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Maquet SERVO-i User Manual

Ventilator system
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THE ABCs OF VENTILATOR MODES
VENTILATOR MONITOR DISPLAY
MCV00020395 REVA
MCV00020395 REVA
MCV00020395 REVA
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  • Page 1 THE ABCs OF VENTILATOR MODES MCV00020395 REVA VENTILATOR MONITOR DISPLAY MCV00020395 REVA MCV00020395 REVA...
  • Page 2 VENTILATOR PARAMETERS MCV00020395 REVA VENTILATION PARAMETERS MCV00020395 REVA MCV00020395 REVA...
  • Page 3 VENTILATOR PARAMETERS Respiratory Rate (frequency): Number of breaths per minute ventilator delivers Ventilator can provide all patient’s ventilation, or patient may be able to breath spontaneously between ventilator breaths May titrate (adjust) rate to control carbon dioxide (CO levels MCV00020395 REVA VENTILATOR PARAMETERS MCV00020395 REVA...
  • Page 4 VENTILATOR PARAMETERS Tidal Volume (TV): Tidal volume is the volume of gas the ventilator will deliver to the patient with each breath Usual setting is 6 to 8 ml/kg (ideal body weight) Example: 100 kg patient = 600 ml tidal volume to 800 ml tidal volume MCV00020395 REVA VENTILATOR PARAMETERS...
  • Page 5 VENTILATOR PARAMETERS MCV00020395 REVA VENTILATOR PARAMETERS Minute Volume (MV): Volume of gas the ventilator will deliver to the patient in one minute Minute volume = respiratory rate x tidal volume Example: RR 10 x 600 ml TV = 6 liter MV MCV00020395 REVA...
  • Page 6 VENTILATOR PARAMETERS MCV00020395 REVA VENTILATOR PARAMETERS ) Conc: Indicates amount of oxygen ventilator delivers Expressed as a percentage — room air is 21% varies widely depending on patient’s condition Arterial blood gases and pulse oximetry values will help determine FiO settings Titrate to keep oxygen saturation SpO >96%...
  • Page 7 MCV00020395 REVA VENTILATOR PARAMETERS PEEP (Positive End-Expiratory Pressure): PEEP maintains small end-expiratory pressure to help prevent alveolar collapse and improve oxygenation Most patients are started on 5 cmH O of PEEP Range on SERVO-i ® (0 to 50 cmH MCV00020395 REVA...
  • Page 8 VENTILATOR PARAMETERS MCV00020395 REVA VENTILATOR PARAMETERS P-Peak (Peak Inspiratory Pressure ) Definition: Reflects airway resistance and lung compliance (work required to move air through airways and into alveoli) Elevated with either increased resistance or decreased compliance MCV00020395 REVA...
  • Page 9 VENTILATOR PARAMETERS MCV00020395 REVA VENTILATOR PARAMETERS Ventilator mode: Method or way a breath is delivered Mode of ventilation should be tailored to needs of the patient Controlled mode Supported (spontaneous) mode Combination mode MCV00020395 REVA...
  • Page 10 VENTILATOR PARAMETERS MCV00020395 REVA CATEGORIES OF VENTILATION MODES MCV00020395 REVA MCV00020395 REVA...
  • Page 11 CATEGORIES OF VENTILATION MODES Controlled modes: Volume Control Pressure Control PRVC Supported (spontaneous) modes: Pressure support / CPAP Volume support NAVA ® Combination modes: SIMV (VC) + PS SIMV (PC) + PS SIMV (PRVC) + PS Bi-vent MCV00020395 REVA CATEGORIES OF VENTILATION MODES Controlled modes: Every breath delivered to patient is a mechanical breath (breath may be triggered by a timing mechanism or patient...
  • Page 12 CONTROLLED MODES MCV00020395 REVA MCV00020395 REVA CONTROLLED MODES Every breath delivered to patient is a mechanical breath (breath may be triggered by a timing mechanism or patient effort) MCV00020395 REVA...
  • Page 13 CONTROLLED MODES Volume Control: A minute or tidal volume is preset Breaths are delivered at a preset frequency/rate Pressure is variable throughout the delivered breath Flow is constant throughout the breath MCV00020395 REVA MCV00020395 REVA...
  • Page 14 CONTROLLED MODES Volume Control — vent settings: Tidal Volume (ml) Respiratory Rate (b/min) PEEP (cmH Oxygen concentration (%) I:E ratio / Insp. time Pause time (s) Inspiratory rise time (s) Trigg. Flow / Trigg. Pressure MCV00020395 REVA CONTROLLED MODES OF VENTILATION...
  • Page 15 CONTROLLED MODES Ti (Inspiratory Time): Part or portion of the ventilatory cycle necessary for inspiration Setting: 0.1 to 5.00 sec Maintain an I:E of 1:2 or greater (1:3, 1:4, etc.) MCV00020395 REVA CONTROLLED MODES OF VENTILATION...
  • Page 16 CONTROLLED MODES T pause: Time for no flow or pressure delivery (%) Setting: 0.0 to 30%, or 0.00 to 1.50 sec MCV00020395 REVA CONTROLLED MODES OF VENTILATION...
  • Page 17 CONTROLLED MODES T insp rise (Inspiratory Rise Time): Inspiratory Rise Time, or “T insp. Rise”, is the time taken to reach the peak inspiratory flow or pressure at the start of each breath Inspiratory Rise Time (%) is applicable in Pressure Control, Volume Control, PRVC, SIMV-Volume Control, SIMV-Pressure Control, SIMV-PRVC.
  • Page 18 CONTROLLED MODES Trigger: This determines the level of patient effort to trigger the ventilator to initiate inspiration Trigger sensitivity can be set in flow triggering (Trigg. Flow) or pressure triggering (Trigg. Pressure) Normally, flow triggering is typically preferable as this enables the patient to breathe with less effort The higher the number (above 0) the more sensitive the ventilator is to patient efforts...
  • Page 19 CONTROLLED MODES Pressure Control: A pressure level is preset Breaths are delivered at a preset frequency / rate Pressure is constant throughout the delivered breath Tidal and minute volume are variable Flow is variable throughout the breath MCV00020395 REVA MCV00020395 REVA...
  • Page 20 CONTROLLED MODES Pressure Control — vent settings: PC (Pressure Control level) above PEEP (cmH Respiratory Rate (b/min) PEEP (cmH Oxygen concentration (%) I:E ratio / Insp. time Inspiratory rise time (s) MCV00020395 REVA...
  • Page 21 CONTROLLED MODES PC (Pressure Control level) above PEEP (cmH The set inspiratory pressure level for each mandatory breath Setting: Infant range is 0 to 80 cmH Adult range is 0 to 120 cmH MCV00020395 REVA CONTROLLED MODES Similar names for Pressure Control: P-CMV PCV-A/C Pressure A/C...
  • Page 22 CONTROLLED MODES PRVC: “Pressure Regulated Volume Control” An alternative to straight pressure control and/or Volume Control In this mode we attempt to obtain best of both volume and pressure control PRVC regulates pressure to changing compliance of lungs to adjust inspiratory flow and pressure to maintain a set tidal volume Breaths are delivered at a preset frequency (timing mechanism) and may also be...
