Page 1 Cosmed does not assume the liability for interpretation mistakes of this documentation or for casual or consequential damages in connection with the provision, representation or use of this documentation. No parts of this manual may be reproduced or transmitted in any form without the express permission of COSMED Srl.
Page 2: Table Of Contents
Quark PFT1 standard packaging........19 Quark PFT2 standard packaging........19 Quark PFT3 standard packaging........20 Quark PFT4 standard packaging........20 Quark PFT Ergo standard packaging......21 Quark PFT2 ergo Standard packaging......21 Quark PFT4 ergo Standard packaging......22 Warranty registration ..............23 Register the product via software ........
Page 3 Carbon Monoxide sensor (CO)........26 Methane sensor (CH ) ............ 26 Humidity absorber ............26 Power Supply..............26 Environmental Sensors ..........26 Dimension and Weight ..........26 Aux inputs..............26 Measurements Pulmonary function tests and measured parameters ....28 Spirometry Tests ..............28 FVC - Forced Vital Capacity.........
Page 4 Enter a new patient..............54 Find a patient................54 Edit patient data................ 54 Delete a patient................. 54 Archive maintenance ..............55 Reorganise the archive ............. 55 Delete the archive..............55 Delete a test ................55 4 - Quark PFT User Manual...
Page 5 Backup and restore..............55 Backup ................55 Restore ................55 Spirometry Settings .................56 Graphs................56 Serial port ..............56 Units of measurements ..........56 Using extra fields............56 Customise the fields............56 Spirometry Setting spirometry options ..............58 Spirometry................58 Automatic Interpretation..........58 Quality control...............
Page 6 The evaluation of the cardiorespiratory function ..... 94 Precautions ................94 Laboratory..............94 Ending the test ............... 94 Preparing the patient ..............94 Before testing..............94 Patient assent..............95 Ending the test ............... 95 6 - Quark PFT User Manual...
Page 7 Start Testing ..................96 Start a test ..............96 Abort the test without saving data ......... 96 End the test saving data ..........96 View data in real-time.............. 96 View graphs in real-time ..........97 Parameters to view..............97 Manual protocol ............... 97 Enter Load and Phase ............
Page 8 O2 Saturation during the test ........115 Spirogram................115 Spirogram during the test..........115 View the events after the test ..........115 Raw data................. 115 Save Raw data.............. 115 Resting Metabolic Rate Test Metabolism ................... 118 8 - Quark PFT User Manual...
Page 9 Total Metabolic Rate.............. 118 Resting Metabolic Rate (RMR) ..........118 Importance to measure RMR ..........118 Measurement of the rest metabolic rate with indirect calorimetry ................118 How to perform a RMR test........... 118 Recommendations .................119 Performing a test ................120 Calibrations ................
Page 10 Automatic diagnosis (algorithm)..........146 Quality Control Messages ............146 References..................147 Spirometry ..............147 Lung Volumes.............. 147 Single-Breath with Apnea..........147 Single-Breath without Apnea........147 Gas Exchange References..........147 Indirect calorimetry............147 Sub-maximal testing ............ 147 10 - Quark PFT User Manual...
Page 11: Getting Started
Getting started...
Page 12: Important Notices
• important studies concerning human physiology; • the collection of important information in sport medicine. No responsibility attaches COSMED Srl for any accident happened after a wrong use of the device, such as: • use by non qualified people; •...
Page 13 9. Keep the device away from heat and flame source, flammable or inflammable liquids or gases and explosive atmospheres. 10. In accordance with their intended use Quark PFT is not to be handled together with other medical devices unless it is clearly declared by the manufacturer itself.
Page 14: Contraindication
1.51 in men and predicted value FEV1 in women less than 1.21. • Recent infection in the superior air tracts • During the asthmatic re-acuting • Hypertension • Pregnancy • A pharmacology treatment epilepsy Contraindications for Exercise testing Read carefully the exercise testing chapter. 14 - Quark PFT User Manual...
Page 15: Environmental Condition Of Use
Due to this the vicinity of power lines is to be avoided as well. Cosmed equipment are not AP not APG devices (according to EN 60601-1): they are not suitable for use in presence of flammable anaesthetic mixtures with air, oxygen or nitrogen protoxide.
Page 16: Safety And Conformity
EN 60601-1-2 EN 55011 Class B (emission), IEC 1000-4-2, IEC 1000-4-3, IEC 1000-4-4 Quality Assurance UNI ISO 9001 (Registration n° 387 Cermet) Medical Device Directive (CE mark) MDD 93/42/EEC (Notified Body 0476). Class IIa 16 - Quark PFT User Manual...
