Evita v800 v600 SW 1n Ifu 9055601 en PDF

Evita V800 / V600
Intensive care ventilator

Software 1.n
Instructions for use
WARNING
To properly use this medical device, read and comply
with these instructions for use.
Evita V800 / V600
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2 Instructions for use | Evita V800 / V600 SW 1.n

Contents
Contents
Evita V800
Intensive care
/ V600
ventilator
1 Information about this document ........................................................... 7

1.1 Typographical conventions ............................................................. 7
1.2 Use of terms ................................................................................... 7
1.3 Illustrations...................................................................................... 7
1.4 Additional documents ..................................................................... 7
1.5 Trademarks..................................................................................... 8
2 Safety-related information....................................................................... 9
2.1 Intended use ................................................................................... 9
2.2 Indications....................................................................................... 9
2.3 Contraindications ............................................................................ 9
2.4 Environments of use ....................................................................... 9
2.5 Essential performance characteristics ............................................ 10
2.6 User group requirements ................................................................ 10
2.7 Information on safety instructions and precautionary statements... 11
2.8 Safety instructions .......................................................................... 12
2.9 Further information ......................................................................... 17
3 Overview ................................................................................................... 18
3.1 Intensive care ventilator.................................................................. 18
3.2 Display unit ..................................................................................... 19
3.3 Ventilation unit ................................................................................ 21
3.4 Trolley ............................................................................................. 25
3.5 GS500 gas supply unit.................................................................... 26
3.6 Range of functions.......................................................................... 26
3.7 Abbreviations .................................................................................. 29
3.8 Symbols .......................................................................................... 36
3.9 Product labels ................................................................................. 40
4 Operating concept.................................................................................... 41
4.1 Screen ............................................................................................ 41
4.2 Using the screen............................................................................. 45
4.3 Setting the ventilation ..................................................................... 51
4.4 Operating the monitoring area ........................................................ 54
4.5 Using the help function ................................................................... 57
5 Assembly and preparation ...................................................................... 59

5.2 Maximum loads............................................................................... 63
5.3 Attaching and adjusting the holders and accessories..................... 64
5.4 Attaching compressed gas cylinders to the trolley.......................... 67
5.5 Preparing the display unit ............................................................... 69
5.6 Preparing the ventilation unit .......................................................... 73
5.7 Establishing the power supply ........................................................ 82
5.8 Checking the main switch ............................................................... 84
5.9 Connecting the potential equalization cable ................................... 84
5.10 Establishing the gas supply ............................................................ 85
5.11 Connecting the nurse call ............................................................... 85
Instructions for use | Evita V800 / V600 SW 1.n 3

Contents
5.12 Closing the lateral device flaps ....................................................... 86

5.13 Intrahospital device transport.......................................................... 87
6 Getting started.......................................................................................... 88
6.2 Turning on the device ..................................................................... 89
6.3 Checking operational readiness ..................................................... 90
6.4 Selecting the therapy type .............................................................. 101
6.5 Admitting a new patient .................................................................. 102
6.6 Starting the therapy ........................................................................ 104
7 Operation .................................................................................................. 106

7.2 Ventilation settings.......................................................................... 110
7.3 Changing the therapy type during therapy...................................... 113
7.4 Changing the body weight during ventilation .................................. 114
7.5 Non-invasive ventilation (NIV) ........................................................ 115
7.6 Apnea ventilation ............................................................................ 116
7.7 Loops .............................................................................................. 117
7.8 Smart Pulmonary View ................................................................... 118
7.9 Maneuvers ...................................................................................... 119
7.10 Medication nebulization .................................................................. 122
7.11 Measurement maneuver Low-flow PV loop .................................... 130
7.12 Diagnostics – measurement maneuver .......................................... 137
7.13 GS500 gas supply unit.................................................................... 140
7.14 Intrahospital patient transport ......................................................... 141
7.15 O2 therapy ...................................................................................... 143
7.16 Interrupting therapy – standby mode .............................................. 145
7.17 Battery operation ............................................................................ 146
8 Ending operation...................................................................................... 150

8.1 Shutting down the device................................................................ 150
8.2 Interrupting the gas supply ............................................................. 151
8.3 Storing the device ........................................................................... 151
8.4 Disassembly ................................................................................... 152
9 Alarms ....................................................................................................... 157

9.1 Display of alarms ............................................................................ 157
9.2 Alarm logbook................................................................................. 158
9.3 Confirming alarm messages ........................................................... 159
9.4 Alarm limits ..................................................................................... 160
9.5 Setting the alarm volume ................................................................ 162
9.6 Alarm silence .................................................................................. 163
9.7 Alarm delay..................................................................................... 164
9.8 Alarm system behavior during power supply failure or after turning
off the device .................................................................................. 164
10 Trends ....................................................................................................... 165

10.1 Opening the dialog.......................................................................... 165
10.2 Displaying trends ............................................................................ 165

Contents
10.3 Displaying current values................................................................ 168

10.4 Displaying the logbook.................................................................... 168
10.5 Displaying the test results............................................................... 169
10.6 Performing a data export ................................................................ 170
11 Monitoring................................................................................................. 172
11.2 Information on monitoring ............................................................... 173
11.3 Flow monitoring .............................................................................. 174
11.4 O2 monitoring.................................................................................. 178
11.5 CO2 monitoring ............................................................................... 180
12 Configuration............................................................................................ 185
12.2 Information on configuration ........................................................... 185
12.3 Configuring the screen display ....................................................... 186
12.4 Configuring the alarm settings ........................................................ 192
12.5 Configuring ventilation settings....................................................... 192
12.6 Configuring the start settings .......................................................... 194
12.7 Importing and exporting configurations........................................... 198
12.8 Activating software options ............................................................. 199
12.9 Performing and configuring the battery test.................................... 200
12.10 Changing the system settings......................................................... 201
13 Troubleshooting ....................................................................................... 204

13.1 Displaying alarm messages............................................................ 204
13.2 Confirming alarm messages ........................................................... 204
13.3 Alarm – Cause – Remedy............................................................... 205
14 Service ...................................................................................................... 229

14.2 Prerequisites................................................................................... 229
14.3 Definition of service terminology..................................................... 230
14.4 Inspection ....................................................................................... 230
14.5 Maintenance ................................................................................... 231
14.6 Repair ............................................................................................. 232
14.7 Replacing the room air filter............................................................ 232
14.8 Replacing the diaphragm of the expiratory valve............................ 232
14.9 Replacing the expiratory valve........................................................ 233
14.10 Maintenance of the gas supply unit GS500 .................................... 233
14.11 Battery maintenance....................................................................... 234
15 Disposal .................................................................................................... 239

15.2 Disposing of the device................................................................... 239
15.3 Disposing of the packaging material............................................... 239
15.4 Disposing of the batteries ............................................................... 239
15.5 Disposing of the flow sensors ......................................................... 239

Contents
16 Technical data .......................................................................................... 240

16.1 Ambient conditions ......................................................................... 240
16.2 Set values ....................................................................................... 241
16.3 Performance characteristics ........................................................... 245
16.4 Displayed measured values............................................................ 247
16.5 Displayed calculated values ........................................................... 252
16.6 Monitoring ....................................................................................... 253
16.7 Operating characteristics ................................................................ 256
16.8 Interfaces and ports ........................................................................ 260
16.9 Measurements and weight.............................................................. 261
16.10 Automatic alarm limits..................................................................... 263
16.11 Device combinations....................................................................... 266
16.12 EMC declaration ............................................................................. 266
16.13 Connections to IT networks ............................................................ 268
16.14 Open-source software .................................................................... 271
17 Principles of operation ............................................................................ 272

17.1 Ventilation modes ........................................................................... 272
17.2 Additional settings for ventilation .................................................... 291
17.3 Maneuvers ...................................................................................... 303
17.4 Smart Pulmonary View ................................................................... 309
17.5 Therapy types ................................................................................. 310
17.6 Leakage adaptation and leakage compensation ............................ 311
17.7 Linking the maximum airway pressure to the upper alarm limit –
Pmax/Paw high autoset .................................................................. 313
17.8 Flow reduction – Anti-air shower .................................................... 314
17.9 Measurements ................................................................................ 314
17.10 Battery concept............................................................................... 317
17.11 Pneumatic functional description .................................................... 321
17.12 Menu structure................................................................................ 323
17.13 List of references ............................................................................ 326
18 Password .................................................................................................. 329

18.1 User password for Evita V800 / V600 Software 1.n........................ 329
18.2 Information about the user password ............................................. 329
Index .......................................................................................................... 331

Information about this document
1 Information about this document

1.1 Typographical conventions
Text Bold, italicized texts indicate labels on the device and screen texts.
1. Numbers followed by a period indicate individual action steps in a
sequence of actions. Numbering begins with the number 1 for each new
sequence of actions.
a. Lowercase letters followed by a period indicate subordinate action steps.
Numbering begins anew with the letter a. for each new subordinate action
step.
● This bullet point indicates individual process steps with no specific
sequence.
► This triangle in safety instructions and precautionary statements indicates
ways to avoid danger.
(1) Numbers in parentheses refer to elements in figures.
1 Numbers in figures indicate elements referred to in the text.
– Dashes indicate listings.
> The greater-than symbol indicates the navigation path in a dialog.
This symbol indicates information that makes it easier to use the product.
 This arrow indicates the result of an action step.
✓ This check mark indicates the result of a sequence of actions.
1.2 Use of terms

Dräger uses the term "accessories" not only for accessories in the sense of
IEC 60601-1, but also for consumables, removable parts, and attached parts.
The products "Evita V800" and "Evita V600" are also referred to as "Evita".
1.3 Illustrations
Illustrations of products and screen content in this document may differ from the
actual products depending on configuration and design.
The figures display the product "Evita V800". The information they contain also
applies to the product "Evita V600".
1.4 Additional documents

The reprocessing for this product is described in the separate reprocessing
instructions delivered with the product.

Information about this document
1.5 Trademarks
1.5.1 Trademarks owned by Dräger
Trademark
Evita®
SmartCare®
ATC®
AutoFlow®
QuickSet®
Infinity®
MEDIBUS®
MEDIBUS.X®
The following web page provides a list of the countries in which the trademarks are
registered: www.draeger.com/trademarks
1.5.2 Trademarks owned by third-party manufacturers

Trademark used Trademark owner
under license
BIPAP Respironics

Safety-related information
2 Safety-related information
2.1 Intended use
The intensive care ventilator Evita is intended for the ventilation of adults, pediatric
patients and neonates. This device provides mandatory ventilation modes and
ventilation modes for supporting spontaneous breathing as well as ventilation
monitoring.
2.2 Indications
The device is used for treating patients who require temporary or longer-term
respiratory support for different medical reasons.
2.3 Contraindications
There are no additional contraindications apart from the contraindications contained
in the sections on safety instructions.
It is the responsibility of the user to select the appropriate ventilation mode for the
underlying disease of the patient. For all ventilator settings, the user needs to
consider the respiratory status and the general state of health of the patient in order
to optimally adapt the ventilation settings to the patient's condition. Any changes to
the patient's condition need to be monitored continuously.
2.4 Environments of use

The device is intended for stationary use in hospitals and medical rooms or for
intrahospital patient transport.
Do not use the device in the following environments of use:
– Hyperbaric chambers
– Magnetic resonance imaging
– Together with flammable gases or flammable solutions that can mix with air,
oxygen, or nitrous oxide
– Areas with danger of explosion
– Areas with combustible and highly flammable substances
– Rooms with insufficient ventilation
Do not operate the device with helium or helium mixtures.

2.5 Essential performance characteristics

If the essential performance characteristics function correctly, this guarantees that
the product can be used in accordance with its intended use. The product has the
following essential performance characteristics:
– Controlled and monitored ventilation with settings defined by the user for the
following monitoring functions:
– Minimum and maximum tidal volume
– Maximum airway pressure
– Minimum and maximum O2 concentration in the breathing gas
– If one of the set limits is exceeded, a corresponding alarm is issued.
Additionally, the integrated monitoring issues an alarm in the following situations:
– Failure of the external power supply
– Battery discharge
– Failure of the gas supply
2.6 User group requirements

The term "user group" describes the personnel responsible who have been
assigned by the operating organization to perform a particular task on a product.
2.6.1 Duties of the operating organization

The operating organization must ensure the following:
– Every user group has the required qualifications (e.g., has undergone specialist
training or acquired specialist knowledge through experience).
– Every user group has been trained to perform the task.
– Every user group has read and understood the relevant chapters in this
document.
2.6.2 User groups

Clinical users
This user group operates the product in accordance with the intended use.
Users have medical specialist knowledge in the field of ventilation. Users have
knowledge of device monitoring and ventilation care.
Reprocessing personnel
This user group carries out the necessary activities to reprocess the product.
Reprocessing personnel has specialist knowledge in the reprocessing of medical
devices.

Service personnel
This user group installs the product and performs the service activities.
Service personnel has specialist knowledge in electrical and mechanical
engineering and experience in the servicing of medical devices.
Where product specific knowledge or tools are required, the service activities must
be carried out by specialized service personnel. The specialized service personnel
was trained by Dräger for these service activities on this product.
2.7 Information on safety instructions and precautionary

statements
Safety instructions and precautionary statements warn of risks and give instructions
for the safe use of the product. Failure to observe them may lead to personal injury
or property damage.
2.7.1 Safety instructions

This document contains sections with safety instructions which warn of risks. The
type of risk and the consequences of non-compliance are described in each safety
instruction.
2.7.2 Precautionary statements

Precautionary statements relate to action steps and warn of risks that may arise
when performing the action steps. Precautionary statements precede the action
steps.
The following warning signs and signal words indicate precautionary statements
and differentiate the possible consequences of non-compliance.
Warning sign Signal word Consequences of non-compliance

WARNING May result in death or serious injury.
CAUTION May result in moderate or minor injury.
NOTICE May result in property damage.

2.8 Safety instructions

2.8.1 Instructions for use
Failure to use the product in accordance with the information contained in these
instructions for use may result in personal injury and property damage.
► Follow these instructions for use.
► Use this product only according to its intended use.
► Keep these instructions for use close to hand.
► Follow these instructions for use and those for any products used in conjunction
with this product.
The instructions for use do not contain any information on the following points:
– Risks that are obvious to users
– Consequences of obvious improper use of the product
– Potentially negative effects on patients with one or more illnesses
2.8.2 Symbols and product labels

Failure to observe symbols and product labels may result in personal injury and
property damage.
► Observe the symbols and product labels.
2.8.3 Monitoring the patient's condition

Monitoring of a patient's condition can range from direct observation to electronic
monitoring by means of medical devices. The patient may be put at risk if his or her
condition is not adequately monitored.
► Monitor the patient's condition by suitable means and at appropriate intervals.
2.8.4 Monitoring
Integrated monitoring
The integrated monitoring uses certain parameters to monitor the therapy (see
"Monitoring functions of ventilation monitoring", page 28).
The following factors may cause changes to these parameters:
– Acute changes in the patient's condition
– Incorrect settings and faulty handling
– Device malfunction
– Failure of the power supply and the gas supply
► If a fault occurs in the integrated monitoring, use separate measuring
instruments.
Monitoring during O2 therapy

During O2 therapy, the monitoring functions of the medical device are limited.
► Observe the following information: "O2 therapy", page 143.

2.8.5 Standby mode

Ventilation does not take place in standby mode. If connected, the patient may be
put at risk.
► Connect the patient only after the therapy has been started.
2.8.6 Keeping a manual ventilation device ready

If a fault is detected in the medical device, its life-support functions may no longer
be assured. The patient may be put at risk.
► Keep an independent ventilation device (e.g., a manual resuscitator) ready.
► Immediately start the ventilation of the patient using the independent ventilation
device. If required, perform ventilation with PEEP and/or with an increased
inspiratory O2 concentration.
2.8.7 Alarms
Alarm volume
If the alarm volume is too low, alarm signals may not be heard. The patient may be
put at risk.
► Set the alarm volume loud enough so that the alarm signals can be heard in the
environment where the device is located.
► The user must remain within hearing distance of the alarm signals.
2.8.8 Device
Ventilation slots
Obstructing or closing off the ventilation slots may cause the device to overheat. An
alarm is issued if the device overheats.
► Make sure air can easily enter the device at the ventilation slots.
Sources of heat
Direct sunlight or other external sources of heat may cause the device to overheat.
► Keep away from sources of heat such as direct sunlight, radiant warmer, or
spotlights.
Penetrating liquid
Penetrating liquid may cause the following:
– Damage to the device
– Electric shock
– Device malfunctions
As a result, the patient may be put at risk.
► Ensure that no liquid penetrates the device.
► Do not place any containers with liquids on or above the device.

Housing
Under the housing, there are live electrical components, which may cause an
electric shock.
► Do not open the housing of the device.
2.8.9 Display unit

If the touchscreen is cleaned or disinfected during therapy, the settings may
inadvertently be changed. The patient may be put at risk.
► Clean and disinfect the touchscreen only if no patient is connected.
2.8.10 Ventilation unit

Gas inlet for the inspiratory valve
If the gas inlet for the inspiratory valve is covered, it is not possible to perform
spontaneous breathing using the emergency breathing valve in the event of device
failure. The patient may suffocate.
► Do not obstruct the gas inlet for the inspiratory valve.
2.8.11 Accessories
Compatible accessories
The use of incompatible accessories may adversely affect the functional integrity of
the product. Personal injury and property damage may occur as a consequence.
► Use only compatible accessories. The accessories that are compatible with this
product are listed in the list of accessories supplied with the product.
Disposable products
Disposable products whose packaging has been opened may be contaminated with
infectious agents.
► Keep disposable products packaged until they are used. Do not use disposable
products whose packaging is damaged.
Disposable products are developed, inspected, and produced exclusively for single
use. Reuse, reprocessing or sterilization may lead to a failure of the accessories
and cause injuries to the patient.
► Do not reuse, reprocess, or sterilize disposable products.
Installing accessories
If accessories are not securely fastened, they may fall down. This may result in
personal injury and property damage.
► Install accessories to the main device in accordance with the instructions for use
of the main device.
► Make sure that there is a safe connection to the main device.

2.8.12 Gases and solutions

Combustible or explosive gas mixtures
If oxygen concentrations over 25 Vol% or combustible or explosive gas mixtures
occur, there is an increased risk of explosion and fire that may result in personal
injury and property damage.
► Do not operate the device in areas where oxygen concentrations exceeding
25 Vol% or combustible or explosive gas mixtures may occur.
► Do not operate the device in areas where combustible solvents or explosive
anesthetic agents are used.
Ignition sources
Ignition source (e.g., open flames or sparks) may lead to fires in the presence of
oxygen. There may be a risk of personal injury.
► Keep the device away from ignition sources.
Increased oxygen concentration in the ambient air

Medical device malfunctions may increase the O2 concentration in the ambient air.
As a result, the medical device may ignite.
► Do not use the medical device in rooms that are enriched with oxygen.
► The medical device is suitable only for use in rooms with sufficient ventilation.
2.8.13 External flow source

Unnoticed change in inspiratory O2 concentration
If an additional flow is delivered by an external flow source, the actual O2
concentration delivered may deviate from the displayed values. The patient may be
put at risk.
► If necessary, use additional monitoring, e.g., external SpO2 monitoring.
Negative impacts on the measured values

An additional flow delivered by an external flow source may affect the measured
values for airway pressure and flow.
► Do not use additional flow.
2.8.14 Modifications to the product

Modifications to the product may lead to malfunctions and unforeseen risks. This
may result in injury to the patient or the user or in property damage.
► Do not modify this product.

2.8.15 Connected devices and device combinations

Any connected devices or device combinations that do not comply with the
requirements mentioned in these instructions for use may compromise the
functional integrity of the medical device. Personal injury and property damage may
occur as a consequence.
► Connections to electric devices not listed in this document may be made only if
approved by their manufacturer.
► Before this device is commissioned, the instructions for use of all connected
devices and device combinations must be heeded.
2.8.16 Data transfer

As a result of misinterpretation of the measured values or other parameters, an
incorrect diagnosis may be made and thus the patient may be put at risk.
► Do not use individual measured values and monitoring parameters as the sole
basis for therapeutic decisions.
2.8.17 Reprocessing
Reusable products must be reprocessed, otherwise there is an increased risk of
infection.
► Perform reprocessing according to the reprocessing instructions delivered with
the product.
2.8.18 Service
If service activities are not performed regularly, malfunctions may occur, which may
result in personal injury and property damage.
► Perform service activities in accordance with the chapter "Service".
2.8.19 Electromagnetic compatibility (EMC)

Medical electrical equipment is subject to special precautionary measures
concerning electromagnetic compatibility. During installation and before initial
operation, follow the information in section: "EMC declaration" (page 266).
Electrostatic discharge
When components that bear the ESD warning symbol are handled, protective
measures against electrostatic discharge must be complied with. Otherwise,
malfunctions may occur that put the patient at risk.
To prevent malfunctions, observe the following measures and train the relevant
personnel:
► Follow the ESD protective measures, such as:
– Wear antistatic clothing and shoes.
– Use electrically insulating and antistatic gloves.
– When establishing connections, touch a potential equalization pin.
► Observe the requirements for the electromagnetic environment. Observe the
following section: "Electromagnetic environment" (page 266).

Electromagnetic disturbances
Wireless communication devices (e.g., cellular phones) and medical electrical
equipment (e.g., defibrillators, electrosurgical devices) emit electromagnetic
radiation. When such devices are operated too close to this device or its cables, the
functional integrity of this device may be compromised by electromagnetic
disturbances. As a result, the patient could be put at risk.
► Maintain a distance of at least 0.3 m (1.0 ft) between this device and wireless
communication devices, to ensure that the essential performance of this device
is fulfilled.
► Maintain an adequate distance between this device and other medical electrical
equipment.
In case of short electromagnetic disturbances as tested according to
IEC 60601-1-2, the following performance degradations may occur:
– Temporary black screens
– Disturbances of CO2 measurement
After elimination of the electromagnetic disturbances, the performance
degradations end at the latest after 8 seconds. In case of present alarms, the
secondary acoustic alarm system will be activated. The ventilation performance is
not affected. The ventilation unit operation display will indicate pressure, volume,
and FiO2.
The ventilator was tested according to the recommendations of
IEC TR 60601-4-2: Medical. During burst coupling of ±1 kV on mains, the following
performance degradations may occur:
– Temporary black screens
– Disturbances of CO2 measurement
After the burst coupling, the degradation of performance ends at the latest after
8 seconds without any user intervention. Changing to another power socket may
help. Burst coupling in the power network can be minimized or prevented by using a
corresponding mains filter in the power network.
2.8.20 Network security

Impermissible usage of data interfaces may result in new risks.
► Only create connections to data interfaces if permission for this has been
obtained from the organization responsible (party responsible for IT and party in
charge of the devices for the hospital).
► Observe the following information: "Connections to IT networks", page 268.
2.9 Further information

2.9.1 Training
Training for users is available via the Dräger organization responsible (see
www.draeger.com).
2.9.2 Mandatory reporting of adverse events

Serious adverse events with this product must be reported to Dräger and the
responsible authorities.

Overview
3 Overview
3.1 Intensive care ventilator
41922
1 1
2 2
3 3
4 4
5 5
No. Designation
1 Display unit
2 Ventilation unit
3 GS500 gas supply unit
4 PS500 power supply unit
5 Trolley
For additional accessories, see the separate list of accessories.

Overview
3.2 Display unit

3.2.1 Front
1 2
38310
6 5 4 3
No. Designation Description

1 Alarm bar The alarm bar flashes briefly during For further infor-
the system startup and indicates that mation see: "Opti-
the alarm system is functioning prop- cal alarm
erly. signals",
page 157.
In the event of an alarm, the alarm bar
flashes in the color corresponding to
the alarm priority.
2 Screen The screen is a touchscreen. For further infor-
mation see:
"Screen",
page 41.
3 Pressing this key pauses all acoustic For further infor-
alarm signals for 2 minutes. mation see:
(Alarm silence "Alarm silence",
key) page 163.
4 Rotary knob The rotary knob is used to select and
confirm settings or functions.
5 LED for mains voltage For further infor-
mation see:
LED for the internal battery "Power supply
LED for the power supply unit PS500 indicators",
page 20.
6 On/off key For further infor-
mation see:
This key is used to switch the device
"Turning on the
on or off. The LED in the key lights up
device", page 89.
when the device is switched on.
For further infor-
mation see:
"Shutting down
the device",
page 150.

Overview
3.2.1.1 Power supply indicators
LED lights up green LED lights up yel- LED does not light
low up
LED for Mains voltage is - The device is discon-
mains volt- available, and the nected from the
age main switch is acti- mains voltage.
vated
LED for the Battery charge is Battery charge is The internal battery is
internal bat- greater than approx. between approx. faulty or discharged,
tery 90 %. 10 % and 90 %. or the device is
switched off with the
main switch.
LED for the Battery charge is Battery charge is The power supply
power sup- greater than approx. between approx. unit is faulty or dis-
ply unit 90 %. 10 % and 90 %. charged, or the
PS500 device is switched off
with the main switch.
3.2.2 Rear
1 2
37930
3 3
43 5

1 Alarm bar The alarm bar flashes briefly during For further infor-
the system startup and indicates that mation see: "Opti-
the alarm system is functioning prop- cal alarm
erly. signals",
page 157.
In the event of an alarm, the alarm bar
flashes in the color corresponding to
the alarm priority.

Overview

2 COM Serial ports (RS-232) for exchanging For further infor-
data via communication protocols mation see: "Con-
(MEDIBUS) necting external
3 USB ports for exporting data, configu- devices to the
ration exchange, and installing soft- data interfaces",
ware options page 72.
4 LAN Port for service purposes
5 HDMI Port for external device (e.g., projec-
tor)
3.3 Ventilation unit

3.3.1 Front
Front, flap closed:
38312
6
4 1
2
3

1 Insp. Inspiratory valve with inspiratory port
(GAS OUTPUT)
2 Emergency air Gas inlet for the inspiratory valve, non-tapered connector,
intake do not obstruct (EMERGENCY AIR INTAKE)
3 Water trap Water trap container of the expiratory valve
4 Exp. Expiratory valve with expiratory port or neonatal expira-
tory valve with expiratory port
(GAS RETURN)
5 Flap Cover of the expiratory unit
For further information see: "Handling the flap", page 73.

Overview

6 Operation display During ventilation, a bar display indicates the inspiratory
and expiratory phases. The measured values for the min-
ute volume MVe and inspiratory O2 concentration FiO2
are also displayed.
If the device is switched off and the power plug is con-
nected to the mains voltage, the charge status indicator of
the batteries and the symbol are displayed when the
batteries are charging.
Front, flap folded upwards:
38313
7
8
9
10
9

7 Exhaust Gas outlet, non-tapered connector
8 Expiratory flow Expiratory flow sensor (see "Fitting the expiratory flow
sensor sensor", page 76) or muffler (see "Assembling the neona-
tal expiratory valve", page 74)
Muffler
9 Connectors Ports for future extensions
10 Nebulizer port Gas outlet for the pneumatic medication nebulizer

Overview
3.3.2 Rear
38314
1
2
3
4
5
6

1 F3 Fuse for the internal battery
2 Neo Flow Port for the neonatal flow sensor
3 Ports for future extensions
4 CO2 Port for the CO2 sensor
5 Potential equalization pin
6 F1, F2 Fuse for the mains power supply
7 Port for the mains power supply

Overview
3.3.3 Left side
38315
1
2
5
3 V2
4
5

1 Port for the system cable which leads to the display unit
2 USB port
3 Port for nurse call
4 V2 Port for future extensions

5 Main switch
6 Room air filter with cover

7 Strain relief for cable
3.3.4 Right side

38317
1
2
3
4

1 V9 Port for the data cable to the GS500 gas supply unit
2 Port for the gas connection to the GS500 gas supply unit

Overview

3 Air Port for compressed gas hose for Air
(FRESH GAS)
4 O2 Port for compressed gas hose for O2
(FRESH GAS)
3.4 Trolley
38318
1
2
3
4
5
6
7
No. Designation
1 Do not push
Mark on the device for areas whose risk of tipping over is increased as a
result of horizontal strain
2 Mount for the display unit
3 Handle
4 Trolley column
5 Hose holder
6 Guide
7 Holder with standard rail, can be swiveled
8 Universal holder with standard rail
9 Double castors with locking brake, 4 pieces

Overview
3.5 GS500 gas supply unit

3.5.1 Rear
38319
1 1
3 2
1 1
No. Designation
1 Screws (to hold the side panels in place)
2 Rating plate
3 Gas connection
3.6 Range of functions

General information
This section describes the entire functionality of the device. Some functions are
only optional and may deviate from the individual device configuration. Options are
shown in the separate list of accessories.
3.6.1 Therapy types

– Invasive ventilation (Tube)
– Non-invasive ventilation (NIV)
– O2 therapy
3.6.2 Ventilation functions

Detailed descriptions are available in the following sections:
– Ventilation functions (see "Principles of operation", page 272)
– Abbreviations (see "Abbreviations", page 29)
Ventilation modes
Volume-controlled ventilation:
– VC-SIMV
– VC-AC
– VC-CMV
– VC-MMV

Overview
Pressure-controlled ventilation:
– PC-SIMV
– PC-BIPAP
– PC-AC
– PC-CMV
– PC-APRV
– PC-PSV
Support of spontaneous breathing:
– SPN-CPAP/PS
– SPN-CPAP/VS
– SPN-PPS
Additional settings for ventilation

– Apnea ventilation
– Trigger
– Sigh
– AutoFlow
– Volume guarantee
– ATC
– AutoRelease
– Variable PS
– SmartCare/PS
Other ventilation functions

– "Insp term" during pressure support
– Anti-air shower
Maneuvers
– Manual insp./inspiration hold
– Expiration hold
– O2/suctioning
– Manual disconnection
– Nebulization
– Measurement maneuver Low-flow PV loop
– Diagnostics – measurement maneuver
– Measurement of intrinsic PEEP (PEEPi)
– Measurement of occlusion pressure (P0.1)
– Measurement of maximum inspiratory effort of the patient (NIF)

Overview
3.6.3 Monitoring functions of ventilation monitoring

Patient monitoring is supported by the following alarm limit settings:
– Maximum airway pressure (Paw)
– Expiratory minute volume (MVe)
– Inspiratory tidal volume (VTi or VT)
– Apnea alarm time (Tapn)
– Spontaneous respiratory rate (RRspon)
– End-tidal CO2 concentration (etCO2)
The inspiratory O2 concentration is monitored by automatically set limits.
During non-invasive ventilation and O2 therapy, certain monitoring functions are
deactivated or can be deactivated.
3.6.4 Screen displays

– Waveforms
– Graphical trends
– Loops
– Alarm logbook
– Logbook
– Numeric parameters
– Lists for measured values and set values
– User-specific lists for measured values and set values
– Smart Pulmonary View
3.6.5 Power supply

The device is designed for connection to the hospital's mains power supply of 100
to 240 V at 50/60 Hz.
If the mains voltage fails, operation can be maintained via the internal battery or the
PS500 power supply unit.
3.6.6 Gas supply

The device features country-specific connectors for the gas supply with oxygen and
medical compressed air.
Additionally, the device can be equipped with the GS500 gas supply unit. GS500
supplies the device with compressed air.
3.6.7 O2 therapy
The device provides high-flow oxygen therapy.

Overview
3.6.8 Data transfer

COM port
The following communication protocols are available for exchanging data between
the device and external medical or non-medical devices:
– MEDIBUS.X
– MEDIBUS
– MED.X.Comp.
USB port
After suitable USB mass storage devices are connected, the following actions (and
others) are possible:
– Export the data.
– Save the screen content as a screenshot.
– Save and load the device configuration.
– Install the software options.
The nebulizer Aeroneb Pro can be connected to the USB port.
LAN port
Use of the port is exclusively permitted for service purposes.
HDMI port
For demonstrative purposes, an external device (e.g., projector) can be connected.
3.6.9 Medication nebulization

For medication nebulization a pneumatic medication nebulizer can be connected.
3.6.10 Attaching accessories

Various holders can be used to attach accessories. The holders are attached to the
device or the trolley.
3.7 Abbreviations
Abbreviation Explanation
% leak Leakage proportion the of inspiratory minute volume in percent
% MVspon Spontaneous breathing portion of minute volume in percent
Adult Adult patient category
Ah Ampere hours (output specification for batteries)
Air Label on the device, port for compressed gas hose for Air
(FRESH GAS)
Alarm reset Dismissing an alarm message that is no longer active
Apnea vent. Apnea ventilation
APRV Airway Pressure Release Ventilation
ATC Automatic tube compensation

Overview
AutoFlow Special function for automatic optimization of inspiratory flow
BF Body Floating
BTPS Body temperature, pressure, saturated
37 °C (98.6 °F) body core temperature, ambient pressure,
100 % relative humidity
C Compliance
C20/Cdyn Ratio of the dynamic compliance of the last 20 % of inspiration
to total dynamic compliance
C20/Cstat Ratio of the static compliance of the last 20 % of inspiration to
total static compliance. Is determined using the low-flow
maneuver.
Cdyn Dynamic compliance
CISPR Comité International Spécial des Perturbations Radioélec-
triques
International special committee on radio interference
CO2 slope Increase of measured CO2 value in phase III of the CO2 wave-
form
COM Serial port
Compens Degree of tube compensation
COPD Chronic Obstructive Pulmonary Disease
Cstat Static compliance
Cycles sigh Number of respiratory cycles per sigh phase (set value)
DHCP Communication protocol
ΔintPEEP Additional intermittent PEEP for sighs (set value)
ΔPsupp Relative pressure support above PEEP (set value)
E Elastance
EIP End-inspiratory pressure
EMC Electromagnetic compatibility
Emergency air Safety air inlet, inspiratory relief valve (EMERGENCY AIR
intake INTAKE)
Endotrach. Endotracheal tube
ESD Electrostatic discharge
etCO2 End-tidal CO2 concentration
Exhaust Gas outlet
Exp term Expiration termination criterion in percent of the peak expiratory
flow
Exp. Label on the device, expiratory port (GAS RETURN)
Exp. Expiration
FiO2 Inspiratory O2 concentration (set value)
Flow Flow (set value)

Overview
Flow assist Flow-based assistance in ventilation mode SPN-PPS (set
value)
Flow max Peak inspiratory flow during non-invasive ventilation (patient
category Neonate)
Flowepeak Peak expiratory flow
Flowipeak Peak inspiratory flow
GS500 Gas supply unit
HDMI High Definition Multimedia Interface
HF High-frequency
I:E Ratio of inspiratory time to expiratory time (set value)
I:E spon I:E during spontaneous breathing
IBW Ideal body weight (kg)
IEC/CEI Acoustic alarm signal according to the standard IEC 60601-1-8
incl. PEEP Measured PEEP after complete expiration at the set PEEP
level
Insp term Inspiration termination criterion in percent of the peak inspira-
tory flow
Insp. Label on the device, inspiratory port (GAS OUTPUT)
Insp. Inspiration
Insp. flow Inspiratory flow
Interval sigh Interval between two sigh phases (set value)
IP21 Degree of protection against ingress of liquids and particles
LAN Local Area Network
LIP Lower inflection point
MED.X.Comp. Communication protocol for medical devices with a data defini-
tion that is standardized across all devices
MEDIBUS Communication protocol for medical devices
MEDIBUS.X Communication protocol for medical devices with uniform data
definition for all devices
Minute volume
Upper alarm limit for minute volume
high
Minute volume
Lower alarm limit for minute volume
low
MV Minute volume, leakage-corrected
MV delay Delay time for the Minute volume high and Minute volume
low alarms
MVapn Minute volume during apnea ventilation
MVe Expiratory minute volume, overall, not leakage-corrected
MVemand Mandatory expiratory minute volume
MVespon Spontaneous expiratory minute volume
MVi Inspiratory minute volume, overall, not leakage-corrected

Overview
MVleak Leakage minute volume
Neonate Neonates patient category
NIF Negative Inspiratory Force
NiMH Nickel-metal hydride, battery technology
NIV Non-invasive ventilation
NTPD Normal temperature, pressure, dry
20 °C (68 °F), 1013 hPa, dry
O2 Label on the device, port for compressed gas hose for O2
(FRESH GAS)
O2/suctioning Suction maneuver
P0.1 Occlusion pressure in P0.1 maneuver
Palv Alveolar pressure
Paw Airway pressure
Paw high Upper alarm limit for airway pressure
PC-AC PC: Pressure Control, AC: Assist Control
Assisted-controlled, pressure-controlled ventilation with back-
up respiratory rate
PC-APRV PC: Pressure Control, APRV: Airway Pressure Release Ventila-
tion
Spontaneous breathing under continuous positive airway pres-
sure with brief pressure releases
PC-BIPAP PC: Pressure Control, BIPAP: Biphasic Positive Airway Pres-
sure
Spontaneous breathing under continuous positive airway pres-
sure with 2 different pressure levels
PC-CMV PC: Pressure Control, CMV: Controlled Mandatory Ventilation
Continuous pressure-controlled ventilation
PC-PSV PC: Pressure Control, PSV: Pressure Support Ventilation
Spontaneous breathing at continuous positive pressure level
with pressure support and backup frequency
PC-SIMV PC: Pressure Control, SIMV: Synchronized Intermittent Manda-
tory Ventilation
Intermittent, triggered, pressure-controlled ventilation
Pediatric patient Pediatric patient category
PEEP Positive end-expiratory pressure
PEEPi Intrinsic PEEP
Phigh Upper pressure level in ventilation mode PC-APRV (set value)
Pinsp Inspiratory pressure (set value)
PIP Peak Inspiratory Pressure
Plimit Pressure limitation for low-flow maneuver (set value)
Plow Lower pressure level in ventilation mode PC-APRV (set value)

Overview
Pmaninsp Inspiratory pressure for manual inspiration during non-invasive
ventilation (patient category Neonate, ventilation mode SPN-
CPAP)
Pmax Maximum allowed airway pressure (set value)
Pmax/Paw high Linking the maximum airway pressure to the alarm limit Paw
autoset high
PMC Point of maximum curvature
Pmean Mean airway pressure
Pmin Minimum airway pressure
Pplat Plateau pressure
Press var Pressure support variability for the function Variable PS (set
value)
PS Pressure support
PS500 Power supply unit
Pstart Initial pressure for low-flow maneuver (set value)
Psupp Absolute pressure support
Ptrach Tracheal pressure
R Resistance
Respiratory rate
Upper alarm limit for respiratory rate
high
Rpat Airway resistance of the patient
RR Respiratory rate (set value)
RRapn Respiratory rate during apnea ventilation (set value)
RRmand Mandatory respiratory rate
RRspon Spontaneous respiratory rate
RRtrig Respiratory rate of triggered mandatory breaths
RSBI Rapid shallow breathing index
Quotient of spontaneous respiratory rate and tidal volume
r² Correlation coefficient for the calculation method "Least Mean
Square" for resistance R, compliance, C and time constant TC
SIM Subscriber Identity Module
Participant identification
Slope Pressure rise time (set value)
Smart Pulmo-
Graphic display of lung characteristics
nary View
SPN-CPAP SPN: Spontaneous, CPAP: Continuous Positive Airway Pres-
sure
Spontaneous breathing with continuous positive pressure level
SPN-CPAP/PS SPN: Spontaneous, CPAP: Continuous Positive Airway Pres-
sure, PS: Pressure Support
with or without pressure support

Overview
SPN-CPAP/VS SPN: Spontaneous, CPAP: Continuous Positive Airway Pres-
sure, VS: Volume Support
with or without volume support
SPN-PPS SPN: Spontaneous, PPS: Proportional Pressure Support
Spontaneous breathing with flow- and volume-proportional
pressure support
SpO2 Pulse oximetry O2 saturation
STPD Standard temperature, pressure, dry
0 °C (32 °F), 1013 hPa, dry
Tapn Apnea alarm time (set value)
TC Time constant tau
TCe Time constant calculated from expiratory tidal volume and peak
expiratory flow
Tdiscon Disconnection alarm time (set value)
Te Expiratory time (set value)
Thigh Time of the upper pressure level in ventilation mode PC-APRV
(set value)
Ti Inspiratory time (set value)
Tidal volume
Upper alarm limit for the inspiratory tidal volume
high
Tidal volume low Lower alarm limit for the inspiratory tidal volume
Timax Maximum inspiratory time for flow during pressure or volume
support (set value)
Tispon Inspiratory time during spontaneous breathing
Tlimit Calculated maximum time for low-flow maneuver
Tlow Time of the lower pressure level in ventilation mode PC-APRV
Tlow max Maximum expiratory time during ventilation mode PC-APRV
(set value)
Tmaninsp Duration of the breath for manual inspiration during non-inva-
sive ventilation (patient category Neonate, ventilation mode
SPN-CPAP)
Tplat Time of inspiratory plateau
Trach. Tracheostomy tube
Trigger Trigger threshold, sensitivity (set value)
Tube Ø Inner diameter of the tube
UIP Upper inflection point
UN Nominal voltage
USB Universal Serial Bus
Serial bus system
Variable PS Variable pressure support in ventilation mode SPN-CPAP/PS

Overview
VC-AC VC: Volume Control, AC: Assist Control
Assisted-controlled, volume-controlled ventilation with fixed
inspiratory flow and backup respiratory rate
VC-CMV VC: Volume Control, CMV: Controlled Mandatory Ventilation
Continuous volume-controlled ventilation
VC-MMV VC: Volume Control, MMV: Mandatory Minute Ventilation
Volume-controlled ventilation to ensure a minimum minute vol-
ume
VC-SIMV VC: Volume Control, SIMV: Synchronized Intermittent Manda-
tory Ventilation
Intermittent, triggered, volume-controlled ventilation
Vds Serial dead space up to the CO2 cuvette
Vds/VTe Ratio of serial dead space to expiratory tidal volume
VG Volume guarantee
Vlimit Volume limit for low-flow maneuver (set value)
Vol assist Volume support in ventilation mode SPN-PPS (set value)
VRLA Valve-regulated lead-acid, battery technology
VS Volume support
VT Tidal volume, leakage-corrected
VT/IBW Tidal volume relative to ideal body weight
VTapn Tidal volume for apnea ventilation (set value)
VTCO2 Amount of CO2 expired per spontaneous breath
VTe Expiratory tidal volume, not leakage-corrected
VTemand Expiratory tidal volume during a mandatory breath
VTespon Expiratory tidal volume during a spontaneous breath
VTi Inspiratory tidal volume, not leakage-corrected
VTimand Inspiratory tidal volume during a mandatory breath
VTispon Inspiratory tidal volume during a spontaneous breath
VTmand Tidal volume during a mandatory breath
Vtrap Volume trapped in the lungs due to intrinsic PEEP
VTspon Tidal volume during a spontaneous breath
V̇ CO2 Amount of CO2 expired per minute

Overview
3.8 Symbols
Additional information about the symbols is available on the following web page:
www.draeger.com/md-symbols
3.8.1 Symbols on the device and trolley

Symbol Explanation
Observe the instructions for use
Observe the instructions for use
Attention!
Observe accompanying documents
General warning
On/off key
Mains voltage
Internal battery
Power supply unit PS500
Alarm silence key
Exhaust Gas outlet (EXHAUST)

Port for medication nebulizer
Expiratory valve locked
Expiratory valve unlocked
Main switch is turned on
Main switch is turned off

Port for the neonatal flow sensor
Applied part type BF (body floating)
Potential equalization connector
Connection to protective grounding

Fuse
Port for nurse call
USB port
Port for system cable

YYYY-MM-DD
Date of manufacture
Manufacturer

Overview
Symbol Explanation
Part number
Serial number
The product is a medical device (CE conformity assessment

procedure)
WEEE indicator
Dispose of electric and electronic devices according to the
WEEE directive
Do not push
Mark on the device for areas whose risk of tipping over is
increased as a result of horizontal strain
Electrostatically sensitive devices
MR unsafe
Do not use this device near MRI scanners.
The product contains hazardous substances
3.8.2 Symbols on the screen

Symbol Explanation
Attention
Alarm silence
Acoustic alarm signal is temporarily suppressed
Acoustic and optical alarm signals are active
Alarm limit off
Adult patient category (Adult)
Patient category for pediatric patients (Pediatric patient)
Neonates patient category (Neonate)
Therapy type Tube
Therapy type NIV
Therapy type O2 therapy

Mains power supply (alternating voltage)
Battery charge 99 to 100 %

Overview
Symbol Explanation
Batteries faulty or no information available on their charge state
Alarms
Setting the alarm limits, alarm logbook
Views
Choosing another display of the monitoring area
Trends/data
Information on the course of ventilation
Sensors
Calibrating and checking sensors, activating and deactivating
monitoring functions
Procedures
Activating and deactivating procedures
System setup
Configuration, system settings
Help
Opening the help function
Additional settings for ventilation
Starting the therapy
Continuing the therapy
Stop the therapy
Current patient
New patient
Patient disconnected
Spontaneous breathing activity by the patient

Temporary oxygen increase
Medication nebulization
Continuous medication nebulization
Upper alarm limit
Lower alarm limit
Displays the cause and remedy of alarm messages in the alarm
logbook
Displays specific sections of the help function
Linked therapy control
Waveforms frozen
Number of view, e.g., View 1
Locked view, e.g., View 1

Overview
Symbol Explanation
Locking the view
Unlocking the view
Test completed successfully
Test failed
Test recommended
Active test step
Test step not performed

Change possible
Closing the dialog
Scroll forwards in the help function
Scroll backwards in the help function
Switches to the previous page in the help function
Switches to the next page in the help function
Language of screen texts

Create screenshot
Available only if the USB mass storage device is connected
USB mass storage device is connected
SmartCare/PS
Patient session running
Running patient session suspended. SmartCare/PS waiting for
the end of the condition that caused suspension.
3.8.3 Symbols on the packaging

Symbol Explanation
Permitted storage temperature range
Permitted ambient pressure range
Permitted relative humidity range
Use by: YYYY-MM-DD

Expiration date
Protect from moisture

Overview
3.9 Product labels

Product label Explanation
Information regarding intrahospital transport
Nominal weight and maximum total weight (see

"Measurements and weight", page 261)
norm. 58 kg (128 Ibs)
max. 133 kg (293 Ibs )

Operating concept
4 Operating concept
4.1 Screen
This section describes the structure of the screen during therapy and in standby
mode and which functions exist.
4.1.1 General structure
40775
2
No. Designation
1 Header bar
2 Main menu bar
3 Therapy bar

Operating concept
4.1.2 Main screen

During therapy, the main screen displays the following information.
2 3 4 5 6 78 9
40805
1
10
11
12
13
25 14
15
16
17
22
21
18
24 23 20 19
Header bar
No. Designation/description
1 Patient category
2 Ventilation mode
3 Therapy type
4 Time
5 Power supply and charge status indicator of the battery
6 Alarm messages
7 Alarm reset button
8 More alarms button
9 The following is displayed depending on the status:
– Remaining runtime of the alarm silence
– Alarm volume
Main menu bar

10 Alarms Button for opening the Alarms dialog. The alarm lim-
its are set and the alarm logbook is displayed in the
dialog.
11 Views Button for opening the Views dialog. The dialog dis-
plays the pick list of the views.
12 Trends/data Button for opening the Trends/data dialog. The dia-
log displays trends, data, and test results. The data
export can be performed.
13 Sensors Button for opening the Sensors dialog. In the dialog,
monitoring is activated or deactivated, and the sen-
sors are calibrated.
14 Procedures Button for opening the Procedures dialog. Maneu-
vers are performed in this dialog.
15 System setup Button for opening the System setup dialog. Device
settings are configured in this dialog.

Operating concept

16 Help Button for opening the help function. The start page
with the table of contents is displayed.
17 Action buttons For direct access to a function or to open a dialog
page, action buttons can be configured (see "Select-
ing the action buttons", page 191).
18 Stop ventilation Button for ending the therapy.
Stop O2 therapy
Therapy bar

19 Other modes Button for opening the pick list with additional ventila-
tion modes and changing the therapy type.
20 Button for displaying the description of the selected
ventilation mode.
21 Button for opening the SmartCare dialog. The current
SmartCare settings are displayed in an information
field next to the button. For additional information,
see the instructions for use for SmartCare.
22 Button for opening the Advanced settings dialog.
The active settings are displayed next to the button.
23 Tabs Selecting the ventilation mode
24 Therapy controls Displaying and setting the ventilation parameters of
the relevant ventilation mode
Monitoring area
No. Description
25 Display of parameters in the following areas:
– Waveform fields
– Parameter fields
For further information see: "Changing the display", page 56.

Operating concept
4.1.3 Standby screen

The following information is displayed in standby mode.
1 2 3
40786
4

1 Header bar The following information is displayed:
– Patient category
– System data (time, power supply, charge status
indicator of the battery)
2 Standby bar Standby mode display. The patient is not ventilated.
3 Progress indicator
1 System test This step incorporates the following functions:
– Performing the system test
– Display of battery status
2 Breathing circuit This step incorporates the following functions:
test – Select breathing circuit
– Humidification type, selecting
– Perform breathing circuit test
3 Patient and ther- This step incorporates the following functions:
apy – Enter patient data
– Select therapy type
– Check and adjust alarm limits
– Check and adjust start settings
4 Depending on the settings, the button offers the following possibilities:
Start ventilation Button for starting the therapy.
Start O2 therapy
Quick start ven-

tilation
Quick start O2
therapy

Operating concept
4.2 Using the screen

4.2.1 Colors
Control elements
Colors indicate the availability of functions and settings, such as for the following
control elements:
– Tabs
– Buttons
– Therapy controls
Example:
Therapy controls Color Status Function

Blue Can be used but Activated
0 not selected
Gray Can be used but Not activated

0 not selected
White with blue Cannot be used Activated

0 ring
White with gray Cannot be used Not activated

0 ring
White Cannot be used Not available
Orange Selected, and entry Can be activated

0 possible via rotary or deactivated
knob
Blue with orange Selected, and entry Activated
0 ring possible via rotary
knob
Rotary knob
If the device is turned on, the rotary knob is back-lit with a color.
Color Meaning
Orange The selected function or setting must be confirmed by pressing
the rotary knob. 10 seconds before the time during which the con-
firmation may be performed ends, the background lighting flashes.
Blue After the device is turned on, the background lighting shines for
2 seconds. During the therapy, the background lighting shines
continually.

Operating concept
Alarms
The following colors are used to identify the priority of alarms:
Color Alarm priority

Red High !!!
Yellow Agent !!
Turquoise Low !
For further information see: "Alarm priorities", page 157.
4.2.2 Options for operation

Button
Pressing buttons opens dialogs or activates functions.
Example:
40822
For some functions, the button must be pressed until the device begins performing
the measure in question or until this measure is completed.
The system displays the remaining runtime for functions that are active for certain
periods of time.
Example: 40832
For functions that are active for a variable period of time, the system displays the
amount of time that has passed.
Example:
40833

Operating concept
Therapy controls
The therapy control displays the value of the parameter. If the therapy control is
pressed, the unit of the value is displayed. This value can be changed by turning
the rotary knob. The new value is displayed in the therapy control, and must be
confirmed by pressing the rotary knob.
Example:
40826
Tabs
If a tab is touched, another dialog page of the open dialog is displayed.
Example:
40825
In the therapy bar, a tab can be touched to select a ventilation mode. The selection
must be confirmed by pressing the rotary knob.
Example:
40824
Parameter pick list
The parameters are combined into groups in the parameter pick list. Each group
has an appropriate group heading.
The following operating options can be used to move the visible section:
– Rotate the rotary knob until the desired section is displayed.
– Touch the list with a finger and scroll to the desired area (gesture control).
The parameter pick list can be closed by touching the button .

Operating concept
Example:
40820
Context dialog
A context dialog contains control elements that can be used to change settings.
Example:
40827
Pop-up window
A pop-up window displays the options for further procedures.
Touch the relevant button to confirm further procedures. The selection must be
confirmed by pressing the rotary knob. The pop-up window is then closed.
The pop-up window can be closed by touching the button .
Example:
40823

Operating concept
Tooltip
In tooltips, the meaning of the information contained is indicated by the following
colors:
Blue: Displays information
Example:
40829
Orange: Displays instructions. Press the rotary knob in order to confirm that the
instruction has been performed.
Example:
40828
Scroll bar
If additional information is available outside of the visible section, the device
displays vertical and horizontal scroll bars when the screen is touched.
The following operating options can be used to move the visible section:
– Rotate the rotary knob until the desired section is displayed.
– Touch the visible section with a finger and scroll to the desired area (gesture
control).
Example:
40830
Cursor
The cursor can be used to display the value of a parameter at a certain time.
The following control options are available:
– Position the cursor on the point of time by rotating the rotary knob.
– Touch the point of time.

Operating concept
Example:
40831
4.2.3 Selecting and setting parameters and functions
Parameters or functions are selected and set with the following control elements:
– Tabs
– Buttons
– Therapy controls
– Rotary knob
Selecting the control element

1. Touch the control element.
 The control element turns orange.
2. Press the rotary knob to confirm.
✓ The selection is applied, and the control element turns gray or blue again.
Some buttons are active immediately without confirmation.
Selecting the control element and changing the setting

1. Touch the control element.
 The control element turns orange.
 With therapy controls, the unit is also displayed.
 The background light of the rotary knob shines orange.
2. To make the setting, rotate the rotary knob to the right or to the left.
 The value is displayed in the control element.
3. Press the rotary knob to confirm.
✓ The setting is applied, and the control element turns gray or blue again.
Exceeding the set limit of a parameter

Once a set limit of a parameter has been reached, the message is displayed in a
tooltip.
● Press the rotary knob to exceed the set limit.
✓ The set limit can be exceeded.
If the maximum set limit for a parameter has been reached, e.g., when it is
dependent on other parameters, it is not possible to exceed the set limit.
● Press the rotary knob.
✓ The maximum possible set value is applied.
Canceling the setting or change procedure

If a change should not be made after all, there are various options for canceling it.
Prerequisites:
– The control element is still orange.