  • Page 23 MCV00020395 REVA CONTROLLED MODES PRVC — vent settings: Tidal Volume Respiratory Rate (b/min) PEEP (cmH Oxygen concentration (%) I:E ratio / Insp. time Inspiratory rise time (s) Trigg. Flow / Trigg. Pressure MCV00020395 REVA...
  • Page 24 CONTROLLED MODES Similar names for PRVC: Adaptive Pressure Ventilation CMV PRVC A/C Autoflow Volume Control Plus (VC+) MCV00020395 REVA SUPPORTED (SPONTANEOUS) MODE MCV00020395 REVA MCV00020395 REVA...
  • Page 25 SPONTANEOUS (SUPPORTED) MODES Every breath is spontaneous (i.e. patient triggered and patient cycled) but supported by ventilator MCV00020395 REVA SPONTANEOUS (SUPPORTED) MODES Pressure Support / CPAP: Pressure Support is a patient-initiated breathing mode in which ventilator supports patient effort Provides a small amount of pressure during inspiration to help patient draw in a spontaneous breath If PS above PEEP is set to 0, it then becomes...
  • Page 26 MCV00020395 REVA SUPPORTED (SPONTANEOUS) MODES OF VENTILATION Pressure Support — vent settings: PS (Pressure Support level) above PEEP (cmH PEEP (cmH Oxygen concentration (%) Inspiratory rise time (s) Trigg. Flow / Trigg. Pressure Inspiratory Cycle-off (%) Backup Ventilation PC (pressure control level) above PEEP (cmH O) in backup ventilation Resp.
  • Page 27 MCV00020395 REVA SPONTANEOUS (SUPPORTED) MODES Similar names for Pressure Support / CPAP: Assisted Spontaneous Breathing Spontaneous Mode Pressure Support Ventilation MCV00020395 REVA...
  • Page 28 SPONTANEOUS (SUPPORTED) MODES VOLUME SUPPORT — description: A patient-adapted constant inspiratory support is supplied when activated by patient effort Volume is continuously monitored and inspiratory pressure automatically adjusts to maintain targeted tidal volume Patient determines frequency Pressure pattern constant Flow pattern decelerating MCV00020395 REVA MCV00020395 REVA...
  • Page 29 SUPPORTED (SPONTANEOUS) MODES OF VENTILATION VOLUME SUPPORT — vent settings: Tidal Volume (ml) PEEP (cmH Oxygen concentration (%) Inspiratory rise time (s) Trigg. Flow / Trigg. Pressure Inspiratory Cycle off (%) Backup Ventilation Tidal Volume in backup ventilation Resp.Rate (b/min) in backup ventilation I:E / Ti (s) in backup ventilation (depending on configuration) MCV00020395 REVA MCV00020395 REVA...
  • Page 30 SPONTANEOUS (SUPPORTED) MODES Similar names for VOLUME SUPPORT: No other names for this mode MCV00020395 REVA SPONTANEOUS (SUPPORTED) MODES NAVA ® — description: Patient-initiated synchronized breathing mode Breathing support is triggered by the electrical activity of the diaphragm (Edi) Patient controls the respiratory rate, inspiratory time, and the tidal volume with assist from the ventilator Operator sets the NAVA level (support)
  • Page 31 SPONTANEOUS (SUPPORTED) MODES NAVA ® — objectives: NAVA ventilation delivers ventilatory assist in proportion and synchronized to the patient’s Edi (the electrical activity of the diaphragm). MCV00020395 REVA MCV00020395 REVA...
  • Page 32 MCV00020395 REVA SPONTANEOUS (SUPPORTED) MODES Similar names for NAVA ® No other vendor has a similar mode MCV00020395 REVA...
  • Page 33 COMBINATION MODES MCV00020395 REVA MCV00020395 REVA COMBINATION MODES Combination of both controlled and supported MCV00020395 REVA...
  • Page 34 COMBINATION MODES SIMV (VC) + PS: “Synchronized Intermittent Mandatory Ventilation (Volume Control) + Pressure Support” Mandatory breaths are Volume Control breaths (controlled) Spontaneous breaths are pressure support (supported) Ventilator provides mandatory breaths which are synchronized with patient’s spontaneous efforts at a preset rate MCV00020395 REVA MCV00020395 REVA...
  • Page 35 COMBINATION MODES OF VENTILATION SIMV (VC) + PS — vent settings: Tidal Volume (ml) / Minute Volume (l/min) SIMV rate (b/min) PEEP (cmH Oxygen concentration (%) I:E ratio / Insp. time Pause time (%/s) Inspiratory rise time (%/s) Breath cycle time (s) Trigg.
  • Page 36 COMBINATION MODES SIMV (PC) + PS: “Synchronized Intermittent Mandatory Ventilation (Pressure Control) + Pressure Support” Mandatory breaths are pressure control breaths (controlled) Spontaneous breaths are pressure support (supported) Ventilator provides mandatory breaths which are synchronized with patient’s spontaneous efforts at a preset rate MCV00020395 REVA MCV00020395 REVA...
  • Page 37 COMBINATION MODES OF VENTILATION SIMV (PC) + PS — vent settings: PC (Pressure Control level) above PEEP (cmH SIMV rate (b/min) PEEP (cmH Oxygen concentration (%) I:E ratio / Insp. time Inspiratory rise time (s) Breath cycle time (s) Trigg. Flow / Trigg. Pressure Inspiratory Cycle-off (%) Supported Breath PS (Pressure Support) above PEEP (for supported breath)
  • Page 38 COMBINATION MODES SIMV (PRVC) + PS: “Synchronized Intermittent Mandatory Ventilation (Pressure Regulated Volume Control) + Pressure Support” Mandatory breaths are PRVC breaths (controlled) Spontaneous breaths are pressure support (supported) Ventilator provides mandatory breaths which are synchronized with patient’s spontaneous efforts at a preset rate MCV00020395 REVA MCV00020395 REVA...
  • Page 39 COMBINATION MODES Other name for SIMV Modes: VCV-SIMV Volume SIMV P-SIMV PCV-SIMV Pressure SIMV SIMV + Autoflow Adaptive Pressure Ventilation SIMV PRVC SIMV MCV00020395 REVA COMBINATION MODES Bi-Vent — description: Pressure controlled breathing that allows the patient the opportunity of unrestricted spontaneous breathing Two pressure levels are set together with the individually set duration of each level...
  • Page 40 MCV00020395 REVA Bi-Vent Settings: Pressure high (PHigh) for the higher pressure level (cmH PEEP for the lower pressure level (cmH Oxygen concentration (%) Time at the higher pressure (THigh) level (s) Time at the lower pressure (TPEEP) level (s) Inspiratory rise time (s) Trigg.
  • Page 41 MCV00020395 REVA COMBINATION MODES Similar names for Bi-Vent: APRV BiLevel BiPhasic DuoPAP MCV00020395 REVA...
  • Page 42 SIMV (PC) + PS SIMV (PRVC) + PS Bi-Vent MCV00020395 REVA THANK YOU MAQUET would like to thank for participating in today’s Web Seminar In order to receive your certificate, please complete the evaluation online http://maquet.training (no .com) Evaluation Code: given during presentation If you have any further questions or comments, please email WebSeminarRegistration@maquet.com...
  • Page 43 User’s manual VENTILATOR SYSTEM SERVO-i V3.0...

