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Stellar™ 150

1. PN NZ LS
2. lt a d Le 248369r6 book Seite 16 Montag 14 Mai 2012 1 40 13 Setting up for invasive use The Stellar 150 can be used invasively only with the ResMed Leak Valve WARNING e Make sure that all the air inlets at the rear of the device and under the device and vents at the mask or at the ResMed Leak Valve are unobstructed If you put the device on the floor make sure the area is free from dust and clear of bedding clothes or other objects that could block the air inlets e Replace the HMEF regularly as specified in the instructions provided with the HMEF e The H4i is contraindicated for invasive use An external humidifier approved for invasive use is recommended according to EN ISO 8185 with an absolute humidity of gt 33 mg L and a maximum flow within the technical specifications of Stellar 150 e For optimal accuracy and synchrony perform Learn Circuit with a change of the circuit configuration in particular when adding or removing high impedance components eg antibacterial filter external humidifier water trap nasal pillow type mask or air tubing See Setup menu Options on page 43 CAUTION 3 When using a humidifier use a water trap and check the air circuit regularly for accumulated water Notes e When the mask type is set to Trach the Non Vented Mask alarm will be automatically enabled to alert the user when the ResMed Leak Valve has no vent holes or when the vent holes are blocked
3. Working with other optional accessories 19 PS T PN 3 NY AIS LY Le 248369r6 book Seite 20 Montag 14 Mai 2012 1 40 13 A NY Using the FiO monitoring sensor CAUTION Do not use the FiO monitoring sensor with the H4i humidifier Preparing to use a new sensor 1 Before use leave the FiO monitoring sensor open to the air for 15 minutes 2 Attach a new FiO monitoring sensor as shown below 3 Perform the sensor calibration see Setup menu Options on page 43 Note The FiO monitoring sensor must be replaced every 12 months Connecting a sensor 1 Connect the air tubing to the T piece adapter Connect the FiO monitoring sensor to the T piece adapter Connect the adapter to the air outlet of the device Connect one end of the cable to the FiO monitoring sensor Connect the other end of the cable to the rear of the device oO of A W N Start calibration see Setup menu Options on page 43 This should be repeated periodically as per the facility policy 20 PN T W D lA as LY Le 248369r6 book Seite21 Montag 14 Mai 2012 1 40 13 e 9 Attaching an antibacterial filter The use of an antibacterial filter can be recommended as per facility policy One antibacterial filter product code 24966 can be purchased separately from ResMed Regularly check the filt
4. Heart Rate Display of heart rate measurement Unit BPM Each graph displays the last 10 minutes Error trace Displays errors In measuring oximetry data Monitoring menu 33 9 e ls A 248369r6 book Seite 34 Montag 14 Mai 2012 1 40 13 Setup menu The Setup menu allows you to view and change therapy alarm and device settings Accessing Clinical mode A CAUTION e For home treatment the device must be set to Patient mode A e Only trained and authorized personnel must make changes to clinical settings To activate Clinical mode hold down and simultaneously for at least three seconds You will be prompted for how long the device should stay in this mode After the set period of inactivity or next power cycle power on off the device automatically switches back to the patient mode and the device beeps When Clinical mode is enabled the lock symbol in the header changes to unlocked and the device beeps Setup menu Clinical Settings On this screen Clinical Settings are displayed according to the set therapy mode and can be changed Additional settings are located on the Advanced Settings screen E a Progl a Pathology Normal oo er olti oolve olmv Return to Clinical Settings 34 D NZ b 4 lt e 248369r6 book Seite 35 Montag 14 Mai 2012 1 40 13 25 Factory default settings and parameter ranges Par
5. Using Learn Targets Manually setting IVAPS Assessing the clinical outcome Data managemen s 4 2 06 A620 eeackt ead eee teak enaeh eed bag eew eh tenth ach dhe th cee bb ao ok ace Lk woe Cleaning and maintenance 0 0 0 0 eee ens Daily Weekly Monthly Replacing the air filter Multipatient use Servicing Ginicaltitranon gulde eys rererere cueur wean AEE acest ANERER Gah Wel ag Bod ot 6a ah Soa RATE ENEE RENA Mouth leaks setting TiControl EPAP PEEP Trigger cycle sensitivities TIM MOD FO SOO ELIMG access cree at tke a tthe tek che etek e athe tt Meh il aaa a lea iat thal cba cet ated Alarm troubleshooting Other troubleshooting TECHAICALSDECINICATIONS tive re royce eree Eeee e E ened a does bade ae e Guidance and manufacturer s declaration electromagnetic emissions and immunity symbols General warnings and cautions ENEA WAGKAINLY lt n4 20405 ud penasys ghee a edd each heats Rech he aes Bowed boas weed an Sad NZ PN ZIN NZ b a Le 248369r6 book Seite 1 Montag 14 Mai 2012 1 40 13 Introduction Read the entire manual before using the device Indications for use The Stellar 150 is intended to provide ventilation for non dependent spontaneously breathing adult and pediatric patients 30 lb 13 kg and above with respiratory insufficiency or respiratory failure with or without obstructive sleep apnea The device is for noninvasive use
6. Warm up feature H4i Ramp time ResMed USB stick Mains power Program External power supply Therapy mode Internal battery dmm gt 77 IN 15 Gag Hest Patient mode or Clinical mode Title bar EIEE Current screen number of screens within the menu Learn Circuit Scroll bar Therapy status bar Saat o Ti 0 0 Vt olmMv a0 Starting therapy Performing a functional test Pertorm a functional test under any of the following circumstances e prior to the initial use of Stellar e in between patients e on long term use patients periodically as per the facility policy If any problems occur see Troubleshooting on page 58 Please also check other provided User Instructions for troubleshooting information Turn off the device by pressing the power switch at the back of the device Check condition of device and accessories Inspect the device and all the provided accessories If there are any visible detects the system should not be used Check the circuit configuration Check the integrity of the circuit configuration device and provided accessories according to the setup descriptions in this Clinical Guide and that all connections are secure Turn on the device and check alarms Press the power switch at the back of the device once to turn on the device Check that the alarm sounds a test beep and the LEDs visual indicator for the alarm signal and the Alarm mute bu
7. as Monitoring menu Screen 1 Treatment quay i 15 Gag Bee G Treatment 4 1 Pressure bar graph with the set pressure limits and measured pressure 100 22 30 00 2 Machine breath indicators 21 07 2010 Machine cycled breath e M the inspiratory phase is sustained up to Ti Min e the inspiratory phase Is cycled down to EPAP PEEP at Ti Max S ST mode or Ti PAC T mode Machine triggered breath the machine initiates the inspiratory phase increasing pressure up from EPAP PEEP Set Ramp see Setting Ramp on page 26 Warm up the humidifier see step 6 on page 24 Set program see Programs on page 27 Oo oO Aa O The Therapy status bar allows you to view treatment data while therapy Is running Therapy status bar parameter descriptions Parameter Range Description Resolution e Leak Lk 0 120 L min Current average unintentional leak Leak is an output of 1 L min the Vsync algorithm see Learn Circuit on page 7 Unintentional leak is calculated by subtracting expected interface vent flow based on the Mask Type in the Settings menu from total leak Averaging is typically over 2 6 breaths and can be shorter in the presence of unstable leak Respiratory Rate 5 60 bom The number of breaths per minute averaged over the RR 1 bom last five breaths A breath is considered as a respiratory cycle if it exceeds 50 mL either spontaneously or machine t
8. 4 Stop therapy 40 PS am 7 e NZ a i 4 LY P 248369r6 book Seite 41 Montag 14 Mai 2012 1 40 13 Alarm High Respiratory Rate 1 On the Setup Clinical Settings menu set Mode to ST and Backup Rate to 30 bom 2 On the Setup Alarm Settings menu set All alarms off to Yes 3 Now set High Resp Rate Alarm Setting to 10 bom and change the alarm to be On 4 Block the air tubing 5 Start ventilation Low Respiratory Rate 1 On the Setup Clinical Settings menu set Mode to ST and Backup Rate to 10 bom 2 On the Setup Alarm Settings menu set All alarms off to Yes 3 Now set Low Resp Rate Alarm Setting to 30 bom and change the alarm to be On 4 Block the air tubing 5 Start ventilation Low FiO 1 Connect FiO cell 2 Calibrate the FiO cell 3 On the Setup Clinical Settings menu set Mode to T 4 Set Respiratory Rate to 10 bom 5 6 be On 7 Start ventilation High FiO 1 Connect the FiO cell 2 Calibrate the FiO cell On the Setup Alarm Settings menu set All alarms off to Yes Now set Low FiO2 Alarm Setting to 80 and change the alarm to 3 Set the High FiO Alarm setting to 30 4 Start ventilation 5 Start O gt supply to provide higher FiO level than alarm threshold The alarm activates within 15 seconds High Leak This test must be carried out using the patient s actual circuit and interface inc
9. 14 Mai 2012 1 40 13 Zi FiO measurement FiO concentration measurement at EPAP IPAP 5 10 cm H20 blue curve 5 20 cm H320 red curve and 5 30 cm H320 green curve R C 5 20 respiratory rate 20 bpm full face mask Full Face Leak OL min 100 0 MV 2 5 L min 90 0 4q 80 0 4 MV 8 2 L min 70 0 MV 12 3 L min 60 0 50 0 47 40 0 FiO concentration 30 0 20 0 10 0 0 0 6 8 10 12 14 16 18 20 22 24 26 28 30 O gt supply L min Full Face Leak 20 L min at 15 cm H20 100 0 90 0 e 80 0 MV 2 5 L min G 70 0 MV 8 3 L min 60 0 4 MV 12 0 L min 50 0 40 0 4 FiO concentration 30 0 20 0 10 0 0 0 6 8 10 12 14 16 18 20 22 24 26 28 30 O gt supply L min Pneumatic flow path Air filter Flow Blower Pressure Backup Leak Port sensor sensor pressure sensor Mask Z Air tubing h aaa Oxygen __ x Inlet 7 f i Z Z Technical specifications 67 PN 9 S2 WF A 4 a Le 248369r6 book Seite 68 Montag 14 Mai 2012 1 40 13 2J Guidance and manufacturer s declaration electromagnetic emissions and immunity 68 Guidance and manufacturer s declaration electromagnetic emissions The device is intended for use in the electromagn
10. 95 non condensing e Air pressure 680 hPa to 1 100 hPa Altitude 9 842 5 3 000 m Note The performance may be limited below 800 hPa NONIN XPOD Product complies with all applicable electromagnetic compatibility requirements EMC according to EC60601 1 2 for residential commercial and light industry environments For further details see Guidance and manufacturer s declaration electromagnetic emissions and immunity on page 68 Electrostatic fibre mesh with TPE frame structure Bacterial filtration efficiency of 99 540 on area weight 100g m2 Flexible plastic 6 6 2 m or 9 10 3 m length 0 9 22 mm diameter Flexible plastic 6 1 83 m length 0 6 15 mm diameter e Class II Clause 3 14 double insulation This adherence means the need for an protective earthing ie an earthed plug is not necessary e Type BF e Continuous operation Medical Portable Electronic Devices M PED that meet the Federal Aviation Administration FAA requirements of RICA DO 160 can be used during all phases of air travel without further testing or approval by the airline operator ResMed confirms that the Stellar 150 meets RTCA DO 160 requirements This device is not suitable for use in the presence of a flammable anesthetic mixture Notes e The manufacturer reserves the right to change these specifications without notice Pressure may be displayed in cm H20 or hPa Technical specifications 6
11. An apnea is scored when flow decreased by more than 75 of baseline ie to 25 or below from the baseline for more than 10 seconds An hypopnea is scored when flow decreases to 50 but greater than 25 of baseline for more than 10 seconds The Apnea Index Al and Apnea Hypopnea Index AHI are calculated by dividing the total number of events that occurred by the total mask on therapy period in hours Note The accuracy of apnea and hypopnea logging are degraded by high mask leak Used Hours 08 17 h 01 00 h 09 00 h Used hours Hours 420 15 h Used Hours during the last seven days of treatment are displayed in a bar graph and can be compared to the data of the last 365 days The daily recordings start at 12 noon and finish at 12 fe noon on the following day eg on November 20th the patient took a nap from 2 p m to 3 p m N the second therapy session on that day started at 10 p m and stopped at 7 a m on November 21st The time is displayed on the vertical axis The horizontal axis displays the date of the recording The related average minimum and maximum values are displayed as numeric values per week Used Hours within the graph legend displays how long the device has been used for treatment since the first treatment session or data was last erased Device information This screen shows the serial number displayed as Device SN software version and other component versions Data on this screen may be reque
12. When the device is turned on and functioning properly new air from the device flushes the exhaled air out through the mask vent holes However when the device is not operating insufficient fresh air will be provided through the mask and the exhaled air may be rebreathed Rebreathing of exhaled air for longer than several minutes can in some circumstances lead to suffocation This applies to most Positive Airway Pressure devices In the event of power failure or machine malfunction remove the mask or the catheter mount from the tracheostomy tube Explosion hazard do not use in the vicinity of flammable anesthetics The device should not be used with anesthetized patients whose breathing depends entirely on mechanical ventilation Do not use the device if there are obvious external defects unexplained changes In performance Only use original and approved ResMed accessories and parts The use of an antibacterial filter is obligatory in situations in which cross contamination is possible Use only accessories from the original package If the packaging is damaged the respective product must not be used and should be disposed along with the packaging Before using the device and the accessories for the first time ensure that all components are In a proper condition and that their operational satety is guaranteed If there are any defects the system should not be used Additional equipment connected to medical electr
13. e ResMed recommends using a breathing system including antibacterial filter air tubings external humidifier and ResMed Leak Valve with an impedance of maximum 2 cm H30 at e 30 L min 5 cm H20 at 60 L min and 16 cm H20 at 120 L min e Catheter mount Learn Circuit i ResMed Leak Valve configuration HMEF Antibacterial filter m om a i AQ M PA ginny _ _ se ele e ee External humidifier AC power cord AC locking clip 1 Connect the power cord 2 Plug the free end of the power cord into a power outlet 3 Connect the antibacterial filter firmly onto the air outlet of the device am AZ P S n N Z b 4 SS 248369r6 book Seite 17 Montag 14 Mai 2012 1 40 13 2J 4 Connect the external humidifier to the other side of the antibacterial filter If not using an external humidifier connect the HMEF to the ResMed Leak Valve at step 9 5 Connect the air tubing to the external humidifier 6 Connect the ResMed Leak Valve to the air tubing Position the ResMed Leak Valve so that air from the vent holes does not blow directly onto the patient s chest WARNING n Always set up the ResMed Leak Valve in the breathing circuit with the arrows and the symbol f pointing in the direction of air flow from the Stellar to the patient 7 Select the mask type Trach selec
14. limited to 2 3 of Ti Max or Ti 50 increments Fall Time sets the time taken for the device to depressurize to EPAP PEEP when cycling occurs see page 10 Notes e The Rise Fall Time milliseconds scale is an approximate only e The actual Fall Time achieved is influenced by factors including compliance resistance leak pressure differential and patient breathing patterns Options min 100 400 100 increments Sets the minimum limit on the time the device spends in IPAP see page 9 Options 0 1 sec Ti Max 0 1 sec increments Sets the maximum limit on the time the device allows the patient to spend in inspiration see page 9 Options 0 3 4 sec or 2 3 of one breath cycle defined by Backup Rate 0 1 sec increments Sets the sensitivity for triggering Triggering occurs when inspiratory flow increases above a certain level and the device changes from EPAP to IPAP see page 9 Options very high high medium low very low Setup menu 37 2e A 248369r6 book Seite 38 Montag 14 Mai 2012 1 40 13 6e Cycle viv vV Medium Sets the sensitivity for cycling Cycling occurs when inspiratory flow decreases below a certain level and the device changes from IPAP to EPAP see page 9 Options very high high medium low very low Mask Type vv Vv x vY FULLFACE Selection of the mask type Options Nasal Ultra Pillow Full Face Trach Pediatric Note When Mask Type is set to Trach
15. once By pressing the Alarm mute key again the alarm sounds again When an alarm is muted the Alarm mute key LED will light constantly For a high or medium priority alarm if after two minutes the problem is still present the alarm will sound again Any active low priority alarm will be permanently muted and the Internal Battery Use alarm will be cleared until the alarm condition is fulfilled again Fixed alarms User adjustable alarms High priority alarms High priority alarms e Circuit disconnected when leak exceeds e Non Vented Mask 105 L min 1 75 L sec for at least 15 sec Medium priority alarms e Over pressure e Blocked tube e Internal battery empty when its charge level is less than 15 the system may stop operating In as little as two minutes e Pressure sensor failure System failure 7 e Motor failure system failure 6 e Critical software failure system failure 38 e Low Min Vent e High Leak e High Pressure e Low Pressure e High Respiratory Rate e Low Respiratory Rate e Apnea Low priority alarms e High FiO level e Low FiO level Medium priority alarms e High temperature internal components such as motor e System failure self test flow sensor software LOW p03 level calibration e Internal battery low when its charge level falls below 30 Low priority alarms e External DC power use e Internal battery use te e Keypad failure e Finger sensor failure e System failu