Operating concept
Possible procedures:
● Touch the control element again.
● Touch another control element.
● Do not press the rotary knob.
✓ After 15 seconds the change is discarded. The alarm message Setting change
not confirmed appears in the alarm logbook.
4.3 Setting the ventilation

4.3.1 Therapy bar overview
40780
1 2 3 4 5

1 Selected ventila- The other tabs display the available ventilation modes.
tion mode The selection of the ventilation modes can be changed.
2 Ventilation The therapy controls display the general settings of the
parameters selected ventilation mode.
3 Button for displaying the description of the selected venti-
lation mode.
4 Other modes Button for changing the following settings:
– Ventilation mode
– Therapy type
5 Button for opening the Advanced settings dialog: The
advanced settings of the selected ventilation mode are
displayed and can be configured.
The current additional settings are displayed in an infor-
mation field next to the button.
4.3.2 Changing the ventilation mode

1. Touch the relevant tab.
 The color of the tab turns orange.
2. If necessary, adjust the ventilation parameter.
3. Confirm with the rotary knob.
 The color of the tab turns white.
✓ The ventilation mode is active. The settings are applied to the patient.
Selecting an additional ventilation mode

1. Touch the Other modes button.
 The pick list with the available ventilation modes is displayed.
2. Touch the button for the corresponding ventilation mode.
✓ The ventilation mode is active and is displayed on an additional tab.

Operating concept
4.3.3 Setting ventilation parameters

1. Touch the corresponding therapy control.
2. Set the value by turning the rotary knob and push to confirm.
✓ The following are examples of information displayed in the tooltips:
– Reaching a set limit for the ventilation parameter
– Additional ventilation parameters with the calculated value that are derived
from the ventilation parameter
4.3.4 Directly setting ventilation parameters (QuickSet)

When a ventilation parameter is set directly, the changes to a setting become
immediately effective for the patient. The user can immediately see the effect the
changed setting has on the patient. The setting does not have to be confirmed
again.
Ventilation parameters can be directly set in all ventilation modes.
The ventilation parameters FiO2 and Flow cannot be set directly.
Procedure:
1. Touch the corresponding therapy control.
2. Press the rotary knob and hold it for approximately 3 seconds.
 The therapy control changes to blue with a wide orange edge.
 The direct setting function is now active.
3. Press and hold the rotary knob and turn it to set the value.
✓ The setting is immediately effective.
Exceeding the set limit during direct setting

Once a set limit of a parameter has been reached, the message is displayed in a
tooltip.
Procedure:
1. Release the rotary knob shortly.
2. Press the rotary knob again and, holding it down, turn it.
✓ The set limit can be exceeded.
4.3.5 Linked setting of ventilation parameters

2 parameters can be set at the same time with the linked setting.
Parameter Meaning
PEEP and Pinsp The difference in pressure remains constant.
RR and Ti The I:E ratio remains constant.
If the respiratory rate is increased, the inspiratory time is
reduced.
If the inspiratory time is increased, the respiratory rate is
reduced.

Operating concept
Procedure:
1. Touch a therapy control.
 The color turns orange.
 The following button is displayed above the other therapy control:
2. Touch the button.
 The color of the other therapy control turns orange.
 Tooltips display information about the settings.
3. Turn the rotary knob to set the value.
4. Press the rotary knob to confirm the value.
✓ The color of the therapy control turns blue.
4.3.6 Setting additional settings

Depending on the ventilation mode, the following additional settings are available:
– Apnea ventilation
– Trigger
– Sigh
– AutoFlow
– Volume guarantee
– ATC
– AutoRelease
– Variable PS
Procedure:
1. Touch the button.
 The Advanced settings dialog with the additional settings for the active
ventilation mode is opened.
2. Touch the tab of the respective additional setting, for example (1).
 The corresponding dialog page appears.
1 6
40751
2 3 4 5
3. Use the buttons, such as (2), to activate or deactivate the additional setting.
4. Set the relevant parameters with the buttons, such as (3), and the therapy
controls, such as (4).
Tooltips display information about the settings.
An information field, such as (5), displays the corresponding alarm limits or
additional settings.
The description of the selected, additional setting is displayed if the button (6)
is pressed. If no additional setting was selected, the table of contents of the help
function is displayed.

Operating concept
Closing the dialog

● Touch the button.
General ventilation functions

– Leakage compensation
– Autom. return from apnea ventilation
– Apnea ventilation alarm
– Pmax/Paw high autoset
– "Insp term" during pressure support
– Expiratory compensation (ATC)
– Inspiratory compensation (ATC)
– Anti-air shower
For further information, see the following section: "Selecting the general
settings", page 193.
4.4 Operating the monitoring area

4.4.1 Switching views
The main screen displays a view of the monitoring area. The views can be
configured in a user-specific manner (see "Possible settings", page 187).
Selecting another view

1. Touch the Views button in the main menu bar.
 The Views dialog is opened.
40761
The symbols indicate whether the relevant view is locked or can be changed.
Example:
– The view is locked:
– The view can be changed:
2. Touch the button for the corresponding view.

✓ The selected view is displayed.
Closing the dialog


Operating concept
4.4.2 Scaling waveforms

The area for scaling the waveforms on the Y-axis can be set in the waveform field.
When the view is switched, the scaling set for the respective parameter is retained.
Procedure:
1. Touch the upper or lower measured value (1) in the waveform field on the Y-axis.
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 The context dialog Waveform scaling (2) opens.
2. Select a range for the scaling (4) or touch the Auto button (3) to have the scaling
take place automatically.
4.4.3 Freezing waveforms

Prerequisites:
– The Freeze waveforms action button is displayed in the main menu bar.
Procedure:
● Touch the Freeze waveforms action button.
✓ The current waveforms are immediately frozen. The cursor (1) displays the time
of "freezing" and the value at the cursor position.
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To display a measured value at a certain point of time:

● Position the cursor on the point of time with the rotary knob.
✓ The measured value or the measured value pair are displayed above the
waveform.
To cancel the Freeze waveforms function:
● Touch the Freeze waveforms button in the main menu bar again.

Operating concept
4.4.4 Changing the display

The following text describes how to change the display of the parameter fields and
waveform fields.
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3 2 1
6 4
No. Designation
1 Parameter field
2 Configuration dialog
3 Display form
4 Parameter pick list
5 Field size
6 Waveform field
Certain field sizes are required for displaying some parameters. For further
information see: "Configuring the views", page 187.
Selecting the display

● Touch a parameter field (1) or a waveform field (6).
✓ The selected field is highlighted. The Configuration dialog is opened.
Selecting the display form

1. Touch the button (3).
 A pick list appears.
2. Touch the display form required (e.g., Waveform, Trend (meas.)).
✓ The corresponding parameter pick list and the possible field sizes are displayed.
Selecting the field sizes

● Touch the button with the field size required.
✓ The field is displayed in the selected field size.
Selecting the parameter

● Touch the desired parameter in the parameter pick list.
✓ The parameter is transferred to the field.
Closing the dialog


Operating concept
4.5 Using the help function

Opening the help function
WARNING
Risk of patient injury through improper use
The Help function is not a substitute for the instructions for use.
► Follow the instructions for use for safe usage.
● Touch the Help button in the main menu bar.
✓ The start page with the table of contents is displayed. The parameter fields and
the therapy bar are still visible.
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1 2 3 4 5 6 7

1 Home Opens the table of contents
2 Switches between the most recently opened pages.
3
4 Index Opens the index
5 Switches to the previous page.
6 Switches to the next page.
7 Closes the help function

8 > Opens the corresponding section
Opening a page
● If the symbol “>” appears in front of the displayed text, touching the text opens
the corresponding page of the help function.

Operating concept
Opening specific sections of the help function

The symbol is displayed in some sections of the screen. Touching this symbol
opens the following sections of the help function:
Position of the symbol Section in the help function

Therapy bar Description of the selected ventilation mode.
When selecting the therapy type O2 therapy:
Description of the O2 therapy.
Advanced settings dialog Description of the selected additional setting. If no
additional setting was selected, the table of con-
tents opens.
Procedures dialog Description of the open dialog page.
Procedure:
● Touch the button in the section in question.
✓ The appropriate section of the help function is displayed.

Assembly and preparation
5 Assembly and preparation

5.1.1 Reprocessed products
Reusable products must be reprocessed, otherwise there is an increased risk of
infection.
► Before each use, reprocess the device and the reusable accessories. Perform
reprocessing according to the reprocessing instructions delivered with the
product.
5.1.2 Fastening the device

If the device is not securely fastened to the trolley or the ceiling supply units,
personal injury and property damage may occur as a consequence.
► Fasten the device securely and check that it is firmly attached.
5.1.3 Trolley
Visible damage to the trolley
If the trolley is damaged (e.g., faulty double castors), the device may be damaged
and, consequently, the patient may be put at risk.
► Check the trolley for visible damage. If there is damage, do not use the trolley.
Contact specialized service personnel.
Weight load or changing the center of gravity

As a result of an excessively high weight load or a change in the center of gravity,
the device may tip over and injure patients, users, and persons nearby. The device
and accessories may be damaged by tipping over.
► Do not use the device if it is tilted by more than 5°.
► Observe the maximum loads and the locations of centers of gravity. For further
information see: "Maximum loads", page 63.
Marking points on the trolley

If handled incorrectly, the trolley may tip over. This may result in personal injury and
property damage.
► Do not lean or press against the trolley above the marking point.
► Do not push or pull the trolley above the marking point.
Unintentional movement of the trolley

If the locking brakes are not applied when the trolley is parked, the trolley may
move and thereby put the patient at risk.
► Engage all double castors on the trolley and check that the brakes are working
properly.

5.1.4 Breathing circuit

Additional components in the breathing circuit
Additional components in the breathing circuit such as bacteria filters, HME filters,
and CO2 cuvettes may increase the dead space, compressible volume, and
resistance. All components that are attached on the patient-side of the Y-piece
increase the serial dead space. This may lead to decreased alveolar ventilation.
Particular care and monitoring are required when using additional components. The
patient may be put at risk.
► Consider the dead space of additional components; see the corresponding
instructions for use.
► Before performing the breathing circuit test, mount all required additional
components up to the patient port.
► When modifying additional components, perform the breathing circuit test.
Increased resistance of additional components

Medication nebulization and active humidification may increase the resistance of
additional components. The patient may be put at risk.
► Check the breathing circuit regularly for signs of increased resistance and
replace additional components if necessary.
Breathing circuits with variable length

When using breathing circuits with variable length, volume-controlled ventilation is
restricted. The patient may be put at risk.
► After changing the hose length, immediately perform a breathing circuit test to
ensure that the hose compliance values are correct.
Expiratory filter
The resistance of the expiratory filter may gradually increase during use. The
► Check the breathing circuit regularly for signs of increased resistance and
replace the expiratory filter if necessary.
5.1.5 Reusable expiratory valves

Expiratory valves that are moist or not reprocessed may impair the functioning of
the device. As a result, the patient may be put at risk.
► Only use properly reprocessed expiratory valves which have been sufficiently
dried.

5.1.6 Flow sensors

Flammable substances
The flow sensor may ignite medications or other substances based on easily
flammable substances. The patient may be put at risk.
► Do not nebulize medications or other substances that are easily flammable or
spray them into the device.
► Do not use substances containing alcohol.
► Do not allow combustible or explosive substances to enter the breathing system
or the breathing circuit.
Residual vapors of highly flammable disinfectants

Residual vapors of highly flammable disinfectants (e.g., alcohols) may ignite when
the flow sensor is operated. The patient may be put at risk.
► After disinfection, allow the flow sensor to air-dry for at least 30 minutes.
Deposits
Deposits that were not removed during reprocessing may damage the measuring
wires in the flow sensor or cause a fire. Patients may be put at risk if the flow
measurement fails.
► Before inserting the flow sensor, check for visible damage, soiling, and particles.
Repeat this check regularly.
► Replace flow sensors when damaged, soiled, or not particle-free.
5.1.7 Mains power supply

If the device is connected to a power socket with incorrect mains voltage or a power
socket without a protective ground conductor, an electric shock may occur.
Personal injury and property damage may occur as a consequence.
► Connect the device only to power sockets with correct mains voltage and a
protective ground conductor.
5.1.8 Gas supply

Compressed gases
If the compressed gases are not suitable for medical purposes, this may impair the
functional integrity of the device and put the patient at risk.
► Use only compressed gases that are approved for medical purposes.
► Use only compressed gases that are dry and free of dust and oil.
Oxygen supply
Oxygen may spontaneously combust when used under pressure with oil or grease.
There may be a risk of personal injury.
► Do not bring any oxygen supply components into contact with oil and grease.

Pressure reducer
If the ventilator is supplied with oxygen from a compressed gas cylinder, a fire may
break out due to overpressure if an O2 pressure reducer that is not permitted is
used. There may be a risk of personal injury.
► Use only pressure reducers that fulfill the ISO 10524 standard.
► Slowly open the pressure reducer manually. Do not use tools.
Oxygen concentrator
If the device is supplied with 93 Vol% oxygen, the FiO2 delivered and the volume
may differ from the displayed value.
► Do not supply the device with 93 Vol% oxygen.
5.1.9 Data transfer

Interfaces
If the devices and networks connected do not satisfy the required electrical
properties, personal injury and property damage may occur.
► Connect only devices or networks with a maximum of 24 V DC nominal voltage
and that fulfill one of the following norms to the serial ports and to the network
port:
– IEC 60950-1: Ungrounded SELV circuits
– IEC 60601-1 (as of the 2nd edition): Touchable secondary circuits
MEDIBUS.X, MEDIBUS
All data transferred via the COM ports are for information only and must not be
used as the sole basis for diagnostic or therapeutic decisions. The COM ports are
not intended for use with a distributed alarm system conforming to the standard
IEC 60601-1-8:2012. The patient may be put at risk.
► Do not use data transferred via the COM ports as the only source of information.
Nurse call
All data transferred via the nurse call are for information only and must not be used
as the sole basis for diagnostic or therapeutic decisions. The nurse call is not
intended for use with a distributed alarm system conforming to the standard
IEC 60601-1-8:2012. A connection interruption between the device and the central
hospital alarm system may result in an interruption of information transfer. The
► Do not use data transferred via the nurse call as the only source of information.
► On the device, check the displays at regular intervals that are appropriate for the
patient. Check whether alarms are active.

5.2 Maximum loads

Position of the Maximum Possible accesso- Maximum distance
holder load ries to the lateral stan-
dard rail
Trolley – 100 kg – –
(220.5 lb)
Universal holder with On the front of the 10 kg Breathing gas –
standard rail trolley (22 lb) humidifier
(G93140)
For use with the fixa-
tion set (8411074)
Holder with standard On the side of the 5 kg (11 lb) Breathing gas –
rail, can be swiveled trolley humidifier
(G93111)
For use with the fixa-
tion set (8411074)
Humidifier holder for On the lateral stan- 5 kg2) Breathing gas 10 cm (3.9 in)
the lateral standard dard rails of the ven- (11 lb) humidifier
rail (8416325) tilation unit1)
IACS hinged arm On the lateral stan- 1 kg Breathing hoses 100 cm (39.4 in)
(MP00690) dard rails of the ven- (2.2 lb)
tilation unit1)
1) 5 kg (11 lb) on each lateral standard rail
2) If a hinged arm is attached to the lateral standard rails in addition to the humidifier holder (8416325), the maximum
load of 5 kg (11 lb) per lateral standard rail must be complied with. The humidifier holder can then only support 4 kg
(8.8 lb).

5.3 Attaching and adjusting the holders and accessories

This section describes how to attach accessories on the device or trolley using
holders.
Attaching and adjusting the universal holder with standard rail to the trolley
The universal holder with standard rail is attached to the front of the trolley.
1. Loosen the locking screw (1) as far as possible.
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2
1
2. Hook the right-hand side of the universal holder into the right-hand side of the
rail (2) when attaching it. Make sure that the catch of the universal holder is
completely in the guide.
3. Align the universal holder (3) horizontally and press the left-hand side of the
universal holder onto the left-hand side of the column.
4. Tighten the locking screw (1). Make sure that the catch of the universal holder is
completely in the guide.
5. Check that the universal holder is fixed securely.

Attaching and adjusting the holder with standard rail to the trolley
The holder is attached to the front of the trolley. The holder can be fastened on the
left or right-hand side of the trolley column. The attachment of the holder on the
right-hand side is shown.
Procedure:
1. Hold the holder at the desired height on the guide (4) of the trolley column.
39355
4
6
2. Turn the locking screw (5) to the left until the base (6) fits into the guide of the
trolley column.
3. Turn the locking screw (5) to the right until the holder is secured firmly in the
guide.
4. Move the standard rail (7) to the desired position.
Attaching the breathing gas humidifier to the standard rail of the holder
Prerequisites:
– The fixation set (8411074) is available.
Procedure:
1. Loosen the locking screw on the fixation set.
2. Hook the fixation set onto the standard rail. Tighten the locking screw.
3. Hook the breathing gas humidifier onto the mount.

Attaching the humidifier holder to the lateral standard rail

If the device is equipped with PS500 the power supply unit or the GS500 gas supply
unit, the humidifier holder for the lateral standard rail can be used. The holder can
be connected to the left-hand or right-hand side of device.
Procedure:
1. Hook the holder on the lateral standard rail (8). Position the holder on the
standard rail so that the lateral device flap can still be opened.
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8
10
2. Turn the locking screw (9) until the holder is fixed securely on the rail.
3. Hook the breathing gas humidifier onto the mount (10).
Attaching the hinged arm

● Hang the hinged arm (11) on the lateral standard rail and tighten the screws.
Depending on the desired position of the device in relation to the bed, the hinged
arm can be fitted to either side of the standard rail.
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11

5.4 Attaching compressed gas cylinders to the trolley
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2
1 1
3 3
3 3
No. Designation
1 Pressure reducer
2 Hose holder
3 Hook-and-loop strap
5.4.1 Attaching the compressed gas cylinders

Prerequisites:
– The gas cylinder holder option is available.
– The compressed gas cylinders have the following dimensions:
– Diameter: 80 to 176 mm (3.15 to 6.93 in)
– Length: 420 to 760 mm (16.54 to 29.92 in)
Procedure:
WARNING
Risk due to unsecured compressed gas cylinders
Not every combination of compressed gas cylinder diameter and length can be
secured. The compressed gas cylinders may fall down and endanger persons.
► The compressed gas cylinder with the pressure reducer must not touch the
ventilation unit, the trolley column, or its handle.
► The diameter must not be wider than 176 mm (6.93 in).

WARNING
Risk due to damaged pressure reducers
If the pressure reducers protrude above the device, they may be damaged during
transport.
► Position the compressed gas cylinders in such a way that the pressure reducers
are prevented from being damaged.
1. Place the compressed gas cylinders into the mountings on the trolley.
WARNING
Risk due to falling compressed gas cylinders
If the compressed gas cylinders are not securely attached to the trolley, the
compressed gas cylinders may fall down.
► Securely attach the compressed gas cylinders to the trolley, using both hook-
and-loop straps.
2. Secure each compressed gas cylinder with 2 hook-and-loop straps (3). If
necessary, have the service personnel make the following changes:
● Adjust the height of the upper gas cylinder holder to the compressed gas
cylinders used. Configure the height so that the upper compressed gas
cylinder holder holds the compressed gas cylinders in the upper half of the
compressed gas cylinders.
● Replace the hook-and-loop strap. The length of the hook-and-loop strap
must be suitable for the circumference of the compressed gas cylinders.
3. Hang the compressed gas hoses over the hose holders (2).

5.5 Preparing the display unit

5.5.1 Positioning the display unit
The display unit can be positioned on the trolley or on a standard rail.
The illustration shows an example of how the display unit is positioned on the
trolley.
39096
1 2
No. Designation
1 Holder
2 Mounting on the trolley
3 Locking screw
Procedure:
1. Hook the holder into the mounting or standard rail on the trolley.
2. Tighten the locking screw.
3. Make sure the display unit is firmly attached to the trolley or standard rail.

5.5.2 Swiveling the display unit

The display unit can be tilted down and up.
1. Press and hold the tilt release key (1).
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1
2. At the same time, tilt the display unit to the desired working position.
3. Release the key and make sure that it engages securely.
5.5.3 Turning the display unit

The display unit can be turned by a maximum of 180° to the left or 90° to the right.
● Turn the display unit to the desired working position.
5.5.4 Connecting the system cable

The pluggable system cable is connected to the display unit and can be connected
to and removed from the ventilation unit. The system cable is fixed in a clamp.
Connecting the system cable to the ventilation unit:
1. Open the left device flap of the ventilation unit.
2. Guide the system cable between the ventilation unit and the handle.

3. Insert the plug (1) into the socket until the connector clicks into place.
 The cable is secured.
1 2
44118
4. Close the left device flap.
Removing the system cable from the ventilation unit:
1. Open the left device flap of the ventilation unit.
2. Press the green button on the plug (2) and pull out the plug.
3. Guide the system cable out between the ventilation unit and the handle.
4. Close the left device flap.
Fixing the system cable in the clamp:
1. Open the clamp cover (3).
3 4 5
44181
2. Place the system cable (4) into the clamp (5). Keep the cable length between
the clamp and the ventilation unit short.
3. Close the clamp cover (3) and engage.
Removing the system cable from the clamp:
1. Open the clamp cover (3).
2. Remove the cable (4) from the clamp.
3. Close the clamp cover (3) and engage.

5.5.5 Connecting external devices to the data interfaces

The following ports are available on the display unit:
43906
2 2
4 2 3

1 COM Serial ports (RS-232) for exchanging data via communica-
tion protocols (MEDIBUS)
2 Only connect the following to the USB port:
– USB mass storage device
– Nebulizer Aeroneb Pro
Do not connect the following to the USB port, e.g.:
– Devices that use wireless technologies
– Cellular phones
3 HDMI An external device (e.g., projector) can be connected to
the HDMI port.
4 LAN The use of the LAN port is permitted for service purposes
only.
Preparing:
– Observe the following information: "COM ports", page 269.
– Observe the following information: "Configuring the interfaces", page 202.
– Only the MEDIBUS cable 8416326 is connected to the COM port.
Procedure:
WARNING
Risk of patient injury due to device malfunctions
If a device with its own power supply (e.g., printer, external hard drive) is connected,
voltage surges may occur that may lead to device malfunctions.
► Do no connect any device powered with a mains voltage to the USB port.
WARNING
Risk of patient injury due to electric shock
Touching the ports of the interfaces and the patient at the same time creates a risk
of electric shock.
► Do not simultaneously touch the ports of the interfaces and the patient.
● Connect the external device to the respective port of the display unit.

5.6 Preparing the ventilation unit

5.6.1 Handling the flap
The flap on the front of the ventilation unit must be open so the expiratory valve can
be inserted. The flap must be closed during ventilation.
Opening and closing the flap

● Open the flap by lifting the lower edge upwards or downwards.
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5.6.2 Selecting the expiratory valve and flow sensor
Depending on the patient category, the following expiratory valves and flow sensors
and the corresponding breathing circuits are used:
Patient category Breathing circuit

Adult Pediatric Neonate (see list of accesso-
patient ries)
Expiratory valve, Yes Yes1) No For adult and pediat-

expiratory flow sensor ric patients
Neonatal expiratory No Yes Yes For neonates and
valve, muffler, neona- pediatric patients
tal flow sensor
1) If the neonatal flow sensor is also installed and functional, flow monitoring is performed using
that sensor.

5.6.3 Preparing the expiratory valve

The expiratory valve is assembled and then fitted to the ventilation unit.
Prerequisites:
– The expiratory valve was selected in accordance with the patient category.
– The expiratory valve is prepared and sufficiently dry. It has been checked for
visible soiling.
Assembling the expiratory valve

1. Attach the new diaphragm (1) onto the edge of the expiratory valve housing.
2 1
39164
2. Make sure that the diaphragm is fitted properly.
3. If the flow sensor sleeve (2) has been removed, fit the flow sensor sleeve.
Assembling the neonatal expiratory valve

1. Attach the new diaphragm (1) onto the edge of the expiratory valve housing.
40314
2 1
2. Make sure that the diaphragm is fitted properly.

3. If the muffler (2) has been removed, fit the muffler.
Only the expiratory valve is described in the following sections. However, the
neonatal expiratory valve is prepared using the same method.

Fitting the water trap container

1. Connect the water trap container (3).
39165
3
Remove the water trap container only briefly during ventilation. Otherwise,
ventilation will be impaired.
Fitting the expiratory valve

Prerequisites:
– The flap is open.
Procedure:
1. Turn the locking ring of the expiratory valve as far as possible to the left.
2. Push the expiratory valve (4) into the fitting.
39115
4

3. Turn the locking ring (5) as far as possible to the right until it perceptibly clicks
into place.
4. Check that it is properly secured by gently pulling on the expiratory valve.
5.6.4 Fitting the expiratory flow sensor

1. Open the flap and push the socket (1) to the left as far as possible.
38999
1 1
2. Insert the flow sensor (2) into the socket with the plug facing towards the device
and push it fully into the socket.
3. Push the flow sensor to the right up to the stop in the flow sensor sleeve (3) of
the expiratory valve.
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3
4. Tilt the flap downwards.
5.6.5 Information on breathing circuits and additional components

Additional components in the breathing circuit may increase the inspiratory and
expiratory resistance values to the point that the standard requirements are no
longer complied with.
Examples for additional components:
– Bacteria filter, inspiratory and expiratory
– HME filter
– CO2 cuvette
– Coaxial breathing hose

Using bacteria filters or HMEs

The device is designed to minimize the patient's work of breathing. Operation does
therefore not require inspiratory or expiratory bacteria filters. The use of bacteria
filters or HMEs requires particular care and monitoring by the user. In particular
during medication nebulization and humidification, the resistance of the expiratory
bacteria filter may increase gradually.
Consequences of increased resistance

Higher resistance values lead to a greater work of breathing and trigger effort
during assisted ventilation. Under unfavorable conditions, an intrinsic PEEP may
occur, which can be recognized by the fact that the expiratory flow is not zero at the
end of the expiration. An unacceptably high PEEP is indicated by an alarm. For
further information see: "Automatic alarm limits", page 263.
Monitoring the resistance

The resistance values at the patient port cannot be monitored directly by the device.
That is why the following actions must be performed:
● Observe the instructions for use for the HMEs, bacteria filters, and breathing
circuits in use.
● Before starting ventilation, use the breathing circuit test to determine the
inspiratory and expiratory resistance values of the breathing circuit in standby
mode.
● Check the patient's condition and the device's measured values for volume and
resistance more frequently.
Information on breathing circuits with variable length

Some breathing circuits have a variable length. This causes the hose compliance to
have an increased variability. Under certain circumstances, breathing circuits of this
type may increase the inaccuracy of volume measurement.
The device detects such ventilation situations and issues a low-priority alarm with
the alarm message Volume measurement inaccurate. In these cases, switch to
pressure-controlled ventilation and use independent volume monitoring. Correctly
entering the breathing circuit being used prevents the device from generating an
alarm in the case of non-variable breathing circuits.
5.6.6 Preparing the breathing gas humidifier

Procedure:
CAUTION
Risk of patient injury due to high resistance
If the HME and breathing gas humidifier are used at the same time, the resistance
increases.
► Use either the HME or the breathing gas humidifier.
1. Prepare the breathing gas humidifier in accordance with the corresponding
2. Connect the breathing gas humidifier (see "Attaching and adjusting the holders
and accessories", page 64).

5.6.7 Fitting the breathing circuit

Preparing
WARNING
The use of antistatic or conductive breathing hoses increases the risk of electric
shock to the patient and of fire in an oxygen-enriched environment.
► Do not use antistatic or conductive breathing hoses.
1. Use a suitable breathing circuit.
2. Select the breathing circuit in accordance with the patient category.
Fitting the breathing hoses for ventilation
40319
1 2
3
5 4
No. Designation
1 Expiratory port
2 Inspiratory port
3 Breathing gas humidifier
4 Water trap
5 Y-piece
Procedure:
CAUTION
Risk of patient injury due to lack of humidification
If the inspiratory hose and the expiratory hose are connected to the wrong port,
humidification is ineffective.
► Do not reverse the ports for inspiration and expiration.
1. Connect the breathing hoses to the inspiratory port and to the expiratory port.
For breathing hoses for ventilating neonatal patients, proceed as follows:
● Insert the inspiratory hose into the inspiratory port.
● Push the expiratory hose onto the expiratory port.
2. Connect the inspiratory hoses to the breathing gas humidifier.

3. If a water trap is required, connect the water trap in a vertical position at the
lowest point of the breathing circuit.
Depending on the breathing circuit used, a water trap may be required for the
breathing gas humidifier.
4. Connect the Y-piece to the breathing hoses.

5. Insert the Y-piece or the breathing hoses into the opening of the hinged arm.
✓ The breathing circuit is connected.
The breathing circuit must be checked (see "Performing the breathing circuit test",
page 97).
Fitting the breathing hoses for O2 therapy

Prerequisites:
– The breathing gas humidifier is used.
Procedure:
● Fit the breathing hoses for inspiration (1). The expiratory port on the device
remains open.
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1 1
5.6.8 Fitting the neonatal flow sensor

Prerequisites:
– The patient category Neonate or Pediatric patient is selected.
– The flow sensor was reprocessed. Observe the reprocessing instructions
delivered with the product. It has been checked for visible damage and soiling.
– The sensor housing and the sensor insert are correctly assembled.
Selecting the neonatal flow sensor

The following neonatal flow sensors are available:
– Flow sensor ISO 15 (8411130)
– Flow sensor Y-piece (8410185)

Fitting the ISO 15 neonatal flow sensor

1. Insert the flow sensor (2) into the patient port of the Y-piece (3).
39372
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2. Connect the plug (1) of the flow sensor cable to the flow sensor.
Fitting the neonatal flow sensor Y-piece

1. Connect the Y-piece with integrated flow sensor (5) to the breathing hoses.
39373
4
2. Connect the plug (4) of the flow sensor cable to the flow sensor.
Further procedure for both neonatal flow sensors

1. Position the patient port of the Y-piece pointing approx. 45° downwards to
prevent condensation from forming on the flow sensor.
2. Run the cable along the breathing hoses to the device.
3. Insert the plug (7) of the flow sensor cable into the socket (6) at the rear of the
ventilation unit.
39374
6 7

5.6.9 Replacing the sensor insert on the neonatal flow sensor
39384
1 2 3
No. Designation
1 Plug of the flow sensor cable
2 Buttons on the sensor insert
3 Sensor insert
4 Sensor housing
Procedure:
1. Disconnect the plug of the flow sensor cable from the flow sensor.
2. Carefully press the buttons on both sides of the sensor insert and, at the same
time, pull the sensor insert out of the sensor housing.
3. Push the new sensor insert in until it engages in the sensor housing.
4. Connect the plug of the flow sensor cable to the flow sensor.
5. Calibrate the flow sensor (see "Calibrating the neonatal flow sensor", page 177).
5.6.10 Fitting the CO2 cuvette and the CO2 sensor
Do not perform a CO2 measurement if the patient category Neonate is selected.

The CO2 cuvette results in a considerable increase in dead space.
Procedure:
1. Insert the cuvette (2) into the patient port of the Y-piece.
The cuvette windows are facing to the side. Position the cuvette as illustrated to
avoid condensate formation.
39386
2. Push the CO2 sensor (1) onto the cuvette. The cable is facing towards the
device.

3. Insert the plug (4) of the CO2 sensor into the socket (3) at the rear of the
ventilation unit.
39390
3 4
4. Select the cuvette type and perform a CO2 zero calibration (see "CO2
monitoring", page 180).
For further information see: "Information on checking the CO2 sensor", page 180.
5.7 Establishing the power supply

5.7.1 Information on the power supply
The device is designed for connection to the hospital's mains power supply.
Information on voltage ranges and mains voltage characteristics can be found in
chapter "Technical data" (see "Technical data", page 240).
Use of power supplies

The device is supplied with electric power from the following sources in the order
stated:
– Mains voltage
– Batteries of the power supply unit PS500
– Internal battery
The switch-over between these sources takes place without interruption to
operation according to the following rules:
– If the mains voltage is sufficient, the power is supplied from the mains.
– If the mains voltage is not sufficient or during a battery test, the power is
supplied from the batteries.
Disconnecting the device from the mains voltage

In the event of device malfunctions or other hazards, the device must be completely
disconnected from the mains voltage.
If the main switch is deactivated, only parts of the device are disconnected from the
mains voltage. The batteries continue to be charged. To completely disconnect the
device from the mains voltage, unplug the power plug.

Failure of the mains power supply

If the mains power supply fails, operation is maintained either via the internal
battery or via the PS500 power supply unit. For further information see: "Battery
operation", page 146.
5.7.2 Establishing the mains power supply

Prerequisites:
– The mains voltage must conform to the voltage range specified on the rating
plate (100 V to 240 V, 50/60 Hz).
Procedure:
1. Plug the appliance socket (2) onto the appliance connector (1).
39392
1 2
2. Perform the following steps:
a. Position the power cable (5) in the clamp (3).
b. Hook the clamp into the housing (6).
c. Tighten the screw (4) (strain relief).
39398
3 4
6
5
WARNING
Risk due to incorrect mains voltage or missing protective ground conductor
If the device is connected to a power socket with incorrect mains voltage or a power
socket without a protective ground conductor, an electric shock may occur.
► Connect the device only to power sockets with correct mains voltage and a
protective ground conductor.
3. Insert the power plug into the power socket.
✓ The LED on the display unit lights up green.

5.8 Checking the main switch

Procedure:
1. Open the left device flap.
39399
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V2
CAUTION
Risk of patient injury due to lack of therapy
Pressing the main switch interrupts the therapy. The patient may be put at risk.
► Do not press the main switch during therapy.
2. Check whether the main switch (2) is activated. Position
WARNING
Touching the ports of the interfaces (1) and the patient at the same time creates a
risk of electric shock.
► Do not simultaneously touch the ports of the interfaces and the patient.
3. If the main switch is deactivated, activate it.
5.9 Connecting the potential equalization cable

Differences in electrical potential between devices can be reduced by potential
equalization. Potential equalization does not replace the protective ground
connection. During operation, the potential equalization connectors must be readily
accessible and must be removable without tools.
Procedure:
1. Plug one end of the potential equalization cable fully on to the potential
equalization pin on the device.
2. Connect the other end of the potential equalization cable to the hospital potential
equalization socket.

5.10 Establishing the gas supply

Connecting to the central supply
1. Open the right device flap.
2. Screw the compressed gas hose for Air onto the connector Air (1) and the
compressed gas hose for O2 onto the connector O2 (2) of the ventilation unit.
39118
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3
3. Plug the probe into the wall terminal units of the central gas supply system.
4. Secure the compressed gas hoses by positioning them over the hose holders
(3).
The gas delivered through the compressed gas hoses is used as fresh gas (FRESH
GAS).
If the central supply fails or is not available, the gas can be supplied from
compressed gas cylinders.
Instead of compressed air supply, the GS500 gas supply unit can be used. For
further information see: "GS500 gas supply unit", page 140.
5.11 Connecting the nurse call

Information on the nurse call
The nurse call is used for transmitting high-priority alarms to a central hospital
alarm system. Medium-priority and low-priority alarms are not transmitted.
The nurse call is also activated if the acoustic alarm system of the device has failed.
If the alarm silence key is pressed in the event of an alarm, the acoustic alarm
signal on the device and the nurse call are suppressed for 2 minutes.
Connecting the nurse call to the central hospital alarm system

● The nurse call cable must be connected to the lead to the central hospital alarm
system by service personnel.

41543
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As soon as the device signals an alarm, the connection between the white cable
and the brown cable (NO and COM) is closed, and the nurse call is activated.
Connecting the nurse call to the ventilation unit

2. Plug the nurse call connector (1) into the socket (2) until it engages audibly.
The plug must engage audibly into the socket to ensure all alarm messages
are transmitted properly.
39117
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V2
3. Test the connected nurse call to make sure it functions properly.
5.12 Closing the lateral device flaps
CAUTION
Risk due to open device flaps
If the lateral device flaps are open, the main switch may be pressed by accident or
connections may be loosened. As a result, the patient may be put at risk.
► Keep both lateral device flaps closed during operation.

● Close the lateral flaps of the device (1) after preparation.
39116
1
5.13 Intrahospital device transport

This section describes how to transport the device when no patients are connected.
During patient transport, additional information must be observed (see
"Intrahospital patient transport", page 141).
5.13.1 Preparing the device

● Use the following measures to increase the tipping stability:
● Swivel the display unit until it is centrally aligned.
● Set the hinged arm to minimum extension.
● Empty the water reservoir of the breathing gas humidifier.
● Secure the breathing gas humidifier to the trolley, not to the lateral standard
rails of the ventilation unit.
● Do not attach any additional parts to the lateral standard rails of the
ventilation unit.
● If fitted, slide the bed coupling into its retracted position.
5.13.2 Transporting the device
WARNING
Risk of tipping over
property damage.
► 2 people are always required to move the device and the bed.
► Make sure to securely hold onto the handle of the trolley whenever moving or
positioning the device.
► Do not lean or press against the trolley above the marking point .
► Do not push or pull the trolley above the marking point .
► Pay special attention at thresholds, on uneven surfaces, and on slopes.
● Grip the handle of the trolley firmly. If no bed coupling is used, push the device in
longitudinal direction.

Getting started
6 Getting started
6.1.1 Ambient temperature
When the device is moved from a cold storage location to a warm environment,
condensate may form and impair the functional integrity of the device. As a result,
the therapy may be impaired.
► Turn on the device only once the condensate has dried away.
6.1.2 Standby mode

Ventilation does not take place in standby mode. If connected, the patient may be
put at risk.
► Connect the patient only after the therapy has been started.
6.1.3 Operational readiness of the device

Checking operational readiness
If the operational readiness of the device is not checked, the patient may be put at
risk by malfunctions.
► Perform the system test before using on the patient. Start the therapy only after
successfully completing the system test.
► Perform the breathing circuit test to ensure the pressure measurement
accuracy. Otherwise the airway pressure may deviate from the set values.
Calibrating the O2 sensor

If the quality of the oxygen from the central gas supply system is insufficient, the
sensor may be calibrated incorrectly. As a result, the patient may be put at risk.
► Calibrate the O2 sensor with test gas (100 % O2).
6.1.4 Therapy types

Intubated patients
In the NIV therapy type, the device cannot sufficiently monitor an intubated patient.
► Use the Tube therapy type for intubated patients.
Changing to Tube therapy type

If flow monitoring is deactivated in the Tube therapy type and the settings are not
suitable for invasive ventilation, the patient may be put at risk.
► Activate flow monitoring.
► Check the alarm limits and ventilation settings and change them, if necessary.

Getting started
6.2 Turning on the device

Prerequisites:
– The ventilation unit, display unit, power supply unit PS500 and the gas supply
unit GS500 are assembled so they are ready for operation.
– The accessories needed for operations on the patient are connected.
– The mains power supply and the gas supply are connected.
– The main switch is turned on. Position
– The device is positioned so the power plug can be freely accessed at all times.
The device is safely disconnected from the mains power supply only once the
power plug has been pulled.
Procedure:
● Press the on/off key on the display unit.
39401
✓ The system is started.
The start dialog is displayed.
39402
1 2

1 Current Existing settings continue to be used.
patient If a data loss occured, the settings cannot be recov-
ered. The button is not displayed.
2 New patient A new patient is admitted.
6.2.1 Using existing settings

1. Touch the Current patient button.
 The Patient and therapy step is displayed.
2. Continue the therapy with the existing settings (see "Starting the therapy",
page 104).

Getting started
6.2.2 Using the start settings for a new patient

1. Touch the New patient button.
 The standby screen is displayed. The step System test is automatically
opened.
All settings that are displayed are factory defaults or configured settings. The
configured settings can be changed (see "Configuring the start settings",
page 194).
2. Perform the system test.

 After a successful system test, a message appears for continuing the
breathing circuit test. This message can be confirmed.
3. Perform the breathing circuit test.
4. After successfully performing the breathing circuit test, touch the step Patient
and therapy and enter the patient data.
The steps can also be manually selected by touching them.
6.3 Checking operational readiness

6.3.1 Information on the tests
The system test and the breathing circuit test are used to check operational
readiness.
In an emergency situation, therapy can be started immediately without
operational readiness being checked.
The Battery test function can be configured (see "Configuring the battery test",
page 200).
Test status indicator
40813
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3

1 Progress indicator Symbols indicate the status of the test. The date and
2 Last system test time of the last test are displayed.
3 Battery status Status indicator
If the battery test needs to be performed, the device
displays the Start button.

Getting started

4 Test steps Symbols indicate the status of the test steps.
Test procedure
The device guides the user through the respective test step using a
question/answer dialog. The information field displays the questions or instructions
for performing the test steps.
If the necessary prerequisites have not been met, a test step is skipped.
Test results
Symbol Description
The test was successful.
The test steps performed were successful.
The test failed.
The test step failed.
The test was not performed.
The test was not completely performed.
The test step was not performed.
The test step is active.
If the software option "Neonatal Ventilation" is installed, either the neonatal flow
sensor or the expiratory flow sensor is tested, regardless of the set patient category.
Since the other flow sensor is not tested, the system test cannot be entirely
completed.
The following symbol is displayed in the progress indicator:
The system test was successfully performed for the test steps checked.
The results, calibration values, and zero-checking values of the sensors remain
stored until the next test, even if the device is switched off.
6.3.2 Test steps and results in the system test

The device displays the test steps required depending on the available software
options.
Troubleshooting
1. Eliminate the causes of the error and repeat the test step.
2. If the test step still fails, contact specialized service personnel.
The following table describes the test steps and remedies for troubleshooting: The
test step CO2 sensor: Zero calibration is missing if the CO2 sensor is not
installed.
Test step Description Remedy

Secondary acoustic Test of secondary acoustic alarm sig- Contact specialized service person-
alarm nal (power supply failure alarm) nel.
There is no need for the user to test
other parts of the alarm system, as
they are tested in the self-test.

Getting started

Breathing circuit con- Visual inspection of the breathing cir- Check whether the breathing hoses
nected cuit are correctly connected to the inspi-
ratory port and the expiratory port.
Humidifier Visual inspection of breathing gas Check whether the breathing gas
humidifier humidifier is used.
Check whether the breathing gas
humidifier is properly assembled.
Check whether the breathing gas
humidifier is properly connected to
the inspiratory hoses.
Expiratory flow sen- Calibration of the expiratory flow sen- Check whether the flow sensor is
sor: Calibration sor properly engaged.
The flow sensor is automatically Check the connection between the
cleaned by heating before calibration. expiratory valve and the flow sensor.
Replace the flow sensor.
CO2 sensor: Zero cali- Zero calibration of the CO2 sensor Check whether the CO2 sensor is
bration connected.
Wait for the CO2 sensor to complete
its three-minute warm-up phase.
Check whether the CO2 sensor is
soiled.
Neonatal flow sensor: Calibration of the neonatal flow sen- Check whether the flow sensor cable
Calibration sor is connected.
The flow sensor is automatically Seal the flow sensor during calibra-
cleaned by heating before calibration. tion.
Replace the flow sensor cable.
Neonatal flow sensor: Validation of the calibration values in Check whether the test lung has
Measurement a certain flow area been removed and make sure the
flow sensor is not sealed.
Check whether the flow sensor is
properly installed.
Replace the flow sensor cable.
Test lung connected For subsequent test steps, leakage -
should be kept to a minimum, and the
system should be closed.
Internal gas sensors For further information see: "Calibra- Check whether the compressed gas
tions in the system test", page 94. hoses are connected.
Shut down the ventilator. Deactivate
the main switch to separate the venti-
lator from the power supply.
Gas supply unit The check is carried out only if the Check whether the gas connection to
functionality of the gas supply unit is the device is kinked.
activated. Check whether the data cable is con-
nected.
If GS500 runs continually, shut down
the ventilator. Deactivate the main
switch to separate the ventilator from
the power supply.

Getting started

O2 supply Check whether the O2 supply is avail- Check whether the compressed gas
able and the compressed gas hose hose for O2 is connected.
for O2 is correctly connected.
Air supply Check whether the Air supply is avail- Check whether the compressed gas
able and the compressed gas hose hose for Air is connected.
for Air is correctly connected.
Pressure sensor: Cali- Calibrate the pressure sensors Connect the test lung. Check the
bration against the ambient pressure. breathing circuit for leakage.
Check whether the compressed gas
hoses are connected.
Check whether the expiratory valve is
properly engaged.
Expiratory valve Check of the expiratory valve Check whether the water trap is con-
nected.
properly engaged.
Make sure that the diaphragm is
properly fitted to the expiratory valve.
Check whether the flow sensor is cor-
rectly inserted (only for the Adult and
Pediatric patient patient categories).
Inspiratory valve Check of safety functions Connect the test lung. Check the
breathing circuit for leakage.
properly engaged.
O2 sensor: Calibration For further information see: "Calibra- Check whether the compressed gas
tions in the system test", page 94. hoses are connected.
Nebulizer port Check of the medication nebulizer Prerequisites:
control – The medication nebulizer is not
connected.
Failed test steps

Errors in the following safety-relevant test steps generate the medium-priority alarm
message System test failed:
– Pressure sensor: Calibration
– Expiratory valve
– Inspiratory valve
The alarm cannot be confirmed. Do not start ventilation!
Errors in non-safety-relevant test steps or test steps that are skipped or not
performed on account of a prerequisite generate the low-priority alarm message
System test incomplete.
The alarm causes and their remedies are displayed on the Alarm logbook dialog
page.

Getting started
6.3.3 Calibrations in the system test

Calibrating the gas supply sensors
The calibration of the gas supply sensors takes approximately 2 minutes. The test
must be performed every 3 months. If the test step is not required, it can be skipped
by touching the No button. The test step is still displayed as "successfully
completed".
If the test step is skipped by touching the Next test button, the test step is displayed
as "not performed".
If a complete calibration is necessary after 3 months, the test step cannot be
skipped.
Calibrating the O2 sensor

The O2 sensor is calibrated during each system test. Regular calibration of the O2
sensor ensures the specified accuracy.
If the test step is skipped by touching the Next test button and the O2 sensor is not
calibrated for 3 months, the accuracy of the O2 sensor will be reduced. The
measured value is displayed in gray in the parameter field FiO2. After the calibration
during the system test, the sensor will work again with full accuracy. The measured
value is displayed in the parameter field.
If the test step is skipped by touching the Next test button, the test step is displayed
as "not performed".
If the device requires the calibration of the O2 sensor and the test step is still
skipped by touching the Next test button, the test step is displayed as "failed".
6.3.4 Performing the system test

Prerequisites:
– No patient is connected to the device.
– The device is in standby mode.
– The medication nebulizer is not connected.
– The System test step is displayed.

Getting started
Overview System test
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1 System test Step and status indicator
2 System test Performing the system test with the following buttons:
– Start
– Cancel
– Repeat
– Yes
– No
– Next test
3 Information field Questions or instructions for performing the test steps
4 Test steps For further information see: "Test steps and results in
the system test", page 91.
5 Last system test Date and status indicator of the last test
6 Test details Button for opening the dialog page with detailed
results
Keeping the test lung ready

1. Keep a suitable test lung ready:
– MP02400 (for adult breathing circuits)
– 8409742 (for pediatric and neonatal breathing circuits)
2. The test lung must be inserted into the patient port of the Y-piece only after the
device has instructed to do so.
Starting the system test

1. Touch the Start button in the System test line.
3. Answer the questions in the information field by touching the Yes or No button.
✓ After a successful system test has been performed, a message appears for
continuing the breathing circuit test. This message can be confirmed (see
"Performing the breathing circuit test", page 97).
Skipping a test step

● Touch the Next test button.

Getting started
Repeating a test step

1. Touch the Repeat button.
✓ All test steps that have not yet been performed or that were unsuccessful are
repeated.
Automatic cancellation
The system test is canceled when the System test step is exited. The system test
can be continued by returning to the System test step.
Canceling the system test

1. Touch the Cancel button.
Displaying the results

● Touch the Test details button.
✓ The following dialog page appears: Trends > Test results > System test
For further information see: "System test results", page 169.
6.3.5 Information on the breathing circuit test

The breathing circuit test must be performed after:
– System test
– Changing the breathing circuit
– Changes to the breathing circuit
– Changing the humidification type
– Changing the patient category
The following test steps are performed for the breathing circuit:
– Leakage
– Compliance
– Insp. Resistance
– Exp. Resistance
The current leakage flow is displayed continuously throughout the test. A leakage
flow of up to 300 mL/min at a pressure of 60 mbar (or hPa or cmH2O) is acceptable.
If a coaxial breathing circuit is used, an additional leakage test is required.
After the leakage test, the device determines the compliance and the inspiratory
and expiratory resistance of the breathing circuit. Based on the calculated
compliance of the breathing circuit, the device automatically corrects the volume-
controlled mandatory breaths as well as the measured flow monitoring values.
If the selection of the breathing circuit and humidification type is changed, the
device automatically resets the values for hose compliance and hose resistance to
default values.
When the patient category is changed, the breathing circuit that was last used in
this category is selected and the corresponding values for hose compliance and
hose resistance are used.

Getting started
The leakage measurement becomes invalid when a new patient is admitted to the
same patient category. The values for hose resistance and hose compliance are
retained.
It is recommended to perform the breathing circuit test before ventilating the patient
with a newly prepared device.
6.3.6 Performing the breathing circuit test

Prerequisites:
– The Breathing circuit test step is displayed.
Overview Breathing circuit test
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4
3
5
6
7
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1 Breathing circuit Step and status indicator
test
2 Breathing circuit The pick lists first display the breathing circuits that are
suitable for the selected patient category.
3 Breathing circuit If a custom breathing circuit is selected, after the
characteristics breathing circuit test is performed, the test results can
be saved and stored for the selected breathing circuit.
The leakage must be measured again for each breath-
ing circuit test.
4 Humidification Selecting the humidification type
5 Breathing circuit Performing the test with the following buttons:
test – Start
– Cancel
– OK
6 Information field Questions or instructions for performing the test steps
7 Last breathing cir- Date and status indicator of the last test
cuit test
8 Test steps If a valid measurement has not yet taken place, the
standard values are displayed. The results are dis-
played after the test.

Getting started

9 Test details Button for opening the dialog page with detailed
results
Selecting the breathing circuit used

Prerequisites:
– The breathing circuit used is in the list of available breathing circuits.
Procedure:
1. Touch the button in the Breathing circuit line.
2. Select the breathing circuit used from the pick list.
Selecting the humidification type used

● Touch the corresponding button in the Humidification line.
Starting the breathing circuit test

1. Touch the Start button in the Breathing circuit test line.
3. Follow the instructions in the information field and touch the OK button when
asked to do so.
Canceling the breathing circuit test

1. Touch the Cancel button.
✓ The leakage measurement becomes invalid. The values for hose resistance and
hose compliance are reset to the default values.
Repeating the breathing circuit test

● Repeat the test in the following situations:
– The breathing circuit was changed.
– The humidification type was changed.
– The patient category was changed.
– The therapy type was changed in the Neonate patient category.
Displaying the results

● Touch the Test details button.
✓ The following dialog page appears: Trends > Test results > Breathing circuit
test
For further information see: "Results of the breathing circuit test", page 169.

Getting started
Testing the coaxial breathing circuit

This test is only required for coaxial breathing circuits. The test measures the
leakage of the inner hose.
Procedure:
1. Fit the inspiratory connector of the coaxial breathing circuit to the inspiratory port
(1).
39403
3 1
2. Insert the coaxial test adapter (2) into the patient port of the coaxial breathing
circuit.
3. Fit the patient port of the breathing hose with the coaxial test adapter to the
expiratory port (3).
4. Open the step Breathing circuit test to perform the test.
5. Start the breathing circuit test.
 The leakage test of the inner hose will be performed.
6. The remainder of the procedure depends on the leakage value displayed.
The leakage value displayed is continually below 120 mL/min.
a. Touch the Cancel button and confirm with the rotary knob.
 The test of the coaxial breathing circuit is completed. Continue with
step 7.
The leakage value displayed is not stable or continually above 120 mL/min.
a. Touch the Cancel button and confirm with the rotary knob.
b. Remove the coaxial breathing circuit from the device and dispose of it. If
required, perform a new test with a new coaxial breathing circuit.
7. After the test, remove the patient port of the breathing hose, together with the
coaxial test adapter, from the expiratory port .
8. Remove the coaxial test adapter from the patient port of the coaxial breathing
circuit and dispose of it.
9. Fit the expiratory connector of the coaxial breathing circuit to the expiratory port
(3).
10.Perform the breathing circuit test (see "Performing the breathing circuit test",
page 97).

Getting started
6.3.7 Checking the switchover to battery operation

1. Unplug the power plug.
 The Battery activated alarm is displayed.
2. Plug the power plug back in.
✓ The device switches back to mains operation. The Battery activated alarm
message is no longer displayed.
6.3.8 Checking the alarm display

Once the system test and the breathing circuit test have been successfully
completed, the device is ready for operation. The alarm signaling can be checked
additionally.
Additional information
– Description of the alarm display (see "Display of alarms", page 157)
– Information on the alarm criteria (see "Alarm – Cause – Remedy", page 205)
High-priority alarm message

1. Start ventilation.
2. After 2 minutes, set the upper alarm limit for the expiratory minute volume MVe
to a value below the measured value of MVe.
✓ The Minute volume high alarm is triggered.
Medium-priority alarm message

2. Set the upper alarm limit for the tidal volume VT to a value below the measured
value of VT.
✓ The Tidal volume high alarm is triggered.
Low-priority alarm message

2. In the Procedures > Maneuvers dialog window, touch and hold the Manual
insp./inspiration hold button until the Inspiration hold interrupted alarm is
triggered.
6.3.9 Testing the acoustic alarm system

The acoustic alarm system does not need to be tested by the user. The device tests
the functions of the acoustic alarm system automatically during the system test.

