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VT Plus HF

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1. Appendices Troubleshooting C Corrective Action Select correct printer type on the Analyzer Review printer s user manual to determine how to set up printer to work with the selected Analyzer printer mode Connect printer If the Analyzer does not eventually communicate with the PC software ensure the cable is correctly connected and that the PC hardware can support the communication port selected Make sure no other device is trying to use the serial port on your PC Close any software that may be using the serial port Make sure that Windows recognizes the serial port in the Control Panel Restart VT for Windows VT Plus HF Operators Manual C 6
2. Biomedical VI Plus HF Gas Flow Analyzer Operators Manual PN 2137275 May 2008 Rev 2 4 09 2008 2009 Fluke Corporation All rights reserved Printed in USA Specifications are subject to change without notice All product names are trademarks of their respective companies Warranty and Product Support Fluke Biomedical warrants this instrument against defects in materials and workmanship for one year from the date of original purchase During the warranty period we will repair or at our option replace at no charge a product that proves to be defective provided you return the product shipping prepaid to Fluke Biomedical This warranty covers the original purchaser only and is not transferable The warranty does not apply if the product has been damaged by accident or misuse or has been serviced or modified by anyone other than an authorized Fluke Biomedical service facility NO OTHER WARRANTIES SUCH AS FITNESS FOR A PARTICULAR PURPOSE ARE EXPRESSED OR IMPLIED FLUKE SHALL NOT BE LIABLE FOR ANY SPECIAL INDIRECT INCIDENTAL OR CONSEQUENTIAL DAMAGES OR LOSSES INCLUDING LOSS OF DATA ARISING FROM ANY CAUSE OR THEORY This warranty covers only serialized products and their accessory items that bear a distinct serial number tag Recalibration of instruments is not covered under the warranty This warranty gives you specific legal rights and you may also have other rights that vary in different jurisdictions Since some j
3. fec054 bmp The Analyzer measures oxygen in the high flow port If oxygen in the low flow port is to be measured the flow of gas must be passed through the high flow port also to measure oxygen Re scale Press the RESCALE soft key to change the scale on the plot of data to a more appropriate window of values Note RESCALE uses the current min max values to determine plot limits Clear Press the CLEAR soft key to reset the statistics and re start the plot The user can select the breath parameters displayed on this screen by following the instructions under Selecting Breath Parameters Refer to Connection and Setup Utilities Oxygen Sensor Calibration for instructions VT Plus HF Operators Manual Full Breath Parameters Test Screen The Full Test screen displays all of the breath parameters calculated by the Analyzer Full Test Hy ATP Ventilator Parameters Minute Yoliis 366 LPM Breath Rate 37 T bpm Tidal Vols 487 2 ml Ex Time H 23 Sec PIF 46 36 LPM In Time BH T6 Sec FEF amp H 33 LPM Ex Hold B AA Sec Base Flows xx LPP In Hold B 41 Sec Compliance sexes m czmHz2 I E Ratio 1 1 43 Q2 FAS x FIF D 2 cmH20 Baro Press 6358 D mmHg MAP B 4 cmHzL Gas Air IPP B H cmH20 Min Pres HBH 3 cmHZz FEEF B H cmH 0 Assists B 2 ecmHz fec055 bmp Note Breath detection must be enabled for breath parameters to be calculated See System Setup for instructions on enabling breath detection Trend
4. VT Plus HF Operators Manual Toolbar The toolbar is provided for both convenience and speed It provides a quick and easy way to call often used functions Figure 4 3 shows the toolbar while Table 4 4 lists the toolbar buttons along with their functions and descriptions je g e XB amp E fec083 bmp Figure 4 3 VT for Windows Toolbar Table 4 4 Toolbar Buttons De fe lee Save to File button Open File button Close File button File Controls button Print button Zeroing button Clear Statistic button Re scale button Breath Detect Mode button Breath Detection Flow Threshold button This button calls up the SAVE AS dialog and allows data to be saved to a file If a file is already open this button is disabled This button calls the open file dialog that allows review of a file If a file is already open this button is disabled This button closes any open data files If no file is open this button is disabled This button calls up the file controls dialog For more information see the Data and File Handling section This button gives quick access to the print functions Click this and the printer dialog appears This button forces the Analyzer unit to zero immediately For more information see the Zeroing section This button forces the Analyzer to clear a selected statistic or all of them This button forces all of the plots to automatically re scale immediately rather than
5. Ensure the correct printer type is selected Refer to your printer s user manual to ensure the printer is setup correctly for the printer language set on the Analyzer i e HP PCL 3 Note your printer may require special dip switch settings for a given printer language support Ensure the printer cable is correctly installed Printer Paper Out The printer reports an out of Put paper in printer Ensure the paper error Not all printers correct printer type is selected report this condition Refer to your printer s user manual to ensure the printer is setup correctly for the printer language set on the Analyzer i e HP PCL 3 Note your printer may require special dip switch settings for a given printer language support Ensure that the printer cable is correctly installed B 4 Table C 1 lists problems possible causes and corrective actions Analyzer does not turn on Screen is dark Analyzer screen turns on but is just white Splash may or may not appear before screen goes white Screen is difficult to read Flicker is observed on left side of Analyzer screen Appendix C Troubleshooting Table C 1 Troubleshooting Possible Cause No power Screen contrast not set Blown fuse Flash program memory not loaded Flash memory or boot memory resulted in incorrect checksum Screen contrast not set Screen contrast not set Slight flicker is normal Corrective Action Plug unit into an AC ma
6. 2 Use the A and V soft keys to highlight High Frequency Oscillator 3 Press the ENTER soft key The High Freq Test screen displays High Freq Test Press cmHz I1 fec074 bmp The high frequency oscillator HFO mode samples flow and airway pressure at a much faster rate 5x than the Analyzer does in normal operation It 1s useful for monitoring the function of extremely high frequency breath rates up to 800 bpm In HFO mode the Analyzer collects two seconds worth of data at a time After the data is collected it is processed to calculate parameters and the first half second of data is plotted on the display The mean min and max values are calculated for both pressure and flow signals These values apply to the entire two seconds of data not just the half second that is plotted The breath rate is calculated and displayed in both breaths per minute and Hz The inspiratory time and tidal volume are also calculated Operation 3 Special Functions To run the HFO test 1 Press the START or AUTO soft key to begin the test The START soft key runs the test once while the AUTO soft key starts the HFO test in automatic mode In automatic mode the HFO test is run every 15 seconds 2 Ifin automatic mode press the STOP soft key to end the test 3 33 VT Plus HF Operators Manual 3 34 Chapter 4 Remote Operation Title Page RTS MIN SUAS H 4 3 System UE PE Connecting to the Analyzer ms 4 3 Installi
7. Low Pressure Fand sta ao aa ce Ken e ME Bi directional Flow Mode Unidirectional Flow Mode nr Printer C able Attachment e ioco Eti srssrersisssssteiese sie ess teens srersdiessetes Using the Setup SCLC ad sic ee ne eee eee some PORT UE Setting Testing Parameters siccscssciacazsosasvaesdsasasesnsadesesadacaezoniadeoesiousasssavadedessiasaans Ee EE Kn VT Plus HF Operators Manual Gas POP E Ambient Ke 2110 sensor eee Relative TE MIG eege CORC HO MOUSE ne ao nee nat tee ane tte at eee a Barometric EE Breath DS EE Inspiratory Expiratory Tidal Volumes PO ModE a D ein dre D MO DA c oies E Display Calibration Date on Startup Screen JST Es Ree ENEE eut Kn CAD c E PROTO Cy c d sedation ea m C X Oxygen Sensor C 3IDE3BOIL siete rene po oet sov bn poo dod REO Exe ASH sanae Syslem Diag Nos CS ar a en E E EN Keele rk RO AGE LL EN A RS ne eee ee are nee LOW PES Rc Barometric PLES SUNS die ann diet rit rccaicentes High Pressure MGasut cient cecus eebeero a Ert anto ERR FER Ere o itte tto Rt Oxygen OO OR ee et eee ete Calculated Breath Parameters see SOILD eie i E E R T E T EE D PI EE Breath Paratmietets eere ras eoe Rare aya data eta ey Ne ERR a Gen Fra ve Pu eR GM ed Breath Detection Icons nennen nennen hene hsee rre re senis Instantaneous N
8. The breath detection algorithm is implemented as a state machine The flow waveform is the input to the state machine The state changes are based on flow waveform crossing of predefined thresholds A threshold is applied to both positive inspiratory and negative expiratory flows The breath detection threshold can be set to a high flow rate to reject noise near zero flow Bi directional Inspiratory Expiratory Breath Detect Modes Figure A 1 shows the circuit connection for setting up the Analyzer in a bi directional mode The gas flows in both directions through the Analyzer This 1s the preferred setup for using the Analyzer with a ventilator A 5 VT Plus HF Operators Manual Inspiratory Hose Ventilator Analyzer Expiratory Hose Figure A 1 Circuit Connection for the Analyzer in Bi directional Mode fec002 eps Note When using the Analyzer with a ventilator and a test lung the bidirectional breath detect mode is preferred Only use the inspiratory and expiratory breath detect modes if measurements cannot be made in the bi directional mode Additional breath detect modes were implemented for users that are accustomed to performing measurements with flow devices that can only measure flow in one direction Base Flow A 6 In the inspiratory and expiratory limb of the breathing circuit some ventilators may have a bias flow when no flow is going to or from the patient test lung This is implemented dif