Page 17: Keynotes
Keynotes Here are the keynotes used to make the manual easier to read. Typographic keynotes These are the typographic keynotes used in the manual. Style Description Bold indicates a control or a key to be pressed. “Italic” indicates a messages shown by the firmware. Graphic keynotes These are the graphic keynotes used in the manual.
Page 18: Systems Overview
Systems Overview Quark PFT is a stationary and modular system designed for Pulmonary Function Testing. This system has been designed to meet the most accredited criteria and recommendations of the latest scientific publications. The system incorporates “plug and play” circuitry, allowing the customisation of features and instant upgrades.
Page 19: Before Starting
Before starting Before operating the Quark PFT system we strongly recommend to check the equipment and register you as a customer. Checking the packing contents Make sure that the package contains the items listed below. In case of missing or damaged parts, please contact Cosmed technical assistance.
Page 20: Quark Pft3 Standard Packaging
Quark PFT4 standard packaging Code Description C00934-01-04 Quark PFT4 unit C02120-01-05 Turbine Ø 28mm C02171-02-11 Kit optoelectronic reader Quark PFT 2/3/4 C01730-01-05 Breathing valve PFT3/4 (3 ways) C00243-01-06 Calibration syringe 3 litres C02210-02-08 Permapure L 2 m A 182 300 004...
Page 21: Quark Pft Ergo Standard Packaging
Code Description C00936-01-04 Quark PFT2 ergo unit C02120-01-05 Turbine Ø 28mm C02171-02-11 Kit optoelectronic reader Quark PFT 2/3/4 C01590-01-05 Breathing valve PFT2 A 800 900 001 Head cap for the adult masks C00243-01-06 Calibration Syringe 3L A 108 106 002...
Page 22: Quark Pft4 Ergo Standard Packaging
Description C00937-01-04 Quark PFT4 ergo unit C02120-01-05 Turbine Ø 28mm C02171-02-11 Kit optoelectronic reader Quark PFT 2/3/4 A 800 900 001 Head cap for the adult masks C00243-01-06 Calibration Syringe 3L A 108 106 002 Tank tubing 6x8 98 shore...
Page 23: Warranty Registration
Warranty registration Before using the system, please take a moment to fill in the registration form and the warranty and return them to COSMED, by doing this you are eligible to the customers assistance service. For further information, please refer to the enclosed registration and warranty form. If the form is not enclosed in the packaging, please contact directly COSMED.
Page 24: Options/Accessories
Options/Accessories The following options are available to enhance or to complete the Quark PFT system: Code Quantity Description A 860 000 004 Calibration cylinder (5% CO2, 16% O2, balance N2) A 860 000 005 DLCO cylinder (0.3% CO, 0.3& CH4, 21% O2, balance N2) A 860 000 006 DLCO st.
Page 25: Pc Configuration Required
VGA, SVGA monitor. • Serial Port RS 232 available (2 serial ports in case of Ergometer control). An USB port can replace one RS232 serial port, if using the USB-RS232 adaptor (Cosmed code A 388 410 001). • Any Mouse and Printer compatible with the MS Windows™ operative system.
Page 26: Technical Features
Aux inputs With the auxiliary RS 232 port and the digital (TTL) input for external ECG signal, Quark PFT offers the possibility to integrate data coming from many equipment such as ECGs and ergometers. 26 - Quark PFT User Manual...
Page 27: Measurements
Measurements...
Page 28: Pulmonary Function Tests And Measured Parameters
VC/IVC - Slow Vital Capacity and Ventilatory pattern Symbol Parameter Expiratory Vital Capacity Inspiratory Vital Capacity Expiratory Reserve Volume Inspiratory Reserve Volume Inspiratory Capacity l/min Expiratory Minute Ventilation Tidal Volume 1/min Respiratory Frequency Duration of Inspiration Duration of Expiration 28 - Quark PFT User Manual...
Page 29: Mvv - Maximum Voluntary Ventilation
Ttot Duration of Total breathing cycle Ti/Ttot —- Ti/Ttot ratio Vt/ti l/sec Vt/ti ratio MVV - Maximum Voluntary Ventilation Symbol Parameter l/min Maximum Voluntary Ventilation Tidal Volume (during MVV) 1/min Maximum Respiratory frequency MVVt MVV duration time Bronchoprovocation Response Symbol Parameter FallFEV1 Fall in FEV1 from baseline or post diluent...