Getting started
6.4 Selecting the therapy type

Prerequisites:
– The Patient and therapy step is displayed.
Overview Patient and therapy
40817
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3
No. Designation Description Additional information

1 Therapy Tube Ventilation of intubated For further information
type patients see: "Ventilation set-
If the therapy type is tings", page 110.
activated, the lines (2)
and (3) are also dis-
played.
NIV Non-invasive ventilation For further information
If the therapy type is see: "Non-invasive venti-
activated in the Neonate lation (NIV)", page 115.
patient category, the fol-
lowing button is dis-
played: Flow max.
O2 therapy High-flow O2 therapy For further information
see: "O2 therapy",
page 143.
2 Tube type Set the tube type used: The line is not displayed
– Endotracheal tube in the Neonate patient
(Endotrach.) category.
– Tracheostomy tube
(Trach.)
3 Tube diameter Set the inner diameter of
the tube used.
Procedure:
1. Touch the button for the relevant therapy type in line (1).

Getting started
6.5 Admitting a new patient

A new patient can be admitted after the device is turned on and after the therapy
has been interrupted.
When a new patient is admitted, the settings and trend data of the previous patient
are deleted.
For a new patient, the start settings of the ventilation parameters are determined
based on the patient category (factory default) or the body weight.
In the Adult and Pediatric patient patient categories, the body height is entered
and used to determine the ideal body weight. In the Neonate patient category, the
body weight is entered directly. The body weight can be changed during therapy.
Prerequisites:
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1
2 4
3
1 Patient category After turning on the device:
If the New patient setting was selected in the start dialog, the
available patient categories are displayed.
After interrupting therapy:
If the New patient button is selected and confirmed using the
rotary knob, the available patient categories are displayed.

Getting started

2 If the Body weight function The start values of the ventilation parameters can be configured
was configured, the following (see "Setting the start values for the ventilation parameters",
buttons are displayed: page 195).
Height, IBW Adult or Pediatric patient patient category:
The body height of the patient is entered. The start values for
VT, RR, Slope, and Trigger are determined based on the ideal
body weight calculated from the body height.
The ideal body weight is calculated as follows:
– (body height [m])2 x 22 (Adult)
e.g., 1.80 x 1.80 x 22 = 72.28 kg
– (body height [m])2 x 16 (Pediatric patient)
e.g. 1.20 x 1.20 x 16 = 23.04 kg
Weight Neonate patient category:
The body weight of the patient is set directly. The start values for
VT, RR, Slope, and Trigger are determined based on the start-
up body weight.
3 Therapy bar The start settings are displayed. Determining the start settings
may take up to 5 seconds. No entries can be made during this
time.
4 Check the alarm limits The start values of the alarm limits are displayed. The start val-
ues of the alarm limits can be configured (see "Setting the start
values for the alarm limits", page 194).
Selecting the patient category

1. Touch the button of the relevant patient category.
 A pop-up window opens.
3. Check whether the test results are valid. If the structure of the device or the
breathing circuit was changed, the tests need to be repeated.
4. If the test results are valid, touch the Yes button.
Setting the body height or the body weight

Prerequisites:
– The Body weight function was configured.
– The patient category was selected.
Procedure:
Adult or Pediatric patient patient category:
1. Touch the button for body height.
2. Set the body height by turning the rotary knob and push to confirm.
Neonate patient category:
1. Touch the button for the start body weight.
2. Using the rotary knob, set the start body weight and confirm the value.
✓ The button for the current body weight is displayed. After the patient has been
admitted, the current body weight corresponds to the start body weight.

Getting started
6.6 Starting the therapy

Overview Patient and therapy
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3
1 2

1 Therapy bar The current settings are displayed in the therapy bar.
2 Start ventilation Button for starting the therapy
3 Alarm limit settings Touching the table opens the dialog page for setting
the alarm limits.
Starting therapy for a new patient

If patient data has been entered (see "Admitting a new patient", page 102) and the
operational readiness of the device has been checked (see "Checking operational
readiness", page 90), therapy can be started.
Continuing therapy with the existing settings

If the setting Current patient was selected in the start dialog after the device was
turned on, therapy can be performed with the existing settings.
The patient-related settings used last, including the alarm limits, therapy type, and
device status, are restored. O2 monitoring and flow monitoring are activated (see
"Information on monitoring", page 173).
Starting or continuing therapy

1. Check the therapy settings:
a. Set the ventilation modes and ventilation parameters (see "Ventilation
settings", page 110).
b. Set the alarm limits (see "Setting the alarm limits", page 161).
✓ The therapy is started. The main screen is displayed.
Therapy quick start

In an emergency situation, therapy can be started immediately without operational
readiness being checked.

Getting started
2. Press the rotary knob.

✓ The therapy is started. The main screen is displayed.

Operation
7 Operation
7.1.1 Neonates
Increased oxygen concentration
With neonates, the administration of increased oxygen concentrations can lead to
retinopathy of prematurity.
► Use additional external monitoring, e.g., SpO2 monitoring.
7.1.2 Ventilation
Mechanical ventilation
Mechanical ventilation may lead to negative effects, such as barotrauma or strain
on the circulatory system.
► Monitor the patient's condition.
Pediatric patients with low compliance

If pediatric patients with relatively low compliance are subjected to volume-
controlled ventilation, deviations from tidal volumes and minute volumes are
possible.
► Switch to pressure-controlled ventilation.
Flow monitoring in the Neonate patient category

If an expiratory flow sensor is used in the Neonate patient category, this impairs the
measurement accuracy. The patient may be put at risk.
► Always use the neonatal flow sensor.
Trigger sensitivity
High trigger sensitivity may cause the ventilator to auto-trigger.
► Set the trigger threshold appropriately.
Provided tidal volume

If leaks are present, e.g., during non-invasive ventilation, the actual tidal volume
may deviate from the measured values for VTe and VTi. The patient may be put at
risk.
► Activate leakage compensation and monitor the measured value VT.
► Minimize or eliminate the leakage.
7.1.3 Non-invasive ventilation

Inactive flow monitoring in the Neonate patient category
Flow monitoring is deactivated in the ventilation mode SPN-CPAP, and apnea
monitoring and minute volume monitoring cannot be carried out. The patient may
be put at risk.
► Use a separate monitoring system.

Operation
High airway pressure

High airway pressures create the risk of aspiration. The patient may be put at risk.
► Avoid high airway pressures.
Masks
Use of masks increases the dead space. As a result, the patient may be put at risk.
► Follow the instructions for use of the breathing mask.
Intubated patients
In the NIV therapy type, the device cannot sufficiently monitor an intubated patient.
► Use the Tube therapy type for intubated patients.
Changing to Tube therapy type

If flow monitoring is deactivated in the Tube therapy type and the settings are not
suitable for invasive ventilation, the patient may be put at risk.
► Activate flow monitoring.
► Check the alarm limits and ventilation settings and change them, if necessary.
7.1.4 Maneuvers
If the maneuver Manual insp./inspiration hold or the maneuver Expiration hold
is performed during endotracheal suctioning, negative pressure may arise in the
breathing circuit. The patient may be put at risk.
► Do not use the maneuver during endotracheal suctioning.
7.1.5 Suction maneuver with oxygenation

Suction catheter
If a suction catheter that is too large is used, the air supply is hindered. Atelectasis
may form as a result of negative pressure during suctioning. The patient may be put
at risk.
► Select an appropriate suction catheter for suctioning.
Closed suction systems

Using closed suction systems produces negative pressure in the patient's airways.
This leads to impaired ventilation and therefore to impaired gas exchange. During
volume-controlled ventilation in particular, the patient may be put at risk by the flow
delivery limitation.
► Monitor the patient's condition.

Operation

Flow sensor
The flow sensor may ignite medications or other substances based on easily
flammable substances. The patient may be put at risk.
► Do not nebulize medications or other substances that are easily flammable or
spray them into the device.
► Do not use substances containing alcohol.
► Do not allow combustible or explosive substances to enter the breathing system
or the breathing circuit.
HME and bacteria filters

If a heat and moisture exchanger (HME) is used during medication nebulization at
the Y-piece, not enough medication reaches the patient. If a bacteria filter is placed
between the medication nebulizer and the tube, the flow resistance may increase
and impair ventilation.
► Do not use an HME.
► Place a bacteria filter device-side.
Medication nebulization unintentionally activated

If the medication nebulizer is left in the breathing circuit after use, ventilation may be
impaired as a result of unintended medication nebulization.
► Remove the medication nebulizer after use.
If medication nebulization is activated, the device delivers a tidal volume that is too
small, even though no pneumatic medication nebulizer is connected.
► Deactivate medication nebulization.
Expiratory valve
Nebulization of aerosols may result in crystalline deposits of salts and medication in
the expiratory valve. Residue and deposits may impair the function of the expiratory
valve. This may impair ventilation.
► If a reusable expiratory valve is used, shorten the reprocessing cycles.
► If a disposable expiratory valve is used, shorten the maximum period of use.
Pediatric patients with low respiratory rate

For respiratory rates below 12 /min, deviations between the set and inspiratory O2
concentration during medication nebulization are very large and cannot be
recorded by the O2 monitoring.
► During medication nebulization, use external SpO2 monitoring.
Tidal volume for pediatric patients

Due to tolerances in the nebulizer flow, the displayed inspiratory tidal volume may
deviate considerably from the inspiratory tidal volume that is delivered to the
patient.
► To the extent practical, use pressure control when ventilating during medication
nebulization.

Operation
7.1.7 Intrahospital patient transport

Damaged breathing circuit
The breathing hoses may be accidentally loosened, or the inspiratory port and the
expiratory port may be damaged.
► Use a device with a protection bar during patient transport.
Discharged batteries
If the batteries are discharged, the device cannot ventilate.
► Only if the batteries are fully charged, start the patient transport.

Operation
7.2 Ventilation settings

7.2.1 Volume-controlled ventilation modes
Volume-controlled ventilation modes are available only in the Adult and Pediatric
patient patient categories.
Ventilation parameters Ventilation mode

VC-SIMV VC-CMV VC-AC VC-MMV
General settings
FiO2 X X X X
VT X X X X
Ti X X X X
RR X X X X
Slope X X
Pmax1) X X X X
Flow2) X X X X
PEEP X X X X
ΔPsupp X X
Additional settings
Apnea ventilation X
VTapn X
RRapn X
Pmax1) X
Trigger/Insp term3)
Trigger X X X
Insp term X X
Sigh X X X X
ΔintPEEP X X X X
Interval sigh X X X X
Cycles sigh X X X X
AutoFlow X X X X
Slope X X X X
Pmax1) X X X X
ATC X X X X
Calculation of tra- X X X X
cheal pressure
Tube type (Endo- X X X X
trach./Trach.)
Tube diameter X X X X
Compens X X X X
Pmax1) X X X X
1) If the following setting is activated: Pmax/Paw high autoset
2) If the additional setting AutoFlow is deactivated.
3) If the following setting is activated: "Insp term" during pressure support

Operation
7.2.2 Pressure-controlled ventilation modes

PC-SIMV PC-BIPAP PC-AC PC-CMV PC-APRV PC-PSV
General settings
FiO2 X X X X X X
Ti X X X X
RR X X X X X
Slope X X X X X X
Pmax1) X X X X X X
Pinsp X X X X X
PEEP X X X X X
ΔPsupp X X
Timax2) X
Thigh X
Tlow X
Phigh X
Plow X
Additional settings
Apnea ventilation X X X
VTapn X X X
RRapn X X X
Pmax1) X X X
PEEP X
Trigger X
Trigger/Insp term3)
Trigger X X X X
Insp term X X X
Sigh X X X X X
ΔintPEEP X X X X X
Interval sigh X X X X X
Cycles sigh X X X X X
ATC X X X X X X
Calculation of tra- X X X X X X
cheal pressure
Tube type (Endo- X X X X X X
trach./Trach.)
Tube diameter X X X X X X
Compens X X X X X X
Volume guarantee X X X X
VT X X X X
Pmax1) X X X X
AutoRelease X
Exp term X
Tlow max X

Operation

2) In the Neonate patient category in the Tube therapy type. In the patient categories Adult and Pediatric patient and
in the NIV therapy type
7.2.3 Spontaneous breathing support

SPN-CPAP/PS SPN-CPAP/VS SPN-CPAP1) SPN-PPS
General settings
FiO2 X X X X
VT X
Timax2) X X X
Slope or Insp. flow3) X X X
Pmax4) X X X
PEEP X X X X
ΔPsupp X
Vol assist X
Flow assist X
Tmaninsp X
Pmaninsp X
Additional settings
Apnea ventilation X X X
VTapn X X X
RRapn X X X
Pmax4) X X X
Slope X
Trigger/Insp term5)
Trigger X X X
Insp term X X X
ATC X X X
Calculation of tra- X X X
cheal pressure
Tube type (Endo- X X X
trach./Trach.)
Tube diameter X X X
Compens X X X
Pmax4) X X X
Variable PS6) X
Press var X
ΔPsupp X
Pmax4) X
1) Only in the Neonate patient category in the NIV therapy type
2) In the NIV therapy type or in the Neonate patient category
3) Depending on the configuration of the setting Slope adjustment

Operation

6) Only in the Adult and Pediatric patient patient categories
7.2.4 Further information about ventilation settings

Detailed descriptions are available in the following sections:
– General settings (see "Ventilation modes", page 272)
– Additional settings (see "Additional settings for ventilation", page 291)
The procedure for configuring settings is described in the section "Setting the
ventilation" (see "Setting the ventilation", page 51).
7.3 Changing the therapy type during therapy

Several procedures can be used to change the therapy type.
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3 2
Procedure 1
1. Touch the field for the therapy type (1) in the header bar.
– Tube
– NIV
– O2 therapy
2. Touch the button of the relevant therapy type.
 The device is in standby mode.
4. Start the therapy (see "Starting the therapy", page 104).
Procedure 2
1. Touch the button (2) in the therapy bar.
2. Touch the Stop ventilation button.
4. Select the therapy type (see "Selecting the therapy type", page 101).

Operation
Procedure 3
The procedure is not available in the therapy type O2 therapy.
1. Touch the Other modes button (3) in the therapy bar.
 The pick list appears.
2. Touch the Change therapy type button.
3. Touch the button of the relevant therapy type.
7.4 Changing the body weight during ventilation

As a result of setting the ideal body weight in the Adult and Pediatric patient
patient categories or the current body weight in the Neonate patient category,
measured values are displayed relative to the body weight.
Procedure:
● Touch the symbol for the patient category (1) in the header bar.
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1
✓ A context dialog (2) opens. The time of the last change is displayed.
Adult or Pediatric patient patient category:
1. Touch the button for the ideal body weight.
2. Using the rotary knob, set the ideal body weight and confirm the value.
Neonate patient category:
1. Touch the button for the current body weight.
2. Using the rotary knob, set the current body weight and confirm the value.

Operation
7.5 Non-invasive ventilation (NIV)

The NIV therapy type is available for non-invasive ventilation. This section
describes the particularities of the therapy type.
7.5.1 Ventilation settings during NIV

Ventilation modes
In the Adult and Pediatric patient patient categories, all the ventilation modes can
be selected. In the Neonate patient category, only the SPN-CPAP and PC-CMV
ventilation modes can be selected.
Additional settings
An automatic tube compensation (ATC) activated in the Tube therapy type, is
ineffective in the NIV therapy type.
Ventilation parameters Timax

The Timax ventilation parameter limits the maximum duration of supported breaths
(PS, VS, PPS) because the inspiration termination criterion may be ineffective in
the presence of very high leakage.
Ventilation parameters Flow max

In the Neonate patient category, the inspiratory flow can be limited with the Flow
max setting. During expiration, the base flow is also activated. If the NIV therapy
type is selected, the setting is reset to the maximum value.
Ventilations parameters Tmaninsp and Pmaninsp

These ventilation parameters are available if the SPN-CPAP ventilation mode is set
in the Neonate patient category.
During manual inspiration, the duration of the mandatory breath is determined by
the ventilation parameter Tmaninsp.
During manual inspiration, the pressure of the mandatory breath is determined by
the ventilation parameter Pmaninsp.
7.5.2 Monitoring during NIV

The following settings are necessary in order to avoid false alarms and ensure
monitoring:
● Adjust the upper and lower alarm limits for the expiratory minute volume MVe in
line with the current value.
Some alarm limits can be deactivated (see "Deactivating the alarm limits",
page 161).
● Use additional external monitoring if required, e.g., SpO2 monitoring and CO2
monitoring.
A disconnection alarm time Tdiscon between 0 and 60 seconds can be set for the
lower alarm limit for the airway pressure.
In the Neonate patient category, flow monitoring is deactivated.

Operation
7.5.3 Applying non-invasive ventilation

1. Connect a mask for non-invasive ventilation.
Use suitable masks. Otherwise excessive leakage may occur.
2. Select the NIV therapy type (see "Selecting the therapy type", page 101).
3. Select the ventilation mode and set the ventilation parameters (see "Ventilation
4. Set the alarm limits (see "Setting the alarm limits", page 161).
5. Start ventilation (see "Starting the therapy", page 104).
7.6 Apnea ventilation

If a ventilation mode is selected in which apnea ventilation is possible, the therapy
bar displays the following:
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123

1 VTapn, RRapn Ventilation parameters for apnea ventilation
2 APN
3 Button for additional settings. On the Apnea ventila-
tion tab, apnea ventilation can be activated or deacti-
vated and the ventilation parameters set.
If apnea ventilation is active, the following is also displayed in the header bar:
38970
4 5 6 7

4 Apnea vent. Instead of the ventilation mode, Apnea vent. is dis-
played
5 End apnea ventila- To return to the original ventilation mode, touch the
tion button and confirm with the rotary knob.
6 Apnea ventilation Alarm message
activated
7 More alarms If more than two alarms with a high priority are acti-
vated, the alarm message Apnea ventilation acti-
vated is displayed in the alarm logbook.

Operation
7.7 Loops
Loops of mandatory breaths and spontaneous breaths can be recorded.
Display in the monitoring area

● Select the display form, the field size, and the parameters (see "Changing the
display", page 56).
1 2 3
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4
5
6
Displaying reference loops
● Touch the Ref. button (1).
✓ A loop is recorded and displayed as a reference loop.
The date and the time of the loop are displayed (4). The reference loop is drawn
in black. The reference loop remains displayed until the Ref. button (1) is
touched again.
Freezing the current loop

● Touch the Freeze loops button (2).
✓ The current loop is recorded, frozen, and saved. The loops are drawn in blue.
After "freezing", a cursor (6) is displayed that can be moved with the rotary knob.
The respective values are displayed (5).
Recording several loops

The following numbers of loops can be recorded: 1, 2, 3, 4, 5, 10
● Touching the 1 loop button (3) increases the number of loops.
✓ The set number is displayed in the button.

Operation
7.8 Smart Pulmonary View

The function Smart Pulmonary View is a graphic display of the calculated values
of compliance and resistance as well as of the spontaneous and mandatory minute
volume. For further information see: "Smart Pulmonary View", page 309.
The presentation form Smart Pulmonary View can be displayed in the waveform
field in the field size Large or Full (see "Configuring the screen display", page 186).
2 3 5
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1
6
No. Description
1 The diagram displays the ratio of spontaneous breathing to controlled ventila-
tion.
Differently colored areas indicate the following:
– Spontaneous minute volume (spont.) in light blue
– Mandatory minute volume (mand.) in dark blue
2 The blue line around the trachea indicates the resistance Rpat. The higher
the resistance, the thicker the line. The value is also displayed.
3 The blue line around the lungs indicates the compliance Cdyn. The higher
the compliance, the thinner the line. The value is also displayed.
4 The movement of the diaphragm indicates synchronized mandatory breaths,
supported (triggered) breaths, or spontaneous breaths.
5 Reference button
6 The display must be calibrated for every new patient. The determined refer-
ence values and the current calculated values for resistance Rpat and com-
pliance Cdyn are displayed in a table. If the values are outside the current
display range, a red line appears, and another calibration is required.
7.8.1 Calibrating the display area

● Touch the Reference (5) button.
✓ The display range is adapted to the current values. The calculated values from
the last calibration are displayed as a broken line.

Operation
7.9 Maneuvers
7.9.1 Opening the dialog page
● Touch the Procedures button in the main menu bar.
1 2 3 4 10
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5
6
7
8
9
No. Designation
1 Maneuvers
2 Low-flow PV loop For further information see: "Measure-
ment maneuver Low-flow PV loop",
page 130.
3 Diagnostics For further information see: "Diagnos-
tics – measurement maneuver",
page 137.
4 Patient transport For further information see: "GS500
gas supply unit", page 140.
5 Manual insp./inspiration hold For further information see: "Manual
inspiration – inspiration hold",
page 120.
6 Expiration hold For further information see: "Expira-
tion hold", page 120.
7 O2/suctioning For further information see: "Suction
maneuver with oxygenation",
page 121.
8 Manual disconnection For further information see: "Manual
disconnection", page 122.
9 Nebulization For further information see: "Medica-
tion nebulization", page 122.
10 Button for opening the help function.
The description of the Maneuvers dia-
log page is displayed.
The functions can be configured as action buttons on the main screen (see
"Selecting the action buttons", page 191).

Operation
7.9.2 Manual inspiration – inspiration hold

The Manual insp./inspiration hold maneuver can be performed in all ventilation
modes and offers the following options:
– Between 2 mandatory breaths, a breath can be manually started and held. The
pattern of the manually started breath corresponds to the ventilation pattern of
the currently active mandatory ventilation mode.
– Regardless of the start time, a mandatory breath can be prolonged.
Prerequisites:
– No endotracheal suctioning is performed.
Starting a manual inspiration

● Touch the Manual insp./inspiration hold button briefly.
Prolonging an inspiration
● Touch and hold the Manual insp./inspiration hold button for the desired
inspiratory time.
✓ The device applies an extended inspiration or extends an inspiration that has
already been triggered.
The device automatically ends inspiration in the following situations:
– After a maximum of 40 seconds in the Adult and Pediatric patient patient
categories
– After a maximum of 5 seconds in the Neonate patient category
7.9.3 Expiration hold

Expiration hold can be activated in all ventilation modes. This maneuver is not
available in the Neonate patient category.
Prerequisites:
– No endotracheal suction is performed.
Procedure:
● Touch and hold the Expiration hold button for the desired expiratory time.
✓ Expiration is ended by the device after a maximum of 45 seconds in the Adult
patient category and 30 seconds in the Pediatric patient patient category.
– The maneuver is required for determining the measured NIF value for weaning.
– Displaying the NIF parameter (see "Diagnostics – measurement maneuver",
page 306)
– Detailed description (see "Diagnostics – measurement maneuver", page 306)

Operation
7.9.4 Suction maneuver with oxygenation

To avoid hypoxia during endotracheal suctioning, the device offers a function for
oxygenation. This maneuver is especially suitable for an open suctioning system.
Phase Duration
Preoxygenation Maximum 180 seconds
Disconnection Maximum 120 seconds
Postoxygenation 120 seconds
During the individual phases, the remaining time is continually displayed.

During disconnection and post oxygenation, the lower alarm limit for the minute
volume is deactivated.
Increasing the O2 concentration

For the Adult patient category, the O2 concentration is increased to 100 Vol%. For
the Pediatric patient and Neonate patient categories, the O2 concentration is
increased to the current inspiratory O2 concentration multiplied by a factor. The
factor can be configured (see "Setting maneuvers", page 194).
Carrying out the oxygenation program

Prerequisites:
– The flow sensor is functional.
– Flow monitoring is activated.
Procedure:
1. Touch the O2/suctioning button.
 The device ventilates in the set ventilation mode with an increased O2
concentration. In the therapy bar, the increased O2 concentration is
displayed above the therapy control FiO2.
The PEEP is automatically set to at least 4 mbar (or hPa or cmH2O) so that
the subsequent disconnection can be detected. A PEEP that is set higher is
retained.
3. Disconnect the patient and perform the suction maneuver.

 The device interrupts ventilation and delivers a minimum flow to
automatically detect the reconnection. The acoustic alarm signals are
suppressed.
4. Reconnect the patient.
 The device detects the reconnection automatically and ventilates in the set
ventilation mode again with an appropriately increased O2 concentration.
Automatic termination of the oxygenation program

The oxygenation program is terminated in the following situations:
– The patient is not disconnected during the preoxygenation phase.
– The patient is not reconnected during the disconnection phase.
 All alarms are immediately active again. The device immediately continues to
ventilate in the set ventilation mode and with the previously set oxygen
concentration.

Operation
Premature termination of the oxygenation program

1. Touch the O2/suctioning button again.
7.9.5 Manual disconnection

When the Manual disconnection maneuver is activated, the device reduces the
flow delivery. The patient can be disconnected within the next 10 seconds. During
manual disconnection, the acoustic alarm signals are suppressed. When the patient
is reconnected, the device resumes ventilation in the set ventilation mode.
Activating manual disconnection

1. Touch the Manual disconnection button.
7.10 Medication nebulization

7.10.1 Information on the compressed air supply
If the central Air supply fails:
– If the central Air supply fails during medication nebulization, the medication
nebulizer will continue to operate with 100 Vol% O2. In this case, deviations in
the inspiratory O2 concentration are possible.
For compressed air supply from the GS500 gas supply unit:
– If the device is supplied with compressed air from the GS500 gas supply unit
and O2 from the central gas supply system, the medication nebulizer operates
with O2 only.
– The measured value FiO2 indicates the O2 concentration of the gas supplied at
the inspiratory port and not the O2 concentration reaching the patient. Observe
the following information: "Compressed air supply from the GS500 gas supply
unit", page 304.
7.10.2 Information on pneumatic medication nebulization

Patient category
Adult Pediatric patient Neonate
Ventilation modes Pressure-controlled ventilation modes
Volume-controlled venti- Volume-controlled venti- -
lation modes lation modes (only with
an expiratory flow sensor
and AutoFlow)
Special ventilation Nebulization is deacti- The diagram "Inspiratory O2 concentration" (see
settings vated for inspiratory "Inspiratory O2 concentration during medication
flows <14 L/min. nebulization", page 303) applies for respiratory
rates >12 /min.

Operation
Patient category
Adult Pediatric patient Neonate
Nebulization Nebulization synchro- Continuous nebulization
nously to the inspiratory The aerosol generated during expiration does not
flow phase reach the lungs, however.
The minute volume
remains constant.
Flow sensor - Neonatal flow sensor.
For nebulization, the flow monitoring must be deac-
tivated, and the flow sensor must be removed. If the
parameter Insp. flow is selected, the device
switches to a pressure rise time which deactivates
the Insp. flow setting.
Monitoring - For further information Use additional external
see: "Monitoring", monitoring, if required
page 124. (e.g., SpO2 monitoring).
If the device is supplied with Air and O2 from the central gas supply system, the
medication nebulizer is operated with mixed gas at the set O2 concentration. Small
deviations in the inspiratory O2 concentration of up to ±4 Vol% are possible.
Neonatal flow monitoring

Before the medication nebulization starts, flow monitoring with the neonatal flow
sensor is deactivated. The neonatal flow sensor must be removed from the
breathing circuit, or a circuit plug must be used. It is not enough to just pull the flow
sensor cable plug from the flow sensor or the device.
If the flow monitoring is already deactivated, an additional medication nebulization
starts in the patient category Pediatric patient when the nebulization time is
entered. In the patient category Neonate, removal of the flow sensor must be
confirmed again.
Nebulization time
Nebulization can be set to 5, 10, 15, or 30 minutes or to continuous nebulization.
The remaining nebulization time is displayed in the main menu bar instead of the
Procedures button.
The device automatically deactivates the medication nebulizer after the
nebulization time has elapsed.
During continuous medication nebulization, the previous nebulization time is
displayed as follows:
– In the main menu bar instead of the Procedures button.
– In the parameter field if the Continuous nebulization setting was selected.
When the expiratory flow sensor is used, medication nebulization is interrupted
every 30 minutes, and the flow sensor is calibrated. After the calibration, medication
nebulization continues.

Operation
Nebulization may lead to increased deposits. Consequently, it may be necessary to
change the following components more often:
– Flow sensor
– Expiratory valve
7.10.2.1 Monitoring
The following steps apply only to the patient category Pediatric patient during
usage of the expiratory flow sensor:
1. Compare the current measured values for minute and tidal volumes with the
values measured before nebulization.
2. If the VT and MV values are unusual, use the ventilation pressure to assess the
ventilation. A comparison of the difference between PEEP and plateau pressure
before and during nebulization allows a comparison of the VT and MV values.
In order to avoid false alarms and ensure monitoring:
● Adjust the upper and lower alarm limits for MVe in line with the current value.
● Use additional external monitoring if required, e.g., SpO2 monitoring.
7.10.3 Preparing the pneumatic medication nebulizer

Procedure:
CAUTION
Risk of patient injury due to insufficient ventilation
If medication nebulization is performed using an incorrect medication container,
there is a danger of considerable deviations in the tidal and minute volumes and the
inspiratory O2 concentration.
► Use the correct medication container.
● Prepare the medication nebulizer with the white nebulizer housing (8412935)
according to the associated instructions for use.
7.10.4 Fitting the pneumatic medication nebulizer

For use in the Adult patient category
1. If a bacteria filter is used, position the bacteria filter between the inspiratory
valve and the medication nebulizer.
2. Connect the medication nebulizer (1) to the inspiratory side of the Y-piece.
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3. Connect the inspiratory hose (2) to the medication nebulizer.

4. Align the medication nebulizer so that the container faces downwards.

Operation
5. Using clamps, run the nebulizer hose (3) back to the device along the inspiratory
hose.
For use in the Pediatric patient and Neonate patient categories

Prerequisites:
– Soft connector (MP03826) and adapter (MP01110) are available. See the list of
accessories.
Procedure:
1. If a bacteria filter is used, position the bacteria filter between the inspiratory
valve and the medication nebulizer.
2. Insert the soft connector (3) into the inlet port of the medication nebulizer.
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1 2 3
3. Insert the adapter (2) into the outlet port of the medication nebulizer.
4. Fit the corrugated hose (1), length 0.13 m (5.1 in) to the adapter (2).
5. Remove the corrugated hose of the breathing circuit (4) from the inspiratory port
of the Y-piece and connect it to the soft connector (3).
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5 3 4
6. Connect the free end of the corrugated hose (5) to the inspiratory port of the Y-
piece.
7. Press the inlet port or the outlet port of the medication nebulizer into one side of
the clip and the expiratory hose into the other.
39406
8. Align the medication nebulizer so that the container faces downwards.

Operation
When using on the incubator

● Push the inlet port or the outlet port of the medication nebulizer into the upper
hose guide of the incubator.
The medication nebulizer must be located outside of the incubator.
39411
Connecting the nebulizer hose
WARNING
Risk of patient injury due to incorrect usage
If the nebulizer port is used for other purposes, this may impair the functional
integrity of the device and put the patient at risk.
► Use the nebulizer port only for medication nebulization.
● Connect the nebulizer hose (2) to the nebulizer port (1).
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1
7.10.5 Performing medication nebulization during expiratory flow

monitoring
Prerequisites:
– The medication nebulizer is filled in accordance with the corresponding

Operation
Activating medication nebulization

1. Touch the button for the required duration on the dialog page Maneuvers in the
line Nebulization.
 The flow monitoring is automatically deactivated and the nebulization started.
CAUTION
Risk of patient injury due to undetected device malfunction
A medication nebulizer fault is not detected by the device.
► Check the correct functioning of the medication nebulizer. Check whether
aerosol is generated.
2. Check whether aerosol is generated.
Canceling medication nebulization

● Touch the Cancel button in the Nebulization line.
After medication nebulization

The expiratory flow sensor is automatically cleaned by heating and calibrated.
1. Remove the medication nebulizer and remove the rest of the medication.
Follow the instructions for use of the medication nebulizer.
2. Check the flow sensor housing for medication residue, if necessary.
7.10.6 Performing medication nebulization during neonatal flow

monitoring
Prerequisites:
– The medication nebulizer is filled in accordance with the corresponding
Activating medication nebulization

1. Touch the button for the required duration on the dialog page Maneuvers in the
line Nebulization.
 The device displays further steps in the procedure on the screen.
2. Confirm the automatic deactivation of the flow monitoring by pressing the rotary
knob.
WARNING
Risk of fire
The measuring wires of the neonatal flow sensor are very hot and may ignite
deposits of medication aerosols during nebulization.
► Before medication nebulization, remove the sensor insert from the flow sensor
and insert a circuit plug. If the flow sensor ISO 15 is used, the entire flow sensor
can be removed.
► Use additional monitoring since otherwise the minute volume is not monitored,
and apnea monitoring is limited.

Operation
3. Remove the flow sensor or the sensor insert from the breathing circuit.
Remove the flow sensor ISO 15 (8411130):
a. Remove the flow sensor (1) from the tube and the Y-piece.
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1
b. Connect the tube (2) to the Y-piece.

Remove the sensor insert (for example: flow sensor Y-piece (8410185)):
a. Remove the plug (3) of the flow sensor cable from the flow sensor (4).
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3
b. Pull out the sensor insert (5).
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5
6
c. Insert the circuit plug (6) (8411024).

4. Confirm the removal of the flow sensor or sensor insert by pressing the rotary
knob.
 Nebulization is started.
CAUTION
Risk of patient injury due to undetected device malfunction
A medication nebulizer fault is not detected by the device.
► Check the correct functioning of the medication nebulizer. Check whether
aerosol is generated.
5. Check whether aerosol is generated.
Canceling medication nebulization

● Touch the Cancel button in the Nebulization line.

Operation
After medication nebulization

1. Remove the medication nebulizer and remove the rest of the medication.
Follow the instructions for use of the medication nebulizer.
2. Reconnect the flow sensor. If there is detectable soiling of the flow sensor or the
sensor insert, replace the flow sensor or clean it (see "Disassembling the
neonatal flow sensor", page 152).
● If the flow sensor ISO 15 (8411130) was removed, re-insert the flow sensor
into the Y-piece.
● If the sensor insert was removed, remove the circuit plug and push the
sensor insert back in.
4. Activate flow monitoring with the neonatal flow sensor (see "Neonatal flow
7.10.7 Medication nebulization with the Aeroneb Pro nebulizer

Before nebulization
● Follow the instructions for use of the Aeroneb Pro nebulizer.
● Observe the following information: "Information on breathing circuits and
additional components", page 76.
● Observe the following information: "Medication nebulization", page 108.
● Remove the pneumatic medication nebulizer from the breathing circuit.
● Do not turn on the Nebulization maneuver on the device as the Aeroneb Pro
nebulizer does not require a nebulizer flow from the device.
When using the expiratory flow sensor, the following steps are also required:
● Deactivate flow monitoring with expiratory flow sensor (see "Expiratory flow
When using the neonatal flow sensor, the following steps are also required:
1. Deactivate flow monitoring with neonatal flow sensor (see "Neonatal flow
WARNING
Risk of fire
The measuring wires of the neonatal flow sensor are very hot and may ignite
deposits of medication aerosols during nebulization.
► Before medication nebulization, remove the sensor insert from the flow sensor
and insert a circuit plug. If the flow sensor ISO 15 is used, the entire flow sensor
can be removed.
► Use additional monitoring since otherwise the minute volume is not monitored,
and apnea monitoring is limited.
2. Remove the flow sensor or the sensor insert from the breathing circuit.

Operation
After nebulization
When using the expiratory flow sensor:
1. Activate flow monitoring with the expiratory flow sensor.
2. Calibrate the expiratory flow sensor (see "Calibrating the neonatal flow sensor",
page 177).
Aerosols distort the flow measurement.
When using the neonatal flow sensor:

1. Reconnect the flow sensor. If there is detectable soiling of the flow sensor or the
sensor insert, replace the flow sensor or clean it (see "Disassembling the
neonatal flow sensor", page 152).
● If the flow sensor ISO 15 (8411130) was removed, re-insert the flow sensor
into the Y-piece.
● If the sensor insert was removed, remove the circuit plug and push the
sensor insert back in.
3. Activate flow monitoring with the neonatal flow sensor (see "Neonatal flow
7.11 Measurement maneuver Low-flow PV loop

This section describes how to perform the measurement maneuver.
This measurement maneuver is not available in the Neonate patient category.
Measurement principle
The measurement maneuver is performed during an extended inspiration or an
inspiration and expiration with a constant and low flow.
The measurement maneuver must only be carried out on patients without
spontaneous breathing.
For further information see: "Low-flow PV loop", page 304.
Opening the dialog page

1. Touch the Procedures button in the main menu bar.
2. Touch the Low-flow PV loop tab (1).
✓ The Maneuver information dialog page (2) is displayed.

Operation
1 3
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2
The description of the Low-flow PV loop maneuver is displayed if the button (3)
is pressed.
7.11.1 Performing the measurement

Prerequisites:
– The following information for performing the measurement must be noted:
– A low-flow PV loop maneuver may decrease systematic blood pressure and
cause a pneumothorax, for example. Carefully check the patient's condition
before adjusting the settings.
– The pressure and volume settings must be suitable for the patient.
– The maximum maneuver time calculated must be suitable for the patient.
– The patient must be hemodynamically stable.
– Minimize the leakage before performing the maneuver.
– Closely monitor arterial blood pressure during the maneuver.
– The sudden release of high airway pressure can increase cardiac preload
and impair the functioning of the heart.
– Only perform low-flow PV loop maneuvers on patients who do not breathe
spontaneously.
– A low-flow PV loop maneuver cannot be started until at least 60 seconds
after a preceding low-flow PV loop maneuver, a nebulization, or a suctioning.
– The running measurement is not interrupted if a different dialog page is
opened.

Operation
Preparing
CAUTION
Risk of patient injury as a result of the low-flow PV loop measurement
maneuver
The patient may be put at risk if the information for performing the maneuver is not
complied with.
► Check the patient's condition before the maneuver and monitor it continually
during the maneuver.
► Adjust the settings and the procedure of the maneuver to the patient's condition.
1. Touch the Maneuver tab (1).
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2 3 1
4 5
6 7
8
2. Touch the relevant therapy control for Pstart (2), Plimit (3), Low flow (4), and
Vlimit (5).
The initial pressure Pstart can be set to between 0 and PEEP.
The volume limit Vlimit is limited by the alarm limit.
The alarm limit Paw high is adapted to the set pressure limitation Plimit for the
duration of the maneuver.
3. Set the values by turning the rotary knob and push to confirm.
4. If required, change the alarm limits (see "Setting the alarm limits", page 161).
✓ The calculated maximum duration of the measurement maneuver Tlimit (6) is
displayed.
Prerequisites for recording

The following prerequisites must be met for recording:
– Valid flow, pressure, and leakage values
– Precise flow values
– Flow monitoring with the expiratory flow sensor is activated
– Mandatory expiratory time <30 seconds
– RR ≥2/min
– If Apnea ventilation is activated, the function must not be active.
– The Tube therapy type is set
– The sensor calibration is not active

Operation
– Ventilation mode with mandatory breaths

– The maneuver cannot be started until at least 60 seconds after a preceding
Low-flow PV loop maneuver, medication nebulization, or suction.
Recording inspiration and expiration

1. Touch the Start insp. + exp. (7) button.
Recording inspiration
1. Touch the Start insp. only (8) button.
7.11.2 Limiting the measurement maneuver

Prerequisites:
– The measurement is active.
During inspiratory and expiratory measurement

● Touch the Stop inspiration button (1).
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1
✓ The device ends inspiration. Expiration occurs at the set flow.
During the inspiratory measurement

● Touch the Stop inspiration button (1).
✓ The device ends inspiration. Expiration occurs with an adjustable pressure
decrease. This value can be configured on the dialog page System setup >
Ventilation > Maneuver.

Operation
7.11.3 Quickly canceling the measurement

1. Touch the Cancel button (1).
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1

✓ The device ends the measurement, and the pressure falls immediately to the set
PEEP.
Leaving the dialog page during the measurement

The running measurement is not interrupted if a different dialog page is opened.
Returning to the dialog page

● Touch the Procedures button in the main menu bar.
✓ During a running measurement, the dialog page Maneuver, on which the
buttons to end the measurement maneuver are located, is opened direclty.
Performing a new measurement

A new measurement can only be performed after 60 seconds. During this time, the
Start insp. + exp. and Start insp. only buttons are grayed out and cannot be
activated.

Operation
7.11.4 Evaluation of the measurement

Prerequisites:
– The measurement has been performed.
Procedure:
1. Touch the Analysis tab (1).
2 3
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1
4
6 7
Measuring the loop

1. Touch the Cursor A (2) or Cursor B (3) button.
 Cursors are represented by a cross-hair cursor. There is a circle at their
intersection. When the loop has an S-like shape, the cursors are positioned
on characteristic points of the loop (UIP or PMC). Otherwise, the cursors are
positioned at the left or right edge of the diagram.
2. Position the selected cursor on an identified point with the rotary knob.
✓ The following values are displayed in the information field (4):
The corresponding measured values for the parameters Paw and VTi are
displayed. The static compliance between 2 values is calculated and displayed.
The Cstat value displayed is the static compliance over the complete breath.
The Cstat (B - A) value displayed is the static compliance between the set
cursor positions.
The measured values are leakage-compensated.
Displaying reference loops

The current loop can be compared with the measured values from previous
maneuvers. The device stores the results of up to 10 maneuvers. In the list (5), the
ventilation mode applied at the start of the maneuver is displayed with the settings
for the parameters PEEP and Pinsp or VT. Reference loops cannot be measured
with the cursor.
● Select the reference loop required from the list (5).

Operation
Optimizing settings
Depending on the set ventilation mode, the PEEP or Plow (6) and Pinsp or Phigh
or VT (7) therapy controls are displayed and can be adjusted right on the Analysis
dialog page.
● Touch the therapy controls, set the value, and confirm.
During setting, a corresponding line appears in the PV loop in order to facilitate
optimization of the settings.
Detailed description of the identification of characteristic points (see "Low-flow PV
loop", page 304).
7.11.5 History
The device saves up to 10 PV loops with characteristic points. Reference loops
cannot be displayed.
Selecting and measuring PV loops

1. Touch the History tab (1).
3 3
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1
2. Select the PV loop needed from the list (2).

 If characteristic points were identified, these points are displayed.
3. Measure the waveform with a cursor (3).
✓ In the list (2), the ventilation mode applied at the start of each maneuver is
displayed with the settings for the parameters PEEP and Pinsp or VT.

Operation
7.12 Diagnostics – measurement maneuver

The following measurement maneuvers can be performed:
– P0.1 maneuver (see "Occlusion pressure – P0.1 maneuver", page 137)
– PEEPi (see "Intrinsic PEEP – PEEPi", page 138)
– Negative inspiratory force (see "Negative inspiratory force – NIF", page 139)
The measurement maneuvers are not available in the Neonate patient category.
For further information see: "Diagnostics – measurement maneuver", page 306.
7.12.1 Occlusion pressure – P0.1 maneuver

General
The occlusion pressure characterizes the negative pressure during a short
occlusion (0.1 seconds) at the beginning of a spontaneous inspiration.
This measurement maneuver can be used in all ventilation modes at regular
intervals in order to check the respiratory drive of a spontaneously breathing patient
or to assess the amount of spontaneous breathing during controlled ventilation.

2. Touch the Diagnostics tab (1).
 The P0.1 dialog page (2) is preselected.
1 8
40623
2
3
5 4
6
7
The device displays the values of the previous measurements (7).
Performing a manual measurement

1. Touch the Start button (3).
✓ The device starts the measurement with the next spontaneous inspiration.
Canceling the measurement

● Touch the Cancel button (4).

Operation
Performing automatic measurements

1. Touch the On button (5).
2. Touch the button for the interval (6).
✓ The remaining time until the next measurement is displayed.
To monitor the therapy success, record the measured value as a trend.
The description of the occlusion pressure (P0.1 maneuver) is displayed if the
button (8) is pressed.
7.12.2 Intrinsic PEEP – PEEPi

General
The intrinsic PEEP is the actual end-expiratory pressure inside the lungs.
This special procedure can be performed in all ventilation modes. Breathing activity
by the patient during this maneuver can distort the measured values.
Performing a measurement
3. Touch the PEEPi tab (2).
 For the last measurements, the following values (5) are displayed with the
date and time:
– PEEPi (intrinsic PEEP, including the set PEEP)
– incl. PEEP (measured PEEP after complete expiration at the set PEEP
level)
– Vtrap (enclosed volume that cannot be expired during the set expiratory
time)
1 6
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2
3 4
5
4. Touch the Start button (3) and confirm with the rotary knob.
✓ The device starts the measurement.

Operation
Canceling the measurement

● Touch the Cancel button (4).
The description of the intrinsic PEEP (PEEPi) is displayed if the button (6) is
pressed.
7.12.3 Negative inspiratory force – NIF

General
The negative inspiratory force parameter (NIF) measures a patient's maximum
inspiratory effort after exhalation. The breathing circuit is sealed during the
measurements by the inspiratory valve and the expiratory valve. As a result of the
inspiratory effort during manual expiration, the patient generates a negative
pressure in relation to PEEP. The relative negative pressure determined is
displayed as an NIF value.
Performing a measurement
3. Touch the NIF tab (2).
 For the last measurements, the following NIF values (4) are displayed with
the date and time.
1 5
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3
2
4
4. Touch and hold the Expiration hold button (3) for the desired expiratory time.
Expiration is ended by the device after a maximum of 45 seconds in the Adult
patient category and 30 seconds in the Pediatric patient patient category.
The function can be configured as an action button on the main screen (see
"Selecting the action buttons", page 191).
The description of the negative inspiratory force parameter (NIF) is displayed if the
button (5) is pressed.

Operation
7.13 GS500 gas supply unit

In order to ensure a continuous compressed air supply, the device can be equipped
with the GS500 gas supply unit. If the device is connected to the central gas supply
system, the gas supply unit guarantees the device is supplied with compressed air
in case the central supply fails. Additionally, the gas supply unit for the compressed
air supply of the device can be used during intrahospital patient transport.
7.13.1 Using the gas supply unit

Prerequisites:
– The functionality of the gas supply unit is activated (see "Activating the
functionality of the gas supply unit", page 201).
If the device is not connected to the central gas supply system, the gas supply unit
automatically starts the compressed air supply.
If the central Air supply fails or if the probe of the compressed gas hose for Air
becomes detached from the wall terminal unit of the central gas supply system, the
device displays an alarm message. The gas supply unit starts supplying
compressed air after 4 seconds at the latest.
Activating the gas supply unit for intrahospital patient transport

2. Touch the Patient transport tab (1).
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1 4
2 3
3. Touch the On button (2).

4. Pull out the probe of the compressed gas hose for Air from the wall terminal unit
of the central gas supply system.
If the probe of the compressed gas hose for Air has not been disconnected
within 5 minutes after activation of the gas supply unit, the device deactivates
the gas supply unit.
5. Pull the probe of the compressed gas hose for O2 out from the wall terminal unit
of the central gas supply system and, if necessary, provide a replacement O2
supply.

Operation
Deactivating the gas supply unit

● Touch the Off button (3).
Deactivate the functionality of the gas supply unit (see "Activating the functionality
of the gas supply unit", page 201).
The description for activating the gas supply unit for intrahospital patient transport is
displayed if the button (4) is pressed.
7.14 Intrahospital patient transport

7.14.1 Preparing the device
Procedure:
● Use a device with a protection bar (see "Transporting the patient", page 142).
● Guarantee the battery supply (see "Battery operation", page 146).
● Guarantee the compressed air supply using gas cylinders or the gas supply unit
GS500 (see "GS500 gas supply unit", page 140).
● Fasten the device to the trolley.
WARNING
If the trolley is coupled to the patient bed, the trolley may tip over if the height of the
patient bed is changed. This may result in personal injury and property damage.
► Do not change the height of the patient bed.
● Once the bed coupling is attached, do not change the height of the patient bed
any more.
● Use the following measures to increase the tipping stability:
● Swivel the display unit until it is centrally aligned.
● Set the hinged arm to minimum extension.
● Hook hoses and cables as close as possible to the trolley.
● If possible, secure the breathing gas humidifier to the trolley, not to the lateral
standard rails of the ventilation unit.
● Do not attach any additional parts to the lateral standard rails of the
ventilation unit.
● If fitted, slide the bed coupling into its retracted position.

Operation
7.14.2 Transporting the patient

Prerequisites:
– When transporting a patient within the hospital, the user must ensure that the
patient is monitored at all times.
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2
No. Designation
1 Protection bar
2 Handle
Procedure:
WARNING
property damage.
► 2 people are always required to move the device and the bed.
► Make sure to securely hold onto the handle of the trolley whenever moving or
positioning the device.
► Do not lean or press against the trolley above the marking point .
► Do not push or pull the trolley above the marking point .
► Pay special attention at thresholds, on uneven surfaces, and on slopes.
● Grip the handle of the trolley firmly. If no bed coupling is used, push the device in
longitudinal direction.

Operation
7.15 O2 therapy
Information on O2 therapy
Patient-side accessories such as oxygen masks or nasal cannulas can be used for
O2 therapy.
During O2 therapy, only the O2 concentration, the inspiratory flow, and the
inspiratory pressure are monitored. The alarm limits for the parameters VT, MVe,
RR, Paw, and Tapn are not active. The alarm limits for O2 monitoring are
automatically set by the device.
O2 therapy preparation
1. Connect the breathing hoses (see "Fitting the breathing circuit", page 78).
2. Turn on the device (see "Turning on the device", page 89).
CAUTION
Risk of patient injury due to deactivated monitoring
Several monitoring functions are deactivated during O2 therapy. This impairs the
device's ability to detect whether the patient's condition has deteriorated.
► Use external SpO2 monitoring for patients who are dependent on an increased
defined O2 concentration.
3. Activate O2 monitoring (see "O2 monitoring", page 178).
Activating O2 therapy
1. Select the O2 therapy (see "Selecting the therapy type", page 101).
CAUTION
Risk of patient injury due to unsuitable masks
Masks for non-invasive ventilation (NIV) are not suitable for O2 therapy because
they have no mandatory leakage.
► Use oxygen masks.
2. Connect patient-side accessories.
3. Activate the O2 therapy (see "Starting the therapy", page 104).
✓ The device displays the main screen.

Operation
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2
3 4
1 Therapy type display: O2 therapy
2 Monitoring area: The display cannot be changed during O2 therapy.
3 Therapy control for O2 therapy:
– FiO2
– Flow
4 Button for displaying the description of the O2 therapy.
Setting FiO2 and flow

1. Touch the corresponding therapy control in the therapy bar.
✓ The FiO2 concentration is graphically portrayed in the monitoring area.
If the pressure needed for the set flow exceeds 30 mbar (or hPa or cmH2O), the
device issues an alarm, and the inspiratory valve is opened. The cause may be one
of the following:
– High flow through prong or nasal cannula with small diameter
– Kinked breathing hose
– Blocked mask
– Blocked nasal cannula
Select and observe the patient interface and the flow. The actual FiO2 value and
airway pressure depend on the following among others:
– Type of the used patient interface
– Actual size of the patient interface
– Set flow
– Effective leakage inside the nares and the mouth opening
– Patient’s inspiratory effort
If the gas supply unit GS500 is used, the FiO2 low alarm may occur in case of
FiO2 >95 %. Use compressed air from the central gas supply system instead of the
gas supply unit GS500 or select a constant flow of at least 5 L/min.

Operation
Deactivating O2 therapy
Procedure 1:
● Select another therapy type (see "Selecting the therapy type", page 101).
Procedure 2:
● Stop the therapy (see "Interrupting therapy – standby mode", page 145).
7.16 Interrupting therapy – standby mode

Switch to standby mode for the following actions:
– Keep the device ready for operation while the patient is absent.
– Changing the therapy type
– Changing the patient category
– Performing the system test and the breathing circuit test
– Shutting down the device
Interrupting therapy
WARNING
Risk of patient injury due to deactivated therapy
Ventilation does not take place in standby mode.
► Do not set the device to standby mode as long as a patient is connected to the
device.
1. Touch the button (1) in the therapy bar.
1
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2
 The following message is displayed in the header bar: Standby mode
activated.
4. Touch the Alarm reset button in the header bar.
✓ The device is in standby mode. The standby screen is displayed.

Operation
Continuing the therapy

Prerequisites:
Procedure:
1. Check the ventilation settings and change them if necessary (see "Ventilation
2. Set the alarm limits (see "Setting the alarm limits", page 161).
If the patient category or the body weight is changed, the device determines new
start values for ventilation.
– For further information see: "Changing the body weight during ventilation",
page 114.
– For further information see: "Admitting a new patient", page 102.
7.17 Battery operation

7.17.1 Screen displays
If the device is turned on, the following symbols are displayed in the header bar of
the screen (example):
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1 2 3
No. Description
1 Mains power supply available
2 Charge status indicator of the batteries
3 The flashing symbol indicates the following:
– The battery test is running.
– The interval for the battery test has expired.
– The last battery test failed.
– Battery replacement is recommended.
If a symbol is touched, a context dialog opens. The device displays information

about the status of the battery charge. If the battery test is required, the device also
displays the Battery test button.
Charge status indicator

The charge status indicator applies for charging and discharging. When the
batteries are being charged, the last segment in the battery symbol flashes.

Operation
Symbol Battery charge

99 to 100 %
75 to 98 %
50 to 74 %
25 to 49 %
0 to 24 %, flashes red.
Batteries faulty or no information available on the battery charge.
The charge status indicator always shows the total battery charge that is available.
If there is a PS500 power supply unit present, the battery charge available from the
internal battery and the PS500 power supply unit is displayed.
For further information see: "Battery concept", page 317.
Battery parameter field

In addition to the charge status indicator, the Battery parameter field can be
configured.
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4
No. Description
Internal (internal battery)
4 Battery runtime in minutes (value corresponds to the battery runtime when
the battery is used at the present power consumption).
5 Battery charge in percent
PS500
6 Battery runtime in minutes (value corresponds to the battery runtime when
the battery is used at the present power consumption).
7 Battery charge in percent
Ageing and use of the batteries can result in a shorter battery runtime compared
with new batteries.
Depending on the battery used, the battery charge is indicated to the nearest 5 or
10 minutes.
The minimum battery runtime is always displayed.