16. or invasive use with the use of the ResMed Leak Valve Operation of the device includes both stationary such as in hospital or home or mobile such as wheelchair usage CAUTION USA ONLY Federal law restricts this device to sale by or on the order of a physician Contraindications The Stellar 150 is contraindicated in patients who are unable to endure more than brief interruptions in ventilation The Stellar 150 is not a life support ventilator The use of the device may be contraindicated in patients with e pneumothorax or pneumomediastinum e pathologically low blood pressure particularly if associated with intravascular volume depletion e cerebrospinal fluid leak recent cranial Surgery or trauma e severe bullous lung disease e dehydration The use of the Stellar 150 or pulse oximetry including XPOD is contraindicated in an MRI environment Adverse effects Patients should report unusual chest pain severe headache or increased breathlessness The following side effects may arise during the course of noninvasive ventilation with the device e drying of the nose mouth or throat e nosebleed bloating e ear or sinus discomfort e eye irritation e skin rashes Introduction 1 PS T PS S P aN d Le 248369r6 book Seite 2 Montag 14 Mai 2012 1 40 13 About Stellar 150 therapy modes Stellar provides a number of therapy modes to suit a vari
17. 00 30 00 A r 03 58 03 59 04 00 04 0i 04 02 aden AU at MARAE NERINN MATAN AMAN pH AN 704 aii aadi aan Hit T TTY Pressure High Rate Itis ideal to observe changes of pressure support level or IPAP throughout the session or night If the pressure support remains at the same level for a long period of time often towards at maximum pressure support level it may indicate e the Target Va is too high e Max PS is set too low to adequately maintain the ventilation e EPAP is too low to treat upper airway obstruction Hints to identify upper airway obstruction include e episodes of desaturation e small flattened breaths on the flow trace e large levels of pressure Support without associated respiratory flow Configuring IVAPS 51 o e LY Le 248369r6 book Seite 52 Montag 14 Mai 2012 1 40 13 Data management 52 Apart from the data available to view directly on the device you can view and update data via ResMed s applications that assist with compliance management These are ResScan and EasyCare Tx When using ResScan you can view therapy data as well as change settings on the device To transfer data between the device and a PC you can use the ResMed USB Stick Use EasyCare Ix for the remote display of real time live data and adjustment of settings For more information see the PC application s manual There are two
18. 1 40 13 Ensuring successful ventilation with Stellar successful ventilation whether using a mask or tracheostomy tube relies on improving gas exchange and reducing the work of breathing for the patient Maintaining patient device synchrony and managing leak is critical to achieving this A good device should help this by e monitoring and compensating for leak e accurately sensing the start and end of a patient s inspiratory effort for triggering and cycling e responding quickly to reach and maintain the set pressure offering flexibility of settings to accommodate pathological variations in the patient s respiratory timing pattern stellar effectively provides this capability through e Learn Circuit method to calculate circuit impedance so that pressure can be controlled and estimated at the patient s airway e Vsync an automatic algorithm to compensate for unintentional leak e Mask selection a correct selection indicates to Stellar how much leak through the mask vent or ResMed Leak Valve can be expected as the therapy pressure varies e Mask fit ensures an optimal seal for the patient interface to avoid unintentional leak e TiControl ofters control over the inspiratory time limits between which the patient can spontaneously cycle Trigger Cycle sensitivities tfive sensitivities for triggering and cycling offer flexibility to personalize therapy and accommodate a range of patient conditions e Rise Fall Time
19. 4 cm H O CPAP 0 2 cm H20 Increments Sets the pressure at the beginning of the ramp time in bilevel modes S ST PS T iVAPS PAC Options 3 cm H O EPAP 0 2 cm H20 increments Setup menu 43 PN ji PN eo eo NZ Zs A 248369r6 book Seite 44 Montag 14 Mai 2012 1 40 13 6e Max Ramp Off Maximum setting for Ramp Time Time Options 0 45 min 5 minute increments Note If the Max Ramp Time is set to 0 min the Ramp Time setting does not appear in Patient mode Factory Resets machine default settings You will be asked to confirm your Defaults selection Note Restoring factory defaults will not affect the Motor run hours logged data eg patient therapy data the clock or the reminder settings 1 Parameter can be set by the patient Setup menu Configuration Menu ma Prog 1 ai reil ST Language English olti oolvt olmv oo lk ooler olti oolve olmv oo 2 Parameter Default Description Language English Sets the display language Options Depending on regional configuration Brightness 70 Sets the LCD backlight brightness Options 20 100 10 increments Backlight Auto Enables the LCD and keypad backlight If the AUTO setting is selected the backlight turns dark after five minutes without any actions and turns on again if any button is pressed again or an alarm occurs Options On Auto Time Sets the current time Note Changing the time setting backw
20. 46 Monitoring 31 Setup 34 Advanced Settings 37 Alarm Settings 30 38 Clinical Settings 29 34 Configuration 44 Options 30 43 Menus 28 Min PS 6 37 Minute Ventilation 31 Mobile use 13 Modes 2 Multi Program 45 O Optional components 11 Oxygen connection 24 P PAC Pressure Assist Control mode 2 Pathology 35 Pathology Defaults 7 10 Patient interface Compatible types 12 PEEP 2 Power Off 25 Pressure Naming 45 Pressure Support 2 Pressure Unit 44 Programs 27 35 PS 35 PS Pressure Support mode 2 Pulse oximeter 24 Push dial 22 R Ramp Setting 26 Ramp Time 43 Respiratory Rate 31 36 Rise Fall Time 7 10 37 S S Spontaneous mode 2 Setup Antibacterial filter 21 FiO2 monitoring sensor 20 Home therapy 17 Invasive use 16 Pulse oximeter 18 Supplemental oxygen 19 73 PN am ae e S a e 4 LY P 248369r6 book Seite 74 Montag 14 Mai 2012 1 40 13 SmartStart Stop 43 ST Spontaneous Timed mode 2 Start Stop 22 Supplemental oxygen 19 T T Timed mode 2 Target alveolar ventilation 5 Target Patient Rate 5 36 Target Va 36 Calculator 36 50 Therapy Start 24 Stop 25 Therapy modes 35 Therapy status bar 31 Ti 35 Ti Max 37 56 Ti Min 37 56 TiControl 7 9 Tidal Volume 31 Time 44 Time Format 44 Trigger 37 Trigger Cycle sensitivities 7 9 U USB stick 52 User adjustable alarms 26 V Vsync 7 74 an Sad
21. Data port OM Canadian Standards Association Temperature limitation for storage and transport gt Handle with care amp Maximum humidity am Keep dry Environmental information his device must be disposed of in accordance with the laws and regulations of the country in which disposal occurs For further information regarding product disposal please contact your local ResMed office or your specialist distributor or visit our website at www resmed com Dispose of used air filters and air tubing according to the directives in your country Technical specifications 69 PS S P aN LY Le 248369r6 book Seite 70 Montag 14 Mai 2012 1 40 13 General warnings and cautions WARNINGS A warning alerts you to possible injury 70 Read the entire manual before using the device The device and the accessories are to be used for the specified intended use only A User Guide is supplied with the device Please ensure the patient has the User Guide The device must only be used with masks and connectors recommended by ResMed or by a clinician or respiratory therapist A mask should not be used unless the device is turned on and operating properly The vent hole or holes associated with the mask should never be blocked Explanation Ihe device is intended to be used with special masks or connectors which have vent holes to allow continuous flow of air out of the mask
22. Le 248369r6 book Seite 18 Montag 14 Mai 2012 1 40 13 Working with other optional accessories Attaching a pulse oximeter 1 2 WARNING Only use compatible NONIN finger pulse sensors CAUTION Factors that may degrade pulse oximeter performance or affect the accuracy of the measurement include the following excessive ambient light excessive motion electrosurgical interference blood flow restrictors arterial catheters blood pressure cuffs infusing lines etc moisture in the sensor improperly applied sensor incorrect sensor type poor pulse quality venous pulsations anemia or low hemoglobin concentrations cardiogreen or other intravascular dyes carboxyhemoglobin methemoglobin dysfunctional hemoglobin artificial nails or fingernail polish or a sensor not at heart level Note he pulse oximeter does not meet the defibrillation proof requirement as per IEC 60601 1 1990 clause 1Zh Connect the plug of the finger pulse sensor to the plug of the pulse oximeter Connect the plug of the pulse oximeter at the rear of the device To view the oximetry values from the Monitoring menu select Monitoring an Y D i W A a Le 248369r6 book Seite 19 Montag 14 Mai 2012 1 40 13 Adding supplemental oxygen WARNING x e Oxygen flow must be turned off when the device is not operating so that unused oxygen does not accumulate within the devic
23. Pressure cm H20 10 04 IR IR 1 amp 8 _J8 IR IK 50 sf Va Veal Val Vad ied a 4 04 100 Flow L min 20s i Lk olrre 15s t L vt 476 mv 71 Progl 100 ieee 6 8 1il vt 479 mv 7 2 o rre 15 Ti Screen 2 Monitoring 1 Pressure bargraph with the set pressure limits 2 The following therapy parameters are displayed e Leak Vt RR Ti refer to Therapy status bar in Treatment screen e Alveolar Ventilation Va minute volume without deadspace Unit L displayed in iVAPS mode e Inspiration to expiration ratio per breath lE e Pulse oximeter measurements from Nonin Heart rate and SpO are both averaged over four beats of the pulse Data Is only displayed when an oximeter is connected to the device e FiQ Average traction of oxygen level in the air outlet Displayed when an oxygen sensor Is connected Note The SpO and FiO values are not appropriate to be used for diagnostic purposes Screen 3 Pressure Flow Pressure Therapy pressure refreshed at 10 Hz 0 1 sec Flow Estimated respiratory flow refreshed at 10 Hz 0 1 sec Unit L min L sec Each graph displays the last 20 seconds of data You can scroll back to view past data from the start of the session Press then turn it anti clockwise Screen 4 Minute Ventilation Respiratory Rate The last five minutes of data averaged over five breaths are displayed Screen 4 IVAPS only Minute Ventilation Alveol
24. USB stick e Store the file once again on the USB stick and try again to readout data e If the problem persists return the USB stick for servicing e The USB stick contains data of the same device Use only equipment as recommended and supplied by ResMed Transfer data to the USB stick either form another device or from ResScan Return the USB stick for servicing Connect the USB stick to a PC and delete data that is not needed Reconnect the USB stick to the Stellar 150 then retry writing data to the USB stick Use only equipment as recommended and supplied by ResMed Return the USB stick for servicing Try data transfer again If the problem persists return the USB stick for servicing 2e MA 4 5 ANS P 248369r6 book Seite 63 Montag 14 Mai 2012 1 40 13 Problem Possible cause Action FiO sensor calibration failure FiO sensor is not attached properly For the correct attachment of the FiO sensor see Using the FiO2 monitoring sensor on page 20 FiO sensor is used or defective If the lifetime of the FiO sensor has exceeded one year please replace the FiO sensor and Start calibration again LCD lt is displayed in the header Battery is not charging e Ensure the ambient temperature conditions are within the specified operating range If the problem persists within the specified operating conditions please return the device for servicing
25. breath detection is enhanced by the device s automatic leak management feature Vsync In addition the device has five adjustable trigger cycle sensitivities to optimize the sensing level according to patient conditions For more information see Trigger cycle sensitivities on page 57 For characteristic data see Technical specifications on page 64 Adjustable Trigger Sensitivity Adjustable Cycle Sensitivity Very High Very Low Medium Medium Very High lt lt Very Low Patient Patient Flow Flow Ensuring successful ventilation with Stellar 9 PN PN Sd P AIS D 4e 248369r6 book Seite 10 Montag 14 Mai 2012 1 40 13 i Rise Fall Time Rise Time sets the time taken for the device to reach the set inspiratory pressure after triggering The greater the Rise Time value the longer it takes for pressure to increase from EPAP to IPAP A controllable Rise Time allows the clinician to optimize the patient s work of breathing comfort and synchrony Fall Time sets the time taken for the device to reach the set expiratory pressure after cycling The greater the Fall Time value the longer it takes for pressure to decrease from IPAP to EPAP Adjustable Fall Time may in certain patients improve breathing comfort and synchrony For more information see Advanced Settings Factory default settings and parameter ranges on page 37 Patholo
26. changing leak by e monitoring average pressure and flow e assuming that on average volume delivered to the patient is equal to volume exhaled by the patient e using this information to continuously estimate the size of the leak opening as it changes e calculating the air flowing through the opening knowing its size and the therapy pressure an Y PN gt ia LY Le 248369r6 book Seite 9 Montag 14 Mai 2012 1 40 13 e as TiControl TiControl allows the clinician to set minimum and maximum inspiratory time limits Ti Min and Ti Max can be set to either side of the patient s ideal spontaneous inspiratory time ensuring adequate time for gas exchange and offering a window of opportunity to cycle into EPAP Ti Max Ti Min Cycle _ Window Patient flow Pressure For some patients whose Inspiratory effort or flow are weak and insufficient Ti Min prevents the premature cycling to EPAP Premature cycling to EPAP can result in insufficiently supported breaths e When breath detection becomes difficult due to excessive leak or inhibited exhalation effort or Le flow Ti Max effectively prevents prolonged inspiration See Setting TiControl on page 56 Trigger Cycle sensitivities Under normal conditions the device triggers initiates IPAP and cycles terminates IPAP and changes to EPAP as it senses the change in patient flow Patient
27. com on the Products page under Service amp Support If you do not have internet access please contact your ResMed representative Humidification A humidifier is recommended especially for patients experiencing dryness of the nose throat or mouth For information on using a humidifier as part of e noninvasive ventilation see Setting up for noninvasive use on page 14 e invasive ventilation see Setting up for invasive use on page 16 Internal battery CAUTION Over time the capacity of the internal battery will decrease This depends on individual use and ambient conditions As the battery degrades it could lead to battery related alarms and or system errors ResMed recommends the battery be tested after two years to assess the remaining battery life Testing and replacement of the internal battery should only be performed by an authorized service agent Note The battery duration depends on the state of charge the environmental conditions the condition and age of battery the device settings and the patient circuit configuration In case of a mains power disruption the device will operate using the internal battery if there is no external battery connected to the device The internal battery will operate for approximately e two hours under normal conditions see Technical specifications on page 64 The power status of the battery is displayed on top of the LCD screen Check the battery status regularly whil
28. condition because the ventilation target can be maintained despite degradation of lung mechanics or muscle function Similarly iWAPS offers advantage in nocturnal hypoventilation iVAPS by providing pressure support when required is more comfortable and better tolerated some key concepts important to clinical understanding of I VAPS operation are discussed below ahead of guidance on the IVAPS setup procedure on Stellar 150 See Configuring IVAPS on page 48 PN am AZ P S FN LY Le 248369r6 book Seite 5 Montag 14 Mai 2012 1 40 13 Target alveolar ventilation IVAPS targets alveolar ventilation Alveolar ventilation was chosen because it is at the level of the alveoli that gas exchange occurs Total ventilation includes the ventilation devoted to the conducting airways whereas alveolar ventilation best represents the useful portion of ventilation that reaches the alveoll Alveolar ventilation cannot be measured directly so IVAPS estimates it using a height approximated value of anatomical deadspace as shown in the graph below Anatomic deadspace is the amount of breath that remains in the conducting airways which does not reach alveoli and does not contribute to gas exchange Its contribution Is proportional to breath rate By using alveolar ventilation as a servo ventilation target as opposed to tidal volume or total ventilation the effect of respiratory rate change on