Page 30: Respiratory Drive - P0.1 Test
O Maximum inspiratory pressure cm H O Maximum expiratory pressure Cardio pulmonary Exercise Testing (CPET) The Ergo option makes the Quark PFT a complete Cardiopulmonary Exercise Testing system able to measure the following parameters: Breath by Breath exercise testing Symbol...
Page 31: Indirect Calorimetry
Ti, Te, Ti/Ttot time breaths Vd/Vt Vd/Vt ratio PaCO2 mmHg arterial PCO2 (estimated) P(a-et)CO2 mmHg Delta PaCO2 – PetCO2 Indirect Calorimetry Symbol Parameter Kcal/day Energy Expenditure EE/BSA Kcal/day/m Energy Expenditure/Body surface area EE/Kg Kcal/day/Kg Energy Expenditure pro Kg Kcal/day Fats Kcal/day Carbohydrate Kcal/day...
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Page 33: Installation
Installation...
Page 34: Unpacking The System
Quark PFT and accessories can have place on the trolley as shown in the following illustration.
Page 35: Setting Up The System
Setting up the system Before starting operating with the system make sure to meet the environmental and operational conditions reported in Chapter 1. Installing the Calibration Gas Cylinders In order to calibrate the sensors you need to have available calibration cylinders with the following gas concentrations: Cylinder Recommended Gas mixture...
Page 36: Connecting Cables And Tubing
Breathing valve connector DLCO mix gas connector Cal gas (16% O , 5% CO ) connector gas connector RS232 Serial Port for PC connection Ground snap connector Power cable connector Switch 110V / 220V 36 - Quark PFT User Manual...
Page 37: Cables And Tubing's Installation Sequence
2. Connect the power cable of the PC and the printer to the trolley 3. Connect the RS232 cable from the Quark PFT (PC RS232) to the PC (COM1 or COM2). If the PC does not have a RS232 port, please use the USB-RS232 adapter (A 388 410 001), available as an accessory.
Page 38: Assemble The Turbine
It has to be used for mask applications on hard to seal faces and where leaks are not tolerated. • Will not irritate the skin • Contains no adhesives. • Has no odour • Will not dry out • Single patient use 38 - Quark PFT User Manual...
Page 39: Apply The Seal To The Mask
Apply the seal to the mask Apply seal to clean, residue-free mask only and follow the instructions below: 1. Remove the plastic tray from the bag. Peel off clear film and retain for later use. 2. While holding tray align the nose area of mask to nose area of Ultimate Seal™ gel. Press together and roll mask down over the surface of the gel seal attaching it to the mask and releasing it from the tray.
Page 40: Software Installation
5. When the installation is over, the program will advise you with a message indicating that the installation has been successfully completed, click on End. Note: the directory for the Ergo software must be the same of the Quark PFT (spiro). Run the software 1.
Page 41: Software Main Features
On-line help COSMED Quark Help is a complete on-line reference tool that you can use at any time. Help is especially useful when you need information quickly or when the Quark user manual is not available. Help contains a description of each command and dialog box, and explains many procedures for accomplishing common tasks.
Page 42 42 - Quark PFT User Manual...
Page 43: Calibration
Calibration...
Page 44: Calibrating Sensors
20.93%), and do the same for the gas concentration of the calibration cylinder. 3. Type the volume of the calibration syringe (i.e. 3000 for a 3 litres calibration syringe). 4. Press OK button to confirm changes. 44 - Quark PFT User Manual...
Page 45: Calibrating Analysers
2. Ensure that the O cylinder is properly connected to the rear panel of the Quark PFT and check that the pressure of the gas is in the range 5-6 bar. 3. Check if the reference values for the calibration gas specified in File/Reference values…...
Page 46: Print The Calibration Report
250ms, please contact the Technical Support. An high value of the O delay can be due to: • Chemical sensor exhausted. • Old or obstructed Permapure tube. • Dust or dirt in the sampling line. 46 - Quark PFT User Manual...
Page 47: Turbine Calibration
±3% accuracy. The calibration syringe The 3 litres calibrated syringe is included in all the Quark PFT line with the exclusion of the PFT 1 model. 3 litres calibration syringe: P/N C00600-01-11.
Page 48: Calibrating The Turbine
4. At each of the 10 steps the software displays the results of the manoeuvre and the percentage error in the reading. 5. At the end of this operation, the software displays the new calibration factors. Press OK to store the new value. 48 - Quark PFT User Manual...
Page 49: Checking The System Signals
The Control Panel, which can be activated from the Calibration/Control panel… menu item, is a useful tool to check the main hardware functions of Quark PFT. By using the controls on Control Panel you are able to do the following: 1.
