Avea Ventilator Quick Tips

NOTE: The AVEA™ ventilator’s quick tips card is not intended to replace the operator manual. You must become completely familiar with the operator manual before using the AVEA ventilator.

User interface

A

B

C

D

E

A. Main: Returns the user to the main screen. B. Event: Selects the event to record in the trends screen. C. Alarm silence: Starts a two-minute silence period. D. Suction: Three functions: 1. Run ↑O2 maneuver for two minutes. 2. Disable demand flow on loss of PEEP. 3. Silence alarms for two minutes. E. Nebulizer: Flows air for 20 minutes, synchronized with inspiration.

User interface (continued) Touch-Turn-Touch™ and Touch-Turn-Accept™ method 1.  Touch the control to select. The control changes color, indicating that it is active.

1

2. Turn the data dial to reach the selected value. 3. T  ouch the control again, or press ACCEPT to confirm the change.

2

3

Setting alarm limits 1.  Press ALARM LIMITS to open or close the window. 2. Use the Touch-Turn-Touch 1 or Touch-Turn-Accept method to modify alarms. 2

Proximal flow sensors The AVEA ventilator accepts either hot wire or variable orifice proximal low sensors. These are in addition to the internal inspiratory flow sensor and heated expiratory flow sensor. The variable orifice sensor attaches to the receptacle circled in dark blue. The hot wire flow sensor attaches to the receptacle circled in light blue, directly below the variable orifice flow sensor connection. To attach the flow sensor, pull back the locking collar. Push firmly onto the receptacle. Push the collar forward to lock the sensor in place. To disconnect, retract the collar and pull the connector straight away from the ventilator.

Monitors and definitions Volume monitors Vte

Exhaled tidal volume.

Vte/kg

Exhaled tidal volume adjusted for patient weight.

Vti

Inspired tidal volume.

Vti/kg

Inspired tidal volume adjusted for patient weight.

Spon Vt

Spontaneous tidal volume.

Spon Vt/kg

Spontaneous tidal volume adjusted for patient weight.

Mand Vt

Mandatory tidal volume: displayed as a rolling average of either eight breaths or one minute, whichever occurs first.

Mand Vt/kg

Mandatory tidal volume adjusted for patient weight.

Vdel

Delivered machine volume measured by the ventilator’s inspiratory flow sensor.

% leak

Percent leakage: the difference between the inspired and exhaled tidal volumes in terms of the percent difference.

Ve

Minute volume. Volume of gas exhaled by the patient during the last minute.

Ve/kg

Minute volume adjusted for patient weight.

Spon Ve

Spontaneous minute volume.

Spon Ve/kg

Spontaneous minute volume adjusted for patient weight.

Rate/time monitors Rate

Breath rate.

Spon rate

Spontaneous breath rate.

Ti

Inspiratory time.

Te

Exhalation time.

I:E

Inspiratory/expiratory ratio. Note: Not active for demand breaths.

f/Vt

Rapid shallow breathing index.

Pressure monitors Ppeak

Peak inspiratory pressure. Note: Not active with spontaneous breaths.

Pmean

Mean airway pressure.

Pplat

Plateau pressure. If no plateau occurs, then the monitor displays.***

PEEP

Positive end expiratory pressure.

Air inlet

Air inlet gas supply pressure.

O2 inlet

Oxygen inlet gas supply pressure.

Gas composition monitors FiO2

Delivered percent O2.

Monitors and definitions (continued) Mechanics CDYN CDYN/kg

Dynamic compliance (CDYN and CDYN/kg), absolute and normalized to patient weight.

Cstat Cstat/kg

Respiratory system compliance (CRS), (i.e., static compliance Cstat), absolute and normalized to patient weight. Note: This requires an Inspiratory Hold maneuver.

PIFR

Peak inspiratory flow rate.

PEFR

Peak expiratory flow rate.

Ccw

The ratio of the tidal volume (exhaled) to the delta esophageal pressure (dPES). Requires an esophageal balloon.