29. data ports at the rear of the device for connecting a USB stick see Stellar 150 at a glance on page 11 Therapy and device data can be stored on it or read from it WARNING Do not connect any device to the data ports other than specially designed devices recommended by ResMed Connection of other devices could result in injury or damage to the Stellar 150 see General warnings and cautions on page 70 CAUTION Do not disconnect the ResMed USB stick while data transfer is in progress Otherwise loss of data or incorrect data may result The download time depends on the data volume Notes You cannot connect two ResMed USB sticks simultaneously for data communication If data transfer is not possible or failed please read the troubleshooting section Do not store files on the USB stick other than those created by the device or application Unknown files may be lost during data transfer Plug the ResMed USB stick to one of the two USB connections on the rear side of the device The first dialogue for the USB data transfer is displayed automatically on the LCD The device checks if there is enough memory capacity on the USB stick and If readable data is available select one of the available options Read settings You will be prompted to decide if the device should read the ResScan configuration or the device configuration The ResScan configuration contains settings changes The device configuration contains settings of anot
30. e For Medium setting 6 0 L min e For Low setting 10 2 L min e For Very Low setting 15 0 L min Accuracy 20 or 2 0 1 5 L min whichever is greater When tested with IPAP 15 cm H20 EPAP 5 cm H 0 Rise Time Min 6 6 2 m air tubing Ultra Mirage mask zero leak The expiratory cycle occurs at the following flow rates e For Very High setting 50 of peak inspiratory flow e For High setting 35 of peak inspiratory flow e For Medium setting 25 of peak inspiratory flow e For Low setting 15 of peak inspiratory flow e For Very Low setting 8 of peak inspiratory flow Accuracy 10 25 or 1 3 L min whichever is greater When tested with IPAP 15 cm H20 EPAP 5 cm H3O Rise Time Min 6 6 2 m air tubing Ultra Mirage mask zero leak 29 dBA as measured according to ISO 17510 1 2002 32 dBA with uncertainty of 3 dBA as measured according to ISO 17510 1 2007 gt 45 dBA lt 85 dBA at 3 3 1 m 3 steps low medium high 7 days of respiratory flow calculated therapy pressure SpO pulse rate breath by breath data EPAP pressure support minute ventilation leak respiratory rate tidal volume inspiration time expiration time soontaneously or machine triggered or cycled breaths 365 days of 5th 50th 95th percentile data leak SoO 5 minute ventilation tidal volume respiratory rate E pressure support AHI Al 9 1 x 6 7 x 4 7 230 mm x 170 mm x 120 mm 4 6
31. e Poweroft the device e Power on the device Troubleshooting 63 PS an 7 e NZ a 112 INY Technical specifications 64 D 8 248369r6 book Seite 64 Montag 14 Mai 2012 1 40 13 Operating pressure range Maximum single fault pressure Maximum breathing resistance under single fault Therapy pressure tolerance Flow accuracy Maximum flow Inspiratory trigger nominal characteristics Expiratory cycle nominal characteristics Sound pressure level Alarm Volume Range Data storage Dimensions L x W x H Weight Air outlet e IPAP 3 cm H20 to 40 cm H20 in S ST T PAC mode e PS 0 cm H320 to 37 cm H30 in S ST T PAC mode e EPAP PEEP 3 cm H20 to 25 cm H3O in S ST T iVAPS PAC mode e CPAP 4 cm H30 to 20 cm H30 in CPAP mode only e Min PS 0 cm H20 to 20 cm H20 in IVAPS mode e Max PS 0 cm H20 to 30 cm H20 in IVAPS mode 60 cm H30 in all modes 2 cm H320 at 30 L min 7 2 cm H20 at 60 L min IPAP 0 5 cm H20 10 of set pressure end of inspiration EPAP or PEEP 0 5 cm H20 4 of set pressure CPAP 0 5 cm H20 10 of set pressure 5 L min or 20 measured value whichever is greater gt 200 L min at 20 cm H20 The minimum flow required to initiate IPAP by ASL5000 simulator with chronically weak efforts R20 C20 BPM20 e For Very High setting 2 4 L min e For High setting 4 2 L min
32. effective ventilation is negated Anatomical Deadspace Estimation 225 200 175 iVAPS Deadspace Estimation 150 125 100 75 Anatomical Deadspace Estimate ml 50 35 35 40 45 50 55 60 65 70 75 80 Height in Adapted from Hart MC et al Journal Applied Physiology 18 3 0519 522 1963 Target Patient Rate IVAPS has a novel approach to providing a backup rate Instead of mandating a fixed backup rate IVAPS intelligent Backup Rate IBR will shift automatically between two limits according to the context The benefit of this approach is improved synchrony while maximizing IVAPS ability to maintain the target ventilation at minimal pressure support e During sustained apnea the IBR will adopt a pre configured Target Patient Rate This Target Patient Rate defines the upper boundary for IBR You set the Target Patient Rate to match the patient s average spontaneous rate unlike a traditional backup rate e During spontaneous ventilation the IBR adjusts to remain well in the background at 2 3rd of the Target Patient Rate This background backup rate gives the patient maximum opportunity to spontaneously trigger e When spontaneous triggering ceases eg at the onset of an apnea the IBR adjusts from its background frequency to its Target Patient Rate It will adjust quickest typically within 4 5 breaths when ventilation is below the target ventilation e A single spontaneous triggered breath r
33. firmly at both ends Straighten or replace tubing Perform the Learn Circuit function The device does not stop when the patient removes their mask SmartStart Stop is disabled Use of a full face mask or tracheostomy tube Incompatible accessories eg humidifier or mask system with high resistance being used High Leak or Low Min Vent alarms are set to On Contirm stop is enabled Enable SmartStart Stop SmartStart is disabled if Full Face or Trach are selected as interface Use only equipment as recommended and supplied by ResMed SmartStop is disabled when High Leak or Low Min Vent alarms are set to On Disable Confirm stop High Leak Alarm is enabled but alarm does not activate when the mask is removed during treatment Incompatible air delivery system being used an Sad Use only equipment as recommended and supplied by ResMed Troubleshooting 61 2e D P 248369r6 book Seite 62 Montag 14 Mai 2012 1 40 13 Problem Possible cause Pressure settings are too low for the air delivery components being used Learn Circuit failed e The circuit configuration is inappropriate as the impedance detected is too high e Joo many components have been included or the impedance of accessories in use is above ResMed s recommendation eg type of filter external humidifier air tubing Action Perform the Learn Circuit function to adju
34. in the air circuit Humidifier control dial set too high resulting in accumulation of water in the air tubing Treatment pressure seems high Pressure required for treatment may have changed There is a change in the impedance in the circuit configuration The device does not start when the patient breathes into the mask SmartStart Stop not on Breath is not deep enough to trigger SmartStart There is excessive leak Plug s missing from port s on mask Air tubing is not connected properly Air tubing is kinked or punctured There is a large impedance eg antibacterial filter in the air circuit Action Remove the mask or the catheter mount from the tracheostomy tube until power is restored Ensure the power cord is connected and press the switch at the back of the device once Wait for air pressure to build up Replace air filter Straighten or replace tubing Connect the air tubing firmly at both ends Adjust position of mask and headgear Replace plug s Conduct a clinical assessment and adjust pressure if necessary Perform the Learn Circuit function Turn humidifier control down and empty the water from the air tubing Conduct a clinical assessment and adjust pressure if necessary Perform the Learn Circuit function Enable SmartStart Stop Ask the patient to take a deep breath in and out through the mask Adjust position of mask and headgear Replace plug s Connect
35. increasing the value 1 Observe the patient s inspiration time and respiratory pattern 2 Set the Ti Max slightly longer eg 1 5 sec for an adult patient than the patient s soontaneous o inspiratory time eg if the patient has a spontaneous Inspiratory time of 1 5 sec a Ti Max time of 1 6 sec may be chosen Note For COPD patients ensure the resultant I E ratio is at least 1 2 ideally 1 3 to allow sufficient time for exhalation You may need to shorten Ti Max or readjust the cycle sensitivity to provide a more appropriate I E ratio Setting Ti Min Ti Min may be useful in patients who have a tendency to cycle inspiration early or prematurely Patients with restrictive disorders eg chest wall deformity neuromuscular diseases often have a decreased compliance of the respiratory system which when using PS modes tends to contribute to early flow cycling Patients in this situation may complain that the device finishes inspiration before they do Lengthening the Ti Min setting may help to ensure that an appropriate inspiratory time and thus minute ventilation is maintained in these conditions Most patients with obstructive pulmonary disease do not have problems with premature cycling therefore the Ti Min setting can remain at the default setting Note Care should be taken not to set Ti Min longer than the patient s spontaneous inspiratory time as this may fight against the patient attempts to exhale creating discomf
36. regions or states do not allow the exclusion or limitation of incidental or consequential damages so the above limitation may not apply to you This warranty gives you specific legal rights and you may also have other rights which vary from region to region For further information on your warranty rights contact your local ResMed dealer or ResMed office R001 325 2 09 09 72 T am 7 e NZ a LY 8 248369r6 book Seite 73 Montag 14 Mai 2012 1 40 13 e Index A Aircraft Use on 13 Alarm Messages 25 Mute 22 Troubleshooting 58 Volume 25 40 Alarms Fixed 26 High priority 26 Low priority 26 Medium 26 Mute 26 Priorities 26 Resetting 26 Testing 40 User adjustable 26 Working with 25 Anatomic deadspace 5 Antibacterial filter 21 B Backup Rate 35 C Clinical mode 34 Confirm Stop 45 Control panel 22 CPAP 35 CPAP mode 2 9 Cycle 38 D Date 44 Date Format 44 Default settings 35 E EPAP PEEP 2 35 Erase Data 45 F FiO2 monitoring sensor 20 24 FiO2 Sensor Calibration 43 Flow Unit 44 Functional test 23 H Height 36 Height Unit 45 Humidification 12 24 Attaching H4i 15 l IBR 5 Info menu 46 Inspiration Time 31 Invasive use 16 IPAP 2335 IVAPS 2 4 50 Indications for use 4 L Language 44 LCD screen 23 Leak 31 Learn Circuit 7 43 M Mask fit 27 Mask Type 38 Max PS 6 37 Medium priority alarms 26 Menu Info
37. seconds LCD Non Vented Mask e Connection of a non vented mask e Mask vents may be blocked e ResMed Leak Valve is missing or vent Is blocked LCD Apnea The device detects an apnea that has exceeded the pre set alarm level LCD Internal Battery Low The internal battery capacity is below 30 Action Ensure the ambient temperature is within the specified operating range If the problem persists within the specified operating conditions please return the device for servicing 1 Stop treatment Check the alarm and pressure settings 3 Re start treatment NO Check the air circuit integrity and reconnect 2 If the alarm doesn t get cleared stop treatment 3 Re start treatment 1 Check the air circuit integrity and reconnect 2 If the alarm is not cleared stop treatment 3 Re start treatment e Reassess the patient to ensure adequate therapy e Ensure the alarm setting is appropriate for the patient e Reassess the patient to ensure adequate therapy o e Ensure the alarm setting is appropriate for the patient e Reassess the patient to ensure adequate therapy e Ensure the alarm setting is appropriate for the patient e Adjust the mask to minimize leak see Using mask fit on page 27 e Check the air circuit integrity and reconnect e Check that the anti asphyxia valve is Tully closed e Ensure the mask has vents e Ensure the mask vents are
38. testing Setramp Oo Ge Storm _ ____ Info menu SL 4 0 cmH20 Alarm mute button LED Ik olrr 10 Ti z2o vt soo mv 5 0 Alarm On when is pressed he y Wr Stellar x Push dial rotate click Therapy LED On during treatment Flashes during mask fitting operation Can be enabled or disabled see Setup menu Options on page 43 Start Stop button Marr S ResMep Key Function Start Stop e Starts or stops treatment e Extended hold for at least three seconds starts the mask fitting feature Alarm mute e During therapy Press once to mute an alarm Press a second time to un mute an alarm If the problem is still present the alarm will sound A again after two minutes see Working with alarms on page 25 e In stand by mode Extended hold for at least three seconds starts the LED and the alarm buzzer test Menu keys Press the appropriate menu button Monitoring Setup Into to enter and scroll through the relevant menu M i Push dial Turning the dial allows you to scroll through the menu and change settings Pushing the dial allows you to enter into a menu or confirm your choice 22 lt a K d P 248369r6 book Seite 23 Montag 14 Mai 2012 1 40 13 The LCD screen The LCD screen displays the menus treatment screens and alarm status Values on this LCD screen and other screens throughout the Clinical Guide are examples only
39. the therapy 2 Press the power switch at the back of the device once and follow the instructions on the display Note lo disconnect the device from the mains power pull out the mains plug from the power socket Working with alarms WARNINGS z e Carefully review the alarm settings prior to use to ensure that the alarm settings are D appropriate for each individual patient e This device is not intended to be used for vital signs monitoring If vital signs monitoring is required a dedicated device should be used for this purpose The device is fitted with alarms to alert you to changes that will affect the patient s treatment Alarm message Alarm LED Alarm mute key Alarm messages are displayed along the top of the screen High priority alarms are displayed in red medium priority alarms in yellow and low priority alarms in light blue The Alarm LED lights red during high priority alarms and yellow during medium and low priority alarms The alarm volume can be set Low Medium or High From the Setup menu select Alarm Settings After the set value has been confirmed the alarm will sound and the alarm LED lights For more information on reviewing and changing alarm settings see Setup menu Alarm Settings on page 38 Starting therapy 25 PN 9 eo cs N Z b 4 SS 248369r6 book Seite 26 Montag 14 Mai 2012 1 40 13 2J You can mute an alarm by pressing 4
40. 248369 6 2012 05 Stelar 150 RESMED AMER ENG Stellar 150 INVASIVE AND NONINVASIVE VENTILATOR Clinical Guide English mal Manufacturer ResMed Germany Inc Fraunhoferstr 16 82152 Martinsried Germany Distributed by ResMed Ltd 1 Elizabeth Macarthur Drive Bella Vista NSW 2153 Australia ResMed Corp 9001 Spectrum Center Blvd San Diego CA 92123 USA ResMed UK Ltd 96 Milton Park Abingdon Oxfordshire 0X14 4RY UK See www resmed com for other ResMed locations worldwide For patent information see www resmed com ip Respiratory Care Solutions ResMed SlimLine SmartStart Stellar and TICONTROL are trademarks of ResMed Ltd ResMed SlimLine SmartStart and Stellar are registered in Ma king q uality of care easy U S Patent and Trademark Office 2012 ResMed Ltd Global leaders in sleep and respiratory medicine www resmed com Setting up for non invasive use Using the menus For full setup see page 14 INFO M MA MONITORING SETUP Clinical Settings Treatment Event Summary Monitoring Leak Pressure Flow Minute Ventilation Alarm Settings AC locking clip AC power cord Min Vent Resp Rate Tidal Volume or MV Va IVAPS Mode Setting up for invasive use For full setup see page 16 Catheter mount Respiratory Rate ResMed Leak Valve HMEF Learn Circuit Leak configuration For full Setup menu details see Antibacterial filter e Clinical Set
41. 30 at 120 L min Connect one end of the air tubing firmly onto the air outlet of the H4i Connect the mask system to the free end of the air tubing am WY Us LY e 248369r6 book Seite 15 Montag 14 Mai 2012 1 40 13 6 Select the mask type select Setup menu then Clinical Settings then Advanced Settings 7 Perform Learn Circuit see Setup menu Options on page 43 Attaching the H4i heated humidifier The Stellar 150 can be used with the H4i heated humidifier for noninvasive use when stationary It will be automatically detected when the Stellar 150 is turned on A humidifier is recommended especially for patients experiencing nasal stuffiness congestion e rhinnorhea following the use of mask ventilation e dryness of the nose throat or mouth e patients with thick secretions eg cystic fibrosis bronchiectasis etc e patients using oxygen Humiditication may be required for patients who experience nasal and upper airway dryness as a consequence of the high flow of air being directed through the nasal and oral passages It may also be required in those individuals who have tenacious secretions Mouth leaks occurring during the use of positive pressure therapy can significantly increase nasal resistance This increase in nasal resistance associated with mouth leaks may be prevented by fully humidifying the inspired air In most cases using heated humidifi
42. 5 PS am 7 e NZ a as K d P 248369r6 book Seite 66 Montag 14 Mai 2012 1 40 13 Displayed values Value Range Accuracy Flow sensor in device Leak 3 0 120 L min 12 L min or 20 whichever is greater Tidal volume 50 3 000 mL 20 or 30 mL whichever is greater Respiratory rate 5 60 bom 1 bom Minute ventilation 0 6 60 L 0 5 L or 20 whichever is Alveolar minute greater ventilation 2 Ti 0 0 4 sec 0 1 sec or 10 whichever is greater Pressure 0 40 cm H20 IPAP 0 5 cm H20 10 of set pressure end of inspiration EPAP or PEEP 0 5 cm H20 4 of set pressure CPAP 0 5 cm H20 10 of set pressure Display Resolution 1 L min 10 mL 1 bom 0 1L 0 1 sec 0 1 cm H20 1 Results may be inaccurate in the presence of leaks and may be affected by vent characteristics 2 Results are expressed at STPH Standard Temperature Pressure ambient humidity 3 Results may be inaccurate in the presence of leak and supplemental oxygen gt 10 L min If necessary for therapy use external monitoring 4 Results may be inaccurate if the tidal volume is below 50 mL Pressure flow table Stellar 150 with 6 6 2 m standard tube Therapy pressure cm H20 0 20 40 60 80 100 120 140 160 180 200 220 240 Flow L min 66 an ad MD LY Zs P 248369r6 book Seite 67 Montag