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Page 51: Database Management
Database Management...
Page 52: Spirometry Patient's Database
Move to the first visit in the archive Move to the previous visit in the archive Move to the next visit in the archive Move to the last visit in the archive Find a visit in the archive 52 - Quark PFT User Manual...
Page 53: Test Card
1. Select the patient. 2. Choose the test and press the key by side. All data will be imported/exported in the XPO file format (Cosmed proprietary). Diagnosis Database The program allows to manage a diagnosis database, whose records are composed by a diagnosis ID code and a string of text.
Page 54: Exercise Testing Patient's Database
1. Select the patient. 2. Press Modify… in order to edit the patient’s data. 3. Edit the desired values and press OK to confirm. Delete a patient 1. Select the patient to be deleted. 2. Press Delete. 54 - Quark PFT User Manual...
Page 55: Archive Maintenance
Archive maintenance The software allows to manage files selecting Archive from the File menu. It is advisable to perform the archive reorganisation every month, in order to free space on the hard disk and/or to correct possible errors present within the database. It is possible also that your have no more hard disk space.
Page 56: Spirometry Settings
3. Enable or disable the Show Info Test option. Serial port You must select the serial port RS 232 that will be used to connect the Quark PFT with the PC. To select the serial port, click on the proper COM button (the selected port must be different from the mouse one).
Page 57: Spirometry
Spirometry...
Page 58: Setting Spirometry Options
Spirometry Automatic Interpretation Quark PFT has the function of interpreting each test performed by a patient visualising an automatic diagnosis. The algorithm has been calculated basing on “Lung Function Testing: selection of reference values and interpretative strategies, A.R.R.D. 144/ 1991:1202-1218”.
Page 59: Parameters Manager
Parameters manager The program allows to calculate a huge number of parameters; it is advisable, in order to simplify the analysis of the results, to view, to print and to sort the desired parameters only. Select the menu item Options/Parameters... View Move the parameters to view into the Selected parameters list.
Page 60: Set The Current Predicted
This form allows the user to manage the formulae associated to a set of predicteds. Select the set of predicteds from the list Predicteds set. To insert a new parameter click on the New... button. The parameter formulae can be: 60 - Quark PFT User Manual...
Page 61: Page Set-Up
• calculated according to the predicteds in the list Use the predicteds formulae; • customised by the user with the option ...or the customised formulae. The Delete button deletes the selected parameter. The Copy button stores the selected parameter in memory. The Paste button inserts a new parameter from the one copied.
Page 62: Spirometry Tests
Before performing any test make sure that: 1. Quark PFT is properly connected to your PC and the selected serial port (COM1, COM2) corresponds to the one effectively use. 2. The name shown on the status bar corresponds to the patient who is to carrying out the tests.
Page 63: Forced Vital Capacity (Pre)
Forced Vital Capacity (pre) FVC is a reference test to verify obstructive (airflow limitations) and restrictive disorders (lung volume limitations). To achieve good test results it is fundamental a good manoeuvre (quality control messages, real time plots …) The main parameters measured during FVC tests are: Forced Vital Capacity FEV1 Forced Expiratory Volume in 1 second...
Page 64: Perform The Fvc Test With The Encouragement
Perform the FVC test with the encouragement 1. Select Encouragement from View menu. 2. Perform the test as explained in the previous paragraph. 64 - Quark PFT User Manual...
Page 65: Slow Vital Capacity
Slow Vital Capacity Important test for assessing COPD (chronic obstructive pulmonary disease) patients affected by this disease might present a the Slow Vital Capacity could be higher than the Forced one (FVC). The main parameters measured during SVC tests are: Expiratory Slow Vital Capacity Inspiratory Slow Vital Capacity Expiratory Reserve Volume...
Page 66: Maximum Voluntary Ventilation
7. Press Exit to visualise the test list carried out during current session together with the results of the main parameters. 8. Select the test that you want to save (the Best Test according to the ATS criteria is highlighted as default) and press OK. 66 - Quark PFT User Manual...
Page 67: Bronchial Provocation Test
Bronchial Provocation Test Bronchodilator test Bronchodilators are administered routinely in the PFT laboratory to determine whether airflow obstruction is reversible. Bronchodilators increase airway calibre by relaxing Note: Read carefully the airway smooth muscle. contraindications in Chapter 1. The test consists of comparing results between the reference FVC (FVC PRE) and the FVC POST performed after the administration of the drug.
