Vyaire Avea User Manual

Avea

™

critical care ventilation

VENTILATION MODES USER GUIDE

The Avea™ ventilator user guide is not intended to replace the operator manual. You must become completely familiar with the Avea ventilator operator manual before using the Avea ventilator.

Section 1: UIM navigation............................................ 1

Touch-Turn-Touch

™

/Touch-Turn-

Accept

™

techniques ��2 Setting breath type and mode ��3–4 Setting advanced settings ��5–6 Setting alarm limits ��7

Section 2: Breath types and modes .........................8

Breath types ��9 Mandatory breaths ��10 Demand breaths ��11 Volume controlled ventilation ��12–14 Volume SIMV mode �� 15 Pressure controlled ventilation ��16–17 Pressure SIMV ��18 TCPL mode �� 19–20 TCPL SIMV mode ��21–24 PRVC SIMV mode �� 25 APRV/BiPhasic �� 26–28 CPAP/PSV ��29 Apnea Backup ventilation�� 30–31 CPAP/PSV ��31

Table of contents

Nasal CPAP/IMV �� 32 Standby ��33–34

Section 3: Advanced settings ................................. 35

Volume Limit ��36 Machine Volume �� 37–38 Inspiratory Rise �� 39 Flow Cycle ��39 Waveform ��40 Sigh ��40 Bias Flow ��41 Pres Trig ��41 Vsync

®

��42–43 Vsync Rise ��43 PSV Rise��44 PSV Cycle ��44 PSV Tmax ��44 Volume Limit ��44 T High PSV��45 T High Sync ��45 T Low Sync ��45 Avea ventilator modes ��46–49

Section 1:

UIM navigation

Touch-Turn-Touch™/Touch-Turn-Accept™ techniques ��2 Setting breath type and mode �� 3–4 Setting advanced settings �� 5–6 Setting alarm limits ��7

1

2

Touch-Turn-Touch™/Touch-Turn-Accept™ techniques

To change most controls on the Avea ventilator:

1. Touch the screen directly over the control to select it. The control highlights (changes color), indicating that it is active.

2. Turn the data dial clockwise to increase the selected value, and turn the dial counter-clockwise to decrease it. Turning the data dial quickly accelerates the rate of change from one setting to another. Turning the data dial slowly gradually changes the setting.

3. Touch the screen directly over the highlighted control again, or press the ACCEPT membrane button to the left of the data dial to accept your new setting.

Note: If you press the CANCEL button or do not actively accept the new setting within 15 seconds, ventilation continues at the previous setting.

3

To access the MODE SELECT screen, press the MODE indicator on the touch screen or the MODE button on the membrane panel.

A. MODE indicator

B. MODE button

Setting breath type and mode

A

B

4

The MODE SELECT screen appears. Select the touch-screen button for the desired mode.

Primary controls for the proposed mode appear at the bottom of the touch screen. Use the techniques described on page 3 to set these controls. Press MODE ACCEPT to accept the new mode and primary control settings.

Setting breath type and mode (continued)

Selecting Volume A/C mode

5

To set advanced settings, press the ADV SETTINGS button on the lower left of the

user interface. Advanced settings reﬁne the breath delivery beyond the primary breath control settings. Press the ADV SETTINGS button for the desired primary control. Not all primary controls have advanced settings. Primary controls with advanced settings are marked with a yellow triangle.

Detailed descriptions of all advanced settings are in section 3.

A. ADV SETTINGS button

Setting advanced settings

A

6

Setting advanced settings (continued)

Advanced settings for volume

Use the Touch-Turn-Touch or Touch-Turn-Accept technique to modify the advanced settings (see page 3).

7

Setting alarm limits

Alarm Limits window with Volume A/C mode selected on MODE SELECT window

Use the Touch-Turn-Touch or Touch-Turn-Accept technique to modify the alarm limits settings (see page 3).

Press the ALARM LIMITS membrane button (to the upper right of the UIM) to open or close the window.

A. ALARM LIMITS button

A

Section 2:

Breath types and modes

Breath types ��9 Mandatory breaths ��10 Demand breaths ��11 Volume controlled ventilation ��12–14 Volume SIMV mode �� 15 Pressure controlled ventilation �� 16–17 Pressure SIMV �� 18 TCPL mode ��19–20 TCPL SIMV mode ��21–24 PRVC SIMV mode �� 25 APRV/BiPhasic ��26–28 CPAP/PSV �� 29 Apnea Backup ventilation��30–31 CPAP/PSV ��31 Nasal CPAP/IMV �� 32 Standby ��33–34

8

9

Section 2: Breath types and modes

This section describes the breath types and ventilation mode combinations available for adult, pediatric and neonatal patients using the Avea ventilator.