  • Page 45: Table Of Contents

    Contents 1 • Introduction ..... . . 1 1.1 Device Description ......1 1.1.1 Device Diagram .
  • Page 46 3 • Power Supply..... . 19 3.1 Introduction ....... . 19 3.1.1 Power Supply Specifications .
  • Page 47 5.2.3 Adjusting Scale/Sweep Speed ..... . 46 5.3 Showing the Event Log ......46 5.4 Showing Loops .
  • Page 48 8 • Accessories ..... . . 67 8.1 Servo Ultra Nebulizer......67 8.1.1 Nebulizer Use Guidelines .
  • Page 49 10.7.1 Allowed Alarm Settings ......89 10.7.2 Autoset Alarm Limits ......90 10.7.3 Alarms Miscellaneous .

  • Page 51: Introduction

    • have experience with ventilation 1.1.1 Device Diagram treatment. 1.1.5 Intended Use Environment User Interface The Servo-i Ventilator System should be used only: • in hospitals • in facilities whose primary purpose is to Patient provide health care Unit Patient •...

  • Page 52: Warnings

    • Improper User 1.2 Warnings MAQUET has no responsibility for the safe Follow these safety guidelines. Additional operation of Servo-i Ventilator System if warnings appear in context throughout this the Intended User requirements specified document. in this document are not followed.

  • Page 53: Fire Hazard

    • Unused module compartments should • may be inaccurate if equipment not always contain an empty module to authorized by MAQUET is used protect the electrical connector pins from • should be discounted if they conflict spillage and dust. with information on the ventilator screen 1.2.3 Fire Hazard...

  • Page 54: Version & Configurations

    1.3 Version & Configurations 1.3.1 Configurations This manual applies to version 3.0 of the The following safety feature is implemented Servo-i Ventilator System, which can be ONLY in the Universal and Infant delivered in three configurations: Servo-i configurations: Infant; Servo-i Adult and Servo-i Universal •...
  • Page 55 Table 1.2: Servo-i Ventilator Configurations Function or Accessory Basic Extended Alarm output connection option Automode, pressure Automode, PRVC Automode, volume Bi-Vent Analyzer NIV (Non Invasive Ventilation) Nasal CPAP Open Lung Tool Pressure Control Pressure Support PRVC (Pressure Reg. Volume Control)

  • Page 56: About This Manual

    1.4 About this Manual Chapter 10 – Specifications Contains system specifications including Chapter 1 – Introduction default settings for breathing parameters Contains information about the proper and and alarm limits. safe use of the system as well as version and Chapter 11 –...

  • Page 57: System Overview

    2 • System Overview 2.1 Ventilator The User Interface controls ventilator settings. Settings may be adjusted using touchpads on the screen or a rotary dial. Breathing parameters are continuously measured by transducers and controlled by a feedback system in the Patient Unit. The ventilator responds to a difference between the actual measured value of a parameter and the preset or calculated value by...

  • Page 58: User Interface

    20. Measured values and alarm limits 2.2 User Interface display (customizable) The User Interface includes: 21. Additional settings • a screen with active touch pads 22. Additional measured values • fixed keys 23. Loudspeaker • rotary dials 24. Cable reel for the control cable 2.2.1 User Interface Components 25.

  • Page 59: User Interface Diagram

    2.2.2 User Interface Diagram Servo… User´s manual English edition Infant Adult Universal Options Order No: 65 14 892 E313E...

  • Page 60: User Interface Symbols

    2.2.3 User Interface Symbols 2.3 Navigating the User Interface Audio off—silence or confirm an alarm The following subsections provide general procedures for working with the user interface. More detailed procedures for Alarm off specific tasks are found in later chapters and in the Appendix.

