).

Note

The new patient size selection will not be active until the on screen
SETUP ACCEPT button is pressed.

Figure 3.5 Patient Size Selection Screen

Note

The ventilator will not allow patient size chang es when the active mode of ventilation is not av ailable in the new patient
size selection. The ventilator will display a message instructing you to first change the ventilation mode. For example, in
neonatal ventilation with TCPL active, you cannot change to a pediatric or adult patient size without first changing the
mode to one available for those patients.

L2786

3-10 Chapter 3 Ventilator Operation AVEA Ventilator Systems

Ventilation Setup

Ventilation Setup Screen

Figure 3.6 Ventilation Setup

In the Setup screen, controls are available to set the following:

Artificial Airway Compensation (AAC)

Range ON/OFF
Default: OFF

When Artificial Airway Compensation is turned on, the ventilator automatically calculates the pres sure drop across the

endotracheal tube and adjusts the airway pressure to deliver the set inspiratory pressure to the distal (carina) end of the

endotracheal tube. This calculation takes into account flow, gas composition (Heliox or Nitrogen/Oxygen), Fraction of

Inspired Oxygen (FiO2), tube diameter, length, and pharyngeal curvature based on patient size (Neonatal, Pediatric,

Adult). This compensation only occurs during inspiration. Artificial Airway Compensation is active in all Pressure

Support and Flow Cycled Pressure Control Breaths.

Note:

Monitored airway pressures (inspiratory) will be higher than set values when Artificial Airway Compensation is active.

WARNING

Activation of Artificial Airway Compensation while ventilating a patient will cause a sudden increase in the peak

airway pressures and a resultant increase in tidal volume. Exercise caution when activating Artificial Airway

Compensation while the patient is attached to the ventilator to minimize the risk of excessive tidal volume

delivery.

Even if inspiratory pressure is set at zero, Artificial Airway Compensation will still provide an elevated airway pressure to

compensate for the resistance of the endotracheal tube.

L2786

Operator’s Manual Chapter 3 Ventilator Operation 3-11

When turned on, the Artificial Airway Compensation (AAC) indicator will appear on the touch screen in all modes of
ventilation, even though Artificial Airway Compe nsation may not be active in the current mode (i.e. in volume controlled
breaths). This is to alert you to the fact that Artificial Airway Compensation is turned on and will become active if a
Pressure Support mode or a combination mode (i.e.: Vo lume Control SIMV) is selected.

Tube Diameter:

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

5.5 mm (Pediatric)

3.0 mm (Neonate)

Tube length:

Range: 2.0 to 30.0 cm (Ad ult)

2.0 to 26.0 cm (Pediatric)

2.0 to 15.0 cm (Neonate)
Default: 30.0 cm (Adult)

26.0 cm (Pediatric)

15.0 cm (Neonate)

Leak Compensation (LEAK COMP)

Range ON/OFF.
Default: OFF

During exhalation, PEEP is maintained by the cooperation of the Flow Control Valve (FCV) and the Exh alation Valve
(ExV). The ExV pressure servo is set to a target pressure of PEEP and the FCV pressure servo is set to a pressure
target of PEEP - 0.4 cmH
when the pressure drops below its target up to a maximum flow rate for the patient size. It is not active during breath
delivery.

2O. The ExV servo relieves when the pressure is ab ove its target and the FCV supplies flow

Circuit Compliance

When Circuit Compliance is active, the volume of gas delivered during a volume controlled or targeted breath is
increased to include the set volume plus the volume lost due to the compliance effect of the circuit.

Exhaled volume monitors, are adjusted for the compliance compensation volume in all modes of
ventilation.

Range: 0.0 to 7.5 ml/cmH2O
Default: 0.0 ml/cmH
Circuit compliance can be measured automatically b y the ventilator during an Extended Systems Test (EST) or enter ed

manually.

2O

Note

Circuit Compliance is active for set Tidal Volume in volume control ventilation, Target Tidal Volume in PRVC and
Machine Volume in Adult and Pediatric ap plications only. Although circuit compliance is displayed on the set up

screen it is not active for neonatal patients.

L2786

3-12 Chapter 3 Ventilator Operation AVEA Ventilator Systems

Humidifier

You can select active or passive humidificati on (ON/active or OFF/passive). Active humidification assu mes 99% RH;

passive assumes 60% RH when using an H ME. This feature adjusts the BTPS correction factor to correct exhaled tid al

volumes.

Range: Active ON/OFF
Default: Active ON

Note:

Incorrect setting of the Humidification feature will affect monitored exhaled volume accuracy

Patient Weight

Patient Weight can be set in the following ranges.

Adult 1 to 300 Kg
Pediatric 1 to 75 Kg
Neonate 0.1 to 16 Kg

Default: 1 Kg

Patient weight is a variable determined by the clinici an and is used for the purpose of displaying monitor ed volume per

unit weight.

Identification

Patient ID. You may input a 24-character (two x 12-character), alphanumeric patient identification. To create a patient

ID, press the Touch Screen directly over the Pati ent IDENTIFICATION field.

A secondary screen appears showing the characters available for patient identification. Turn the data dial at the bottom

of the UIM (see figure 3.7) to scroll through the

characters. Press the ACCEPT membrane key to

accept each character and build your Patient ID

code. When the Patient ID code is complete, once

again press the Touch Screen directly over the

Patient IDENTIFICATION field to accept the entire

Patient ID code.

Check the rest of the screen parameters and if you

are satisfied with the setup, press the SETUP ACCEPT button.

Figure 3.7 Data Dial, Accept & Cancel Button

Note

Primary breath controls active for the selected (hig hlighted) mode are visible at the bottom of the touch screen during

setup. The Advanced Settings dialog box and the Alarm Limits dialog box can also be opened during setup. All controls

are active and may be modified while in the Set Up screen.

L2786

Operator’s Manual Chapter 3 Ventilator Operation 3-13

EST (Extended Systems Test)

From the Setup screen, press the EST button.
A message will appear instructing you to remove the

patient and block the patient wye. After confirming that
the patient is disconnected and the circuit wye blocked,
press Continue (Cont).

The ventilator begins the EST and displ ays a countdown
clock. During the EST the ventilator will perform:

A Patient circuit leak test.
A Patient circuit compliance measurement.
A two point calibration of the oxygen sensor

The patient circuit compliance measureme nt and leak
test are performed simultaneously with the oxygen
sensor calibration. The maximum time for the EST is 90
seconds. To restart the EST at any time, press Cancel to
return to the set up screen.

After each test is complete the ventilator will display a
“Passed” or “Failed” message next to the corresponding
test.

The “SET UP ACCEPT” key must be pressed in or der for
the AVEA to retain the circuit compliance measurement.
At this point, even after power cycling off, if “SAME PT” is
selected, the circuit compliance measurement will
continue to be retained. If “NEW PT” is selected, the
EST will be required to use this feature.

Figure 3.8 Extended Systems Test Screens

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

L2786

3-14 Chapter 3 Ventilator Operation AVEA Ventilator Systems

Note:

If the ventilator is NOT connected to an oxygen supply the O2 Sensor Calibration will immediately fail.

