VIASYS AVEA User Manual
Operator’s Manual
AVEA
Ventilator Systems
L2786 Rev. D
ii AVEA Ventilator Systems
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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
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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.
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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
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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
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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: +1 800 231-2466
+1 714 283-2228
Fax: +1 714 283-8471
www.viasyshealthcare.com
VIASYS Healthcare GmbH
Leibnizstrasse 7
97204 Hoechberg
Germany
Telephone: +49 931 4972-0
Fax: +49 931 4972-423
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.
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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.
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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.
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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.
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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
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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.
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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
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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.
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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
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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
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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.
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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.
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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
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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)
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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.
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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
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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
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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
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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.
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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
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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.
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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
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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.
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