Page 68: Perform The Test
2. Type the Protocol name, the Bronchoprovocator name and the unit of measurement in the proper input fields. 3. If the bronchoprovocator has a cumulative effect select the cumulative check button. 4. Enter the quantities for each step and press the button 68 - Quark PFT User Manual...
Page 69: Viewing Results
Viewing results All the visualisation functions refer to the test carried out by the Current Patient, whose name is indicated on the left-side of the status bar. To view tests results: 1. Select the Patients from the File menu 2. Select the patient corresponding to the test you want to view. 3.
Page 70: Printing Results
CO diffusing capacity Prints the best DLCO Steady State test of the current visit Steady State Respiratory drive Prints the best P0,1 test of the current visit. Preview Views a report preview on the screen. 70 - Quark PFT User Manual...
Page 71: Printing The Active Window
Text button in the dialog box Save as allows you to configure the separators for character based files. With the *.xpo Cosmed file format it is possible to import data from another Quark archive. Press OK to confirm.
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Page 73: Lung Volumes
Lung Volumes...
Page 74: Lung Volumes Tests (N Washout)
2. Body Plethysmography 3. Multiple-breath closed circuit Helium washout COSMED Quark PFT uses the nitrogen wash-out technique to measure Lung volumes. This method involves removing or “washing-out” the N2 gas present in a patient’s lung by having the patient breathe 100% O2 for several minutes (usually 7 minutes or until the final concentration of N2 is below 1.5-2.5%).
Page 75: Perform The Test
Option Description End-of-test criterion FetN value under which the wash-out test is concluded automatically FRC Extrapolating Enable the extrapolation of FetN to the end-of-test criterion Vt stability threshold Recognition criterion of regular respiration Breathing Depth Range of respiration control bar during FRC (tidal volume) Breathing Frequency Range...
Page 76: Closing Volume Test (Cv)
This column is green if the flow is within the acceptable range, otherwise it is red. 6. The test stops automatically. 7. In order to visualise the graph and the main parameters press the follow buttons: View CV graph. 76 - Quark PFT User Manual...
Page 77 view Volume Time graph view data of the test At the end of the test, you can edit the test: • Display the test to be modified • Right click with the mouse and select Edit...to change the test properties (wash-out volume, sample volume, effective breath hold time calculation...).
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Page 79: P0.1 Respiratory Drive
P0.1 Respiratory drive...
Page 80: P0,1 (Respiratory Drive)
P0.1 parameter. 4. Repeat the above mentioned manoeuvre several time both in room air or with enhanced CO inspiratory gas. 5. Press F3 to end the test. 80 - Quark PFT User Manual...
Page 81 6. To visualise the V/t graph and the main parameters press the follow buttons: view P0.1 graph view Volume Time graph view breath by breath data 7. Press the Abort button to stop the acquisition discarding the results. Chapter 8 - P0.1 Respiratory drive - 81...
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Page 83: Lung Diffusing Capacity
Lung diffusing capacity...
Page 84: Co Diffusing Capacity (Dlco) Test
Recognition criterion of regular respiration from the beginning of the inspiration till the beginning of sampling from 70% of inspiratory time, to 50% of sampling from 50% of Inspired Volume to the beginning of sampling 84 - Quark PFT User Manual...
Page 85: Recommendations
Pressing the System… button, you can set the following options: Option Description System dead space Add the volume of the viral filter eventually used concentration content of the used mixture (ATS 21%, ERS 17%) Pressing the Patient… button, you can set the following options: Option Description Physiologic dead space...
Page 86 Double-click with the left mouse button in order to modify the test options (wash-out volume, sampling volume, calculation of the real apnoea time…). Checking the box ATS95 Criteria, it is possible to set automatically 1 litre for wash-out and sampling values, according to the ATS95 criteria. 86 - Quark PFT User Manual...
Page 87: Dlco Without Apnoea ("Intrabreath" Method)
DLCO without apnoea (“intrabreath” method) 1. Remove the sampling line from the flowmeter 2. Select Single Breath CO diffusing capacity from the Test menu 3. Confirm or in case change the test options: - Breath hold time (deselect the check box) - Simulated test (it allows to carry out the manoeuvre without inhaling gas, useful for teaching purposes) - Hb (haemoglobin)
Page 88 88 - Quark PFT User Manual...
Page 89: Mip/Mep (Option)
MIP/MEP (option)
Page 90: Mip/Mep Test
MEP and MIP can be conducted during the same acquisition. 9. Press F3 or wait the end of the test, so that the software displays the graphs, the measured parameters, and the predicteds values. 90 - Quark PFT User Manual...