Breath types

There are two basic breath types:

• Mandatory breaths (delivered according to the set ventilator parameters)

• Demand breaths (triggered by the patient)

All breaths are deﬁned by four variables:

1

• Trigger (initiates the breath)

• Control (controls the delivery)

• Limit (terminates the breath)

• Cycle (initiates the frequency of delivery)

10

Mandatory breaths

Mandatory breaths can be triggered by the machine, patient or operator. The Avea ventilator can deliver ﬁve mandatory breath types:

1. Volume breaths

2. Pressure breaths

3. Time cycled pressure limited (TCPL) breaths (neonatal patients only)

4. Pressure regulated volume control (PRVC/Vsync

®

) breaths

(adult and pediatric patients only)

5. Volume Guarantee (VG) breaths (neonatal patients only)

Note: The volume controlled breath is the default breath type for adult and pediatric patients. The TCPL breath type is only available for neonates and the default breath type for neonate patients.

11

Demand breaths

All demand breaths are patient triggered, pressure controlled 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 touch screen. The Avea ventilator delivers two demand breath types:

1. PSV: Active when CPAP/PSV, synchronized intermittent mandatory ventilation (SIMV)

and airway pressure release ventilation (APRV)/BiPhasic modes are selected.

2. Spontaneous breath: For adult and pediatric patients during a spontaneous demand

breath, inspiratory pressure is pre-set at positive end-expiratory pressure (PEEP) + 2 cmH

2

O. For neonatal patients, a spontaneous breath is a demand ﬂow breath delivered

at the pre-set PEEP.

12

Volume controlled ventilation

Avea ventilator intra-breath demand system

The Avea ventilator features a unique intra-breath demand system in volume controlled ventilation designed to provide additional ﬂow to the patient during periods of demand.

The Avea ventilator measures the peak inspiratory pressure (Ppeak) every 2 ms throughout the breath cycle and sets a virtual pressure support target at the greater of PEEP + 2 cmH

2

O or Ppeak–2 cmH2O.

The minimum virtual pressure support level is set PEEP + 2 cmH

2

O, and the maximum is two times the set PEEP. Simultaneously, the ventilator monitors and compares the Ppeak measurement to its previous value. If the Ppeak decreases by 2 cmH2O, the ventilator recognizes the patient demand and automatically switches over to deliver a pressure support breath at the virtual pressure support target. This allows ﬂow to exceed the set peak ﬂow, thereby meeting patient demand.

Once the set tidal volume has been delivered, the ventilator looks at the inspiratory ﬂow. Should the peak inspiratory ﬂow be greater than set peak ﬂow, the ventilator determines that the patient continues to demand ﬂow. The breath then cycles when inspiratory ﬂow falls to 25% of the peak inspiratory ﬂow. If the peak inspiratory ﬂow is equal to the set ﬂow, the ventilator determines the patient is not demanding ﬂow and ends the breath as a volume control breath.

13

Volume breaths are controlled by inspiratory ﬂow, limited by a pre-set volume or maximum inspiratory pressure and cycled by volume or time. During mandatory breaths, the demand system can provide additional ﬂow if needed. The mode for this breath type is Volume Assist Control (A/C) mode.

All breaths are mandatory breaths at the set tidal volume. Breaths are triggered when a patient eort is detected, the breath interval elapses when no patient eort is detected or the MANUAL BREATH key is activated. The initiation of a breath by any means resets the breath interval. The patient may initiate all breaths. Without patient eort, breaths deliver at the set breath rate.

Volume A/C with decelerating ﬂow pattern

14

In a volume breath, airway pressure increases until the set tidal volume delivers. Flow delivers at the set ﬂow rate for the duration of the inspiratory time (with a square waveform selected) or can decelerate to 50% of the set peak ﬂow during the inspiratory phase of the breath (with a decelerating waveform selected).

Primary controls: Active in Volume A/C mode are Rate, Volume, Peak Flow, Inspiratory

Pause, PEEP, Flow Trigger and %O

2

.

Advanced settings: Available in Volume A/C mode are Vsync*, Vsync Rise*, Volume Limit++,

Demand Flow, Flow Cycle++, Sigh*, Waveform, Bias Flow and Pressure Trigger.

*Available for adult and pediatric patients only. ++Only available when Vsync is active.

15

Volume SIMV mode

In synchronized intermittent mandatory ventilation (SIMV), mandatory and demand breath types can deliver. Mandatory breaths deliver when the SIMV Time window is open as a patient eort is detected, the breath interval elapses when no patient eort is detected or the MANUAL BREATH key is activated.

Primary controls: Active in Volume

SIMV mode are Rate, Volume, Peak Flow, Inspiratory Pause, PSV, PEEP, Flow Trigger and %O

2

.

Advanced settings: Available in

Volume SIMV mode are Vsync*, Vsync Rise*, Volume Limit, Sigh*, Waveform, PSV Rise, PSV Cycle, PSV Tmax, Demand Flow, Bias Flow, Flow Cycle++, Waveform and Pressure Trigger.

* Available for adult and pediatric

patients only.

++Only available when Vsync is active.

Volume SIMV with mandatory (1) and assisted (2) breaths

Vyaire Avea User Manual

Specifications and Main Features

Frequently Asked Questions

User Manual