CAUTION

Although failure of any of the above tests will not prevent the ventilator from functioning, it should be checked to ma ke

sure it is operating correctly before use on a patient.

Setting the Ventilation Breath Type and Mode

To access the Mode selection options, press the Mode membrane button to the left of the LCD screen.

Figure 3.9 Adult and Pediatric Mode Select Screen

Figure 3.10 Infant Mode Select Screen

The choices displayed in the Mode Select screen are a combination of breath type and ventilation delivery mode (e.g. a

Volume limited breath with Assist /Control ventilation is shown as Volume A/C). APNEA Backup ventilation choices

appear when CPAP/PSV or APRV / BIPHASIC mode is selected. Apnea Backup is active in all Assist Control, SIMV,

APRV / BIPHASIC and CPAP/PSV modes.

L2786

Operator’s Manual Chapter 3 Ventilator Operation 3-15

Note

When CPAP/PSV or APRV / BIPHASIC (Airway Pressure Release Ve ntilation) is selected, you MUST

1. Set the primary and advanc ed se ttings for CPAP/PSV or APRV / BIPHASIC
2 Select the breath type for AP NEA backup mode by pressing the Apnea Settings key

3 Set the primary and advanced controls visible at the bottom of the touch screen, for the selected apnea breath type

before pressing the MODE ACCEPT button. The controls for the apnea breath type will not be visible once the
MODE ACCEPT button has been pressed. Only those controls that are active and required for CPA P/PSV or APRV
/ BIPHASIC will remain. To review the Apnea backup settings press the Mode button at any tim e and select APNEA
Settings.

Breath Types

This section contains a brief description of the breath types and ventilation mode combination s available for adult,
pediatric and neonatal patients.

There are two basic breath types:

Mandatory breaths (delivered according to set ventilator parameters)

and

Demand breaths (triggered by the patient)

All breaths are defined by four variables:

Trigger (initiates the breath),
Control (controls the delivery),
Cycle (primary breath termination), and
Limit (secondary breath termination).

Mandatory Breaths

Mandatory breaths can be triggered by the machine, the p atie nt, or the operator. There are 4 mandatory breath types
delivered by the AVEA.

1. Volume breaths, which are:

• Controlled by flow (inspiratory);

• Limited by pre-set volume or maximum inspiratory pressure.

• Cycled by volume, flow, and time.

Note.

The Volume Controlled breath is the default breath type for adult and pediatric patients.

The Intra-Breath Demand System in Volume Ventilation

AVEA features a unique intra-breath demand system in Volume Controlled ventilation, designed to provide
additional flow to the patient during periods of demand. AVEA measures the Peak Inspir atory Pressure (Ppeak)

L2786

3-16 Chapter 3 Ventilator Operation AVEA Ventilator Systems

every 2 milliseconds throughout the breath cycle and sets a “virtual” Pres sure Support Target of the greater of:
PEEP + 2 cmH

O or Ppeak – 2 cmH2O.

2

The minimum “virtual” Pressure Support level is set PEEP + 2 cmH
The maximum is 2 times the set PEEP.
Simultaneously, the ventilator monitors and compar es the Ppeak measurement to its previous value. Should the

Ppeak decrease by the 2 cmH
deliver a Pressure Support breath at the virtual Pressure Support Target. This allows flow to exceed th e set Peak
Flow, thereby meeting the patient’s demand.

Once the set tidal volume has been deliv ered, the ventilator “looks” at the inspiratory flow. If the Peak Inspiratory
Flow is greater than set peak flow, the ventilator determine s that the patient is continuing to demand flow and cycles
the breath when inspiratory flow falls to 25% of peak inspir atory flow. If the Peak inspiratory Flow is equal to the set
flow, the ventilator determines that there is no continued patient demand and ends the breath as a Volume Control
breath.

Default is on. Can be turned off by accessing advanc ed setting of Peak Flow in Volume Controlled Vent ilation.

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

2

2

O.

2. Pressure breaths, which are:

• Controlled by pressure (inspiratory + PEEP);

• Limited by pressure (inspiratory + PEEP + margin);

• Cycled by time or flow.

3. Time Cycled Pressure Limited (TCPL) breaths (available for neonatal patients only), which are:

• Controlled by inspiratory flow;

• Limited by pressure (inspiratory + PEEP);

• Cycled by time, flow (inspiratory), or volume (Volume Limit).

Note

TCPL breath type is only available for Neonates. This is the default breath type for neonate patients.

Note

The ventilator will not allow the operator to set a Peak Inspiratory Pressure (Insp Pres or PSV + PEEP, or baseline

pressure in APRV / BiPhasic, greater than 90 cmH

that the Ppeak > 90 cmH

to less than or equal to 90 cmH

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

2

O.

2

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

2

WARNING

Total resistance of the inspiratory and expiratory limbs of the breathing circuit with accessories should not

exceed 4cmH2O at 5 L/min if inspiratory flows > 15 liters per minute are used in TCPL ventilation modes. For

instructions on how to perform a circuit resistance test see Appendix E.

L2786

Operator’s Manual Chapter 3 Ventilator Operation 3-17

4. Pressure Regulated Volume Control (PRVC) breaths are pressure breaths where the press ure level is

automatically modulated to achiev e a preset volume. PRVC breaths are:

• Controlled by pressure (inspiratory + PEEP) and vo lume;

• Limited by pressure (inspiratory + PEEP + margin);

• Cycled by time or flow.

PRVC breath operation is as follows:
When PRVC is selected, a decelerating flow, volume controlled test breath, to the set tidal volume with a 40 msec

pause, is delivered to the patient. The demand system is active during this test breath.

The ventilator sets the target pressure at the end insp iratory pressure of the test breath for the first pressure control

breath.

The next breath and all subsequent breaths are delivered as pressure control breaths. The inspiratory pressure is

based on the dynamic compliance of the prev ious breath and the set tidal volume.

Inspiratory pressure is adjusted automatically by the ventilator to maintain the target volume. The maximum step
change between two consecutive bre aths is 3 centimeters of water pressure. The maximum tidal volume delivered
in a single breath is determined by the Volume Limit setting.

The test breath sequence is initiated when any of the fo llowing occur:

Entering the Mode (PRVC)
Changing the set tidal volume while in PRV C
Reaching the Volume Limit setting
Delivered tidal volume >
Flow termination of the test breath
Exiting Standby
Activation of any of the following alarms

High Peak Pressure Alarm
Low Peak Pressure Alarm
Low PEEP Alarm
Patient Circuit Disconnect Alarm
I-Time Limit
I:E Limit

1.5 times the set volume

Note

If flow cycling is active during a PRVC or Vsync breath flow cycling of the breath can only occur if the target tidal volume
has been delivered. This allows for expiratory synchrony while assuring delivered tidal volume.

Note

Demand Flow is active for all mandatory breaths. The maximum peak inspiratory pressure achievable by the

ventilator is limited by the high peak pressure alarm setting.

L2786

3-18 Chapter 3 Ventilator Operation AVEA Ventilator Systems

Demand Breaths

All demand breaths are patient-triggered, con trolled by pressure, and flow or time cycled. Demand breaths can be either

pressure supported (PSV) or spontaneous. All demand breaths are accompanied by the yellow patient demand

indicator, which flashes in the upper left of the screen.