9. Yes 100 6784h es fec036 bmp 2 Press the BACK soft key to return to the Utilities menu 2 21 VT Plus HF Operators Manual Unlock Calibration This function is for technical service personnel to use while repairing the Analyzer When the Unlock Calibration is highlighted and the ENTER soft key is pressed calibration is unlocked and the display returns to the Utilities menu Information This setting shows Analyzer product information such as serial number and copyright To read system information l From the Setup screen highlight Information and press the ENTER soft key The Information screen displays Inf arnat i an UT Plus Gos Flow Analyzer EE 2 I3 5 e Serial Number oot Version l S Flash RUM Checksum DH IHDEU Copyright 1999 Hardware Version 2 Press OK to return to the Setup screen 2 22 fec037 bmp Chapter 3 Operation Airway Pross ce a en on Low Pros U E Barometric E EE High Pressure Measurement eege deet Oxygen C OME SIT S T OD iso eegene Calculated Breath Barameterg ire Sree ODI ECS eege ELO EE Ib ME D e E Breath Paramete nb a a Id EDO BUDE Breath Detection Icons eine Instantaneous Numeric Data ice S EET EE Breith EE fe EE RIG HSE LOW SCLC CM sca eerie bietet dad made tpud o fa dam LOW FIOW SCTCCM aerei aesscesa auo et ao pud etbRo osa cU TOM ERES sente ot VETE NOR M Mod A Pressure EE Eege Lsh Pressure SORES eege eege ee L w ee Airway P
10. g ee EE 4 3 Starine dee 4 4 Overview of VT for Windows PC Software 4 5 Egeter 4 6 Kale m EEN Main Screens and Tests assorties sse IP Mei pta eM SPAM MPISIMEIN 4 9 Monor OEC EE 4 9 Sinole Plot SCT s 519 9399919 9399559 3299139 999399949 8 09 959 94 939092 9 99 9 9 0005 4 10 OO EE 4 11 Full EE 4 12 I Te n A eer ee aCe nee eer 4 12 IP cU oNN 4 16 Stacked Volume Test e BE 4 18 Serial COMMMUMICALIONS nn er ns deene geben dese 4 20 pelecune COMORES sae canausecaneeee cteaenaeeee 4 20 Selecting the Serial Communications Mode esee 4 20 Da and File ad eer has saree anon ceauedesaaevesessbasepararces Fe EUCH E 4 21 Opening and Closing Data Fles E Fil Control er TE 4 23 Pla Dac COOL ce m Dui MMC IMMUNE 4 24 Ee 4 25 File Information Patel un oerte ascension restes ous 4 26 Byent E 4 26 Generating Signal sig Files iiie basi tek Dos Zeg geed de kn 4 26 Generating Parameter par Files 4 26 IS DORE PAR eee eee Ges Operating System Loading accetta etude aono ttv e a ed oto tad edad estote titu coke dades PETER IS ei eaten 4 28 Automatically Re scaling Plots VU 4 28 Manually Re scaling PIOIS itrtr o Foren PIX edes dees eege epos 4 28 Signal Te EE 4 29 4 1 VT Plus HF Operators Manual Zn ame 4 30 Manual Eege 4 30
11. on the right side of the display moves indicating the plot area selected Press the ASSIGN soft key to change which signal is plotted in the selected position Four breath parameters can be displayed in place of a signal plot in the lowest position The user can select the parameters displayed in this screen Press the UNITS soft key to change the units of the signal and the units of the instantaneous value for the plot in the selected position The possible units for each of the various signals are the same as the units that can be displayed in the screens that display that signal exclusively Press the RESCALE soft key to change the scale on the plot of data to a more appropriate window of values 3 19 VT Plus HF Operators Manual Units of Measure The Analyzer has the capability to display the above signals and parameters m the following units of measure shown in Table 3 4 Table 3 4 Available Units of Measure Loo o oU eseription SSC SSC 3 20 Operation 3 Special Functions The Analyzer has conversion factors for gas volume and flow measurements as shown in Table 3 5 Table 3 5 Available Conversion Factors Conversion Factor Description ATP Conversion for gas flow and volume to ambient temperature and pressure STPDO Conversion for gas flow and volume to a standard temperature of 0 C and a standard barometric pressure of 760 mmHg STPD21 Conversion for gas flow and volume to a standard temperature
12. 1 Parameters Calculated a the Analyzer Abbreviation How HowCalculated Inspiratory Time In Time Time of the inspiratory period including the inspiratory hold time Expiratory Time Ex Time Time of the expiratory period including the Ce hold time Inspiratory Hold Time In Hold Time of the End Time of the End Inspiratory State State Expiratory Hold Time Ex Hold Time of the End Expiratory State Inspiratory to Expiratory Ratio l E Ratio of the inspiratory time to the Expiratory Time Time Inspiratory Hold Average pressure during the End Inspiratory Pressure State Positive End Expiratory PEEP Average pressure during the End Expiratory Pressure State Mean Airway Pressure MAP Mean pressure over the entire breath Mean pressure over the entire breath Peak Inspiratory Maximum pressure during the Inspiratory Time Pressure Tidal Volume Tidal Vol Total volume accumulated over the Inspiratory Time Minute Volume Minute Vol Expiratory Tidal Volume times the respiratory rate in breaths per minute reported as an eight breath average Peak Inspiratory Flow PIF Maximum of the absolute value of the Flow Rate Rate measured during the Inspiratory Time Peak Expiratory Flow PEF Maximum of the absolute value of the Flow Rate Rate measured during the Expiratory Time Compliance N A Expiratory Tidal Volume divided by the difference of the Inspiratory Hold Pressure and PEEP VT Plus HF Operators Manual Screen Objects Class
13. AS a OE TE Breath Detection TOR n Available Units of Measure esses eene Available Conversion Factofs eo aan ras aeu au d a EEES Supported RI200 FUncolis eret tpa ath tr ER d Elements of the VT for Windows Interface Menu Bar ODEOES i cucao eontra ta uic inea ento ad ado oa upauen und dun ea linea aH y Ado ege Setup Submenu Re te E Toolbar EE AE ES A EE A E E E E E Generated File Ke Payback Eer PROF NO ccu r E E EE EE AE Troubleshooting ae eh eee ect et D D D D CO aS DS C DS VT Plus HF Operators Manual vi List of Figures Figure Title 1 1 Front and Right Analyzer Panel l 2 Rear and Lent Analyzer Pas a 1 9 Analyzer POP AA a sure tadesetonensssesueese 2 1 Connecting the Analyzer in a Bi Directional Flow Mode 2 2 Connecting the Analyzer to the Inspiratory Limb of the Breathing Circuit 2 3 Connecting the Analyzer to the Expiratory Limb of the Breathing Circuit 3 1 Information Shown on Analyzer Display 3 2 IA T aa a p eMe eye aye 3 3 Ventilator Breathing Circuit Setup for Bi Directional Measurements 4 WT for Windows PC software Interface 4 5 4 2 VT for Windows Menu Bar eene eee een enn nnn nnns nennen nnn nnns 4 6 4 5 VI tor Windows eelere ee Ee 4 8 4 4 Eet 4 9 2 5 MUONS POS a BO OOP OR on em RME CSC a 4 85 Trend lest Setup S Cre i aue ice coeur t ta nt eed ee o Pa att aepo YN ES eno atre etn tas nn 4 9 Trend Test
14. Analyzer and disconnect its power cord before opening the case or performing any service procedures Introduction and Specifications 1 Instrument Familiarity A Caution To avoid damage to the Analyzer or adverse affects on its performance follow these guidelines e Do not expose the system to temperature extremes Ambient temperatures should remain between 10 C and 40 C System performance may be adversely affected if temperatures fluctuate above or below this range e Clean the Analyzer only by wiping it down with a clean lint free cloth dampened with a mild detergent solution A solution of 70 isopropyl alcohol may be used to remove stains and clean the system No other solvents are recommended Do not spray liquid directly on or immerse the unit Instrument Familiarity Figure 1 1 shows the top and right panels of the Analyzer fec120 eps Figure 1 1 Front and Right Analyzer Panels 1 5 VT Plus HF Operators Manual Front Panel The components of the front panel are listed in Table 1 2 See Front Panel Details for detailed descriptions of front panel components Table 1 2 Front Panel Components LCD Display with CFL backlight Contrast Pause resume print and help keys Test Mode keys Right Panel The components of the right panel of the Analyzer are described in Table 1 3 Table 1 3 Right Panel Components Low Pressure Gas Or Fluid Port Low Pressure Dry Gas Only Port Figure 1 2
15. MODIFY soft key Use the keypad to enter the number of breaths for the test and press the ENTER soft key To run the test i 2 Press the START or AUTO soft key to begin the test The display changes to show the progress of the test Stacked Volume Test Total Volume Last Volume Avg Volume Hum Of Breaths Total Breaths fec067 bmp The values shown are described below Total Volume The total volume of all breaths together Last Volume The volume of the last breath taken Avg Volume The average volume of all breaths taken Num Of Breaths The total number of breaths taken Total Breaths The total number of breaths to be taken Note If a stacked volume test is started with the START soft key the test accumulates the requested number of breaths and ends If the test is started using the AUTO soft key the test automatically restarts after the requested number of breaths have accumulated When the test is complete press the STACK soft key to start a new stacked volume test or press the EXIT soft key to exit 3 27 VT Plus HF Operators Manual RT200 Emulation Mode The Analyzer can emulate RT200 serial port communications This mode is used for some ventilator automated test procedures To set the RT200 emulation mode 1 From the Setup screen select System 2 Use the A and V soft keys to highlight Serial Mode 3 Press the MODIFY soft key to change Serial Mode to RT200 To acces
16. OK to return to the Gas Settings dialog box 4 4 33 VT Plus HF Operators Manual 9 Click OK to accept all gas settings changes Barometric Pressure The Analyzer automatically calculates the barometric pressure to within 2 of full scale To give greater accuracy the Analyzer allows the user to calibrate the barometric pressure offset by entering the local barometric pressure into the system This value is used to calibrate the system barometric pressure offset during future use To change the barometric pressure 1 From the Setup menu select Barometric Pressure 2 Enter the local barometric pressure in the box provided 3 Click OK 4 34 Chapter 5 Maintenance Service and Calibration Title Page D S a 5 3 Avoiding KE 5 3 RS MUMIA ooo ete EEN 5 3 Oxygen Sensor TEE EE 5 3 Fuse RS PACS il sce D MM 5 4 Service and Oe Vile e 5 5 5 1 VT Plus HF Operators Manual 5 2 Maintenance Service and Calibration 5 Maintenance Maintenance The Analyzer requires little maintenance or special care however it is a calibrated measuring instrument and should be treated as such The optional carry case is recommended for storage It is further recommended that the storage environment be free from vibration Avoiding Damage Do not drop the instrument or subject it to any mechanical abuse that could cause a shift in the calibrated settings A Caution To avoid damage to the Analyzer or adverse affects on