43. LY Le 248369r6 book Seite 54 Montag 14 Mai 2012 1 40 13 Replacing the air filter 54 A W N Replace the air filter every six months or more often if necessary WARNING Do not wash the air filter The air filter is not washable or reusable Remove the air filter cover at the back of the device Remove and discard the old air filter Insert a new filter Refit the air filter cover air filter air filter cover PN gt LP is an Y N Z b 4 X 248369r6 book Seite 55 Montag 14 Mai 2012 1 40 13 2J Multipatient use WARNING An antibacterial filter is mandatory if the device is used on multiple patients Ina mulitpatient use environment you must perform the following before the device is provided to a new patient Air filter and the Replace antibacterial filter Mask Reprocess Cleaning disinfection and sterilization instructions are available from the ResMed website www resmed com masks sterilization americas If you do not have Internet access please contact your ResMed representative Air tubing Replace the air tubing Alternatively consult the air tubing instructions for cleaning and disinfection information Device Disinfect the Stellar 150 as follows Use an anti bacterial cleaning disintectant solution such as Mikrozid AF or CaviCide with a clean non dyed disposable cloth to clean and disinfect the exterior surfaces
44. The Stellar 150 comprises e Stellar 150 device e Hypoallergenic air filter e AC Power cord e Carry bag 6 6 2 m air tubing e ResMed USB stick e Low pressure oxygen connector The following optional components are compatible with Stellar 150 9 10 3 m air tubing SlimLine air tubing e clear air tubing disposable e H4i heated humidifier e Antibacterial filter e Heat moisture exchanger filter HMEF e ResMed XPOD oximeter e Nonin pulse oximetry sensors e FiO monitoring kit external cable T piece adapter e FiO monitoring sensor e Stellar Mobility bag e ResMed Leak Valve e Tubing wrap WARNING The Stellar 150 should only be used with air tubing and accessories recommended by ResMed Connection of other air tubing or accessories could result in injury or damage to the device ResMed regularly releases new products Please check the catalogue of ventilation accessories on our website at www resmed com Stellar 150 at a glance 11 am WY P U NZ b Le 248369r6 book Seite 12 Montag 14 Mai 2012 1 40 13 Patient interface Both masks and tracheostomy tubes can be used with Stellar To set the patient interface type go to the Setup menu select Clinical Settings then Advanced Settings For information on using masks see the mask manual For a full list of compatible masks for this device see the Mask Device Compatibility List on www resmed
45. Treatment screen provides the option to start warming the 22 30 00 humidifier If the humidifier is heating the related symbol is 100 F 21 07 2010 displayed at the top of the LCD screen For more information see the H4i User Guide 40 Warm up the humidifier Fan ______setProgram e Note The H4i in heating mode can only be used when the E A E N E N Sa device is connected to mains supply 7 Check the FiO monitoring sensor if in use Start the FiO sensor calibration Select Setup menu then Options see Setup menu Options on page 43 Follow the instructions on the display 8 Check pulse oximeter if in use Attach the accessories according to the setup descriptions see Attaching a pulse oximeter on page 18 From the Monitoring menu go to the Monitoring screen Check that the values for SpO and Heart rate are displayed 9 Check oxygen connection if in use Attach the accessories according to the setup descriptions see Adding supplemental oxygen on page 19 Starting therapy WARNING Always ensure that the values in the ventilator therapy and alarm settings are appropriate before starting therapy Notes When the device is turned on it operates in Patient mode where settings are restricted You can switch the device into Clinical mode see Setup menu on page 34 e Always ensure that you verify the correct operation of triggering and cycling and act
46. a damp cloth and mild detergent CAUTION Do not hang the air tubing in direct sunlight as the tubing may harden over time and eventually crack e Do not use bleach chlorine alcohol or aromatic based solutions including all scented oils moisturizing or antibacterial soaps to clean the air tubing or the device on a daily basis other than the approved cleaning agents Mikrozid AF or CaviCide These e solutions may cause hardening and reduce the life of the product Le The use of cleaners and disinfecting solutions containing alcohol other than the approved cleaning agents is acceptable for periodic cleaning of the device such as for cleaning between patients or especially for service periods but not recommended for daily use Weekly 1 Remove the air tubing from the device and the patient interface Wash the air tubing in warm water using mild detergent Rinse thoroughly hang and allow to dry Reconnect the air tubing to the air outlet and patient interface or A W N If the device is visibly soiled wipe the exterior surfaces of the device and the pulse oximeter if used with a damp cloth and mild detergent Monthly 1 Wipe the exterior of the device and the pulse oximeter if used with a damp cloth and mild detergent 2 Visually inspect the air filter to check if it is blocked by dirt or contains holes Cleaning and maintenance 93 5 T oD
47. adjustable duration for transitions to both inspiration and expiration offer opportunity for maximal comfort e Pathology Defaults offer a choice of disease specific preset setting values to facilitate a quick and sensible starting point to therapy Learn Circuit The Learn Circuit procedure permits optimal therapy and monitoring accuracy by measuring and storing the breathing system impedance up to and including the vent This allows the device to accurately estimate the therapy pressure For more information on performing a Learn Circuit see Setup menu Options on page 43 Vsync and mask selection stellar s unique leak management combines Vsync and Mask Selection to monitor leak ie unintentional mask leak and vent leak and effectively compensate for its potentially detrimental effect on therapy It is important for a device to monitor the patient s respiratory flow which provides information about lung ventilation and timing of the patient s effort Using the respiratory flow signal the device is able to trigger and cycle breaths that synchronize closely with the patient s effort Leak flow both unintentional and from the mask inline vent adds to the Total Flow measured by the device s flow sensor and obscures the true Respiratory Flow Without leak compensation this would cause asynchronous triggering and cycling as well as Inaccurate data monitoring which may impact clinical decision making stellar is able to extract
48. ameter Mode Default Description aoa a 9 lt E 8 Onnkr 2a Pathology v Bay avy Normal Disease specific preset setting values to facilitate efficient commencement of therapy see page 10 Note If the default pathology settings have been changed the button is marked with an asterisk Options Obstructive restrictive normal obesity hypoventilation Program mY ba bev Prog 1 The program setting is only available if the option Multi program in the Configuration menu is set to Dual Clinical settings and alarms can be stored in two different programs see page 27 Note The program name can be set via ResScan Options Prog 1 Prog 2 Mode Vv VV VY Vv ST Sets the therapy mode see page 2 Options CPAP S ST PS T iVAPS PAC CPAP v 8 0 cm H2O Continuous Positive Airway Pressure Sets the fixed treatment pressure in CPAP mode Note When changing from CPAP to bilevel mode the set CPAP pressure becomes the new IPAP and EPAP pressure e Options 4 20 cm H20 0 2 cm H20 increments IPAP y xy v 11 0cmH H O Inspiratory Positive Airway Pressure IPAP is the pressure which will be delivered to the patient when the device is triggered into inspiration Options 3 40 cm H20 0 2 cm H20 increments EPAP or vv x v 5 0cmH 0 Expiratory Positive Airway Pressure PEEP EPAP is the pressure which will be delivered to the patient when the device is cycled into expiration see page 57 Options 3 25 cm H30 alway
49. ansmitters such as base stations for radio cellular cordless telephones and land mobile radios amateur radio AM and FM radio broadcast and TV broadcast cannot be predicted theoretically with accuracy To assess the electromagnetic environment due to fixed RF transmitters an electromagnetic site survey should be considered If the measured field strength in the location in which the device is used exceeds the applicable RF compliance level above the device should be observed to verify normal operation If abnormal performance is observed additional measures may be necessary such as reorienting or relocating the device P Over the frequency range 150 kHz to 80 MHz field strengths should be less than 3 V m PS T PS P aN K d P 248369r6 book Seite 69 Montag 14 Mai 2012 1 40 13 e eal Manufacturer tt Upside Catalogue number Serial number Batch code amp Do not re use T Use by date aN Keep away from sunlight Do not use if package is eo damaged Latex tree Recommended separation distances between portable and mobile RF communications equipment and the device The device is intended for use in an environment in which radiated RF disturbances are controlled The customer or the user of the device can help prevent electromagnetic interference by maintaining a minimum distance between portable and mobile RF communications equipment transmitters and the device as recommende
50. ar Ventilation The last five minutes of data averaged over five breaths are displayed Alveolar Ventilation has a guideline of Target Va Screen 5 Leak Average instantaneous leak Sampled variably depending on leak change Unit L min L sec Pressure Flow graph Therapy pressure and estimated respiratory flow sampled at 10 Hz 0 1 sec Each graph displays the last 20 seconds of data Screen 6 Tidal Volume The last 14 breaths of data averaged over five breaths are displayed o A 248369r6 book Seite 33 Montag 14 Mai 2012 1 40 13 is olrre is ti u2ivr 485 mv 7 2 olrre aisiti a1alvr 478 mv 7 0 Screen 7 Synchronisation Diagram of the measured inspiration phases of the last 20 breaths The last 20 breaths of measured inspiration time sec The height of the bar indicates the Inspiration time In S ST modes Ti Min Ti Max thresholds are shown as Min Max e Settings changed A Alarm activated Additional information is displayed on the Event summary page e The inspiratory phase is sustained up to Ti Min S ST mode e The red bar indicates for how long the inspiratory phase is sustained up to Ti Min S ST mode or Ti PAC T mode e The inspiratory phase is cycled down to EPAP PEEP at Ti Max S ST mode or Ti PAC T mode e A The machine initiates the inspiratory phase increasing pressure up from EPAP PEEPR Screen 8 Oximetry SpO The oxygen saturation level
51. ards will erase all logged data Options hours minutes seconds Date Sets the current date Note Changing the date setting backwards will erase all logged data Options day month year Time Format 12 hrs Sets the time format Options 24 hrs 12 hrs Date Format mm dd Sets the date format yyYyY Options dd mm yyyy mm dd yyyy Pressure Unit cm H20 Selection of the display units for pressure Options cm H0O hPa Flow Unit L min Selection of the display units for flow Options L min L sec 44 e N Z b 4 SS 248369r6 book Seite 45 Montag 14 Mai 2012 1 40 13 2J Parameter Default Description Therapy LED On Enables or disables the therapy LED If enabled the blue therapy LED in the Start Stop button is lit while the device is delivering therapy Options On Off Confirm Stop On This feature helps to avoid anyone inadvertently stopping therapy When enabled On if you press during therapy the Confirm Stop screen will appear If YES is selected therapy stops If NO is selected or any other key is pressed therapy continues Options On Off Pressure IPAP Choose the terminology type used through the screens displays Naming EPAP Options PS PEEP IPAP EPAP Multi Program single You have the option to define two different programs for therapy and alarm settings The program selection can be made in the Clinical Settings menu if this option is set to dual If dual is
52. b 2 1 kg 0 9 22 mm taper compatible with ISO 5356 1 2004 Anesthetic amp Respiratory Equipment Conical Connectors PS am 7 e NZ a 112 INY 4 LY P 248369r6 book Seite 65 Montag 14 Mai 2012 1 40 13 Pressure measurement Flow measurement Power supply External DC Power Supply isolated Internal Battery Housing construction Environmental conditions Stellar 150 Electromagnetic compatibility Air filter Air tubing SlimLine air tubing IEC 60601 1 classifications Air travel requirements Internally mounted pressure transducer Internally mounted flow transducer AC 100 240V 50 60Hz 2 2 A max 65 W 24V 3A Lithium lon battery 14 4 V 1 6 Ah 23 Wh Operating hours 2 h with a new battery under normal conditions see below Patient type home chronic pressure IPAP EPAP 15 5 cm H320 mask type Ultra Mirage air tubing 6 6 2 m leak 0 respiratory rate 20 bom battery capacity 100 Patient type hospital acute pressure IPAP EPAP 20 5 cm H30 mask type Ultra Mirage air tubing 6 6 2 m leak 0 respiratory rate 45 bom battery capacity 100 Flame retardant engineering thermoplastic e Operating temperature 32 F 0 C to 95 F 35 C e Operating humidity 10 95 non condensing e Storage and transport temperature 4 F 20 C to 140 F 60 C 122 F 50 C e Storage and transport humidity 10
53. cation is the most effective way to decrease nasal resistance For information on using the H4i see the H4i user guide WARNING e Always place the H4i on a level surface below the level of the patient to prevent the mask and tubing from filling with water j e Make sure that the water chamber is empty and thoroughly dried before transporting the humidifier e The H4i humidifier is not intended for mobile use Do not overfill the water chamber as during use this will cause water to spill into the air circuit e For optimal accuracy and synchrony perform Learn Circuit with a change of the circuit configuration in particular when adding or removing high impedance components eg antibacterial filter external humidifier water trap nasal pillow type mask or air tubing See Setup menu Options on page 43 CAUTION Check the air circuit for water condensation Use a water trap or a tubing wrap If humidification is causing water condensation within the tube Notes A humidifier increases resistance in the air circuit and may affect triggering and cycling and accuracy of display and delivered pressures Therefore perform the Learn Circuit function see Setup menu Options on page 43 The device adjusts the airflow resistance The heating feature of the H4i is disabled when the device is not mains powered Setting up for noninvasive use 15 an Bei wv
54. d below according to the maximum output power of the communications equipment Separation distance according to frequency of transmitter m Rated maximum output power of 150 kHz to 80 MHz 80 MHz to 800 MHz 800 MHz to 2 5 GHz transmitter W d 1 17 VP d 1 17 VP d 2 33 VP 0 01 0 12 0 12 0 23 0 1 0 37 0 37 0 74 1 1 17 1 17 2 33 10 3 70 3 70 737 100 11 70 11 70 23 30 For transmitters rated at a maximum output power not listed above the recommended separation distance d in metres m can be determined using the equation applicable to the frequency of the transmitter where P is the maximum output power rating of the transmitter in watts W according to the transmitter manufacturer NOTE 1 At 80 MHz and 800 MHz the separation distance for the higher frequency range applies NOTE 2 These guidelines may not apply in all situations Electromagnetic propagation is affected by absorption and reflection from structures objects and people Symbols Follow instructions for use Class Il equipment A Type BF applied part A Bell Remote Alarm IP31 Device is protected against solid foreign objects of 0 1 2 5 mm diameter and greater and vertically falling water drops A Caution A General warning sign see H4 connector plug and AC connection on the device ON STAND BY Standby or preparatory state for a part of equipment power switch O Connection for oxygen supply max 30 l min max 30 I min e lt
55. e and create a risk of fire ResMed strongly recommends adding oxygen into Stellar s oxygen inlet at the rear of the device Entraining oxygen elsewhere ie into the breathing system via a side port or at the mask has potential to impair triggering and accuracy of therapy monitoring and alarms eg High Leak alarm Non vented mask alarm If used in this way therapy and alarm operation must be verified each time oxygen flow is adjusted e Oxygen supports combustion Oxygen must not be used while smoking or in the presence of an open flame Only use oxygen supply in well ventilated rooms The breathing system and the oxygen source must be kept at a minimum distance of 6 6 2 m away from any sources of ignition eg electrical devices Use only certified clean oxygen sources Oxygen must not be used while the device is being operated within the mobility bag Oxygen supply Press spring to release connection after use Note Up to 30 L min at maximum oxygen pressure of 50 mbar 0 73 psi can be added Starting therapy using oxygen 1 Fit the oxygen connector to the oxygen inlet of the device 2 Attach the other end of the oxygen supply tubing to the oxygen supply 3 Press to start treatment Ensure you complete titration with the same circuit configuration that the patient will be using at home 4 Turn on oxygen Stopping therapy using oxygen 1 Turn off oxygen 2 Press to stop treatment
56. e customer or the user of the device should assure that it is used in such an environment Immunity test IEC60601 1 2 test level Compliance level Electromagnetic environment guidance Electrostatic discharge 6 kV contact 6 kV contact Floors should be wood concrete or ceramic tile If floors are covered with ESD IEC 61000 4 2 8 kV air 8 kV air synthetic material the relative humidity should be at least 30 Electrical fast 2 kV for power supply 2 kV Mains power quality should be that of a typical commercial or hospital transient burst lines environment IEC 61000 4 4 1 kV for input output 1 kV lines Surge IEC 61000 4 5 1 kV differential mode 1 kV differential mode Mains power quality should be that of a typical commercial or hospital 2 kV common mode 2 kV common mode environment Voltage dips short lt 5 Ut gt 95 dip in Ut lt 12 V gt 95 dip in 240V Mains power quality should be that of a typical commercial or hospital interruptions and voltage for 0 5 cycle for 0 5 cycle environment variations on power 40 Ut 60 dip in Ut 96 V 60 dip in 240 V If the user of the device requires continued operation during power mains supply input lines for 5 cycles for 5 cycles interruptions it is recommended that the device be powered from an IEC 61000 4 11 70 Ut 30 dip in Ut 168 V 30 dip in 240 V uninterruptible power source for 25 cycles lt 12 V gt 95 dip in 240 V for 5 sec for 25 cycles lt 5 Ut