1. PSV (Pressure Support Ventilation)

A PSV breath is a demand breath in which the pressure level during inspiration is a preset PSV level plus PEEP.
The minimum pressure support level is PEEP + 2 cmH
PSV pressure level. In neonatal applications the minimum pressure support level is zero.

PSV breaths are:

• Controlled by pressure (preset PSV level + PEEP);

• Limited by pressure (preset PSV level + PEEP)

• Cycled by time (PSV T

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

max) or flow (PSV Cycle).

O in adult and pediatric applications, independent of the set

2

Note

The ventilator will not allow the operator to set a Peak Inspiratory Pressure (Insp Pres or PSV + PEEP, or baseline

pressure in APRV / BiPhasic, greater than 90 cmH

that the Ppeak > 90 cmH

to less than or equal to 90 cmH

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

2

O.

2

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

2

2. Spontaneous breath

In adult and pediatric applications, a Spontaneous breath is a demand breath where the pressure level during
inspiration is preset at PEEP + 2 cmH

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

2

O.

Note

IF PSV level is insufficient to meet patient demand, premature termination of the breath may occur with auto-cycling. In

these cases the PSV level should be increas ed slightly.

Figure 3.11 PSV Waveform

In figure 3.11breath number 1 represents the flow tracing which occurs when the PSV level is insufficient to meet the

patient demand. Breath two shows resolution after increasing the PSV level slightly. (Pressure tracing will show a similar

appearance).

L2786

Operator’s Manual Chapter 3 Ventilator Operation 3-19

p

Ventilation Modes

Leak Compensation.

The ventilator incorporates a leak compensation system. This system compensates for baseline leaks at the patient ­interface. To activate leak compensation, use the touch screen control displayed in the Setup scree n.

Assist Control Ventilation (A/C)

This is the default mode for all patient types. In Assist Contro l ventilation mode, all breaths initiated and delivered are
mandatory breaths. The initiation of a breath is triggered by one of the following:

• Patient effort activates the inspiratory trigger mechanism,

• The breath interval, as set by the RATE control, times out,

• The operator presses the MANUAL BREATH key.

Initiation of a breath by any means resets the breath interval timing mechanism. It is possible for the pa tient to initiate
every breath if he/she is breathing faster than the preset breath rate. If the patient is not actively breathi ng, the ventilat or
automatically delivers breaths at the preset in terval (set breath rate).

PRESSURE

1 Mandatory Breath (Breath interval expired)
2 Mandatory Breath (Patient triggered)

Breath Interval
ela

sed

Breath Interval
elapsed

TIME

Figure 3.12 Assist Control Ventilation Waveform

L2786

3-20 Chapter 3 Ventilator Operation AVEA Ventilator Systems

Synchronized Intermittent Mandatory Ventilation (SIMV)

In SIMV mode, the ventilator can deliver both mandatory and demand breath types. Mandatory breaths are delivered

when the SIMV “time window” is open and

A patient effort is detected;
The breath interval has elapsed with no patient effort detected;
The MANUAL BREATH key has been pressed.

Pressure

one of the following occurs:

Time

Assist Window Open
Patient triggered Volume breath
Pressure supported breath

Figure 3.13 SIMV Waveform

The breath interval is established by the preset br eath rate. It resets as soon as the interval time determined by the set

breath rate has elapsed, or when the MANUAL BREATH key is pressed.

L2786

Operator’s Manual Chapter 3 Ventilator Operation 3-21

Airway Pressure Release Ventilation (APRV / BIPHASIC)

APRV / BiPhasic is a Time Cycled Pressure mode in whic h the ventilator cycles between two different baseline
pressures based on time, which can be synchro nized with patient effort. Controlled ventilation can be maintained by
timed cycling the transitions between baseline pressures. Additionally, pressure support can be added to improve
comfort for the spontaneous breathing patient.

In this mode, the patient is allowed to breathe spontaneously at two preset pressure levels. These are set using the

Pres High and Pres Low controls. The maximum duration at each pressure during time cycling is set with the Time
High and Time Low controls.

The operator can also adjust the length of the respective trigger (Sync) windows with the Time High and Time Low Sync
controls, which are advanced settings of Time High and Time L ow. The Sync windows are adjustable from 0 to 50%, in
5% increments of set Time High and Time Low.

The ventilator synchronizes the change from Pressure Low to Pressure High with the detection of inspiratory flow or the
first inspiratory effort detected within the T Low Sync window. Transition from Pressure High to Pressure Low occurs
with the first end of inspiration detected after the T High Sync window opens.

Note

Time High and Time Low are maximum time settings for a time-cycled transition. Actual times may vary depending on
the patient’s spontaneous breathing pattern and the Sync window setting.

Setting the Sync to 0% cycles the transition between pressure levels on time only and will not provide synchronization
with patient efforts.

The Manual Breath button is not active in APRV / BiPh asic.
The monitored PEEP in APRV/BIPHASIC is relative to the breath type. In the absence of spontaneous breathing, the

monitored PEEP will be the Pressure Low. In the presence of spontaneous breathing the monitored PEEP will reflect the
baseline pressure over which spontaneous breathing is occurred.

Adjustable PSV in APRV / BiPhasic

APRV / BiPhasic features adjustable PSV. The PSV is delivered above the current phase baseline pressure. PSV
breaths are available during Time High also, by activating T High PSV (an advanced setting of Time High). If T High
PSV is activated, during Time High, the ventilator will deliver the same PSV level for both Pressure Low and Pressure
High.

Note

The ventilator will not allow the operator to set a Peak Inspiratory Pressure (Insp Pres or PSV + PEEP, or baseline
pressure in APRV / BiPhasic, greater than 90 cmH
that the Ppeak > 90 cmH
to less than or equal to 90 cmH

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

2

O.

2

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

2

L2786

3-22 Chapter 3 Ventilator Operation AVEA Ventilator Systems

Apnea Ventilation in APRV / BiPhasic

Apnea ventilation is available in APRV / BiP hasic. If the patient does not initiate a spontaneous eff ort, or the venti lator

does not time cycle between pressure levels before the apnea interval has elapsed, the ventilator will alarm for apnea

and begin apnea ventilation at the apnea ventilation settings. A spontaneous effort from the patient or a transition in

baseline pressure will reset the apnea alarm and timer and return the ventilator to APRV / BiPhasic ventilation.

Airway Pressure Release Ventilation

(APRV / BIPHASIC)

Time High
Pressure High

Pressure

Time Low
Pressure Low

Time

Demand Breath
Spontaneous Breath triggers change to Pressure High

Spontaneous Breath triggers change to Pressure Low

Figure 3.14 APRV / BIPHASIC Mode

L2786

Operator’s Manual Chapter 3 Ventilator Operation 3-23

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

Pressure

Time

Demand Breath

Figure 3.15 CPAP Waveform

In CPAP/PSV mode, all breaths are patient-initiated demand breaths unless the MANUAL BREATH key is pressed or
apnea backup ventilation is activated. When the MANUAL BREATH key is pressed, a single breath is delivered at the
currently selected apnea backup control settings.

Pressure Support is active in CPAP mode (see Demand Breaths in this Chapter).