  • Page 61: Main Rotary Dial

    Main Rotary Dial becomes inoperative for 2 seconds to indicate that a limit has been reached. This feature is implemented only in the Universal and Infant versions of the Servo-i. Servo… User´s manual English edition Infant...
  • Page 62 Direct Access Knob becomes inoperative for 2 seconds to indicate that a safety limit has been reached. This feature is implemented only in the Universal and Infant versions of the Servo-i. Servo… User´s manual English edition Infant Adult...

  • Page 63: Menu Key

    2.3.5 Menu Key 2.3.6 Status Touchpad To access the user interface windows: 1. Press the fixed key Menu. The Status touchpad indicates the power Touchpads leading to the user interface supply currently being used by the ventilator windows appear. (AC power, battery power, or external 12V DC power).

  • Page 64: Patient Unit

    2.4 Patient Unit The patient unit consists of the following components: • gas supplies and their connectors • power supplies and their connectors • connectors for accessories 2.4.1 Patient Unit Components Refer to the Patient Unit Diagram for locations of the following numbered components: 1.

  • Page 65: Patient Unit Diagram

    2.4.2 Patient Unit Diagram Servo… User´s manual English edition Infant Adult Universal Options Order No: 65 14 892 E313E...

  • Page 66: Patient Unit Symbols

    Inspiratory label—gas flow to 2.4.3 Patient Unit Symbols patient. CE label—indicates compliance with the requirements of the Medical Gas exhaust port label—exhaust Device Directive 93/42/EEC gas flow from ventilator CSA label—Indicates compliance Note: This port should not be with Canadian standards connected to a spirometer because the volume through the exhaust Class I equipment, Type B—...

  • Page 67: Transport And Storage

    2.5 Transport and Storage 2.5.1 Before Transport 2.5.2 During Transport Before transporting the ventilator with or While transporting the ventilator with or without a patient connected, follow facility without a patient connected, follow facility guidelines and: guidelines and: • Be sure the patient unit and the user •...
  • Page 68 Servo… User´s manual English edition Infant Adult Universal Options Order No: 65 14 892 E313E...

  • Page 69: Power Supply

    3 • Power Supply 3.1 Introduction 3.1.2 Battery Data Summary The Servo-i Ventilator System is equipped with an AC power supply with automatic Lifetime 2.5 years from range selection. The ventilator will manufacture date automatically operate properly using 100- 120 Volt AC or 220 - 240 Volt AC outlets.

  • Page 70: Viewing Battery Status

    The following information is displayed for 3.2 Viewing Battery Status each mounted battery module: When operating from batteries, the • Slot number estimated remaining battery time in minutes is displayed in the upper right corner of the • Serial number screen on the Status touch pad.

  • Page 71: Alarms And Safety

    ventilator. All settings will saved until the 3.3 Alarms and Safety ventilator is powered again. The status of the battery modules is continuously monitored by the ventilator. If 3.3.2 Warnings the status is unsatisfactory, four types of messages may be displayed at the top of the •...

  • Page 72: Status Messages

    3.3.3 Status Messages Message (message type) Meaning Remedy Technical error no. 1 - 6, 29, Power failure. Contact a service technician. 10001 (technical error) Check battery status There is a problem with the Open the Battery Status (Informative Text Message) battery modules.

  • Page 73: Operation Overview

    4.1 Work Flow Summary 4.2 Pre-Use Check The following summary procedure provides The Pre-Use Check includes tests and an overview of the operation of the Servo-i measurements of: Ventilator System. • internal technical functionality 1. Turn on the ventilator and perform a •...

  • Page 74: Performing A Pre-Use Check

    Internal Tests 4. Connect the blue test tube between the inspiratory outlet and the expiratory inlet. Important:Use only the MAQUET blue test tube. Check Switch Between AC and Battery If a battery module is connected, you should test the ventilator’s ability to switch between AC and battery power when AC power is lost and restored.
  • Page 75 5. When the on-screen instruction appears, disconnect the ventilator from AC power. 6. When the on-screen instruction appears, reconnect the ventilator to AC power. Check Patient Breathing System/Y Sensor SVX-155 7. Connect a complete breathing system 10. Unblock the Y Sensor and follow the on- including (if available) a humidifier and screen instructions.
  • Page 76 Compensate for Circuit Compliance Complete the Pre-Use Check 13. Press OK to confirm and to have the Pre- Use Check tests logged. The ventilator 11. When the Compensate for circuit now switches to Standby mode. compliance? dialog appears on the Note: After the Pre-Use Check is completed screen, do one of the following: (or skipped), you’ll be prompted to keep or...
  • Page 77 4.2.2 Pre-Use Check Messages Message Meaning Remedy Cancelled The test was cancelled by the MAQUET recommends performing a Pre-Use Check user. before connecting the ventilator to a patient. Failed The test did not pass. Check all connections and the expiratory cassette.
  • Page 78 4.2.3 Pre-Use Check Tests Test Description Remedy if test fails Alarm state Checks that no Technical error Refer to service technician. alarms are active during the Pre- Use Check. Barometer Checks the barometric pressure Check the barometric pressure value in measured by the internal the Status Window.
  • Page 79 Test Description Remedy if test fails Patient circuit Checks the patient circuit leakage, If the internal leakage test has passed, leakage with patient tubing connected, the leakage is located in the patient using the inspiratory and expiratory circuit. Check for leakage or replace pressure transducers.

  • Page 80: Patient Circuit Test

    correct this problem to avoid triggering the 4.3 Patient Circuit Test Low Expiratory Minute Volume alarm. If the In Standby mode, the Patient Circuit Test leakage persists, adjust the alarm limit may be performed separately from the Pre- down to its lowest level (10 ml)—if this step Use Check.

  • Page 81: Start-Up Configuration

    • Service 4.4 Start-up Configuration • Edit configuration The ventilator will always start up with the previous Start-Up Configuration. The Start- • Copy configuration Up Configuration can be edited, copied, and • Set date and clock saved. You can edit the following Start-Up •...
  • Page 82 Procedure Diagram: Editing the Start-Up 4.4.2.1 Changing the Patient Category Configuration If you have the Servo-i Universal model, you can select the patient category (Adult or Infant) while editing the Start-Up Configuration. You can also change the patient category when the ventilator is in Running mode.
  • Page 83 Procedure Diagram: Changing the Patient 4.4.2.2 Selecting the Type of Category in Running Mode Ventilation To change the type of ventilation press Menu>Biomed>Edit configuration>Start-up configuration and follow these steps. 1. Press Invasive ventilation 2. Press NIV (Non-Invasive Ventilation) Note: The background color on the touch pads changes when NIV is activated.

