Table of Contents
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●● This Quick Guide is not a substitute for the Operation Manual. Read the
Operation Manual carefully before operating the unit.
●● This Quick Guide explains only some of the operations of the fabian HFO
ventilator. For details about content not included in this Quick Guide refer to
the Operation Manual.
Quick guide for fabian +nCPAP evolution 01-04-2014
fabian HFO
Quick guide
TO THE OPERATOR AND PERSON IN CHARGE OF
MAINTENANCE AND CARE OF THE UNIT:
1
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Table of Contents
Summary of Contents for Acutronic Medical Systems fabian HFO
- Page 1 ●● This Quick Guide is not a substitute for the Operation Manual. Read the Operation Manual carefully before operating the unit. ●● This Quick Guide explains only some of the operations of the fabian HFO ventilator. For details about content not included in this Quick Guide refer to the Operation Manual.
- Page 2 Quick guide for fabian HFO ventilator Preparations of the ventilator: Connections: (Power cord, gas supply) • Connect power cord with respective power source • Connect medical gas hoses to the respective connections • Connect power cord of humidifier to respective power source Patient breathing circuit, exhalation valve: •...
- Page 3 Turn ventilator on: • Once patient circuit is set up, turn ventilator on by pushing the green ON/OFF button • After a 20s startup and selftest routine, the calibration screen comes up Calibrate Flow Sensor now: • Block both ends of Flow Sensor by hand using a sterile glove •...
- Page 4 Ventilation Parameter setting: • Select desired ventilation mode first Important: By pushing the button, the parameters of the ventilation mode can be preset. (button turns yellow), the new ventilation mode is only activated by re-tapping! As long as mode is not confirmed, ventilator will continue ventilation in previous mode •...
- Page 5 7067! Turn off of the ventilator: • fabian HFO has an integrated safety system in case of accidentally turning off the ventilator • To turn off the device press the green button for at least 5 seconds until all the blue points in the status line are gone •...
- Page 6 Ventilation modes Description of the ventilation modes on fabian HFO ventilator: Available modes are: IPPV (CMV) Intermittent Positive Pressure Ventilation SIPPV (ASSIST) Synchronised Intermittent Positive Pressure Ventilation (Assist Controlled Ventilation) SIMV Synchronised Intermittent Mandatory Ventilation SIMV+PSV Synchronised Intermittent Mandatory Ventilation...
- Page 7 Alarm screen, alarm limit setting To access the alarm limits screen, push the alarm limits button To adjust alarm limits, move cursor to the parameter, push rotary knob and adjust value according your clinical guidelines Note! In PSV mode, the apnea delay time determines after which delay the backup ventilation will start. To allow the baby breathing with short periods of apnea, the apnea time should be set somewhere in between 3 seconds and 6 seconds.
- Page 8 IPPV (CMV) In IPPV, there is no synchronisation with patients breathing pattern. This mode should only be used for patients without spontaneous breathing efforts. Sedated patients for instance. Settings to start with: I-Flow between 8 LPM E-Flow same as I-Flow Rate between 55 and 60 bpm Inspiratory time Ti...
- Page 9 SIPPV (ASSIST) Every inspiratory effort triggers a breath with a fixed inspiratory time and inspiratory pressure. The minimum rate per minute is the preset one. A patient triggered breath is coloured green, a none triggered is grey. Note: It is important that the Ti is watched carefully in this mode – too long a set Ti in an infant with tachypnoea will result in a short expiratory time (Te) and leads to air trapping, with the risk of air leak.
- Page 10 SIPPV (ASSIST) with VG (Volume Guarantee) If VG is added to the SIPPV (ASSIST) ventilation, each breath is maintained at same exhaled tidal volume. In case of an improvement of lung compliance, the P is automatically reduced. insp Every single inspiratory effort of the patient is supported with a mechanical breath with fixed inspiratory time and fixed Inspiratory Pressure.
- Page 11 Step 3 Turn rotary knob clockwise > current Tidal Volume V is taken from readings. P button insp changes to orange colour and P insp is automatically increased by 5 cmH O to allow ventilator to compensate for a changing lung compliance. Confirm setting by pushing rotary knob. Setting is accepted if button turns to blue colour again.
- Page 12 The following graphic shows different support of triggered and none triggered breath. To maintain the preset exhaled tidal volume, the ventilator changes the P breath to breath by peak maximum change of 3 cmH Note: , a warning message „Tidal If the preset target volume is not achievable within the set P insp Volume not reached“...
- Page 13 SIMV+PSV The ventilator synchronizes patient’s inspiratory efforts and delivers a fixed amount of synchronised mechanical breath with preset inspiratory time. Spontaneous inspiratory efforts in between mechanical breath are supported with pressure support level P . Patient determines begin and end of PSV breath depending on the preset flow termination criteria. The I-Time button has changed to orange, indicating that the set I-Time is only valid for SIMV breath and represents maximal I-Time in case flow termination criteria isn‘t met.
- Page 14 The ventilator synchronizes the patients inspiratory effort and delivers a breath at fixed pressure levels but variable I-Time is controlled by patient based on preset flow termination criteria. The rate is controlled by the patient. Settings to start with: The PSV breath is terminated at I-Flow 8 LPM one of the following criteria's:...
- Page 15 PSV+VG If Volume Guarantee is added to PSV, the ventilator automatically is adjusting the P level necessary to maintain preset target volume. In case of an apnea, the ventilator will start cycling at preset rate and P . As soon as spontaneous activity restarts, the backup stops. Backup Settings to start with: I-Flow...
- Page 16 HFO Ventilation High Frequency Oscillatory ventilation uses the following settings: Settings to start with: Flow 8 LPM about 2 cmH O above MAP used for conventional ventilation Amplitude start at about 22 cmH 12 to 15 Hz for babies below 1kg and 8 – 12 Hz for babies above Frequency 1kg I:E Ratio If used in your clinical guidelines for lung recruitment, otherwise...
- Page 17 CPAP The CPAP mode can be used for intubated patient as well as for nasal CPAP. If used with nasal CPAP systems like F&P bubble CPAP, Hudson or similar, the Flow Sensor must be deactivated manually in the calibration screen. The ventilator automatically compensates leaks by increasing flow to max Flow plus100% to avoid CPAP pressure drop.
- Page 18 Therapy Therapy is an option which allows use of a continuous flow of blended gas, from 1 – 15 LPM. Nasal cannulas of various makes like F&P, Atom or similar can be used. There are no alarm functions active in this mode, except for the set FiO For weaning purposes, this mode can also be used in conjunction with variable flow systems , Inspire™...
- Page 19 Features Graphics: Waves: Displays 3 waveforms, Pressure, Flow and Volume simultaneously Freeze: Freezes the waves or Loops Loops: Pressure-Volume and Flow-Volume Loops Trends: up to 5 days trending of measured values Save Loop: The save Loop function stores one Loop and keep it as reference until a new Loop is saved Waves: Manual scaling mode.
- Page 20 Trends: Sub Menu: The submenu allows access to fine-tune some of the ventilation modes, i.e.: • Manual breath • Flow termination criteria for PSV ventilation • Flush time • ………….
- Page 21 It is important to place the Flow Sensor of the NO delivery system directly at the fresh gas outlet of the fabian HFO. The measuring line shall be placed close to patient in inspiratory limb.