CLUNG

The ratio of the tidal volume (exhaled) to the delta transpulmonary pressure. The delta transpulmonary pressure is the difference between the airway plateau pressure (during an inspiratory pause) and esophageal pressure (at the time the airway plateau pressure is measured) minus the difference between the airway and esophageal baseline pressures. Requires an inspiratory hold and esophageal balloon.

C20/C

The ratio of the dynamic compliance during the last 20% of inspiration (C20) to the total dynamic compliance (C).

RRS

The total resistance during the inspiratory phase of a breath. Respiratory system resistance is the ratio of the airway pressure differential (peak– plateau) to the inspiratory flow 12 ms prior to the end of inspiration. Requires an inspiratory hold.

RPEAK

The peak expiratory resistance (RPEAK) is defined as the resistance at the time of the peak expiratory flow (PEFR).

RIMP

The airway resistance between the wye of the patient circuit and the tracheal sensor. Requires an inspiratory hold and tracheal catheter.

RLUNG

The ratio of the tracheal pressure differential (peak–plateau) to the inspiratory flow 12 ms prior to the end of inspiration. Requires an inspiratory hold and tracheal catheter.

dPAW

The difference between peak airway pressure (PPEAK AW) and baseline airway pressure (PEEPAW).

dPES

The difference between peak esophageal pressure (PPEAKES) and baseline esophageal pressure (PEEPES).

AutoPEEP

The airway pressure at the end of an expiratory hold maneuver. Requires a passive patient.

dAutoPEEP

The difference between airway pressure at the end of an expiratory hold maneuver and the airway pressure at the start of the next scheduled breath after the expiratory hold maneuver. Requires a passive patient.

AutoPEEPES

The difference between esophageal pressure measured at the end of exhalation (PEEPES) minus the esophageal pressure measured at the start of a patient-initiated breath (PES start) and the sensitivity of the ventilator’s demand system. The sensitivity of the ventilator’s demand system is the difference between the baseline airway pressure (PEEPAW) and the airway pressure when the patient initiates a breath (PAW start). Requires an esophageal balloon.

Ptp Plat

Transpulmonary pressure during an inspiratory hold, which is the difference between the airway plateau pressure (PPLAT AW) and the corresponding esophageal pressure. Requires an inspiratory hold and esophageal balloon.

Monitors and definitions (continued) Mechanics (continued) Ptp PEEP

The difference between the corresponding airway and esophageal pressures at the end of the expiratory hold during an AutoPEEP maneuver. Requires an inspiratory hold and esophageal catheter.

MIP

The maximum negative airway pressure that is achieved by the patient during an expiratory hold maneuver.

P100

The negative pressure that occurs 100 ms after an inspiratory effort has been detected.

WOBV

Ventilator work of breathing (WOBV) is defined as the summation of airway pressure (PAW) minus the baseline airway pressure (PEEPAW) times the change in tidal volume to the patient (-V) during inspiration, and normalized to the total inspiratory tidal volume (Vti).

WOBP

Patient work of breathing (WOBP), normalized to the total inspiratory tidal volume. Patient work of breathing is defined as the summation of two work components: Work of the lung and work of the chest wall. Requires an esophageal balloon.

WOBI

Imposed work of breathing (WOBI) is defined as the work performed by the patient to breathe spontaneously through the breathing apparatus, (i.e., the ET tube), the breathing circuit and the demand flow system. Requires a tracheal catheter. Note: Monitored values are displayed as BTPS.

Capnography EtCO2

The patient’s peak expired CO2 as measured and reported by the CO2 sensor in the airway, calculated for each breath then averaged as specified by set ETCO2 averaging time.

VCO2

Minute volume of exhaled CO2 measured continuously and averaged over a user-selectable time. Requires flow measurement at the wye or circuit compliance active.

VtCO2

Tidal volume of exhaled CO2, measured for each breath and then averaged over the set VCO2 averaging time. Requires flow measurement at the wye or circuit compliance active.

Vd ana

The volume of dead space in the patient’s conducting airways from the nose to the level of the terminal bronchioles measured for each breath, then averaged over the set CO2 averaging time. Also includes any mechanical dead spaces added to the ventilator circuit between the CO2 sensor and the patient. Requires flow measurement at the wye or circuit compliance active.