Operation
7.17.2 Displays on the ventilation unit operation display

If the device is switched off and the power plug is connected to the mains voltage,
the charge status indicator of the batteries and the symbol are displayed when
the batteries are charging.
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7.17.3 Alarm messages during battery operation
Switch-over to the batteries is indicated with the alarm message Battery activated.
The alarm priority can be configured (see "Configuring the alarm settings",
page 192).
Alarm messages are displayed on the basis of the battery charge remaining to warn
against the complete discharge of the batteries (see "Alarm – Cause – Remedy",
page 205).
● Reestablish the mains power supply immediately to avoid interruption of the
ventilation functions.
When battery power supply is no longer needed, recharge the batteries (see
"Charging the batteries", page 148).
7.17.4 Battery runtime

The battery runtime depends on the following factors:
– Age of the battery
– Utilization of the battery (frequency, duration, and power consumption)
– Battery charge
– Ambient temperature
Observe the following:
● Information on battery runtime for fully charged and new batteries and typical
ventilation (see "Technical data", page 240)
● Information on battery aging (see "Battery ageing", page 318)
● Maintenance intervals (see "Maintenance", page 231)
7.17.5 Charging the batteries

The batteries are charged in the following order when the device is supplied with
mains voltage:
– Internal battery
– Batteries of the power supply unit PS500
Charging times
Observe the following information: "Technical data", page 240.

Operation
7.17.6 Failure of the power supplies

If the mains power supply fails and the batteries are discharged, the device issues a
power supply failure alarm.
The following data are retained even in the event of a power supply failure:
– Set values for ventilation
– Alarm limits
– Set values for monitoring
When the power supply is restored, the device starts automatically with the
previous values.

Ending operation
8 Ending operation
8.1 Shutting down the device
Prerequisites:
Procedure:
1. Press the on/off key on the display unit.
39401
 The Shutdown pop-up window opens.
If the on/off key is pressed during therapy, the pop-up window for interrupting
therapy opens. For further information see: "Interrupting therapy – standby
mode", page 145.
2. Touch the Confirm button.

✓ The device ends operation.
To return to standby mode, touch the Cancel button in the Shutdown pop-up
window.
If the device cannot be turned off due to a device malfunction, perform the following
steps:
2. Turn off the main switch.
Perform the following steps to put it back into operation:
2. Turn on the main switch.
3. Press the on/off key on the display unit.
For further information see: "Turning on the device", page 89.

Ending operation
8.2 Interrupting the gas supply
CAUTION
Risk of patient injury due to outflowing gases
If the compressed gas hose for O2 is connected to the central gas supply system,
oxygen may flow out of the device due to small leakages in the device or in the
compressed gas hose. As a result, the device may ignite.
► After ending operation, disconnect the compressed gas hose for O2 from the
central gas supply system.
1. Pull the probe of the compressed gas hose for O2 out of the wall terminal unit of
the central gas supply system.
2. Pull out the probe of the compressed gas hose for Air from the wall terminal unit
of the central gas supply system.
8.3 Storing the device

If the device is stored for a longer period of time, it must be set to energy-saving
mode.
1. Turn off the device (see "Shutting down the device", page 150).
2. Right after turning off the device, turn off the main switch.
3. Pull the power plug from the power socket.

Ending operation
8.4 Disassembly
Observe before disassembly
1. Switch off the device and all devices connected to it.
2. Disconnect all power plugs.
3. Drain the water traps and the breathing hoses.
4. Drain the water reservoir of the breathing gas humidifier.
8.4.1 Removing and disassembling patient-specific accessories

Removing the breathing circuit
● Pull the breathing hoses from the inspiratory port and the expiratory port.
Removing the expiratory flow sensor from the ventilator Evita

1. Open the flap.
2. Push the flow sensor to the left end position.
3. Remove the flow sensor (1) from the socket (2).
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2 2
Disassembling the neonatal flow sensor

Prerequisites:
– The sensor plug was pulled out from the rear of the device.
Procedure for the ISO 15 neonatal flow sensor:
1. Remove the flow sensor housing (4) from the Y-piece.
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1 2 3
2. Disconnect the plug of the flow sensor cable (1) from the flow sensor.
3. Gently press the knobs (2) on both sides while pulling the insert (3) out of the
sensor housing (4).

Ending operation
Procedure for the neonatal flow sensor Y-piece:

1. Pull the breathing hoses from the flow sensor Y-piece (4).
39433
1
2
3
4
2. Disconnect the plug of the flow sensor cable (1) from the flow sensor.
3. Gently press the knobs (2) on both sides while pulling the sensor insert (3) out of
the flow sensor Y-piece (4).
Removing the CO2 sensor

Prerequisites:
– The sensor plug was pulled out from the rear of the device.
Procedure:
1. Remove the CO2 sensor (1) from the cuvette.
39435
1
2. Remove the cuvette (2) from the patient port of the Y-piece.
Removing the pneumatic medication nebulizer (white 8412935)

After use in the Adult patient category:
1. Remove the nebulizer hose (1) from the medication nebulizer (2) and from the
nebulizer port on the device.
39439
2. Remove the medication nebulizer (2) from the breathing hoses.

3. Disassemble the medication nebulizer in accordance with the corresponding

Ending operation
After use in the Pediatric patient and Neonate patient categories:

1. Remove the nebulizer hose (7) from the medication nebulizer (5) and from the
nebulizer port of the device.
2. Pull the medication nebulizer (5) out of the breathing hoses.
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3 4 5 6
3. Pull the soft connector (6) out of the inlet port.

4. Pull the adapter (4) out of the outlet port.
5. Remove the corrugated hose (3) from the adapter (4).
6. Disassemble the medication nebulizer in accordance with the corresponding
8.4.1.1 Removing and disassembling additional accessories

● Remove and disassemble the breathing gas humidifier, the Aeroneb Pro
nebulizer, and the bacteria filter in accordance with the corresponding
8.4.2 Removing and disassembling device-specific components

Removing the expiratory valve or neonatal expiratory valve from the
ventilator
This section describes how to remove the expiratory valve. The neonatal expiratory
valve is removed in the same manner.
Prerequisites:
– The flap on the front of the ventilator is open.
– The expiratory flow sensor is removed from the ventilator Evita.

Ending operation
Procedure:
1. Turn the locking ring (1) as far as possible to the left.
39425
1
2. Remove the expiratory valve from the fitting.
Disassembling the expiratory valve or the neonatal expiratory valve
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1 2 3 2
4 4
No. Expiratory valve Neonatal expiratory valve

1 Flow sensor sleeve -
2 Diaphragm Diaphragm
3 - Muffler
4 Water trap container Water trap container

Ending operation
Procedure:
1. Remove the flow sensor sleeve (1) from the expiratory valve or remove the
muffler (3) from the neonatal expiratory valve.
2. Remove the diaphragm (2) and do not disassemble it further.
3. Remove the water trap container (4).
4. Drain the water trap container.
Removing the inspiratory valve from the ventilator

Prerequisites:
– The inspiratory valve is removed and disassembled only if patient gas has
flowed through the inspiratory valve.
– The device is switched off.
Procedure:
1. Press and hold the locking lever (2) on the underside of the inspiratory valve (1).
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1
2. Simultaneously turn the inspiratory valve approx. 20° counterclockwise.

3. Remove the inspiratory valve from the fitting.
Disassembling the inspiratory valve

1. Remove the diaphragm with adapter (1) from the fitting of the inspiratory valve.
39437
1 2
2. Remove the seal (2).

Alarms
9 Alarms
9.1 Display of alarms
9.1.1 Alarm priorities
A certain priority indicating the urgency is assigned to each alarm.
The following table shows the differences between the alarm priorities with respect
to identification and the action required.
Alarm priority Background Indicator in Action required

color the logbook
High Red !!! Immediate action is necessary in
order to avert an acute danger
Medium Yellow !! Immediate action is necessary in
order to avert danger
Low Turquoise ! Attention is necessary
9.1.2 Optical alarm signals
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1
2
3
4
No. Designation
1 Alarm bar
2 More alarms
3 Alarm message field
4 Parameter field
If alarms are generated, the optical alarm signals are displayed as follows:
Designation Alarm priority

High Agent Low
Alarm bar Flashes red Flashes yellow –
Alarm message field Red background Yellow back- Turquoise back-
ground ground
Parameter field Flashes red Flashes yellow –
The alarm message field (3) can display a maximum of two alarm messages. If
more than two alarms are issued at the same time, the alarm message field
displays the two alarms with the highest priority. Additionally, the More alarms (2)
button appears which can be used to open the alarm logbook.

Alarms
Position of the user relative to the alarm system

The optical alarm signals are designed as follows:
– At a distance of 4 m (157 in) it is possible to recognize which device is issuing an
alarm.
– At a distance of 1 m (39 in) the alarm message can be read clearly.
9.1.3 Acoustic alarm signals

The primary acoustic alarm system produces different alarm signals (see
"Configuring the alarm settings", page 192).
The alarm volume can be set (see "Setting the alarm volume", page 162).
The primary acoustic alarm signal can be suppressed for 2 minutes (see "Alarm
silence", page 163).
Failure of the primary acoustic alarm signal

If, as a result of a defect, the functional integrity of the primary acoustic alarm
system is impaired, the secondary acoustic alarm system issues an intermittent
tone.
This intermittent tone is also used for the power supply failure alarm. For further
information see: "Failure of the power supplies", page 149.
9.2 Alarm logbook

Several procedures can be used to open the alarm logbook.
Procedure 1:
● Touch the alarm message in the header bar.
Procedure 2:
● Touch the More alarms button (1) in the header bar.
Procedure 3:
1. Touch the Alarms button (2) in the main menu bar.
2. Touch the Alarm logbook tab (3). 40811
3 4 5 1
1 More alarms button
2 Alarms button

Alarms
3 Alarm logbook tab
4 The alarm messages are displayed with their duration and priority.
5 This displays the cause and remedy for the alarm message selected.
The alarm logbook lists all alarms that are active and no longer active. The alarms
are colored according to their respective alarm priority:
Active alarms History of alarms

The entire line in the background color The field Prio. in the background color
of the alarm message field of the alarm message field
The alarm logbook is part of the logbook. The logbook can save up to a maximum
of 5000 entries. If the maximum number of entries is reached and an alarm or an
event occurs, the oldest entry is deleted every time a new entry is made. A new
event in the logbook can thus displace the oldest alarm in the alarm logbook.
Turning the device off and on are not recorded in the logbook.
Displaying causes and remedies

1. Touch the alarm message or select it in the list by using the rotary knob or
touching it.
2. Touch the button .
The alarm messages with the causes and remedies are listed (see
"Troubleshooting", page 204).
9.3 Confirming alarm messages

9.3.1 Alarm message that is no longer active
1. Touch the Alarm reset button in the header bar.
After the error has been eliminated, the acoustic alarm signal is silenced.
Medium- and low-priority alarm messages expire automatically. High-priority alarm
messages continue to be displayed for information after the cause of the alarm has
been eliminated, and they need to be confirmed.

Alarms
9.3.2 All alarm messages that are no longer active

Prerequisites:
– The Alarm logbook dialog page (1) is displayed.
Procedure:
1. Touch the Reset all alarms button (2).
1 2
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✓ The alarm messages are deleted from the header bar and displayed in the alarm
logbook in the list History of alarms.
9.4 Alarm limits

Procedure 1:
● Touch the alarm limits table in standby mode in the Patient and therapy step.
Procedure 2:
● Touch the Alarms button in the main menu bar.
 The Alarm limits dialog page (1) is preselected.
1
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2
3
4
No. Designation/symbol Description

1 Alarm limits Tabs
2 Upper alarm limit
3 Current value Current measured value
4 Lower alarm limit

Alarms
9.4.2 Setting the alarm limits
WARNING
Risk of patient injury due to incorrect settings
Extreme settings for the alarm limits may make the alarm system useless and
thereby put the patient at risk.
► The alarm limits must be set to meet the needs of the therapy required by the
current patient.
1. Touch the corresponding button for the alarm limit.
The start values for the alarm limits can be configured (see "Setting the start values
for the alarm limits", page 194).
The alarm limits are displayed based on the ventilation parameter in the parameter
field (see "Display of alarm limits in the parameter field", page 162).
9.4.3 Deactivating the alarm limits

The following alarm limits can be deactivated:
Patient category Therapy type Tube Therapy type NIV

Adult Respiratory rate high Minute volume low
Tidal volume high Respiratory rate high
Tidal volume low Tapn
– Tidal volume high
– Tidal volume low
Pediatric patient Respiratory rate high Minute volume low
Tidal volume high Respiratory rate high
Tidal volume low Tapn
– Tidal volume high
– Tidal volume low
Neonate Minute volume low –
Respiratory rate high Respiratory rate high
Tapn Tapn
Tidal volume high –
Tidal volume low –
Procedure:
WARNING
Risk of patient injury due to incorrect settings
If alarm limits are deactivated, the device cannot monitor the patient.
► Only if the safety of the patient is not jeopardized by the absence of an alarm,
alarm limits may be deactivated.
1. Touch the corresponding button for the alarm limit.
2. Rotate the rotary knob until the following symbol is displayed:

Alarms

✓ The alarm limit is deactivated. The following symbol is displayed in the header
bar:
9.4.4 Display of alarm limits in the parameter field

If the alarm limits are assigned to a ventilation parameter, the alarm limits are
displayed in the parameter fields for single parameters (standard and double size).
The following assignments have been defined:
Alarm limits Measured values

Minute volume high, Minute volume low MVe
Tidal volume high, Tidal volume low VT, VTi
Paw high PIP
Respiratory rate high RR
etCO2 high, etCO2 low etCO2
9.5 Setting the alarm volume

The lower value for the alarm volume is limited by the configured minimum alarm
volume (see "Configuring the alarm settings", page 192).
An automatic increase in volume can be activated (see "Configuring the alarm
If the alarm silence is active, the button in the header bar can be touched to open
the context dialog for setting the alarm volume.
Procedure:
1. Touch the Alarms button in the main menu bar.
 The Alarm limits dialog page (1) is preselected.
WARNING
Risk of not hearing alarm signals
If the alarm volume is too low, alarm signals may not be heard.
► The user must remain within hearing distance of the alarm signals.
2. Touch the button (2) in the Alarm volume line.

Alarms
3. Set the alarm volumes by turning the rotary knob, and push to confirm.
1 2
40719
9.6 Alarm silence
The acoustic alarm signal can be suppressed for 2 minutes maximum.
● Press the alarm silence key.
39419
✓ This suppresses the acoustic alarm signal for 2 minutes.
The header bar displays the button with the symbol and the remaining runtime
of the alarm silence.
If an alarm with a higher priority appears during this time, the acoustic alarm signal
sounds once.
If the fault triggering the alarm is not eliminated after 2 minutes, the acoustic alarm
signal sounds again.
Premature termination of the alarm silence

● Press the alarm silence key again.

Alarms
9.7 Alarm delay

To avoid an unnecessary alarm, some alarms are not displayed immediately after a
limit value is exceeded, but with a delay time >5 s. The times specified in the
following table are the maximum delay time.
Alarm message Alarm priority

Low Agent High
Alarm system failed 75 s --- ---
Respiratory rate high --- --- 1 min
Air supply low, GS500 active --- 30 s ---
FiO2 high --- --- 32 s
FiO2 low --- --- 32 s
Flow measurement inaccurate --- 64 s ---
O2/Air supply pressures differ --- 1 min ---
too much
GS500 internal failure --- 10 min ---
No Air supply --- 30 s 30 s
No O2 supply --- 30 s 30 s
Minute volume high --- --- 1 min
Minute volume low --- --- 1 min
O2 measurement failed --- --- 95 s
Secondary acoustic alarm sys-
--- 600 min ---
tem failed
Ambient pressure measure-
--- 30 s ---
ment failed
9.8 Alarm system behavior during power supply failure or

after turning off the device
Regardless of the duration of a power supply failure or how long a device is
switched off, the following settings and data are retained:
– Alarm limits
– Minimum alarm volume
– Entries in the alarm logbook

Trends
10 Trends
10.1 Opening the dialog
● Touch the Trends/data button in the main menu bar.
The Trends/data dialog consists of the following dialog pages:
Dialog page Additional information

Trends The trends from the last 31 days are saved. Trends can be dis-
played as graphics or tables. For further information see: "Dis-
playing trends", page 165.
Values The following are displayed: current measured values, set val-
ues, and user-specific combinations of measured values and
set values. For further information see: "Displaying current val-
ues", page 168.
Logbook The logbook can save up to a maximum of 5000 entries. For
further information see: "Displaying the logbook", page 168.
Test results The detailed results of the system test and the breathing circuit
test are displayed. For further information see: "Displaying the
test results", page 169.
Export data Data can be exported to a USB mass storage device. For fur-
ther information see: "Performing a data export", page 170.
10.2 Displaying trends

10.2.1 Graphical trends
In graphical trends, measured values are displayed in black and set values in blue.
1. Touch the Trends/data button in the main menu bar.
 The Trends > Graphical trend dialog page is preselected.
1 4 5
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2
6
No. Description
1 Trends tab
2 Graphical trends
The trends from the last 31 days are saved.
3 Selected interval

Trends
No. Description
4 Cursor for selecting a certain point of time
5 Date and time of the selected point of time
The marked point of time in the trends corresponds with the marked row of
this point of time in the logbook.
6 Values for the selected time
Selecting the parameters

1. Touch the respective button.
 The parameter pick list is displayed.
2. Touch the respective button for measured values (7) or set values (8).
3. Touch the desired parameter.
✓ The parameters are displayed in the trends.
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7 8
Apnea trend, apnea ventilation trend

In the apnea trend, the number of the apneic events that occurred per minute is
represented as a histogram. The number per minute is represented as a bar height.
If an apnea lasts longer than one minute, the apnea is only counted once in the
period of occurrence.
The duration of an apnea is displayed only in the alarm logbook.
The apnea trend is recorded only when apnea ventilation is switched off.
In the apnea ventilation trend, the system displays whether or not apnea ventilation
is activated.

Trends
Recruiting trends
The recruitment trend displays the relevant parameters for the lung recruitment
maneuvers beside one another.
1. Select the display form Multi trend for the waveform field.
2. Select the parameter Recruitment trends.
✓ The following measured values are displayed: EIP, PEEP, VTe, Cdyn
10.2.2 Tabular trend

The device displays the trends of all parameters in a table. The parameters that are
displayed first are the parameters configured by the user. These are followed by all
measured values, and then all set values.
In tabular trends, measured values are displayed in black and set values in blue.
 The Trends dialog page (1) is preselected.
2. Touch the Tabular trend tab (2).
1 3
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2
No. Description
1 Trends tab
2 Tabular trend tab
3 Date and time of the selected point of time
The marked point of time in the trend display also corresponds with the
marked row of point of this time in the logbook.
4 Values for the selected time
5 Cursor for selecting a certain point of time
6 Selected interval

Trends
10.3 Displaying current values

Measured values are displayed in black letters, and set values are displayed in blue
letters.
2. Touch the Values tab (1).
40711
2
3
4
5
The following dialog pages are available:

1 Values
2 Configured values Displays the user-specifically compiled parameters
with current measured values and set values
For further information see: "Configuring parame-
ters for patient files", page 191.
3 Measured values Displays the current measured values
4 Set values Displays the current set values
5 SmartCare/PS – Information on the patient session
– Displays the current measured values and set
values
10.4 Displaying the logbook

The logbook records changes, events, and alarms in chronological order. Events
include, e.g., using the medication nebulizer or flow sensor calibration. For alarms
only the occurrence of the alarm condition is recorded, not its termination.
The entries in the logbook are also retained after the device has been turned off and
on again or there has been a power supply failure.
2. Touch the Logbook tab (1).

Trends
1 2
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3

1 Logbook
2 Cursor Cursor for selecting a certain point of time. The marked
row corresponds with the cursor position in the trends.
3 Set values For the marked row, the device displays all the set values
of the ventilation mode effective at this point of time in the
information field.
10.5 Displaying the test results

10.5.1 System test results
2. Touch the Test results tab.
3. Touch the System test tab.
✓ The detailed results and date of the last test are displayed.
10.5.2 Results of the breathing circuit test

2. Touch the Test results tab.
3. Touch the Breathing circuit test tab.
✓ The detailed results and date of the last test are displayed.
Designation Unit
Leakage mL/min
Compliance mL/mbar (or mL/cmH2O)
Inspiratory resistance mbar/L/s (or cmH2O/L/s)
Expiratory resistance mbar/L/s (or cmH2O/L/s)

Trends
10.6 Performing a data export

Data can be exported to a USB mass storage device.
Procedure:
1. Insert the USB mass storage device into a USB port on the display unit (see
"Connecting external devices to the data interfaces", page 72).
3. Touch the Export data tab (1).
1
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2
3 6
4 7
5 8
9

1 Export data Tabs
2 All data All data is exported.
3 Current measured and set The current settings and measured values
values are exported.
4 System test results The last system test results are exported.
The results of the last battery test are
exported if the function was activated and
a battery test was performed.
5 Breathing circuit test The last breathing circuit test results are
results exported.
6 Logbook The logbook entries for 1 day or 7 days are
exported.
7 Alarm logbook The alarm logbook entries for 1 day or
7 days are exported.
8 Trends The trends for 1 day or 31 days are
exported.
9 The interval can be selected for the trend.
4. Touch the appropriate Export button.

✓ The data is exported to the USB mass storage device. After successfully
exporting the data, the device displays a message.
After the data export

● Remove the USB mass storage device from the USB port after waiting at least
2 seconds.

Trends
If data export was not successful

If the data export fails owing to the USB mass storage device being full, the button
is deactivated.
● Remove the USB mass storage device from the USB port and use another USB
mass storage device.
When no USB mass storage device is connected, the button is deactivated.
The exported files can only be viewed with a Unicode-enabled editor and a Unicode
font.
An import into word processors or spreadsheets is possible.

Monitoring
11 Monitoring
11.1.1 Calibrating the sensors
If the sensors are not regularly calibrated, their measurement accuracy will be
reduced. As a result, the patient may be put at risk.
► Calibrate the sensors at the specified intervals.
11.1.2 Flow monitoring

Flow monitoring in the Neonate patient category
False alarms may occur during ventilation with very low tidal volumes. As a result,
the patient may be put at risk.
► Use additional external monitoring.
Flow monitoring in the Pediatric patient patient category

If larger pediatric patients have severe infections and strong coughs, expectorated
secretion may cause corrosion in the neonatal flow sensor.
► Use the expiratory flow sensor present in the device for flow monitoring.
Therapy without flow monitoring

If flow monitoring and volume monitoring are deactivated, the patient may be put at
risk.
► Immediately ensure appropriate substitute monitoring.
► Use independent apnea monitoring.
Therapy without flow monitoring with expiratory flow sensor

If flow monitoring with the expiratory flow sensor is deactivated, disconnection
cannot be reliably detected. The patient may be put at risk. Additionally, neither
volume-controlled ventilation nor patient-triggered ventilation is possible.
► Reactivate flow monitoring as soon as possible.
Therapy without flow monitoring with neonatal flow sensor

If flow monitoring with the neonatal flow sensor is deactivated, disconnection
cannot be reliably detected. The patient may be put at risk. Additionally, no patient-
triggered ventilation is possible.
► Reactivate flow monitoring as soon as possible.
11.1.3 O2 monitoring
Therapy without O2 monitoring
If O2 monitoring is deactivated, the patient may be put at risk.
► Immediately ensure appropriate substitute monitoring.

Monitoring
11.1.4 CO2 monitoring

The cuvette windows of the reusable cuvette have different optical properties to the
cuvette windows of the disposable cuvette. If the cuvette type used is not
configured on the device, the zero point is shifted by up to 8 mmHg CO2 (or
1.1 Vol% or 1.1 kPa). The patient may be put at risk as a result of incorrect CO2
measured values.
► Select the correct cuvette type in the dialog.
► Use the cuvette type that is also used for the CO2 measurement to check the
CO2 sensor.
11.2 Information on monitoring

The monitoring and thus the alarm function is activated on the factory side. Each
monitoring function can be deactivated separately.
O2 monitoring and flow monitoring are activated after the device is turned on.
In the Pediatric patient patient category, flow monitoring is activated depending on
the flow sensor and expiratory valve used.
After the device is turned on, CO2 monitoring has the same status as before the
device was turned off.
11.2.1 Possible information displayed for measured values

Instead of a measured value, the following information can be displayed in the
parameter fields or tables:
Display Cause
OFF Monitoring was deactivated by the user
ERR Sensor error
CAL Calibration is active, thus, the measured value cannot
be displayed
Grey measured value Reduced sensor accuracy
No measured value Prerequisites for measurement or calculation are cur-
rently not met
+++ Measured value is above specified measurement range
--- Measured value is below specified measurement range
11.2.2 Display of etCO2 measured values

The measured value for etCO2 can be displayed in the units Vol%, kPa, or mmHg
(see "Selecting the units", page 202).

Monitoring
11.2.3 Calibrating the sensors

Sensors Intervals
Expiratory flow sensor Observe the following information: "Calibrating the expi-
ratory flow sensor", page 176.
Neonatal flow sensor Observe the following information: "Calibrating the neo-
natal flow sensor", page 177.
O2 sensor Observe the following information: "Calibrating the O2
sensor", page 179.
CO2 sensor Observe the following information: "Information on
checking the CO2 sensor", page 180.
Pressure sensors Automatic calibration takes place immediately and one
hour after the device has been turned on, afterwards
every 12 hours.
11.2.4 Saving calibration values

The calibration or zero-checking values of the sensors that were last determined
remain stored until the next calibration or zero check, even if the device is turned
off.
11.3 Flow monitoring

11.3.1 Information on flow monitoring
The following flow sensors are used for flow monitoring in accordance with the
patient category:
Patient category Flow sensor

Adult Expiratory flow sensor
Pediatric patient Expiratory flow sensor or neonatal flow sensor
Neonate Neonatal flow sensor
The measured values MVe and VTe are not leakage-corrected (see "Leakage
adaptation and leakage compensation", page 311) and are therefore lower than the
actual minute volumes and tidal volumes applied to the patient if a leakage occurs.
When leakage compensation is activated, the volume values and flow measured
values, as well as the waveforms for flow and volume, are displayed leakage-
corrected.
In order to avoid false alarms and assure proper monitoring, the following settings
are required:
● Adjust the upper and lower alarm limits for the expiratory minute volume MVe in
line with the current value.
● Use additional external monitoring if required, e.g., SpO2 monitoring.
Flow monitoring with neonatal flow sensor in the Neonate patient category
Use additional external monitoring during ventilation with very low tidal volumes.

Monitoring
Flow monitoring in the Pediatric patient patient category

If the neonatal flow sensor is activated in the Pediatric patient patient category,
flow monitoring is performed using that sensor.
If the neonatal flow sensor is faulty or if flow monitoring with the neonatal flow
sensor is deactivated, flow monitoring is performed using the expiratory flow sensor
present in the device. Volume-controlled ventilation continues to be possible.
If larger pediatric patients have severe infections and strong coughs, use the
expiratory flow sensor present in the device.
Therapy without flow monitoring

When flow monitoring is deactivated, the ventilation functions and ventilation
monitoring are limited.
Flow monitoring with the expiratory flow sensor cannot be fully substituted by
external monitoring. Set the minute volume alarm limits of the substitute monitoring
accordingly.
Neonatal flow monitoring must be deactivated in the following cases:
– If the flow sensor is removed and medication nebulization is performed.
Flow monitoring can be deactivated in the following cases, for example:
– To permit ventilation in the event of major tube leakage.
– If the flow sensor has failed but cannot be replaced immediately. A faulty or
disconnected flow sensor may lead to deviations in the minute volumes and tidal
volumes or to auto-triggering.
In the Neonate patient category, flow monitoring is automatically deactivated if the
therapy type is switched to NIV.
If flow monitoring is deactivated, the measured flow-based values are no longer
displayed. The alarm function is deactivated. OFF is displayed in the corresponding
parameter fields.
In the Pediatric patient patient category, flow monitoring is only deactivated if no
flow sensor is present in the device or if flow monitoring with that flow sensor is
deactivated.
If the flow monitoring with the expiratory flow sensor is deactivated, the alarm
function is based on the measurement of the inspiratory tidal volume.

Monitoring
11.3.2 Expiratory flow monitoring

1. Touch the Sensors button in the main menu bar.
2. Touch the Flow sensor tab (1).
1
40746
2 3

1 Flow sensor
2 Expiratory flow monitoring Flow monitoring can be activated or deacti-
vated.
3 Calibration Calibration can be started or canceled.
4 Trigger Opens the dialog page for setting the flow
trigger. For further information see: "Trig-
ger", page 293.
11.3.3 Calibrating the expiratory flow sensor

The calibration of the flow sensor in the device corresponds to a zero calibration.
As long as automatic calibration is possible, the flow sensor can be reused.
The flow sensor is automatically calibrated in the following cases:
– At the start of ventilation
– Every hour during ventilation or if deviations are detected
– After flow sensor replacement
– After medication nebulization with the pneumatic medication nebulizer
Manual calibration of the flow sensor is necessary in the following cases:
– During the system test
The neonatal flow sensor is automatically cleaned by heating before every
manual calibration. This heating is performed 30 minutes after turning on the device
at the earliest, or 30 minutes after replacement of the flow sensor at the earliest.
Starting the calibration

Prerequisites:
– The Flow sensor dialog page is displayed.
Procedure:
1. Touch the Start button.
2. Perform the instructions displayed in the tooltip.

Monitoring

✓ The device uses the next inspiratory phase for calibrating the flow sensor. Short
inspiratory times are extended to approx. 1 second.
After the calibration is complete, the Start button turns blue.
11.3.4 Neonatal flow monitoring

2. Touch the Neonatal flow sensor tab (1).
40744
2 3
4

1 Neonatal flow sensor
2 Neonatal flow monitoring Flow monitoring can be activated or deacti-
vated.
3 Calibration Calibration can be started or canceled.
4 Sensor type Selecting the sensor type used:
– Y flow sensor
– ISO-15 flow sensor
5 Trigger Opens the dialog page for setting the flow
trigger. For further information see: "Trigger",
page 293.
11.3.5 Calibrating the neonatal flow sensor

The calibration of the flow sensor corresponds to a zero calibration.
The flow sensor must be manually calibrated at least once a day and in the
following cases as well:
– During the system test and before use
– After replacing the following components:
– Sensor insert
– Flow sensor
If the flow sensor was unplugged only briefly, it does not need to be recalibrated.
The neonatal flow sensor is automatically cleaned by heating before every manual
calibration.

Monitoring
Performing the calibration

Prerequisites:
– The Neonatal flow sensor dialog page is displayed.
Procedure:
1. Select the sensor type used in the line Sensor type.
2. Touch the Start button.
3. Perform the instructions displayed in the tooltip.
Sealing the neonatal flow sensor

Prerequisites:
– Wear a sterile glove when sealing the flow sensor.
Procedure:
1. Remove the tube connector.
2. Seal the flow sensor ISO 15 (1) or the flow sensor Y-piece (2).
39421
1 2
✓ This ensures that the requirement for calibration (no flow) is met.
Starting the calibration

● Press the rotary knob.
 The tooltip displays information.
✓ After the calibration is complete, the Start button turns blue.
After calibration of the neonatal flow sensor

● Connect the tube connector.
11.4 O2 monitoring
11.4.1 Information on O2 monitoring
The O2 sensor is deactivated in standby mode. When the therapy is started, the O2
concentration is not displayed until after about 5 seconds.

Monitoring
11.4.2 Therapy without O2 monitoring

O2 monitoring can be replaced by appropriate substitute monitoring. The O2 alarm
limits can be set for the substitute monitoring, for example according to the set
value for FiO2:
Set value FiO2 O2 alarm limit

≤60 Vol% ±4 Vol%
>60 Vol% ±6 Vol%
If O2 monitoring is deactivated, the measured values are no longer displayed. The

corresponding parameter field displays OFF. The automatic alarm limits are no
longer monitored.
● Reactivate O2 monitoring as soon as possible.

2. Touch the O2 sensor tab (1).
40743
2

1 O2 sensor
2 O2 monitoring O2 monitoring can be activated or deactivated.
11.4.4 Calibrating the O2 sensor

The O2 sensor is calibrated during the system test. Regular calibration during the
system test ensures the specified accuracy.
If the O2 sensor is not calibrated for 3 months, the accuracy of the O2 sensor is
reduced.
Procedure:
CAUTION
Risk of patient injury due to incorrect calibration
If the quality of the oxygen from the central gas supply system is insufficient, the
sensor may be calibrated incorrectly.
► Calibrate the O2 sensor with test gas (100 % O2).
● Perform the system test.
✓ After calibration, the sensor will work again with full accuracy.

Monitoring
11.5 CO2 monitoring

11.5.1 Information on CO2 monitoring
The CO2 sensor is factory-calibrated.
Various cuvette sizes are available for CO2 monitoring in the Adult and Pediatric
patient patient categories.
CO2 cuvette type

The following cuvettes can be used:
– Reusable cuvettes
– Disposable cuvettes
If the selected cuvette does not correspond to the cuvette used, the following alarm
message is displayed: Check CO2 cuvette
Therapy without CO2 monitoring

If a faulty CO2 sensor cannot immediately be exchanged or if the CO2 measured
values are currently not needed, deactivate CO2 monitoring.
If CO2 monitoring is deactivated, the measured values are no longer displayed. The
alarm function is deactivated. The CO2 parameter field displays OFF.
11.5.2 Information on checking the CO2 sensor

The CO2 sensor is factory-calibrated.
Information on checking the zero indication and zero calibration

When the zero indication is checked or the zero calibration is performed, the CO2
concentration in the cuvette or in the cuvette slot of the sensor must not be higher
than the usual background concentration of approximately 0.4 mmHg (or 0.05 Vol%
or 0.05 kPa) in rooms. For this reason, do not breathe on or into the cuvettes or into
the cuvette slot.
The following checks are required for the CO2 sensor:
Check When required?

Check the CO2 zero indication Before measurement and when changing the CO2
in ambient air sensor to another ventilation unit
Perform a CO2 zero calibra- If the CO2 zero indication in ambient air is not
tion between 0 and 1 mmHg (or 0 and 0.1 Vol%, or
0 and 0.1 kPa).
Check the calibration of the Every 4 weeks
CO2 sensor with a test filter
During the checks a low-priority alarm is displayed. No measured value is

displayed in the CO2 parameter field.
The zero calibration in ambient air and the calibration check with test filter can be
performed during ventilation.

Monitoring
11.5.3 Information on the alarm messages issued during CO2

monitoring
This information refers to the alarm messages which are generated due to a soiled
cuvette or sensor.
Alarm message CO2 cuvette soiled

If the CO2 cuvette soiled message is displayed, the following windows may be
soiled:
– Cuvette (disposable or reusable cuvette)
– CO2 sensor
1. Clean the cuvette or use another cuvette.
● When using reusable cuvettes, insert a clean reusable cuvette.
● When using disposable cuvettes, insert a new disposable cuvette.
2. Clean the CO2 sensor.
Alarm message CO2 zero calibration required

If the CO2 zero calibration required message is displayed or if incorrect measured
values are suspected, e.g., etCO2 values are too low, then proceed as follows:
1. Check whether the cuvette windows are soiled.
2. Clean the soiled windows.
● If a reusable cuvette was used previously, use a clean reusable cuvette.
● If a disposable cuvette was used previously, use a new disposable cuvette.
If the cuvette windows are extremely soiled, e.g., from deposits due to medication
nebulization, this may result in a zero shift. The CO2 measured values may be
incorrect even before insufficient measuring light causes the CO2 cuvette soiled
message to appear.
If the CO2 zero calibration required message continues to be displayed or if the
measured CO2 values remain suspect, a zero calibration must be performed.

Monitoring

2. Touch the CO2 sensor tab (1).
40741
2 3
4
5

1 CO2 sensor
2 CO2 monitoring CO2 monitoring can be activated or deacti-
vated.
3 Zero calibration The zero calibration can be started.
4 Type of CO2 cuvette Selecting the cuvette type used:
– Reusable
– Disposable
5 Test with test filter The test can be started.
11.5.5 Checking the CO2 zero indication

Prerequisites:
– A clean CO2 sensor is positioned on the cuvette that is used for measurements.
Either that or a clean or a new cuvette of the same cuvette type is used.
– The wait for the completion of the CO2 sensor warm-up phase (3 minutes) has
ended.
Procedure:
1. Select the cuvette type (see "Information on CO2 monitoring", page 180).
2. Display the CO2 measured values as waveform (see "Changing the display",
page 56).
3. Remove the CO2 sensor with the cuvette from the breathing circuit and hold it in
ambient air. Do not breathe on or into the cuvette.
4. Observe the CO2 measured value. If 0 to 1 mmHg (or 0 to 0.1 Vol% or 0 to
0.1 kPa) is not displayed in the ambient air, perform a zero calibration.

Monitoring
11.5.6 Performing the CO2 zero calibration

Prerequisites:
– The CO2 sensor dialog page is displayed.
– The cuvette type used is selected on the dialog page.
ended.
Procedure:
1. Remove the CO2 sensor (1) from the cuvette (2).
39422
1
2
2. Touch the Start button in the line Zero calibration and confirm with the rotary
knob.
✓ The device performs the zero calibration and displays the following information:
The zero calibration is in progress.
If zero calibration was successful

After about 5 seconds, the device displays the following information: The zero
calibration was successful.
● Fit the CO2 sensor (1) back on the cuvette (2).
If zero calibration was not successful

The device displays the following information: The zero calibration failed.
● Repeat the zero calibration.
If zero calibration is still impossible

1. Check whether the sensor is soiled and clean it if necessary. If the sensor is
faulty, replace it.
2. Repeat the zero calibration.

Monitoring
11.5.7 Checking the calibration of the CO2 sensor with the test filter
● Perform the calibration check of the CO2 sensor with a test filter at intervals of
one month.
Prerequisites:
ended.
– The CO2 sensor dialog page is displayed.
Before the check

● Perform the CO2 zero calibration.
Performing the test

1. Remove the sensor from the cuvette and connect it to the test filter (1) on the
sensor cable.
39423
1
2. Touch the Start button in the Test with test filter line.
✓ The test is performed.
If the test was successful

If the test value lies within the allowed tolerance, the device displays the following
information: The filter test was successful.
● Fit the CO2 sensor back on the cuvette.
If the test was not successful

If the test value lies outside the allowed tolerance, the device displays the following
information: The filter test failed.
The following causes are possible:
Cause Remedy
The CO2 sensor is soiled. Clean the CO2 sensor. Repeat the test.
The CO2 sensor is faulty. Replace the CO2 sensor. Check the
CO2 zero indication.

Configuration
12 Configuration
12.1.1 Alarm settings
Alarm volume
If the alarm volume is too low, alarm signals may not be heard. The patient may be
put at risk.
► The user must remain within earshot of the alarm signals.
12.1.2 Start settings

Start values for alarm limits
If the same devices are used with different user-specific settings within one area,
these settings may be unsuitable for the current patient. The patient may be put at
risk.
► Uniformly configure the same devices within one area.
12.2 Information on configuration

12.2.1 Factory defaults
Dräger delivers the device with factory defaults with which the device starts the first
time.
Resetting to factory defaults

The Factory defaults button is located on several dialog pages. It can be used to
reset the user-specific settings to the factory defaults.
If the factory defaults are selected, other start settings on the Start settings dialog
pages and the Alarms dialog page are reset to the factory defaults.
Procedure:
1. Touch the Factory defaults button.
12.2.2 User-specific settings

The user-specific settings can be transferred to additional devices. For further
information see: "Importing and exporting configurations", page 198.
Start settings
The start settings can be changed and saved after the user password is entered.
The start settings are effective after the device is restarted or a new patient is
admitted. For further information see: "Configuring the start settings", page 194.

Configuration
Additional settings
Users can specify specific settings for the device. Settings are effective immediately
after being confirmed. Some settings can be changed and saved only after the user
password is entered.
12.2.3 Information about the user password

To prevent unauthorized changes, the following dialog pages are protected by a
user password:
– Screen > Views
– Alarms
– Ventilation
– Start settings
– Options
– Battery > Test activation
– System > Password
After the service password is entered, these dialog pages can also be opened,
and the settings can be changed.
Entering the user password

Prerequisites:
– The numeric keypad is displayed.
Procedure:
● Enter the user password.
✓ The selected dialog page is opened.
If the password is incorrect, the password entry can be deleted with the button.
The user password only needs to be entered once as long as the System setup
dialog remains open.
For further information see: "Password", page 329.
12.3 Configuring the screen display

12.3.1 Selecting the color scheme and the brightness
Dialog page System setup > Screen > General settings
Designation Description
Day/night mode (man- Select day mode or night mode on the screen.
ual)
Day/night mode (auto- Turn the automatic switch from day mode to night mode
matic) on or off.
The following settings are automatically changed:
– Illumination of the screen
– Volume of the acoustic alarm signal
– Automatic increase of the alarm volume

Configuration
Night time Set the time range for night mode.
The illumination of the screen is reduced with a dark
background color for the time period entered.
Brightness (day) For day and night, select the automatic or manual set-
Brightness (night) ting for the screen brightness. The screen brightness is
specified in percent for the manual setting.
Dimming Automatic dimming of the screen can be set for standby
mode and battery operation.
12.3.2 Configuring the views

Dialog page System setup > Screen > Views
The user password must be entered.
View Select the view to be configured.
Lock view The selected view can be locked against overwriting. If
the view is locked, the display of the monitoring area
cannot be changed.
Template Select the appropriate format template. The selection is
possible only if the selected view is not locked.
Monitoring area Select the parameters for the waveform fields and
parameter fields.
For further information see: "Changing the display",
page 56.
Load saved view The saved settings can be loaded from a USB mass
storage device. Every view can be individually reset to
the saved setting. The view must not be locked.
Factory defaults Select the factory defaults.
Save view The current configuration for the selected view is saved.
Possible settings
The following can be configured for the monitoring area:
– Parameter
– Display form
– Field size of the parameter fields and waveform fields
All fields can also be configured without contents.
The following table lists the possible display forms for the fields. For devices with
small screens, not all settings can be selected.
Field Field size Display form

Waveform field Small Waveform
Multi trend
Trend (meas.)
Trend (setting)

Configuration
Field Field size Display form

Waveform field Large Waveform
Multi trend
Trend (meas.)
Trend (setting)
Loops
Pulmonary View
1 parameter
2 parameters
Parameter group
Waveform field Full Loops
Pulmonary View
1 parameter
2 parameters
Parameter group
Parameter field Small 1 parameter
2 parameters
Parameter field Large 1 parameter
Parameter group
Trend (meas.)
Trend (setting)
Single loop
Battery
Factory defaults for the ventilator Evita V800

View 1:
Waveform fields Parameter fields

Waveform: FiO2
Paw Pmean
Waveform: PEEP
Flow MVe
Waveform: RR
Volume VT
View 2:
Parameter fields Waveform fields Parameter fields

Trend (measured val- Waveform: Paw MVe/MVespon
ues): RR/
PIP
Trend (measured val- Waveform: Flow VT
ues): VTspon
% MVspon
Trend (measured val- Waveform: Volume PIP
ues): PEEP
RRspon

Configuration
View 3:

Loops: Cdyn
Paw/Volume
C20/Cdyn
R
TC
% leak
View 4:

Waveform: FiO2
Paw MVleak
Waveform: PEEP
Flow MVe/MVespon
Waveform: RR/RRspon
Volume VTspon
View 5:

Waveform: FiO2
Paw Pmean/PEEP
Waveform: VTemand/VTspon
Flow RR/RRspon
Waveform: MVe/MVespon
Volume R/Cdyn
View 6:

Waveform: Parameter group > 6 parameters:
Paw Airway pressure
Waveform: Pmean/PEEP
Flow RR/RRspon
Waveform: MVe/MVespon
Volume VTspon

Configuration
Factory defaults for the ventilator Evita V600

View 1:

Waveform: FiO2
Paw MVe
Waveform: VTe
Flow
Waveform: RR
Volume
View 2:

Waveform: FiO2
Paw MVe/MVespon
Waveform: VTe/VTespon
Flow RR/RRspon
View 3:

Loops: FiO2
Paw/Volume
TC/C20/Cdyn
R/Cdyn
View 4:

Waveform: FiO2
Paw MVe
Waveform: VTe
Flow
Waveform: RR
Volume
View 5:

Waveform: FiO2
Paw MVe/MVespon
Waveform: VTe/VTespon
Flow RR/RRspon

Configuration
View 6:

Waveform: FiO2
Flow
TC/C20/Cdyn
Waveform: R/Cdyn
Volume
12.3.3 Configuring the waveform scaling

Dialog page System setup > Screen > Waveform scaling
The settings become effective with the admission of a new patient.
Paw An automatic scaling or different scaling ranges can be
Flow configured for waveforms.
Volume
CO2
12.3.4 Configuring parameters for patient files

Dialog page System setup > Screen > Configured values
Current measured and Configuring the parameters for the following dialog page:
set values Trends/data > Values > Configured values
Measured values are displayed in black letters, and set
values are displayed in blue letters.
12.3.5 Selecting the action buttons

Dialog page System setup > Screen > Buttons
Buttons For direct access to a function or to open a dialog page,
action buttons can be displayed in the main menu bar.
For further information see: "Action buttons in the main
menu bar", page 325.
12.3.6 Configuring the graphic trend display

Dialog page System setup > Screen > Graphical trend
The graphic trend display for the following dialog page can be configured:
Trends/data > Trends > Graphical trend.
The dialog page setup and the selection procedure are the same. For further
information see: "Graphical trends", page 165.

Configuration
12.4 Configuring the alarm settings

Dialog page System setup > Alarms
Minimum alarm vol- Setting the minimum alarm volume sets the lower limit of
ume the factory setting range for the alarm volume (10 to
100 %). This allows the setting range to be adjusted to
the acoustical situation at the operating location.
Alarm volume (day) Set the alarm volume for day mode and night mode. The
Alarm volume (night) automatic increase in alarm volume can be turned on.
Acoustic alarm signal The following acoustic alarm signals are available:
– IEC/CEI: Alarm signals in accordance with the stan-
dard IEC 60601-1-8
– Dräger: Usual alarm signals of Dräger ventilators
(factory default)
Priority for battery Various priorities are available for battery alarms.
alarms For further information see: "Priority of battery alarms",
page 192.
Alarm "Battery acti- The Battery activated alarm message indicating the
vated" switchover to battery operation can be configured as a
high- or medium-priority alarm when Dräger is selected.
Confirmation prompt The display of messages and alarms requesting confir-
mation of ventilation settings can be activated or deacti-
vated.
Factory defaults If the factory defaults are selected, other start settings on
the Ventilation dialog page are reset to the factory
defaults.
12.4.1 Priority of battery alarms

Depending on the setting, alarm messages have the following priorities:
Alarm message IEC/CEI in accordance with Dräger

the standard ISO 80601-2-
12
Battery acti- Low-priority alarm High-priority or medium-priority
vated alarm
Battery low Medium-priority alarm High-priority alarm
Battery depleted High-priority alarm High-priority alarm
12.5 Configuring ventilation settings

12.5.1 Selecting the ventilation modes for the therapy bar
Dialog page System setup > Ventilation > Ventilation modes
If --- is configured for a ventilation mode, the corresponding tab is not available in
the therapy bar.

Configuration
The same ventilation mode cannot be configured on 2 buttons.

The button with the active ventilation mode is highlighted in gray and cannot be
changed. The button assignment can only be changed after another ventilation
mode is activated in the therapy bar.
Depending on the configuration, the number of displayed ventilation modes can
vary between 1 and 4.
Designation Factory default

Start mode VC-AC
Mode 2 VC-SIMV
Mode 3 PC-BIPAP
Mode 4 SPN-CPAP/PS
12.5.2 Selecting the general settings

Dialog page System setup > Ventilation > General settings
The settings can be activated or deactivated. Ventilation starts with the selected
settings.
Leakage compensa- For further information see: "Leakage adaptation and
tion leakage compensation", page 311.
Autom. return from For further information see: "Apnea ventilation",
apnea ventilation page 291.
Apnea ventilation If the function is activated, the device displays the follow-
alarm ing alarm during active apnea ventilation: Apnea venti-
lation activated
Pmax/Paw high If the setting is active, the therapy bar displays the Pmax
autoset therapy control.
For further information see: "Linking the maximum air-
way pressure to the upper alarm limit – Pmax/Paw high
autoset", page 313.
"Insp term" during For further information see: "Inspiration termination",
pressure support page 294.
Expiratory compensa- If the function ATC is activated, the settings for inspira-
tion (ATC) tory and expiratory compensation are effective immedi-
ately.
For further information see: "ATC", page 297.
Inspiratory compensa- Inspiratory compensation can be selected for sponta-
tion (ATC) neous breaths and mandatory breaths or only sponta-
neous breaths.
Anti-air shower For further information see: "Flow reduction – Anti-air
shower", page 314.

Configuration
12.5.3 Setting maneuvers

Dialog page System setup > Ventilation > Maneuvers
Low-flow PV loop Setting the pressure drop for the limitation of a purely
deflation inspiratory maneuver.
FiO2 during suction Setting the FiO2 concentration for the suction maneuver.
maneuver Adult patient category: The start value for FiO2 is set to
100 Vol% and cannot be changed.
Pediatric patient and Neonate patient categories:
For the suction maneuver, FiO2 is set based on the cur-
rent FiO2 concentration using a factor between 1.0 and
2.0.
12.6 Configuring the start settings

12.6.1 Selecting the start settings for the patient categories
Dialog page System setup > Start settings > Patient categories
Selectable patient cat- Select those patient categories from a list that shall be
egories available after the device is turned on.
Default patient cate- Selecting the patient category that shall be preselected
gory after the device is turned on.
12.6.2 Setting the start values for the alarm limits

Users cannot set internal alarm limits for the device (see "Automatic alarm limits",
page 263).
Dialog page System setup > Start settings > Alarm limits
The start values for the alarm limits can be adjusted. The
settings become effective with the admission of a new
patient. The measured values are displayed in the Cur-
rent value line.
Factory defaults If the factory defaults are selected, other start settings
and the settings on the Alarms dialog page are reset to
the factory defaults.

Configuration
The alarm limits with setting ranges and factory defaults are listed in the following
table:
Alarm limit Setting range Factory default

MV 1 to 100 % (VT x RR) +50 %
(VT x RR) –20 %
(deactivated)
1 to 100 %
MV delay 0 to 30 seconds 0 seconds
0 to 30 seconds 0 seconds
VT 1 to 100 % VT +99 %
(deactivated)
VT –50 %
(deactivated)
1 to 100 %
Paw 7 to 105 mbar (or hPa or 30 mbar (or hPa or cmH2O)
cmH2O)
RR 1 to 100 % RR +20 %
(deactivated)
Tapn 5 to 60 seconds 15 seconds
etCO2 0.1 to 13.1 Vol% 8.0 Vol%
1 to 98 mmHg 60 mmHg
0.1 to 13.3 kPa 8.0 kPa
0 to 13.0 Vol% 4.0 Vol%
0 to 97 mmHg 30 mmHg
0 to 13.2 kPa 4.0 kPa
12.6.3 Setting the start values for the ventilation parameters

Dialog page System setup > Start settings > Trigger, VT, RR
Calculation basis The start values of the ventilation parameters can be
determined using the patient category and body weight.
Patient category The start values of the ventilation parameters for the
patient categories are determined. If the patient category
is set on the standby screen, ventilation begins with
these start values.
Body weight The start values of the ventilation parameters for the
body weight are determined.
Adult and Pediatric patient patient categories:
If the body height is entered on the standby screen, the
device uses it to determine the ideal body weight. The
start values for ventilation are derived.
In the Neonate patient category:
If the body weight is entered on the standby screen, the
start values for ventilation are derived.

Configuration
Ventilation parameters:
VT Setting the start values for the ventilation parameters.
RR
Slope
Trigger
Factory defaults If the factory defaults are selected, other start settings
and the settings on the Alarms dialog page are reset to
the factory defaults.
Factory defaults
The following table lists the factory defaults for the ventilation parameters based on
the patient category:
Patient category VT RR Slope Trigger

(mL) (/min) (s) (L/min)
Neonate 5.0 60 0.1 0.3
Pediatric patient 50 29 0.2 1.0
Adult 500 12 0.2 2.0
The following table lists the factory defaults for the ventilation parameters based on
body weight according to the Radford nomogram:
Weight VT RR Slope Trigger

(kg) (mL) (/min) (s) (L/min)
0.5 3.0 100 0.05 0.2
5 36 32 0.2 1.0
15 110 26 0.2 1.0
75 520 12 0.2 2.0
12.6.4 Setting the start values for additional ventilation parameters

Dialog page System setup > Start settings > Pressures, FiO2, I:E
Pressure PEEP Ventilation parameters
ΔPsupp
Pinsp
Pmax
Pressures in Plow
APRV Phigh
"Exp term" in APRV Determining the start values for the expiratory ter-
mination criterion.
FiO2 Ventilation parameters
I:E
Factory defaults If the factory defaults are selected, other start set-
tings and the settings on the Alarms dialog page
are reset to the factory defaults.

Configuration
Factory defaults
In the following table, the factory defaults for additional ventilation parameters are
listed:
Parameter Factory default

PEEP 5 mbar (or hPa or cmH2O)
ΔPsupp 0 mbar (or hPa or cmH2O)
Pinsp 15 mbar (or hPa or cmH2O)
Pmax 40 mbar (or hPa or cmH2O)
Plow 5 mbar (or hPa or cmH2O)
Phigh 15 mbar (or hPa or cmH2O)
FiO2 21 Vol%
I:E 1:2
12.6.5 Determining the start settings for the advanced settings

Dialog page System setup > Start settings > Advanced settings
After the Factory defaults button on another Start settings dialog page or the
Alarms dialog page is touched, the settings are also reset to the factory defaults.
Volume guarantee Activating or deactivating the advanced setting.
AutoFlow Activating or deactivating the advanced setting.
Apnea ventilation Activating or deactivating the advanced setting.
Automatic tube com- Activating or deactivating the advanced setting.
pensation
Tube type Selecting the tube type:
– Endotrach.
– Trach.
In the Neonate patient category, only the Endotrach.
tube type is available. That is why the tube type selec-
tion is not displayed in the step Patient and therapy.
Tube diameter Entering the inner diameter of the tube for the selected
tube type for every patient category.
Compensation Entering the degree of compensation for the patient cat-
egories.
Setting ranges for the tube diameter

Patient category Tube type Endotrach. Tube type Trach.
(mm) (mm)
Neonate 2 to 5 2.5 to 5
Pediatric patient 2 to 8 2.5 to 8
Adult 5 to 12 5 to 12

Configuration
Tube type and tube diameter

The inner diameter of the tube and the tube type can be entered for the following
functions:
– Displaying the tracheal pressure Ptrach, independent of ATC
– Measuring the airway resistance of the patient Rpat and the index C20/Cdyn
If the inner diameter of the tube and the tube type are entered, the measured value
Rpat corresponds with the airway resistance of the patient. Only if the inner
diameter of the tube and the tube type are entered correctly are the measured
value Rpat and the index C20/Cdyn displayed correctly. The measured value R
always corresponds with the total resistance.
12.7 Importing and exporting configurations

The configuration of the device can be exported onto a USB mass storage device.
The configuration saved on the USB mass storage device can be imported to other
devices of the same type.
The following settings from the system configuration are exported and imported:
Horizontal tabs Vertical tab

Screen General settings
Views1)
Waveform scaling
Configured values
Buttons
Graphical trend
Alarms
Ventilation Ventilation modes
General settings
Maneuvers
Start settings Patient categories
Alarm limits
Trigger, VT, RR
Pressures, FiO2, I:E
Advanced settings
System Status
Country
Units
Interfaces
1) Views are exported only if the view configured was first saved on the Screen dialog page.
When a configuration is imported, all the current views are overwritten, including the locked
views.