  • Page 84: Entering Patient Data

    4.5 Entering Patient Data Procedure Diagram: Entering Patient Data To enter data for a new patient press Menu>Biomed>Edit configuration>Start-up configuration and follow these steps. 1. Press the Admit patient touchpad. 2. Activate touchpads by turning and pressing the Main Rotary Dial or by pressing the appropriate touchpads.

  • Page 85: Setting Ventilation Mode

    4.6 Setting Ventilation Mode Procedure Diagram: Setting Ventilation Mode To set the ventilation mode outside of the Start-up Configuration: 1. Press the Mode touchpad. 2. Press the arrow at the active Mode pad. Available ventilation modes appear. 3. Press the touch pad for desired mode of ventilation.

  • Page 86: Setting Alarm Limits

    Main Rotary Dial becomes inoperative for 2 seconds. This feature (implemented only in the Universal and Infant versions of the Servo-i) alerts you that a safety limit has been reached. To set alarm limits: 1. Press the fixed key Alarm Profile.

  • Page 87: Starting Ventilation

    4.8.1 Starting Invasive Ventilation 00:14 SVX-9028_EN 1. When the Standby key is pressed and the Servo-i is configured for NIV, a waiting position dialog is shown. When the system is configured for invasive Note: All patient-related alarms are turned ventilation press the fixed key Standby to off for 120 seconds.

  • Page 88: Additional Settings Window

    4.9 Additional Settings Components Diagram: The Additional Settings Window Window To adjust breathing parameters during ventilation, press the Additional settings touchpad to open the Additional Settings Window. 1. The Additional settings touchpad is in the lower left corner of the screen. 2.

  • Page 89: Using Suction Support

    4.10 Using Suction Support 4.10.1 Preparation Phase The Suction Support function makes it possible to automatically inhibit the ventilator from cycling during a tracheal suction procedure without activating alarms. Suction Support includes: • preparation phase • disconnect phase • post-oxygen phase WARNING! Suction Support is not intended to be used together with closed-suction systems.

  • Page 90: Disconnect Phase

    When the patient is reconnected, the system valid until the ventilator is switched off. automatically enters the post-oxygen phase Important: Before using the Servo-i, always and restarts ventilation. perform a Pre-Use Check to make sure the It is also possible to restart the ventilation cell is properly calibrated.

  • Page 91: Disconnecting The Patient

    4.12 Disconnecting the Patient SVX-9058 To disconnect and stop ventilation: 1. Physically disconnect the patient from the ventilator. 2. Press the fixed key Standby. 3. Press Yes to stop ventilation. 4. Turn the ventilator off using the On/Off switch behind the user interface. Note: The battery modules will recharge as long as the ventilator is connected to AC power.
  • Page 92 Servo… User´s manual English edition Infant Adult Universal Options Order No: 65 14 892 E313E...

  • Page 93: Monitoring And Recording

    5 • Monitoring and Recording 5.1 Measured Values Display 5.1.2 Displaying Additional Pages During ventilation, measured or calculated values of breathing parameters are displayed. This section describes the display, gives the procedure for displaying additional pages of parameters, and lists all viewable parameters.

  • Page 94: Parameter List

    5.1.3 Parameter List Cdyn Dynamic characteristics Parameters in boldface are shown on the Cstatic Static compliance, respiratory first page by default. system Elastance Ppeak Maximum inspiratory pressure Inspiratory resistance Pplat Pressure during end-inspiratory Expiratory resistance pause WOB v Work of breathing, ventilator Pmean Mean airway pressure WOB p...

  • Page 95: Waveform Display

    5.2 Waveform Display 5.2.2 Showing and Hiding If the optional CO Analyzer is connected, the following color-coded waveforms are shown on the user interface screen by default: • pressure vs. time • flow vs. time • volume vs. time • CO concentration vs.

  • Page 96: Adjusting Scale/Sweep Speed

    4. To adjust the scale of a waveform, turn the Main Rotary Dial to the desired value or use auto scale (press Auto). Important: MAQUET does not recommend using auto scale in Bi-Vent mode, when patient breathing is spontaneous on both levels.

  • Page 97: Showing Loops

    5.4 Showing Loops 5.5 Showing Trends The Loops function provides a graphical Trend values are stored every 60 seconds representation of the relationship between and retained as far back as 24 hours. Stored flow-volume and pressure-volume. events and system changes are shown as event stamps.

  • Page 98: The Open Lung Tool

    To use the Open Lung Tool: 5.6 The Open Lung Tool 1. Press the fixed key Quick access. The Open Lung Tool provides breath-by- breath graphical presentation of the 2. Press the Open Lung Tool touchpad. following parameters: 3. Activate Cursor Mode by pressing the •...

  • Page 99: Saving Data

    5.7 Saving Data Waveforms and settings may be saved in the following ways: • A 20-second recording may be taken for immediate on-screen analysis. • Screen data or patient data may be written to an optional Ventilation Record Card for later analysis (file is readable by Microsoft Excel).

  • Page 100: Using Recorded Waveforms

    5.7.2 Using Recorded Waveforms. 5.7.3 Ventilation Record Card The Ventilation Record Card (VRC) can be used in Standby mode or during ventilation. The following data can be saved for analysis: • screen data • patient data Important: Always handle the VRC and its contents in accordance with regulations and hospital routines.
  • Page 101 Notes: • To make another screen copy, press the Save key again. • When the VRC is removed or the ventilator is restarted, the Save key is automatically reconfigured to save a recording. 5.7.3.2 Copying Patient Data to a Ventilation Record Card The following patient data may be copied to a VRC: Event Log, Trends, Recordings, Open Lung Tool data, Patient Name, Patient ID,...
  • Page 102 Servo… User´s manual English edition Infant Adult Universal Options Order No: 65 14 892 E313E...

