EvitaXL

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Ventilation Modes Volume-controlled ventilation with PLV and AutoFlow® Sigh This effect can also be caused during ventilation, e.g. due to a build-up of secretion. In this situation, the pressure is limited by the alarm limit »PAW W«. The pressure rise stops 5 mbar below the alarm limit »PAW W«, and the alarm »Volume not constant« is only given when the set tidal volume VT is not longer applied. The start of mandatory inspiration can be synchronised with the patient's own efforts with the aid of the variable Flowtrigger. Only in IPPV mode can Flowtrigger be fully switched off (IPPVAssist -> IPPV). The steepness of the pressure rise from the PEEP level to the inspiration level can be even more closely adapted to the needs of the patient in SIMV and MMV modes by means of the pressure rise time »Ramp«. Start-up procedure with AutoFlow On switching on the AutoFlow function, EvitaXL applies the set tidal volume VT through a volume-controlled ventilation stroke with minimum inspiration flow and subsequent inspiratory pause. The plateau pressure PPlat calculated for this ventilation stroke serves as start-up inspiration pressure for the AutoFlow function. Sigh "Sigh" is effective in the form of intermittent PEEP in the IPPV, IPPVAssist and ILV modes. The purpose of expiratory sigh during ventilation is to open collapsed areas of the lung, or to keep open "slow" areas of the lung. Since atelectatic alveoli have a longer time constant – also caused by obstructed bronchioles – increased airway pressure maintained over a longer period is required to open them. In EvitaXL the activated sigh has an expiratory effect with an intermittent PEEP for two ventilation strokes every 3 minutes. The average airway pressure is higher, and a longer filling time is normally available. To avoid overinflation of the lung, the pressure peaks during the sigh phase can be limited by pressure limitation Pmax, without impairing the sigh function. During the sigh phase, the "Volume not constant" alarm is disabled. 210 Instructions for Use EvitaXL PEEP Pmax PAW Flow PAW interm. PEEP PEEP Tinsp Te 1 f VT Pinsp = f (VT,C) without spontaneous breathing with spontaneous breathing Sigh phase PAW > t t t 018 019
SIMV Synchronised Intermittent Mandatory Ventilation Combination of machine ventilation and spontaneous breathing. SIMV enables the patient to breathe spontaneously in regular prescribed cycles, with the mechanical mandatory ventilation strokes providing a minimum ventilation during the remaining cycles. The minimum ventilation is controlled by the two set values tidal volume (VT) and ventilation frequency (f) and is determined from the product of VT x f. The ventilation pattern results from the set values tidal volume VT, insp. flow, frequency f and inspiration time Tinsp. To prevent the mandatory ventilation stroke being applied during spontaneous expiration, the Flowtrigger of the machine ensures that the ventilation stroke is triggered in synchrony with the patient's spontaneous inspiratory effort within a "trigger window". The "trigger window" is 5 seconds long in adult mode and 1.5 seconds long in paediatric mode. For expiration times shorter than 5 seconds or 1.5 seconds, the "trigger window" covers the entire expiration time. Since the synchronisation of the mandatory ventilation stroke reduces the effective SIMV time, which would result in an undesirable increase in effective IMV frequency, EvitaXL prolongs the subsequent breathing time by the missing time difference ∆T – thus preventing an increase in SIMV frequency. The frequency parameter f remains constant. This parameter, in combination with the tidal volume VT, sets the minimum ventilation. If the inspiratory volume of the patient is considerable at the beginning of the "trigger window", the machine reduces the subsequent mandatory ventilation stroke by shortening the time for the inspiratory flow phase and the inspiration time. In this way, the tidal volume VT remains constant, and overinflation of the lungs is avoided. During the spontaneous breathing phases, the patient can be assisted with pressure by ASB pressure support. In the further weaning process, the frequency f on the ventilation unit is further reduced, thereby prolonging the spontaneous breathing time, until finally the required minute volume is entirely covered by spontaneous breathing. Ventilation Modes SIMV Instructions for Use EvitaXL 211 PAW PEEP trigger window mandatory ventilation Tinsp spontaneous breathing spontaneous breathing time synchronised mandatory stroke spontaneous breathing time + T set IMV time set IMV time 1 1 f f t 020
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EvitaXL Intensive Care Ventilator S
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Contents Contents For Your Safety a
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For Your Safety and that of Your Pa
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Intended Medical Application Intend
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Lung Protection Package (optional)
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Operating concept Operating concept
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The screen... displays all the most
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To set the ventilation mode and ven
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To set ventilation parameters direc
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PressureLink* Linked adjustment of
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Preparing for use Preparing for use
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1 lock it in position = pull tab un
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Using HME, bacterial filters and ho
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1 Hang the hinged arm from the rail
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Fitting CO2 cuvette and CO2 sensor
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Gas supply ● Screw the connecting
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Connecting the nurse call (optional
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Preparing the child test lung 84 09
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● Touch the screen key »Check«.
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Leak test This test must be perform
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Ventilation while transferring a pa
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Operation Starting up . . . . . . .