Configuration
Preparing
1. Insert the USB mass storage device into a USB port on the display unit (see
"Connecting external devices to the data interfaces", page 72).
2. Open the following dialog page: System setup > Configuration import/export.
3. Enter the user password.
✓ The dialog page is displayed.
Exporting the configuration

1. Touch the button in the Export line.
✓ If the USB mass storage device already contains a configuration, a message
appears stating that this configuration will be overwritten.
No export is possible onto the USB mass storage device if it is full. The button is
grayed out and cannot be activated.
Importing a configuration
A configuration can be imported only in standby mode.
1. Switch the device to standby mode.
2. Touch the button in the Import line.
 The pick list appears.
3. Select the configuration.
4. Touch the following button: Import configuration
 If there is no valid configuration saved on the USB mass storage device, a
corresponding message is displayed.
After the import, the device is switched off automatically.
6. Turn on the device again.
 The end of the import is indicated with a low-priority alarm.
7. Check the settings of the imported configuration.
12.8 Activating software options

The device can be supplemented with additional Dräger software options.
The activation code is bound to the serial number of the device in question and
cannot be transferred. The activation codes can either be read by a USB mass
storage device or entered manually.
1. Open the following dialog page: System setup > Options.
2. Enter the user password.
✓ The dialog page is displayed.

Configuration
12.8.1 Reading in the activation code from a USB mass storage device
Prerequisites:
– The USB mass storage device with valid activation codes for this device is
connected to the USB port.
Procedure:
1. Touch the Load button.
 The activation codes found on the mass storage device are read in and
displayed in the list Available options.
3. Touch the Install button.
✓ The installed options are displayed in the list Installed options.
12.9 Performing and configuring the battery test

12.9.1 Performing the battery test
Dialog page System setup > Battery > Battery test
Full test Complete battery test
PS500 Battery test for the PS500 power supply unit
Internal battery Battery test for the internal battery
The battery test in question can be started or canceled. The remaining runtime is
displayed during the battery test.
Observe the following information: "Maintenance", page 231.
Observe the following information: "Battery test", page 235.
12.9.2 Configuring the battery test

Dialog page System setup > Battery > Test activation
The Battery test function can be activated or deactivated.
If the function is deactivated, the following are not available:
– The Battery test dialog page
– The Battery parameter field
– The Battery test in progress alarm
– The Consider battery test alarm
– The flashing symbol in the header bar that displays the following:
– The battery test is running.
– The interval for the battery test has expired.
– The battery test failed.
– Battery replacement is recommended.

Configuration
12.10 Changing the system settings

12.10.1 Displaying the status
Dialog page System setup > System > Status
Service Appointment for the next maintenance
Display unit Operating time in standby mode
Operating time in operation mode
Ventilation unit Operating time in standby mode
Operating time in operation mode
Gas supply unit GS500 Operating time of the turbine
Installation date
Power supply unit Total charge produced
PS500 Installation date
Internal battery Total charge produced
12.10.2 Activating the functionality of the gas supply unit

Dialog page System setup > System > Supply unit
Gas supply unit GS500 After the gas supply unit has been activated, the system
test must be performed.
The gas supply unit can be deactivated if the device is
equipped with a gas supply unit that is currently not sup-
posed to be used. If the gas supply unit is deactivated,
the Gas supply unit test step is not displayed in the
system test.
For further information see: "Using the gas supply unit",
page 140.
12.10.3 Changing the country-specific settings

Dialog page System setup > System > Country
Language The language of the screen texts can be changed. The
language of the customer is set in the factory.
Date and time The date and time can be set. The device does not
switch automatically between daylight saving time and
standard time. The user must change the time manually.
Otherwise the times will be incorrect on the screen and
for saved values and actions (e.g., in the logbook).
Changing the system time changes the time displayed in
trends, the logbook, the alarm logbook, maneuver mea-
sured values and reference loops. The data saved up to
the change is displayed with the system time up till then.
After completing all settings, touch the Apply button.

Configuration
12.10.4 Selecting the units

Dialog page System setup > System > Units
The units for the parameters can be selected.
Designation Description Units

Airway pres- The selected unit is applied in the alarm limit mbar
sure settings. cmH2O
Height The selected unit is used as the calculation m, cm
basis in the alarm limit settings. ft, in
CO2 The selected unit is applied in the alarm limit Vol%
settings. mmHg
kPa
12.10.5 Configuring the interfaces

The communication settings can be configured to enable connection to a network
and data exchange with other devices. The connections are located at the rear of
the display unit.
Dialog page System setup > System > Interfaces
LAN Use of LAN ports is permitted for service purposes
only. Parameters must be set for connection to a net-
work.
DHCP If the settings of the network parameters need to be
changed, the protocol must be deactivated.
IP address Entering the access data for the network parameters.
Subnet mask After completing all settings, touch the Apply button.
Gateway Turn on the protocol again.
COM COM 1 The data exchange takes place via the serial ports
COM 2 with MEDIBUS-capable display devices, e.g., a
COM 3 patient monitor or patient data management system.
Protocol The following communication protocols are available:
– MEDIBUS.X
– MED.X Comp
– MEDIBUS
Baud rate
Parity

Configuration
12.10.6 Changing the user password

The user password can be changed.
Dialog page System setup > System > Password
Password The current user password must be entered. If the
user password is not available, contact specialized
service personnel.
Enter the new user pass- Enter a new user password consisting of 4 numbers.
word
Save new password Save the new user password.
Factory defaults Select the factory default.
12.10.7 Opening the service dialog

Dialog page System setup > System > Service
The service dialog is password-protected and reserved for specialized service
personnel.
For further information see: "Remote Service", page 231.

Troubleshooting
13 Troubleshooting
13.1 Displaying alarm messages
The alarm messages are displayed in the alarm message field of the header bar in
hierarchical order (see "Display of alarms", page 157).
In the following table, the alarm messages are listed in alphabetical order. If an
alarm occurs, the table helps to identify causes and remedies. The different causes
and remedies should be worked through in the order listed until the alarm has been
resolved.
In order to classify the alarms within an alarm category, internal priority numbers
are given after the exclamation marks in the table below. The most critical alarm
receives the number 255 in each case. The priority of the alarms decreases the
lower their number.
13.2 Confirming alarm messages

If an alarm message can be confirmed, the Alarm reset button is displayed in the
header bar.

Troubleshooting
13.3 Alarm – Cause – Remedy

Priority Alarm Cause Remedy
!! 100 Air supply low, GS500 The central Air supply is Check the connection to the
active insufficient to deliver the Air supply. Ensure that the
required flow and pressure. supply pressure corresponds
Air is delivered by the gas with the specified operating
supply unit GS500. Air sup- data. Adjust the ventilation
ply is not required if settings if necessary. If the
FiO2 = 100 Vol%. condition persists, disconnect
the device from the Air supply
to avoid reverse flow into the
Air supply.
To downgrade the alarm,
touch the "Alarm reset" but-
ton and confirm with the
rotary knob.
The central Air supply is Check the connections to the
insufficient. Air is delivered central Air supply and to the
by the gas supply unit gas supply unit GS500.
GS500. Ensure that the supply pres-
sure corresponds with the
specified operating data.
Adjust the ventilation set-
tings if necessary. If the con-
dition persists, disconnect the
device from the Air supply to
avoid reverse flow into the Air
supply.
rotary knob.
!!! 205 Airway pressure high The breathing hose is Check the breathing circuit.
kinked. Check the tube or mask.
The upper alarm limit for the Check the patient's condition.
airway pressure has been Check the ventilation set-
exceeded. The patient is tings.
breathing against the ventila- Adjust the alarm limit if nec-
tor or is coughing. essary.
!!! 200 Airway pressure low Leakage or disconnection Ensure that the breathing cir-
has occurred. cuit is connected tightly.
Ensure that the expiratory
valve is installed properly.
Ensure that the tube or mask
is connected properly.

Troubleshooting

!!! 140 Airway pressure negative The airway pressure has Disconnect the tube before
fallen below -10 mbar performing a suction maneu-
(-10 cmH2O). ver.
Check the patient's condition.
Check the ventilation set-
tings.
During O2 therapy, the Connect the breathing hose
breathing hose is connected to the inspiratory valve.
to the expiratory valve.
! 200 Alarm limit change not One or more alarm limits If necessary, change these
confirmed have been changed but not alarm limits and confirm with
confirmed. the rotary knob.
!! 50 Alarm silence key over- The alarm silence key is Stop pressing the alarm
used or stuck stuck or faulty or has been silence key. The alarm
pressed for more than silence key is not functional
6 seconds. as long as the condition is
present. If the condition per-
sists, contact specialized ser-
vice personnel.
!! 50 Alarm silence key used too The alarm silence key is The alarm silence key is not
often faulty or was pressed more functional as long as the con-
than 80 times within an hour. dition is present. If the condi-
tion persists, contact
specialized service person-
nel.
! 120 Alarm system failed The primary acoustic alarm To continue ventilation with
system failed. In the event of this device, closely monitor
an alarm situation, the sec- the functional integrity. Con-
ondary acoustic alarm signal tact specialized service per-
will sound. sonnel.
!! 100 Ambient pressure mea- The ambient pressure mea- The measurement accuracy
surement failed surement failed. of parameters depending on
the ambient pressure may be
impaired (e.g., MV, O2 con-
centration). Contact special-
ized service personnel.
!!! 181 Apnea The patient has stopped Check the patient's condition.
breathing. Use controlled ventilation if
necessary.
An obstruction occurred. Check the patient's condition.
Check the breathing circuit.
Check the tube or mask.
The flow sensor is not cali- Calibrate the flow sensor.
brated or is faulty. Replace it if necessary.

Troubleshooting

!! 230 Apnea ventilation activated The ventilator has automati- Check the patient's condition.
cally switched to apnea ven- Check the tube or mask.
tilation because it detected Check the ventilation settings
an apnea. and the patient's condition.
To return to the previous ven-
tilation mode, touch the "End
apnea ventilation" button and
confirm with the rotary knob.
!!! 160 Battery activated The device is powered by the Connect the device to the
battery as there is no mains mains power supply.
power supply. To downgrade the alarm,
rotary knob.
!! 200 Battery activated The device is powered by the Connect the device to the
power supply. To downgrade the alarm,
rotary knob.
! 201 Battery activated The device is powered by the Connect the device to the
power supply.
! 127 Battery charging deferred Battery charging is deferred Battery charging will continue
to prevent the battery from automatically when the bat-
overheating. The device can tery has cooled down. Bat-
be used normally. tery charging is indicated by
a flashing segment in the bat-
tery symbol.
!!! 254 Battery depleted The remaining calculated Immediately connect the
operating time of the battery device to the mains power
is less than 5 minutes. supply.
!! 120 Battery failure Battery operation is not avail- To continue ventilation with
able in the event of a mains this device, closely monitor
power supply failure. the functional integrity. Con-
tact specialized service per-
sonnel.
rotary knob.
!!! 250 Battery low The remaining calculated Connect the device to the
operating time of the battery mains power supply.
is less than 10 minutes.
!! 251 Battery low The remaining calculated Connect the device to the
operating time of the battery mains power supply.
is less than 10 minutes.

Troubleshooting

! 100 Battery test in progress The battery test was started Wait until the battery test is
by the user but it was not completed, before using the
completed. device for patient transport.
!! 205 Breathing hose kinked During O2 therapy: The pres- Check the breathing circuit.
sure at the inspiratory port is Check the tube or mask.
higher than 30 mbar
(30 cmH2O), e.g., due to a
kinked or blocked hose, or a
blocked mask. During venti-
lation: The upper alarm limit
for the airway pressure has
been exceeded due to a
kinked hose.
!!! 240 Calibrat. of gas supply sys- A technical fault was Disconnect the patient from
tem required detected during operation. the device and continue ven-
The calibration of the gas tilation without delay using
supply system failed. A new another ventilator. Perform
calibration is required. Venti- the system test.
lation is not possible.
! 12 Calibrat. of gas supply sys- A technical fault was Perform the system test.
tem required detected in standby mode. Ventilation can only be
The calibration of the gas started after the system test
supply system is due. The has been performed.
accuracy of the gas supply
system may be impaired. A
new calibration is required.
A technical fault was Perform the system test.
detected in standby mode. Ventilation can only be
The calibration of the gas started after the system test
supply system failed. A new has been performed.
calibration is required.
!!! 228 Calibrate neonatal flow The calibration data are cor- Patient category "Neonate":
sensor rupt. Calibrate the neonatal flow
sensor. If the calibration fails,
deactivate the integrated
neonatal flow monitoring and
use external flow monitoring.
Contact specialized service
personnel.
Patient category "Pediatric
patient": Calibrate the neona-
tal flow sensor. If the calibra-
tion fails, deactivate the
integrated neonatal flow
monitoring and use expira-
tory flow monitoring. Contact
nel.

Troubleshooting

!! 115 Calibrate neonatal flow After the device has been Calibrate the neonatal flow
sensor switched on, the neonatal sensor.
flow sensor must be cali-
brated.
! 100 Calibration of exp. flow The calibration of the expira-Calibrate the flow sensor.
sensor failed tory flow sensor failed. Replace it if necessary.
!!! 228 Calibration of neonatal flow The calibration of the neona- Calibrate the neonatal flow
sensor failed tal flow sensor failed. sensor. Seal the neonatal
flow sensor properly during
calibration.
The neonatal flow sensor is Replace the neonatal flow
faulty. sensor or the sensor insert.
Calibrate the sensor again.
!! 115 Calibration of neonatal flow The calibration of the neona- Calibrate the neonatal flow
sensor failed tal flow sensor failed. sensor. Seal the neonatal
flow sensor properly during
calibration.
!! 100 Check CO2 cuvette The selected CO2 cuvette Select the correct CO2
type is not correct. cuvette type.
The CO2 cuvette or the CO2 Clean the CO2 cuvette or the
sensor is soiled. CO2 sensor.
There is a CO2 sensor drift. Perform zero calibration.
The inspiratory CO2 concen- Check the ventilation set-
tration is too high. tings. Check the patient's
condition.
!! 146 Check CO2 sensor The plug of the CO2 sensor Reinsert the plug.
was removed during opera-
tion.
The CO2 sensor is not posi- Place the CO2 sensor on the
tioned on the CO2 cuvette. CO2 cuvette.
The CO2 sensor is faulty. Replace the faulty CO2 sen-
sor.
!!! 228 Check flow sensor, ventila- The flow sensor is not Insert the flow sensor prop-
tion impaired inserted properly into the erly.
rubber lip of the expiratory
valve.
!! 140 Check flow sensor, ventila- Ventilation modes which Pressure meas. failed, vent.
tion impaired require a flow sensor cannot impaired
be used. The device applies Activate the flow monitoring.
back-up ventilation. Switch to a ventilation mode
which does not require a flow
sensor.
Calibrate the flow sensor.
Replace it if necessary.

Troubleshooting

!!! 229 Check neonatal flow sen- The neonatal flow sensor is Ensure that the neonatal flow
sor not connected. sensor and the sensor cable
are connected properly.
!!! 140 Check neonatal flow sen- The neonatal flow sensor is Ensure that the neonatal flow
sor not installed in the breathing sensor is installed properly.
circuit. Replace the neonatal flow
sensor if necessary.
!! 119 Check neonatal flow sen- The neonatal flow sensor is Ensure that the neonatal flow
sor not connected. sensor and the sensor cable
are connected properly.
! 140 Check neonatal flow sen- The neonatal flow sensor is Ensure that the neonatal flow
sor not installed in the breathing sensor is installed properly.
circuit. Replace the neonatal flow
sensor if necessary.
!! 252 Check ventilation settings Due to data loss, the device Check all ventilation settings
is using previous settings. and adjust them if necessary.
To dismiss the message,
rotary knob.
A power interruption The device may use default
occurred while ventilation settings. Check the ventila-
settings or alarm limits were tion settings and the alarm
being adjusted. limits. To dismiss the mes-
sage, touch the "Alarm reset"
button and confirm with the
rotary knob.
A loss of data occurred. The device may use default
settings. Check the ventila-
tion settings and the alarm
limits. To dismiss the mes-
rotary knob.
! 120 CO2 calibration in progress The calibration of the CO2 During calibration, the CO2
sensor has been started by measurements become
the user and is now in prog- invalid. Wait for the calibra-
ress. tion to finish.
!! 144 CO2 cuvette soiled The windows of the CO2 Use a clean CO2 cuvette and
cuvette or of the CO2 sensor a clean CO2 sensor.
are soiled, e.g., with deposits
from nebulization.

Troubleshooting

!! 145 CO2 measurement failed The CO2 sensor is faulty. Replace the faulty CO2 sen-
sor.
The CO2 measurement is not Use external CO2 monitoring
accurate. and deactivate the inte-
grated CO2 monitoring. Con-
tact specialized service
personnel.
!! 145 CO2 measurement inaccu- The CO2 sensor is faulty. Replace the faulty CO2 sen-
rate or failed sor.
The CO2 measurement is not Use external CO2 monitoring
accurate. and deactivate the inte-
grated CO2 monitoring. Con-
tact specialized service
personnel.
!! 142 CO2 zero calibration The zero point of the CO2 Perform zero calibration.
required sensor is not within the toler-
ance range.
The windows of the CO2 Use a clean CO2 cuvette and
cuvette or of the CO2 sensor a clean CO2 sensor.
are soiled, e.g., with deposits
from nebulization.
! 100 Consider battery test The interval for the battery Perform the battery test.
test has been exceeded.
! 100 Continuous nebulization Continuous nebulization was To end continuous nebuliza-
active activated by the user. tion, press the "Cancel" but-
ton if necessary.
!! 252 Data loss Stored data have been lost. To continue ventilation with
this device, closely monitor
the functional integrity. Con-
sonnel.
rotary knob.
!!! 253 Device failure Due to missing measure- Disconnect the patient from
ments, ventilation is no lon- the device and continue ven-
ger possible. tilation without delay using
another ventilator. Contact
nel.
!!! 253 Device failure (01) A failure of the internal safety Disconnect the patient from
system was detected. the device and continue ven-
tilation without delay using
nel.

Troubleshooting

!!! 253 Device failure (02) A failure of the internal safety Disconnect the patient from
system was detected. the device and continue ven-
another ventilator. Switch off
the device. Contact special-
!!! 253 Device failure (05) The gas supply system is Disconnect the patient from
faulty. the device and continue ven-
nel.
nel.
nel.
!!! 253 Device failure (08) A test alarm was triggered Contact specialized service
during service. personnel.
!! 100 Device failure (09) No mass storage device To dismiss the message,
found. touch the "Alarm reset" but-
rotary knob. Contact special-
!!! 253 Device failure (10) A failure was detected by the Disconnect the patient from
safety software system. the device and continue ven-
nel.
!!! 253 Device failure (11) A fault was detected during Disconnect the patient from
the start-up phase. the device and continue ven-
nel.
!!! 253 Device failure (12) A system failure was Disconnect the patient from
detected. the device and continue ven-
nel.

Troubleshooting

!! 90 Device failure (13) The broken wire detection of Ventilation is not affected.
the flow sensor failed. Contact specialized service
personnel.
!!! 253 Device failure (14) An internal failure of the dis- Disconnect the patient from
play unit occurred. the device and continue ven-
!!! 253 Device failure (15) The system detected a prob- Disconnect the patient from
lem with the internal storage. the device and continue ven-
nel.
!!! 200 Device temperature high The internal device tempera- Disconnect the patient from
ture is too high. the device and continue ven-
!! 141 Device temperature mea- The internal measurement of To continue ventilation with
surement failed the breathing gas tempera- this device, use external
ture failed. In the event of a breathing gas temperature
too high breathing gas tem- monitoring. Contact special-
perature, no alarm will be ized service personnel.
triggered.
The internal temperature To continue ventilation with
measurement failed. In the this device, closely monitor
event of a too high device the functional integrity. Con-
temperature, no alarm will be tact specialized service per-
triggered. sonnel.
!!! 200 Disconnection detected Leakage or disconnection Ensure that the breathing cir-
! 120 Display and ventilation unit There is a mismatch Ventilation is not affected.
mismatch between the display and the Connect the proper display to
ventilation unit. the ventilation unit.
! 100 Display unit restarted An internal communication Check all ventilation settings
error caused the display unit and adjust them if necessary.
to restart. To dismiss the message,
rotary knob.

Troubleshooting

!!! 138 etCO2 high The upper alarm limit for the Check the patient's condition.
end-tidal CO2 concentration Check the ventilation set-
has been exceeded. tings. Adjust the alarm limit if
necessary. Perform CO2 zero
calibration if necessary.
Ensure that the cuvette win-
dows are not soiled.
!!! 138 etCO2 low The lower alarm limit for the Check the patient's condition.
end-tidal CO2 concentration Check the ventilation set-
has been exceeded. tings. Adjust the alarm limit if
necessary. Perform CO2 zero
calibration if necessary.
Ensure that the cuvette win-
dows are not soiled.
! 150 Expiration hold interrupted The "Expiration hold" button Release the "Expiration hold"
was pressed too long. button.
!!! 227 Expiratory flow measure- The flow measurement Ventilation is affected. To
ment failed failed. continue ventilation with this
device, use external flow
monitoring and deactivate the
integrated flow monitoring.
personnel.
There is water in the flow Dry the flow sensor.
sensor.
!!! 105 Expiratory valve incompati- The connected expiratory Replace the expiratory valve.
ble valve is incompatible.
!!! 130 FiO2 high The O2 sensor is not cali- Calibrate the O2 sensor.
brated.
The gas mixer is faulty. Contact specialized service
personnel.
!!! 130 FiO2 low The O2 sensor is not cali- Calibrate the O2 sensor.
brated.
The gas mixer is faulty. Contact specialized service
personnel.
If the gas supply unit GS500 Use compresser air from the
is used, the "FiO2 low" alarm central gas supply system
may occur in case of instead of the gas supply unit
FiO2 > 95 %. GS500.
Select a constant flow of at
least 5 L/min.

Troubleshooting

!! 100 Flow measurement inaccu- Previous nebulization may Calibrate the flow sensor.
rate have soiled the heated wires Replace it if necessary.
of the flow sensor.
There is water in the flow Drain the water trap of the
sensor. breathing circuit. Dry the flow
sensor.
The flow measurement is not To continue ventilation with
reliable. The measured expi- this device, use external flow
ratory minute volume monitoring and deactivate the
exceeds the minute volume integrated flow monitoring.
delivered by the device. This may impair the quality of
ventilation. Contact special-
!!! 110 GS500 communication The communication link to To dismiss the message,
failed the gas supply unit GS500 touch the "Alarm reset" but-
was lost. ton and confirm with the
! 110 GS500 communication The communication link to To dismiss the message,
failed the gas supply unit GS500 touch the "Alarm reset" but-
was lost. ton and confirm with the
!!! 100 GS500 failed The Air supply is insufficient Ensure that the gas supply
to deliver the required flow unit GS500 is connected
and pressure. The gas sup- properly. If the condition per-
ply system is supplied with sists, contact specialized ser-
O2 only. Ventilation continues vice personnel.
with O2 only.
!!! 110 GS500 internal failure The gas supply unit GS500 Shut down the ventilator.
failed. Switch off the main switch to
disconnect the ventilator from
the power supply. Switch on
the main switch and restart
the ventilator. If the condition
persists, contact specialized
service personnel.
!! 110 GS500 internal failure The gas supply unit GS500 To continue ventilation with
failed. this device, closely monitor
sonnel.
!!! 110 GS500 temperature too The temperature of the gas Shut down the ventilator.
high supply unit GS500 is too Switch off the main switch.
high. Contact specialized service
personnel.

Troubleshooting

! 20 Import failed, check set- The import of the configura- Check all settings and adjust
tings tion data failed. them if necessary. To dismiss
the message, touch the
"Alarm reset" button and con-
firm with the rotary knob.
! 20 Import successful, check The import of the configura- Check all settings and adjust
settings tion data was successful. them if necessary. To dismiss
! 150 Inspiration hold interrupted The "Manual insp./inspira- Release the "Manual
tion hold" button was insp./inspiration hold" button.
pressed too long.
!! 210 Internal battery activated The power supply unit Charge the power supply unit
PS500 is depleted. The PS500 as soon as possible.
The power supply from the
device is supplied with power
from the internal battery. internal battery is limited.
rotary knob.
!! 120 Internal power supply fail- A technical fault was To continue ventilation with
ure detected. this device, closely monitor
sonnel.
rotary knob.
! 140 Leakage The measured relative leak- Ensure that there is no leak-
age exceeds 55 %. It is only age in the breathing circuit.
monitored for intubated Ensure that the tube is con-
patients. nected properly.
!! 40 Low-flow PV loop maneu- An internal fault occurred Do not perform the low-flow
ver failed during the low-flow PV loop PV loop maneuver until the
maneuver. device is checked. Contact
nel.
! 140 Low-flow PV loop maneu- The low-flow PV loop Perform the low-flow PV loop
ver overused maneuver has been per- maneuver less frequently.
formed more than 5 times
within one hour.
! 8 MEDIBUS communication The MEDIBUS communica- Ventilation is not affected.
failed tion failed. Check the MEDIBUS con-
nection. Check the MEDIBUS
settings.

Troubleshooting

!!! 160 Minute volume high The upper alarm limit for the Check the patient's condition.
minute volume has been Check the ventilation set-
exceeded. tings.
Adjust the alarm limit if nec-
essary.
There is water in the flow Drain the water trap of the
sensor. breathing circuit. Dry the flow
sensor.
!!! 160 Minute volume low The lower alarm limit for the Check the patient's condition.
minute volume has been Check the ventilation set-
exceeded. tings.
essary.
An obstruction occurred. Check the patient's condition.
Check the tube or mask.
Leakage or disconnection Ensure that the breathing cir-
A device failure occurred. Disconnect the patient from
the device and continue ven-
nel.

Troubleshooting

!! 110 Nebulization canceled The inspiratory flow is insuffi- Increase the inspiratory flow
cient for nebulization. to more than 9 L/min for neo-
nates and pediatric patients
or to more than 16 L/min for
adults. To dismiss the mes-
rotary knob.
The Air and O2 supplies are Check the connections to Air
insufficient to deliver the and O2 supply. Ensure that
required flow and pressure the supply pressures corre-
for nebulization. Nebuliza- spond with the specified
tion was canceled. operating data. To dismiss
The Air supply is insufficient Check the connection to the
to deliver the required flow Air supply. Ensure that the
and pressure for nebuliza- supply pressure corresponds
tion. with the specified operating
data. To dismiss the mes-
rotary knob.
The O2 supply is insufficient Check the connection to the
to deliver the required flow O2 supply. Ensure that the
tion. with the specified operating
data. To dismiss the mes-
rotary knob.
The internal supply pres- To dismiss the message,
sures are too high. The Air touch the "Alarm reset" but-
and O2 supplies are not ton and confirm with the
appropriate to deliver the rotary knob. Contact special-
required flow and pressure ized service personnel.
for nebulization. Nebuliza-
tion was canceled.
The neonatal flow monitor- Deactivate the neonatal flow
ing is active. Nebulization is monitoring and remove the
only possible if the neonatal neonatal flow sensor from the
flow monitoring is deacti- breathing circuit. To dismiss
vated and the neonatal flow the message, touch the
sensor is removed from the "Alarm reset" button and con-
breathing circuit. firm with the rotary knob.

Troubleshooting

The expiratory flow monitor- Check the expiratory flow
ing failed. Nebulization is sensor and ensure that the
only possible if the expiratoryexpiratory flow monitoring is
flow monitoring is activated. activated. To dismiss the
message, touch the "Alarm
reset" button and confirm
with the rotary knob.
Nebulization is not possible Select an appropriate ventila-
in the selected ventilation tion mode. To dismiss the
mode. Nebulization is only message, touch the "Alarm
possible in volumecontrolled reset" button and confirm
ventilation modes with Auto- with the rotary knob.
Flow or in pressure-con-
trolled ventilation modes.
Nebulization is not possible Select an appropriate ventila-
in the selected ventilation tion mode. To dismiss the
mode. Nebulization is only message, touch the "Alarm
possible in pressurecon- reset" button and confirm
trolled ventilation modes with the rotary knob.
without volume guarantee.
! 100 Nebulization finished Nebulization is completed or To dismiss the message,
was canceled. touch the "Alarm reset" but-
rotary knob. If necessary,
install the neonatal flow sen-
sor and activate the neonatal
flow monitoring.
!! 100 Nebulizer uses Air only The O2 supply is insufficient Check the connection to the
tion. The nebulizer is sup- with the specified operating
plied with Air only. The set data. To downgrade the
value for FiO2 is not reached. alarm, touch the "Alarm
!! 100 Nebulizer uses O2 only The Air supply is insufficient Check the connection to the
tion. The nebulizer is sup- with the specified operating
plied with O2 only. The set data. To downgrade the
value for FiO2 is not reached. alarm, touch the "Alarm

Troubleshooting

!!! 228 Neonatal flow measure- The neonatal flow measure- Check the ventilation set-
ment failed ment failed. tings. Change the ventilation
mode if necessary. Use
external flow monitoring and
neonatal flow monitoring.
personnel.
Patient category "Pediatric
patient": Deactivate the inte-
grated neonatal flow monitor-
ing and use expiratory flow
monitoring. Contact special-
!! 115 Neonatal flow measure- The neonatal flow measure- Ventilation continues using
ment failed ment failed. the expiratory flow sensor.
Deactivate the integrated
personnel.
! 100 Neonatal flow sensor The neonatal flow sensor If the neonatal flow sensor in
exchanged? was reconnected. use has been calibrated
before, dismiss the message.
If the neonatal flow sensor
was replaced, calibrate the
sensor.
The neonatal flow monitor- If the neonatal flow sensor in
ing was temporarily deacti- use has been calibrated
vated. before, dismiss the message.
If the neonatal flow sensor
was replaced, calibrate the
sensor.
!!! 228 Neonatal flow sensor faulty The cable of the neonatal Replace the cable of the neo-
flow sensor is faulty. natal flow sensor.
The neonatal flow measure- Check the ventilation set-
ment failed. tings. Change the ventilation
mode if necessary. Use
external flow monitoring and
personnel.

Troubleshooting

!! 115 Neonatal flow sensor faulty The cable of the neonatal Replace the cable of the neo-
flow sensor is faulty. natal flow sensor.
The neonatal flow measure- Ventilation continues using
ment failed. the expiratory flow sensor.
Deactivate the integrated
personnel.
!! 115 Neonatal flow sensor There is water or secretion in Replace the neonatal flow
soiled the neonatal flow sensor. sensor or the sensor insert.
!!! 250 No Air supply The Air supply is insufficient Check the connection to the
and pressure. The gas sup- supply pressure corresponds
ply system is supplied with with the specified operating
O2 only. Ventilation continues data. Adjust the ventilation
with O2 only. settings if necessary. If the
condition persists, disconnect
Air supply.
!! 100 No Air supply The Air supply is insufficient. Check the connection to the
Air supply is not required if Air supply. Ensure that the
FiO2 = 100 Vol%. supply pressure corresponds
with the specified operating
data. Adjust the ventilation
settings if necessary. If the
Air supply.
rotary knob.
!!! 190 No inspiratory flow The device applies only a Check the patient's condition.
detected small volume with each man- Check the tube or mask.
datory breath. The breathing
circuit, tube, or mask may be
blocked.
The patient is breathing Check the patient's condition.
against the mandatory Check the ventilation set-
breaths in pressure-con- tings.
trolled ventilation.

Troubleshooting

!!! 250 No O2 supply The O2 supply is insufficient Check the connection to the
and pressure. The gas sup- supply pressure corresponds
ply system is supplied with with the specified operating
Air only. Ventilation continues data. Adjust the ventilation
with Air only. settings if necessary. If the
the device from the O2 supply
O2 supply.
!! 100 No O2 supply The O2 supply is insufficient. Check the connection to the
O2 supply is not required if O2 supply. Ensure that the
FiO2 = 21 Vol%. supply pressure corresponds
with the specified operating
data. Adjust the ventilation
settings if necessary. If the
the device from the O2 supply
O2 supply.
rotary knob.
!! 132 O2 measurement failed The O2 measurement failed. To calibrate the O2 sensor,
perform the system test. Ven-
tilation can be continued
even if the alarm does not
disappear. Use external O2
monitoring and deactivate the
integrated O2 monitoring.
personnel.
!! 110 O2/Air supply pressures The difference between the Check the connections to Air
differ too much supply pressures for O2 and and O2 supply. Ensure that
Air may lead to an incorrect the supply pressures corre-
O2 concentration during neb- spond with the specified
ulization. operating data. To dismiss
!! 100 On/off key failed The on/off key has been Stop pressing the on/off key.
pressed for more than The on/off key is not func-
10 seconds. tional as long as the condition
is present. If the condition
persists, contact specialized
service personnel.

Troubleshooting

!! 40 Oxygenation failed An internal fault occurred Do not perform the suction
during oxygenation. maneuver until the device is
checked. Contact special-
Do not perform the suction
maneuver until the device is
! 140 Oxygenation overused The suction maneuver has Perform the suction maneu-
been performed more than ver less frequently.
5 times within one hour.
!!! 140 PEEP high The expiratory valve or the Check the breathing circuit
breathing circuit is and the expiratory valve.
obstructed. Check for condensate.
The expiratory resistance is Check the bacteria filter.
increased. Replace it if necessary.
Check the respiratory rate
and the patient's condition.
nel.
!! 140 PEEP high The expiratory valve or the Check the breathing circuit
A device failure occurred. To continue ventilation with
sonnel.
rotary knob.
!!! 140 PEEP low The measured value for Ensure that the breathing cir-
PEEP is 5 mbar (5 cmH2O) cuit is connected tightly.
less than the set value. Ensure that the expiratory

Troubleshooting

!! 210 Perform system and The system test and the Perform the tests. To dismiss
breathing circuit test breathing circuit test must be the message, touch the
performed before operation. "Alarm reset" button and con-
!!! 140 Plow high The expiratory valve or the Check the breathing circuit
nel.
Plow is not monitored Deactivate AutoRelease or
because AutoRelease is acti- set Tlow to a value greater
vated or Tlow is set to a than 1 second.
value below 1 second.
!!! 140 Plow low The measured value for Plow Ensure that the breathing cir-
is 5 mbar (5 cmH2O) less cuit is connected tightly.
than the set value. Ensure that the expiratory
! 140 Pressure limited The pressure of a breath is Check the patient's condition.
limited by the set "Paw high" Check the ventilation set-
alarm limit or by Pmax. tings.
Adjust the "Paw high" alarm
limit or Pmax.
! 140 Pressure limited, tidal vol. The pressure of a breath is Check the patient's condition.
not reached limited by the set "Paw high" Check the ventilation set-
alarm limit or by Pmax. The tings.
set tidal volume could not be Adjust the "Paw high" alarm
delivered. limit or Pmax.
!! 140 Pressure meas. failed, Ventilation modes which To continue ventilation with
vent. impaired require a pressure sensor this device, use external
cannot be used. The device pressure monitoring. Contact
applies back-up ventilation. specialized service person-
nel.
!!! 238 Pressure measurement The pressure measurement Disconnect the patient from
failed failed. the device and continue ven-
nel.

Troubleshooting

!! 140 Pressure measurement The pressure measurement The measurement accuracy
impaired failed. of measured values based on
pressure may be impaired.
To continue ventilation with
sonnel.
!! 100 Pressure measurement Previous nebulization may Calibrate the flow sensor.
inaccurate have soiled the heated wires Replace it if necessary.
of the flow sensor.
There is fluid in the expira- Replace the expiratory valve.
tory valve. Clean and dry the used
valve.
The breathing circuit test has Perform or repeat the breath-
not been performed. ing circuit test.
The inspiratory or expiratory Check the breathing circuit.
hose is obstructed.
The pressure measurement To continue ventilation with
failed. this device, closely monitor
sonnel.
!!! 150 Respiratory rate high The patient is breathing at a Check the patient's condition.
high respiratory rate. Check the ventilation settings
and the spontaneous respira-
tory rate.
essary.
The upper alarm limit for the Adjust the set value or the
respiratory rate has been upper alarm limit for the
exceeded. respiratory rate.
Water in the breathing circuit Drain the water trap of the
is causing auto-triggering. breathing circuit. Dry the flow
sensor.
!! 50 Rotary knob stuck or The rotary knob is faulty or If the rotary knob is still
pressed too long has been pressed for more pressed, release it. Other-
than 60 seconds without wise press and turn the rotary
turning. knob a few times. If the con-
dition persists, settings can
no longer be adjusted. Dis-
connect the patient from the
device and continue ventila-
tion without delay using
nel.

Troubleshooting

!! 50 Rotary knob used too often The rotary knob is faulty or Press and turn the rotary
was pressed more than knob a few times. If the con-
5 times per second. dition persists, settings can
no longer be adjusted. Dis-
connect the patient from the
device and continue ventila-
tion without delay using
nel.
!! 120 Secondary acoustic alarm The secondary acoustic To continue ventilation with
system failed alarm system failed. In the this device, closely monitor
event of a mains power sup- the functional integrity. Con-
ply failure and a discharged tact specialized service per-
battery, there is no power sonnel.
supply failure alarm. If the To downgrade the alarm,
primary acoustic alarm sys- touch the "Alarm reset" but-
tem failed as well, there are ton and confirm with the
no acoustic alarm signals at rotary knob.
all.
! 200 Setting change not con- One or more settings have If necessary, change these
firmed been changed but not con- settings and confirm with the
firmed. rotary knob.
!! 140 Setting not changed The attempt to confirm a Ventilation is not affected.
safety-related setting failed. Check all settings and adjust
The setting was not them if necessary. To dismiss
changed. the message, touch the
!! 255 Simulation mode: Not for The device is in simulation Disconnect the patient from
clinical use mode. the device and continue ven-
!!! 255 Standby mode activated The device is in standby To acknowledge the standby
mode. mode, touch the "Alarm
!! 40 Suction maneuver failed An internal fault occurred Do not perform the suction
during the suction maneuver. maneuver until the device is
! 140 Suction maneuver over- The suction maneuver has Perform the suction maneu-
used been performed more than ver less frequently.
5 times within one hour.

Troubleshooting

!! 240 System test failed A safety-related fault was Disconnect the patient from
detected during the system the device and continue ven-
test. tilation without delay using
valve is correctly assembled
and positioned. Replace the
expiratory valve if necessary.
Do not use this device for
ventilation until the system
test is repeated successfully.
! 100 System test incomplete The system test was not Perform the tests. To dismiss
completely performed or only the message, touch the
partially successful. "Alarm reset" button and con-
!! 166 Tidal volume high The upper alarm limit for the Check the patient's condition.
tidal volume has been Check the ventilation set-
exceeded for 3 consecutive tings.
breaths of the same type Adjust the alarm limit if nec-
(either spontaneous or man- essary.
datory).
Leakage or disconnection Ensure that the breathing cir-
!! 166 Tidal volume high (mini- The patient is breathing Check the patient's condition.
mum pressure) spontaneously with a tidal Check the ventilation set-
volume higher than the set tings.
value.
The tidal volume delivered Check the patient's condition.
with minimum airway pres- Check the ventilation set-
sure is higher than the set tings.
value due to leakage or Ensure that there is no leak-
increased compliance. age in the breathing circuit.
!! 166 Tidal volume low The lower alarm limit for the Check the patient's condition.
tidal volume has been Check the ventilation set-
exceeded for 5 consecutive tings.
breaths (adults and pediatric Adjust the alarm limit if nec-
patients) or for 8 consecutive essary.
breaths (neonates) of the
same type (either sponta-
neous or mandatory).
! 140 Tidal volume not reached The set tidal volume could Check the patient's condition.
not be delivered in volume- Check the ventilation set-
controlled ventilation. tings.

Troubleshooting

! 140 Tidal volume not reached, The set tidal volume could Ensure that there is no leak-
leakage not be reached. The flow age in the breathing circuit.
delivery is stopped. Ensure that the tube or mask
! 140 Tidal volume not reached, The pressure limitation Pmax Check the patient's condition.
Pmax active is active. Check the ventilation set-
tings.
If ventilation with limited pres-
sure is acceptable, touch the
firm with the rotary knob to
dismiss the message.
! 200 Ventilation mode change The ventilation mode has If necessary, change the ven-
not confirmed been changed but not con- tilation mode and confirm
firmed. with the rotary knob.
!! 255 Ventilation unit restarted An internal communication Check all ventilation settings
error caused the ventilation and adjust them if necessary.
unit to restart. To dismiss the message,
rotary knob.

Service
14 Service
Intervals
Wear and material fatigue of the components may lead to device failure and
malfunctions. Personal injury and property damage may occur as a consequence.
► Perform the service activities at the specified intervals.
Proper service
Personal injury and property damage may occur if the service activities are not
performed properly.
► Service activities must be performed by those user groups that are assigned to
the particular measure.
Proper reprocessing
The product may be contaminated with infectious agents.
► Before service is performed and before the product is sent back for repair,
reprocess the product. Perform reprocessing according to the reprocessing
instructions delivered with the product.
Housing
Under the housing, there are live electrical components, which may cause an
electric shock.
► The housing may only be opened by those user groups that are assigned to that
particular activity.
Room air filter

If the room air filter is not replaced at regular intervals, the functional integrity of the
device may be impaired.
► Replace the room air filter at the intervals specified.
14.2 Prerequisites
Only perform service activities when no patient is connected to the device.

Service
14.3 Definition of service terminology

Concept Definition
Service All measures (inspection, maintenance, repair) intended to
maintain or restore the functional integrity of a product
Inspection Measures intended to determine and assess the current state
of a product
Maintenance Regular specified measures intended to maintain the functional
integrity of a product
Repair Measures intended to restore the functional integrity of a prod-
uct after a failure
A service contract with Dräger is recommended.
14.4 Inspection
Measure Interval User group
Inspection and safety check Every Service personnel
12 months
14.4.1 Safety checks

Safety checks are not a substitute for maintenance, which includes the preventive
replacement of wearing parts as specified by the manufacturer.
Performing the safety checks

1. Check that the respective instructions for use are present.
2. Perform a functional test of the following functions according to the instructions
for use:
– System test and breathing circuit test
– Airway pressure measurement
– Flow measurement
– Internal battery and PS500
3. Check that the product is in good condition:
– All labels are complete and legible
– There is no visible damage
– Fuses that are accessible from the outside are in compliance with the
specified values.
4. Observe the instructions for use and check that all components and accessories
needed to use the product are present.
5. Check the electrical safety in accordance with the IEC 62353 standard.
6. Check the following safety equipment:
– Correct functioning of the emergency expiratory valve: Pressure rise of 0.7 to
3.2 mbar (or hPa or cmH2O) at a flow of 4.5 to 5.5 L/min
– Correct functioning of the non-return valve in the expiratory valve
– Correct functioning of the emergency breathing valve: Maximum pressure
drop of 4 mbar (or hPa or cmH2O) at a suction flow of 60 to 65 L/min
– Correct functioning of the alarm generator

Service
– Correct functioning of the non-return valves in the gas inlet for O2 and Air
14.4.2 Remote Service

The device supports the following Remote Service functionalities:
– Help Ticket
– Remote Device Check
Further information about the Remote Service function is available from Dräger.
14.5 Maintenance
Component Interval Measure User group
Room air filter Every 4 weeks Cleaning User
Replace if needed (see User
"Replacing the room air fil-
ter", page 232)
Every 12 months Replace (see "Replacing User
the room air filter",
page 232)
Diaphragm of the expi- Every 12 months Replace (see "Replacing User
ratory valve the diaphragm of the expi-
ratory valve", page 232)
Expiratory valve Every 2 years Replace (see "Replacing User
the expiratory valve",
page 233)
GS500: Breathing gas Every 12 months Replace (see "Replacing Service personnel
filter in the blower unit the breathing gas filter of
the blower unit", page 233)
GS500: Filter cloth Every 12 months Replace (see "Replacing Service personnel
the filter cloth", page 234)
Batteries Every 3 months Check the capacity with Service personnel
the battery test (see "Bat-
tery test", page 235)
Replace if needed Specialized service per-
sonnel
Every 2 years or Replace Specialized service per-
depending on the sonnel
results of the battery
test
Air filter (in the Air gas Every 2 years Replace Specialized service per-
inlet) sonnel
O2 filter (in the O2 gas Every 6 years Replace Specialized service per-
inlet) sonnel

Service
14.6 Repair
Repairs may be performed only by specialized service personnel.
It is recommended that only original parts from Dräger are used and that the parts
are replaced by Dräger.
14.7 Replacing the room air filter

Procedure:
1. Unscrew the screw (1) on the cover of the room air filter.
2 1
39447
2. Open the cover (2).
3. Remove the filter from the mount.
4. Fit a new filter or clean the old filter in warm soapy water and dry thoroughly.
5. Insert the filter into the mount without creasing.
6. Close the cover (2) and retighten the screw (1).
7. Dispose of the used filter with domestic waste.
14.8 Replacing the diaphragm of the expiratory valve

Prerequisites:
– The expiratory valve is removed from the ventilation unit (see "Removing the
expiratory valve or neonatal expiratory valve from the ventilator", page 154).
Procedure:
1. Remove the diaphragm (1).
39206
1 1
2. Dispose of the used diaphragm with domestic waste.

Service
3. Attach the new diaphragm onto the edge of the expiratory valve housing. Make
sure that the diaphragm is fitted properly.
4. Fit the expiratory valve (see "Fitting the expiratory valve", page 75).
14.9 Replacing the expiratory valve

1. Remove the expiratory valve from the ventilation unit (see "Removing the
expiratory valve or neonatal expiratory valve from the ventilator", page 154).
2. Dispose of the expiratory valve in accordance with local waste disposal
regulations.
3. Assemble the new expiratory valve and fit it to the ventilation unit (see
"Preparing the expiratory valve", page 74).
14.10 Maintenance of the gas supply unit GS500

14.10.1 Replacing the breathing gas filter of the blower unit
The breathing gas filter is located behind the left-hand side panel of the GS500 gas
supply unit.
1. Loosen the screws (1) on the rear of the device sufficiently for the side panel to
be removed.
39445
1
2
3
2. Remove the side panel (2). Ensure that the filter cloth attached to the side
section is not loosened.
3. Take hold of the breathing gas filter (3) by the handle and withdraw it from the
GS500 gas supply unit. Dispose of the used breathing gas filter in accordance
with local waste disposal regulations.
4. Insert the new breathing gas filter (3). Insert it into the GS500 gas supply unit
until it reaches the end position.
5. Fit the side panel (2) and tighten the screws (1).

Service
14.10.2 Replacing the filter cloth

The filter cloth is fastened to the inside of the left-hand side panel of the GS500 gas
supply unit.
1. Loosen the screws (1) on the rear of the device sufficiently for the side panel to
be removed.
39446
3
1
1
2
2. Remove the side panel (2).

3. Remove the filter cloth (3) and dispose of it in accordance with local waste
disposal regulations.
4. Fit the new filter cloth (3) with its side to the boundary. Carefully press the filter
cloth onto the pointed retaining elements. Check that the filter cloth is secured.
5. Fit the side panel (2) and tighten the screws (1).
14.11 Battery maintenance

14.11.1 Information on battery maintenance
To achieve the maximum life span of the batteries, the following actions are
required:
Maintenance:
● Observe the maintenance intervals. Batteries are wearing parts. The
replacement intervals depend on the utilization.
During operation:
● Observe the ambient conditions (see "Technical data", page 240).
● After battery operation, connect the device to the mains power supply. Fully
charge the batteries. Observe the required charging time.
● Avoid shocks and vibrations.
● Use the battery tests to check the capacity of the batteries on a regular basis.
The batteries must have sufficient capacity. Replace the batteries if necessary.

Service
During storage:
● Storage at an increased ambient temperature reduces the life span of the
batteries. The storage duration must not be exceeded. Observe the following
information: "Technical data", page 240.
● Always fully charge the batteries.
● After 5 days at the latest, connect the device to the mains power supply. Fully
charge the batteries. Observe the required charging time.
If recharging is not possible after 5 days at the latest, do the following:
● Turn off the main switch and then unplug the power plug.
✓ The device is then in the energy-saving mode, and the discharge is reduced
to the self-discharge of the batteries.
Before using on the patient:
● Check that the capacity of the batteries is sufficient. The batteries may be deeply
discharged or faulty as a result of excessively long storage.
14.11.2 Battery test

To determine the current state of the batteries, a battery test is required at regular
intervals. The battery test determines the approximate operating time.
The battery test consists of a charge-discharge-charge cycle. After the batteries
have been fully charged, the device is operated in test mode with power supply
from the batteries. The determined operating time is the approximate operating time
to be expected in the next period of battery operation with typical ventilation without
the GS500 gas supply unit.
Dräger recommends the following test intervals:
Internal battery (NiMH) Every 3 months

PS500 power supply unit (VRLA) Every 3 months
Operating time
The following table shows the expected typical operating time due to the ageing of a
new battery without operation with an activated gas supply unit GS500.
If the batteries do not correspond to the approximate operating time listed,
replacement of the batteries is recommended.
Age of the bat- Operating time if completely charged

tery Internal battery (NiMH) PS500 (VRLA)
3 months 29 min 225 min

Service
The operating time may be reduced due to the utilization of the battery. The data
are approximate values and cannot be regarded as guaranteed for every battery,
Replace the batteries if the operating time falls below the minimum value (see
"Battery ageing", page 318) or after 24 months.
The figures are based on the assumed following average battery usage:
– Applies for PS500 without use of the GS500:
400 battery discharges of up to 90 minutes per discharge during device
operation with the PS500 over a time period of 2 years.
This corresponds to a monthly usage of approx. 16 discharges of up to
90 minutes per discharge.
This corresponds to a weekly usage of approx. 4 discharges of up to
– Applies to the internal battery without using the GS500:
400 battery discharges of up to 15 minutes per discharge during device
operation with the internal battery over a time period of 2 years.
This corresponds to a monthly usage of approx. 16 discharges of up to
This corresponds to a weekly usage of approx. 4 discharges of up to
The battery lifespan is shortened if the battery is discharged more frequently or for
longer than 90 minutes (PS500) or 15 minutes (internal battery). This can lead to a
deviation from the maximum operating time specified in the table above.
A discharge is defined as the usage and subsequent charging of the battery.
Preparing the battery test

The battery test can be performed independently of the operating status of the
device. If a patient is being ventilated, note the charge status indicator.
Prerequisites for the battery test while a patient is being ventilated:

– The device is connected to the central gas supply system.
– The device is connected to the mains power supply.
Prerequisites for the battery test when a test lung is connected:
– The device is connected to the central gas supply system.
– The device is connected to the mains power supply.
– The device is prepared and ready for use.
– The test lung is connected.

Service
– A ventilation pattern is set, e.g.:

– PC-AC ventilation mode
– FiO2 = 21 Vol%
– RR = 12/min
– Pinsp = 20 mbar (or hPa or cmH2O)
– PEEP = 5 mbar (or hPa or cmH2O)
– Ventilation is started.

1. Touch the System setup button in the main menu bar.
2. Touch the Battery tab (1).
3. Touch the Battery test tab (2).
1
40618
2
3
6 7
4 9
6 7 8
5 9
6 7
8
The following battery tests can be performed:

– Full test (3)
– PS500 (4)
– Internal battery (5)
The device displays the following in the relevant field (8):
– Date of the last battery test
– Determined operating time
Value determined in the battery test during typical ventilation without the gas
supply unit GS500 (see "Battery test", page 235).
– Next battery test due in xx days
– Battery replacement in xx months
– Current operating time
This value is indicated to the nearest 5 or 10 minutes depending on the battery
used and based on the present power consumption of the device.

Service
Starting the battery test

The battery test can only be started if the device is connected to the mains power
supply.
1. Touch the Start button (6).
✓ The respective battery test is started. The duration of the battery test is
decremented in hours and displayed in field (9). The result of the battery test is
displayed after completion.
If a battery test fails, the device will cancel the test.
Canceling the battery test

● Touch the Cancel button (7) and confirm.
✓ The appropriate battery test will be canceled.

Disposal
15 Disposal
Reprocessing the product
The product may be contaminated with infectious agents.
► Before disposal, reprocess the product. Perform reprocessing according to the
reprocessing instructions delivered with the product.
15.2 Disposing of the device

The disposal of electrical and electronic devices is subject to special guidelines.
This device must be disposed of in accordance with national regulations. In
countries of the European Union, Dräger will organize the return of the device.
Additional information is available at www.draeger.com (search term: WEEE).
15.3 Disposing of the packaging material

Dispose of the packaging material of the device and the accessories listed in the list
of accessories in accordance with the applicable laws and regulations.
15.4 Disposing of the batteries

The device contains batteries with toxic substances. This batteries must be
disposed of in accordance with national laws and regulations.
15.5 Disposing of the flow sensors

The flow sensors must be disposed of as infectious waste. Low-emission
combustion must be performed at over 800 °C (1472 °F).