  • Page 103: Ventilation Modes

    6 • Ventilation Modes 6.1 Introduction 6.1.1 Warnings The Servo-i Ventilator System can operate in Note: Not all warnings apply to all modes. 14 different modes. This chapter describes • Be sure to set alarm limits as appropriate the modes, their settings, and associated safety information.

  • Page 104: Settings

    6.1.2 Settings Ventilation Mode Abbreviation Settings Pressure Regulated Volume PRVC TV/MV; RR; PEEP; O2; IE/IT; IRT; TF/TP Control Volume Control TV/MV; RR; PEEP; O2; IE/IT; PT; IRT; TF/TP Pressure Control PC+; RR; PEEP; O2; IE/IT; IRT; TF/TP Volume Support TV; PEEP; 02; IRT; TF/TP; ICO Pressure Support PS+;...

  • Page 105: Summary

    6.1.3 Summary Ventilation Mode Abbreviation Notes Pressure Regulated PRVC ALARM if target volume cannot be delivered due to Volume Control setting of UPL; cm; eb; df Volume Control IMPORTANT to set UPL; cm; eb; cf Pressure Control IMPORTANT to set alarm limits for MVol; cm; eb; df Volume Support ALARM if target volume cannot be delivered due to setting of UPL;...

  • Page 106: Ventilator Operation

    Notes: 6.2 Ventilator Operation This section contains information about • The previous ventilation mode function is setting the ventilation mode, recalling not available after a Pre-Use Check, previous ventilation modes, using special changing of patient category, admitting a ventilatory functions, and back-up new patient, using the same ventilation ventilation functionality.

  • Page 107: Backup Ventilation

    pause pressure. Use for static 6.3 Breathing Parameters compliance measuring and to determine concentration (O Conc.)—The gas the total PEEP. The dynamic pressure is mixture can be set from 21% O to 100% shown on the PEEP numerical value. .There is an absolute minimum alarm limit of 18% O which is independent of operating 4.
  • Page 108 Inspiration time (T WARNING! If the trigger sensitivity is set too )—Time for active flow or pressure delivery to the patient (s). high, a self-triggering (autotriggering) Note: Breathing parameter settings can be condition may be reached. This condition configured in two different ways, based on: can also be reached if there is leakage in the breathing system, e.g., if an uncuffed •...
  • Page 109 timeout increases successively during the first ten breaths Time high (T )—Time at P level in Bi- High High Vent (s). Time PEEP (T )—Time at PEEP level in Bi- PEEP Vent (s). Pressure Support above Pressure high (PS )—Inspiratory pressure support above P High level for breaths triggered during the T...
  • Page 110 Servo… User´s manual English edition Infant Adult Universal Options Order No: 65 14 892 E313E...

  • Page 111: Alarms

    The alarm with highest priority is have been trained in the use of the Servo-i displayed first. Ventilator System. 2. The corresponding measured value or set value box flashes and an arrow 7.1.1 Alarm Output Connection...

  • Page 112: Handling Alarms

    7.2 Handling Alarms 7.2.2 Resetting Latched Alarms The system can signal four types of alarm: High Priority alarms are “latched”—the alarm message remains on the screen even if • High Priority—red background the alarm condition ceases. Medium and Low • Medium Priority—yellow background Priority alarms are not latched.

  • Page 113: Presilencing Alarms

    For these alarms, you can silence the audio • Pressing the Audio Pause key again for less signal even if the alarm condition is not than two seconds will now prolong the resolved. However, the system will silent period for two additional minutes. eventually reactivate the alarm.

  • Page 114: Turning Off The Apnea Alarm

    7.2.6 Turning Off the Apnea Alarm 7.3 Alarm Settings for Breathing Parameters To turn off the apnea alarm in Nasal CPAP mode: This section discusses viewing and setting 1. Press the fixed key Alarm Profile. alarm limits, lists alarm settings, explains the conditions under which alarm limits are 2.

  • Page 115: Conditions Leading To Default Alarm Settings

    7.3.4 Conditions Leading to Default Alarm Settings Alarm limits become set to their default values when: • restarting the ventilator • admitting a new patient • changing type of ventilation • changing patient category Servo… User´s manual English edition Infant Adult Universal Options...

  • Page 116: Alarm Ranges And Defaults

    7.3.5 Alarm Ranges and Defaults Allowed Range; (Factory Default Value) Audio Off Alarm (priority) concentration high (HP) NA; (Set Value+6vol%) concentration low (HP) NA; (Set Value-6vol% or ≤ 18vol%) High continuous pressure (HP) NA; (Set PEEP level+15 cmH O for > 15 sec) Adult: 16 - 120 cmH O;...

  • Page 117: Accessories

    8 • Accessories 8.1.1 Nebulizer Use Guidelines Servo Ultra Nebulizer These guidelines are reminders for health The Servo Ultra Nebulizer is intended for care professionals who have already been administering nebulizing drugs to patients trained to use the Servo Ultra Nebulizer: requiring mechanical ventilation or positive pressure breathing assistance via an •...

  • Page 118: Nebulizer Components

    8.1.2 Nebulizer Components 8.1.3 Operation 1. Gas from ventilator 2. Cable from ventilator 3. Ultrasonic generator 4. Sterile buffer water 5. Medication mist produced in the medication cup The 10 ml cup is disposable. It can be filled during nebulization through an injection membrane in the T-piece, or before mounting the T-piece.

  • Page 119: Co Analyzer

    3. Press the CO calibration touchpad. • Use only a MAQUET airway adapter with 4. Press the Cell zero touchpad if the the capnostat sensor. capnostat sensor has been shifted. 5. Press the Verification touchpad to...
  • Page 120 Procedure Diagram: CO Analyzer Calibration Notes: • The etCO concentration low alarm can be permanently silenced (Audio off) when the message Silence alarm permanently? is shown. • During calibration no CO waveforms or measured CO values will be displayed. • During zero calibration the adapter must contain room air only.
  • Page 121 8.2.3.1 Cell Zero Calibration 1. Press the Cell zero touchpad; wait for on-screen instructions. 2. Place the capnostat sensor on the zero cell. 8.2.3.3 Verification Calibration Press the Verification touchpad; wait for on-screen instructions. 2. Place the capnostat sensor on the zero cell; wait for on-screen instructions. 3.