57. e operating the device with the internal battery and connect the device in time to mains power or alternatively to the external battery Additionally the Internal battery use alarm will be displayed Press the Alarm mute button to clear the alarm To recharge the internal battery connect the device to mains power It can take up to three hours to fully recharge the internal battery however this can vary depending on environmental conditions and if the device is in use The internal battery has to be discharged and recharged every six months Maintenance The internal battery has to be discharged and recharged every six months 1 Remove the power cord while the Stellar 150 is turned on stand by or in operation and let the device operate with the internal battery to a charge level of 50 2 Reconnect the power cord to the mains power The internal battery will be fully recharged Storing If the device is stored for a longer period the internal battery should be at the charge level of approximately 50 to increase the durability Note Check the charge level every six months if necessary recharge the internal battery to a charge level of 50 PN am 7 P S FN D e 248369r6 book Seite 13 Montag 14 Mai 2012 1 40 13 ResMed USB stick A ResMed USB stick may be used with the device either to help you to monitor the patient s treatment to provide the patien
58. e oximeter adapters e Humidifiers and humidifier cleanable water tubs e Titration control devices e CPAP bilevel and ventilation devices including external power supply units 2 years e Battery accessories e Portable diagnostic screening devices This warranty is only available to the initial consumer It is not transferable If the product fails under conditions of normal use ResMed will repair or replace at its option the defective product or any of its components This limited warranty does not cover a any damage caused as a result of improper use abuse modification or alteration of the product b repairs carried out by any service organization that has not been expressly authorized by ResMed to perform such repairs c any damage or contamination due to cigarette pipe cigar or other smoke Warranty is void on product sold or resold outside the region of original purchase Warranty claims on defective product must be made by the initial consumer at the point of purchase This warranty replaces all other expressed or implied warranties including any implied warranty of merchantability or fitness for a particular purpose Some regions or states do not allow limitations on how long an implied warranty lasts so the above limitation may not apply to you ResMed shall not be responsible for any incidental or consequential damages claimed to have resulted trom the sale installation or use of any ResMed product Some
59. ecruiting and or maintaining lung volume aiding gas exchange improving lung compliance or minimizing lung injury e In obstructive lung disease to offset intrinsic PEEP to reduce work of breathing and or maximize effective triggering e To splint open or stabilize the upperairway during sleep For nocturnal ventilation a starting pressure of 5 cm H20 is recommended If there is any indication of symptoms such as daytime sleepiness obesity an anatomically narrow airway or neuromuscular disease or pressure support frequently reaching the maximum level an additional 1 3 cm H20 may be helpful Stellar provides monitoring such as optional integrated SpO and high resolution flow data to assist with titrating EPAP PEEP in order to maintain upper airway patency Evidence of desaturation or flow limitation may lead to EPAP PEEP adjustment Trigger cycle sensitivities High trigger sensitivity decreases the flow threshold necessary for the device to move from EPAP to IPAP making it easier for the patient to trigger So for example for patients who have insufficient inspiratory effort flow set the trigger setting to High or Very High to increase sensitivity to patient effort So the patient needs to exert less effort to trigger the device Less sensitive settings Low and Very Low provide flexibility for patients prone to auto triggering caused by restrictive lung diseases and cardiogenic artefact Cardi
60. er for entry of moisture or other contaminants The filter must be replaced according to the manufacturer s specifications Note ResMed recommends using a filter with a low impedance less than 2 cm H30 at 60 L min eg PALL BB 50 filter WARNING An antibacterial filter is mandatory if the device is used on multiple patients Do not use the antibacterial filter product code 24966 with the H4i f U Fit the antibacterial filter to the air outlet of the device Attach the air tubing to the other side of the filter Attach the mask system to the free end of the air tubing A W N Perform the Learn Circuit function see Setup menu Options on page 43 From the Setup menu select Options This enables the device to compensate for the impedance introduced by the filters Working with other optional accessories 21 PS T PN 9 eo z Gis NZ b a Le 248369r6 book Seite 22 Montag 14 Mai 2012 1 40 13 Stellar 150 basics About the control panel Mains power LED LCD screen On when operating on mains power External power supply LED On when external battery is connected Internal battery LED On when internal battery is in use Flashes when device is turned off and battery is charging EN i 150g a Treatment Monitoring menu Alarm LED vol 22 30 00 Red or yellow during an alarm We 21 07 2010 Setup menu or during alarm
61. esets the IBR to its background rate 2 3rds of Target Patient Rate About Stellar 150 therapy modes 5 PN am 7 P S FN K d P 248369r6 book Seite 6 Montag 14 Mai 2012 1 40 13 IBR brings the patient back on target when back up breaths are required Patient effort gt lt _ No Patient effort gt lt Patient effort 5b g k A A amp tL g e A a z A D 2 UA A A A A A A A A A A ma Time Target patient rate Patient spontaneous rate A iVAPS intelligent back up rate iBR Min Max PS The default settings for maximum and minimum pressure support are normally adequate but you may wish to alter them in some patients Min PS and Max PS define the range of pressure support adjustment available to the IVAPS algorithm as it regulates alveolar ventilation It is recommended that Max PS be set high enough to allow the alveolar ventilation target to be met while exercising clinical judgement over considerations such as patient comfort and tolerance lung mechanics age mask seal etc It is recommended that Min PS is left at the level set when learning the patient s ventilation target unless the patient finds this too little for comfort an ad A ALIS LY 8 248369r6 book Seite 7 Montag 14 Mai 2012
62. esponse IVAPS is tuned to be fast enough to avoid blood gas derangement associated with most breathing challenges including during sleep but is gentle enough to avoid disruption e IVAPS has an intelligent Backup Rate IBR which aims to keep out of the way while the patient is breathing yet during sustained apnea will mimic the patient s own breath rate This contributes to iVAPS ability to maintain its ventilation target and so stabilize blood gases even during sleep e IVAPS has ResMed s robust leak compensation feature Vsync a product of ResMed s long experience in noninvasive ventilation This promotes synchrony and comfort even during significant leak Pressure support is adjusted continuously during the Inspiration phase breath to breath aiming to maintain target alveolar ventilation If ventilation falls pressure support is increased until the target is reached Conversely if alveolar ventilation rises above target pressure support falls The range of pressure support adjustment is constrained within Min PS and Max PS The rate of increase in pressure support can reach up to 0 7 cm H O sec The breath to breath changes in pressure support depend on the breath rate and how far the patient is from the target alveolar ventilation Typically the change in pressure support does not exceed 3 cm H20 per breath IVAPS provides benefits across a range of situations For example it can benefit patients with a progressive lung
63. etic environment specified below The customer or the user of the device should assure that it is used in such an environment Emissions test Electromagnetic environment guidance RF emissions CISPR11 Group 1 The device uses RF energy only for its internal function Therefore its RF emissions are very low and are not likely to cause any interference in nearby electronic equipment RF emissions CISPR 11 Class B The device is suitable for use in all establishments including E domestic establishments and those directly connected to the Harmonic Emissions Class A public low voltage network that supplies buildings used for IEC 61000 3 2 domestic purposes Voltage Fluctuations Flicker Emissions IEC 61000 3 3 Complies Medical Electrical Equipment needs special precautions regarding EMC and needs to be installed and put into service according to EMC information provided in this document Warnings The device should not be used adjacent to or stacked with other equipment If adjacent or stacked use is necessary the device should be observed to verify normal operation in the configuration in which it will be used The use of accessories e g humidifiers other than those specified in this manual is not recommended They may result in increased emissions or decreased immunity of the device Guidance and manufacturer s declaration electromagnetic immunity The device is intended for use in the electromagnetic environment specified below Th
64. ety of ventilation requirements Regardless of the mode Stellar 150 assists spontaneous breathing by providing two pressures in response to the patient flow or a preset fixed time Common setting parameters The inspiratory positive airway pressure IPAP or the sum of PEEP and Pressure Support PS assists inspiration The lower expiratory positive airway pressure EPAP or PEEP eliminates exhaled air through the exhaust vent This pressure also provides a stent to maintain an open upper airway improves small airway recruitment and therefore oxygenation and may improve triggering in some patients with intrinsic PEEP The difference of the two pressures Pressure Support PS contributes to improved patient ventilation i One Breath Cycle Ti Max Ti Min lt lt PAP beeeeceeedeey Pressure Support EPAP oe Rise time Fall time 0 stellar provides the following modes e CPAP mode a fixed pressure is delivered e S Spontaneous mode the device senses the patient breath and triggers IPAP in response to an increase in flow and cycles into EPAP at the end of inspiration The breath rate and the respiratory pattern will be determined by the patient e ST Spontaneous Timed or PS Pressure Support mode the device augments any breath initiated by the patient but will also supply additional breaths should the patient breath rate fall below the clinician s set backup breath rate T Timed mode the fixed brea
65. gt 95 dip in Ut for 5 sec Power frequency 3 A m 3 A m Power frequency magnetic fields should be at levels characteristic of a 50 60 Hz magnetic field typical location in a typical commercial or hospital environment IEC 61000 4 8 Portable and mobile RF communications equipment should be used no closer to any part of the device including cables than the recommended separation distance calculated from the equation applicable to the frequency of the transmitter Recommended separation distance Conducted RF 3 Vrms 3 Vrms d 1 17 VP IEC 61000 4 6 150 kHz to 80 MHz Radiated RF 3 V m 3 V m d 1 17 VP 80 MHz to 800 MHz IEC 61000 4 3 80 MHz to 2 5 GHz d 2 33 VP 800 MHz to 2 5 GHz where P is the maximum output power rating of the transmitter in watts W according to the transmitter manufacturer and d is the recommended separation distance in metres m Field strengths from fixed RF transmitters as determined by an electromagnetic site survey should be less than the compliance level in each frequency range Interference may occur in the vicinity of equipment marked with the following symbol ko NOTE 1 Utis the AC mains voltage prior to application of the test level NOTE 2 At 80 MHz and 800 MHz the higher frequency range applies NOTE 3 These guidelines may not apply in all situations Electromagnetic propagation is affected by absorption and reflection from structures objects and people a Field strengths from fixed tr
66. gy Defaults The Pathology Defaults offer a choice of disease specific preset setting values to facilitate efficient commencement of therapy You can select trom four sets of respiratory system mechanics Before use you will need to review the set parameters on the Clinical Settings screen Setting a Obstructive Restrictive Obesity Normal O lung lung Hypoventilation lung T i lt gt disease disease Syndrome mechanics IPAP cm H30 Ba M 13 11 15 11 EPAP or PEEP cm HO V v al v vy 5 5 7 5 PS cm H20 MM 8 6 8 6 Rise Time ms MKA 150 300 300 200 Fall Time ms VLLL 200 200 200 200 gt Trigger sensitivity V vy v x Medium Medium Medium Medium D i Cycle sensitivity E V High Low Medium Medium Min PS cm H320 v 4 4 4 2 Max PS cm H 0 v 20 20 18 20 Ti Min sec V Ey v 0 3 0 5 0 5 0 5 Ti Max sec viv v 1 0 t5 1 5 15 The Rise Fall Time milliseconds scale is an approximate only PS PN NY 7 p FIN as d Le 248369r6 book Seite 11 Montag 14 Mai 2012 1 40 13 Stellar 150 at a glance Handle Oxygen inlet H4i connector plug and J AC connection Air outlet Air filter cover Infrared connection for H4i humidifier ON STAND BY XPOD pulse oximeter connection DC power socket AC power socket FiO sensor connection Power on stand by switch Data port for USB stick Remote alarm connection Data port for direct PC connection
67. hase sustained up to Ti Min lt Ti Min lt _ Ti Max li One breath cycle Period of increased leak About Stellar 150 therapy modes 3 KA Dl Gis an Y K d P 248369r6 book Seite 4 Montag 14 Mai 2012 1 40 13 More about iVAPS The iVAPS therapy mode is indicated for patients 66 Ib 30 kg and above You may prefer some assurance that the patient s ventilatory needs will be maintained if their condition varies A variety of dual mode schemes exist that aim to combine the benefits of pressure target and volume target most of which can be categorized generically as volume assured pressure support or VAPS modes With VAPS devices in general the ventilatory assistance pressure support aims to automatically adjust to changes in patient condition over time typically to maintain a target tidal volume Pressure Target alveolar ventilation Current alveolar ventilation Min PS Wj l E ee eee mi 5 Time M IVAPS offers the comfort and synchrony of pressure support but with the assurance offered by a volume target IVAPS has the following advantages over traditional VAPS schemes e IVAPS is a unique combination for a servo controlled ventilator in that iVAPS has the goal of regulating alveolar ventilation to a prescribed target and IVAPS has a rapid but gentle servo control r
68. he mask are unobstructed If you put the device on the floor make sure the area is free from dust and clear of bedding clothes or other objects that could block the air inlets Hoses or tubes must be non conductive and antistatic Do not leave long lengths of the air tubing or the cable for the finger pulse sensor around the top of the bed It could twist around the patient s head or neck while sleeping CAUTION e Be careful not to place the device where it can be bumped or where someone is likely to trip over the power cord e Make sure the area around the device is dry and clean Notes e ResMed recommends using the AC power cord supplied with the unit If a reolacement power cord is required contact your ResMed Service Centre e Place the device on a flat surface near the head of the bed i p TN AC power cord AC locking clip Connect the power cord Plug the free end of the power cord into a power outlet Attach the H4i heated humidifier to the front of the Stellar 150 If the H4i is not in use and if applicable connect the antibacterial filter firmly onto the air outlet of the device see Attaching an antibacterial filter on page 21 Note Other external humidifiers can be used for noninvasive setup ResMed recommends using a breathing system including antibacterial filter air tubings external humidifier with an impedance of maximum 2 cm H20 at 30 L min 5 cm H30 at 60 L min and 16 cm H
69. her device To read the device configuration the device has to be in clinical mode The device configuration must contain a different serial number e Write settings Settings of the device will be stored on the ResMed USB stick e Write settings and loggings settings and loggings eg breath by breath data of the device will be stored on the ResMed USB stick e Cancel Confirm the data transfer an ad wz b 2 9 248369r6 book Seite 53 Montag 14 Mai 2012 1 40 13 Cleaning and maintenance The cleaning and maintenance described in this section should be carried out regularly This also helps to prevent the risk of cross contamination Refer to the mask humidifier and other accessories user guide for detailed instructions for care and maintenance WARNING Beware of electric shock Do not immerse the device pulse oximeter or power cord in water Turn off the device unplug the power cord from the power socket and the device before cleaning and be sure that it is dry before reconnecting The mask system and air tubing are subject to normal wear and tear Inspect them regularly for damage CAUTION The Stellar 150 cannot be sterilized Daily Disconnect the air tubing from the device and humidifier if used and hang It in a clean dry place until next use If the device is visibly soiled wipe the exterior surfaces of the device and the pulse oximeter if used with