Technical data
16 Technical data
16.1 Ambient conditions
During operation
Temperature 10 to 40 °C (50 to 104 °F)
Ambient pressure 700 to 1060 hPa
Altitude Up to 3000 m (9842 ft)
Relative humidity 10 to 90 % without condensate formation
During storage and transportation

Ambient pressure 500 to 1060 hPa
Relative humidity 5 to 95 %, without condensate formation
Temperature
Device without power supply unit PS500
For charging subsequent to storage
For storage up to 6 months –20 to <45 °C (–4 to <113 °F)
For storage up to 1 month –20 to <55 °C (–4 to <131 °F)
For storage up to 1 week –20 to 60 °C (–4 to 140 °F)
Device with power supply unit PS500
For charging subsequent to storage
For storage up to 6 months –15 to 25 °C (5 to 77 °F)
For storage up to 3 months –15 to 40 °C (5 to 104 °F)
Information on the batteries The technical specifications of the battery man-
ufacturer regarding the maximum storage life
refer to a relative humidity of 45 to 85 %. If it is
stored outside of these conditions, a battery
test must be performed before the device is
used. Completely charging the battery every 6
months at the latest is recommended. Several
charge cycles and discharge cycles may be
required as a battery test in order to completely
reactivate the electrochemical composition after
long term storage.
Depending on the accessories used, more
stringent ambient conditions may apply.
Observe the corresponding instructions for use.

Technical data
16.2 Set values

Accuracy The desired parameters can be set without loss
of accuracy using the therapy controls. The
controlled parameters pressure, flow, volume,
and O2 concentration can be applied only with
the accuracy of the associated measured val-
ues.
The accuracies indicated apply only under the
following conditions:
– The device is ready for operation, see the
chapter "Getting started".
– Any accessories being used are approved for
the device, see the list of accessories.
– In the step Breathing circuit test, the humidifi-
cation type is correctly selected.
The tolerances do not include the measurement
accuracy of external test equipment. This infor-
mation is available on request.
Respiratory rate RR
Adults 0.5 to 98 /min
Pediatric patients 0.5 to 150 /min
Neonates 0.5 to 150 /min
Inspiratory time Ti
Adults 0.11 to 10 s
Pediatric patients 0.1 to 10 s
Neonates 0.1 to 10 s
Maximum inspiratory time for supported Timax

breaths
Adults 0.1 to 4 s
Pediatric patients 0.1 to 4 s
Neonates 0.1 to 1.5 s
Tidal volume VT
Adults 100 to 3000 mL
Pediatric patients 20 to 300 mL
Neonates 2 to 100 mL
Tidal volume for pressure support VT

Apnea ventilation status On, off

Technical data
16.2 Set values (continued)

Status of the function Autom. return from apnea On, off
ventilation
Tidal volume for apnea ventilation VTapn

Respiratory rate during apnea ventilation RRapn

Adults 2 to 80 /min
Pediatric patients 2 to 150 /min
Neonates 2 to 150 /min
Inspiratory flow Flow

Adults 2 to 120 L/min
Pediatric patients 2 to 30 L/min
Maximum flow during non-invasive ventilation Flow max
of neonates 0 to 30 L/min
Inspiratory pressure Pinsp
1 to 95 mbar (or hPa or cmH2O)
Pressure limitation Pmax
O2 concentration FiO2
21 to 100 Vol%
T0...90 Test conditions in accordance with ISO 80601-
2-12:2011, Sec. 201.12.1.104
Time until the changed O2 concentration is Taking account of the airway-conducting acces-
available at the patient port sories with the greatest internal volume and
with flow monitoring switched on
Adults <36 s at a tidal volume of 500 mL
<50 s at a tidal volume of 150 mL
Pediatric patients At a tidal volume of 150 mL:
<25 s with neonatal flow monitoring
<45 s with expiratory flow monitoring
At a tidal volume of 30 mL:
<35 s with neonatal flow monitoring
<65 s with expiratory flow monitoring
Neonates <18 s
Positive end-expiratory pressure PEEP
The minimum applicable ventilation pressure is
limited by the expiratory resistance and the
base flow.
Trigger threshold Trigger
0.2 to 15 L/min

Technical data

Pressure support ΔPsupp
Pressure rise time Slope

Adults 0 to 2 s
Pediatric patients 0 to 2 s
Neonates 0 to 1.5 s
With a set value of 0 s, the actual pressure rise
time applied is greater than 0 s due to the pneu-
matic time response.
Inspiration termination criterion (in relation to Insp term
the peak inspiratory flow) 5 to 70 % Flowipeak
Airway Pressure Release Ventilation APRV

Inspiratory time Thigh
0.1 to 30 s
Expiratory time Tlow
0.05 to 30 s
Maximum duration of lower pressure level Tlow max
0.05 to 30 s
Upper pressure level Phigh
Lower pressure level Plow
The minimum applicable ventilation pressure is
limited by the expiratory resistance and the
base flow.
Expiration termination criterion (in relation to Exp term
the peak expiratory flow) 1 to 80 % Flowepeak
Automatic tube compensation ATC

Inner diameter of the tube Tube diameter
Endotracheal tube Endotrach.
Adults 5 to 12 mm (0.2 to 0.47 in)
Pediatric patients 2 to 8 mm (0.08 to 0.31 in)
Neonates 2 to 5 mm (0.08 to 0.2 in)
Tracheostomy tube Trach.
Adults 5 to 12 mm (0.2 to 0.47 in)
Pediatric patients 2.5 to 8 mm (0.1 to 0.31 in)
Degree of tube compensation Compens
0 to 100 %
Status of ATC during mandatory inspiration Inspiratory compensation (ATC)
On, off

Technical data

Status of ATC during expiratory phase Expiratory compensation (ATC)
On, off
Proportional Pressure Support PPS

Flow-based assistance Flow assist
Adults 0 to 30 mbar/L/s (or hPa/L/s or cmH2O/L/s)
Pediatric patients 0 to 100 mbar/L/s (or hPa/L/s or cmH2O/L/s)
Neonates 0 to 300 mbar/L/s (or hPa/L/s or cmH2O/L/s)
Volume-based assistance Vol assist
Adults 0 to 100 mbar/L (or hPa/L or cmH2O/L)
Corresponds to compliance compensation 10000 to 10 mL/mbar (or mL/hPa or
mL/cmH2O)
Pediatric patients 0 to 1000 mbar/L (or hPa/L or cmH2O/L)
Corresponds to compliance compensation 10000 to 1 mL/mbar (or mL/hPa or mL/cmH2O)
Neonates 0 to 4000 mbar/L (or hPa/L or cmH2O/L)
Corresponds to compliance compensation 1000 to 0.3 mL/mbar (or mL/hPa or mL/cmH2O)
O2 therapy
Constant flow Flow
2 to 50 L/min, BTPS
O2 concentration FiO2
21 to 100 Vol%
Variable PS
Status On, off
Pressure support variability 0 to 100 %
Maneuver settings
Initial pressure during low-flow PV loop maneu- Pstart
ver 0 to 50 mbar (or hPa or cmH2O)
Pressure limitation during low-flow PV loop Plimit
maneuver 1 to 80 mbar (or hPa or cmH2O)
Volume limitation during low-flow PV loop Vlimit
maneuver
Flow during low-flow PV loop maneuver Low flow
Adults 2 to 15 L/min
Pediatric patients 2 to 10 L/min
Pressure drop during the low-flow PV loop 1 to 6 mbar/s (or hPa/s or cmH2O/s)
maneuver after an inspiratory measurement
Additional intermittent PEEP for sighs ΔintPEEP

Technical data

Interval between sighs Interval sigh
20 s to 180 min
Number of respiratory cycles per sigh phase Cycles sigh
1 to 20 exhalations
Oxygenation for suction maneuver
Factor for neonates 1 to 2
Factor for pediatric patients 1 to 2
16.3 Performance characteristics

Control principle Time-cycled, volume-constant, pressure-con-
trolled
Length of intermittent PEEP 1 to 20 expiratory cycles
Medication nebulization For 5, 10, 15, 30 minutes, continuously (∞)
Endotracheal suction
Disconnection detected Automatic
Reconnection detected Automatic
Preoxygenation Max. 3 minutes
Active suction phase Max. 2 minutes
Postoxygenation Max. 2 minutes
Supply system for spontaneous breathing Adaptive CPAP system with high initial flow
and Psupp
Inspiratory flow Max. 180 L/min, BTPS
Inspiratory flow for pediatric patients (if proximal Max. 60 L/min, BTPS
flow measurement is used, the measuring
range is restricted, see section on displayed
flow values)
Inspiratory flow for neonates Max. 30 L/min, BTPS + base flow
Base flow, neonates 6 L/min
Base flow during active pneumatic nebulization, 9 L/min
neonates
Base flow after adapting the O2 settings, neo- Max. 15 L/min
nates
Base flow, pediatric patients 3 L/min
Base flow during active pneumatic nebulization, 9 L/min
pediatric patients
Base flow after adapting the O2 settings with 15 L/min
activated flow monitoring and a proximal flow
sensor, pediatric patients
Base flow, adults 2 L/min

Technical data
16.3 Performance characteristics (continued)

System resistance in the event of device failure In a combination of proximal flow sensor with fil-
ter, HME, breathing connector, and CO2
cuvette, the resistance of the system can be
more than 6 mbar (or hPa or cmH2O) if there is
a failure of the device and a flow of 15 L/min.
Inspiratory resistance in the event of device Determined with the accessories that, when
failure combined, yield the worst case scenario
Adults <6 mbar at 30 L/min
<6 hPa at 30 L/min
<6 cmH2O at 30 L/min
Pediatric patients <6 mbar at 15 L/min
<6 hPa at 15 L/min
<6 cmH2O at 15 L/min
Neonates <1.5 mbar at 2.5 L/min
<1.5 hPa at 2.5 L/min
<1.5 cmH2O at 2.5 L/min
Expiratory resistance in the event of device Determined with the accessories that, when
failure combined, yield the worst case scenario
Adults <5.5 mbar at 30 L/min
<5.5 hPa at 30 L/min
<5.5 cmH2O at 30 L/min
Pediatric patients <6.0 mbar at 15 L/min
<6.0 hPa at 15 L/min
<6.0 cmH2O at 15 L/min
Neonates <1.0 mbar at 2.5 L/min
<1.0 hPa at 2.5 L/min
<1.0 cmH2O at 2.5 L/min
Device compliance, incl. breathing circuit Determined with the accessories that, when
combined, yield the worst case scenario
Adults, maximum value ≤3.6 mL/mbar
≤3.6 mL/hPa
≤3.6 mL/cmH2O
Pediatric patients, maximum value ≤3.6 mL/mbar
≤3.6 mL/hPa
≤3.6 mL/cmH2O
Neonates, maximum value ≤1.5 mL/mbar
≤1.5 mL/hPa
≤1.5 mL/cmH2O

Technical data
16.3 Performance characteristics (continued)

Measurement accuracy The accuracies for pressure and volume speci-
fied for the measured values according to
ISO 80601-2-12:2011, paragraphs
201.12.1.101 and 201.12.1.102, were deter-
mined depending on the patient category and
the above measured values for the least favor-
able combination of accessories that conduct
breathing gas.
Additional functions
Inspiratory valve Opens if the compressed air supply fails (sup-
ply gas flow is not sufficient to provide the inspi-
ratory flow required), enables spontaneous
breathing with ambient air.
16.4 Displayed measured values

Accuracy does only apply for the measure-
ment range specified.
Airway pressure measurement The pressure sensors measure within a range

of –60 to 120 mbar (or hPa or cmH2O).
Plateau pressure Pplat
Positive end-expiratory pressure PEEP
Peak Inspiratory Pressure PIP
Mean airway pressure Pmean
Minimum airway pressure Pmin
Lower pressure level in APRV Plow
End-inspiratory pressure for mandatory breaths EIP
Upper pressure level in APRV Phigh
Intrinsic PEEP (determined via PEEPi maneu- PEEPi
ver)
PEEP at the end of the PEEPi maneuver incl. PEEP
Range Within the associated setting range (maximum
range 0 to 95 mbar (or hPa or cmH2O))
Accuracy In phases with no flow:
±6 % of measured value or ±0.5 mbar (or hPa
or cmH2O), whichever is greater
Otherwise:
±2 mbar (or hPa or cmH2O) ±4 % of the mea-
sured value
T0...90 (for Pmean) 33 s for intubated adults
20 s for adults with NIV
20 s for pediatric patients
10 s for neonates

Technical data
16.4 Displayed measured values (continued)

Negative Inspiratory Force NIF
Range Depending on the PEEP level set
–80 to 0 mbar (or hPa or cmH2O)
Accuracy ±6 % of measured value or ±0.5 mbar (or hPa
Occlusion pressure P0.1

Range 0 to –25 mbar (or hPa or cmH2O)
Accuracy ±6 % of measured value or ±0.5 mbar (or hPa
O2 measurement (inspiratory side)

Inspiratory O2 concentration (in dry air) FiO2
Range 18 to 100 Vol%
Accuracy ±3 Vol%
Drift of measurement accuracy 0.2 Vol% in 6 hours (corresponding to
ISO 80601-2-55)
The measured values of the O2 measure-
ment are barometrically pressure-compen-
sated.
Warm-up phase Max. 3 minutes, typically 1 minute
Flow measurement (expiratory)

Minute volume measurement
Minute volume, leakage-corrected MV
Inspiratory minute volume, overall, not leak- MVi
age-corrected
Expiratory minute volume, overall, not leak- MVe
age-corrected
Mandatory expiratory minute volume, over- MVemand
all, not leakage-corrected
Spontaneous expiratory minute volume, MVespon
overall, not leakage-corrected
Range 0 to 99 L/min, BTPS
Accuracy ±10 % of the measured value or ±(10 mL * (RR
+ 2 /min)), whichever is greater, under calibra-
tion conditions (1013 mbar (or cmH2O), dry
gas, 20 °C (68 °F)), 5 % CO2, with the flap
closed and no leakage
T0...90
Adults 33 s
Pediatric patients 33 s

Technical data

Tidal volume measurement
Tidal volume, leakage-corrected VT
Mandatory tidal volume, leakage-corrected VTmand
Spontaneous tidal volume, leakage-cor- VTspon
rected
Inspiratory tidal volume, not leakage-cor- VTi
rected
Mandatory inspiratory tidal volume, not leak- VTimand
age-corrected
Spontaneous inspiratory tidal volume, not VTispon
leakage-corrected
Expiratory tidal volume, not leakage-cor- VTe
rected
Mandatory expiratory tidal volume, not leak- VTemand
age-corrected
Spontaneous expiratory tidal volume, not VTespon
leakage-corrected
Range 0 to 5500 mL, BTPS
Accuracy ±10 % of the measured value or ±10 mL,
whichever is greater, under calibration condi-
tions (1013 mbar (or cmH2O), dry gas, 20 °C
(68 °F)), 5 % CO2, with the flap closed and no
leakage
Volume trapped in the lungs (determined by Vtrap
the PEEPi maneuver)
Accuracy ±12 % of the measured value or ±12 mL,
whichever is greater, under calibration condi-
tions (1013 mbar (or cmH2O), dry gas, 20 °C
(68 °F)), 5 % CO2, with the flap closed and no
leakage
Flow measurement (proximal)

Minute volume measurement
Minute volume, leakage-corrected MV
Inspiratory minute volume, overall, not leak- MVi
age-corrected
Expiratory minute volume, overall, not leak- MVe
age-corrected
Mandatory expiratory minute volume, over- MVemand
all, not leakage-corrected
Spontaneous expiratory minute volume, MVespon
overall, not leakage-corrected

Technical data

Accuracy Measured with neonatal flow sensor:
±(10 % of the measured value + 0.6 mL *
(RR + 2 /min)) under the following conditions:
1013 mbar (or cmH2O), dry air, 20 ±3 °C
(68 ±5.4 °F)
T0...90
Pediatric patients 33 s
Neonates 20 s
Tidal volume measurement
Tidal volume, leakage-corrected VT
Mandatory tidal volume, leakage-corrected VTmand
Spontaneous tidal volume, leakage-cor- VTspon
rected
Inspiratory tidal volume, not leakage-cor- VTi
rected
Mandatory inspiratory tidal volume, not leak- VTimand
age-corrected
Spontaneous inspiratory tidal volume, not VTispon
leakage-corrected
Expiratory tidal volume, not leakage-cor- VTe
rected
Mandatory expiratory tidal volume, not leak- VTemand
age-corrected
Spontaneous expiratory tidal volume, not VTespon
leakage-corrected
Volume trapped in the lungs (determined by Vtrap
the PEEPi maneuver)
Theoretical display range, actual measured val-
ues, and display values depend on the ventila-
tion settings
Accuracy Measured with neonatal flow sensor:
±(10 % of the measured value + 0.6 mL) under
the following conditions: 1013 mbar (or
cmH2O), dry air, 20 ±3 °C (68 ±5.4 °F)
Respiratory rate measurement

Respiratory rate RR
Mandatory respiratory rate RRmand
Respiratory rate of triggered mandatory breaths RRtrig
Spontaneous respiratory rate RRspon
Range 0 to 300 /min
Accuracy ±1 /min for respiratory rates ≥2 /min and
±2 /min for respiratory rates <2 /min

Technical data

T0...90 33 s for respiratory rates ≥8 /min
Max. 60 s for respiratory rates <8 /min
Effective inspiratory time during spontaneous Tispon
breathing 0 to 20 s
Effective expiratory time Tlow if the setting 0 to 20 s
AutoRelease is active
Ratio of inspiratory time to expiratory time for I:E
controlled ventilation 1:300 to 600:1
Ratio of inspiratory time to expiratory time for I:E spon
spontaneous breathing 1:300 to 600:1
Mainstream CO2 measurement

End-tidal CO2 concentration etCO2
Range 0 to 100 mmHg or
0 to 13.2 Vol% (at 1013 mbar (or cmH2O)) or
0 to 13.3 kPa
Accuracy According to ISO 80601-2-55
±(3.3 mmHg +8 % of the measured value)
±(0.44 kPa +8 % of the measured value)
±(0.43 Vol% +8 % of the measured value)
Measurement conditions Respiratory rate: 6 to 100 /min
Inspiratory time: ≥250 ms
Expiratory time: ≥250 ms
Drift of measurement accuracy According to ISO 80601-2-55
<0.2 kPa (at 5.00 kPa) over 6 h
The measured values of the CO2 measure-
ment are barometrically pressure-compen-
sated.
Response time, total ≤200 ms
Time until specified precision <180 s (at 23 ± 2 °C (73.4 ± 3.6 °F) with dispos-
has been reached able cuvette)
Sampling rate 20 ms
With reference to the displayed measured

values, the following dead spaces must be
taken into account:
CO2 cuvette, adults (6870279, MP01062) 4.3 mL
CO2 cuvette, pediatric patients (6870280, 1.9 mL
MP01063)
Neonatal flow sensor ISO 15 (8411130) 0.9 mL
Neonatal flow sensor Y-piece (8410185) 1.7 mL

Technical data
16.5 Displayed calculated values

Dynamic compliance Cdyn
Range 0 to 650 mL/mbar (or mL/hPa or mL/cmH2O)
Elastance E
Range
Adults 0 to 9999 mbar/L (or hPa/L or cmH2O/L)
Pediatric patients 0 to 9999 mbar/L (or hPa/L or cmH2O/L)
Neonates 0 to 10 mbar/mL (or hPa/mL or cmH2O/mL)
Resistance R
Range 0 to 1000 mbar/L/s (or hPa/L/s or cmH2O/L/s)
Airway resistance of the patient Rpat

Range 0 to 1000 mbar/L/s (or hPa/L/s or cmH2O/L/s)
Leakage minute volume MVleak

T0...90 33 s for intubated adults
20 s for adults with NIV
20 s for pediatric patients
10 s for neonates
Leakage in % 0 to 100 %, for adults
10 to 100 %
Leakages below 10 % are displayed as 0 %, for
pediatric patients and neonates
Spontaneous breathing proportion of minute % MVspon
volume 0 to 100 %
CO2 elimination per minute V̇ CO2

Range 0 to 1000 mL/min, STPD
T10...90 33 s
Serial dead space Vds

CO2 elimination per breath VTCO2

Rapid shallow breathing index RSBI

Range
Adults 0 to 9999 (/min/L)
Pediatric patients 0 to 9999 (/min/L)
Neonates 0 to 300 (/min/mL)
For accuracy, see measurement of VT and RR

Technical data
16.5 Displayed calculated values (continued)

Static compliance (determined by low-flow PV Cstat
loop maneuver) 0 to 500 mL/mbar (or mL/hPa or mL/cmH2O)
Ratio of the dynamic compliance of the last C20/Cdyn
20 % of inspiration to total dynamic compliance 0 to 5
Ratio of the static compliance of the last 20 % C20/Cstat
of the inspiration to the total static compliance 0 to 5
(determined using the low-flow maneuver)
Tidal volume per kg of body weight 0 to 100 mL/kg
Expiratory time constant (calculated from TCe
VTe/Flowepeak) 0.01 to 20 s
Time constant (product of Rtotal and Cdyn) TC
0.01 to 20 s
Dead space ventilation Vds/VTe

Ratio of serial dead space to expiratory tidal
volume
Range 0 to 100 %
CO2 slope
Range 0 to 9.99 Vol%/L or
0 to 9.99 kPa/L or
0 to 74.9 mmHg/L
Waveform displays
Airway pressure Paw (t) –30 to 100 mbar (or hPa or cmH2O)
Flow (t) –180 to 180 L/min
Volume V (t) 2 to 3000 mL
CO2 (t) 0 to 100 mmHg or
0 to 13.2 Vol% (at 1013 mbar (or cmH2O)) or
0 to 13.3 kPa
16.6 Monitoring
A-rated sound pressure level LpA of alarm
signals measured in accordance with
IEC 60601-1-8 and A1:2012:
Primary acoustic alarm signal IEC/CEI
Setting range (all priorities) >41 dB(A) to <92 dB(A)
Incrementation Adjustable in 9 increments
Primary acoustic alarm signal Dräger
Setting range (all priorities) >45 dB(A) to <92 dB(A)
Incrementation Adjustable in 9 increments
Range for power supply failure alarm and sec- >60 dB(A) to <80 dB(A)
ondary acoustic alarm signal

Technical data
16.6 Monitoring (continued)

Delay time until the secondary acoustic alarm Max. 19 s
signal rings if the primary acoustic alarm signal
fails
Expiratory minute volume MVe

Upper alarm limit alarm If the upper alarm limit has been exceeded
Setting range in invasive ventilation 0.03 to 41 L/min
Setting range in non-invasive ventilation 0.03 to 60 L/min
Automatic alarm delay During and 2 minutes after the low-flow PV loop
maneuver
Configurable alarm delay MV delay
Adults 0 to 30 s
Neonates 0 to 15 s
Lower alarm limit alarm If the value has fallen below the lower alarm
limit
Setting range 0.02 to 40 L/min,
Off (for NIV or neonates)
Automatic alarm delay 2 minutes after leaving standby mode
During and 2 minutes after suctioning
2 minutes after activating on flow monitoring
During and 2 minutes after the low-flow PV loop
maneuver
During and 2 minutes after the manual discon-
nection maneuver
2 minutes after calibrating the proximal flow
sensor
Configurable alarm delay MV delay
Adults 0 to 30 s
Neonates 0 to 15 s
Airway pressure Paw

Setting range 7 to 105 mbar (or hPa or cmH2O)
Maximum airway pressure 120 mbar (or hPa or cmH2O)
Inspiratory O2 concentration FiO2

Upper alarm limit alarm After 32 seconds at the latest, if the upper
alarm limit has been continuously exceeded
Lower alarm limit alarm After 32 seconds at the latest, if the value has
fallen below the lower alarm limit

Technical data

Setting range Both alarm limits are automatically adapted to
the set value:
Up to 60 Vol% with ±4 Vol%, above 60 Vol%
with ±6 Vol%
(Lower alarm limit 18 Vol% at 21 Vol%)
End-tidal CO2 concentration etCO2

Setting range 1 to 98 mmHg (or 0.1 to 12.9 Vol% or 0.1 to
13.1 kPa)
Lower alarm limit alarm If the value has fallen below the lower alarm
limit
Setting range 0 to 97 mmHg (or 0 to 12.8 Vol% or 0 to
13.0 kPa)
Respiratory rate RR
Upper alarm limit alarm If the respiratory rate (mandatory and sponta-
neous breaths) has been exceeded
Setting range 5 to 200 /min, Off
Volume monitoring VT
Upper alarm limit alarm If the tidal volume administered exceeds the
upper alarm limit, the inspiration will be aborted
and the expiratory valve opened
Setting range
Adults 110 to 3100 mL, Off
Pediatric patients 21 to 3100 mL, Off
Neonates 3 to 3100 mL, Off
Automatic alarm delay During the first two consecutive spontaneous
breaths where the applied inspiratory tidal vol-
ume exceeds the upper alarm limit
During the suction maneuver with the exception
of the postoxygenation, where the alarm crite-
rion is re-evaluated
Lower alarm limit alarm If the set tidal volume has not been supplied
Setting range 1 to 2900 mL, Off
Automatic alarm delay
Adults During the first five consecutive spontaneous
ume has fallen below the lower alarm limit
Pediatric patients During the first five consecutive spontaneous

Technical data

Neonates During the first eight consecutive spontaneous
Apnea alarm time Tapn

Alarm If no breathing activity was detected
Setting range 5 to 60 seconds, Off
Disconnection alarm time Tdiscon

Setting range 0 to 60 seconds
16.7 Operating characteristics

Protection class
Ventilation unit Class I
Display unit
GS500 gas supply unit
PS500 power supply unit
CO2 sensor (connected) Type BF
Proximal flow sensor (connected) Type BF
Degree of protection against ingress of liquids IP21
and particles Protection against penetration of solid foreign
matter with a diameter exceeding 12.5 mm
(0.47 in)
Protection against vertically dripping water
Mains power supply

Electric power inlet 100 V to 240 V
50/60 Hz
Current consumption
At 230 V Max. 1.3 A
At 100 V Max. 3.0 A
Inrush current Approx. 8 to 24 A peak
Approx. 6 to 17 A quasi-RMS
Power consumption
Maximum 300 W
During ventilation, without charging the bat- Approx. 100 W ventilation unit with display unit
tery Approx. 180 W with GS500
Device fuses
Range 100 V to 240 V F6,3H 250V IEC 60127-2/V (2 pcs.) ventilation
unit

Technical data
16.7 Operating characteristics (continued)

Batteries
The battery runtime applies when the batteries
are fully charged and new and ventilation is typ-
ical.
Low temperatures may reduce the battery run-
time.
The charging time applies to new and com-
pletely discharged batteries during typical venti-
lation and the GS500 is not used. The actual
charging time depends on the battery charge.
If the GS500 is operating or the ambient tem-
perature is high, the battery charging process
may be restricted or interrupted.
Typical ventilation
Ventilation mode PC-AC
FiO2 21 Vol%
PEEP 5 mbar (or hPa or cmH2O)
Pinsp 20 mbar (or hPa or cmH2O)
RR 12 /min
MV (measured value) 6 L/min
Ambient temperature 22 °C (71.6 °F)
Internal battery of ventilation unit (without
PS500)
Type NiMH battery, sealed
F3 fuse of the ventilation unit F15A 80 V UL248
Capacity 2.5 Ah
Voltage 24 V
Electric current 0 to 15 A
Battery runtime if mains power supply is not
available
Without GS500 30 minutes
With GS500 15 minutes
Charging
Charging time (to charge battery fully) <4 hours

Technical data

Batteries of power supply unit PS500
Type VRLA batteries
F1 and F2 fuse at PS500 behind the side F15A 80 V UL248
part
Capacity 24 Ah
Voltage 24 V
Electric current 0 to 15 A
Battery runtime if mains power supply is not
available
Without GS500 240 minutes
With GS500 120 minutes
Charging
Charging time (to charge battery fully) <24 hours (<20 hours for 80 % charge)
Screen values
Screen size Evita V800 464.8 mm (18.3 in)
Screen size Evita V600 396.2 mm (15.6 in)
Aspect ratio 16:9
Resolution 1366 x 768 pixels
Touchscreen values
Touchscreen technology Capacitive touchscreen with glass front
Gas supply
O2 positive operating pressure 2.7 to 6.0 bar (or 270 to 600 kPa or 39 to
87 psi)
O2 peak input flow Max. 180 L/min
O2 connection Depending on configuration: DIN, NIST, DISS,
Air Liquide
Air operating pressure 2.7 to 6.0 bar (or 270 to 600 kPa or 39 to
87 psi)
Air peak input flow Max. 180 L/min
Air connection Depending on configuration: DIN, NIST, DISS,
Air Liquide
Dew point At least 5 kelvin or 5 °C (9 °F) below the ambi-
ent temperature
Oil concentration <0.1 mg/m3
Particle size Dust-free air (filtered with pore size <1 µm)

Technical data

Gas consumption
Consumption for ventilation Depends on ventilation settings
Consumption for pneumatic medication nebu- Compressed air or O2, max. 2.1 bar (or
lizer 210 kPa or 30.5 psi), max. 11 L/min
Automatic gas switch-over If one gas fails, the device switches to the other
gas
Noise emission as per ISO 80601-2-12:2011

Under consideration of ISO 4871:2009 and
ISO 3744:2010
A-rated mean surface sound pressure level Approx. 33.0 dB
(LpA) with a radius of 2 m (79 in) Approx. 43.5 dB with GS500
Uncertainty (k) 3.5 dB
A-rated surface sound power level (LWA) Approx. 46.0 dB
Approx. 57.5 dB with GS500
Uncertainty (k) 3.5 dB
Classification
Electromagnetic compatibility EMC Tested in accordance with IEC 60601-1-2
Classification Medical Device Europe II b
UMDNS code Universal Medical Device 17-429
Nomenclature System - Nomenclature for med-
ical devices
For Nurse call

Connection Via cable 8417370 only
Potential-free DC contact
Switching voltage 24 V DC max.
Switching current 1 A DC max.
Switching capacity 15 W max.
Contact pin assignment, see chapter "Assem-
bly and preparation", section "Connecting the
nurse call"

Technical data
16.8 Interfaces and ports

Ventilation unit ports
System cable Not electrically isolated
USB 2.0 Not electrically isolated, only for passive stor-
age media
Nurse call Not electrically isolated
V2 Not used
Neonatal flow sensor Electrically isolated (test voltage 1500 V)
CO2 sensor Not electrically isolated
V9 GS500
Display unit ports

LAN 10/100 Mbit/s, electrically isolated (test voltage
1500 V)
3 x RS232 (MEDIBUS) Electrically isolated (test voltage 1500 V)
4 x USB 2.0 Not electrically isolated, only for passive stor-
age media
HDMI Not electrically isolated, not for clinical use, only
for demonstration purposes, only for devices
that fulfill IEC 62368-1 or IEC 60950-1 with
safety extra-low voltage at the outlet
System connector Port for system cable
MEDIBUS or MEDIBUS.X protocol

Baud rate 1200, 2400, 4800, 9600, 19200, 38400 baud
(19200 and 38400 baud are required for trans-
mitting high-speed data, e.g. for the flow wave-
form)
Data bits 8
Parity Even, odd, no
Stop bit 1
Maximum alarm delay time (measured from the 3 s at a baud rate ≥19200
time of inquiry) 10 s at a baud rate <19200
Alarm conditions are only transmitted on the
network if they are present at the time of an
active inquiry by a connected device. An alarm
logbook is not transmitted.
Pin assignment of COM1, COM2 and COM3
Pin 2 RXD
Pin 3 TXD
Pin 5 GND
Housing SHLD / GND

Technical data
16.9 Measurements and weight

Evita V800
40697
PPLQ PPLQ
PPLQ
PP
LQ
PPLQ
PP
LQ
PP
LQ
PP
LQ
PPLQ PPLQ
Designation Weight
Ventilation unit Approx. 16 kg (34.9 lb)
Display unit Approx. 7 kg (15.4 lb)
Ventilation unit and display unit Approx. 23 kg (50.7 lb)
Trolley Approx. 33 kg (72.8 lb)
PS500 Approx. 27 kg (59.5 lb)
GS500 Approx. 10.5 kg (23 lb)
Nominal weight (weight of the ventilation unit 58 kg (128 lb)
and display unit on trolley)
Maximum weight (permitted maximum total 133 kg (293 lb)
weight)

Technical data
Evita V600
40700
PPLQ PPLQ
PPLQ
PP
LQ
PPLQ
PP
LQ
PP
LQ
PP
LQ
PPLQ PPLQ
Designation Weight
Ventilation unit Approx. 16 kg (34.9 lb)
Display unit Approx. 5 kg (11 lb)
Ventilation unit and display unit Approx. 21 kg (46.3 lb)
Trolley Approx. 33 kg (72.8 lb)
PS500 Approx. 27 kg (59.5 lb)
GS500 Approx. 10.5 kg (23 lb)
Nominal weight (weight of the ventilation unit 58 kg (128 lb)
and display unit on trolley)
Maximum weight (permitted maximum total 133 kg (293 lb)
weight)

Technical data
16.10 Automatic alarm limits

The following tables describe the alarm limits which cannot be set by the user.
16.10.1 Pressure monitoring

Alarm message Description/Detection
Airway pressure high The airway pressure is monitored to detect whether the upper alarm
limit is exceeded.
If the upper alarm limit for the airway pressure is linked to ventilation
therapy controls, this limit is set 5 mbar (or hPa or cmH2O) above the
highest pressure which is regularly applied during ventilation accord-
ing to the user settings (Pmax/Paw high autoset). When factory
defaults are used, the link is deactivated. For further information see:
"Selecting the general settings", page 193.
Breathing hose kinked An excessive pressure during an O2 therapy is monitored. The alarm
(O2 therapy) limit is 30 mbar (or hPa or cmH2O).
Airway pressure negative Situations in which the pressure becomes negative are monitored.
The alarm limit is –10 mbar (or hPa or cmH2O).
PEEP high / Plow high The alarm limit is 8 mbar (or hPa or cmH2O) above the set PEEP or
(!!!) Plow level. The alarm triggers a pressure release to ambient pres-
sure. The alarm is not triggered below 11 mbar (or hPa or cmH2O).
An alarm is triggered if this condition applies for 2 mandatory breaths
or after a maximum of 15 seconds.
To avoid false alarms, it is not monitored whether the lower pressure
level has been reached if, in the ventilation mode PC-APRV, the Tlow
value is smaller than 1 s or the setting AutoRelease is activated.
PEEP high / Plow high The alarm limit is 4 mbar (or hPa or cmH2O) above the set PEEP. An
(!!) alarm is triggered if this condition applies for 2 mandatory breaths or
after a maximum of 15 seconds.
PEEP low / Plow low A too low PEEP or Plow value during ventilation is monitored. The
alarm limit depends on the set value of the PEEP or Plow level. The
alarm limit is 5 mbar (or hPa or cmH2O) below the set value in each
case. An alarm is triggered if this condition applies for 10 mandatory
breaths.
Pressure limited (ATC/SPN- The upper pressure limit is monitored to detect whether it is reached
PPS) when using the function ATC or the ventilation mode SPN-PPS.
If the Paw high alarm limit is adjustable, the alarm limit is derived
from this value and lies in the range Paw high - 5 mbar (or hPa or
cmH2O) to Paw high - 1 mbar (or hPa or cmH2O), depending on how
close the Paw high value comes to the currently applied ventilation.
If the Paw high alarm limit is linked (Pmax/Paw high autoset), the
pressure limit corresponds to the value of the Pmax therapy control.
Airway pressure low An insufficient airway pressure is monitored by checking whether the
integral of undercutting the measured pressure values of the lower
pressure level exceeds 22.5 mbar x s (or hPa x s or cmH2O).

Technical data
16.10.2 Volume monitoring

The expiratory minute volume MVe is monitored in the Pediatric patient and Adult
patient categories and during invasive ventilation in the Neonate patient category
within the set alarm limits.
The tidal volume VT is monitored within the set alarm limits. When leakage
compensation is deactivated, this is accomplished by monitoring the value VTi in
the Pediatric patient and Adult patient categories and the value VTe in the
Neonate patient category. If the leakage compensation is activated, the set value
VT is generally used.
Because the device ensures the minimum inspiratory tidal volume when volume-
controlled ventilation modes or pressure-controlled ventilation modes with volume
guarantee/AutoFlow are selected, it is not possible to set the lower alarm limit for
the parameters VTi, VT, or VTe manually. The lower alarm limit is set at 90 % of the
set value for VT low.

Tidal volume not reached, Volume-controlled mandatory breaths are monitored to detect
leakage whether the set volume is reached. The alarm limit is set at 90 % of
Tidal volume not reached the set value for VT.
Tidal volume not reached,
Pmax active
Pressure limited During ventilation with AutoFlow or volume guarantee, mandatory
breaths are monitored to detect whether the volume to be applied is
reached if the applicable ventilation pressure cannot automatically be
increased any further (Pmax/Paw high autoset). The alarm limit is
set at the set value for the volume. For further information see:
"Selecting the general settings", page 193.

Technical data
16.10.3 Monitoring of the breathing circuit and the patient connection

Disconnection detected The disconnection monitoring checks whether the breaths reach a
certain pressure level. This pressure level is derived from the
selected ventilation settings. The alarm limit is derived from the set
values for ventilation.
During pressure-controlled ventilation, the alarm is triggered when
the airway pressure is lower than the lower pressure level plus 50 %
of the pressure difference between the upper and lower pressure lev-
els.
During assisted ventilation with pressure support, the alarm is trig-
gered if the airway pressure is lower than the lower pressure level
plus 30 % of the pressure difference between the upper and lower
pressure levels.
During ventilation with AutoFlow, volume guarantee, or volume sup-
port, the limit is 50 % of the pressure difference between the upper
pressure level and the lower pressure level currently calculated by
the device.
The disconnection monitoring does not issue an alarm if a sufficiently
large expiration was detected.
In the event of an excessive inspiratory flow at the current airway
pressure, a disconnection due to an excessive inspiratory volume is
detected. This volume depends on the patient category:
– 4.5 L in the Adult patient category
– 1.5 L in the Pediatric patient patient category
– 0.5 L in the Neonate patient category
Leakage Leakage is monitored in the Adult and Pediatric patient patient cat-
egories. The alarm limit is set at 55 % of relative leakage. Leakage
during NIV is not monitored.
No inspiratory flow detected Obstructions in the breathing circuit are monitored by observing the
flow delivered to the patient during a defined period.
16.10.4 FiO2 monitoring

FiO2 high An excessive O2 concentration of the applied gas is monitored.
The alarm limit is 4 Vol% above the set value if the value is less than
or equal to 60 Vol%.
The alarm limit is 6 Vol% above the set value if the value is greater
than 60 Vol%.
FiO2 low An insufficient O2 concentration of the applied gas is monitored.
For an FiO2 concentration of 21 Vol%, the alarm limit is 18 Vol%.
The alarm limit is 4 Vol% below the set value if the value is greater
than 21 Vol% and less than or equal to 60 Vol%.
The alarm limit is 6 Vol% below the set value if the value is greater
than 60 Vol%.

Technical data
16.10.5 CO2 monitoring

Check CO2 sensor The correct functioning of the CO2 sensor is monitored. An alarm is
immediately generated in the event of a technical defect or if a sensor
is not connected.
An alarm is generated after 60 s if the sensor is removed from the
cuvette or the sensor does not detect any breathing activity.
16.11 Device combinations

This device can be operated in combination with other Dräger devices or with
devices from other manufacturers. Follow the accompanying documents of the
individual devices.
If a device combination is not approved by Dräger, the safety and the correct
functioning of the individual devices can be compromised. The operating
organization must ensure that the device combination complies with the applicable
editions of the relevant standards for medical devices.
Device combinations approved by Dräger meet the requirements of the following
standards:
– IEC 60601-1 (electrical safety, mechanical safety, software)
– IEC 60601-1-2 (EMC)
– IEC 60601-1-8 (alarm systems)
16.12 EMC declaration

16.12.1 General information
This device was tested for electromagnetic compatibility using accessories from the
list of accessories. Other accessories may only be used if they do not compromise
the electromagnetic compatibility. The use of non-compliant accessories may result
in increased electromagnetic emissions or decreased electromagnetic immunity of
the device.
This device may be used in the direct vicinity of other devices only if Dräger has
approved this device arrangement. If no approval has been given by Dräger, it must
be ensured that this device functions correctly in the desired arrangement before
use. The instructions for use for the other devices must be followed.
16.12.2 Electromagnetic environment

This device may only be used in environments specified in the section
"Environments of use" (see "Environments of use", page 9).
Emissions Compliance
Radiated emissions Class A, group 1 (30 MHz to 1 GHz)
Conducted emissions Class A, group 1 (150 kHz to 30 MHz)

Technical data
The emissions characteristics of this equipment make it suitable for use in

industrial areas and hospitals (CISPR 11 class A). If it is used in a residential
environment (for which CISPR 11 class B is normally required), this device might
not offer adequate protection to radio-frequency communication services. The user
might need to take mitigation measures, such as relocating or re-orienting the
equipment.
Immunity against Test level and required electromagnetic

environment
Electrostatic discharge (ESD) Contact discharge: ±8 kV
(IEC 61000-4-2) Air discharge: ±15 kV
Fast transient electrical disturbances Power cable: ±2 kV
(bursts) (IEC 61000-4-4) Longer signal input lines/output lines: ±1 kV
Impulse voltages (surges) Voltage, external conductor – external con-
(IEC 61000-4-5) ductor: ±1 kV
Voltage, external conductor – protective
ground conductor: ±2 kV
Magnetic fields at mains frequency 50 Hz: 30 A/m
(IEC 61000-4-8)
Voltage dips and short interruptions Voltage dips of 30 % to 100 %, 8.3 ms to
in the supply voltage 5 s, different phase angles
(IEC 61000-4-11)
Radiated high-frequency distur- 80 MHz to 2.7 GHz: 3 V/m
bances (IEC 61000-4-3)
Conducted high-frequency distur- 150 kHz to 80 MHz: 3 V, ISM bands: 6 V
bances (IEC 61000-4-6)
Electromagnetic fields in the vicinity Various frequencies from 385 MHz to
of wireless communication devices 5785 MHz: 9 V/m to 28 V/m
16.12.3 Recommended separation distances from wireless

communication devices
To ensure that the full functional integrity of this device is not compromised, there
must be a separation distance of at least 1.0 m (3.3 ft) between this device and
wireless high-frequency communication equipment.

Technical data
16.13 Connections to IT networks

In an IT network, data can be exchanged by means of wired or wireless
technologies. An IT network can be any data interface (e.g., RS-232, LAN, USB)
that is described in standards and conventions.
During operation, this device can exchange information with other devices by
means of IT networks and supports the following functions:
– Display of waveforms and parameter data
– Signaling of alarms
– Transfer of device settings and patient data
– Service mode, access to logbooks
Connecting this device to a network that incorporates other devices or making
subsequent changes to that network can lead to new risks for patients, users, and
third parties. Before the device is connected to the network or the network is
changed, these risks need to be identified, analyzed, and evaluated by the person
responsible for IT at the hospital as per the standard IEC 80001-1 (risk
management for IT networks with medical devices). Corresponding measures need
to be taken based on the results.
Examples of subsequent changes to the network:
– Changing the network configuration
– Removing devices from the network
– Adding new devices to the network
– Performing upgrades or updates on devices that are connected to the network
16.13.1 LAN interface

Service
In connection with the Dräger ServiceConnect Gateway (SCG) or a DrägerService
computer, the LAN interface makes the following functions possible:
– Via the SNMP protocol:
Monitoring the service status of the device, querying the service status, support
during installation of the device software and software download, configuration
support
– Via the FTP protocol (as client):
Querying the device status, support during installation of the device software
and software download, configuration support
The following personal data is transmitted in unencrypted form using the interface:
– Logbook with information on the patient’s weight and height
Required properties
The LAN must be securely separated from other networks and no devices that
could be a potential source for malicious attacks may be connected.
The LAN must ensure the connection between the device and the following
destinations:
– ServiceConnect Gateway or DrägerService computer:

Technical data
Connections between the medical device and the corresponding destina-

tions
Function Proto- Port on Direction Remote Remote Connec-
col the port partner tion
medical
device
SNMP V3 UDP 161 >1023 SCG
TCP SNMP UDP >1023 162 SCG
V3
(Trap)
FTP TCP >1023 21 SCG New, set
(command) up
FTP TCP >1023 21 SCG Set up
(command)
FTP TCP >1023 >1023 SCG New, set
(data) up
FTP TCP >1023 >1023 SCG Set up
(data)
DHCP UDP 67 67 DHCP
server
Typical data volume:

– Device firmware update: Typically 50 MB
– Help ticket (system logbook for service purposes): Normally 3 MB
When the service functions are used, the device can cause a network load up to the
maximum transmission speed of its LAN interface. During normal usage, the
bandwidth used is negligibly small.
Dangerous situations
If the network does not fulfill the required properties, the following dangerous
situations may occur:
– Exported patient-related data (weight, height) and therapy-related data can be
intercepted, falsified, or damaged.
– If the device overloads as a result of high network utilization (e.g., caused by
denial of service attacks), this can lead to the deactivation of the device-side
network interface. The interface is then available only after the device has been
restarted.
16.13.2 COM ports

The RS-232 ports support communication protocols for exchanging data between
the device and the following external medical or non-medical devices, for example:
– Hemodynamic monitor
– Data management system
– Computer
– RS232-to-Ethernet converter

Technical data
The data transferred contains the following information, for example:

– Settings
– Measured values that comply with the specified precision
– Waveforms
– Text messages
– Alarm status
If the specified precision for measured values cannot be complied with, these
measured values are displayed in gray on the screen. The measured values are not
transferred via MEDIBUS.X.
Before the data transfer, note the documentation for the following communication
protocols:
MEDIBUS.X
MEDIBUS.X, Rules and Standards for Implementation 9052607
MEDIBUS.X, Profile Definition for Data Communication V1.n 9052608
MED.X.Comp.
MEDIBUS.X, Communication protocol for Evita V800/V600 and 9056567
Babylog VN800/VN600 SW 1.n
MEDIBUS
MEDIBUS for V and VN ventilators 9039527
Dräger RS 232 MEDIBUS, Protocol Definition 9028258
The documents are available only in English.

MEDIBUS.X is the MEDIBUS standard. If this communication protocol is used, all
data can be transferred. The communication protocols MEDIBUS and
MED.X.Comp. serve only purposes of exchanging data with older devices.
In combination with MEDIBUS.X, the device fulfills the requirements of the standard
ISO 80601-2-55:2018.
In combination with MED.X.Comp. or MEDIBUS, the device fulfills the requirements
of the standard ISO 80601-2-55:2011.
– Therapy data with information on the patient’s weight and height
The data can be used to set up a distributed alarm system with unconfirmed alarm
transmission conforming to IEC 60601-1-8 in order to improve the clinical
procedure. However, the data must not be used as a replacement for the medical
device as a primary alarm source.
Note: Every device connected within the distributed alarm system must be labeled
with the following precautionary statement: Receipt of alarm signals is not
guaranteed.
Required properties
The RS-232 port is a point-to-point connection. Connected devices must prevent
unauthorized users from accessing the data sent using the RS-232 port and must
themselves be protected against infections via malware and computer viruses.

Technical data
16.13.3 USB ports

The USB port facilitates data transfer to external storage media. Existing data on
external storage media can be deleted during this procedure.
– Logbook with information on the patient’s weight and height
– Screenshots with information about the patient’s weight and height, if applicable
Required properties
Only devices that are listed in the list of accessories or that correspond to the USB
device class "mass storage device" may be connected. For example, connecting
devices to charge batteries is not one of the intended purposes. Dräger
recommends using storage devices compatible with FIPS 140-2 and featuring
hardware encryption.
If active devices are connected to the USB port of the medical device, the medical
device may restart.
16.13.4 HDMI port

The HDMI port supports the display of screen content on an externally connected
device (e.g., a projector). This display is not intended for clinical use; instead, it is
intended only for demonstration purposes and must not be used on patients.
Required properties
Connected devices must fulfill the standards IEC 62368-1 or IEC 60950-1 with
safety extra-low voltage at the outlet. The connected device must be able to display
the resolution 1366 x 768 pixels at 60 hertz.
If the connected device does not fulfill the required properties, electric danger may
exist for the user.
16.14 Open-source software

Dräger devices that use software may use open-source software, depending on
their setup. Open-source software may be subject to different terms of license.
Additional information regarding the open-source software used in this device is
available at the following web page:
www.draeger.com/opensource

Principles of operation
17 Principles of operation
17.1 Ventilation modes
17.1.1 VC-CMV ventilation mode
VC: Volume Control, CMV: Controlled Mandatory Ventilation
Continuous volume-controlled ventilation with fixed inspiratory flow
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Volume-controlled ventilation
The tidal volume of the mandatory breaths is determined by the volume VT. The
length of mandatory breaths is determined by the inspiratory time Ti. The pressure
rise is determined by the inspiratory flow Insp. flow. If the inspiratory flow is so high
that the set tidal volume is reached before the set inspiratory time Ti has fully
elapsed, an inspiratory pause occurs. If leakage compensation is activated, the
device increases the inspiratory flow in order to apply the set volume despite
leakage.
The mandatory breaths are time-cycled and are not triggered by the patient. The
number of mandatory breaths is determined by the respiratory rate RR.
In the Neonate patient category, this mode is only available with AutoFlow
activated. In the Neonate patient category, the ventilation mode VC-CMV cannot be
selected with non-invasive ventilation.
Pressure limitation
The therapy control Pmax is activated when the user couples the upper alarm limit
for the airway pressure with the therapy control Pmax. The device can avoid the
pressure peak with the pressure limitation Pmax, complying with the set tidal
volume VT.
The tidal volume VT remains constant provided the plateau pressure Pplat is
present. The device limits the pressure by reducing the inspiratory flow when the
set value for Pmax is reached.

If the tidal volume VT can no longer be applied with the selected pressure Pmax,
e.g., due to reduced compliance, the low-priority alarm message Tidal volume not
reached, Pmax active is issued.
17.1.2 VC-SIMV ventilation mode

VC: Volume Control, SIMV: Synchronized Intermittent Mandatory Ventilation
Intermittent, triggered, volume-controlled ventilation with a fixed inspiratory flow,
allowing spontaneous breathing during the expiratory phase
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activated. In the Neonate patient category, the ventilation mode VC-SIMV cannot
be selected with non-invasive ventilation.
Synchronization
The mandatory breaths can be triggered by the patient's inspiratory effort on PEEP
level.
A mandatory breath can only be triggered within a "trigger window" by the flow
trigger in synchrony with the patient's spontaneous inspiratory effort. This prevents
the mandatory breath from being applied during expiration.
The trigger window is 5 seconds in the Adult patient category and 1.5 seconds in
the Pediatric patient and Neonate patient categories.

For expiratory times shorter than 5 seconds in the Adult patient category or
1.5 seconds in the Pediatric patient and Neonate patient categories, the trigger
window covers the entire expiratory time minus a refractory period for the previous
expiration.
Synchronization of mandatory breaths reduces the expiratory time. The device
extends the subsequent expiratory time or spontaneous breathing time by the
missing time. This prevents an increase of the mandatory respiratory rate.
The number of mandatory breaths is determined by the respiratory rate RR.
If the patient breathes in at the beginning of the trigger window and has already
inspired a significant volume, the device takes this volume into account. During the
subsequent mandatory breath, the ventilation unit reduces the inspiratory flow
phase and extends the inspiratory pause.
Pressure support
During spontaneous breathing at the PEEP level, the patient can receive pressure
support from PS. Every inspiratory effort of the patient that meets the trigger criteria
triggers a pressure-supported breath. By setting the trigger level, the patient's
inspiratory efforts are synchronized. The time, number, and duration of pressure-
supported breaths is determined by the patient's spontaneous breathing.
As in all pressure-controlled ventilation modes, the tidal volume supplied depends
on the difference in pressure "Psupp – PEEP", the lung mechanics (resistance and
compliance) and the patient's respiratory drive. The pressure rise from the lower
pressure level PEEP to the upper pressure level Psupp is determined by the Slope
setting.
The pressure support is terminated as soon as the inspiratory flow falls below a
certain proportion of the peak inspiratory flow.
The proportion of the peak inspiratory flow can be adjusted using the Insp term
setting. If the Insp term setting is not configured, this proportion is 25 % in the
Adult patient category and 15 % in the Pediatric patient and Neonate patient
categories.
The pressure support is also terminated as soon as the duration of the support has
reached the maximum inspiratory time. For intubated patients, the maximum
inspiratory time is limited to 4 seconds in the Adult patient category and to
1.5 seconds in the Pediatric patient and Neonate patient categories. For non-
invasive ventilation, the maximum inspiratory time is limited to 130 % of Ti
(maximum 4 seconds) in the Adult patient category and to 130 % of Ti (maximum
1.5 seconds) in the Pediatric patient patient category.
Pressure limitation
volume VT.

17.1.3 VC-AC ventilation mode

VC: Volume Control, AC: Assist Control
Assisted-controlled, volume-controlled ventilation with fixed inspiratory flow and
backup respiratory rate
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activated. In the Neonate patient category, the ventilation mode VC-AC cannot be
selected with non-invasive ventilation.
Assisted-controlled ventilation
Every inspiratory effort of the patient at the PEEP level triggers a synchronized
mandatory breath. Thus, the time and number of mandatory breaths are
determined by the patient. The trigger window covers the expiratory time minus a
refractory period for the previous expiration. The expiratory time is determined by
the respiratory rate RR and the inspiratory time Ti. A non-synchronized mandatory
breath is triggered at the latest at the end of the expiratory time (backup respiratory
rate). The minimum number of mandatory breaths is determined by the respiratory
rate RR.

Pressure limitation
volume VT.
17.1.4 VC-MMV ventilation mode

VC: Volume Control, MMV: Mandatory Minute Ventilation
Volume-controlled ventilation to ensure a mandatory minute volume
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elapsed, an inspiratory pause occurs.