17. Software To install the VT for Windows PC software on the PC l Insert the VT for Windows PC software disk into a 3 25 in disk drive on the PC 2 Select Run from the start menu under Microsoft Windows 95 98 NT 3 When the Run dialog box appears type a setup exe If the disk drive is not a substitute the correct drive letter for a 4 Click OK The installation program for VT for Windows PC software asks several questions before installing the program e The user is given the option to specify where to install the program on the computer e If installing over a previous version of this software the user is asked where to back up old copies of the files e Also the user is asked where to put the icons for the VT for Windows PC software program Simply follow the instructions given by the installation program If no changes are made to the default installation options VT for Windows PC software 1s installed to C Program Files VTPlus and the shortcuts to the program are in the VT Plus group 4 3 VT Plus HF Operators Manual Starting the Software The software application is ready to start when the software has been installed and the Analyzer connected The first time the software 1s used the application attempts to establish communications with the Analyzer and displays the following Biomedical VT Plus HF Gas Flow Analyzer Designed by KORR Medical Technologies fec109 bmp The sof
18. This means that the percentage of this gas is automatically adjusted to insure that the total percentage of gases totals 100 6 Make the following changes as necessary a To change the balance gas click the radio button to the left of the gas name Any of the five standard gases may be used as a balance gas b Adjust the percentage of each gas in the mixture by changing the values in the two columns to the right of the gas name If any gas in the mixture is not one of the five standard gases one of the other gases may be chosen c Select a gas from the list of predefined gases or if the gas being used is not one of the predefined gases select the user defined option There are three predefined gas options and one user defined option d Enter the molecular weight viscosity coefficient and viscosity intercept into the boxes provided e Click the Air button or the Respiration button to set the calculator to the defaults for air or respiration f Enter the temperature and relative humidity for both inspired and expiratory gases in the boxes provided Viscosity and molecular weight are calculated every time a change is made to any of the controls g When finished click OK to accept the values and return to the Gas Settings Data Entry dialog box The viscosity relative humidity molecular weight and temperature populate the appropriate boxes 7 Continue entering changes in the Gas Settings Data Entry dialog box 8 Click
19. Windows the user may select Com Port from the Communications menu to change communications settings Selecting the Serial Communications Mode 4 20 The Analyzer has four modes for data transmission via the serial port available from the Communications menu The currently selected mode shows a check mark next to its name Test Parameter the parameter that was chosen for running this test this value does not change during the test Wave Form starts the continuous transmission of waveform data from the Analyzer flow volume airway pressure auxiliary pressure and differential pressure data are received at a 50 Hz rate Both starts the automatic transmission of both waveform data and parameter data as described above Parameters start the automatic transmission of parameters that are calculated at the end of a breath these parameters are calculated on a breath to breath basis Note No parameters are calculated for a breath if a zero occurs during that breath None selects no data transmission this stops all automatic data transmissions from the Analyzer Remote Operation Data and File Handling Data and File Handling VT for Windows files handle three kinds of data as described in Table 4 5 Table 4 5 Data Types Data Type Descriptions Signals Raw flow pressure and volume time series waveforms Breath by breath ventilator parameters calculated by the Analyzer device Information placed into the da
20. a simple interface for recording and playing back data calculated by the Analyzer The software provides most Analyzer functions on a simple interface for recording and playing back data calculated by the Analyzer Figure 4 1 shows the VT for Windows PC software interface and Table 4 1 identifies its essential elements i T Plus for Windows Communcations Plots Statistics Zero Setup Help E fa amp N kx Ere 17 16 LPM Min 90 16 Max 158 87 Avg 2 99 Airway Pressure 06 cmH20 Volume Min Max Avg 22 7 55 4 0 0 Molume Min Max Avg f 2m 1 1 1011 9 38U U Monitor Screen f Single Plot Screen Full Test A Trend Test Stacked Volume Test FILE Ca Program FilesWTPlustSignalsM Litenaves vtp Figure 4 1 VT for Windows PC software Interface VT Plus HF Operators Manual Table 4 1 Elements of the VT for Windows Interface ma 0 Eme o mum 6 fems 69 fee S 9 65 9 o seems OOO 8 sme 5 ET SE BCE BCE Review and test screens are accessed through the Screen tabs near the bottom of the screen these are described in Main Screens and Tests below Other functions are accessed through the menu and commonly used menu functions are assigned to buttons on the toolbar amp amp amp C 9 At the bottom of the screen is a status bar that shows the current status of several user settings including zeroing mode correct
21. change or the ESCAPE soft key to cancel the change 4 Press the BACK soft key to return to the Settings menu Demo Data This setting allows the user to show recorded data on screen without needing to connect the Analyzer to a ventilator or do any measurements The word DEMO appears on the menu bar when this mode is engaged The recorded data is for demonstration purposes To select the demo data function 1 Highlight Demo Data 2 Press the MODIFY soft key to toggle to the desired value Connection and Setup Setting Analyzer Operating Parameters 3 Press the ENTER soft key to save the change or the ESCAPE soft key to cancel the change 4 Press the BACK soft key to return to the Settings menu Filtering This setting is used to adjust the transition of signals on the flow meters The filter has four levels Soft Medium Hard and None Note When filtering is on full test parameters are invalid To change the filtering level 1 Highlight Filtering 2 Press the MODIFY soft key to toggle to the desired value 3 Press the ENTER soft key to save the change or the ESCAPE soft key to cancel the change 4 Press the BACK soft key to return to the Settings menu Display Calibration Date on Startup Screen Use this option to control whether the calibration due date appears on the startup screen To select whether the calibration due date is shown on the startup screen 1 Highlight Display Cal Date 2 Press the MODIFY sof
22. change the scale on the plot of data to a more appropriate window of values Note RESCALE uses the current min max values to determine plot limits Clear Press the CLEAR soft key to reset the statistics and re start the plot The user can select the breath parameters displayed on this screen by following the instructions under Selecting Breath Parameters 3 12 Operation 3 Pressure Screens Pressure Screens There are two types of pressure screen high pressure and low pressure based on which Analyzer pressure port is used High Pressure Screen The High Pressure screen displays the signal and statistics for the pressure signal from the high pressure ports of the Analyzer High Press 2208 Statistics Mint 5 Max 5 Avg H FIF 2 T cmHz IFF 2 9 cmHz MAP B 2 cmHz FEEF H H cmHz fec051 bmp Range Press the RANGE soft key to change between low pressure airway pressure and high pressure screens Units Press the UNITS soft key to change the units of measure for the high pressure screen Possible units of measure for this screen include mbar millibar 001 Bar bar 14 7 PSIG Barometric mmHg millimeters of mercury inHg inches of mercury cmH O centimeters of water inH O inches of water PSIG pounds per square inch atm atmospheres kPa kilopascals Re scale Press the RESCALE soft key to change the scale on the plot of data to a more appropriate window of values Note RESCALE uses the curr
23. different than User s expected value was Review expectations expected incorrect Flow baseline drifts causing a false non zero flow reading when flow was actually zero Zero the flow reading Consider using the auto zero mode Analyzer is out of calibration If possible verify calibration with a 3 liter calibration syringe Ensure gas settings are correct With the Analyzer in the bi directional breath detect mode and the gas correction mode set to ATP stroke syringe such that flows are near the midrange for the flow sensor Compare the Analyzer tidal volume to calibration syringe volume If difference is out of specification return unit for calibration Gas settings are incorrect Review Analyzer gas settings Correction mode is set to BTPS Set gas mode to appropriate or STPD instead of ATP setting for your application Most applications may require the ATP mode Invalid parameters exist in expiratory only breath detect mode Tidal volume errors in expiratory only mode Table C 1 Troubleshooting cont Possible Cause BTPS or STPD correction method on the Analyzer is different that the method used by the ventilator manufacturer Compliance of breathing circuit tubing is causing a compressible volume loss The Analyzer is used with humidified gases Condensation on the flow sensors causes a calibration error on the flow measurement Some parameter values are always invalid in this mod
24. has been paused a second press of the Pause Resume key resumes the plot Note The Analyzer stops sampling the transducers while in the Pause mode 1 8 Introduction and Specifications 1 Instrument Familiarity Table 1 6 Functions cont Print ST o P PRESSURE 1 Key VOLUME 2 Key u 8 MONITOR 6 Key This key prints the current data to the printer The mode and format of the printout is set using the printer options function selected under the setup menu This key displays help for any screen A brief description of the screen and of the options available from that screen is provided when help is pressed These are four programmable keys located directly below the display Each display mode has unique options assigned to its soft keys This key selects the flow mode on the Analyzer The flow mode displays signal instantaneous numeric value and statistical data for the high or low flow signal This key is also the O key for numeric data entry This key selects the pressure mode The pressure mode displays the signal instantaneous numeric value and statistical data for the high low or airway pressure signal This key is also the 1 key for numeric data entry This key selects the volume mode The volume mode displays the signal instantaneous numeric value and statistical data for the volume signal This key is also the 2 key for numeric data entry This key selects the oxygen mode The oxygen mod