70. holes may be inadequate to clear all exhaled gases and some rebreathing may occur e The device may not be exposed to excessive force e If the device should fall accidentally on the ground please contact an authorized service agent e Pay attention to leaks and other unusual sounds If there is a problem contact an authorized service agent Note A note advises to special product features The above are general warnings and cautions Further specific warnings cautions and notes appear next to the relevant instructions in the manual e Position the device ensuring the power cord can be easily removed from the power outlet General warnings and cautions 71 am 7 P S FN SA 4 5 ANS P 248369r6 book Seite 72 Montag 14 Mai 2012 1 40 13 Limited warranty ResMed Ltd hereafter ResMed warrants that your ResMed product shall be free from defects in material and workmanship from the date of purchase for the period specified below Product Warranty period e Mask systems including mask frame cushion headgear and tubing 90 days excluding single use devices e Accessories excluding single use devices e Flextype finger pulse sensors e Humidifier water tubs e Batteries for use in ResMed internal and external battery systems e Clip type finger pulse sensors 1 year e CPAP and bilevel device data modules e Oximeters and CPAP and bilevel devic
71. ical equipment must comply with the respective IEC or ISO standards e g IEC 60950 for data processing equipment Furthermore all configurations shall comply with the requirements for medical electrical systems see IEC 60601 1 1 or clause 16 of the 3Ed of IEC 60601 1 respectively Anybody connecting additional equipment to medical electrical equipment configures a medical system and is therefore responsible that the system complies with the requirements for medical electrical systems Attention is drawn to the fact that local laws take priority over the above mentioned requirements If in doubt consult your local representative or the technical service department No modification of this equipment is allowed 1 Ports may be incorporated into the mask or in connectors that are near the mask 2 During partial below rated minimum voltage or total power failure therapy pressures will not be delivered When power is restored operation can be proceeded with no change to settings PN am AZ P S FN N Z b 4 SS 248369r6 book Seite 71 Montag 14 Mai 2012 1 40 13 2J CAUTIONS A caution explains special measures for the safe and effective use of the device e When using accessories read the manufacturer s User Manual For consumables important information can be provided on the packaging For more information see Symbols on page 69 e At low pressures the flow through the mask vent
72. ich most patients can tolerate 5 Select Target Va calculator Prag 2 iW APS 8 Enter the patient s Height Il Enter the patient s spontaneous breath rate lll Enter a previously measured Minute Ventilation MV or Tidal Volume Vt Note Press Monitoring or Info key to scroll through the related pages eg Breath Rate MV Vt if necessary IV Check the Target Va The calculator returns a Target Alveolar Ventilation Tgt Va using this information to estimate anatomical deadspace Target Va Tidal Volume Deadspace Height x Patient Rate Minute Ventilation Deadspace Height x Patient Rate The Target Va Calculator displays an estimate of the Average Tidal Volume Avg Vt as a function of ideal body weight IBVV Average Vt mL kg Tidal Volume 48 0 91 x Height 152 4 Note Typically Va should be below 7 L min for non COPD patients and below 11 L min for COPD patients V Accept to apply this Target Va to IVAPS therapy settings 6 Review the secondary therapy settings in Advanced Settings eg Min PS Max PS see Min Max PS on page 6 7 Connect the patient Start therapy 1 Adapted from DA Dongelmans et al Determinants of Tidal Volumes with Adaptive Support Ventilation A Multicenter Observational Study Critical Care and Trauma 2007 107 3 P932 937 50 PN T an I D o A 248369r6 book Seite 51 Mo
73. ient Rate in preparation for IVAPS mode It is recommended that the patient be set up in a quiet place preferably with a distraction to ensure they don t fall asleep During Learn Targets the device delivers two pressures EPAP PEEP and Pressure Support without backup breath like S mode These parameters are available on the Learn Targets screen Perform a Learn Circuit on the current circuit configuration ensuring you select the appropriate mask setting see Setup menu Options on page 43 Set Pathology Defaults see Pathology Defaults on page 10 Select IVAPS mode Enter the patient Height approximate or arm span D NY A LY Le 248369r6 book Seite 49 Montag 14 Mai 2012 1 40 13 Connect the patient Select Learn Targets The device has to be in Standby to commence the Learn Targets procedure Turn on oxygen if in use Il Configure primary therapy controls Enter the preliminary EPAP or PEEP see page 57 It is recommended that you start at 4 6 cm H20 which most patients can tolerate III Adjust Pressure Support The level of Pressure Support during the Learn Targets procedure should be individually assessed Excessive Pressure Support during the learn session can result in an alveolar ventilation target that is in excess of the patient s metabolic need For patients who enjoy adequate daytime ventilation but who have significant problems during sleep ie OHS
74. ional accessories 0 00 000 0 eee Attaching a pulse oximeter Adding supplemental oxygen Starting therapy using oxygen Stopping therapy using oxygen Using the FiO2 monitoring sensor Attaching an antibacterial filter Selar 1 SOK Sl C aene douse a docs eE dole due cures be iedeuds duke ds a tee Bae io ders Siac About the control panel SAUL GENS WOW a sot ec ase ese ee ees ke ne Da AE oe SA Ete ae UA He ES Wet ee aes ea we Performing a functional test Starting therapy Stopping therapy Turning off the power Working with alarms Tailoring treatment setup options Programs Using mask tit USMO OMe MCS anes amp ae a an ede a Ao oe a aes ew ae Bd CRB Wahid eee hed Boake eD Monitoring INGA terstctesy stack nettle run ey let eiu ats yee Caw ex OMAR eer ah ae Soe eRS DOCU MENE pakertaa peasy e nie athe Ghee a bead bbe Hand doe Goes Accessing Clinical mode Setup menu Clinical Settings Setup menu Alarm Settings Testing the alarms Setup menu Options an Sud NZ GIN 112 INY D 8 248369r6 book Seite ii Montag 14 Mai 2012 1 40 13 Setup menu Configuration Menu Hairong aLe cect thtees recess Bier mack ce OB hE se E eg hs tg hE eee re Event Summary General therapy information Apnea Apnea Hypopnea Index Used Hours Device information Reminders COMMOUHINO IVAR S 25 05 o2asmra hese nese he sh eee hesh nese beserreeecenaeanecen dt peace ETENE
75. ions 110 250 cm 43 in 98 in 5 cm 2 in increments Tool used to set IVAPS targets See Using Learn Targets on page 48 e MA 4 LY P 248369r6 book Seite 37 Montag 14 Mai 2012 1 40 13 Advanced Settings Factory default settings and parameter ranges Parameter Min PS Max PS Rise Time Fall Time Ti Min Ti Max Trigger Mode Default aoa 9 a E oe OO O Z 0 v 2 cm H20 v 20 cm H20 Ea Rav 200 Ea Ea 200 vv v 0 5 sec VE V 1 5 sec e vv Medium an Sud Description Minimum pressure support in IVAPS mode Options 0 20 cm H20 Min PS always below Max PS 0 2 cm H20 increment Maximum pressure support in IVAPS mode Options 0 30 cm H20 0 2 cm H20 increments Rise Time sets the time taken for the device to pressurize to IPAP see page 10 Notes e The Rise Fall Time milliseconds scale is an approximate only e The actual Rise Time achieved is influenced by factors including compliance resistance leak pressure differential and patient breathing patterns e Prolonged Rise Time inhibits pressurisation Care should be taken to ensure Rise Time is set according to the patients inspiratory flow and work of breathing Patients with a high work of breathing short Ti and fast Respiratory Rate will require shorter rise times than those with lower Respiratory Rate quiet breathing and normal Ti e Options min 150 900
76. ivation of High Leak alarm Press the power switch at the back to turn on the device 2 Tostart treatment press or if the SmartStart function is enabled instruct the patient to breathe into the patient interface and treatment will begin Note When the ResMed Leak Valve is used check that the anti asphyxia valve membrane within the ResMed Leak Valve stays closed during the entire breathing cycle Increase the EPAP if necessary 24 PS T PN 9 NY AIS as LY Le 248369r6 book Seite 25 Montag 14 Mai 2012 1 40 13 9 Stopping therapy You can stop therapy at any time simply remove the patient interface and press to stop airflow or if SmartStart Stop is enabled simply remove the patient interface and treatment will stop automatically Notes e SmartStop may not work if Full face or Trach is selected as mask type the High Leak alarm or the Low Min Vent alarm is enabled Confirm Therapy Stop is enabled or the mask fitting feature is running e When the device is stopped and operating in standby mode with an integrated humidifier connected it will continue to blow air gently to assist cooling of the humidifier s heater plate e Masks with high resistance eg pediatric masks may cause the operation of the SmartStop feature to be restricted e When using with oxygen turn off oxygen flow when stopping therapy Turning off the power 1 Stop
77. luding catheter mount and cannula If in use If oxygen Is in use include the oxygen flow entrained to the oxygen inlet at the rear of the device 1 On the Setup Clinical Settings menu set Mode to T and Respiratory Rate to 30 bom 2 Set the High Leak Alarm to ON 3 Start therapy 4 Partially block the air tubing The alarm is triggered when leak exceeds 40 L min 0 67 L sec for at least 20 sec If too much leak occurs the Circuit Disconnected alarm may be activated Circuit Disconnected 1 Disconnect air tubing at the device air outlet 2 Start therapy If your configuration does not adequately trigger this alarm it is due to the resistance of your accessories not the device Consider using the High Leak Low Minute Ventilation Low Pressure Low Respiratory Rate and Apnea alarms am ae Testing interval Each new patient Each new patient Always when oxygen is used and the FiO cell has been recalibrated Always when oxygen is used and the FiO cell has been recalibrated On each new patient If required for the patient particularly if the High Leak alarm has been disabled to avoid rebreathing if the air circuit becomes disconnected at the device during the therapy Setup menu 41 Z FIN T A 248369r6 book Seite 42 Montag 14 Mai 2012 1 40 13 o 1 With the device set up to deliver therapy using the patient s mask When con
78. me Sa a a ee Ramp time Programs Program Up to two sets of therapy settings ie Programs can be m tlt 15 ag e A G Treatment fs saved for convenient retrieval They are stored while in the Clinical Settings menu If both ie dual is selected the patient can choose the program to use on the reatment ab 22 30 00 screen If only a single program is selected the option does 21 07 2010 not display Single or dual programs can be set in the Setup menu Options Configuration menu The Program names can be personalized using ResScan eg olrr iol Ti 20 vt soolmv 5 0 Day and Night oO Using mask fit The patient can use mask fit to help you fit the mask properly This feature delivers constant treatment pressure for a three minute period prior to starting treatment during which the patient can check and adjust the mask fit to minimize leaks The mask tit pressure is the set CPAP or EPAP pressure or 10 cm H20 whichever is greater 1 Instruct the patient to lie down in bed or in their typical usage position and to put the mask on according to the mask user guide 2 Hold down for at least three seconds until pressure delivery starts 3 Adjust the mask mask cushion and headgear until the patient has a good mask fit After three minutes at the mask tit pressure the prescribed treatment mode and pressures will commence Mask fit can be stopped at any time by pressing Notes e Press for a
79. ne LCD Keypad Failure One of the keys was held down for more than Remove any blockages from the keypad 10 sec or got stuck oy LCD Attention High Temp 42 43 44 45 3 The temperature inside the device Is high Ensure the ambient temperature conditions are within the specified operating range LCD Internal Battery Use The device is using the internal battery Check if the power cord is properly connected to the device if you want to run from mains power Press the Alarm mute button to cancel the alarm LCD External DC Power Use The device is powered by an external battery Check if the AC power cord is properly connected to the device if you want to run from mains power Note The alarm will be cleared automatically after one minute 60 PN am 7 P S FN A ALIS 4 D P 248369r6 book Seite 61 Montag 14 Mai 2012 1 40 13 Other troubleshooting Problem Possible cause No display Power failure The device stops delivering air pressure Power not connected or device is not switched on Treatment pressure seems low Ramp time Is iN use Air filter is dirty Air tubing is kinked or punctured Air tubing is not connected properly Mask and headgear not positioned correctly Plug s missing from access port s on mask Pressure required for treatment may have changed There is a large impedance eg antibacterial filter
80. nected Range On Off 70 95 1 increments High FiO Off Sets the maximum allowed average oxygen fraction Activates when the measured FiO fraction is greater than the set level for more than 15 sec Note This alarm is only selectable when the FiO3 monitoring sensor is connected Range On Off 30 100 1 increments Low FiO Off Sets the minimum allowed average oxygen fraction Activates when the measured FiO fraction is less than the set level for more than 15 sec Note This alarm is only enabled when the FiO monitoring sensor is connected Range On Off 18 80 1 increments Setup menu 39 PS am 7 e NZ a NZ b 4 lt e 248369r6 book Seite 40 Montag 14 Mai 2012 1 40 13 2J Alarm Setting Default Description Apnea On 20s Sets the maximum apnea time Activates when there is no inspiration either patient or machine triggered detected from the previous beginning of inspiration Two consecutive inspirations either patient or machine triggered resets the Apnea alarm Range On Off 10 60 sec 1 sec increments Alarm Volume High Sets the alarm volume Options Low medium high 1 When the High Leak or Low Min Vent alarms are set to ON SmartStop is automatically disabled Testing the alarms When the device is turned on the Alarm LED and the Alarm mute key LED will flash and the alarm will sound to confirm that the alarm is working If required
81. ngs are maintained when the device is powered down and in the event of a power loss f multiple alarms are active simultaneously the alarm with the highest priority will be displayed first Ifan alarm activates repeatedly discontinue use and return the device for servicing Problem Possible cause LCD Internal Battery Empty The remaining battery charge is below 15 The device can be powered by the internal battery for Action Connect the device to mains power Note In case of a total power failure the therapy maximum 2 minutes settings will be stored and therapy will resume when the device is powered again LCD System Failure Component failure 1 Power off the device 0 The device stops delivering air pressure system 2 Poweron the device again OR failure 6 7 9 22 38 If the problem persists return the device for Therapy cannot be started system failure 21 Servicing Component failure system failure 8 25 1 Power off the device if the system failure is continuously present 2 Power on the device again If the problem persists return the device for servicing The following system failures can occur motor failure system failure 6 pressure sensor failure system failure 7 software failure system failure 8 calibration fault system failure 9 self test failure system failure 21 flow sensor failure system failure 22 system component failure system failure 25 critical
82. not blocked e Ensure the ResMed Leak Valve is installed and that the vent is not blocked e Ensure oxygen if in use has only been connected at the rear of the device e Reassess the patient to ensure adequate therapy e Ensure the alarm setting is appropriate for the patient Connect the device to mains power Troubleshooting 59 PS am ae e NZ a N Z b 4 X 248369r6 book Seite 60 Montag 14 Mai 2012 1 40 13 2J Problem Possible cause Action LCD Low Sp02 SpO has dropped below pre set alarm level e Check the attachment of the sensor e Reassess the patient to ensure adequate therapy LCD SpO2 finger sensor failure The finger sensor is not connected properly or Check if the finger sensor is attached properly to delivers faulty values the finger and connection to the pulse oximeter LCD Xpod oximeter disconnected The pulse oximeter is disconnected Check if the pulse oximeter is connected properly to the device LCD Low FiO2 Level FiO has dropped below the pre set alarm level Perform FiO sensor calibration e Reassess the patient to ensure adequate therapy LCD High FiO2 Level FiO has exceeded the pre set alarm level e Perform FiO sensor calibration e Reassess the patient to ensure adequate therapy LCD FiO2 sensor disconnected The FiO monitoring sensor is not connected Connect the FiO monitoring sensor or replace it with a new o
83. ntag 14 Mai 2012 1 40 13 9 Refine EPAP PEEP to suit the type of therapy required For more information see Assessing the clinical outcome on page 51 Assessing the clinical outcome If the patient sleeps well on the Stellar 150 and SpO if available shows adequate oxygen saturation throughout the night this can be a good indication of successful therapy ResScan may assist you assessing the therapy outcome A close look at the Detail graph in statistics is useful to evaluate the quality of treatment Splitting the screen allows you to view the overview of navigation window 8 hrs with SpO pressure leak minute ventilation e detail window 5 min showing leak flow pressure may present a suggestion to readjust the settings or mask For more information see Data management on page 52 Review Example Smith John ResMed x B Statistics Ial Summary Graphs jv Detailed Graphs Oximetry Statistics E Device Log Product Stellar Serial No 20100315491 Monday 17 May 2010 view le Hours 00 00 06 00 Sp02 96 00 91 00 peep ray f abel wey aT nad eu E cia desi aa iiiu i i ie Gaal aie ai l Hon eit ARRAT mond mee ee Bua bal to 85 50 ae 00 z mner 4 UU Minute Yentilation 7 50 7 00 lil T A O N Limin 3 50 Respiratory Rate 30 0 22 5 15 0 Dur iih PPan HA rte a MAEA Wad ie UPRA rit T Wk hhm a VER y Fi la h P breaths min 45