If leakage compensation is activated, the device increases the inspiratory flow in

order to apply the set volume despite leakage.
activated. In the Neonate patient category, the ventilation mode VC-MMV cannot
be selected with non-invasive ventilation.
MMV works similar to SIMV, however, the mandatory breaths are only provided if
spontaneous breathing is not sufficient and below the prescribed minimum
ventilation. Should spontaneous breathing increase, fewer mandatory breaths will
be provided. The minimum ventilation is determined by the setting of the tidal
volume VT and the respiratory rate RR.
The maximum number of mandatory breaths is determined by the respiratory rate
RR. However, this number is only provided when insufficient spontaneous breathing
is present.
Pressure support
setting.
categories.
invasive ventilation, the maximum inspiratory time is limited to 130 % of the
inspiratory time Ti (maximum 4 seconds) in the Adult patient category and to
130 % of the inspiratory time Ti (maximum 1.5 seconds) in the Pediatric patient
patient category.
Pressure limitation
volume VT.

17.1.5 PC-CMV ventilation mode

PC: Pressure Control, CMV: Controlled Mandatory Ventilation
Continuous pressure-controlled ventilation allowing spontaneous breathing (open
system) during the entire respiratory cycle
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Pressure-controlled ventilation
The upper pressure level is determined by the inspiratory pressure Pinsp. The
length of mandatory breaths is determined by the inspiratory time Ti. As in all
pressure-controlled ventilation modes, the tidal volume supplied depends on the
difference in pressure "Pinsp – PEEP", the lung mechanics (resistance and
pressure level PEEP to the upper pressure level Pinsp is determined by the Slope
setting.
The mandatory breaths are time-cycled and are not triggered by the patient. The
number of mandatory breaths is determined by the respiratory rate RR.

17.1.6 PC-BIPAP ventilation mode

PC: Pressure Control, BIPAP: Biphasic Positive Airway Pressure
Intermittent, synchronized, pressure-controlled ventilation allowing spontaneous
breathing (open system) during the entire respiratory cycle and expiratory
synchronization
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setting.
The switch-over from the inspiratory to the expiratory pressure level is synchronized
with the patient's spontaneous breathing. Synchronization of the mandatory breath
reduces the duration of the mandatory breath. The device extends the subsequent
breath by the missing time. This prevents an increase in respiratory rate.
In the Neonate patient category, this mode is not available with non-invasive
ventilation.
Synchronization
level.
the mandatory breath from being applied during expiration.

For expiratory times shorter than 5 seconds in the Adult patient category or
1.5 seconds in the Pediatric patient and Neonate patient categories, the trigger
window covers the entire expiratory time minus a refractory period for the previous
expiration.
Pressure support
setting.
categories.
invasive ventilation, the maximum inspiratory time is limited to 130 % of the
patient category.

17.1.7 PC-SIMV ventilation mode

PC: Pressure Control, SIMV: Synchronized Intermittent Mandatory Ventilation
Intermittent, triggered, pressure-controlled ventilation allowing spontaneous
breathing (open system) during the entire respiratory cycle
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RR
Flow
setting.
ventilation.
Synchronization
level.
By setting the trigger level, the mandatory breaths can be synchronized with the
patient's inspiratory efforts.
the mandatory breath from being applied during spontaneous expiration.
the Pediatric patient and Neonate patient categories. For expiratory times shorter
than 5 seconds in the Adult patient category or 1.5 seconds in the Pediatric
patient and Neonate patient categories, the trigger window covers the entire
expiratory time minus a refractory period for the previous expiration.


Pressure support
setting.
categories.
1.5 seconds in the Pediatric patient and Neonate patient categories.
For non-invasive ventilation, the maximum inspiratory time is limited to 130 % of the
patient category.

17.1.8 PC-AC ventilation mode

PC: Pressure Control, AC: Assist Control
Assist-controlled, pressure-controlled ventilation allowing spontaneous breathing
during the entire respiratory cycle and backup respiratory rate
41064
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RR
Flow
setting.
ventilation.
Assisted-controlled ventilation
Every inspiratory effort of the patient at the PEEP level triggers a synchronized
mandatory breath. Thus, the time and number of mandatory breaths are
determined by the patient.
The trigger window covers the expiratory time minus a refractory period for the
previous expiration. The expiratory time is determined by the respiratory rate RR
and the inspiratory time Ti. A non-synchronized mandatory breath is triggered at the
latest at the end of the expiratory time (backup frequency).
The minimum number of mandatory breaths is determined by the respiratory rate
RR.

17.1.9 PC-PSV ventilation mode

PC: Pressure Control, PSV: Pressure Support Ventilation
Pressure-controlled ventilation with guaranteed minimum respiratory rate (backup
respiratory rate)
41068
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Pressure support
support from PS. The level of pressure support is determined by the inspiratory
pressure Pinsp. Every inspiratory effort of the patient that meets the trigger criteria
supported breaths is determined by the patient's spontaneous breathing. If the
patient's respiratory rate is less than the set backup frequency RR or if there is no
spontaneous breathing present, the device administers pressure-supported breaths
with the respiratory rate RR.
on the difference in pressure "Pinsp – PEEP", the lung mechanics (resistance and
setting.
categories.
reached the maximum inspiratory time.

For intubated patients, the maximum inspiratory time is limited to 4 seconds in the
Adult patient category and to 1.5 seconds in the Pediatric patient patient category.
For the Neonate patient category, the maximum inspiratory time can be set with the
parameter Timax to a maximum of 1.5 seconds.
For non-invasive ventilation, the maximum duration of a breath for the Adult and
Pediatric patient patient categories can be set with the parameter Timax. In the
Neonate patient category, this mode is not available with non-invasive ventilation.
17.1.10 PC-APRV ventilation mode

PC: Pressure Control, APRV: Airway Pressure Release Ventilation
Spontaneous breathing under continuous positive airway pressure with brief
pressure releases
41065
Paw
Phigh
Plow
W
Thigh
Tlow
Flow
The patient breathes spontaneously at a high pressure level Phigh for an

adjustable length of time Thigh. For very short expiratory times Tlow, the device
switches to a low pressure level Plow. The normal lung areas are emptied, but the
"slow" lung areas change volume only to a lesser extent1).
The number of pressure releases is determined by the Thigh and Tlow settings.
The releases are time-cycled and are not triggered by the patient. The duration is
determined by the parameter Tlow. The tidal volume exchanged during the release
phases depends on the difference in pressure Phigh – Plow, the lung mechanics
(resistance and compliance) and the length of pressure release Tlow. The
steepness of the pressure rise from the lower pressure level Plow to the upper
pressure level Phigh is determined by the Slope setting.
During the activation of the function AutoRelease, the duration of the pressure
release is determined by the course of the expiratory flow. The Exp term setting
determines the percentage by which the expiratory flow must fall short in relation to
the peak flow in order for the ventilation to return to the high pressure level.
1) References [1], [2], [3], [4] (see "List of references", page 326)

When AutoRelease is activated, the change from the upper pressure level Phigh to
the lower pressure level Plow is synchronized with the patient's spontaneous
breathing.
For further information see: "AutoRelease", page 301.
Synchronization of the mandatory breath reduces the time on the upper pressure
level. The device prolongs the subsequent ventilation time on the upper pressure
level by the missing time. This prevents an increase in respiratory rate.
ventilation.
17.1.11 SPN-CPAP/PS ventilation mode

SPN: Spontaneous, CPAP: Continuous Positive Airway Pressure, PS: Pressure
Support
Spontaneous breathing with continuous positive pressure level with or without
pressure support
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When the pressure support is deactivated, the patient's spontaneous breathing is

supported only by an increased PEEP.
triggers a pressure-supported breath. The time, number, and duration of pressure-
setting.

categories.
1.5 seconds in the Pediatric patient patient category. For the Neonate patient
category, the maximum inspiratory time can be set with the parameter Timax to a
maximum of 1.5 seconds. For non-invasive ventilation, the maximum duration of
support can be set with the parameter Timax.
ventilation.
17.1.12 SPN-CPAP/VS ventilation mode

SPN: Spontaneous, CPAP: Continuous Positive Airway Pressure, VS: Volume
Support
Spontaneous breathing with continuous positive pressure level with or without
volume support
41073
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PEEP
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Insp term
Flow
For volume support VS, every inspiratory effort by the patient on the PEEP level
that meets the trigger criteria triggers a volume-supported breath. By setting the
trigger level, the patient's inspiratory efforts are synchronized. The time, number
and duration of volume-supported breaths is determined by the patient's
spontaneous breathing. The pressure rise is determined by the Slope setting.
The volume support is terminated as soon as the inspiratory flow falls below a
certain proportion of the peak inspiratory flow. The proportion of the peak inspiratory
flow can be adjusted using the Insp term setting. If the Insp term setting is not
configured, this proportion is 25 % in the Adult patient category and 15 % in the
Pediatric patient and Neonate patient categories.
The volume support is also terminated as soon as the duration of the support has
reached the maximum inspiratory time.

For intubated patients, the maximum inspiratory time is limited to 4 seconds in the
Adult patient category and to 1.5 seconds in the Pediatric patient patient category.
For the Neonate patient category, the maximum inspiratory time can be set with the
parameter Timax to a maximum of 1.5 seconds. For non-invasive ventilation, the
maximum duration of support for the Adult and Pediatric patient patient
categories can be set with the parameter Timax.
ventilation.
The set tidal volume of the supported breaths is reached through the automatically
controlled pressure level of the volume support. With volume support, the support
pressure is automatically adjusted to changes in lung conditions (resistance and
compliance) and to the spontaneous breathing demand of the patient.
If the parameter Paw high is linked to the Pmax therapy control, set the maximum
pressure that can be applied with the Pmax setting.
If the parameter Paw high is not linked to the Pmax therapy control, always set the
Paw high alarm limit so that the device issues an alarm in the event of an increase
in airway pressure due to reduced compliance. The maximum pressure that can be
applied is limited to 5 mbar (or hPa or cmH2O) below the upper alarm limit.
17.1.13 SPN-CPAP ventilation mode

SPN: Spontaneous, CPAP: Continuous Positive Airway Pressure
Spontaneous breathing with continuous positive pressure level in the NIV therapy
type
41071
Paw
PEEP
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Flow
The SPN-CPAP ventilation mode is only available with non-invasive ventilation in

the Neonate patient category.
The patient's spontaneous breathing is supported with an increased PEEP.
For the Manual insp./inspiration hold maneuver, the pressure of the breath is set
with the Pmaninsp therapy control and the duration of the breath is set with the
Tmaninsp therapy control.

17.1.14 SPN-PPS ventilation mode

SPN: Spontaneous, PPS: Proportional Pressure Support
Spontaneous breathing with flow- and volume-proportional pressure support
Flow assist
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Flow assist Pressure curve proportional to flow
Vol assist Inspiratory pressure curve proportional to tidal volume
VT
In ventilation mode SPN-PPS, the device supports the patient’s spontaneous

breathing in proportion to the patient’s inspiratory effort. If the patient breathes
strongly, the device supports this effort with high pressure support. If the patient has
shallow breathing, the device reacts with low pressure support. Mechanical support
is omitted altogether if there is no spontaneous breathing. Monitoring of apnea and
minute volume must therefore be set appropriately.
The degree of support in PPS mode can be set separately according to the resistive
and elastic components. Using the resistive proportion Flow assist, the user
defines how much of the resistive work of breathing is taken over by the device.
Using the elastic proportion Vol assist, the user defines how much of the elastic
work of breathing is taken over by the device. This support is only effective during
inspiration.

certain proportion of the peak inspiratory flow. The proportion of the peak inspiratory
flow can be adjusted using the Insp term setting. If the Insp term setting is not
configured, this proportion is 25 % in the Adult patient category and 15 % in the
1.5 seconds in the Pediatric patient patient category. For the Neonate patient
category, the maximum inspiratory time can be set with the parameter Timax to a
maximum of 1.5 seconds. For non-invasive ventilation, the maximum duration of
support for the Adult and Pediatric patient patient categories can be set with the
parameter Timax.
ventilation.
If the upper alarm limit for airway pressure is linked to the Pmax therapy control, set
the maximum pressure that can be applied with the Pmax setting.
If the upper alarm limit for airway pressure is not linked to the Pmax therapy control,
always set the Paw high alarm limit so that the device issues an alarm in the event
of an increase in airway pressure due to reduced compliance. The maximum
pressure that can be applied is limited to 5 mbar (or hPa or cmH2O) below the
upper alarm limit.
Always set the alarm limit Tidal volume high in order to issue an alarm in the event
of an increase in airway pressure and tidal volume resulting from excessive
support.
17.1.15 Additional information

The following information is relevant for all patient categories with the following
ventilation modes and ventilation settings:
– All volume-controlled ventilation modes, e.g. VC-AC, VC-SIMV
– All volume-controlled ventilation modes with AutoFlow, e.g. VC-SIMV/AF
– All pressure-controlled ventilation modes with volume guarantee (VG), e.g. PC-
SIMV/VG
In all the ventilation modes listed above in which a tidal volume is set, the ventilator
limits the maximum pressure increase from one spontaneous breath to the next to
5 mbar (or hPa or cmH2O) above the average peak inspiratory pressure (PIP) in
order to avoid potential excessively high pressures.
In certain situations, such as if the breathing circuit or the endotracheal tube is
kinked, if there is a blocked endotracheal tube or fluctuating leakage, or during use
of a closed suctioning system or during bronchoscopy, the maximum pressure of
the ventilator is correspondingly restricted.
This may trigger alarm messages like Minute volume low or Tidal volume low
that indicate a potential negative impact on patient ventilation.

17.2 Additional settings for ventilation

17.2.1 Apnea ventilation
Apnea ventilation in the Adult and Pediatric patient patient categories
For switching over automatically to volume-controlled mandatory ventilation in the
event of apnea
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If the patient is ventilated using a volume-controlled mode without the function

AutoFlow, apnea ventilation is also volume-controlled without AutoFlow. In all
other cases, apnea ventilation is volume-controlled with AutoFlow.
For the device to be able to detect an apnea, flow measurement must function, and
the flow monitoring must be activated.
The device detects an apnea when no expiratory flow is measured or insufficient
inspiratory gas is delivered during the set apnea alarm time Tapn. If apnea
ventilation is activated, the device starts volume-controlled ventilation in the
ventilation mode VC-SIMV with the ventilation parameters RRapn and VTapn.
The inspiratory time for apnea ventilation is determined from the set respiratory rate
during apnea ventilation RRapn and a fixed I:E ratio of 1:2.
The patient can breathe spontaneously, and the mandatory breaths are
synchronized with the patient's spontaneous breathing. The respiratory rate during
apnea ventilation RRapn remains constant.
Apnea ventilation is terminated by touching the End apnea ventilation button. The
device continues to ventilate again in the previous ventilation mode. Changing the
ventilation mode or the additional settings, e.g., PS, also terminates apnea
ventilation.
If during active apnea ventilation another apnea situation occurs and a
corresponding alarm is issued, this indicates that the respiratory rate during apnea
ventilation RRapn has been set too low in relation to the apnea alarm time Tapn.

Apnea ventilation in the Neonate patient category

For switching over automatically to volume-guaranteed mandatory ventilation in the
event of apnea
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For the device to be able to detect an apnea, flow measurement with the neonatal
flow sensor must function, and flow monitoring with the neonatal flow sensor must
be activated.
The device detects an apnea when no expiratory flow is measured or insufficient
inspiratory gas is delivered during the set apnea alarm time Tapn. If apnea
ventilation is activated, the device starts volume-guaranteed ventilation in the
ventilation mode VC-SIMV with AutoFlow with the ventilation parameters RRapn
and VTapn. The inspiratory time for apnea ventilation is determined from the set
respiratory rate during apnea ventilation RRapn and a fixed I:E ratio of 1:2.
The patient can breathe spontaneously, and the mandatory breaths are
synchronized with the patient's spontaneous breathing. The respiratory rate during
apnea ventilation RRapn remains constant. The device provides synchronized
intermittent mandatory ventilation.
Apnea ventilation is terminated by touching the End apnea ventilation button. The
device continues to ventilate again in the previous ventilation mode. Changing the
ventilation mode or the additional settings, e.g., PS, also terminates apnea
ventilation.
If during active apnea ventilation another apnea situation occurs and a
corresponding alarm is issued, this indicates that the respiratory rate during apnea
ventilation RRapn has been set too low in relation to the apnea alarm time Tapn.
Automatic return from apnea ventilation

If the Autom. return from apnea ventilation function is activated, then the device
automatically switches to the previous ventilation mode when sufficient
spontaneous breathing is resumed. The following conditions must be met:
– Apnea ventilation must have been active for at least 2 minutes.
– The alarm message Minute volume low is not active.

– One of the following conditions must additionally be met:

– The ratio of the parameter MVespon to the parameter MVe is greater than
25 %, and the ratio of the parameter MVleak to the parameter MVe is less
than 40 %.
– 80 % of the mandatory breaths are triggered spontaneously.
If apnea reoccurs within 3 minutes following automatic termination of apnea
ventilation in the Adult and Pediatric patient patient categories, the Autom.
return from apnea ventilation function is deactivated until apnea ventilation is
terminated manually or another ventilation mode is selected.
The Autom. return from apnea ventilation function can be configured, (see
"Selecting the general settings", page 193).
17.2.2 Trigger
The flow trigger is used to synchronize mandatory breaths with spontaneous
breathing. The flow trigger is also used to trigger breaths in the ventilation modes
SPN-CPAP/PS and SPN-CPAP/VS.
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With the trigger threshold Trigger, the mandatory breaths are synchronized with
the inspiratory efforts. The start setting of the flow trigger can be configured (see
"Setting the start values for the ventilation parameters", page 195).
Spontaneous breathing activity of the patient is indicated on the screen by the brief
appearance of the symbol.
In order to prevent a possible error when measuring the respiratory rate, e.g.,
caused by cardiogenic oscillations, only those spontaneous breaths are counted
which meet the adjustable trigger criterion.

17.2.3 Inspiration termination
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For spontaneous breaths supported with PS, VS, or PPS, the length of inspiration is
determined by the inspiration termination criterion. Inspiration termination specifies
at which percentage of the peak inspiratory flow Insp term expiration is to start.
The standard setting is 25 % in the Adult patient category and 15 % in the
The termination criterion can be configured (see "Selecting the general settings",
page 193).
When configured, the inspiration termination can be set with the Insp term therapy
control in order to achieve better adaptation to the patient's lung properties and
breathing pattern.
17.2.4 Sighs
41060
Interval sigh
Paw
Cycles sigh
ΔintPEEP
PEEP
Atelectasis can be prevented by activating the sigh function and setting the sigh in
the form of an intermittent PEEP. The purpose of expiratory sigh is to open
collapsed areas of the lungs or to keep open "more dependent" areas of the lungs.
The sigh function can be activated in all ventilation modes with mandatory breaths,
with the exception of the PC-APRV ventilation mode. During a sigh, the end-
expiratory pressure PEEP increases by the set value of the intermittent PEEP.

The time between two sigh phases can be set with the therapy control Interval
sigh. After this interval has passed, the next sigh phase is started with a complete
breath.
The therapy control Cycles sigh controls how many respiratory cycles are covered
by the sigh phase. The mean airway pressure is higher, and a longer filling time is
normally available.
In pressure-controlled ventilation, the inspiratory pressures Pinsp, Psupp increase
by the amount ΔintPEEP.
17.2.5 AutoFlow/volume guarantee

Paw
41063
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Pinsp
PEEP
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Ti Te

Flow RR
VT
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Pinsp = f (VT, C)
The device provides ventilation with AutoFlow/volume guarantee with a decreasing
flow in order to avoid pressure peaks. The device determines the pressure required
for the set tidal volume, with consideration of the lung conditions (compliance,
resistance) and the patient’s spontaneous breathing demand.
When the patient breathes in, the device delivers an additional inspiratory flow
limited by the alarm limit Tidal volume high. The patient can also breathe out
during the inspiratory plateau phase. The alarm limit for Tidal volume high must be
set with care to prevent, for example, overdistention of the lungs following rapid
changes in compliance.
The inspiratory pressure is limited by the alarm limit Paw high. The maximum
pressure that can be applied is limited to 5 mbar (or hPa or cmH2O) below the
upper pressure limit Paw high. Always set the alarm limit so that an alarm is
generated if the airway pressure increases due to reduced compliance.
If the Paw high alarm limit is linked to the Pmax therapy control, the user can
adjust the maximum value for the airway pressure. Since the set value for the
pressure limitation Pmax may be reached in this case with AutoFlow/volume
guarantee, the current condition of the patient must always be taken into
consideration when the value is set in order to exclude the possibility of causing
harm if the airway pressure is too high.

The minimum inspiratory pressure for mandatory breaths that are not triggered is
3 mbar (or hPa or cmH2O) above PEEP. For triggered mandatory breaths and
spontaneous breaths, it is 0.1 mbar (or hPa or cmH2O) above PEEP.
Typically, the selected inspiratory time Ti is much longer than the lung filling time.
The inspiratory pressure Pinsp corresponds to the minimum value calculated from
the tidal volume VT and compliance C of the lungs. The inspiratory flow is
automatically controlled so that there is no pressure peak caused by the
resistances of the tube and the airways. With AutoFlow/volume guarantee, changes
in inspiratory flow occur from breath to breath in increments of maximum 3 mbar (or
hPa or cmH2O).
If the tidal volume VT is reached (inspiratory flow = 0) before the inspiratory time Ti
has fully elapsed, the control system for the inspiratory and expiratory valves
ensures that the patient can breathe in and out during the remaining inspiratory
time, even during the constant plateau pressure Pplat. If the patient breathes in or
out during mandatory inspiration, the inspiratory pressure does not fluctuate during
that breath. Only the inspiratory and expiratory flow are adapted to the patient’s
demand. The applied tidal volume VT may deviate from the set tidal volume VT in
individual breaths. However, as an average over time, a constant tidal volume VT is
supplied.
Exceeding the tidal volume VT can be limited by the alarm limit Tidal volume high.
If the set alarm limit is exceeded once, the device issues a low priority alarm
message (!). If it is exceeded three times in succession, the device issues a
medium priority alarm message (!!). By switching to PEEP level, the tidal volume is
actively limited to the value of the alarm limit Tidal volume high.
Regardless of the alarm limit Tidal volume high setting, the device ends a breath
with AutoFlow/volume guarantee when the supplied inspiratory volume (minus the
volume supplied to compensate the compliance of the breathing circuit) exceeds
the set volume by 100 %. This may occur in the event of a major leakage. In this
case, the device issues the low-priority alarm message Tidal volume not reached,
leakage.
Set the alarm limits Minute volume high and Minute volume low appropriately in
order to avoid excessive or insufficient flow following rapid changes in compliance.
When using AutoFlow/volume guarantee, activate flow monitoring.
A set inspiratory time Ti shorter than the lung filling time can be recognized from the
flow waveform. The flow at the end of the inspiratory time has not dropped to zero.
In this case, it must be decided whether the current condition of the patient permits
prolongation of the inspiratory time Ti in order to reduce peak pressure even further.
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 device as described. If the
set tidal volume VT can no longer be fully applied as a result, the low-priority alarm
message Pressure limited is issued.
The pressure rise from the PEEP level to the inspiratory level can be even more
closely adapted to the needs of the patient by adjusting the ventilation parameter
pressure rise time Slope.

Start procedure with AutoFlow/volume guarantee

When AutoFlow/Volume guarantee is activated, the device applies the set tidal
volume VT by means of a volume-controlled breath with minimum inspiratory flow
and subsequent inspiratory pause. The peak pressure calculated for this breath
serves as the start value for inspiratory pressure under AutoFlow/Volume
guarantee. If an appropriate pressure cannot be calculated for this breath or the
volume cannot be applied, the device applies a pressure-controlled breath with an
inspiratory pressure of 5 mbar (or hPa or cmH2O) above the set PEEP. The device
measures the applied volume in this case and calculates an initial target pressure
for the set volume. The next mandatory breath is applied with an inspiratory
pressure that corresponds to 75 % of this target pressure. The device measures the
applied volume again and calculates a new target pressure for the set volume. The
next mandatory breath is applied with this target pressure. As described above, the
following mandatory breaths are changed in the inspiratory pressure so that the set
volume is reached on average.
17.2.6 ATC
Automatic tube compensation
41057
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The function ATC regulates the airway pressure to the tracheal level. This function
calculates and displays the tracheal pressure on the basis of a mathematical tube
model, the set tube type and the inner diameter of the tube.
When tube compensation is activated, the device displays the calculated tracheal
pressure in the pressure waveform together with the pressure at the Y-piece as a
line. When tube compensation is activated, the text ATC and the tube diameter are
displayed in the header bar of the screen. When selecting loops, tracheal pressure
can also be selected as a parameter. Tracheal pressure can also be displayed
when tube compensation is deactivated if the calculation of the tracheal pressure
was activated and the tube type and diameter were entered. The device uses this
value for calculating leakage and determining the lung mechanics, but not for tube
compensation. The selected degree of compensation is not considered when
displaying tracheal pressure or when determining leakage and lung mechanics.

Calculating tracheal pressure

The device calculates tracheal pressure on the basis of a square function of tube
resistance and patient flow.
PTrachea = Paw – KTube x Flow x |Flow|

PTrachea Tracheal pressure
Paw Pressure at the Y-piece of the breathing circuit
KTube Tube coefficient
Flow Patient flow
Inspiration: Flow >0
Expiration: Flow <0
The selected tube type and the inner diameter of the tube must correspond with the
real tube for correct calculation and display of the tracheal pressure. This is
required for correct tube compensation.
When tube compensation is activated, the ventilation pressure in the breathing
circuit is increased during inspiration or decreased during expiration. The airway
pressure is adjusted to the tracheal level if 100 % compensation of the tube
resistance has been selected.
Expiratory tube compensation can be deactivated.
In volume-controlled ventilation modes with a constant inspiratory flow (VC-CMV,
VC-SIMV, VC-MMV, VC-AC) tube compensation is only active during expiration
and spontaneous respiratory phases.
For the mandatory portion of the breath, the inspiratory tube compensation can be
deactivated.
When tube compensation is activated, the device controls the ventilation pressure
so that the resistive work of breathing on the tube is compensated in accordance
with the selected degree of compensation.
Depending on the direction of the patient flow, the airway pressure is increased
during inspiration or decreased during expiration.
The airway pressure can be reduced to a minimum of 0 mbar (or hPa or cmH2O).
The maximum value for the airway pressure can be set using the Pmax therapy
control. If the parameter Pmax is not linked to the alarm limit Paw high, the
maximum pressure is limited to 5 mbar (or hPa or cmH2O) below the alarm limit
Paw high. When the maximum permitted values are reached, the pressure
limitation message is displayed.
If the value selected for the parameter Paw high or Pmax is too low, it may impair
the effectiveness of tube compensation. If the value selected for the parameter Paw
high or Pmax is too high, it may result in unwanted high airway pressures. When
setting the parameter Pmax, be aware that this value may actually be reached, in
contrast to the value for the parameter Paw high.

Calculating the support

The level of support ΔPaw applied during ATC is calculated on the basis of a
square law function of tube resistance and patient flow.
ΔPaw = Comp. x KTube x Flow x |Flow|

Comp. Degree of compensation 0 to 100 %
KTube Tube coefficient
Flow: Patient flow
Tube coefficient
The tube coefficient KTube is largely determined on the basis of the results obtained
by Guttmann et al2).
The tube coefficient KTube for the full-length tube is always taken as the basis. The
effect of the shortened length is negligible.
The values for the tube coefficients are shown in the following tables.
Table for endotracheal tube:
Inner diameter of the tube Tube coefficient KTube

(mm) (mbar/L2/s2)
(hPa/L2/s2)
(cmH2O/L2/s2)
2.00 2072.15
2.50 776.19
3.00 347.11
3.50 175.39
4.00 96.95
4.50 57.38
5.00 35.88
5.50 23.47
6.00 15.94
6.50 11.19
7.00 8.08
7.50 5.99
8.00 4.54
8.50 3.52
9.00 2.80
9.50 2.28
10.00 1.89
10.50 1.59
11.00 1.37
11.50 1.19
12.00 1.05
2) Reference [5] (see "List of references", page 326)

Table for tracheostomy tube:
Inner diameter of the tube Tube coefficient KTube

(mm) (mbar/L2/s2)
(hPa/L2/s2)
(cmH2O/L2/s2)
2.00 1097.91
2.50 411.21
3.00 184.71
3.50 94.02
4.00 52.46
4.50 31.42
5.00 19.92
5.50 13.24
6.00 9.15
6.50 6.55
7.00 4.84
7.50 3.67
8.00 2.86
8.50 2.29
9.00 1.87
9.50 1.56
10.00 1.33
10.50 1.15
11.00 1.01
11.50 0.91
12.00 0.82

17.2.7 AutoRelease
Paw
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Flow
Exp term
In PC-APRV ventilation mode with AutoRelease activated, the duration of the

pressure release is determined from the expiratory flow waveform. The Exp term
setting specifies when ventilation returns to the pressure level Phigh dependent on
the decline in percent of the peak expiratory flow. The therapy control Tlow max
limits the maximum duration of pressure release.
When AutoRelease is activated, the change from the upper pressure level Phigh to
the lower pressure level Plow is synchronized with the patient's spontaneous
breathing.
Synchronization of the mandatory breath reduces the effective duration of the upper
pressure level. The device prolongs the subsequent ventilation time on the upper
pressure level by the missing time. This prevents an increase of the respiratory rate
resulting from the settings.

17.2.8 Variable PS
Random variation of pressure support in the SPN-CPAP/PS ventilation mode
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Assisted ventilation with pressure support is frequently used while weaning the
patient from ventilation. Various additional device functions can be combined with
the SPN-CPAP/PS ventilation mode. This also applies for the function Variable PS.
The basic principle of pressure-supported spontaneous breathing is fully retained
and is not modified.
When the function Variable PS is activated, differing pressure support levels are
applied for the breaths. The amount of the pressure support variability Press var
can be changed in the range of 0 to 100 % at any time. Setting is performed as a
percentage of the set pressure support. Different ventilation pressures and tidal
volumes occur with each spontaneous breath as a result of the variation in pressure
support. These ventilation pressures and tidal volumes are independent of the
patient’s inspiratory effort. The variation of the support pressure is performed based
on the fixed mean support pressure ΔPsupp. The maximum support pressure
achievable through the variation is limited by the maximum airway pressure setting
Pmax. The lower limit for the variation is specified by the set CPAP level. Limitation
of the pressure support variability Press var using the maximum airway pressure
Pmax should basically be regarded as a restriction of variability. This means that
the set variability may not be fully exploited. Limitation using the parameter Pmax
also limits the pressure support variability ΔPsupp downwards.
Independently of the patient’s inspiratory effort, the variation of pressure support
using the function Variable PS can lead to a greater variability of the tidal volume
VT than is the case with conventional assisted ventilation with pressure support.
Moreover, the function Variable PS can result in improved oxygenation and a
redistribution of the pulmonary blood flow.3)
Due to the variation of pressure support ΔPsupp, the inspiratory tidal volume VTi or
VT and the expiratory tidal volume VTe also vary. The corresponding measured
values are displayed as mean values.
3) Reference [33] (see "List of references", page 326)

The function Variable PS can be combined with the functions ATC and Apnea
ventilation.
17.3 Maneuvers
Inspiratory O2 concentration during medication nebulization
Use only medication nebulizer 8412935 (white central section core). If other
medication nebulizers are used, considerable deviations may occur in the tidal
volume and the inspiratory O2 concentration.
To minimize the deviation from the set O2 concentration, the device uses a gas
mixture to drive the medication nebulizer. The gas mixture is generated by
switching over between compressed air and O2 in short intervals.
In the Adult patient category, the device synchronizes application of the medication
aerosol with the inspiratory flow phase and maintains a constant minute volume.
The medication nebulizer is supplied with compressed air, O2, or a gas mixture of
compressed air and O2 by the device, depending on the set O2 concentration.
In the Pediatric patient and Neonate patient categories, the medication nebulizer
nebulizes continuously. The aerosol generated during expiration does not reach the
lungs, however. The medication nebulizer is supplied with compressed air, O2, or a
gas mixture of compressed air and O2 by the device, depending on the set O2
concentration.
The diagram shows the possible deviations in the applied O2 concentration from
the set FiO2 concentration with minimum inspiratory flow (14 L/min) in the Adult
patient category and at respiratory rates above 12 /min in the Pediatric patient and
Neonate patient categories.
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Compressed air supply from the GS500 gas supply unit

If the device is supplied with compressed air from the GS500 gas supply unit and
O2 from the central gas supply system, the medication nebulizer operates with O2
only. The measured value FiO2 indicates the O2 concentration of the gas supplied
at the inspiratory port and not the O2 concentration reaching the patient. Depending
on the patient category, the following systematic deviations are possible:
Patient category Systematic deviation

Adult Up to +32 Vol%
Pediatric patient Up to +40 Vol%
Neonate Up to +40 Vol%
17.3.2 Low-flow PV loop

The Low-flow PV loop measurement maneuver records a static pressure-volume
waveform, which can be used to assess the mechanical properties of the lungs.
By slowly filling the lungs with a small, constant flow, only the elasticity properties
are determined in the PV loop. This almost static process shows a good correlation
with the static super-syringe method or occlusion method [6, 7, 8].4), as long as the
flow is small [9 to 13]4).
There are various approaches for optimizing ventilation settings based on
measurements of the lung mechanics. All approaches aim at avoiding a recurrent
collapsing and re-opening of alveoli and a possible overdistention of the lungs. It is
recommended to set the PEEP on the basis of the lower inflection point (LIP) and to
limit the tidal volume VT or the plateau pressure Pplat on the basis of the upper
inflection point (UIP) [14 to 17]4). Other research recommends taking into account
the expiratory limb of the PV loop when determining the positive end-expiratory
pressure (PEEP) required to maintain an alveolar recruitment. Characteristic points
on the expiratory limb are described in this context as the point of maximum
curvature (PMC) [6, 9, 11, 14, 18 to 24]4).
The device calculates the static compliance Cstat based on the volume applied for
inspiration during the maneuver and the generated pressure difference.
The alveolar pressure is calculated from the airway pressure using the following
formula:
Palv = Paw – Rk1 x Flow – Rk2 x |Flow| x Flow
Rk1 and Rk2 are coefficients which are determined during the dynamic calculation
of airway resistance of the patient Rpat.
The device calculates the overdistension index C20/Cstat. In the process, C20 is
the compliance of the last 20 % of a breath. The value C20 is set in relation to the
compliance Cstat of the entire breath. An overdistension index C20/Cstat with a
value less than 0.8 may indicate an overdistension of the lungs [25]4).
4) References (see "List of references", page 326)

The recorded data is analyzed using the method according to Harris RS, Hess DR,
Venegas JG [26]4). After successful calculation, the three following characteristic
points are marked in the loop:
– the lower inflection point on the inspiratory section of the loop
– the upper inflection point on the inspiratory section of the loop
– the upper inflection point on the expiratory section of the loop or the point of
maximum curvature on the expiratory section of the loop
To evaluate the results of the maneuver, two cursors can be moved over the PV
loop. The values for pressure and volume marked by the cursor are displayed. The
static compliance between 2 values is calculated and displayed. If characteristic
points are identified on the loop, the two cursors are initially positioned on these
points so that the corresponding values can be read off.
The last ten loops can be stored in the display for reference, but cannot be
measured. On the Procedures > Low-flow PV loop > History dialog page, the last
up to ten loops, including the inflection points where applicable, are stored and can
be measured with the cursor.
Optimization of the settings PEEP and VT or Pinsp can be performed directly on
the Procedures > Low-flow PV loop > Analysis dialog page. A horizontal or
vertical line indicates the position on the PV loop during setting.
Performing a low-flow maneuver may involve risks for the patient such as
decreasing the patient's systemic circulatory pressure or causing a pneumothorax.
The patient's condition must therefore be taken into account when making the
settings.
The applied pressures and volumes must be suitable for the patient. Potentially
high intrathoracic pressures may be applied over a relatively long period while
performing the maneuver. The patient must therefore be considered to be
hemodynamically stable before starting the maneuver. The monitoring data must be
closely monitored and documented during the entire measurement. A significantly
increased venous return caused by an abrupt relieving of the intrathoracic pressure
may overstrain the heart under certain conditions. This is why the maneuver is
usually terminated with an adjustable pressure decrease, even after only an
inspiratory application.
The maneuver is similar to an apnea with a single slow spontaneous breath. An
acceptable maneuver duration should also be estimated for the patient. To avoid
lengthy periods with a reduced gas exchange, the maneuver can be started again
at the earliest 60 seconds after nebulization, suctioning, or a previous Low-flow PV
loop maneuver.
Spontaneous breathing or leakage during the maneuver distort the measured
values and should be ruled out before the application.
Depending on the duration of the maneuver and the metabolic rate of the patient,
the expiratory limb of a PV loop, in particular, may be easily influenced by the O2
consumption, which is not offset by a corresponding CO2 production5).
5) References [27, 28] (see "List of references", page 326)

17.3.3 Diagnostics – measurement maneuver

Occlusion pressure – P0.1
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Respiratory drive can be measured at the start of inspiration by measuring the

mouth pressure during a short-term occlusion. Within the first 100 ms, the pressure
is not influenced by physiological reactions that would try to compensate for the
occlusion (e.g., reflex apnea or increased respiratory drive). In principle, this
pressure is also independent of the muscle strength of the diaphragm. Therefore,
the occlusion pressure P0.1 after 0.1 seconds is a direct measure of the
neuromuscular respiratory drive6). For patients with healthy lungs and regular
breathing, the P0.1 value will be about –3 to –4 mbar (or hPa or cmH2O). A high
P0.1 value signifies a high respiratory drive, which can only be maintained for a
limited period of time. P0.1 values above –6 mbar (or hPa or cmH2O), e.g., for a
COPD patient, indicate impending exhaustion (RMF – respiratory muscle fatigue).
The device keeps the inspiratory valve closed after one expiration and measures
the airway pressure produced by the patient's inspiratory effort during 100 ms. The
100 ms time interval starts when a negative pressure of –0.5 mbar (or hPa or
cmH2O) below PEEP/CPAP is measured during the inspiratory effort. The second
pressure value is determined after 100 ms. Simultaneously, the inspiratory valve is
opened. The patient can breathe normally again. The occlusion pressure P0.1 is
the difference between the pressure values "P2 – P1".
6) Reference [29], [30] (see "List of references", page 326)

Intrinsic PEEP – PEEPi
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The intrinsic PEEP is the actual end-expiratory pressure inside the lungs. Owing to
dynamic influences of the lung mechanics (resistance, compliance, closing volume)
and the ventilation setting parameters, the intrinsic PEEP may deviate from the
PEEP in the upper airways.
This measurement maneuver also measures the "trapped" volume Vtrap in the
lungs, which does not participate in gas exchange.
The intrinsic PEEP is measured in two phases. The device keeps the inspiratory
and expiratory valves closed during measuring interval 1. This ensures that it is
impossible for inspiratory gas to flow into the breathing circuit or for gas to escape
from it. During this closed phase, pressure is equalized between the lungs and the
breathing circuit. The device measures the pressure over time.
Measuring interval 1 is terminated:
– when no pressure changes are detected any longer, but at the earliest after
0.5 seconds
– at the latest after 3 seconds in the Adult patient category and after 1.5 seconds
in the Pediatric patient patient category
The start value corresponds to PEEP, and the value at the end of the closed phase
is the intrinsic PEEP. At the end of measuring interval 1, the device opens the
expiratory valve and measures the expiratory flow generated by the intrinsic PEEP
during measuring interval 2. During this period, lung pressure is allowed to
decrease to the PEEP level.
Measuring interval 2 is terminated:
– when the expiratory flow has returned to 0, but after 0.5 seconds at the earliest
– at the latest after 7 seconds in the Adult patient category and after 3.5 seconds
in the Pediatric patient patient category
The integrated flow corresponds to the Vtrap air volume trapped in the lungs by the
intrinsic PEEP.

Measuring times of measuring interval 1 for the intrinsic PEEP:

– Adult patient category: max. 3 seconds
– Pediatric patient patient category: max. 1.5 seconds
Measuring times of measuring interval 2 for Vtrap:
– Adult patient category: max. 7 seconds
– Pediatric patient patient category: max. 3.5 seconds
Negative inspiratory force – NIF

The negative inspiratory force (NIF) parameter7) measures the patient's maximum
inspiratory effort after exhalation. The breathing circuit is closed during the
measurement of the NIF value. As a result of the inspiratory effort during manually
lengthened expiration, the patient generates a negative pressure in relation to
PEEP. The probability that the patient can be extubated successfully increases with
the magnitude of this negative pressure. Patients reaching an NIF value of less
than –30 mbar (or hPa or cmH2O) can in all probability be weaned successfully.
Extubation of patients with an NIF value that is not below –20 mbar (or hPa or
cmH2O) will most likely prove unsuccessful.
The device determines the NIF value during manually prolonged expiration. While
the Expiration hold button remains pressed, the breathing circuit closes after an
expiration and the device measures the maximum inspiratory effort made by the
patient. The NIF value is measured as a pressure relative to PEEP. The
measurement maneuver is ended when the Expiration hold button is released or
after a maximum of 15 seconds. The device displays the last measured NIF value
and the time when the measurement was made.
Influence of spontaneous breathing on resistance and compliance values

Spontaneous breathing influences the compliance Cdyn and resistance R values
as follows:
– Trigger activity
The trigger activity is filtered out of the calculation and has virtually no influence
on the compliance Cdyn and resistance R.
– Patient breathing synchronously with the ventilator
– Compliance Cdyn becomes incorrectly high
– Resistance R becomes incorrectly low
Changes in the values indicate to what extent the patient is able to perform
work of breathing and determine ventilation.
The trends provide information on progress.
– Patient breathing synchronously against the ventilator
– Compliance Cdyn becomes incorrectly low
– Resistance R becomes incorrectly high
– Purely spontaneous breathing
In the case of purely spontaneous breathing, no information on the compliance
Cdyn and resistance R is available.
7) Literature reference [31], [32] (see "List of references", page 326)

17.3.4 C20/C
The C20/C index is a calculation of the compliance of the last 20 % (C20) of a
breath in relation to the compliance (C) of the entire breath.
During a breath, the device continuously determines the pressure applied and the
resulting tidal volume. The compliance of the last 20 % of a breath determined in
this manner is set in proportion to the total compliance.
From the ratio determined, the following information can be derived:
– C20/C <1: A decrease of compliance at the end of the breath was detected. The
lungs may be overdistended.
– C20/C >1: An increase of compliance at the end of the breath was detected.
Tidal recruitment may be occurring.
– C20/C = 1: No change in compliance at the end of a breath could be detected.
The lungs may not be overdistended, or tidal recruitment may not be occurring.
The calculation of C20/C takes into account the effect of the resistance of the
endotracheal tube used or the tracheostomy tube used. For this, the tube diameter
is required. The correct tube diameter entry of the tube used determines the quality
of the C20/C index calculated.
The C20/C index is always displayed as long as a correction delivers plausible
results with regard to the resistance. If, for instance, a smaller tube diameter was
entered than that of the tube actually used, a correction to the measured values
may deliver an implausible result. In this case, no C20/C index is displayed. The
parameter field remains empty.
17.4 Smart Pulmonary View

Graphic display of lung characteristics
Smart Pulmonary View is a graphic display of compliance and resistance.
The representation corresponds to the displayed measured values of the respective
patient.
The display range of compliance is 0 to 400 mL/mbar (or mL/hPa or mL/cmH2O).
The display range of resistance is 0 to 300 mbar/L/s (or hPa/L/s or cmH2O/L/s).
To detect an improvement or deterioration of the patient's condition with regard to
compliance and resistance, it is possible to adapt the representation to the current
values of the patient. One measuring range starts at 0 and goes to double the value
of the current compliance; the other measuring range starts at 0 and goes to double
the value of the current resistance. After the adaptation, the measured values
determined are displayed as reference values with the time and date. In the
diagram, the current values (calibration values) are displayed as an orange broken
line. The scales for compliance and resistance are adapted.
The compliance and resistance measured respectively are displayed by thin or
thick lines accordingly.
The point when the maximum value that is based on the last calibration is reached
is represented with a red line as a boundary. This indicates that the measured
values determined can no longer be represented graphically. The measured values
are outside the display range. The device displays a request for a new calibration.

The diaphragm is displayed schematically underneath the representation of the

lungs. The movement of the diaphragm indicates synchronized mandatory breaths,
supported (triggered) breaths, or spontaneous breaths.
The ratio between spontaneous breathing and mandatory ventilation is displayed in
a diagram. The display is a qualitative representation of the respective minute
volume.
From this, the following information can be derived:
– The ratio between the spontaneous and mandatory minute volumes
– Spontaneous breathing quality and pattern, e.g., rapid shallow breathing index
Smart Pulmonary View is a qualitative representation of the ventilation situation.
Local pathophysiological peculiarities, such as atelectasis or airway obstructions of
the lungs, cannot be displayed.
Furthermore, individual patient situations cannot be displayed, such as the
condition after a pneumectomy or a diaphragmatic hernia.
17.5 Therapy types

17.5.1 NIV – Non-invasive ventilation
Non-invasive ventilation by mask for patients with spontaneous breathing
Leakage is greater with non-invasive ventilation than with invasive ventilation. The
device considers the leakage in the NIV therapy type accordingly. The inspiratory
trigger and the termination criterion are automatically adapted to the measured
leakage. This prevents auto-triggering due to a flow trigger which has been set too
low and extended inspirations, as well as insufficient inspiration due to a termination
criterion which has been set too high.
The inspiratory tidal volume is typically far higher than the patient’s tidal volume.
The expiratory tidal volume is slightly lower than the patient’s tidal volume. The
measured values for tidal volume are leakage-corrected and indicate the patient's
actual tidal volume. In the ventilation modes with AutoFlow and volume guarantee,
the corrected measured values are set when leakage compensation is selected.
During volume-controlled ventilation, the inspiratory volume escaping through the
leakage is additionally supplied.
The Tidal volume low, Tidal volume high, Minute volume low and Tapn alarm
limits can be deactivated in the NIV therapy type. The Tdiscon setting may be used
to delay the Airway pressure low alarm.
In the Neonate patient category, only the SPN-CPAP or PC-CMV ventilation modes
may be selected. When using prongs or a mask, the neonatal flow sensor must be
removed from the breathing circuit. The device deactivates flow monitoring with the
neonatal flow sensor.
17.5.2 O2 therapy
O2 therapy can be used for patients with independent breathing. The continuous
flow is applied via an oxygen mask or nasal cannula, for example. The O2
concentration and the flow can be set. The flow can be set in a range of 2 to
50 L/min.

17.6 Leakage adaptation and leakage compensation

17.6.1 Determining the leakage
The device determines the difference between the delivered inspiratory flow and
the measured expiratory flow. The difference is the measure for the amount of
leakage, and the device displays it with the following calculated values:
– Leakage minute volume MVleak
– Leakage proportion of inspiratory minute volume % leak (MVleak to MVi)
The leakage minute volume MVleak displays the leakage that exists at the mean
airway pressure Pmean. A higher percentage of volume is lost during inspiration
than during expiration because the leakage is proportional to the pressure. Due to
technical tolerances, a small leakage minute volume may be displayed, even for a
closed system. If the leakage changes quickly, the device needs several breaths to
determine the new leakage value. During volume-controlled ventilation without
AutoFlow, the device supplies additional volume during the inspiration in order to
compensate for the losses caused by the leakage. The device compensates for
volume losses of up to 100 % of the set tidal volume VT.
Leakage rate
The device determines the mean leakage flow from the difference between the
inspiratory minute volume MVi and the expiratory minute volume MVe (displayed as
MV). Standardized as MVi, the result is the leakage rate displayed in percent:
Leakage rate = 100 % x (MVi – MVe) / MVi
In the Pediatric patient and Neonate patient categories, leakage values that are
smaller than 10 % are displayed as 0 %.
17.6.2 Leakage adaptation

A leakage flow can impact the synchronization of breaths. Self-triggering can be
caused, for instance, if at the end of the expiration there is an inspiratory flow. If the
flow flows through a tube leak instead of into the lungs, for example, the set trigger
threshold can be exceeded and a new breath can thus be triggered. In a ventilation
mode with a synchronized end of inspiration (e.g., PC-PSV), a continual leakage
flow cannot reach the inspiratory termination (see "Inspiration termination",
page 294).
To avoid this, the device automatically and continually adapts the following settings
to the amount of leakage:
– Flow trigger threshold for inspiration
– Termination criterion for a breath
The automatic adaptation is always active, and the user cannot configure it.
Working principle with leakage adaptation:
The device determines the leakage flow. The leakage flow is subtracted from the
total flow in order to determine the patient flow. Only the patient flow is used to
adapt the flow trigger threshold and the termination criterion to the actual amount of
leakage. After a few breaths, the device avoids self-triggering or late termination of
the breath. If the leakage changes, the flow-trigger threshold is automatically
adapted.

17.6.3 Leakage compensation

The leakage compensation is a function that optimizes the tidal volume control and
display for leakage. The goal is to display the leakage-corrected values of the tidal
volumes. If the leakage compensation is activated, additional measured values for
volume and flow (VT, MV) are calculated, less the leakage. Additionally, a leakage-
corrected waveform for flow is displayed.
The calculated values (MVleak, % leak) are not corrected. The leakage-corrected
measured values and display values are provided with corresponding indexes. If
leakage compensation and AutoFlow are activated or if volume-controlled
ventilation is used, the value VT is the basis for regulation.
The user can activate and deactivate the Leakage compensation function. If the
leakage compensation is activated, the flow waveform and the relevant parameter
fields display the corresponding information. If the leakage compensation is
deactivated, the parameter fields for the calculated values (VT, MV) are empty.
Example of leakage compensation with AutoFlow or volume guarantee

These calculations are displayed in a simplified manner and do not take pressures
and mechanical lung properties into consideration. The working principle is
illustrated using the following values as an example:
– Set tidal volume VT: 500 mL
– Pediatric patient or Adult patient category
– Leakage: approx. 20 %
Working principle without leakage compensation:
The device selects the inspiratory pressure so the inspiratory tidal volume
VTi = 500 mL is delivered. The patient receives only 450 mL because 50 mL are
lost during inspiration owing to the leakage.
Working principle with leakage compensation:
The device adapts the inspiratory pressure so the leakage-corrected tidal volume
VT delivered to the patient is 500 mL. The inspiratory tidal volume VTi is
correspondingly higher.
Example of leakage compensation during volume-controlled ventilation

These calculations are displayed in a simplified manner and do not take pressures
and mechanical lung properties into consideration. The working principle is
illustrated using the following values as an example:
– Set tidal volume VT: 500 mL
– Pediatric patient or Adult patient category
– 10 % tube leakage
Working principle without leakage compensation:
The device delivers 500 mL. The delivered value is displayed as the inspiratory tidal
volume VTi. 50 mL escape as leakage during inspiration. 450 mL reach the lungs
and are exhaled. Again, during exhalation, 45 mL of them escape as leakage.
405 mL are measured and displayed as expiratory tidal volume VTe. As a result,
the volume in the lungs is slightly overestimated when the leakage compensation is
turned off. Thus, at a respiratory rate of 10 /min, an inspiratory minute volume of
5.0 L/min will be delivered and an expiratory minute volume of 4.05 L/min will be

measured. The lungs are ventilated with a minute volume of 4.5 L/min. Without
leakage compensation, the VTi therapy control determines the volume the device
supplies during inspiration.
The following applies: VTi = VT > VTe with VTi = VT = set tidal volume
(analog: MVi = MV > MVe). The volume in the lungs cannot be displayed.
Working principle with leakage compensation:
With automatic leakage compensation, the device does not deliver a tidal volume of
500 mL. Instead, based on the measured leakage minute volume, it delivers an
inspiratory tidal volume VTi of 550 mL in this example. 500 mL reach the lungs, and
50 mL escape as leakage. The volume in the lungs is displayed as leakage-
corrected tidal volume VT. The measured expiratory tidal volume is not displayed
as leakage-corrected, even when leakage compensation is activated, and is
therefore 450 mL. The measured expiratory minute volume is 4.5 L/min and is also
not displayed as leakage-corrected. With leakage compensation, the VT therapy
control determines the volume to be delivered to the patient.
The following applies: VTi > VT > VTe with VT = set tidal volume
(analog: MVi > MV > MVe). The volume in the lungs is displayed by the measured
value VT.
Explanation of parameters
VTi Inspiratory tidal volume (measured value)
VTe Expiratory tidal volume (measured value)
VT Leakage-corrected tidal volume (calculated value for activated
leakage compensation)
MVi Inspiratory minute volume (measured value)
MVe Expiratory minute volume (measured value)
MV Leakage-corrected minute volume (calculated value for activated
leakage compensation)
MVleak Leakage minute volume (calculated value)
% leak Leakage proportion of inspiratory minute volume in percent (calcu-
lated value)
17.7 Linking the maximum airway pressure to the upper

alarm limit – Pmax/Paw high autoset
If the function Pmax/Paw high autoset is activated, the maximum airway pressure
is linked to the upper alarm limit for the airway pressure. The Pmax therapy control
is displayed in the therapy bar.
When factory defaults are used, the link is deactivated.
If the function Pmax/Paw high autoset is deactivated, the maximum airway
pressure is limited to 5 mbar (or hPa or cmH2O) below the set alarm limit Paw high.