  • Page 122: Y Sensor

    • The Y Sensor is intended for single-patient use only. • Do not insert two Y Sensor modules at the same time. The Servo-i Ventilator System can handle only one Y Sensor module at a time. • Do not apply tension to the Y Sensor tubing.

  • Page 123: System Messages

    9 • System Messages 9.1 Introduction This chapter lists and describes alarm, pre- use check, CO Analyzer calibration, and technical messages. The lists also provide suggested actions in response to the messages. Note: Most technical errors require the attention of a service technician. WARNING! Always disconnect the ventilator when performing operations that increase risk to the patient, such as replacing the O...

  • Page 124: High Priority Alarms

    9.2 High Priority Alarms Alarm Message Possible causes Remedies Apnea Preset or default alarm limit exceeded. Check patient and breathing system. Time between two consecutive inspiratory efforts exceeds the set Check ventilator settings. alarm limit. Backup ventilation An apnea has caused the ventilator to Check patient.
  • Page 125 Alarm Message Possible causes Remedies High continuous Constant high airway pressure for more Check patient and breathing pressure than 15 seconds (PEEP + 15 cmH system. Check ventilator settings. Contact a service technician. Leakage out of range Leakage too high. The mask / prongs Check patient and breathing may not be adjusted properly for the system.
  • Page 126 Alarm Message Possible causes Remedies concentration: Measured O concentration is below the Check O supply line. set value by more than 6 Vol.% or Perform a Pre-Use Check. concentration is below 18 Vol.% which is Perform O cell adaptation. independent of operator settings. Gas delivered in O supply line is not sensor faulty or exhausted.
  • Page 127 Note: Expiratory Minute Volume: Low Considerable leakage may occur around the endotracheal tube if it is uncuffed. The combination of small tidal volumes, leakage around the tube and activated compliance compensation may trigger the Low Expiratory Minute Volume alarm, due to a very low expiratory flow passing from the patient through the expiratory channel.

  • Page 128: Medium Priority Alarms

    9.3 Medium Priority Alarms Alarm message Possible causes Remedies Air supply pressure: Air supply pressure above 6.5 kPa x 100. Check the gas supply lines. Perform High a Pre-Use Check. Air supply pressure at gas inlet is too high. Contact a service technician. Air supply pressure: Air supply pressure below 2.0 kPa x 100.
  • Page 129 Alarm message Possible causes Remedies sensor error Hardware error in CO capnostat sensor. Unplug and reinsert the capnostat sensor. The values in the capnostat memory failed the internal test. Calibrate the capnostat sensor. Change the capnostat sensor. Contact a service technician. sensor Possible hardware error.
  • Page 130 Alarm message Possible causes Remedies supply pressure: supply pressure above 6.5 kPa x 100. Check the gas supply lines. High Perform a Pre-Use Check. supply pressure at gas inlet is too high. Contact a service technician. supply pressure: supply pressure below 2.0 kPa x 100 Check and connect gas supply lines.

  • Page 131: Low Priority Alarms

    Alarm message Possible causes Remedies VT inspiratory Setting causing larger volume than Check the adjustment for the overrange allowed for the selected category. inspiratory tidal volume. Limited adjustment of excessive tidal volume. Y Sensor mismatch Y Sensor does not match the selected Check patient category setting.

  • Page 132: Pre-Use Check Messages: General

    9.5 Pre-Use Check Messages: General Message Cause Remedies Cancelled The test was cancelled by the user. You should always perform a Pre- Use Check before connecting the ventilator to a patient. Failed The test did not pass. Check all connections and the expiratory cassette.

  • Page 133: Pre-Use Check Messages: Specific

    9.6 Pre-Use Check Messages: Specific Message Description Remedies, if test fails Alarm state test Verifying that no Technical Error Refer to Service. Alarms are active. Barometer test Checking barometric pressure Check the barometric pressure measured by the internal value in the Status Window. barometer.
  • Page 134 Message Description Remedies, if test fails Patient circuit leakage Checks the patient circuit leakage, If the internal leakage test has test with patient tubing connected using passed, the leakage is located in the inspiratory and expiratory the patient circuit. Check for pressure transducers.

  • Page 135: Analyzer: Calibration Error Messages

    Analyzer: Calibration Error Messages Message Description Remedies Adapter zero: Failed An error was detected during the Perform a verification calibration. verification calibration (adapter Hardware problem: contact a zero). The airway adapter is service technician. occluded or CO gas is present in the adapter.

  • Page 136: Technical Error Messages

    9.8 Technical Error Messages Error code number Causes Remedies xxxx (General) Technical problem, identified Restart the ventilator and perform by the error code xxxx. a Pre-Use Check. Shut down ventilator and contact a service technician. 1 - 6, 29, 10001 Power failure.

  • Page 137: Specifications

    12.0V - 15.0V DC, 10A The EMC declaration: Information to the Responsible Caution: When external +12 V DC is used, at least one Organization is available from MAQUET. installed Battery module is required to ensure proper Patient Range (kg) operation.

  • Page 138: Ventilator

    10.2 Ventilator 10.4 Inspiratory Channel Pressure drop 10.2.1 General Maximum: 3 cmH O at a flow of 1 liter/s Internal compressible factor Dimensions (mm) Maximum: 0.1 ml/cmH User Interface: 355 W x 53 D x 295 H Gas delivery system Patient Unit: 300 W x 205 D x 415 H Microprocessor controlled valves Weight, approximate (kg)

  • Page 139: Expiratory Channel

    10.5 Expiratory channel 10.7 Alarms Pressure Drop 10.7.1 Allowed Alarm Settings Maximum: 3 cmH O at a flow of 1 liter/s Internal Compressible Factor Airway Pressure (upper) Maximum: 0.1 ml/cmH Adult: 16 - 120 cmH PEEP Regulation Infant: 16 - 90 cmH Microprocessor controlled valve High Continuous Pressure (>...