25. imported into a spreadsheet The par files are generated from the vtp files using a file conversion program initiated by clicking Generate Param File on the File menu Files must be closed to enable this option 4 26 Remote Operation Report Printing Report Printing Reports can be printed from VT for Windows software to any printer installed on a computer There are two ways to print from VT for Windows Select Print from the File menu to display the system print dialog box This allows the user to select which printer to use and adjust settings on that printer Click OK to send the report to the printer Click the Print button on the tool bar The report is automatically sent to the default system printer No print dialog displays The print header at the top of the reports is stored in the Analyzer It is loaded into VT for Windows every time it connects to a Analyzer unit The print header can be changed using the Print Header function in the Setup menu Operating System Loading VT for Windows can be used as a utility to load new versions of the Analyzer operating system software into the flash memory of the Analyzer Contact the Fluke Biomedical Service Center for Analyzer software updates Note Using VT for Windows as a utility to load new versions of Analyzer software overwrites any user Settings stored in the Analyzer but it does not change the calibration of the Analyzer To load new Analyzer operating system s
26. is assumed that there is no flow in the unselected port The purpose of this is to provide a means to zero the flow without having to disconnect from the ventilator circuit or other flow source being measured Note When auto zeroing is selected it is important that there is no flow on the unselected flow port For example if the high flow range is selected there should not be any flow in the low flow port if auto zeroing is selected When auto zero is selected the user may still push the ZERO 7 key to initiate a flow zero The valves still automatically switch to obtain the zero reading Therefore it is not necessary for the user to disconnect the flow to zero No message appears indicating that the flow source should be removed With the auto zero setting enabled the flow automatically zeros every 20 minutes If more frequent zeroing is desired manually zero the flow using the ZERO 7 key Because some data is lost during a zero ventilator parameter data for breaths affected by an auto zero are discarded Airway pressure is also zeroed whenever flow is zeroed Airway pressure can also be independently zeroed from the airway pressure screen Breath Detection To monitor ventilator parameters the Analyzer must first determine when a breath occurred and delineate the various phases of the breath For example the breath detection algorithm determines the beginning and ending of the integration periods for calculating tidal volumes
27. its performance do not expose the system to temperature extremes Ambient temperatures should remain between 10 C and 40 C Cleaning Clean the exterior of the Analyzer occasionally with a cloth dampened with a mild detergent solution A solution of 70 isopropyl alcohol may be used to remove stains and clean the system No other solvents are recommended A Caution To avoid damage to the Analyzer or adverse affects on its performance do not spray liquid directly on or immerse the unit Oxygen Sensor Replacement The Analyzer uses a galvanic oxygen sensor that is under warranty for 12 months The oxygen sensor cell must be replaced when the oxygen calibration cannot be successfully completed The oxygen sensor may operate for longer than 12 months depending on use To replace the oxygen sensor 1 Disconnect the power cord before opening the oxygen sensor door 2 Remove the three screws in the oxygen sensor door on the back of the Analyzer The oxygen sensor is a round plastic cylinder about one inch in diameter with wires protruding from the back of the sensor Disconnect the in line electrical connector on the sensor wire Un screw the old sensor and remove it Screw in the new sensor Fluke part 2138514 Re connect the sensor wire Replace the oxygen sensor door oS et des ae Xe Re calibrate the oxygen sensor following the instructions under Connection and Setup Utilities Oxygen Sensor Calibration 5 3 V
28. m Loop Flat 2 wv Leak Plot fec110 bmp Auto scaling is automatically turned off for a plot if the plot is manually re scaled Auto scaling can also be turned off by right clicking on a plot and unchecking the Auto Scale option Selecting the Plots Scaling Auto Scale function or clicking the Re Scale Now button on the tool bar forces an automatic re scale to occur immediately Manually Re scaling Plots There are two ways to specify a specific range to view on a plot e Select Scaling and Manual Scale from the Plots menu bar as shown below Statistics ero Setup Help Scaling Re Scale Ctrl H Monitor Flat Auto 5 cale d Monitor Plot Manual Scale Monitor Plot 1 Monitor Plot 2 Monitor Plat 2 Single Flat d Monitor Plot 3 Single Plot Loop Plot 1 Loop Plat 2 Leak Plat fec111 bmp Then click the preferred plot The following dialog box appears 4 28 Remote Operation Plots Hew Scale Range Rescale Monitor Plot 1 Y Range Hi AE Y Range Low 1 81 46 Td OF x Cancel Type the desired the range and click OK fec112 bmp e Right click the plot to re scale Select Manual Scale the above dialog box appears Type the preferred range and click OK Signal Selection Three plots on the Monitor screen and the plot on the single plot screen can be set up to display any of the signals flow volume airway pressure low pressure high pressure or oxygen To chan
29. of the signals The ZERO ALL function zeros all of the signals except oxygen To zero any of the individual signals select its name from the ZERO menu Airway pressure and flow are always zeroed at the same time Setup The setup menu provides access to most of the user setup features found in the Analyzer Table 4 3 Setup Submenu Options o option Description OO Flow Port Use this menu to select which flow port to use The checked option is the currently selected flow port Zeroing The Zeroing menu is used to select a zeroing mode either automatic or manual The current zeroing mode is checked See the Zeroing section later in this chapter Breath Detect Use the breath detect menu to switch breath detection modes and to set the breath detect threshold for the current flow port Gas Settings The gas settings function brings up the GAS SETTINGS dialog box See the Gas Settings section later in this chapter Barometric Pressure This function brings up the barometric pressure dialog box Enter the local barometric pressure in mmHg and click OK to calibrate the barometric pressure sensor Signal Units The signal units function brings up a dialog box for entering the desired units for the signals See Signal Selection under the Plots section of this chapter Print Header The print header function sets the print header in the Analyzer See the Printing section in this chapter Accesses the VT for Windows help file 4 4 7
30. select the signal to be zeroed from the given list Setup Help B Zero All ero Flow ero Volume ero Low Pressure ero High Pressure ero Duugen 21 Calibrate Oxygen 1007 fec114 bmp Or 1 Click the Zeroing Speed button on the toolbar 2 Choose the preferred plot from the given list 3 Click the Zeroing button this is the same as selecting Zero All Automatic Zeroing The Analyzer can be set to automatically zero flow and airway pressure periodically This nulls offset errors in the pressure transducers During an auto zero the Analyzer uses pneumatic valves to temporally switch flow ports for the zero Do not use this option if there is flow in both flow ports A zero can be forced by manually zeroing a signal even if automatic zeroing is turned on 4 30 Remote Operation Other Setup Functions Other Setup Functions VT for Windows allows selection of settings in the Setup menu Breath Detect The Analyzer has a built in breath detection algorithm The algorithm determines the breath phase inspiration expiration inspiratory pause single phase bi directional This algorithm is designed to reject signal noise and other artifact when determining the phases of a breath To change the breath detect mode l From the Setup menu select Breath Detect 2 Click the preferred option Breath Detect Threshold The Analyzer breath detection algorithm uses a flow rate threshold that the flow
31. shortened the longer the sensor is exposed to oxygen This includes oxygen in room air as well as higher flow rates of oxygen containing gases past the sensor The Analyzer checks to detect 1f the oxygen sensor is depleted every time an oxygen zero is performed The oxygen sensor should be recalibrated by the user with 100 oxygen and dry air at the beginning of any testing day in which oxygen concentrations are to be measured Flow Measurements The flow measurements in the Analyzer are made by measuring the differential pressure across a resistive screen mesh The resulting differential pressure is nearly linear with respect to the volumetric flow Simple corrections are applied to correct for any nonlinearities A table of correction factors 1s applied for each the low and high flow sensors The information regarding these tables can be seen using the Setup Utilites Linearization screen on the Analyzer Gas Settings The flow measurement sensors in the Analyzer are linearly dependent on the viscosity of the applied gas The Analyzer setup options allow the user to specify what type of gas is being used Additional choices are available using the User Define mode The user defined gas settings are set using the PC software The gas calculator on the PC software can determine the effective viscosity for a combination of various gases The Analyzer calculates the temperature dependent viscosity for the gas type selected except for use