Page 91: Pulse Oximetry (Option)
Pulse oximetry (option)
Page 92: The Oximetry Test
Heart rate How to perform the test 1. Connect the pulse oximeter to auxiliary RS232 port on the back of the Quark PFT. 2. Connect the probe to finger or ear of the Patient (different probes are available). 3. Select Oximetry from the Test menu and wait for the green led is prompted on the right side of the screen.
Page 93: Exercise Testing
Exercise testing...
Page 94: Recommendations For The Exercise Testing
The patient must wear comfortable suit and gymnastic shoes and two hours before test stop any kind of drugs, eat light and avoid coffee and smoke. 94 - Quark PFT User Manual...
Page 95: Patient Assent
It’s very important acquire information on the patient’s clinical past before performing the test. Keep attention in particular way to the use of drugs, tobacco, to the physical fitness and symptoms produced with the exercise. Patient assent The patient is informed that he will be submitted to a maximum effort, which could be stopped at any moment, and of the risks of the test execution.
Page 96: Start Testing
The visualisation features and capabilities of the data and graphs are identical to the ones described in the Data management chapter. Starting the test a small window will appear on the right corner displaying time, bmp and, if selected before, the ergo protocol and trainer. 96 - Quark PFT User Manual...
Page 97: View Graphs In Real-Time
View graphs in real-time 1. Choose Graph from the View menu. 2. Follow the instructions described in data management section to edit the graphs. Parameters to view While the test is running, it is possible to choose the parameters to view. 1.
Page 98: Data Management
3. Choose the parameters you require on the X, Y1 and eventually for Y2; select if necessary some of the following options by pressing the more button and press OK to confirm. It is possible to access quickly 5 common graphs from the View/Graph… dialog box. 98 - Quark PFT User Manual...
Page 99: Customise The Graphs
Note: Double-click in the graph window to open the edit test Right-clicking, the graph can be exported in bmp file format. Customise the graphs 1. With a graph on the screen, choose Customise graph from the View menu. 2. On the Customise graph dialog box, select options to obtain the wished graph. Option Function Grid on X, Y axes...
Page 100: Viewing Predicted Values
The software allows to customise two of the three graphs for the LT visualisation. 1. Choose Lactate Threshold from the Options menu. 2. Choose the parameters you want to be shown on the LT window and press OK to confirm your choices. 100 - Quark PFT User Manual...
Page 101: Fittings
Fittings The purpose of the fitting function is to find the function that fits as better as possible the measured data. The software allows to fit data according to 3 different functions: Model Function Algorithm Available for Linear Y=A*X+B Least squares Any Y vs any X graph Mono-Exp Y=A+B*exp[(t-t...
Page 102: Calculate The "Mean Value
OK. You can lock data checking the relative field 102 - Quark PFT User Manual...
Page 103: Information About The Test
Information about the Test The Test Information dialog box shows all the information concerning environmental data, patient data and some data about the test View the Information Choose Information from the View menu. Modify the information 1. Press the Modify button on the Information dialog box. 2.
Page 104: Print The Current Window
View the report This function allows to show a preview of a selected report. 1. Select Report from the View menu. 2. Select the test and the report to visualise and press OK to confirm. 104 - Quark PFT User Manual...
Page 105: Data Editing
Data Editing The software allows the user to edit the data acquired during the test in the following ways: • deleting one or more steps • editing row data Nota: In Data view, double- click in the window to enter •...
Page 106: Using The User Fields
Time range Specifications From, To specifies the time range. All steps applies the editing from the beginning to the end of the test. 106 - Quark PFT User Manual...
Page 107: Restore The Original Test
Apply to Specifications Parameter specifies the reference parameter >, >=, =, <, <=, <> higher than, higher or equal, equal to, lower than, lower or equal, different Value/Formula… specifies the value (mathematical expression) compared with the value of the specified parameter. All steps do not use any selection criteria.
Page 108: Customise The Parameters
6. Press the buttons in the calculation group and insert the mathematical formulas for men and women, adults and paediatrics. Press OK twice to confirm. Once you create the new predicted you can see it in the predicted window. 108 - Quark PFT User Manual...
Page 109: Exporting Data
If you selected ASCII format, by clicking on Text button you can then select the Thousands sep. and Column sep. according to the program you want to use. With the xpo Cosmed format you can import/export the tests performed on another Quark equipment.
Page 110: Creating Test Protocols
8. To edit a step, select it from the list and change the relative values in the Edit boxes below the list. Press the Tab button to save changes. 9. To delete a step, highlight the step and press Delete. 110 - Quark PFT User Manual...