  • Page 140: Autoset Alarm Limits

    Automode Control mode Support mode <----------- ----------> <----------- ----------> PRVC <----------- ----------> In Servo-i flow measurements all preset and indicated volumes are referenced to ambient pressure at +21˚C (AP21). Servo… User´s manual English edition Infant Adult Universal...

  • Page 141: Trend Function

    10.9 Trend Function 10.10 Open Lung Tool Trend Peak Airway Pressure Ppeak Pause Airway Pressure Pplat PEEP Mean Airway Pressure Pmean End Expiratory Pressure PEEP Continuous Positive Airway CPAP Pressure C dyn i Spontaneous breaths per minute RRspont VTCO Analyzer) Breathing frequency 10.11 Log function Spontaneous Exp.

  • Page 142: Immediate Functions

    The Status menu on the user interface shows the current operating time. • Battery modules must be replaced every 3 years. • Original parts from MAQUET must be used. • Service repair must be performed by MAQUET- authorized personnel only.

  • Page 143: Co Analyzer

    5 minutes to full specification. Power consumption: ≤ 8 W at 12V, during warm up; Oxygen concentration compensation ≤ 6.5 W at 12V, during normal operation Automatic. Values supplied from the Servo-i Ventilator Sensor: powered from the CO Analyzer module. System.

  • Page 144: Y Sensor Measuring

    159 W x 205 L x 29 H Tubing 2.0 m Medical grade PVC Gas Cylinder Restrainer Power Source Y Sensor Module supply voltage: powered from Servo-i, Maximum load < 5 W at 12 V (normal operation) Two 5-liter bottles. Y Sensor Measuring Performance...

  • Page 145: Breathing Parameters: Default Values & Allowed Settings (Standard Configuration)

    10.18 Breathing Parameters: Default Values & Allowed Settings (Standard Configuration) Parameter Factory set default Setting range Infant Adult Universal Infant Adult Universal Infant Adult Infant Adult Automode ON/OFF ON/OFF ON/OFF ON/OFF ON/OFF Automode trigger 3 - 7 7 - 12 3 - 7 7 - 12 timeout (s)
  • Page 146 Parameter Factory set default Setting range Infant Adult Universal Infant Adult Universal Infant Adult Infant Adult Mode (in NIV) Mode (Invasive ventilation) Nebulizer ON/OFF ON/OFF ON/OFF ON/OFF Nebulizer time (min) 5 - 30 5 - 30 5 - 30 5 - 30 NIV Rate (b/min) 4-40 4-20...

  • Page 147: Alarm Limits: Default Settings & Allowed Ranges

    10.19 Alarm Limits: Default Settings & Allowed Ranges Alarm limits Factory set default Setting range Infant Adult Universal Infant Adult Universal Infant Adult Infant Adult Airway pressure, upper 16 - 90 16-120 16 - 90 16-120 limit (cmH Airway pressure, upper 16 - 60 16-60 16 - 60...
  • Page 148 Alarm limits Factory set default Setting range Infant Adult Universal Infant Adult Universal Infant Adult Infant Adult Respiratory frequency, 1 - 160 1 - 160 1 - 160 1 - 160 lower limit (b/min) Respiratory frequency, 1 - 160 1 - 160 1 - 160 1 - 160 upper limit (b/min)

  • Page 149: Definitions

    11 • Definitions b/min—Breaths per minute Bias flow—The continuous flow during the Minute Volume—Volume per minute or expiratory phase target volume (l) Breath cycle time—Total cycle time per MVe—expiratory Minute Volume mandatory breath in SIMV (inspiratory + MVe sp—Spontaneous expiratory minute pause + expiratory).
  • Page 150 Respiratory Rate—Rate of controlled mandatory breaths or used for calculating target volume (b/min) Ri—inspiratory resistance RR—Respiratory rate Service card—Field service software card SIMV—Synchronized Intermittent Mandatory Ventilation SIMV rate—Rate of controlled mandatory breaths (b/min) Start breath—Manually triggered set breath T—Time Tc—Time constant Ti—Inspiration time Ti/Ttot—Duty cycle or ratio of inspiration time to total breathing cycle time (only...

  • Page 151: Appendix • User Interface

    Appendix • User Interface A.1 Fixed Keys Audio off / Audio pause (Silence or pre-silence alarms) Note. Autoset is not possible in NIV. Note. In NIV the alarm sound can be permanently silenced (Audio off). The Save key can be used either to: - copy screen or - save one recording (10 s before and 10 s after pressing the key).

  • Page 152: Quick Access Key

    A.3 Quick Access Key This function allows the user to disconnect the patient from the ventilator and turning off the alarms (for apnea, minute volume, frequency alarm, check tubing, EtCO2, low PEEP) during suction support. Suction Support Note. Suction Support is not available when NIV or O2 Breaths is activated.

  • Page 153: Main Screen Key

    A.4 Main Screen Key A.5 Menu Key (in Standby Mode) Alarm profile setup Possible selections: By pressing the autoset in controlled modes of ventilation the alarm limits are - Pressure (upper) - Minute Volume (lower and upper) automatically set for: - Pressure - Respiratory Rate (lower and upper) - End Expiratory Pressure (lower)

  • Page 154: Menu Key (During Ventilation)

    A.6 Menu Key (During Ventilation) Alarm profile setup Possible selections: By pressing the autoset in controlled - Pressure (upper) modes of ventilation the alarm limits are - Minute Volume (lower and upper) automatically set for: - Respiratory Rate (lower and upper) - Pressure - End Expiratory Pressure (lower) - Volume...

  • Page 155: Biomed Menu (Standby Mode)

    A.7 Biomed Menu (Standby Mode) Enter code 1973 to access the Biomed menues. Note. The access code can be change by the user. SVX-632_EN Technical alarms Alarm sound level NIV adult alarm NIV infant alarm Start-up configuration Copy configuration to/from PC Card. Change Change access code to Biomed menu.

  • Page 156: Screen Touch Pads

    A.8 Screen Touch Pads O cell/sensor Batteries Status of O cell/sensor CO Module Status ofY Sensor module (if available) Status of batteries Y Sensor Measuring the bar is white when the pressure triggering is selected. NIV Backup This pad is only visible during NIV Pressure Support mode Note.

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