32. shows the rear and left panels of the Analyzer 1 6 Introduction and Specifications H a St Figure 1 2 Rear and Left Analyzer Panels Rear Panel The components of the back panel are listed in Table 1 4 Table 1 4 Back Panel Components Description 1 RS232 Serial Port Parallel Printer Port 3 Power Switch Power Cord Input Oxygen Sensor Access Left Panel The components of the left panel are listed in Table 1 5 Table 1 5 Left Panel Components High Flow Exhaust Port Low Flow Exhaust Port Instrument Familiarity 1 fec121 eps 1 7 VT Plus HF Operators Manual Front Panel Details Figure 1 3 shows details of the Analyzer front panel and Table 1 6 describes the various keys their icons and functions FLLIKES VT PLUS HF GAS FLOW ANALYZER Biomedical TEST MODES FLOW PRESSURE VOLUME MORE Go MONITOR ZERO SETUP PARAMETRS fec011 eps Figure 1 3 Analyzer Front Panel Table 1 6 Front Panel Functions Contrast Adjustment This key adjusts the screen contrast to match the user s preference Each time the key is pressed the screen becomes lighter When the minimum contrast is reached the screen is set to the maximum contrast and the screen can be made lighter until the preferred setting is achieved Pause Resume This key pauses the plots and numeric data on the screen to allow further examination of the data or for transcription of the data by the user After the screen
33. support a given language To select the printer options highlight Printer Options The Printer Options screen appears Printer Options Printer Type ASCII 80 Char Graphics Text Only fec033 bmp Printer Type 2 16 To choose a printer 1 Highlight Printer Type and press the MODIFY soft key to toggle to the desired printer type 2 Press the ENTER soft key to save the change or the ESCAPE soft key to cancel the change 3 Press the BACK soft key to return to the Settings menu Graphics Connection and Setup Setting Analyzer Operating Parameters To choose the format of reports shown l Highlight Graphics and press the MODIFY soft key to toggle between Graphics or Text Only Press the ENTER soft key to save the change or the ESCAPE soft key to cancel the change Press the BACK soft key to return to the Settings menu Audio Levels This setting adjusts the level of sound for the functions of the Analyzer To adjust the sound highlight Audio Levels The Audio Levels screen appears General Audio Levels Keypad Errors fec034 bmp To adjust the general audio level l Keypad Highlight General and press the MODIFY soft key to toggle between Low High or Off Press the ENTER soft key to save the change or the ESCAPE soft key to cancel the change Press the BACK soft key to return to the Settings menu When keypad buttons are pushed a beep signals this action This option adju
34. values shown in the statistics area e Erase the plot and re initialize the statistics and breath parameters Press the CLEAR soft key e See more information in any screen Press the HELP key e Pause and resume the plot screen respectfully Press the PAUSE RESUME key Printer Cable Attachment The printer uses a D25 male to Centronics parallel cable for parallel printing This cable is available from Fluke part 2238072 or from most electronic supply outlets To attach the parallel cable 1 Connect the 36 pin end for the Centronics type parallel cable to the printer s parallel input connector 2 Attach the 25 pin male end of the parallel cable to the 25 pin connector on the back of the Analyzer 2 6 Connection and Setup Using the Setup Screen Using the Setup Screen To use the Setup screen l Press the SETUP 8 key The Setup screen displays System Utilities Information fec027 bmp The options are e Settings a menu for choosing options that affect flow and measurement on the Analyzer e System a menu for choosing options that affect how information on the Analyzer is set up such as time and date e Utility used for system service and calibration only e Information product information about the Analyzer such as serial number and copyright Use the A and VW soft keys to highlight an option Press the ENTER soft key to select the option Press the BACK soft key to retur
35. 00 Relative Humidity fo Relative Humidity fo Gas Correction Ambient Temperature fo E Correction Mode ATP H Gas Calculator OK 4 Make appropriate entries to adjust temperature viscosity molecular weight and relative humidity for both inhaled and exhaled gases Ambient temperature can be adjusted and the flow can be adjusted to one of six standard modes ATP BTPS STPD as shown below 5 Ifthe viscosity or molecular weight of the gas being used is unknown click the Gas Calculator button The Gas Calculator dialog box displays Viscosity fec117 bmp Remote Operation Other Setup Functions Gas Calculator E Balance l Gas Gas Inspiratory Expiratory User bas 1 Molecular Weight D Viscosity Cael Viscosity Intercept Select Gas None User Gas 2 Molecular Weight g mole Viscosity Caef aP C Viscosity Intercept p eut CO He N0 User Gas 1 User Gas H2 G MS OM oH HO M Ae G G NM NO NO HO Aa ON User Gas 3 Select Gas None D Temperature 273 E User Gas 3 SET dax Relative Humidit ER LU A Molecular Weight g mole Viscosity Caef nF C Viscosity 43 3 af Viscosity Intercept AP GU Molecular Weight 28 84 g mole Select Gas None G Aur G Respiration fec118 bmp The gas calculator allows calculation of the viscosity and molecular weight of a gas mixture One gas serves as a balance gas
36. 00 function The menu is function sensitive and the options in the menu correlate to the RT200 special functions 00 01 F1 and F2 The values set in this menu include those shown below ek ATP Function HI DC Concentration 100 Volume Accum l Correction Mode ATP Ambient Temp 70 Rise Delay Time 50 Fall Delay Time 100 Trigger Level Low Turn Off RT2 amp OO Emulation fec070 bmp 3 30 Operation 3 Special Functions Assist Test The Assist test determines the sensitivity of the ventilator in patient assist mode and helps to calibrate the full range of assist pressures under which the ventilator can operate During an assisted breath the airway pressure drops during the inspiration due to the spontaneous breath The assist is triggered by a negative pressure relative to the end expiratory pressure during the expiratory hold period See Figure 3 2 AIRWAY PRESSURE ASSISTED BREATH N NORMAL BREATH TIME MINIMUM AIRWAY PRESSURE fec072 eps Figure 3 2 The Assist Test To perform an Assist test 1 Press the FULL 5 key The Full Test screen displays 2 Connect the ventilator breathing circuit to the Analyzer in the bidirectional measurement configuration as shown in Figure 3 3 Inspiratory Hose Ventilator Analyzer Ee Outlet d Expiratory Hose Figure 3 3 Ventilator Breathing Circuit Setup for Bi Directional Measurements fec002 eps 3 Adjust the ventilator contro
37. 5 71 L Current Value 5 71 L Limit 5 Percent Difference 0 0 Test Number Number Or Incidents 0 Elapsed Time 00 00 02 Single Plot Screen Full Test A Trend Test A LeakTest Stacked Volume Test No File Selected Manual Zera ATF Low Flo Figure 4 9 Trend Test Screen Testing Underway fec091 bmp While a test is running screens cannot be changed until the STOP button that appears at the bottom of the screen has been clicked During a trend test the following values are reported to the user every time a breath occurs Test Parameter This is the parameter that was chosen for running this test This value does not change during the test Current Value This is the current value of the chosen test parameter Every time a breath occurs this is updated and compared against the initial value of the test parameter Starting Value Shows the initial value for the test parameter This value does not change during the test Difference This value is calculated each time a breath occurs If it is greater than the limit an incident is reported Limit This is the value entered before starting the test It does not change during the test of Tests Incremented each time a breath is detected of Incidents The number of incidents is incremented each time the percent difference exceeds the percent limit Elapsed Time This value is updated continuously It keeps track of the l
38. A dialog box appears showing the exact time that was written to the file One use of this function is to correlate data collection in a laboratory notebook or data collection worksheet with the data in the file Pressing the Annotate button during recording displays a dialog box wherein the user may enter text notes Clicking OK places the notes and a time stamp in the data file The time stamp represents the time that the OK button was clicked not the Annotate button Automatic Event Markers In the absence of user events such as Time or Annotate there are only beginning and end of file events Therefore automatic event markers are placed in data files to assist in the rewind and forward functions during playback The time intervals between automatic events can be adjusted To set the time interval l Select Timed Breaks form the File menu The Timing dialog box displays 30 Sec Cancel 5 Min X Cancel 10 Min Help fec107 bmp This setting determines how often an automatic event marker is placed in the data file Select the desired time interval between automatic event markers and click OK Event markers are used with the Forward and Reverse functions of file playback Shorter times let the user see more of the data during playback The software keeps a timer for the automatic event marker If the user inserts an event by using Time or Annotate the timer is reset to avoid having automatic even
39. CENT Blus for Windows fec089 bmp Figure 4 7 Full Test Screen These parameters are only updated when a new breath occurs A value means that value is invalid or could not be calculated Depending on the breath detect mode some parameters can t be calculated Trend Test The Trend test is used for monitoring a single breath parameter over an extended period of time Each time a breath occurs the chosen breath parameter is compared to an initial value If it exceeds the percent limit given for the test an incident is reported Following the test a report may be printed detailing all of the incidents that occurred during the test 4 12 Remote Operation 4 Main Screens and Tests Setting Trend Test Parameters The Trend test setup screen shown in Figure 4 8 allows the user to choose the parameter to run the test on and to choose the percent limit for the test an WT Plus for Windows Minute volume D 5 fec090 bmp Figure 4 8 Trend Test Setup Screen Initially the start button is not enabled A trend test may be started only after receiving a valid value for the breath parameter chosen 4 13 VT Plus HF Operators Manual Running the Trend Test To run the Trend test 1 Click the START button The screen changes as shown in Figure 4 9 ak WT Plus for Windows File Communications Plots Statistics Zero Setup Help HG ein Ska e Test Parameter Minute Volume Initial Value