Vd/Vt ana

Anatomic Vd/Vt is averaged over the set VCO2 averaging time. Requires flow measurement at the wye or circuit compliance active.

Vd phy

Comprises Vd ana as well as the volume of the respiratory zone (respiratory bronchioles, alveolar ducts and alveoli) not participating in gas exchange. Requires an arterial blood gas sample.

Vd/Vt phy

Physiologic Vd/Vt is averaged over the set VCO2 averaging time. Requires an arterial blood gas sample.

Vd alv

Alveolar dead space is the difference between physiological dead space and anatomical dead space. It represents the volume of the respiratory zone that is from ventilation of relative under-perfused or non-perfused alveoli. Requires an arterial blood gas sample.

Monitors and definitions (continued) Capnography (continued) VA

Alveolar ventilation is the volume of gas participating in gas exchange per minute. Requires an arterial blood gas sample.

P/F

The PaO2/FIO2 ratio is a simple assessment of gas exchange calculated from the FiO2 monitor value and an arterial blood oxygen measurement (required) entered by the clinician.

OI

Oxygenation index is a dimensionless number often used to assess the “pressure cost” of oxygenation calculated from the FiO2 mean airway pressure and an arterial blood oxygen measurement (required) entered by the clinician.

Available modes Mode Volume A/C Volume SIMV Pressure A/C* Pressure SIMV*

Adult

Pediatric

Neonatal

• • • •

• • • •

• • • •

• • • •

• • • • • •

TCPL A/C* TCPL SIMV* PRVC A/C PRVC SIMV APRV/BiPhasic CPAP/ PSV Nasal CPAP/IMV * Volume guarantee breaths available for neonates

•

Normal values and indications for weaning (adults) Parameter

Normal range

Indications for weaning

Respiratory rate

10 to 20 breaths/min

< 30 B/min△

Esophageal pressure

5 to 10 cmH2O

< 15 cmH2O

Tidal volume

7 to 10 mL/kg

> 5 mL/kg△

Minute ventilation

5 to 10 L/min

< 10 L/min

WOBP

3 to 0.6 J/L

< 0.75 J/L △

Pressure time index

0.05 to 0.12

< 0.15 △

Airway resistance

2 to 5 cmH2O/L/s

< 15 cmH2O/L/s

Lung compliance

50 to 100 mL/cmH2O

> 25 mL/cmH2O

Maximum inspiratory

-30 cmH2O low effort

> -20 cmH2O△

Pressure (MIP)

-140 cmH2O high effort

Auto PEEP

0

< 3 cmH2O

Respiratory drive P0.1

2 to 4 cmH2O

< 6 cmH2O△

f/VT

60 to 90

< 105

Pressure time

200 to 300 cmH2O sec/min

Product (PTP) Ti/TTOT

0.3 to 0.4

Parameter

Acceptable range

SaO2

> 90% on FiO2 of < 40%

P(A - a) O2 on FlO2 of 100%

< 350 mmHg

PaO2/FlO2

> 200 mmHg

Qs/Qt

< 20%

Vd/Vt

< 0.6

Heart rate

> 70 and < 120 BPM

Mean blood pressure

> 70 and < 110 mmHg

NOTE: Research indicates these pulmonary parameters may aid qualified medical personnel in evaluating weaning potential. If measured values exceed acceptable range, successful weaning may be less likely. Ranges from these parameters are not intended to substitute clinical assessment by qualified medical personnel, and Vyaire assumes no liability for their use in patient care. A list of references is available upon request.

G LO B A L H E A D Q UA RT E RS V y a i re M e d i c a l , I n c. 2 61 2 5 N o r t h R i v e r w o o d s B l vd M e tta w a , I L 6 0 0 4 5 USA

v ya ire.co m For global distribution. Trademarks are the property of their respective owners. 2020 Vyaire. Vyaire, the Vyaire logo and all other trademarks or registered trademarks are property of Vyaire Medical, Inc., or one of its affiliates. Please read the complete Instructions For Use that come with the devices or follow the instructions on the product labelling. VYR-GBL-2000139