CAUTION

When CPAP/PSV is selected, you must

1. Select the breath type for APNEA backup mode AND

2. Set the primary controls visible at the bottom of the touch screen, for the selected apnea breath type before pressing
the MODE ACCEPT button. The controls for the apnea breath type will not be visible once the MODE
ACCEPT button has been pressed. Only those controls that are active and required for CPAP/PSV will remain.
To review the settings for Apnea backup ventilation open the mode window, and select Apnea Settings

Note

IF PSV level is insufficient to meet patient demand, premature termination of the breath may occur with auto-cycling. In
these cases the PSV level should be increas ed slightly.

L2786

3-24 Chapter 3 Ventilator Operation AVEA Ventilator Systems

Figure 3.16 PSV Waveform

In figure 3.16 breath number 1 represents the flow tracing which occurs when the PSV level is insufficient to meet the
patient demand. Breath two shows resolution after increasing the PSV level slightly. (Pressure tracing will show a similar
appearance).

Non-Invasive Ventilation

The ventilator can perform non-invasive ventilation with a standard dual limb circuit. Leak compensation should be
turned on when using this feature. To turn leak compensation on, use the touch screen control displayed in the Ventilator
Set-Up Screen.

NOTE

Non invasive ventilation requires the use of a snug fitting mask with no bleed holes. Excessive leaks around the mask
may result in false triggering of the ventilator or assertion of disconnect alarms.

Apnea Backup Ventilation

Apnea Backup Ventilation is available in Assist Control, SIMV, CPAP/PSV and APRV / BIPHASIC modes.

Apnea Backup in Assist Control or SIMV

When in Assist Control or SIMV modes, the apnea backup rate is determined by the operator-set mandatory br eath Rate
or the Apnea Interval setting (whichever provides the highest respiratory rate).

When the Apnea Interval setting (found in the Alarm Limits window) determines the backup rate, the ventilator will
continue to ventilate at this rate until the apnea has been resolved.

All other controls for apnea ventilation in Assist Control an d SIMV are set when the primary control values for these
modes are selected.

Apnea ventilation will terminate when one of the following criteria are met:

• The patient initiates a spontaneous breath

• A manual breath is delivered

• The mandatory respiratory rate is increased above the apnea interval setting.

NOTE

The apnea interval timer is suspended during a Patient Circuit Disconnect Alarm.

L2786

Operator’s Manual Chapter 3 Ventilator Operation 3-25

Apnea Backup in CPAP/PSV or APRV / BIPHASIC

When CPAP/PSV or APRV / BIPHASIC is selected, you MUST:

1. Set the primary and advanc ed se ttings for CPAP/PSV or APRV / BIPHASIC and

2. Select the breath type for APNEA backup mode (Volume or Pressure in adult and pediatric patients or
Volume, Pressure or TCPL in neonatal patients) by pressing the Apnea Settings key.

3. Set the primary and advanced controls appearing at the bottom of the touch screen, for the selected apnea
breath type before pressing the MODE ACCEPT button. The controls fo r apnea backup ventilation will

not be visible once the MODE ACCEPT button has been pressed. Only the controls that are active
and required for CPAP/PSV or APRV / BIPHASIC will remain.

See figures 3.17 to 3.20 for Apnea backup settings available in each mode.

Figure 3.17 Volume Apnea Backup Settings for APRV / BIPHASIC mode

L2786

3-26 Chapter 3 Ventilator Operation AVEA Ventilator Systems

Figure 3.18 Pressure Apnea Backup setting for APRV / BIPHASIC Mode

Figure 3.19 Volume Apnea Backup settings for CPAP Mode

L2786

Operator’s Manual Chapter 3 Ventilator Operation 3-27

Figure 3.20 Pressure Apnea Backup settings for CPAP mode

Apnea ventilation will terminate when one of the following criteria are met:

• The patient initiates a spontaneous breath

• A manual breath is delivered

• A timed transition between baseline pressures in APRV / BiPhasic

To review the Apnea backup settings press the Mode button at any time a nd select APNEA Settings.

Note

When changing from a controlled mode of ventilation to CPAP/PSV or APRV / BIPHASIC, the default apnea settings will
be the same as those set in the controlled mode. If a New Patient is selected, the default apnea settings are the same
as the factory set default settings for each of the controlled modes.

Note

The current set FiO2 is delivered during Apne a ve ntilation.

L2786

3-28 Chapter 3 Ventilator Operation AVEA Ventilator Systems

Standby

To initiate Standby, press the Screens membrane butto n on the UIM identified by the icon shown here.

The Screen Select box will display, see figure 3.21.

Figure 3.21 Screen selection

Press STANDBY. The following message will display

Figure 3.22 Standby Message

If you select “YES”, the ventilator will stop ventilating, the safety valve will close and the ventilator will supply 2 L/min of
gas continuously to the patient circuit and will display th e message shown in figure 3.22.

L2786

Operator’s Manual Chapter 3 Ventilator Operation 3-29

Figure 3.23 Standby Screen

To resume patient ventilation, press the Resume button. The ventilator will restart ventilation at the most recent settings.
Do not re-connect the patient to the ventilator until the RESUME button has been pressed and ventilation has restarted.

CAUTION

The 2 liters of bias flow, which is maintained during standby, is intended to reduce the risk of circuit ov erheating in the
event an active humidifier is in use and left on.
To ensure flow through the entire ventilator circuit, the patient wye should be plugged to direct flow down the expiratory
limb of the circuit. Failure to do this may result in damage to the ve ntilator circuit if the humidifier is left on. Consult the
circuit manufacturer to confirm that 2 L/min of flow is sufficient to prevent overheating.

L2786

3-30 Chapter 3 Ventilator Operation AVEA Ventilator Systems

Available Breath Types & Modes by Patient Size

Adult and Pediatric Ventilation Modes

The following breath types & ventilation modes are available for Adult and Pediatric patients. When a mode is selected,
its description is displayed at the top left of the touch screen.

Table 3.1 Adult and Pediatric Displayed Modes

Displayed Mode Description

Volume A/C
Pressure A/C
Volume SIMV

Pressure SIMV

CPAP / PSV

PRVC A/C

PRVC SIMV

APRV /

BIPHASIC

Volume breath with Assist ventilation (Default for adult and pediatric patients)
Pressure breath with Assist ventilation
Volume breath with Synchronized Intermittent Mandatory Ventilation (SIMV) and an adjustable level

of pressure support for spontaneous breaths.
Pressure Breath with Synchronized Intermittent Mandatory Ventilation (SIMV) and an adjustable level

of pressure support for spontaneous breaths.
Continuous Positive Airway Pressure (Demand Breath) with Pressure Support Ventilation

Pressure Regulated Volume Controlled breath with Assist Ventilation
Pressure Regulated Volume Controlled breath with Synchronized Intermittent Mandatory Ventilation

(SIMV) and an adjustable level of pressure support for spontaneous breaths.
Spontaneous demand breath at two alternating baseline pressure lev els or contro lle d ven til atio n

cycled by time.