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Starting up Switching on ● Switch
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Setting new ventilation parameters
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IPPV Intermittent Positive Pressure
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To view additional text information
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ILV ILV = Independent Lung Ventilat
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Setting the Master and Slave device
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ILV: Master and Slave Synchronisati
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BIPAP, BIPAP/ASB Biphasic Positive
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BIPAPAssist Biphasic Positive Airwa
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CPAP-ASB Continuous Positive Airway
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No initial values for PPS To protec
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To review, activate or set: In the
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Apnoea Ventilation For automatic sw
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AutoFlow for automatic regulation o
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-----------------------------------
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PLV* Pressure Limited Ventilation S
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Selecting application mode »Mask«
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Setting alarm limits ● Press key
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Remedy the fault ● Refer to the l
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Displaying graphics The following r
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Freeze To freeze the current real-t
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Display 1 hr trend ● Touch the fu
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Display logbook Changes, events and
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Additional functions Medicament neb
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Switch on the medicament nebuliser:
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EvitaXL ventilates the patient in t
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Expiration Hold This function may b
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Set the interval ● Touch the scre
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Negative Inspiratory Force NIF The
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Measuring procedure ● Touch the s
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Measurement analysis After the meas
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● Press the key » Sensor Paramet
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O2 sensor calibration — After rep
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CO2 zero calibration Only possible
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● Place the test filter in the CO
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Calibrating the CO2 sensor — If t
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Resetting CO2 calibration — If ca
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Selecting Standby Mode — To perfo
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O2 Therapy (optional) During the O2
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Switching on O2 Therapy ● Touch t
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Configuration Configuration . . . .
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Day/night function for screen brigh
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Define the trends to be recorded
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Define customised values and settin
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Lock the screen configuration again
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Select units Specific national unit
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Specific initial therapy values ●
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Set initial values for VT and f…
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Define start-up values for special
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Fault — Cause — Remedy Fault -
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Message Cause Remedy Apnoea !!! Pat
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Message Cause Remedy Exp. hold inte
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Message Cause Remedy Leakage Not di
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Message Cause Remedy Fault - Cause
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Message Cause Remedy Tidal volume h
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Preparing Preparing . . . . . . . .
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Medicament nebuliser (optional) 1 R
Page 159 and 160: The expiration valve is only disman
Page 161 and 162: As for ventilation hoses, water tra
Page 163 and 164: Assembling Mounting the expiration
Page 165 and 166: Maintenance/Disposal Maintenance/Di
Page 167 and 168: Replace cooling air filter — Clea
Page 169 and 170: Mains power/DC power operation Main
Page 171 and 172: Use of the power supplies Operation
Page 173 and 174: Connecting an external battery Note
Page 175 and 176: Operation with mains power The vent
Page 177 and 178: Evita 4 Link (optional) Evita 4 Lin
Page 179 and 180: Preparation The interface board may
Page 181 and 182: Select printer protocol ● See "Se
Page 183 and 184: What's what What's what . . . . . .
Page 185 and 186: Front connections 1 » « Gas outle
Page 187 and 188: Technical Data Technical Data . . .
Page 189 and 190: APRV Airway Pressure Release Ventil
Page 191 and 192: Performance characteristics Control
Page 193 and 194: Frequency Measurement Breathing fre
Page 195 and 196: Monitoring Expiratory minute volume
Page 197 and 198: Materials used Part Appearance Mate
Page 199 and 200: Technical Data Equipment outputs An
Page 201 and 202: LUST protocol LUST: List-controlled
Page 203 and 204: End of telegram "EOT" Status telegr
Page 205 and 206: 23 FiO2 high 24 FiO2 low 25 MV low
Page 207 and 208: Description Ventilation Modes . . .
Page 209: AutoFlow ® The AutoFlow function c
Page 213 and 214: Response times longer than 15 secon
Page 215 and 216: BIPAPAssist Biphasic Positive Airwa
Page 217 and 218: PPS (optional) In ventilation mode
Page 219 and 220: The difference between measured val
Page 221 and 222: Unlimited volume compensation is in
Page 223 and 224: Tube type Inside diameter of tube (
Page 225 and 226: Rapid-Shallow-Breathing RSB The Rap
Page 227 and 228: Low Flow PV-Loop The Low Flow PV-Lo
Page 229 and 230: Screen configurations Screen config
Page 231 and 232: Screen configurations Screen config
Page 233 and 234: Abreviation Explanation P 0.1 100 m
Page 235 and 236: Bibliography [1] Baum, M., Benzer,
Page 237 and 238: Special ASCII characters used Chara
Page 239 and 240: Instructions for Use EvitaXL 239
Page 241 and 242: For paediatric ventilation Item No.
Page 243 and 244: Name/Description Order No. For CO2
Page 245 and 246: New features in EvitaXL SW 6.n Indi
Page 247 and 248: Index A Abbreviations . . . . . . .
Page 249 and 250: Performance characteristics . . . .
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EvitaXL

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