17.8 Flow reduction – Anti-air shower

When the Anti-air shower function is activated and a disconnection is detected
during ventilation, the flow is reduced until reconnection is detected.
Simultaneously, the Disconnection detected alarm is displayed. For non-invasive
ventilation, the time before the alarm is triggered can be delayed with the setting
Tdiscon. The minute volume may be reduced due to the already reduced flow.
The Anti-air shower function can be configured, (see "Selecting the general
17.9 Measurements
17.9.1 Flow / volume measurement
Independent of whether ventilation is pressure-controlled or volume-controlled,
positive pressures are generated during the inspiratory phase both in the breathing
circuit as well as in the patient's lungs. The volume delivered by the ventilator is
distributed to both the patient lungs and the breathing circuit used between patient
and device. This distribution occurs according to the ratio of lung compliance
versus compliance of the breathing circuit.
Resulting expiratory deviations for the measurand of flow and its derived values of
minute volume and tidal volume are minimal during ventilation in the Adult patient
category. This is due to the relatively large lung compliance compared to the
considerably smaller compliance of the breathing hoses. Significant differences are
possible during ventilation in the Pediatric patient and Neonate patient categories.
As only the volume actually entering and leaving the lungs is relevant for the
efficiency of ventilation, the device always compensates for the effect of the
compliance of the breathing circuit on ventilation.
Compensating for the effect of the compliance of the breathing circuit

During the breathing circuit test before ventilation, the device determines the
compliance of the breathing hoses. It then compensates for the effect of this
compliance on flow and volume measurement during ventilation.
Depending on the airway pressure, the device increases the tidal volume by the
same amount that remains in the breathing hoses. The device compensates losses
in volume caused by the hoses up to a compliance of 4 mL/mbar (or mL/hPa or mL/
cmH2O) in the Adult patient category and 3 mL/mbar (or mL/hPa or mL/cmH2O) in
In addition to the influence of the compliance of the breathing circuit, flow/volume
measurement is affected by the following factors:
– the ambient conditions temperature and pressure
– the composition of the gas
– leakage in the breathing circuit
The device takes these effects into account and corrects the set and measured
values accordingly.

Adaptation to ambient conditions

The volume of a gas depends on the ambient conditions with regard to
temperature, pressure, and humidity. In lung physiology, reference is made to the
conditions inside the lungs for the values of minute volume and tidal volume: 37 °C
(99 °F) body temperature, pressure inside the lungs, 100 % relative humidity.
Flow and volume measured values under these conditions are characterized as
BTPS. Medical gases from cylinders or from a central supply are dry
(approximately 0 % relative humidity) and are delivered by the ventilator at 20 °C
(68 °F) and 1013 mbar (or hPa or cmH2O). Flow and volume measured values
under these conditions are characterized as NTPD.
The difference between NTPD and BTPS measured values is approximately 12 %
at a pressure of 1013 mbar (or hPa or cmH2O).
Example: 250 mL tidal volume NTPD become 282 mL BTPS when warmed to
37 °C (99 °F) and humidified to 100 % relative humidity.
The device controls the tidal volume in such a way that the set tidal volume value is
applied under BTPS conditions in the lungs.
17.9.2 Measurement principles

Measurement principle of the flow measurement
The measurement principle used for flow measurement is based on hot-wire
anemometry. Hot-wire anemometry is a thermal measurement maneuver in which
the measuring wires of the flow sensor are kept at a constant excess temperature.
The higher the flow, the more current is required to maintain a constant excess
temperature. The flow rate is calculated based on the magnitude of the heating
current.
To ensure correct function, check regularly for visible damage, soiling, and particles
before and after inserting the flow sensor. Replace flow sensors when damaged,
soiled, or not particle-free. If the measurement wires of the flow sensor glow
continuously during operation, this is an indication of soiling. Immediately reprocess
or replace the flow sensor.
Flow measurement with expiratory flow sensor

Expiratory flow is measured with a hot wire anemometer. The flow passes through
the sensor, cooling the hot wire in the process. The amount of energy required to
maintain the hot wire at a temperature of 130 °C (266 °F) is a measure for the flow.
Flow measurement with neonatal flow sensor

The flow is measured with a hot wire anemometer between the Y-piece and the
tube. The flow direction is detected by the use of two hot wires, one of which is
shielded on one side.
The amount of energy required to keep the wire at a temperature of 400 °C (752 °F)
is used as a measure of the flow passing through the sensor, cooling the hot wire.
The lowest flow at which detection functions reliably is 0.2 L/min. Lower flow values
are therefore suppressed and displayed as zero.
Two different sensor types are available:
– Y-sensor, integrated in the Y-piece
– ISO sensor to insert between Y-piece and tube connector

Both sensor types use the same sensor insert. Despite this, the sensor properties
are not identical. The sensor type is set in the Sensors > Neonatal flow sensor
dialog page in order to adapt the measurement for this type of sensor optimally.
O2 measurement
A heater and a temperature sensor are positioned in a homogeneous magnetic field
which is periodically activated and deactivated. The thermal conductivity of O2
changes due to the magnetic field. The change in thermal conductivity is a measure
of the O2 concentration.
CO2 measurement
The mainstream CO2 measurement is based on an absorption measurement.
A light source generates a spectrum. Two sensors record the characteristic
absorption spectrum and supply electrical signals that change with the CO2
concentration.
These signals are then evaluated and displayed. Heating the CO2 sensor probe
prevents condensate formation.
17.9.3 Airway pressure measurement

The device measures the airway pressure indirectly using two internal pressure
sensors. The sensors are installed in the inspiratory and expiratory limbs, thereby
eliminating the need for an external pressure measuring line between the Y-piece
and the device. As long as one side is without flow, the measured value of the
pressure sensor concerned corresponds to the airway pressure at the Y-piece.
In the Neonate patient category, there is a constant base flow during ventilation.
However, due to this constant base flow, a condition without flow is never attained –
neither on the inspiratory nor on the expiratory side. The pressure measured by the
inspiratory pressure sensor varies with the variations in airway pressure but is
increased by the pressure drop in the inspiratory limb of the breathing circuit. The
pressure measured by the expiratory pressure sensor is reduced by the pressure
drop in the expiratory limb of the breathing circuit. These pressure differences are
caused by the flow resistance of the breathing circuit.
During expiration, the value measured at the inspiratory pressure sensor (Pinsp) is
reduced by the pressure drop caused by the base flow (Flowbf) in the inspiratory
limb of the breathing circuit (Rinsp):
Paw = Pinsp – Rinsp x Flowbf

Paw Airway pressure at Y-piece
Pinsp Airway pressure at the inspiratory pressure sensor
Rinsp Flow resistance of the inspiratory breathing hose
Flowbf Base flow

During inspiration, the value measured by the expiratory pressure sensor (Pexp) is
raised relatively to the airway pressure by the pressure drop caused by the flow
(normally Flowout ≤ Flowbf,) in the expiratory limb of the breathing circuit (Rexp):
Paw = Pexp + Rexp x Flowout

Paw Airway pressure at Y-piece
Pexp Airway pressure in expiratory breathing hose
Rexp Flow resistance of the expiratory breathing hose
Flowout Flow through the expiratory valve during inspiration
The hose resistances are determined during the breathing circuit test.
17.10 Battery concept

17.10.1 General information
At the time of manufacture and delivery, batteries have a typical capacity which is in
accordance with the information specified in the battery manufacturer's data sheet.
The electrochemical composition of the battery is crucial for its total capacity. The
battery runtime is derived from this information (see "Technical data", page 240).
The capacity of batteries changes with increasing age and utilization.
All the following information and specifications refer to perfectly functioning

batteries. If batteries are faulty, the correct device function, e.g. battery charge
indication or alarms, may be impaired (see "Battery test", page 235).
17.10.2 Battery charge indication on the screen

The charge status indicator shows the available battery charge determined by the
electrochemical processes. When the batteries are, e.g., fully charged, this state is
indicated by a corresponding symbol.
Symbol Battery charge

99 to 100 %
75 to 98 %
50 to 74 %
25 to 49 %
0 to 24 %, flashes red.
Batteries faulty or no information available on the battery charge.
The charge status indicator is a relative indication which is based on the

electrochemical properties of the battery. The charge status indicator is evaluated
on the basis of a battery model.
The use of a model-based indication is a state-of-the-art technique which finds
application in many fields, e.g., computers, cellular phones, etc.

The model-based indication of battery charge takes account of the following

information, among other things:
– Type of battery (e.g., NiMH or VRLA)
– Maximum capacity on delivery (e.g., 12 Ah)
– Age of the battery (e.g., new or 2 years)
– Capacity spent (irreversibly lost) over the utilization time (e.g., 1000 Ah)
– Device power consumption (e.g., 2.5 A)
– Discharging mode
– Charging mode
If the power consumption changes, e.g., due to switching to standby mode,
operation of a GS500 gas supply unit, or after adjusting the screen brightness, the
remaining battery runtime of the device also changes. The charge status indicator is
updated to take account of the power consumption.
In accordance with the specification, the charge status indicator is only displayed
and updated after the device has been completely started up. This procedure may
take a few minutes.
17.10.3 Battery ageing

The electrochemical composition of a battery alters as a result of ageing and
utilization. Consequently, every battery loses a proportion of its maximum capacity
when compared to the maximum capacity of the battery in its new condition. This
loss of capacity is typically irreversible.
As a result of ageing and utilization of the battery, there is a change in the actual
maximum battery runtime which cannot be displayed by the percentage values in
the charge status indicator. The percentage value refers to the battery charge,
which entails a different operating time depending on the age of the battery, for
example.
New batteries
The following data for minimum battery runtime apply to new and fully charged
batteries. The symbol for a fully charged battery is displayed (see "Battery charge
indication on the screen", page 317). For further information see: "Technical data",
page 240. Owing to production fluctuations during the manufacture of batteries, the
battery runtime can be considerably longer.
Battery used (battery type) Minimum battery run- Minimum battery run-
time without operating time while operating a
a GS500 GS500
Internal battery 30 min 15 min
PS500 240 min 120 min

Aged batteries, e.g., 2 years old

The following data for the minimum battery runtime apply, e.g., to 2-year old and
fully charged batteries. The data are approximate values and cannot be regarded
as guaranteed for every battery, The symbol for a fully charged battery is displayed
(see "Battery charge indication on the screen", page 317). For further information
see: "Technical data", page 240.
Battery used (battery Minimum battery run- Minimum battery run-

type) time without operating a time while operating a
GS500 GS500
Internal battery 22 min 11 min
PS500 120 min 60 min
A reduction in the capacity of batteries due to ageing and utilization is normal. As

a greatly simplified approximation, an average linear reduction in capacity can be
assumed. The current individual capacity of a battery depends on the following
factors, among others:
– Age
– Utilization (frequency, duration, and power consumption)
– Battery charge
– Ambient temperature
Spent batteries
When the internal battery and the batteries in the PS500 show less than the
following remaining battery runtimes, they are considered to be spent.
Battery used (battery Remaining battery runtime

type)
Internal battery <22 min
PS500 <120 min
17.10.4 Alarm behavior during battery operation

The switch-over of the device to battery operation is indicated by the Battery
activated alarm (see "Alarm – Cause – Remedy", page 205). The alarm can be
acknowledged by the user. Consequently, the Battery activated alarm will no
longer be displayed until the mains power supply is re-established.
When the device is equipped with a PS500 power supply unit, in battery operation
the PS500 is discharged first. If the mains power supply has not been re-
established, the device switches over to the internal battery after the battery runtime
of the PS500 has elapsed. The switch-over is indicated by the Internal battery
activated alarm.
At the end of the battery runtime of the internal battery, the device issues the
Battery low alarm. The Battery depleted alarm follows after that.
These alarms appear at the time specified by the model-based calculation for the
particular battery.

Schematic representation of the sequence of alarms
Battery activated
41052
9ROWDJH>9@
Internal battery activated
36 ,QWHUQDOEDWWHU\ Battery low
Battery depleted
6ZLWFKRIIYROWDJH 'HYLFHVKXWVGRZQ
7LPH>PLQ@

36EDWWHU\UXQWLPH %DWWHU\UXQWLPHIRUWKHLQWHUQDOEDWWHU\
The schematic representation of the sequence of alarms with respect to battery

utilization is shown in an example with a PS500 but without the use of a GS500.
The representation corresponds to the battery runtime of new and fully charged
batteries.
When the voltage drop of the internal battery reaches an operationally critical value,
a shut-down of the device due to an inadequate supply is imminent. In this case, the
power supply failure alarm sounds.
If the device displays the Battery low alarm message or the Battery depleted
alarm message, connect the device to the mains power supply.
When the remaining calculated battery runtime is less than 10 minutes, the
model-based Battery low alarm appears. When the remaining calculated battery
runtime is less than 5 minutes, the model-based Battery depleted alarm appears.
The remaining battery runtime after the corresponding alarms can be

considerably longer than the specified minimum battery runtime.
When the device is fitted with the GS500 gas supply unit, the device calculates
the time for the Battery depleted alarm allowing for the power consumption of a
GS500, regardless of whether the GS500 is activated or not.

17.11 Pneumatic functional description

17.11.1 Pneumatic circuit diagram of the ventilation unit
41094
$ %
S )
(

S &2
( 9
( (

* & $LU
2

+ ( ' ,QVSLUDWRU\JDV
2 S 9 ([SJDV
, ( ( (
1HEXOL]HUJDV
No./pos. Designation
1 Gas inlet Air
2 Gas inlet O2
3 Non-return valve Air
4 Non-return valve O2
5 Dosage valve Air
6 Dosage valve O2
7 Tank
8 Dosage valve gas mixture
9 Inspiratory valve
10 Emergency expiratory valve
11 Emergency breathing valve
12 Patient's lungs
13 Expiratory valve
14 Non-return valve
15 Expiratory flow sensor
16 Barometric pressure sensor
17 Calibration valve for inspiratory pressure sensor
18 Inspiratory pressure sensor
19 Calibration valve for expiratory pressure sensor
20 Expiratory pressure sensor
21 O2 sensor
22 Nebulizer gas outlet
23 Pressure reducer Air
24 O2 pressure reducer
25 Nebulizer mixer valve
26 Nebulizer switchover valve
27 CO2 sensor

No./pos. Designation
28 Neonatal flow sensor (depending on the patient category)
A Gas mixture and gas delivery assembly
B Inspiratory valve assembly
C Expiratory valve assembly
D Expiratory flow sensor
E Barometric pressure sensor
F Pressure measurement assembly
G Calibration assembly
H O2 sensor
I Medication nebulization assembly
17.11.2 Description of the pneumatic working principle

The ventilation unit consists of 9 pneumatic assemblies.
The gas mixture and dosage assembly (A) delivers the time-variable flow of a gas
mixture with adjustable proportions of O2 and air. Gas from the central gas supply
system enters the ventilation unit via the gas inlets for O2 and Air (1, 2). Two non-
return valves (3, 4) prevent one gas from returning to the supply line of the other
gas. The mixing of the gases takes place in the tank (7) and is controlled via two
control valves (5, 6). The supplied inspiratory flow is controlled via a third control
valve (8).
The inspiratory valve assembly (B) consists of the inspiratory valve (9) and two
non-return valves (10, 11). In normal operation, the inspiratory valve is closed so
that the inspiratory flow is supplied to the patient (12) from the gas mixture and gas
delivery assembly. During other operating states, e.g., when the device is in
standby mode, the inspiratory valve is open and enables spontaneous inspiration
through the emergency breathing valve (11). When the expiratory valve (13) is
blocked, the emergency expiratory valve (10) provides a second channel for
expiration.
The expiratory valve assembly (C) consists of the expiratory valve (13) and a non-
return valve (14). The expiratory valve is a proportional valve and is used to adjust
the pressure in the breathing system. In conjunction with the spring-loaded valve of
the emergency air outlet (10), the non-return valve (14) prevents pendulum
breathing during spontaneous breathing. The expiratory flow sensor (D, 15)
measures the expiratory flow in accordance with the hot-wire anemometry
measurement principle. Therefore the measured flow is a mass flow (NTPD).
The inspiratory valve, expiratory valve, and expiratory flow sensor assemblies can
be detached from the ventilation unit for cleaning purposes.
The mass flow to volume flow conversion (BTPS) requires knowledge of the
ambient pressure. The ambient pressure is measured with the barometric
pressure sensor (E, 16).
The pressure in the breathing system is measured with two independent pressure
sensors (18, 20) Together, they form the pressure measurement assembly (F).
The pressure sensors are regularly zero calibrated. For this, the pressure sensors
are connected to ambient pressure via the two calibration valves (17, 19). Together,
they form the calibration assembly (G).

The O2 sensor (H, 21) measures the inspiratory O2 concentration based on a

sidestream measurement principle. For calibration by the user during the system
test, the O2 sensor can be flushed with pure O2 from the tank (7).
A pneumatic medication nebulizer can be connected to the nebulizer gas outlet (22)
for medication nebulization. The device provides an intermittent gas flow consisting
of O2 and air to drive the medication nebulizer. This ensures that the deviation of
the set O2 concentration remains within the specified limits. For this, the gas from
the two gas inlets (1, 2) is throttled by the pressure reducers (23, 24). The
intermittent gas delivery is done by nebulizer mixer valve (25). When the nebulizer
is not switched on, the nebulizer switchover valve (26) closes the nebulizer gas
outlet.
The nebulizer mixer valve, the nebulizer switchover valve, and the two pressure
reducers form the medication nebulization assembly (I).
The CO2 concentration of the breathing gas can be measured using the CO2
sensor (27). CO2 is measured according to an optical measurement principle in the
mainstream.
An active breathing gas humidifier (see "Preparing the breathing gas humidifier",
page 77) and a pneumatic medication nebulizer (see "Medication nebulization",
page 122) can also be installed.
17.12 Menu structure

17.12.1 Main menu bar buttons
The following table lists the buttons of the main menu bar with the resulting dialogs
of the same name and the tabs. For further information see: "Operating concept",
page 41.
Sym- Button in the main Horizontal tab Vertical tab

bol menu bar
Alarms Alarm limits
Alarm logbook
Views
Trends/data Trends Graphical trend

Tabular trend
Values Configured values
Measured values
Set values
Logbook
Test results System test
Breathing circuit test
Export data
Sensors Neonatal flow sensor
Flow sensor
O2 sensor
CO2 sensor

Sym- Button in the main Horizontal tab Vertical tab

bol menu bar
Procedures Maneuvers
Low-flow PV loop Maneuver information
Maneuver
Analysis
History
Diagnostics P0.1
PEEPi
NIF
Patient transport
System setup Screen Overview
General settings
Views
Waveform scaling
Configured values
Buttons
Graphical trend
Alarms
Ventilation Overview
Ventilation modes
General settings
Maneuvers
Start settings Overview
Patient categories
Alarm limits
Trigger, VT, RR
Pressures, FiO2, I:E
Advanced settings
Configuration
import/export
Options
Battery Battery test
Test activation
System Overview
Status
Supply unit
Country
Units
Interfaces
Password
Service
Help

17.12.2 Action buttons in the main menu bar

Action button Corresponding dialog page
Day/night System setup > Screen > General settings
Freeze waveforms
Main screen
Logbook Trends/data > Logbook
Tabular trend Trends/data > Trends > Tabular trend
Configured values Trends/data > Values > Configured values
Nebulization Procedures > Maneuvers > Nebulization
Low-flow PV loop Procedures > Low-flow PV loop
O2/suctioning Procedures > Maneuvers > O2/suctioning
Manual insp./inspiration hold Procedures > Maneuvers > Manual insp./inspi-
ration hold
Manual disconnection Procedures > Maneuvers > Manual disconnec-
tion
P0.1 Procedures > Diagnostics > P0.1
PEEPi Procedures > Diagnostics > PEEPi
NIF Procedures > Diagnostics > NIF
Expiration hold Procedures > Maneuvers > Expiration hold
Trigger Advanced settings > Trigger
Apnea ventilation Advanced settings > Apnea ventilation
Flow sensor Sensors > Flow sensor
O2 sensor Sensors > O2 sensor
CO2 sensor Sensors > CO2 sensor
Neonatal flow sensor Sensors > Neonatal flow sensor
SmartCare trends Trends/data > Trends > SmartCare/PS
SmartCare logbook Trends/data > Logbook > SmartCare/PS
SmartCare values Trends/data > Values > SmartCare/PS
SmartCare overview SmartCare/PS > Overview

17.13 List of references

[1] Meyer, J.: Neue Beatmungsformen. Anästhesiol. Intensivmed. Notfallmed.
Schmerzther. [New Ventilation Modes. Anesthesiology. Intensive-Care Med-
icine. Emergency Medicine. Pain Therapy.] 26 (1991): 337-342
[2] Vincent, J.-L.: Yearbook of Intensive Care and Emergency Medicine.
Springer-Verlag, 1993
[3] Stock, M. C., Downs, J. B., Frolicher, D.: Airway Pressure Release Ventila-
tion. Critical Care Medicine 15 (1987): 462-466
[4] Räsänen, J., Cane, R. D., Downs, J. B., et al.: Airway Pressure Release
Ventilation During Acute Lung Injury: A Prospective Multicenter Trial. Critical
Care Medicine 19 (1991): 1234-1241
[5] Guttmann, W., Eberhard, L., Fabry, B., et al.: Continuous Calculation of Tra-
cheal Pressure in Tracheally Intubated Patients. Anesthesiology 79 (1993):
503-513
[6] Mehta, S., Stewart, T. E., MacDonald, R., et al.: Temporal Change, Repro-
ducibility, and Interobserver Variability in Pressure-Volume Curves in Adults
with Acute Lung Injury and Acute Respiratory Distress Syndrome. Critical
Care Medicine 31 (2003): 2118-2125
[7] Servillo, G., De Robertis, E., Maggiore, S., et al.: The Upper Inflection Point
of the Pressure-Volume Curve. Influence of Methodology and of Different
Modes of Ventilation. Intensive Care Medicine 28 (2002): 842-849
[8] Servillo, G., Svantesson, C., Beydon, L., et al.: Pressure-Volume Curves in
Acute Respiratory Failure: Automated Low Flow Inflation Versus Occlusion.
Am J Respir Crit Care Med 155 (1997): 1629-1636
[9] Gama, A. M., Meyer, E. C., Gaudêncio, A. M., et al.: Different Low Constant
Flows Can Equally Determine the Lower Inflection Point in Acute Respira-
tory Distress Syndrome Patients. Artif Organs. 25 (2001): 882-889
[10] Blanc, Q., Sab, J. M., Philit, F., et al.: Inspiratory Pressure-Volume Curves
Obtained Using Automated Low Constant Flow Inflation and Automated
Occlusion Methods in ARDS Patients with a New Device. Intensive Care
Medicine 28 (2002): 990-994
[11] Albaiceta, G. M., Piacentini, E., Villagra, A., et al.: Application of Continuous
Positive Airway Pressure to Trace Static Pressure-Volume Curves of the
Respiratory System. Critical Care Medicine 31 (2003): 2514-2519
[12] Bensenor, F. E., Vieira, J. E., Auler, J. O. Jr.: Guidelines for Inspiratory Flow
Setting When Measuring the Pressure-Volume Relationship. Anesth Analg.
97 (2003): 145-150
[13] Rouby, J-J., Vieira, S.: Pressure/Volume Curves and Lung Computed
Tomography in Acute Respiratory Distress SyndromeEuropean Respiratory
Journal 22 (2003), no. Supplement 42: 27-36
[14] Takeuchi, M., Goddon, S., Dolhnikoff, M., et al.: Set Positive End-expiratory
Pressure During Protective Ventilation Affects Lung Injury. Anesthesiology
97 (2002): 682-692
[15] Matamis, D., Lemaire, F., Harf, A., et al.: Total Respiratory Pressure-Volume
Curves in the Adult Respiratory Distress Syndrome. Chest. 86 (1984): 58-
66
[16] Suter, P. M., Fairley, B., Isenberg, M. D.: Optimum End-expiratory Airway
Pressure in Patients with Acute Pulmonary Failure.N Engl J Med 292
(1975): 284-289

[17] Amato, M. B., Barbas, C. S., Medeiros, D. M., et al.: Beneficial Effects of the
"Open Lung Approach" with Low Distending Pressures in Acute Respiratory
Distress Syndrome. A Prospective Randomized Study on Mechanical Venti-
lation. Am J Respir Crit Care Med 152 (1995): 1835-1846
[18] Arnold, J. H.: To Recruit or not Derecruit: that Is the Question. Critical Care
Medicine 30 (2002): 1925-1927
[19] Harris, R. S., Hess, D. R., Venegas, J. G.: An Objective Analysis of the
Pressure-Volume Curve in the Acute Respiratory Distress Syndrome. Am J
Respir Crit Care Med 161 (2000): 432-439
[20] Hickling, K. G.: The Pressure-Volume Curve is Greatly Modified by Recruit-
ment. A Mathematical Model of ARDS Lungs. Am J Respir Crit Care Med
158 (1998): 194-202
[21] Kallet, R. H.: Pressure-Volume Curves in the Management of Acute Respi-
ratory Distress Syndrome. Respir Care Clin N Am 9 (2003): 321-341
[22] Pelosi, P., Gattinoni, L.: Respiratory Mechanics in ARDS: a Siren for Physi-
cians? Intensive Care Medicine 26 (2000): 653-656
[23] Rimensberger, P. C., Cox, P. N., Frndova, H., et al.: The Open Lung During
Small Tidal Volume Ventilation: Concepts of Recruitment and "Optimal"
Positive End-expiratory Pressure. Critical Care Medicine 27 (1999): 1946-
1952
[24] Rimensberger, P. C., Pristine, G., Mullen, B. M., et al.: Lung Recruitment
During Small Tidal Volume Ventilation Allows Minimal Positive End-expira-
tory Pressure without Augmenting Lung Injury. Critical Care Medicine 27
(1999): 1940-1945
[25] Fisher, J. B., Mammel, M. C., Coleman, J. M., et al.: Identifying Lung Overd-
istention During Mechanical Ventilation by Using Volume-Pressure Loops.
Pediatr Pulmonol 5 (1988): 10-14
[26] Harris, R. S., Hess, D. R., Venegas, J. G.: An Objective Analysis of the
Pressure-Volume Curve in the Acute Respiratory Distress Syndrome. Am J
Respir Crit Care Med 161 (2000): 432-439
[27] Dall'ava-Santucci, J., Armaganidis, A., Brunet, F., et al.: Causes of Error of
Respiratory Pressure-Volume Curves in Paralyzed Subjects.J Appl Physiol
64 (1988): 42-49
[28] Gattinoni, L., Mascheroni, D., Basilico, E., et al.: Volume/Pressure Curve of
Total Respiratory System in Paralysed Patients: Artifacts and Correction
Factors. Intensive Care Medicine 13 (1987): 19-25
[29] Sassoon, C. S., Te, T. T., Mahutte, C. K., et al.: Airway Occlusion Pressure.
An Important Indicator for Successful Weaning in Patients with Chronic
Obstructive Pulmonary Disease. Am Rev Respir Dis 135 (1987): 107-113
[30] Kuhlen, R., Hausmann, S., Pappert, D., et al.: A New Method for P0.1 Mea-
surement Using Standard Respiratory Equipment. Intensive Care Medicine
21 (1995): 554-560
[31] Jubran, A.: Advances in Respiratory Monitoring During Mechanical Ventila-
tion. Chest 116 (1999): 1416-1425
[32] Tobin, M. J., Charles, G. A.: Discontinuation of Mechanical Ventilation.In:
Tobin, M. J.: Principles and Practice of Mechanical Ventilation. 1177-1206.
McGraw-Hill, 1994.
[33] Gama de Abreu, M., Spieth, P. M., Pelosi, P., et al.: Noisy Pressure Support
Ventilation: A Pilot Study on a New Assisted Ventilation Mode in Experimen-
tal Lung Injury. Critical Care Medicine 36 (2008): 818-827


Password
18 Password
18.1 User password for Evita V800 / V600 Software 1.n
Cut out from the Evita V800 / V600 Software 1.n instructions for use
To prevent unauthorized changes, the device settings for Evita V800 / V600 are
protected by the following user password in the factory default settings:
1210
18.2 Information about the user password

To prevent unauthorized changes, the device settings for Evita V800 / V600 are
protected by a user password. For further information see: "Information about the
user password", page 186.
The factory default user password is located on this page of the instructions for use.
● Cut out the area with the user password and keep it in a place which is protected
from access by unauthorized persons.
Only specialized service personnel can reset the user password.


Index
Index
A AutoFlow
Description . . . . . . . . . . . . . . . . . . . . . . . 295
Abbreviations . . . . . . . . . . . . . . . . . . . . . . . . . 29 Setting . . . . . . . . . . . . . . . . . . . . . . . . . . . 53
Accessories AutoRelease
Safety instructions . . . . . . . . . . . . . . . . . . 14 Description . . . . . . . . . . . . . . . . . . . . . . . 301
Action buttons . . . . . . . . . . . . . . . . . . . . . . . . 42 Setting . . . . . . . . . . . . . . . . . . . . . . . . . . . 53
Description . . . . . . . . . . . . . . . . . . . . . . . 325
Selecting . . . . . . . . . . . . . . . . . . . . . . . . . 191
Additional settings B
Determining start settings . . . . . . . . . . . . 197 Bacteria filter . . . . . . . . . . . . . . . . . . . . . . . . . 76
Setting . . . . . . . . . . . . . . . . . . . . . . . . . . . 53 Battery
Aeroneb Pro nebulizer . . . . . . . . . . . . . . . . . 129 Charging. . . . . . . . . . . . . . . . . . . . . . . . . 148
Alarm delay . . . . . . . . . . . . . . . . . . . . . . . . . 164 Disposal . . . . . . . . . . . . . . . . . . . . . . . . . 239
Alarm limits . . . . . . . . . . . . . . . . . . . . . . . . . 160 Battery alarms
Deactivating . . . . . . . . . . . . . . . . . . . . . . 161 Priority . . . . . . . . . . . . . . . . . . . . . . . . . . 192
Setting . . . . . . . . . . . . . . . . . . . . . . . . . . 161 Battery concept . . . . . . . . . . . . . . . . . . . . . . 317
Setting start values . . . . . . . . . . . . . . . . . 194 Battery maintenance . . . . . . . . . . . . . . . . . . 234
Alarm logbook . . . . . . . . . . . . . . . . . . . . . . . 158 Battery operation . . . . . . . . . . . . . . . . . . . . . 146
Alarm priorities. . . . . . . . . . . . . . . . . . . . . . . 157 Battery test . . . . . . . . . . . . . . . . . . . . . . . . . 235
Alarm settings, configuring . . . . . . . . . . . . . 192 Configuring. . . . . . . . . . . . . . . . . . . . . . . 200
Alarm signals Performing . . . . . . . . . . . . . . . . . . . . . . . 200
Acoustic . . . . . . . . . . . . . . . . . . . . . . . . . 158 Body height, setting. . . . . . . . . . . . . . . . . . . 103
Failure. . . . . . . . . . . . . . . . . . . . . . . . . . . 158 Body weight
Optical . . . . . . . . . . . . . . . . . . . . . . . . . . 157 Changing during ventilation . . . . . . . . . . 114
Alarm silence . . . . . . . . . . . . . . . . . . . . . . . . 163 Setting . . . . . . . . . . . . . . . . . . . . . . . . . . 103
Alarm system Breathing circuit
Position of the user . . . . . . . . . . . . . . . . . 158 Fitting . . . . . . . . . . . . . . . . . . . . . . . . . . . . 78
Alarm volume. . . . . . . . . . . . . . . . . . . . . . . . 185 Information . . . . . . . . . . . . . . . . . . . . . . . . 76
Minimum . . . . . . . . . . . . . . . . . . . . . . . . . 192 Monitoring . . . . . . . . . . . . . . . . . . . . . . . 265
Setting . . . . . . . . . . . . . . . . . . . . . . . . . . 162 Removing . . . . . . . . . . . . . . . . . . . . . . . . 152
Alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 157 Selecting . . . . . . . . . . . . . . . . . . . . . . . . . 98
Confirming . . . . . . . . . . . . . . . . . . . . . . . 159 Breathing circuit test
Displaying causes and remedies . . . . . . 159 Performing . . . . . . . . . . . . . . . . . . . . . . . . 97
Safety instructions . . . . . . . . . . . . . . . . . . 13 Breathing gas humidifier
Anti-air shower Preparing . . . . . . . . . . . . . . . . . . . . . . . . . 77
Description . . . . . . . . . . . . . . . . . . . . . . . 314 Brightness, adjusting . . . . . . . . . . . . . . . . . . 186
Turning on or off . . . . . . . . . . . . . . . . . . . 193 BTPS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 315
Apnea trend . . . . . . . . . . . . . . . . . . . . . . . . . 166 Button . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46
Apnea ventilation . . . . . . . . . . . . . . . . . . . . . 116
Description . . . . . . . . . . . . . . . . . . . . . . . 291 C
Setting . . . . . . . . . . . . . . . . . . . . . . . . . . . 53
Turning alarm on or off . . . . . . . . . . . . . . 193 C20/C
Turning automatic return on or off . . . . . 193 Description . . . . . . . . . . . . . . . . . . . . . . . 309
Assembly and preparation . . . . . . . . . . . . . . . 59 Charge status indicator . . . . . . . . . . . . . . . . 146
Safety instructions . . . . . . . . . . . . . . . . . . 59 Clinical users . . . . . . . . . . . . . . . . . . . . . . . . . 10
ATC CO2 cuvette. . . . . . . . . . . . . . . . . . . . . . . . . . 76
Description . . . . . . . . . . . . . . . . . . . . . . . 297 Fitting . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81
Setting . . . . . . . . . . . . . . . . . . . . . . . . . . . 53 Types . . . . . . . . . . . . . . . . . . . . . . . . . . . 180
Setting compensation . . . . . . . . . . . . . . . 193 CO2 monitoring . . . . . . . . . . . . . . . . . . . . . . 180
Alarm messages . . . . . . . . . . . . . . . . . . 181
Automatic alarm limits . . . . . . . . . . . . . . 266

Index
CO2 sensor Expiratory flow sensor

Checking. . . . . . . . . . . . . . . . . . . . . . . . . 180 Calibrating . . . . . . . . . . . . . . . . . . . . . . . 176
Checking calibration with test filter . . . . . 184 Expiratory valve
Fitting . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81 Disassembling . . . . . . . . . . . . . . . . . . . . 155
Removing . . . . . . . . . . . . . . . . . . . . . . . . 153 Fitting . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75
CO2 zero calibration . . . . . . . . . . . . . . . . . . 183 Preparing . . . . . . . . . . . . . . . . . . . . . . . . . 74
CO2 zero indication . . . . . . . . . . . . . . . . . . . 182 Removing . . . . . . . . . . . . . . . . . . . . . . . . 154
Coaxial breathing circuit Replacing . . . . . . . . . . . . . . . . . . . . . . . . 233
Test . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 99 Replacing the diaphragm . . . . . . . . . . . . 232
Coaxial breathing hose . . . . . . . . . . . . . . . . . 76 Selecting . . . . . . . . . . . . . . . . . . . . . . . . . 73
Color scheme
Selecting . . . . . . . . . . . . . . . . . . . . . . . . . 186 F
Colors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45
Compressed gas cylinders . . . . . . . . . . . . . . 67 Factory defaults. . . . . . . . . . . . . . . . . . . . . . 185
Configuration . . . . . . . . . . . . . . . . . . . . . . . . 185 FiO2 monitoring
Exporting and importing . . . . . . . . . . . . . 198 Automatic alarm limits . . . . . . . . . . . . . . 265
Safety instructions . . . . . . . . . . . . . . . . . 185 Flow / volume measurement . . . . . . . . . . . . 314
Connecting external devices . . . . . . . . . . . . . 72 Flow monitoring . . . . . . . . . . . . . . . . . . . . . . 174
Context dialog . . . . . . . . . . . . . . . . . . . . . . . . 48 Flow reduction . . . . . . . . . . . . . . . . . . . . . . . 314
Contraindications . . . . . . . . . . . . . . . . . . . . . . . 9 Flow sensor
Country-specific settings, changing . . . . . . . 201 Disposing of . . . . . . . . . . . . . . . . . . . . . . 239
Current values . . . . . . . . . . . . . . . . . . . . . . . 168 Selecting . . . . . . . . . . . . . . . . . . . . . . . . . 73
Cursor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49 Flow sensor, expiratory
Fitting . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76
Removing . . . . . . . . . . . . . . . . . . . . . . . . 152
D Flow sensor, neonatal
Data export . . . . . . . . . . . . . . . . . . . . . . . . . 170 Disassembling . . . . . . . . . . . . . . . . . . . . 152
Data transfer . . . . . . . . . . . . . . . . . . . . . . . . . 29 Fitting . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79
Date and time . . . . . . . . . . . . . . . . . . . . . . . 201 Selecting . . . . . . . . . . . . . . . . . . . . . . . . . 79
Device Fuse . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
Turning on. . . . . . . . . . . . . . . . . . . . . . . . . 89
Device combinations . . . . . . . . . . . . . . . . . . 266 G
Diagnostics – measurement maneuver . . . . 137
Display unit Gas supply . . . . . . . . . . . . . . . . . . . . . . . . . . 28
Overview. . . . . . . . . . . . . . . . . . . . . . . . . . 19 Establishing . . . . . . . . . . . . . . . . . . . . . . . 85
Disposable cuvettes. . . . . . . . . . . . . . . . . . . 180 Interrupting . . . . . . . . . . . . . . . . . . . . . . . 151
Disposal . . . . . . . . . . . . . . . . . . . . . . . . . . . . 239 Gas supply unit . . . . . . . . . . . . . . . . . . . . . . 140
Safety instructions . . . . . . . . . . . . . . . . . 239 Activating or deactivating . . . . . . . . . . . . 201
Overview . . . . . . . . . . . . . . . . . . . . . . . . . 26
General settings . . . . . . . . . . . . . . . . . . . . . 193
E Getting started. . . . . . . . . . . . . . . . . . . . . . . . 88
Electromagnetic compatibility . . . . . . . . . . . . 16 Safety instructions . . . . . . . . . . . . . . . . . . 88
EMC declaration . . . . . . . . . . . . . . . . . . . . . 266 GS500 gas supply unit
Environments of use . . . . . . . . . . . . . . . . . . . . 9 Maintenance. . . . . . . . . . . . . . . . . . . . . . 233
Expiration hold . . . . . . . . . . . . . . . . . . . . . . . 120
Expiratory flow monitoring . . . . . . . . . . . . . . 176 H
Help function . . . . . . . . . . . . . . . . . . . . . . . . . 57
Hinged arm, attaching . . . . . . . . . . . . . . . . . . 66
HME . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76
Holder
Fitting . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64
With standard rail . . . . . . . . . . . . . . . . . . . 65
Humidification type, selecting . . . . . . . . . . . . 98

Index
I Manual inspiration . . . . . . . . . . . . . . . . . . . . 120

Manual ventilation device
Indications . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 Safety instructions . . . . . . . . . . . . . . . . . . 13
Inspection . . . . . . . . . . . . . . . . . . . . . . . . . . 230 Measurement principles . . . . . . . . . . . . . . . 315
Inspiration hold . . . . . . . . . . . . . . . . . . . . . . 120 Measurements . . . . . . . . . . . . . . . . . . . . . . 261
Inspiration termination Medication nebulization. . . . . . . . . . . . 122, 122
Description . . . . . . . . . . . . . . . . . . . . . . . 294 Description . . . . . . . . . . . . . . . . . . . . . . . 303
Turning on or off . . . . . . . . . . . . . . . . . . . 193 Performing . . . . . . . . . . . . . . . . . . . 126, 127
Inspiration termination criterion . . . . . . . . . . 294 Medication nebulizer
Inspiratory valve Fitting . . . . . . . . . . . . . . . . . . . . . . . . . . . 124
Disassembling . . . . . . . . . . . . . . . . . . . . 156 Preparing . . . . . . . . . . . . . . . . . . . . . . . . 124
Removing . . . . . . . . . . . . . . . . . . . . . . . . 156 Removing . . . . . . . . . . . . . . . . . . . . . . . . 153
Instructions for use Menu structure . . . . . . . . . . . . . . . . . . . . . . 323
Safety instruction . . . . . . . . . . . . . . . . . . . 12 Modifications
Intended use . . . . . . . . . . . . . . . . . . . . . . . . . . 9 Safety instruction . . . . . . . . . . . . . . . . . . . 15
Interfaces, configuring . . . . . . . . . . . . . . . . . 202 Monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . 172
Intrahospital patient transport . . . . . . . . . . . 141 Safety instruction . . . . . . . . . . . . . . . . . . . 12
Intrinsic PEEP Safety instructions . . . . . . . . . . . . . . . . . 172
Description . . . . . . . . . . . . . . . . . . . . . . . 307 Monitoring area . . . . . . . . . . . . . . . . . . . . . . . 54
Measurement . . . . . . . . . . . . . . . . . . . . . 138 Monitoring functions . . . . . . . . . . . . . . . . . . . 28
IT networks . . . . . . . . . . . . . . . . . . . . . . . . . 268
N
L
Negative Inspiratory Force
Language of screen texts . . . . . . . . . . . . . . 201 Description . . . . . . . . . . . . . . . . . . . . . . . 308
Lateral flaps on the device. . . . . . . . . . . . . . . 86 Measurement . . . . . . . . . . . . . . . . . . . . . 139
Leakage adaptation . . . . . . . . . . . . . . . . . . . 311 Neonatal flow monitoring. . . . . . . . . . . . . . . 177
Leakage compensation . . . . . . . . . . . . . . . . 312 Neonatal flow sensor
Leakage rate . . . . . . . . . . . . . . . . . . . . . . . . 311 Calibrating . . . . . . . . . . . . . . . . . . . . . . . 177
List of references . . . . . . . . . . . . . . . . . . . . . 326 Replacing the sensor insert . . . . . . . . . . . 81
Loads Non-invasive ventilation
Maximum . . . . . . . . . . . . . . . . . . . . . . . . . 63 Applying . . . . . . . . . . . . . . . . . . . . . . . . . 115
Logbook . . . . . . . . . . . . . . . . . . . . . . . . . . . . 168 Description . . . . . . . . . . . . . . . . . . . . . . . 310
Loops . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 117 NTPD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 315
Low Flow PV Loop Nurse call, connecting . . . . . . . . . . . . . . . . . . 85
Description . . . . . . . . . . . . . . . . . . . . . . . 304
Measurement maneuver. . . . . . . . . . . . . 130
O
M O2 monitoring . . . . . . . . . . . . . . . . . . . . . . . 178
O2 sensor
Main menu bar
Calibrating . . . . . . . . . . . . . . . . . . . . . . . 179
Action buttons . . . . . . . . . . . . . . . . . . . . . 325
O2 therapy . . . . . . . . . . . . . . . . . . . . . . . . . . 143
Buttons . . . . . . . . . . . . . . . . . . . . . . . . . . 323
Description . . . . . . . . . . . . . . . . . . . . . . . 310
Main screen . . . . . . . . . . . . . . . . . . . . . . . . . . 42
Occlusion pressure P0.1
Main switch . . . . . . . . . . . . . . . . . . . . . . . . . . 24
Description . . . . . . . . . . . . . . . . . . . . . . . 306
Checking. . . . . . . . . . . . . . . . . . . . . . . . . . 84
Maneuvers . . . . . . . . . . . . . . . . . . . . . . . 137
Mains power supply
Open-source software . . . . . . . . . . . . . . . . . 271
Establishing . . . . . . . . . . . . . . . . . . . . . . . 83
Operating concept . . . . . . . . . . . . . . . . . . . . . 41
Failure. . . . . . . . . . . . . . . . . . . . . . . . . . . . 83
Operation . . . . . . . . . . . . . . . . . . . . . . . . . . 106
Maintenance . . . . . . . . . . . . . . . . . . . . . . . . 231
Ending . . . . . . . . . . . . . . . . . . . . . . . . . . 150
Mandatory reporting. . . . . . . . . . . . . . . . . . . . 17
Safety instructions . . . . . . . . . . . . . . . . . 106
Maneuvers
Operational readiness, checking . . . . . . . . . . 90
Setting . . . . . . . . . . . . . . . . . . . . . . . . . . 194
Options for operation. . . . . . . . . . . . . . . . . . . 46
Manual disconnection . . . . . . . . . . . . . . . . . 122
Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18

Index
P Sensors
Calibrating . . . . . . . . . . . . . . . . . . . . . . . 174
Parameter Service . . . . . . . . . . . . . . . . . . . . . . . . . . . . 229
Exceeding the set limit . . . . . . . . . . . . . . . 50 Safety instructions . . . . . . . . . . . . . . . . . 229
Selecting . . . . . . . . . . . . . . . . . . . . . . . . . 166 Service dialog . . . . . . . . . . . . . . . . . . . . . . . 203
Parameter pick list . . . . . . . . . . . . . . . . . . . . . 47 Service personnel . . . . . . . . . . . . . . . . . . . . . 11
Patient category Shutting down . . . . . . . . . . . . . . . . . . . . . . . 150
Selecting . . . . . . . . . . . . . . . . . . . . . . . . . 103 Sigh
Selecting start settings . . . . . . . . . . . . . . 194 Setting . . . . . . . . . . . . . . . . . . . . . . . . . . . 53
Patient files Smart Pulmonary View . . . . . . . . . . . . . . . . 118
Configuring parameters . . . . . . . . . . . . . 191 Description . . . . . . . . . . . . . . . . . . . . . . . 309
Patient transport . . . . . . . . . . . . . . . . . . . . . 141 Software options, activating . . . . . . . . . . . . 199
Performance characteristics . . . . . . . . . . . . . 10 Spontaneous breathing
Pneumatic functional description . . . . . . . . . 321 Support. . . . . . . . . . . . . . . . . . . . . . . . . . 112
Pop-up window . . . . . . . . . . . . . . . . . . . . . . . 48 Standby mode . . . . . . . . . . . . . . . . . . . . . . . 145
Power supply . . . . . . . . . . . . . . . . . . . . . . . . . 28 Standby screen . . . . . . . . . . . . . . . . . . . . . . . 44
Display . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 Start settings . . . . . . . . . . . . . . . . . . . . . . . . 185
Establishing . . . . . . . . . . . . . . . . . . . . . . . 82 Status, displaying . . . . . . . . . . . . . . . . . . . . 201
Failure. . . . . . . . . . . . . . . . . . . . . . . . . . . 149 Storing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 151
Power supply failure alarm . . . . . . . . . . . . . 158 Suction maneuver with oxygenation . . . . . . 121
Precautionary statements . . . . . . . . . . . . . . . 11 Symbols . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36
Preparing the ventilation unit . . . . . . . . . . . . . 73 Safety instruction . . . . . . . . . . . . . . . . . . . 12
Pressure limitation . . . . . . . . . . . . . . . . . . . . 272 System cable, connecting . . . . . . . . . . . . . . . 70
Pressure monitoring System test . . . . . . . . . . . . . . . . . . . . . . . . . . 94
Product label
Safety instruction . . . . . . . . . . . . . . . . . . . 12 T
Product labels . . . . . . . . . . . . . . . . . . . . . . . . 40 Tabs. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47
Technical data . . . . . . . . . . . . . . . . . . . . . . . 240
Q Test lung . . . . . . . . . . . . . . . . . . . . . . . . . . . . 95
Test results, displaying . . . . . . . . . . . . . . . . 169
QuickSet . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52 Therapy
Interrupting . . . . . . . . . . . . . . . . . . . . . . . 145
R Starting. . . . . . . . . . . . . . . . . . . . . . . . . . 104
Range of functions. . . . . . . . . . . . . . . . . . . . . 26 Therapy bar
Recruiting trends . . . . . . . . . . . . . . . . . . . . . 167 Overview . . . . . . . . . . . . . . . . . . . . . . . . . 51
Reference loops. . . . . . . . . . . . . . . . . . . . . . 117 Therapy controls . . . . . . . . . . . . . . . . . . . . . . 47
Remote service . . . . . . . . . . . . . . . . . . . . . . 231 Therapy type
Repair . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 232 Changing . . . . . . . . . . . . . . . . . . . . . . . . 113
Reprocessing personnel . . . . . . . . . . . . . . . . 10 Selecting in standby mode . . . . . . . . . . . 101
Reusable cuvettes . . . . . . . . . . . . . . . . . . . . 180 Tooltip . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49
Room air filter, replacing . . . . . . . . . . . . . . . 232 Trademarks . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Transport of the device . . . . . . . . . . . . . . . . . 87
Trends . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 165
S
Graphical . . . . . . . . . . . . . . . . . . . . . . . . 165
Safety checks . . . . . . . . . . . . . . . . . . . . . . . 230 Tabular . . . . . . . . . . . . . . . . . . . . . . . . . . 167
Safety instructions . . . . . . . . . . . . . . . . . . 11, 12 Trigger
Safety-related information . . . . . . . . . . . . . . . . 9 Description . . . . . . . . . . . . . . . . . . . . . . . 293
Scaling waveforms. . . . . . . . . . . . . . . . . . . . . 55 Setting . . . . . . . . . . . . . . . . . . . . . . . . . . . 53
Screen Trolley . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
Operating concept . . . . . . . . . . . . . . . . . . 41 Troubleshooting. . . . . . . . . . . . . . . . . . . . . . 204
Scroll bar . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49 Turning off . . . . . . . . . . . . . . . . . . . . . . . . . . 150

Index
U
Units, selecting . . . . . . . . . . . . . . . . . . . . . . 202
Universal holder with standard rail. . . . . . . . . 64
USB mass storage device . . . . . . . . . . . . . . 198
User password
Changing . . . . . . . . . . . . . . . . . . . . . . . . 203
Entering . . . . . . . . . . . . . . . . . . . . . . . . . 186
Information . . . . . . . . . . . . . . . . . . . . . . . 186
Users . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
User-specific settings. . . . . . . . . . . . . . . . . . 185
V
Variable PS
Description . . . . . . . . . . . . . . . . . . . . . . . 302
Setting . . . . . . . . . . . . . . . . . . . . . . . . . . . 53
Ventilation functions. . . . . . . . . . . . . . . . . . . . 26
Ventilation mode
Changing . . . . . . . . . . . . . . . . . . . . . . . . . 51
Ventilation modes
Pressure-controlled . . . . . . . . . . . . . . . . 111
Selecting for the therapy bar . . . . . . . . . 192
Volume-controlled . . . . . . . . . . . . . . . . . . 110
Ventilation parameters
Exceeding the set limit . . . . . . . . . . . . . . . 50
Linked setting . . . . . . . . . . . . . . . . . . . . . . 52
Setting . . . . . . . . . . . . . . . . . . . . . . . . . . . 52
Setting directly . . . . . . . . . . . . . . . . . . . . . 52
Setting further start values . . . . . . . . . . . 196
Setting start values . . . . . . . . . . . . . . . . . 195
Ventilation settings. . . . . . . . . . . . . . . . . . . . 110
Ventilation unit
Front . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
Left side . . . . . . . . . . . . . . . . . . . . . . . . . . 24
Rear . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
Right side . . . . . . . . . . . . . . . . . . . . . . . . . 24
View
Configuring . . . . . . . . . . . . . . . . . . . . . . . 187
Switching . . . . . . . . . . . . . . . . . . . . . . . . . 54
Volume guarantee
Description . . . . . . . . . . . . . . . . . . . . . . . 295
Setting . . . . . . . . . . . . . . . . . . . . . . . . . . . 53
Volume monitoring
W
Waveform scaling
Configuring . . . . . . . . . . . . . . . . . . . . . . . 191
Waveforms, freezing . . . . . . . . . . . . . . . . . . . 55
Weight . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 261

Manufacturer
Drägerwerk AG & Co. KGaA
Moislinger Allee 53 – 55
23542 Lübeck
Germany
+49 451 8 82-0
These instructions for use are provided for customer information only and are only updated or exchanged upon customer request.
www.draeger.com
9055601 – GA 6500.600 / 6500.620 en
© Drägerwerk AG & Co. KGaA
Edition: 2 – 2019-12 (Edition: 1 – 2018-12)
Dräger reserves the right to make modifications to the
device without prior notice.
Á9055600(È

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Evita V800 / V600

Intensive care ventilator

Instructions for use

2 Instructions for use | Evita V800 / V600 SW 1.n

1 Information about this document ........................................................... 7

5 Assembly and preparation ...................................................................... 59

Instructions for use | Evita V800 / V600 SW 1.n 3

5.12 Closing the lateral device flaps ....................................................... 86

7 Operation .................................................................................................. 106

8 Ending operation...................................................................................... 150

9 Alarms ....................................................................................................... 157

10 Trends ....................................................................................................... 165

4 Instructions for use | Evita V800 / V600 SW 1.n

10.3 Displaying current values................................................................ 168

13 Troubleshooting ....................................................................................... 204

14 Service ...................................................................................................... 229

15 Disposal .................................................................................................... 239

Instructions for use | Evita V800 / V600 SW 1.n 5

16 Technical data .......................................................................................... 240

17 Principles of operation ............................................................................ 272

18 Password .................................................................................................. 329

Index .......................................................................................................... 331

6 Instructions for use | Evita V800 / V600 SW 1.n

1 Information about this document

1.2 Use of terms

1.4 Additional documents

Instructions for use | Evita V800 / V600 SW 1.n 7

1.5.2 Trademarks owned by third-party manufacturers

8 Instructions for use | Evita V800 / V600 SW 1.n

2.4 Environments of use

Instructions for use | Evita V800 / V600 SW 1.n 9

2.5 Essential performance characteristics

2.6 User group requirements

2.6.1 Duties of the operating organization

2.6.2 User groups

10 Instructions for use | Evita V800 / V600 SW 1.n

2.7 Information on safety instructions and precautionary

2.7.1 Safety instructions

2.7.2 Precautionary statements

Warning sign Signal word Consequences of non-compliance

Instructions for use | Evita V800 / V600 SW 1.n 11

2.8 Safety instructions

2.8.2 Symbols and product labels

2.8.3 Monitoring the patient's condition

Monitoring during O2 therapy

12 Instructions for use | Evita V800 / V600 SW 1.n

2.8.5 Standby mode

2.8.6 Keeping a manual ventilation device ready

Instructions for use | Evita V800 / V600 SW 1.n 13

2.8.9 Display unit

2.8.10 Ventilation unit

14 Instructions for use | Evita V800 / V600 SW 1.n

2.8.12 Gases and solutions

Increased oxygen concentration in the ambient air

2.8.13 External flow source

Negative impacts on the measured values

2.8.14 Modifications to the product

Instructions for use | Evita V800 / V600 SW 1.n 15

2.8.15 Connected devices and device combinations

2.8.16 Data transfer

2.8.19 Electromagnetic compatibility (EMC)

16 Instructions for use | Evita V800 / V600 SW 1.n

2.8.20 Network security