Neonatal Ventilation Modes

The following table shows the breath types and ventilation modes available for Neonatal patients

Table 3.2 Neonatal Displayed Modes

Displayed Mode Description

Volume A/C
Pressure A/C
Volume SIMV

Pressure SIMV

TCPL A/C

TCPL SIMV

CPAP / PSV

Volume breath with Assist ventilation (Default for adult and pediatric patients)
Pressure breath with Assist ventilation
Volume breath with Synchronized Intermittent Mandatory Ventilation (SIMV) and an adjustable level

of pressure support for spontaneous breaths.
Pressure Breath with Synchronized Intermittent Mandatory Ventilation (SIMV) and an adjustable level

of pressure support for spontaneous breaths.
Time Cycled Pressure Limited breath with Assist ventilation (Default for neonatal patients)

Time Cycled Pressure Limited breath with SIMV and an adjustable level of pressure support for
spontaneous breaths.

Continuous Positive Airway Pressure (Demand Breath) with Pressure Support Ventilation

L2786

Operator’s Manual Chapter 3 Ventilator Operation 3-31

Primary Breath Controls

The Primary Breath Controls are the operator set controls, which directly affect the wa y a breath is delivered to your
patient. They are displayed along the bottom of the A VEA LCD touch screen. Only the active controls for the selected
mode of ventilation will be displayed.

Table 3.3 Primary Breath Controls

Displayed

Control

bpm
Rate

ml

Volume

cmH2O

Insp Pres

L/min

Peak Flow

sec

Insp Time

sec

Insp Pause

cmH2O

PSV

cmH2O

PEEP

L/min

Flow Trig

%

2

%O

cmH2O

Pres High

sec

Time High

sec

Time Low

cmH2O

Pres Low

Description Range Accuracy

Breath rate shown in Breaths
per Minute

Tidal Volume in milliliters 0.10 to 2.50 L (Adult)

Inspiratory Pressure in
centimeters of water pressure

Peak Inspiratory Flow in Liters
per Minute

Inspiratory Time in Seconds 0.20 to 5.00 sec

Sets an inspiratory pause which
will be in effect for each Volume
breath delivered

Pressure Support in centimeters
of water pressure

Positive end expiratory pressure
in centimeters of water pressure

Sets inspiratory flow trigger
point in liters per minute

Controls the percentage of
oxygen in the delivered gas.

In APRV / BIPHASIC mode,
controls the baseline pressure
achieved during Time High.

In APRV / BIPHASIC mode sets
the minimum time for which the
high-pressure setting is
maintained.

In APRV / BIPHASIC mode sets
the minimum time for which the
low pressure setting is
maintained.

In APRV / BIPHASIC mode
controls the baseline pressure
achieved during Time Low.

1 to 150 bpm (Neo / Pediatric)
1 to 120 bpm (Adult)

25 to 500 ml (Pediatric)

2.0 to 300 ml (Neonate)
0 to 90 cmH2O (Adult/Pediatric)
0 to 80 cmH2O (Neonate)
3 to 150 L/min (Adult)
1 to 75 L/min (Pediatric)

0.4 to 30.0 L/min (Neonate)

(Adult/Pediatric)

0.15 to 3.00 sec (Neonate)

0.0 to 3.0 sec ± 0.10 sec

0 to 90 cmH2O (Adult/Pediatric)
0 to 80 cmH2O (Neonate)
0 to 50 cmH2O

0.1 to 20.0 L/min

21% to 100%

0 to 90 cm H

0.20 to 30.0 sec ± 0.1 sec

0.20 to 30.0 sec

0 to 45 cmH

2O ± 3 cmH2O

2O

± 1 bpm

± (0.2 ml + 10% of setting)

± 3 cmH2O or ± 10% whichever is greater

± 10% of setting or ± (0.2 L/min + 10% of
setting), whichever is greater

± 0.10 sec

± 3 cmH2O or ± 10% whichever is greater

± 2 cmH

2

greater
+ 1.0 / − 2.0 L/min ( for PEEP <
+ 2.0 / − 3.0 L/min ( for PEEP > 30 cmH2O)
± (0.2 L/min + 10% of setting) (Wye flow

sensor only)
± 3% O

2

± 0.1 sec

± 2 cmH

2

greater

O or ± 5% of setting, whichever is

O or ± 5% of setting, whichever is

30 cmH2O)

L2786

3-32 Chapter 3 Ventilator Operation AVEA Ventilator Systems

To Activate a Primary Control:

To activate a primary breath control, press t he touch screen directly over the
control. The control highlights (changes color) indicating that it is active.

Figure 3.24 Highlighted Control

To modify the settings for the highlighted control, turn the data dial
below the touch screen (see figure 3.25). Turning in a clockwise
direction increases the selected value, turning counterclockwise
decreases it.

Figure 3.25 Data dial.

To accept the displayed value, either pre ss the touch screen directly over the highlighted control or press the ACCEPT
membrane button to the left of the data dial. The control color will change back to normal and the ve ntilator will begin
operating with the new setting. If you press the CANCE L b utton or do not actively accept the new setting within 15
seconds, ventilation will continue at the previous settings.

L2786

Operator’s Manual Chapter 3 Ventilator Operation 3-33

Descriptions of Primary Breath Controls

Breath Rate (Rate)

The breath rate control sets the breath interval. Its function is dependent upon the selected mode of ventilation and it has
different effects on the breath cycle, depending on which mode is selected.

Range: 1 to 150 bpm (Neonate / Pediatric)
1 to 120 bpm (Adult)
Breath Interval: (60/Rate) sec.
Defaults: 12 bpm (Adult)
12 bpm (Pediatric)
20 bpm (Neonate)

Tidal Volume (Volume)

A volume breath delivers a predetermined v olume of gas to the patient. Tidal Volume, together with the Insp Flo w, and
Waveform settings determine how the volume breath is delivered.
Range: 0.10 to 2.50 L (Adult)
25 to 500 ml (Pediatric)

2.0 to 300 ml (Neonate)
Defaults: 0.50 L (Adult)
100 ml (Pediatric)

2.0 ml (Neonate)

Sigh: 1.5 x Volume (Adult/Pediatric only)

Note

When operated from the internal compressor, the maximum Tidal Volume that the ventilator can achieve is 2.0 L.
The maximum minute volume that the ventilator is capable of delivering using wall gas supply is at least 60L and using
internal compressor is 40L.

Inspiratory Pressure (Insp Pres)

During a mandatory pressure breath, the ventilator controls the inspiratory pressure in the circuit. For Pressure & TCPL
breaths, the pressure achieved is a combination of th e preset Insp. Pres. level plus PEEP.
Range: 0 to 90 cmH
0 to 80 cmH
Maximum Flow: > 200 L/min (Adult)
<
<

120 L/min (Pediatric)
50 L/min (Neonate)

Default: 15 cmH

Note

The ventilator will not allow the operator to set a Peak Inspiratory Pressure (Insp Pres or PSV + PEEP, or baseline
pressure in APRV / BiPhasic, greater than 90 cmH
that the Ppeak > 90 cmH
to less than or equal to 90 cmH

O (Adult/Pediatric)

2

O (Neonate)

2

O

2

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

2

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

2

O.