40. EE 4 30 EIERE 4 31 Breath ECE T 4 31 Breath Detect Threshold 4 31 Gas DS TNS sso Sates TOT 4 31 E ee e 4 34 4 2 Remote Operation Getting Started Getting Started The Analyzer can be run by the VT for Windows PC software from a PC that meets the minimum requirements listed below The two must be connected properly and the VT for Windows PC software installed as described Then the PC must establish communications with the Analyzer System Requirements The following are minimum requirements for PC e Microsoft Windows 98 NT 2000 XP e 8 MB of RAM required 32 MB of RAM recommended e 100 MHz Pentium system required 200 MHz Pentium II system recommended On slower computers the Analyzer software may not be able to display the real time waveform data If using a slower computer than recommended and a problem occurs select Parameters Only from the Communications menu Connecting to the Analyzer To make connection between the Analyzer and a PC plug a standard 9 pin serial cable into the RS232 port on the back of the Analyzer and into an unused serial com port on the PC Note When the VT for Windows PC software is launched the Analyzer is automatically placed into the computer control mode No graphics are available on the Analyzer screen while serial communications are active A screen displays on the Analyzer indicating that serial communications are enabled installing the
41. Each event is marked in the vtp data file with a time stamp For the beginning of a recording and for an annotated event a dialog box appears with a space provided for the user to enter the text annotation 4 21 VT Plus HF Operators Manual The user initiates TIME STAMP and ANNOTATE events by pressing a button provided for each Each event is described below A file control interface is provided to aid in data collection and data playback Automatic events are placed in the file to assist in the rewind and forward functions of the data file playback Opening and Closing Data Files The File menu is shown in Figure 4 15 Selected file opening and closing options and their functions are explained below Ss Communications Plots L Save Data File Ctrl S Review Data File Ctl 0 CH Close Files Ctrl C File Controls Timed Breaks Generate Signal File Generate Param File Load Flash Print E mit Rf fec097 bmp Figure 4 15 File Menu Opening files e Review Data File opens an existing file for playback e Open File button on the tool bar e Save Data File opens data for recording e Save to File button on the toolbar saves the file as a new or existing file If it is an existing file the user is prompted to decide to overwrite the existing file If NO is selected the end of the file is appended Closing files e Close Files e File Close button on the toolbar Note VT for Windows does not store data in a b
42. NPT male to 1 16 ID to bulkhead connection Introduction and Specifications Accessories Table 1 9 Optional Accessories ES ET Graphics Printer 110 V Citizen IDP3110 2248762 220 V Citizen IDP3110 2719653 D25 male to Centronics parallel cable 2238072 ACCU LUNG Lung Simulator with Soft sided 2387318 carrying case 2397628 1 VT Plus HF Operators Manual Chapter 2 Connection and Setup CCOHBE CLA EE ee de de de ot Pacurmalc COMING CONS ceosiseoc ceerencceaeneecnveanttcettemened meneecctaenenessnenteceueemecesiaes High Flow Inlet and Exhaust nnnnnnnnnnnnnnnnnnnennrrrrrrrrrrrrrrrrerrrrrerrren Low Flow Inlet and Exhaust ss High Pressure F ande E Low Pressure Pad e EE Test System LE OR DONA MMIPN II NNNM OPI PNIS TeRi Bi directional Flow Mode eee tritt tra dr eue Yo Edo sn Unidirectional Flow Mode Printer Cable Attachment essei ett deeg etin ege deeg Using the Set p Sefes o eie eme sonieesneesrsonedeceresesecrsonsaerrseceesesesennte tons Setting Testing Parameters scrissi Yos ia etim Mu anna Tm EL ses anna r mature GaS A Bb E Gas THEORIE Raeren Ambient Kee red ee een eco en eu ALY d TS CO EE a en ae eee en E Eeer senc FOEDE IR o E EDR URISDE ENIEEDDETR A RP Breath DS E Inspiratory Expiratory Tidal Volumes PO MOO e Domo Dala PRE P EE Display Calibration Date on Startup Screen SEET lee EIERE eet KEE CDS EEEEER AO RS SES ETS egene 2 1 VT Pl
43. PAGE tentiam tet REER 4 26 Event EE i EAE EOE 4 26 Generating Signal EE RT 4 26 Generating Parameter par Files 4 26 Eege 4 27 Operating Systemi E EE 4 27 d 4 28 Automatically Re scaling Plots VU 4 28 Manually Re scaling POS ses Seu et den to axem tpe ttu uU 4 28 Si Ke e E O Sov EA 4 29 EE 4 30 ENEE EE 4 30 EE 4 30 iii VT Plus HF Operators Manual Other Setup DEL e EE Breath RE EE Breath Detect PATS Gt ds tarde laine beet ordo da GAS CARS EE to nee A tiens at tie et eee Datottietrto Pressure c o leavin E EN Ni Appendices A EK dh re E B Eege C Troubleshooting nn nr tenace een tonnes eee Table ESS WW er et Bet PO ah ETS euh ES ES ES Er eed D D OS Ur D D me Oo D D 00 1 OS Ca D List of Tables Right Panel eege E back Panel Components oie sons caczntneasaonnsdaatoaboeesaoeaicaateaneiasaonsdaatmaeadsaneaidauseanees Lett Panel Components 55 023 sscasnsaseqeacsossenesosecbaesocacasnsosacmacessasanesosecbcedonasanneeadaas ter Front Panel Dee E Breath Parameter Accuracy Specifications Sidpdard CCS SS ONC E Optional ACCOSSOFIGS cs ssccasse sascandeaaisaaesedeneessonsewas sameness senedeaseadeneetsoredeasenteeessesaderenes TAS VIS EE Breath D tection Options eiie ortu es tinh ino s aes adds aunq a SIS aae niea ANSA ai inni Geral Pott Eege GOK YTD CPA MS eser E tet Parameters Calculated by the Analyzer ss Display COM ONS
44. Press the TREND soft key to print the trend of a single parameter See Special Functions for a more description of the trend function Clear Press the CLEAR soft key to reset the statistics and re start the plot If asterisks appear for a parameter value the parameter is either invalid for the current breath detect mode or the system does not have sufficient information to accurately calculate the parameter For example Base Flow is invalid during bi directional breath detection mode because the base flow 1s seen only in the inspiratory and expiratory limbs of the ventilator circuit In another example it would be impossible to measure the inspiratory hold pressure during the expiratory only mode Note The Assist Pressure Assist and the Minimum Pressure Min Pres are not available for trending and cannot be added to other screens using the parameter selection Refer to Special Functions for instructions on Assist Mode testing 3 18 Operation 3 Monitor Screen Monitor Screen The Monitor screen shows three signals and their corresponding values Monitor ATP High Flow H Ae fec056 bmp Alternatively the lower signal can be replaced by a set of four breath parameters The user can select which signals are displayed on the monitor screen Select Assign Units Re scale Press the SELECT soft key to change the position of the plot that can be altered using the ASSIGN and UNITS soft keys The vertical cursor bar
45. Screen Testing Underway nennen 4 10 Trend Test Screen Final Values Displayed ccccccccccccccccceeeeeeeeeeeeeceeeeeeeeeeeeees DIE Leak Test Setup CU EE 4 12 Leak Test Screen Testing Underway sseeH 4 13 Stacked Volume Test Setup Screen iier eterna n nee ena naa enn 4 14 Stacked Volume Screen Testing Underway S Mol uns w 4 16 File Control Ite aCe sre nn e File ao OR Pane EE Dak ET E ue de er de du dore A 1 Circuit Connection for the Analyzer in Bi directional Mode vil VT Plus HF Operators Manual viii Chapter 1 Introduction and Specifications rte ee EE SO E Unpacking and Inspection G n ral Safety Consid rations sssssstuie so sesmereereeeeceesoneete visu M Wamines dnd SE le EE Instrument Familiarity ccccccccscecccccccceseecceeeeeeeeeceeeeeeeeeeeeeeeeeeeeeeeeeeeeees OTIC E E It E IT EE IR Pane E Fron Panel RE EE SPCC AOS a EN General Specifica OMS EE Performance Specifications iii Breath Parameter Accuracy Specifications ACEO OO aer ob eo den ous 1 1 VT Plus HF Operators Manual 1 2 Introduction and Specifications 1 Introduction Introduction The VT Plus HF Gas Flow Analyzer referred to hereafter as the Analyzer is a general purpose gas flow analyzer with special modes for testing mechanical patient ventilators The Analyzer me
46. T Plus HF Operators Manual Fuse Replacement The Analyzer fuses may have to be replaced The fuse compartment is located on the side panel of the instrument as shown in Figure 5 1 fec122 eps Figure 5 1 Fuse Compartment To replace the fuses l Power off Analyzer and unplug the main power cord 2 Usinga small flat blade screwdriver or similar tool carefully pry off the cover to the fuse compartment The fuse block assembly 1s attached to the back of the cover Pull out the fuse block assembly and carefully lift the old fuses from the fuse slots 4 Replace the fuses two 0 5 A Slo Blo fuses Fluke part 46026 AA Warning To avoid possible fire electrical shock or personal injury use only the recommended fuse 5 Replace the cover fuse block in the fuse compartment m Plug in the Analyzer 5 4 Maintenance Service and Calibration 5 Service and Calibration Service and Calibration The Analyzer should be calibrated annually to maintain accurate measurements If the Analyzer fails to operate successfully or if it needs calibration return it to the Fluke Biomedical Service Center as indicated under Warranty and Product Support As part of this service hardware and software updates are automatically installed Product upgrades are also available for an additional fee The available upgrade for the Analyzer includes the RT 200 mode a user interactive mode and HFOV mode performance evaluation for high fre
47. WT Plus for Windows File Communications Plots Statistics Zero Setup Help 1848 Low Pressure 16 51 kPA 450 900 1350 1800 Compliance 0 0 miftmH20 Volume Lost 0 00 L Initial Pressure 1016 Leak Rate 27 00 cmH20 sec Start Time 2 27 25 PM Time Remaining 0 24 57 Single Plat Screen Full Test LeakTest A Stacked Volume Test No File Selected Manual Zero ATP Low Flow Figure 4 12 Leak Test Screen Testing Underway fec094 bmp Screens cannot be changed until the test being run has ended The Leak test plots the chosen pressure channel airway low or high pressure over the chosen length of time The Leak test also displays the following values that are calculated during the test Test Parameter This is the parameter that was chosen for running this test This value does not change during the test Compliance This is the compliance value entered when starting the Leak test This value doesn t change during a Leak test Initial Pressure This is the pressure read on the selected pressure channel when the Leak test was started The initial value doesn t change during a Leak test Start Time This is the time that the Leak test was started Volume Lost If a compliance value was entered at the start of the Leak test this value is the amount of volume lost during the Leak test Leak Rate This is the rate at which pressure is being lost Time Remaining This shows the amount of time left in