84. of the device Wipe all accessible surfaces of the device including the air outlet avoid liquid entering any openings in the device Follow the manufacturer s recommended cleaning instructions Humidifier As instructions for humiditiers vary see the user guide for the humidifier in use For multipatient use environment use the H4i water chamber disposable in place of the H4i reusable water chamber Servicing CAUTION e Inspection and repair should only be performed by an authorized agent Under no circumstances should you attempt to open service or repair the device yourself This product should be inspected by an authorized ResMed service centre five years trom the date of manufacture except for the internal battery which ResMed recommends be tested after two years to assess the remaining battery life Prior to this the device is intended to provide sate and reliable operation provided that it is operated and maintained in accordance with the instructions provided by ResMed Applicable ResMed warranty details are provided with the device at the time of original supply Of course as with all electrical devices if any irregularity becomes apparent you should exercise caution and have the device inspected by an authorized ResMed service centre Cleaning and maintenance 59 PN am Y P S FN G N Ss 8 248369r6 book Seite 56 Montag 14 Mai 2012 1 40 13 Clinical ti
85. ogenic artefact refers to impulses within in the respiratory flow signal that originate trom cardiac activity rather than respiratory effort It can result in false triggering if the impulses exceed the trigger flow threshold High cycle sensitivity will result in an earlier transition from IPAP to EPAP and low cycle sensitivity will delay this transition For example for patients who cannot maintain inspiratory flow or who complain of having their breath cut off set the cycle setting to Low or Very Low which will delay the transition from IPAP to EPAP This will tend to prolong inspiratory time For characteristic data see Technical specifications on page 64 Clinical titration guide 57 am ae PS NZ LS NZ b lt e 248369r6 book Seite 58 Montag 14 Mai 2012 1 40 13 Troubleshooting If there is a problem try the following suggestions If the problem cannot be solved contact ResMed Alarm troubleshooting The most common reason for an alarm to sound is because the system has not been properly assembled Check that the air tubing has been properly attached to the device and patient interface and humidifier if used Notes e The alarm actions listed below are based on having the appropriate alarm settings for the patient s therapy When a user adjustable alarm is activated re confirm the alarm settings The alarm log and alarm setti
86. or Full Face the Non Vented Mask alarm automatically turns on For a full list of compatible masks for this device see the Mask Device Compatibility List on www resmed com on the Products page under Service amp Support If you do not have internet access please contact your ResMed representative Setup menu Alarm Settings ca AlarmSettings Lk 0 0 RR o Ti 0 0 vt olmv oo Lk oo RR o Ti 0 0 vt olmv oo The following alarms that can be set in while in Clinical mode Set all alarms off Yes Sets all user selectable alarms off Note When the mask type is set to Trach the Non Vented Mask alarm will stay ON Low Min Vent On 2L Sets the minimum minute ventilation Activates at least Low minute ventilation 30 sec after the measured level remains below the set limit Range On Off 2 30 L 1 L min increments High Leak On Enables disables High Leak alarm When enabled leaks gt 40 L min 0 7 L sec for gt 20 sec result in the alarm sounding and a High leak message Options On Off 38 MA 4 5 ANS P 248369r6 book Seite 39 Montag 14 Mai 2012 1 40 13 Alarm Setting Default Description Non Vented Mask On This alarm activates within 30 sec of therapy being delivered with a non vented interface attached or a vented mask with occluded vents Note When the mask type is set to Full Face or Trach the Non Vented Mask alarm will be enabled automaticall
87. ort and increased work of breathing If the patient complains that inspiratory time is too long consider reducing the value 1 Observe the patient s inspiration time and spontaneous respiratory rate The measured Ti and lE ratio on the Monitoring and Synchronisation screen may help 2 Adjust the Ti Min in accordance with the measured Ti see table below Check that the patient doesn t feel that the inspiratory time is too long The patient s spontaneous rate can be found in the monitoring summary 06 PS T am 7 e NZ a LY 8 248369r6 book Seite 57 Montag 14 Mai 2012 1 40 13 Observe the patient to determine if the Ti Min should be shortened eg 0 2 or 0 3 sec shorter than patient inspiration time TiControl calculation guide The following table is a guide to selecting the Ti Max and Ti Min values that best correspond to the patient s respiratory rate ideally while using the ventilator at rest Patient breaths Wee KETAN LESTA ESIS per min 60 breaths eg normal eg restrictive lungs eg obstructive per min lungs lungs See Ti Min Ti Max Ti Max 10 6 2 1 0 2 5 15 15 4 1 3 1 0 Ley IS 20 3 1 0 0 8 LS 1 0 25 2 4 0 8 0 7 1 2 0 8 30 2 0 7 0 6 1 0 0 7 35 17 0 6 0 5 0 8 0 7 40 15 0 5 0 5 0 7 0 7 EPAP PEEP The appropriate setting of PEEP or EPAP is fundamental to modern ventilation practice across most modes of therapy Examples of its use include e R
88. pm Internal Battery Use Alarm cleared 07 01 57pm Internal Battery Use Alarm activated 04 09 2010 10 54 08pm Data erased Event Summary displays the summary of three types of events changes In settings alarms and system events eg data erased connection of ResMed USB stick There are up to 200 events of each type displayed in chronological order with the most recent event displayed at the top by default General therapy information 46 Frog 1 a ST OR Percentile Median Sth Percentile 13 14 15 16 17 18 19 Nev 2010 Information on the following categories is displayed for a period of seven days where each day is defined as from midday to midday Leak Minute Ventilation Tidal Volume Respiratory Rate I E ratio Pressure Support AHI SpO gt Press and turn the Push Dial to view data for data up to 365 days in the past The statistical data is displayed in a bar graph in 5M and 95t percentile and median values These values are averaged across total therapy duration per day Note If therapy is not running for at least 10 minutes data will not be captured LY Le 248369r6 book Seite 47 Montag 14 Mai 2012 1 40 13 gt s Apnea Apnea Hypopnea Index This screen displays the apneas and hypopneas measured per hour for one day The daily index values will be displayed for a period of seven days and can be compared to data from the last 365 days
89. r invasive use do not connect a catheter mount tracheostomy tube or HMEF 4 Leave the air circuit unobstructed and open to the air 5 Press to start the Learn Circuit 6 Wait for the device to complete its automated tests lt 30 sec The results are displayed when complete If the circuit configuration has been successfully learnt G displays If unsuccessful S displays see Troubleshooting on oO page 58 The device starts the calibration of the FiO monitoring sensor to measure the oxygen concentration of the breathable air 1 Press to start the FiO sensor calibration 2 Wait for the device to complete its calibration The results are displayed when complete Note Turn off the oxygen flow If enabled the device will start automatically when the patient breathes into the patient interface and will stop automatically SmartStop when the mask is taken off This means the Start Stop key does not have to be pressed to begin end treatment Note The SmartStop feature is disabled if e Full face or Trach is selected as mask option e High leak or Low minute ventilation alarms are set to ON e Mask fit operation is proceeding e Confirm therapy stop option is enabled Options On Off If Max Ramp Time has been set the patient may select any value up to this time Options 0 min Max Ramp Time max 45 minutes 5 minutes increments Sets the pressure at the beginning of the Ramp Time in CPAP mode Options
90. re software system component e Disconnected FiO sensor e Disconnected XPOD pulse oximetry e High temperature attention internal components such as motor Resetting alarms When the Alarm mute key is pressed during therapy for at least three seconds the following alarm messages and the audible alarm will be temporarily cleared e High Pressure e High Breath Rate e Low Pressure e Low Breath Rate e High Leak e High FiO e Non Vented Mask e Low FiO e Low Min Vent e Apnea Low SpO5 Tailoring treatment setup options Setting Ramp If the patient experiences difficulty falling asleep with full pressure they may wish to make use of Ramp where the pressure starts very gently and slowly increases to the set treatment pressure over a selected time period see Setup menu Options on page 43 The Treatment screen following shows Max Ramp set at 15 minutes while the graph shows the pressures experienced during ramp while in bilevel mode 26 PN am AZ P S FN LY Le 248369r6 book Seite 27 Montag 14 Mai 2012 1 40 13 CAUTION EPAP PEEP and Pressure Support achieve their configured values at the end of the ramp period Some patients require full support from the commencement of therapy Ramp may not be appropriate in such cases Ramp time 100 WH 15 Cag frog go IPAP G Treatment fs wohl 22 30 00 21 07 2010 EPAP Start pressure 0 Ti
91. riggered Inspiration Time 0 1 4 sec The duration of the ventilator inspiratory phase This is Ti 0 1 sec a set Ti value in Timed and PAC modes Tidal Volume Vt 50 3000 mL Tidal Volume is an estimate of quantity of inhaled air 10 mL per breath calculated as an integral of respiratory flow based on the leak flow the mask vent flow and the total flow rate The display is based on a five breath moving average updated every breath Minute Ventilation 0 6 60 L min Minute Ventilation is the product of Respiratory Rate MV 0 1 L min and Tidal Volume The display is based on a five breath moving average updated every breath Note Preferences for pressure and flow units can be set in the in the Setup menu Options Configuration menu Monitoring menu 31 PN PN S P AIS a A 248369r6 book Seite 32 Montag 14 Mai 2012 1 40 13 32 Progl iVAPS CG Monitoring 2 8 40 I 4 0cmH20 eee Lk olrr i1o0 Ti 20 vt soolmv 5 0 1 2 Pressure cm H20 Flow L min olrr isiti 12 vr 564 mv 3 5 ja am Gr MV RespRate 4 8 Minute Ventilation L 5 min ee Rate 5min Lk olrr isiti i1alvt 462 mv 68 Progl oj ae a MAE 4 8 Minute Ventilation L 10 0 _ es A Target Va L Alveolar Ventilation L x mm tt Lk EE olrr isliti 12 vr sez mv_ 3 6 Leak L min 60 DRE 2o 20 E R 20s
92. s below or equal to IPAP 0 2 cm H20 increments PS vv xy v 60cmH O Pressure support PS IPAP EPAP The pressure support is the pressure increase above EPAP PEEP delivered during inspiratory phase Options 0 37 cm H20 0 2 cm H20 increments Ti v vV 1 5 sec Sets the inspiratory time Options 0 2 4 sec or 2 3 of one breath cycle defined by Respiratory or Backup Rate 0 1 sec increments Backup Rate v v 10 bom Sets the breaths per minute bpm Options 5 60 bom 1 bom increments Setup menu 39 PS am 7 e NZ a o A 248369r6 book Seite 36 Montag 14 Mai 2012 1 40 13 Respiratory Rate Target Patient Rate Target Va Target Va Calculator Height Learn Targets 36 10 bom 15 bom 5 2 L min 175 cm 69 in Sets the fixed number of breaths per minute bpm The patient cannot spontaneous trigger the machine in this mode Options 5 60 bpm 1 bom increments The rate input to the iVAPS algorithm This should be set at the patient s actual respiratory rate See Target Patient Rate on page b Options 8 30 bom 1 bom increments An input to the iVAPS algorithm See Target alveolar ventilation on page 5 Options 1 30 L min 0 1 L increments Tool used to set IVAPS target See Manually setting IVAPS on page 50 The body height is needed for the calculation of the dead space You can enter the arm span instead Opt
93. selected the patient can select between the two programs in the Treatment screen Options single dual Height Unit inches Selection of the unit of measure for patient height for iVAPS setup Options cm inches Erase Data You can erase the following data that is logged during therapy e Used hours therapy run hours e High resolution data patient flow therapy pressure oximetry data e Breath by breath data eg pressure and flow related data e Summary data statistics in the Summary menu e Alarm events e Settings changes 0 e System events eg learn circuit passed cancelled When erasing the data you will be prompted to confirm the action before the data Is erased Note Motor run hours Power on hours and all settings cannot be reset with this option To return to the Options screen press the Return button J 1 Parameter appears in both the patient and clinical mode Setup menu 45 PN am 7 P S FN o A 248369r6 book Seite 46 Montag 14 Mai 2012 1 40 13 Info menu i The nfo menu provides event summary therapy results device information and reminders Stellar 150 stores usage and summary data up to 365 treatment sessions The stored data can be accessed in the nfo menu or using ResScan Event Summary 05 09 2010 07 04 57 pm PAF changed from 30 0 cmH20 to 20 0 cmH2Q 2 O7 0423pm Therapy mode changed fram T to ST A OF 02 09
94. sidered and circuit start therapy necessary by the 2 Block the mask s vent holes clinician The alarm should sound within 30 sec 1 Start therapy If required for the patient 2 Block the air tubing with your hand The alarm is triggered when tubing is blocked for at least 15 sec 1 With the device set up to deliver therapy and the FiO cell and If required for the patient circuit connected start therapy 2 Disconnect the FiO cell The alarm should sound within 5 sec 1 Connect the finger sensor If measurement 2 Start therapy problems are expected 3 Disconnect the sensor or remove it from the patient s finger with the finger sensor The alarm should sound within 30 sec Completing alarm testing Return all settings to their original settings appropriate to the patient ahead of delivering therapy 42 e LY Le 248369r6 book Seite 43 Montag 14 Mai 2012 1 40 13 ww L Pa W R Setup menu Options The optional device settings are available from the Options menu and its Configuration submenu Parameter Learn Circuit FiO Sensor Calibration SmartStart Stop Ramp Time Start CPAP Start EPAP or Start PEEP Default Off Off 4 0 cm H20 4 0 cm H20 Description If in use turn off the oxygen flow 2 Select the mask type 3 Set up the air circuit including accessories and patient interface Note Fo
95. software failure system failure 38 LCD Over Pressure 1 Power off the device 2 Check that the air tubing is connected properly 3 Power on the device again 4 Start Learn Circuit function Note If the alarm activates repeatedly internal components may be defective Discontinue use and return the device for servicing The device generates a pressure that is greater than 59 cm H20 Treatment will be stopped LCD Blocked Tube Air path is blocked 1 Check the air path for any blockages 2 Remove the blockages 3 If the alarm is not cleared stop treatment 4 Re start treatment 08 PS am 7 e NZ ZS 4 LY P 248369r6 book Seite 59 Montag 14 Mai 2012 1 40 13 Problem Possible cause LCD High Temperature 10 11 12 23 The temperature inside the device is too high Treatment may lead to stop LCD High Pressure Therapy pressure exceeds pre set alarm level LCD Low Pressure The air tubing is not connected properly LCD Circuit disconnected The air circuit is not connected properly LCD Low Minute Ventilation Minute ventilation level has dropped below the alarm setting level LCD High Respiratory Rate The respiratory rate level has exceeded the pre set alarm level LCD Low Respiratory Rate The respiratory rate level has dropped below the pre set alarm level LCD High Leak High mask leak for more than 20
96. st the therapy pressure according to the patients air tubing system Review the components included in the circuit configuration and adjust as appropriate then rerun Learn Circuit see Setup menu Options on page 43 The delivered airflow ts not humid heated although the H4i humidifier is in use The humidifier is not properly attached The humidifier does not heat The humidifier does not work The water chamber is empty Date or time in data files is wrong Date or time on the device is wrong Correctly attach the humiditier The device is currently powered by battery use or not connected to the mains Return the device and the humidifier for Servicing Fill the water chamber of the humidifer Correct the current time and date in the Options menu Note Changing the time or date setting backwards will erase all logged data Unable to read or write settings from USB stick Wrong Serial number USB stick contains unreadable data USB stick is not compliant with USB 2 0 USB stick contains no data USB stick is defective Unable to write settings to USB stick There is not enough space on the USB stick USB stick is not compliant with USB 2 0 or write protected USB stick is defective Data transfer failed Incorrect data an Sad Please check the serial number of the Stellar 150 in the Device Information screen of the Summary menu Write the Serial number via a ResScan on the