2

L2786

3-34 Chapter 3 Ventilator Operation AVEA Ventilator Systems

Peak Flow

Peak flow is the flow delivered by the ventilator during the inspiratory phase of a mandatory volume or TCPL breath.
Range: 3 to 150 L/min (Adult)
1 to 75 L/min (Pediatric)

0.4 to 30.0 L/min (Neonate)
Defaults: 60 L/min (Adult)
20 L/min (Pediatric)

8.0 L/min (Neonate)

Inspiratory Time (I-Time)

The I-Time control sets the inspiratory time cycle variable for all mandatory pressure, TCPL or PRVC breaths.
Range: 0.20 to 5.00 seconds (Adult/Pediatric)

0.15 to 3.00 seconds (Neonate)
Default: 1.0 second (Adult)

0.75 seconds (Pediatric)

0.35 second (Neonate)

Note

If the preset I-Time is greater than actual I- Time (as determined by Vt, FP, and the waveform), an Inspiratory Pause time
equal to the preset I-Time minus the actual I- Time is added to the breath.

Inspiratory Pause (Insp Pause)

Sets an Inspiratory Pause, which will be in effect for each vol ume breath delivered.
A preset inspiratory pause will be delivered with each volume breath.
Range: 0.00 to 3.00 seconds

Default: 0.00 second

PSV (Pressure Support)

The PSV control sets the pressure in the circuit during a pressure supported breath.
Range: 0 to 90 cmH
0 to 80 cmH
Maximum Flow: > 200 L/min (Adult)
<
<
Default: 0 cmH

120 L/min (Pediatric)
50 L/min (Neonate)

Note

The ventilator will not allow the operator to set a Peak Inspiratory Pressure (Insp Pres or PSV + PEEP, or baseline
pressure in APRV / BiPhasic, greater than 90 cmH
that the Ppeak > 90 cmH
to less than or equal to 90 cmH

O (Adult/Pediatric)

2

O (Neonate)

2

O

2

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

2

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

2

O.

2

L2786

Operator’s Manual Chapter 3 Ventilator Operation 3-35

Note

In adult and pediatric ventilation, a minim um of 2 cmH2O of PSV above PEEP is applied even when the control is set to
zero.

Note

IF PSV level is insufficient to meet patient demand, premature termination of the breath may occur with auto-cycling. In
these cases the PSV level should be increas ed slightly.

Figure 3.26 PSV Waveform

In figure 3.26 breath number 1 represents the flow tracing which occurs when the PSV level is insufficient to meet the
patient demand. Breath two shows resolution after increasing the PSV level slightly. (Pressure tracing will show a similar
appearance).

Note

Monitored airway pressures (inspiratory) will be higher than set when AAC is active. With an ins piratory pressure setting
of zero, AAC will still provide an elevated airway pressure, to compensate for the resistance of the endotracheal tube.

Positive End Expiratory Pressure (PEEP)

PEEP is the pressure that is maintained in the patient circuit at the end of exhalation.
Range: 0 to 50 cmH
Defaults: 6 cmH

3 cmH

O

2

O (Adult/Pediatric)

2

O (Neonate)

2

Note

The ventilator will not allow the operator to set a Peak Inspiratory Pressure (Insp Pres or PSV + PEEP, or baseline
pressure in APRV / BiPhasic, greater than 90 cmH
that the Ppeak > 90 cmH
to less than or equal to 90 cmH

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

2

O.

2

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

2

L2786

3-36 Chapter 3 Ventilator Operation AVEA Ventilator Systems

Inspiratory Flow Trigger (Flow Tr ig)

The inspiratory trigger mechanism* is activated when the Net Flow becomes greater than the Inspiratory Flow Trigger
setting. Net Flow is defined as [Delivered Flow − Exhaled Flow] (or Wye Inspiratory Flow when using a wye flow
sensor). When the Inspiratory Flow Trigger is enabled, a l ow level of Bias Flow is delivered to the patient circuit during
the exhalation phase of the breath.

Range: 0.1 to 20.0 L/min
Defaults: 1.0 L/min (Adult/Pediatric)

0.5 L/min (Neonate)

*See Also Pressure Trigger in Advanced Settings, this chapter.

Note

To ensure adequate bias flow for inspiratory triggering the bias flow setting should be at least 0.5 liters per minute
greater than the flow trigger threshold.

%O2

The % O2 control sets the percentage of oxygen in the delivered gas.
Range: 21 to 100%
Default: 40%

Note

During Heliox administration the %O2 control sets the percent of Oxygen in the delivered gas. The balance of the
delivered gas is Helium.

Pressure High (Pres High)

This control is only available in APRV / BIPHASIC Mode. It controls the baseline pressure achieved during Time High.
Range: 0 to 90 cmH2O
Default: 15 cmH2O

Time High

Available in APRV / BIPHASIC mode only, this control sets the maximum time for which the Pressure High setting is
maintained.

Range: 0.2 to 30 seconds
Default: 4 seconds

Time Low

In APRV / BIPHASIC mode, this control sets the maximum time for which the Pressure Low setting is maintained.
Range: 0.2 to 30 seconds
Default: 2 second

L2786

Operator’s Manual Chapter 3 Ventilator Operation 3-37

Pressure Low

In APRV / BIPHASIC Mode, this control sets the baseline pressure achieved during Time Low.
Range: 0 to 45 cmH2O
Default: 6 cmH2O

Advanced Settings

When the mode and the primary breath controls have been set, you can further refine delivery of the breath by accessing
the Advanced Settings.

Accessing the Advanced Settings

To access the advanced settings group, press the A DV
SETTINGS membrane button located to the left of the touch
screen between the Mode and the Set-up buttons. The LED
indicator on the button illuminates and the Advanced Settings
screen appears. When you select a primary control by pressing
and highlighting the control at the bottom of the touch screen,
the available advanced settings for that selected c ontrol appear
in the advanced settings screen.

Primary Controls, which feature an advanced setting, will display a
yellow triangle to the right of the control name.

Figure 3.28 Advanced settings indicator

Note

Not every primary control will have an associated advanced setting.

Figure 3.27 The Advanced Settings

membrane button

L2786

3-38 Chapter 3 Ventilator Operation AVEA Ventilator Systems

Table 3.4 Controls and Advanced Settings Associated with Breath Type & Mod e

BREATH

TYPE

& MODE
PRIMARY

CONTROLS

RATE

bpm

VOLUME

ml

INSP PRES

cmH

O

2

PEAK FLOW

L/min

INSP TIME

sec

INSP PAUSE

sec

PSV

O

cmH

2

PEEP

cmH

O

2

FLOW TRIG

L/min

% OXYGEN

%o2

PRES HIGH

O

cmH

2

TIME HIGH

sec

TIME LOW

sec

PRES LOW

O

cmH

2

ADVANCED

SETTINGS

AVAILABLE

WITHIN EACH

MODE

* Available only with Vsync activated for adult or pediatric patients only.
** Available for adult and pediatric patients only.