Page 111: Software Configuration
Software configuration The software can be customised as you wish. Most of the feature are easily editable to be tailored according to different purposes. Data viewing The software allows to calculate a huge number of parameters; it is advisable, in order to simplify the analysis of the results, view in the data window the only desired parameters.
Page 112: Printout Reports
3. To insert an image click the Logo button. An image editor will be opened, draw the own logo and close the image editor to save changes. 4. Press OK to save the Printout header. 112 - Quark PFT User Manual...
Page 113: Electronic Reports (*.Pdf)
Electronic reports (*.pdf) If an Adobe PDF writer “Printer Driver” is installed and set as the default printer, it is possible to store the printout report automatically in any location of the HD or eventually LAN paths according to a customizable filename format. It is possible to define the created filename format selecting Options/Printout header..., and then Name format…...
Page 114: Events Management During Exercise Testing
3. As soon as 5 or 6 complete breaths have been acquired press F3 to stop the acquisition. O2 Saturation (optional) The O2 Saturation event is useful to check the quality of SpO2 signal acquired by the on-board Oxymeter (if available) during the test. 114 - Quark PFT User Manual...
Page 115: O2 Saturation During The Test
O2 Saturation during the test 1. Start with normal Exercise test and begin the memorisation of breath values (F2). 2. Select O2 Saturation from Test/Event... 3. As soon as 5 or 6 complete pulses have been acquired press F3 to stop the acquisition.
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Page 117: Resting Metabolic Rate Test
Resting Metabolic Rate Test...
Page 118: Metabolism
10%, average RQ changes by less than 5% • Stable interpretable measurements should be obtained in a 15 to 20 minute test. • Renal failure patients requiring hemodialysis should not be tested during dialysis therapy. 118 - Quark PFT User Manual...
Page 119: Recommendations
Recommendations Since the ventilation is very low (normally <10 litres/min), the turbine calibration has to be performed with very slow manoeuvres (each complete manoeuvre in about 10-15 seconds), to obtain the best accuracy. Use the following correction for the dead space (V - 50 ml for the small mask - 60 ml for the medium mask - 70 ml for the large mask...
Page 120: Performing A Test
Selection of the RMR workspace (windows placement); The test is fully automatic, the software will stop it and save the data at the end of the minute. The real time view is as shown in the following picture: 120 - Quark PFT User Manual...
Page 121: Viewing The Test
Viewing the test At the rend of the test, it will be opened automatically a window with the test results. At the end of the test, or if it is selected View/RMR, the main results are shown: • The average time interval (default: 10 minutes) •...
Page 122: How To Modify The Average Interval
To move the start line, left-click on the exact time in which you want to start the calculations, for the end line, right-click. Print The print of the current window generates a report similar to the one in the following page. 122 - Quark PFT User Manual...
Page 123 Chapter 13 - Resting Metabolic Rate Test - 123...
Page 124 124 - Quark PFT User Manual...
Page 125: Sub-Maximal Exercise Testing
Sub-maximal Exercise Testing...
Page 126: Introduction
Other unusual signs or symptoms that may preclude testing • Risk factors for coronary heart disease • History of major cardiorespiratory events • Current medications • Activity patterns • Nutritional habits • Reading and signing an informed consent form 126 - Quark PFT User Manual...
Page 127: Sub-Maximal Exercise Testing
Sub-maximal exercise testing Heart rate varies linearly with VO to the point of maximum exertion; thus, VO 2max be estimated using the relation between heart rate and VO without subjecting the individual to maximum levels of physical stress. During sub-maximal exercise testing, predetermined workloads are used to elicit a steady state of exertion (plateau of heart rate and VO ).
Page 128: Staffing
Noticeable change in heart rhythm Subject requests to stop Physical or verbal manifestations of severe fatigue Failure of the testing equipment Assuming that testing is non-diagnostic and is being performed without direct physician involvement or electrocardiographic monitoring. 128 - Quark PFT User Manual...
Page 129: Considerations For Accuracy
Considerations for accuracy The ability to obtain valid and reproducible results is essential to ensure that any differences between pre-treatment and post-treatment test results are due to exercise training rather than variations in testing procedures. Some inconsistencies that are inherent may increase variability: •...
Page 130: Performing The Test
HR at the end of the 2 step is: <80 80-89 90-100 >100 set the workload at (kgm/min) step: if the HR at the end of the 3 step is: <80 80-89 90-100 >100 set the workload at (kgm/min) 1050 130 - Quark PFT User Manual...