97. sted for servicing or as part of problem solving by a technician Info menu 4 PN T W D lA o A 248369r6 book Seite 48 Montag 14 Mai 2012 1 40 13 Reminders You can use the Reminders menu to alert the patient to specific events for example when to replace their mask when to replace the filter and so on Using ResScan you can select which Reminder message to show when and its recurrence frequency Off 1 24 months The reminder appears in yellow as the date approaches within 10 of the reminder period The reminder also displays when the device is powered on Patients can clear a reminder message by selecting Reset which clears the current reminder date to OFF or displays the next pre set Reminder date Note When the motor run hour is below two hours Reminders can be set but will not display After two hours of the motor running the correct date displays Configuring IVAPS There are two ways in which you can configure IVAPS mode e using Learn Targets which learns the patient s breathing pattern and calculates the targets automatically or e directly entering the targets Prog 1 2 Prag1 2 iv APS iv APS Pathology Timin Obstruct 0 3 o Ti 0 0 vt olmv oo Using Learn Targets 48 Learn Targets monitors the patient s resting ventilation with the goal of learning the patient s Target Alveolar Ventilation and Target Pat
98. t Setup menu then Clinical Settings then Advanced Settings Perform Learn Circuit see Setup menu Options on page 43 If an external humidifier is not being used connect the HMEF to the patient side of the ResMed Leak Valve 10 Connect the catheter mount The ResMed Leak Valve or the HMEF can be connected to standardized tracheostomy interfaces including connector pieces like catheter mounts The catheter mount and the external humidifier are not part of the ResMed component Setting up for home therapy You may be required to set up a device for a patient to use at home There are a number of things to be aware of 1 Before sending the device home with a patient and to ensure the same therapy is delivered 0 then parameters and oxygen levels for the configuration must be set to match the way in which it will be used in the patient s home eg same mask system with the humidifier connected the oxygen line entrained at the same place the same oxygen source filters in the same position and same length air tubing so that the therapy is working correctly Make sure the alarms are working as expected see Testing the alarms on page 40 2 Set the device to Patient mode a 3 Make sure that the patient has a contact phone number in case of emergency A good place to write this is in the front of the User Guide Setting up for home therapy 17 PN 9 NY i LY
99. t least three seconds during mask fit to start treatment immediately The Treatment screen will be displayed e The mask fitting feature is disabled when the mask type Trach is selected e Availability of this feature is country dependent Starting therapy 2 KA Ge an Y LY Le 248369r6 book Seite 28 Montag 14 Mai 2012 1 40 13 gt ww NZ NS Using the menus The device has three menus Monitoring Setup Info accessed by the equivalent buttons on the right of the LCD screen In each menu there are screens that display settings device or therapy information The menu structure Is the same in Patient and Clinical modes Differences mainly exist in the settings that will be described in the following pages MA MONITORING 2 SETUP INFO Clinical Settings Treatment Event Summary Monitoring Leak Pressure Flow Minute Ventilation Alarm Settings Min Vent Resp Rate Tidal Volume or MV Va IVAPS Mode Respiratory Rate Leak LE Ratio Tidal Volume Pressure Support synchronisation AHI Oximetry Used Hours Device Information Reminder A O NO 28 Oo ANIA as an Y Y b a 6 248369r6 book Seite 29 Montag 14 Mai 2012 1 40 13 Setup menu Clinical Settings SETUP EA MENU fA Clinical Settings Advanced Settings CPAP Mode CPAP Advanced Mask 8 cm H20 Se
100. t with updated device settings or to transfer settings from one device to another For more information see Data management on page 52 Use on an aircraft ResMed confirms that the Stellar 150 can be used during all phases of air travel without further testing or approval by the airline operator See Technical specifications on page 64 Mobile use The Stellar Mobility bag allows the Stellar to be used in mobile situations eg in a wheelchair For setup and correct use see the Stellar Mobility Bag User Guide For extended mobile use the ResMed Power Station external power supply unit can be used as an additional power source Limitations apply to the use of oxygen with the Stellar Mobility Bag For more information contact your local ResMed representative Remote Alarm The Remote Alarm may be used to transfer audible and visual alarms by a direct cable connection For more information on using the Remote Alarm see the Remote Alarm user guide Stellar 150 at a glance 13 PS T am 7 e NZ ZS K d P 248369r6 book Seite 14 Montag 14 Mai 2012 1 40 13 Setting up for noninvasive use WARNING The air filter cover protects the device in the event of accidental liquid spillage onto the device Ensure that the air filter and air filter cover are fitted at all times Make sure that all the air inlets at the rear of the device and under the device and vents at t
101. th rate and the fixed inspiration time set by the clinician are supplied regardless of patient effort e PAC Pressure Assist Control the inspiration time is preset in the PAC mode There is no spontaneous flow cycling The inspiration can be triggered by the patient when respiratory rate Is above a preset value or time triggered breaths will be delivered at the backup breath rate iVAPS intelligent Volume Assured Pressure Support designed to maintain a preset target alveolar ventilation by monitoring delivered ventilation adjusting the pressure support and providing an intelligent backup breath automatically The iVAPS therapy mode is indicated for patients 66 Ib 30 kg and above an Sy SZ gt a Le 248369r6 book Seite 3 Montag 14 Mai 2012 1 40 13 These therapy modes excluding CPAP mode where a single level of continuous pressure is delivered are shown below Very short breath Long breath Restrictive lungs Leak or obstructive lungs RE No breath effort Inspiration t j f Patient Effort M Expiration Leak flow IPAP S IPAP One breath cycle S T A IPAP V One breath cycle T p a A A A A K IPAP v V Vv One breath cycle PAC Ti EPAP A iVAPS A Machine initiates inspiratory phase increasing pressure up from EPAP PEEP V_ Inspiratory phase cycled down to EPAP PEEP at Ti Max S ST mode or Ti PAC T mode A Inspiratory p
102. the goal is to capture the resting daytime ventilation with minimal Pressure Support such that the patient is breathing comfortably but not excessively ventilated For patients with significant daytime hypercapnia an increased pressure support ie 6 10 cm H20 may be appropriate ie such that an assisted daytime ventilation is measured IV View data The Learn Targets screen displays a blank graph on which up to 15 min of live data monitored Alveolar Ventilation Va and Respiratory Rate RR will be plotted as time passes The values are calculated from the median within a 5 min range You can select the 5 min portion that best represents stable Va and RR by using the dial to highlight the 5 min of interest It is recommended to choose where the lines of Va and RR look stable usually 10 15 minutes after starting this process 9 100 nA RR L Va5 8 RRL tert Va and RR are calculated from the median m snes within a 5 min range Adjustable 5 min window to be used for calculation of median target values V If the target values are viewed as e acceptable select Accept and therapy will commence in iVAPS mode Typically Va should be below 7 L min for non COPD patients and below 11 L min for COPD patients e not acceptable or to exit Learn Targets without altering settings select Cancel This stops the Learn Targets process the menu returns to Clinical Settings and therapy terminates Press Moni
103. the patient s Respiratory Flow from the Total Flow It uses information trom Mask Selection to accommodate for mask in line Vent Leak and Vsync to compensate for Unintentional Leak That is Estimated Respiratory Flow Total Flow Vent Leak Unintentional Leak Ensuring successful ventilation with Stellar 1 am ae PS NZ LS P lt a d Le 248369r6 book Seite 8 Montag 14 Mai 2012 1 40 13 Unintentional eak Mask vent leak E ia Patient respiratory flow Total flow Unintentional leak may arise due to factors such as poor mask fit mask movement during sleep and fast therapy pressure transitions When an unintentional leak is introduced see below graph synchrony between the device and the patient is disrupted The increased flow from a leak can be interpreted as patient inhalation and cause the ventilator to trigger from EPAP to IPAP out of time with the patient s actual effort A Vsync responds rapidly to correct the disruption and restore synchrony within 2 6 breaths B depending on the patient s respiratory rate and the size of the leak Unintentional leak introduced Period of asynchrony Therapy pressure Patient effort Total flow Estimated patient respiratory flow snare If AA rv ag i Unintentional leak flow varies with changes to therapy pressure or the size of the leak opening Vsync calculates
104. tings on page 34 I E Ratio le a ee Tidal Volume e Alarm Settings on page 38 oot e Options on page 43 Pressure Support AHI i nn el Air tubing External humidifier Accessing Clinical Mode Weed Maur AC locking clip Device Information 22 30 00 f 21 07 2010 Reminder N 52 O N Respiratory Care Solutions Respiratory Care Solutions Making quality of care easy Making quality of care easy A AIS D 8 248369r6 book Seite i Montag 14 Mai 2012 1 40 13 Contents MIEFOCLICTIOIN 24 22 schoo oi 206 oo eS a Bed eae Sab be He eu Eb e i Oe Ke Ewe RO Eas Bear ewas Be Indications for use Contraindications Adverse effects About Stellar 150 therapy modes 0 0 0 0s Common setting parameters More about IVAPS Ensuring successful ventilation with Stellar 00 0 0 00 0 cee Learn Circuit Vsync and mask selection TiControl Trigger Cycle sensitivities Rise Fall Time Pathology Defaults Stella OO Ald dlate tea ane 6s doa eed ee edn eae chan ads h nE Robes ek ROERNE Patient interface Humiditication Internal battery ResMed USB stick Use on an aircraft Mobile use Remote Alarm Setting up for noninvasive use cic healt es hoe a et we iat eh eee eee tba eee se baeee sk es Attaching the H4i heated humidifier Setting Up TOM invasive USC pins ieee ie nh a a ee a a aa aa Seting Up Tor NOME INELADY sades od inchs ahh coke oe Lok bad eae eee cheese is Working with other opt
105. toring or Info key to scroll through the related pages eg Breath Rate MV Vt if necessary When press Setup menu key you come back to Learn Targets CAUTION Because Cancel will terminate therapy the patient should be disconnected from the ventilator unless ventilation is to be resumed immediately Review the secondary therapy settings in Advanced Settings eg Min PS Max PS see Min Max PS on page 6 Start therapy Retine EPAP PEEP to suit the type of therapy required For more information see Assessing the clinical outcome on page 51 Configuring IVAPS 49 am WL g LY Als P 248369r6 book Seite 50 Montag 14 Mai 2012 1 40 13 5 Manually setting iVAPS While the Learn Targets procedure offers the best means of obtaining an initial ventilation estimate IVAPS also allows manual entry of its target using an entered minute ventilation spontaneous rate and patient height From these iVAPS can calculate the target alveolar ventilation and adopt its Target Patient Rate 1 Perform a Learn Circuit on the current circuit configuration ensuring you select the appropriate mask setting see Setup menu Options on page 43 2 Set Pathology Defaults see Pathology Defaults on page 10 3 Select iVAPS mode Contigure primary therapy controls Enter the preliminary EPAP or PEEP see page 57 It is recommended that you start at 4 6 cm H20 wh
106. tration guide Mouth leaks If mouth leaks are a persistent problem the patient may benefit from humidification a chin strap or a full face mask The chin strap fits over the patient s head and helps to hold their mouth closed during the night Full face masks cover both the nose and mouth preventing mouth leaks and are available from ResMed Contact your supplier for more details or see www resmed com ResScan detailed data also provides a visual representation of leak Setting TiControl The Ti Max and Ti Min settings S ST and IVAPS mode allow you to vary the minimum and maximum amount of inspiratory time see Ensuring successful ventilation with Stellar on page 7 Setting Ti Max Under conditions of high or variable leaks eg mouth leak or where respiratory flow Is restricted eg COPD Ti Max provides an inspiratory time limit which prevents late cycling and can provide a better match to the patient s ideal inspiratory time Ti Max can be set between 0 3 4 sec or 2 3 of one breath cycle defined by Backup Rate So for a patient with a Backup Rate of 15 bom ie one breath cycle of 4 sec the maximum value that can be set for Ti Max would be 2 6 sec Note Care should be taken not to set Ti Max shorter than the patient s actual inspiratory time as this may lead to a decrease in the effectiveness of pressure support and result in discomfort for the patient If the patient complains that inspiratory time is too short consider
107. ttings Type S Mode Mode IPAP Tri Pathol gas EPAP Advanced 4 cm H20 Settings ST Mode Pathology IPAP Trigger 10 cm H20 EPAP Backup Advanced 4 cm H20 Rate Settings T Mode Pathology ode IAP T 10 cm H20 8 d EPAP Ti Resp 4 cm H20 Rate Advanced Settings Target Pt Target Va Target Va Rate Calculator Learn Advanced Targets Settings PAC Mode Pathology IPAP Trigger 10 cm H20 EPAP a Backup 4 cm H20 Rate Advanced Settings Note When the Option Multi Program is set to dual the setting Program is displayed in the Clinical Settings menu See Setup menu Clinical Settings on page 34 Using the menus 29 K KA WN gt a K 248369r6 book Seite 30 Montag 14 Mai 2012 1 40 13 P Setup menu Alarm Settings and Options SETUP J MENU iz Alarm Settings Set all alarms off Low Min Vent High Leak Non Vented Mask High Pressure Low Pressure High Resp Rate Low Resp Rate Low SpO High FiO Alarm Low FiO Alarm Apnoea Alarm Alarm Volume Options Configuration Menu Learn FiO sensor Language Brightness Backlight Circuit calibration Ramp Start CPAP Max Ramp Time Time Start PEEP Time Format Factory Pressure Defaults Therapy Confirm Pressure LED Stop Naming Multi Height Program Unit 30 Ka Gp LY Le 248369r6 book Seite 31 Montag 14 Mai 2012 1 40 13 e
108. tton flash The device is ready tor use when the reatment screen is displayed If the display shows the Reminder screen follow the instructions then press J to display the reatment screen Check batteries Disconnect the device from the mains and external battery if in use so that the device is powered by the internal battery Check that the Battery use alarm will be displayed and the battery LED is on Note If the charge state of the internal battery is too low or if the battery is empty an alarm occurs See the Alarm troubleshooting section on page 58 for further information Reconnect the external battery if in use and check that the LED for the external power supply is lit The External DC power use alarm will be displayed and the Alarm LED will light Reconnect the device to the mains Starting therapy 23 am WL gt 4 KA ig as d Le 248369r6 book Seite 24 Montag 14 Mai 2012 1 40 13 9 6 Check the H4i heated humidifier if in use Check that the warm up feature is displayed on the Treatment screen Start the warm up feature Check that the humidifier warm up symbol is displayed on top of the screen Wermug humniditier You can use the warm up feature to pre heat the water in the humidifier prior to starting treatment The humidifier will be fom 15 ag 8 A G Treatment automatically detected when the device Is turned on The
109. y to ensure the circuit configuration has an intentional leak It can then be turned off for Full Face Options On Off High Pressure On Sets the high pressure limit Activates when the pressure 35 cm H2O exceeds the set limit in two consecutive cycles or for a period of 5 sec Range On Off 4 45 cm H20 1 cm H30 increments Low Pressure On Sets the maximum drop in pressure with reference to a set 5 cm H20 IPAP or CPAP pressure during the inspiration phase Activates when the pressure drops by more than the set level within 18 sec Notes e This alarm is not enabled in iVAPS mode e When SmartStart Stop is enabled SmartStop activates before the Low Pressure alarm Range On Off 2 to 10 cm H20 1 cm H20 increments High Respiratory Rate Off Sets the maximum respiratory rate Activates when the measured respiratory rate exceeds the set level for four breath cycles Note This alarm is not enabled in T mode Range On Off 5 60 bpm 1 bpm increments Low Respiratory Rate Off Sets the minimum allowed respiratory rate Activates when the measured respiratory rate remains below the set level for four breath cycles Note This alarm is not enabled in T mode Range On Off 5 30 bpm 1 bpm increments Low SpO Off Sets the minimum allowed SpO value Activates when the measured SpO level remains below the set level for at least 5 sec Note This alarm is only selectable when the pulse oximetry accessory is con
110. you can test the alarm manually by holding down the Alarm mute button for at least three seconds when therapy is not running and no alarm is active Initial setup 1 Turn off all configurable alarms 2 Set up the device with the air tubing attached but no mask 3 Set Ramp Time to 0 mins 4 Set SmartStart Stop to Off Alarm simulation Alarm Testing interval 6 High Pressure e 1 On the Setup Clinical Settings menu set Mode to T and EPAP to On patient titration 4 cm H320 2 Set Pressure Support to 10 cm H30 3 On the Setup Alarm Settings menu set All alarms off to Yes 4 Now set the High Pressure Alarm Setting to 7 cm H20 and change the alarm to be On 5 Block the air tubing 6 Start ventilation Low Pressure 1 Set the Low Pressure Alarm to 2 cm H30 On patient titration 2 Set IPAP and EPAP to 25 cm H320 3 Start ventilation 4 Partially block the open end of the tube with your hand The alarm activates within 15 seconds If the Blocked Tube or Circuit Disconnected Alarm activates repeat the test 5 Stop therapy Low Min Vent Low minute ventilation 1 Set the Low Min Vent Alarm to 30 L min On patient titration 2 Start ventilation 3 Partially block the open end of the tube with your hand so that the measured MV in the therapy status bar displays lower value than 30 L min The alarm activates within 30 seconds If the Blocked Tube or Circuit Disconnected Alarm activates repeat the test

Stellar™ 150

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Stellar&trade; 150

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Stellar™ 150