VOL A/C VOL SIMV

* * * * * *
* * * *

* *

* *

* * * *

* *

* * * * * *
* * * * * * * * * *
* * * * * * * * * *
* * * * * * * * * *

Vsync*,

Vsync

rise*,

Sigh,**

Waveform,

Bias flow,

Pres trig
Vol limit

(when

Vsync =

ON), Flow

Cycle*,

Demand

Flow

Vsync*,

Vsync rise*,

Sigh,**

Waveform,

Vol. Limit,
PSV rise,

PSV cycle,

PSV Tmax,

Bias flow,

Pres trig,

Flow

Cycle*,

Demand

Flow

PRES

A/C

Mach

vol,

Vol limit,

Insp rise,

Flow

cycle,

Bias
flow,

Pres trig

PRES

SIMV

Mach vol,

Vol limit,

Insp rise,

Flow

cycle,

PSV rise,

PSV cycle,

PSV

Tmax,

Bias flow,

Pres trig

PRVC A/C

Insp rise,

Bias flow,

Pres trig

Vol Limit,

Flow

Cycle

PRVC

SIMV

Vol limit,

PSV rise,

PSV cycle,

PSV

Tmax,
Bias flow,
Pres trig,

Flow

Cycle

CPAP/PSV

*

Apnea
Mode

*

Apnea
Mode

Apnea

*

Mode

*

Apnea

Mode

*

Apnea
Mode

*

Apnea
Mode

Vol limit,

PSV rise,

PSV cycle,

PSV Tmax,

Bias flow,

Pres trig

APRV /

BIPHASIC

* Apnea

Mode

* Apnea

Mode

* Apnea

Mode

* Apnea

Mode

* Apnea

Mode

* Apnea

Mode

*
*
*

*

Vol limit,

PSV rise,

PSV cycle,

PSV

Tmax,

Bias flow,

Pres trig

T High

Sync

T High

PSV

T Low

Sync

TCPL A/C

TCPL
SIMV

* *

* *
* *
* *

Vol limit,

Flow

cycle,

Bias flow,

Pres trig

Vol limit,

Flow

cycle,

PSV rise,

PSV

cycle,

PSV

Tmax,

Bias flow,

Pres trig

L2786

Operator’s Manual Chapter 3 Ventilator Operation 3-39

Advanced Settings Characteristics and Ranges

Volume Limit (Vol Limit)

The Vol Limit setting sets the volume limit for a Pressure Limited breath. When the volume delivered to the patient
meets or exceeds the preset Vol Limit, the inspiratory phase of the breath is terminated.

Range:
Normal: 0.10 to 2.50 L (Adult)

25 to 750 ml (Pediatric)

2.0 to 300.0 ml (Neonate)
Defaults: 2.50 L (Adult)

500 ml (Pediatric)
300 ml (Neonate)

The Vol Limit setting sets the volume limit for a Pressure limited breath. When the volume delivered to the patient meets
or exceeds the preset Vol Limit, the inspiratory ph ase of the breath is terminated.

Volume Limit is active for Pressure, PRVC / Vsync, TCPL, and PSV breaths only. In neo natal applications Volume Limit
requires the use of a wye flow sensor. Whenever a pr oximal flow sensor is used (Neonatal, Pediatric or Adu lt
applications) the Volume Limit is activated by the inspiratory tidal volume measured by th e wye flow sensor. In adult and
pediatric applications where no wye flow sensor is used Volume Limit is determined by the calculated inspiratory wye
flow. When the volume limit threshold has been reached the ventilator alarm status indicator will chang e to yellow and
display the words Volume Limit. The alarm status ind icator cannot be reset until the ventilator has delivered a breath,
which does not meet the volume limit threshold. To reset the alarm status window use the alarm-reset button.

Note

Excessive inspiratory flow rates or highly complia nt ve ntilator circuits may allow delivery of a tidal volume that exceeds
the volume limit setting. This is due to the ventilator circuit recoiling and providing additional tidal v olume to the patient.
Delivered tidal volumes should be closely monitored to ensure Volume Limit accuracy.

L2786

3-40 Chapter 3 Ventilator Operation AVEA Ventilator Systems

Machine Volume (Mach Vol)

The Machine Volume control sets the minimum tidal volume delivered from the ventilator when the control is activated
in a pressure control breath. This control is always used with the time cycling criterion in pressure control ventilation.
Machine volume is circuit compliance compensated in adult and pediatric applications.

Range:
Normal: 0.10 to 2.50 L (Adult)

25 to 500 ml (Pediatric)

2.0 to 300.0 ml (Neonate)
Defaults: 0 L (Adult)

0 ml (Pediatric)
0 ml (Neonate)

Once you set the machine volume, the ventilator calculates the decelerating inspiratory flow required to deliver the
Machine Volume in the set inspiratory time. When a Pr essure Control breath is delivered and Peak Flow decelerates to
this calculated peak inspiratory flow, if the Machine Volume has not been met the ventilator will automatically transition to
a continuous flow until the Machine Volume has been delivered. Once the set Machine Volume has been delivered the
ventilator will cycle into exhalation. When the Machine Volume is met or exceeded during de livery of the pressure
control breath, the ventilator will complete the breath as a normal Pressure Control breath.

During this transition in flow, the Inspiratory Time will remain constant and the Peak Inspiratory Pressure will increase to
reach the set Machine Volume. The maximum Peak Inspiratory Pressure is determined by the High Peak Pressure
alarm setting.

Note

Pmax is disabled when Machine Volume is set. In the e vent Flow Cycling is active in Pressure Control the ve ntilator will
not Flow Cycle until the Machine Volume has been met. Machine Volume must be set to zero to change patient size.

To set Machine Volume in adult and pediatric applications (with circuit compliance compensation active) simply set the
minimum desired tidal volume.

In neonatal applications with proximal flow sensor in use:

• Adjust the peak inspiratory pressure to reach the desired tidal volume.

• Select Vdel as one of the monitored parameters. Read the Vdel (uncorrected Tidal Volume delivered from the

machine) during a pressure control breath.

• Set the Machine volume to or slightly below the Vdel measurement. This will set the machine volume to a level
that will provide more consistent tidal volume delivery in the case of slight decreases in lung compliance.

Note

To protect against larger changes in lung compliance, the machine volume should be s et higher and Volume Limit
should be added.

L2786

Operator’s Manual Chapter 3 Ventilator Operation 3-41

Insp Rise

The Inspiratory Rise setting controls the slope of th e pressure rise during a mandatory breath. This co ntrol is a relative
control with fast being a setting of 1 and slow, a setting of 9.

Range: 1 to 9
Default: 5

The Inspiratory Rise control is not active for TCPL breaths.

Flow Cycle

The flow cycle setting sets the percentage of the peak i nsp iratory flow (Peak Flow), at which the inspirat ory phase of a
Pressure Control, TCPL or PRVC/Vsync breath is terminated.

Range: 0 (Off) to 45 %
Default: 0% (Off)

Flow cycling is active for Pressure, PRVC/Vsync or TCPL breaths only.

Note

If flow cycling is active during a PRVC or Vsync breath flow cycling of the breath can only occur if the target tidal volume
has been delivered. This allows for expiratory synchrony while assuring delivered tidal volume.

Note

If Flow Cycling is active during a pressure control breath, monitored airway pressures (ins piratory) will be higher than set
when AAC is active. In pediatric and adult ventilati on with an inspiratory pressure setting of zero AAC wi ll still provide an
elevated airway pressure, which will c ompensate for the resistance of the endotracheal tube.