48. alyzing only expired breaths or when the Analyzer is connected in the expired limb of the ventilator breathing circuit Unidirectional inspired only Use this breath detection mode when the Analyzer is analyzing only inspired breaths or when the Analyzer is connected in the inspired limb of the ventilator breathing circuit ATP ATP This indicates the conversion of gas flow and volume to ambient temperature and pressure ETPS BTPS This indicates the conversion of gas flow and volume to body temperature of 37 C with 100 relative humidity STPO STPDO This indicates the conversion of gas flow and volume to a standard temperature of 0 C and a standard barometric pressure of 760 mmHg STPD STPD21 This indicates the conversion of gas flow and volume to a standard temperature of 21 C and a standard barometric pressure of 760 mmHg Inspiratory Tidal Volumes This indicates that the reported tidal volumes are measured over the inspiratory phase of the breath This only applies to the bidirectional breath detect mode Expiratory Tidal Volumes This indicates that the reported tidal volumes are measured over the expiratory phase of the breath This only applies to the bidirectional breath detect mode Light Soft Filtering This indicates that the filtering option is turned on and the filter is set to light or soft filtering In this mode all of the signals flow and pressure have a Digital Signal Processing DSP low pass filter appl
49. anging the I E ratio or by decreasing the lung compliance higher pressures Ensure that the change in airway pressure during the breath is greater than 5 cmH20 Use the bi directional breath detect mode Ensure that the Analyzer is placed between the Y of the breathing circuit and a test lung VT Plus HF Operators Manual Table C 1 Troubleshooting cont Possible Cause Corrective Action Flow or pressure measurement Baseline drift of pressure Zero the affected signal by using is not equal to zero when zero transducer the zero key while the affected signal is being displayed For example low pressure can be zeroed while the low pressure screen is currently displayed flow or pressure is applied No message appears to remove Auto zeroing mode is enabled This is normal Because the auto flow when attempting to zero The Analyzer is zeroing flow but zero mode is enabled the flow Appears that system will no message is supposed to be Analyzer assumes that the not zero flow No message displayed because the Analyzer unused flow sensor can be used appears uses valves to switch to the to obtain the zero reading unused flow port Ensure the unused flow sensor has zero flow when the auto zero mode is enabled Zeroing flow results in Flow was not zero Ensure that there is no flow unexpected flow readings or an when zeroing the flow sensor error message Auto zero mode was enabled Whenever the auto zero mode is an
50. asurement accuracy is obtained by allowing the Analyzer to fully warm up and manually zeroing before reading or documenting a measurement Breath Parameter Accuracy Specifications Breath parameter accuracy specifications are listed in Table 1 7 Note If a choice of readings is indicated by an or choose whichever is greater for example 3 6 or 250 ml Introduction and Specifications Specifications Table 1 7 Breath Parameter Accuracy Specifications Expiratory Tidal Volume high low flow spec high low flow spec te Voume orm oo Inspiratory to Expiratory 0 01 1 200 to 200 1 2 or 1 Time Ratio I E Ratio Peak Inspiratory 0 1 cmH O 120 cmH O 3 or 1 cmH O Pressure Inspiratory Pause 0 1 cmH O 120 cmH O 3 or 1 cmH O Pressure Mean Airway Pressure 0 1 cmH O 80 cmH O 3 or 0 5 cmH O Positive End expiratory 0 1 cmH O 5 to 40 cmH O or 0 5 cmH O Pressure PEEP 2 2 Lung Compliance 0 1 ml cmH O 0 150 ml cmH O 5 96 or 5 ml cmH O 3 Flow Bias 0 01 lpm 0 30 Ipm 2 96 or 0 5 lpm Inspiratory pause time gt 0 5 sec Expiratory pause time gt 0 5 sec 1 VT Plus HF Operators Manual Accessories Table 1 8 lists standard accessories provided with the Analyzer Table 1 9 lists optional accessories Table 1 8 Standard Accessories e O HE Power cable US 2238562 Schuko 769422 UK 2238570 Australia 658641 Two 1 4 NPT male to 1 8 ID tubing barb fitting Nylon Two 1 4
51. asures bidirectional flow in both high and low ranges as well as high and low pressure ranges Users control the unit using the command system or a special control mode that uses RT200 style commands Multiple special function tests allow efficient troubleshooting The Analyzer can measure either high or low flow and pressure eliminating the need for gauges and flow meters It measures 21 ventilator parameters and can display all of them on one screen Results can be printed directly from the unit or from Windows compatible software on a PC The Analyzer also has onboard graphing capability and shows the minimum maximum average and absolute measurement for all parameters This manual provides a description of the Analyzer and its applications It should be used as a guide when using the instrument to analyze a ventilator and test lung Key Features e Bi directional flow low and high pressure volume and oxygen concentration and pressure measurements e Very high frequency measurement capability up to 900 BPM 15 Hz e RS232 and printer ports e Included Windows compatible graphics software e Minimum maximum average absolute and graph for all parameters e All 21ventilator parameters displayed on one screen simultaneously e Operation by user friendly command mode or RT200 command mode e Operation with a variety of precision test lungs available from Fluke Biomedical to complete a fully NIST traceable ventilator test e Tes
52. ation 3 Pressure Screens Airway Pressure Screen The Airway Pressure screen displays the signal and statistics for whichever range 1s currently selected in either the high or low flow ports of the Analyzer This screen measures the pressure in a ventilated test lung The airway pressure displayed 1s that for the selected high or low flow port Range Press the RANGE soft key to change between low pressure airway pressure and high pressure screens Units Press the UNITS soft key to change the units of measure for the airway pressure screen Possible units of measure for this screen include mbar millibar 001 Bar bar 14 7 PSIG Barometric mmHg millimeters of mercury inHg inches of mercury cmH O centimeters of water inH O inches of water PSIG pounds per square inch atm atmospheres kPa kilopascals Re scale Press the RESCALE soft key to change the scale on the plot of data to a more appropriate window of values Note RESCALE uses the current min max values to determine plot limits Clear Press the CLEAR soft key to reset the statistics and re start the plot The user can select the breath parameters displayed on this screen by following the instructions under Selecting Breath Parameters 3 15 VT Plus HF Operators Manual Volume Screen The Volume screen displays the signal and statistics for the volume signal Statistics Mint 6 342 H FS Maxi x B4 Ava DH DDR H Be Minute Val 45 S96 L Ex Hold Tidal V
53. d shock absorbent material around the instrument Returns for partial refund credit Every product returned for refund credit must be accompanied by a Return Material Authorization RMA number obtained from our Order Entry Group at 1 800 850 4608 ext 2560 or 1 440 498 2560 Repair and calibration To find the nearest service center go to www flukebiomedical com service or In the U S A Cleveland Calibration Lab Tel 1 800 850 4606 Email globalcal flukebiomedical com Everett Calibration Lab Tel 1 888 993 5853 Email service status fluke com In Europe Middle East and Africa Eindhoven Calibration Lab Tel 3 1 402 675300 Email ServiceDesk fluke com In Asia Everett Calibration Lab Tel 425 446 6945 Email mailto service international fluke com Certification This instrument was thoroughly tested and inspected It was found to meet Fluke Biomedical s manufacturing specifications when it was shipped from the factory Calibration measurements are traceable to the National Institute of Standards and Technology NIST Devices for which there are no NIST calibration standards are measured against in house performance standards using accepted test procedures WARNING Unauthorized user modifications or application beyond the published specifications may result in electrical shock hazards or improper operation Fluke Biomedical will not be responsible for any injuries sustained due to unauthorized equipment modi
54. d the unused flow sensor had enabled ensure that there is no a non zero flow present flow on the unused flow sensor Barometric pressure is incorrect Barometric pressure offset drift Enter correct barometric pressure No flow measurement is Wrong flow range is selected From the flow screen ensure observed when flow is applied that the range low vs high flow matches the range depicted on the side panel of the Analyzer for the port where the flow is being applied No airway pressure is observed Wrong flow range low vs high From the flow screen ensure flow selected that the range low vs high flow matches the range depicted on the side panel of the Analyzer for the port where the flow is being applied Pressure is negative when a Pressure is being applied to the Ensure that pressure is applied positive pressure is applied connection instead of the to the correct connection connection Ventilator parameters seem Analyzer in circuit backwards Ensure the inlet side of the incorrect Analyzer is connected closest to the inspiratory hose from the ventilator In bi directional mode this means the inlet is near to the Y piece Analyzer does not print Wrong printer type selected Analyzer takes a long time to establish communications with PC software Table C 1 Troubleshooting cont Possible Cause Printer not set up for selected printer language Printer not connected This is normal