Page 131: System Maintenance
System maintenance...
Page 132: System Maintenance
Rubber mouthpieces, face masks, breathing valve and the other parts are not shipped sterile. They should be disinfected before using according to the following instructions. All materials used in the construction of the Quark PFT are non toxic and pose no safety risk to the patient or operator.
Page 133: Cleaning The Turbine Flowmeter
Cleaning the turbine flowmeter Warning: Do not use alcoholic solutions for the turbine, otherwise there can be damages to the plastic material. It is necessary to disinfect periodically the turbine for sanitary measures or/and for the correct device function. As disinfecting solution it is suggested Sodium hypochlorite 5% (bleach). The disinfecting procedure is easy and may be effected every time the user needs, keeping attention to some precautions: 1.
Page 134 134 - Quark PFT User Manual...
Page 135: Masks Cleaning And Disinfection
Masks cleaning and disinfection The face masks should be cleaned and sterilised after each test. Disassembling the different parts of the mask 1. Remove the valves from their place. 2. Remove the adapter for the optoelectronic reader. Cleaning the mask 1.
Page 136: Select The Proper Power Supply Voltage
Select the proper power supply voltage The power supply voltage can be changed in the following way: 1. Open the power supply cover using a screwdriver. 2. Rotate the voltage selector in order to read the desired value. 136 - Quark PFT User Manual...
Page 137: Appendix
Appendix...
Page 138: Service - Warranty
Service - Warranty Warranty and limitation of liability COSMED provides a one (1) year limited warranty from the date of the original sale of COSMED products. All COSMED products are guaranteed to be free from defect upon shipment. COSMED’s liability for products covered by this warranty is limited exclusively to replacement, repair, or issuance of a credit for the cost of a defective product, at the sole discretion of COSMED.
Page 139: Repair Service Policy
(Pro-forma Invoice and Customs Paper) as requested by the Italian law. • The shipment has to be qualified as a Temporary Export. • All the goods returned to COSMED without the customs papers will not be accepted. For European Community members: Pro-Forma invoice complete with: •...
Page 140 Privacy Information Dear Customer, we inform you that your personal data are gathered and will be used by Cosmed Srl in conformity with the requirements of the Italian privacy law (Decreto Legislativo 196/2003). We believe it is important for you to know how we treat your personal data.
Page 141 Heart Rate – TTL input The Heart Rate TTL input allows to measure the hearth rate signal from any ECG with a pulse signal (0-5 Volts) available or from the POLAR belt receiver probe. Referring to the connector labelled as HEART RATE on the rear panel of the Quark PFT, the pin out assignment is the following: Signal TTL input...
Page 142 Base line and Gain: factors used to convert the acquired raw data (mV) into the final format according to Y=(mV-BL)*Gain. The value entered for gain must be multiplied by 1000 (for Gain=1, enter 1000). Precision: the number of decimals shown as 0 142 - Quark PFT User Manual...
Page 143 Calculations references and VCO "Energy Expenditure and Fuel Selection in Biological Systems: The Theory and Practice of Calculations Based on Indirect Calorimetry and Tracer Methods": M. Elia, G. Livesey, World Rev. Nutr. Diet. Basel, Karger, 1992, vol 70, pp 68-131. "Nutritional Assessment in Critical Care, A Training Handbook": Donald C.
Page 144 10 mm/l Flow: 5 mm/l/sec Time: 20 mm/sec F/V ratio: The total number of error (FVC e FEV1 >±3.5%, FEF25-75% >5.5%) during the measurement of the 24 standard waveforms must be lower than 4. 144 - Quark PFT User Manual...
Page 145 Predicted values ERS93 Reference Adult: Standardized Lung Function Testing: Official Statement of the European Respiratory Society, The European Respiratory Journal Volume 6, Supplement 16, March 1993. Reference Paediatric: Compilation of reference values for lung function measurements in children: Ph. H. Quanjer, J.
Page 146 2 max FVC within 0.2 l FEV1 reproducible diff. 2 max FEV1 within 0.2 l PEF reproducible diff. 2 max PEF within 10 % MVV time too short MVV time less than 12 sec 146 - Quark PFT User Manual...
Page 147 References Spirometry ATS ’94: “Standardization of Spirometry: 1994 Update”, American J. Respiratory Critical Care Medicine, Vol. 152, 1107-1136; 1995 ERS ’93: “Standardized Lung Function Testing: Official Statement of the European Respiratory Society”, The European Respiratory Journal Volume 6, Supplement 16, March ”...
Page 148 148 - Quark PFT User Manual...

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