Waveform

During the delivery of a volume breath, flow can be delivered in one of two user selectable waveforms: square wave or
decelerating wave. The default waveform is Decelerating Wave.

Square Wave (Sq)

With this waveform selected, the ventilator delivers gas at the set peak flow for the duration of the inspiration.

Decelerating Wave (Dec)

With this waveform selected, the ventilator delivers ga s starting at the peak flow and decreasing until the flow
reaches 50% of the set peak flow.

Demand Flow

Enables and disables the Intra-Breath Demand system in volume controlled ventilation. The default position is on.

Note

Should the patient’s inspiratory demand be sustained beyond the controlled inspiratory ti me plus the minimum expiratory
time with the demand system turned off auto-cycling or double cycling may occur. This is the result of the patient
demanding more flow than available res ulting in a breath trigger after the minimum expiratory time. This may be
resolved by increasing the inspiratory flow rate to meet the patients demand or turning the demand system back on.

L2786

3-42 Chapter 3 Ventilator Operation AVEA Ventilator Systems

Sigh

The ventilator delivers sigh volume breaths when this setting is ON. A sigh volume bre ath is delivered every 100th breath
in place of the next normal volume breath.

Range: Off, On (every 100 breaths)
Sigh Volume: 1.5 times set tidal volume
Sigh Breath Interval (sec): Set Normal Breath Interval x 2 (Assist mode) or
set Normal Breath Interval (SIMV mode)
Default: Off

Sigh breaths are only available for Volume b r eaths in Assist and SIMV modes for adult and pediatric patients.

Bias Flow

The Bias Flow control sets the background flow ava ilable between breaths. Additionally, this control establishes the base
flow that is used for flow triggering.

Range: 0.4 to 5.0 L/min
Defaults: 2.0 L/min

Note

To ensure adequate bias flow for inspiratory triggering the bias flow setting should be at least 0.5 liters per minute
greater than the flow trigger threshold. Consult the ventilator circuit manufacturer to ensure that bias flow setting is
sufficient to prevent overheating of the ventilator circuit.

Pres Trig

Sets the level below PEEP at which the inspiratory trigger mechanism is activated. When the pressure in the patient
circuit falls below PEEP by the set pressure trigger level, the ventilator will cycle to inspiration.

Range: 0.1 to 20.0 cmH
Default: 3.0 cmH

O

2

O

2

Vsync

Vsync breaths are:

• Controlled by pressure (inspiratory + PEEP) and vo lume;

• Limited by pressure (inspiratory + PEEP + margin);

• Cycled by time. Inspiratory time in Vsync is determined i ndirectly by setting the peak inspiratory flow. The set

inspiratory time is displayed in the message bar.

Vsync breath operation is as follows:
When Vsync is selected, a decelerating flow, volume test breath to the set tidal volume with a 40 msec pause is

delivered to the patient. The ventilator sets the tar get pressure at the end inspiratory pressure of the test breath or the
first pressure control breath. The next breath and all subsequent breaths are delivered as pressure control breaths.
Inspiratory pressure is adjusted automaticall y, based on the dynamic complianc e of the previous breath, to maintain the
target volume. The maximum step change between two consecutiv e breaths is 3 centimeters of water pressure. The
maximum tidal volume delivered in a single breat h is determined by the Volume Limit setting.
This test breath sequence is initiated when any of the following occur:

L2786

Operator’s Manual Chapter 3 Ventilator Operation 3-43

• Entering the Mode (Vsync)

• Changing the set tidal volume while in Vsync

• Reaching the Volume Limit setting

• Delivered tidal volume >

• Flow termination of the test breath

• Exiting Standby

• Activation of any of the following alarms

- High Peak Pressure Alarm

- Low Peak Alarm

- Low PEEP Alarm

- Patient Circuit Disconnect Ala rm

- I-Time Limit

- I:E Limit

Vsync is only available for adult and pediatric patients.

1.5 times the set volume

Note

If flow cycling is active during a PRVC or Vsync breath flow cycling of the breath can only occur if the target tidal volume
has been delivered. This allows for expiratory synchrony while assuring delivered tidal volume.

Note

The Peak Flow control sets the flow rate, which is used by the ventilator for the test breath only. The ventilator uses the
Peak Flow setting and Inspiratory Pause to determine the maximum inspiratory time durin g Vsync ventilation.

Vsync Rise

With Vsync active, this control sets the slope of the pressure rise during the volume breath. It is a relative control ranging
from fast (1) to slow (9).

Range: 1 to 9
Default: 5

PSV Rise

This control sets the slope of the pressure rise during a pressure-supported breath. It is a relative control with a range
from fast (1) to slow (9).

Range: 1 to 9
Default: 5

PSV Cycle

Sets the percentage of peak inspiratory flow at which the inspiratory phase of a PSV breath is terminated.

Range: 5 to 45%
Default: 25% (Adult/Pediatric)

10% (Neonate)

L2786

3-44 Chapter 3 Ventilator Operation AVEA Ventilator Systems

PSV Tmax

Controls the maximum inspiratory time of a press ure-supported breath.

Range: 0.20 to 5.00 seconds (Adult/Pediatric)

0.15 to 3.00 (Neonate)
Default: 5.00 seconds (Adult)

0.75 seconds (Pediatric)

0.35 seconds (Neonate)

Note

PSV Rise, PSV Cycle and PSV Tmax are active even if the PSV level is set to Zero

Independent Lung Ventilation (ILV)

Independent lung ventilation allows 2 ventilators to be synchronized to the same breath rate (the rate control set on the
master ventilator), while all other primary and advanced controls for each ventil ator can be set independently. Master
and slave ventilators need not operate in the same mode during ILV.

The AVEA offers a port to allow Independent Lung Ventilation (ILV). This connection is located on the rear panel (see
figure 2.19, C). The output provides a 5 VDC lo gic signal, synchronized to the breath phase of the master ventilator.

A specially configured accessory cable kit, available from VIASYS (P/N 16246) is required to implement ILV.

WARNING

Do NOT attempt to connect a standard DB-25 cable to this receptacle. This could cause damage to the
ventilator. A specially configured cable is required for ALL features associated with this connector. Contact
VIASYS Tech Support.

To enable Independent Lung Ventilation, refer to Chapter 2, Ventilator Setup, Independent Lung Ventilation (ILV).

NOTE

During ILV, the alarm limits for each ventilator should be set to appropriate levels for each ventilator to assure
appropriate patient protection. Confirm apnea timer s etti ngs and apnea ventilation settings for the Slave ventilator. These
settings will be used in the event of a loss of signal from the Master ventilator.

WARNING

Since the master ventilator controls the breath rate for both ventilators, care should be taken when setting the other
independent breath controls for the slave ventilator, to ensure sufficie nt time is allowed for exhalation to occur.

CAUTION

If the cable connecting the master and slave ventilators becomes detached, the slave ventil ator will alarm for loss of
signal. In this event, only the master ventilator will cont inue to provide ventilation at the current settings. The slave
ventilator will begin apnea ventilation after its apnea timer has elapsed at its current apnea ventilation settings.

L2786