55. e Analyzer also has several internal pressure measurements These include barometric pressure differential pressure for the flow measurement and airway pressure Airway pressure is measured internally in the tube for the flow sensors This is done for convenience for the user while measuring ventilator parameters Having a pressure measurement for airway pressure in addition to the external low pressure measurement ensures that the pressure is measured at a consistent location and eliminates the need for cumbersome adapters for placing pressure taps in the airway circuit When the Analyzer is set to measure from the high flow port the airway pressure 1s measured from the high flow port Likewise when the low flow range is selected the airway pressure 1s measured from the low flow port In both cases the airway pressure measurement is made on the exhaust side of the flow sensor Zeroing the Pressure Signals The zero reading offset of the pressure measurements may drift slightly with time and temperature A zeroing function is provided for the user to zero the offset drift Typically this is done when a non zero reading occurs when there is zero applied pressure However it is good practice to zero the respective signal before any measurement is taken Although a five minute warm up period is built into the Analyzer power up cycle a 40 minute warm up period is suggested for maximum measurement accuracy and stability The offset drift is
56. e displays the signal instantaneous numeric value and statistical data for the oxygen signal This key is also the 3 key for numeric data entry MORE MORE 4 Key This key selects other tests such as the Leak test and the Trend test This key is also the 4 key for numeric data entry This key selects the full breath parameters mode The full mode displays all of the breath parameters calculated by the Analyzer following every breath Note that one of the breath detect settings must be enabled to observe volume signals or data Refer to System Setup for breath detection settings This key is also the 5 key for numeric data entry This key selects the monitor mode The monitor mode displays the signal and instantaneous value for three of the signals measured by the Analyzer Alternatively the lower of the three plots may be replaced by selected breath parameters The user can select the signals and or parameters that are displayed This key is also the 6 key for numeric data entry VT Plus HF Operators Manual Table 1 6 Functions cont ZERO ZERO 7 Key This key initiates the zero function in the Analyzer All of the n pressure and differential pressure flow sensors in the Analyzer must be periodically zeroed or calibrated to a zero reference When zero is selected the device measures the zero value of the selected signal for flow measuring The Analyzer can be set to periodically call of the zero function Refer to Sys
57. e due to insufficient information in the expiratory only signal All parameters are invalid including base flow The Analyzer must be able to accurately detect base flow for the parameters to be valid Some ventilators servo control the base flow during the expiratory period Because the Analyzer must assume the base flow is constant during expiration errors result due to the changing base flow from the ventilator during the expiratory phase Appendices Troubleshooting C Corrective Action Corrections for BTPS and STPD may vary among different ventilator manufactures The biggest difference is in the water vapor volume correction The Analyzer uses the setting for relative humidity and temperature to determine the actual volume of water vapor in the flowing gas This volume is subtracted from the total volume for dry gas corrections For saturated gas correction a make up volume of water vapor is computed and added to the measured volume Determine the breathing circuit compliance to calculate the expected volume loss due to compressibility of the gas and expansion of the hose Run DRY air through the flow sensor for 10 to 30 minutes to allow the screen mesh to dry Do not use the Analyzer with condensing humidified gases Use the bi directional breath detect mode Ensure the Analyzer is placed between the Y of the breathing circuit and a test lung Increase the end expiratory period by either ch
58. e made using a differential pressure drop across a resistive screen mesh The low flow signal can be used for infant neonatal ventilators or for determining the performance of many other types of flow meter Valves switch between the low flow and the high flow measurements depending on the range selected in the display flow screens Airway Pressure The airway pressure is measured from a tap off of the proximal near the exhaust port of the flow sensor housings This tap is connected to a 120 cmH 0 pressure sensor that generates the airway pressure signal Valves switch between the low flow and the high flow measurements When the low flow port is selected the airway pressure is measured off the low flow port Likewise when the high flow port is selected the airway pressure is measured off the high flow port Use the RANGE soft key from any of the flow screens to select which flow port high or low airway pressure is measured from Low Pressure This is a dual port connection consisting of a positive and a negative pressure port The differential pressure range is 500 mmHg This pressure measurement can be used for any pressure differential or gauge pressure in the given range The transducer is capable of measuring fluid pressure on the positive port as indicated on the label 3 3 VT Plus HF Operators Manual Barometric Pressure A barometric pressure measurement is provided by the Analyzer The barometer can read absolut
59. e pressures from 8 to 18 PSIA The barometer is also used in the automatic ATP BTPS and STPD conversions for flow and volume measurements The barometric pressure signal can be fine tuned using the procedure described in System Setup High Pressure Measurement The high pressure measurement is made from a dual port connection consisting of a positive and a negative pressure port The differential pressure range is 100 psi This pressure measurement can be used for any pressure differential or gauge pressure in the given range The transducer is capable of measuring fluid pressure on the positive port as indicated on the label Oxygen Concentration Oxygen concentration is measured through the high flow port of the system on the rear panel bulkhead fitting An integrated sensor measures the oxygen percent of the gas in the high flow channel of the Analyzer The range for this sensor is 0 to 100 The oxygen cell is mounted inside the enclosure on the rear bulkhead for the high flow circuit The fuel cell must be replaced approximately once a year Oxygen readings are compensated for airway pressure Calculated Breath Parameters 3 4 From the primary flow and pressure measurements the Analyzer is designed to calculate breath rate leak and base flow A breath detection algorithm determines the various phases of a ventilator breath and calculates the parameters listed in Table 3 1 Operation 3 Measured Signals Table 3
60. easurement is equivalent to a gauge measurement For gauge pressures the measurement is relative to the ambient pressure This is how a normal pressure gauge works If a positive gauge pressure is applied to the measurement port a positive pressure reading results If a negative gauge pressure is applied to the measurement port a negative pressure reading results Likewise if a positive gauge pressure is applied to the measurement port a negative pressure reading results If a negative gauge pressure 1s applied to the measurement port a positive pressure reading results Fluidic Pressure Measurements The connection for both high and low pressures are labeled as compatible with either fluids or gases When measuring fluidic pressures it 1s important to realize that any fluid entering the pressure measurement port or the connecting tubing may cause a bias error in the measured pressure For example if a fluidic pressure measurement is made and a 5 cmH O column is in the connecting tubing an error of about 5 cmH O may occur VT Plus HF Operators Manual If fluid enters into the pressure measurements connections of the Analyzer it is important to evacuate the fluid before storage and before any pressure measurements are made The fluid can be evacuated by connecting a 100 cc syringe directly to the pressure measurement connection and then pulling back the syringe to create a vacuum Internal Pressure Measurements Th
61. egins the Analyzer switches into Inspiratory Only breath detect mode At the end of the test the breath detect mode is restored to its previous state The stacked volume test reports five values to the user they are updated every time a breath 1s detected Total Volume the total of the tidal volumes for the breaths tested Last Volume the tidal volume for the last breath Average Volume the average tidal volume over the breaths that have been tested and calculated Number of Breaths the number entered at the start of the test it does not change during a test Breath Count the current number of breaths included in the test if tidal volume can t be calculated for a breath that breath and volume are not included in the test 4 19 VT Plus HF Operators Manual Ending the Stacked Volume Test To end the Stacked Volume test 1 Either click the STOP button or let the Stacked Volume test end following the number of requested breaths 2 Click the Print button to print a final report for the Stacked Volume test Click the New Test button to start a new Stacked Volume test Serial Communications The Analyzer communicates with a PC through a serial COM port If the Analyzer is connected to a computer and turned on when the software 1s started the software automatically detects which COM port the Analyzer is on and then initiates communications between the Analyzer and your PC Selecting COM Port While running VT for
62. ength of time the current trend test has been run 4 14 Remote Operation 4 Main Screens and Tests Ending the Trend Test To end the Trend test l Click the STOP button When the trend test is stopped the final values are displayed as shown in Figure 4 10 zm WT Plus For Windows neis emt fec092 bmp Figure 4 10 Trend Test Screen Final Values Displayed 2 Click the Print button to print a copy of the results and the incident reports for the test 3 Click the New Test button to start a new trend test 4 15 VT Plus HF Operators Manual Leak Test The Leak test 1s used for measuring the leak rate of a sealed vessel or test lung over a period of time Setting Leak Test Parameters The Leak test setup screen shown in Figure 4 11 allows the user to choose the desired pressure channel on which to run the test ae T Plus for Windows DETTE x fec093 bmp Figure 4 11 Leak Test Setup Screen Also the displayed pressure units can be changed If a compliance value is entered for the system being tested the volume lost during the test is calculated Enter the test time to set the length of time that the Leak test is to run At the end of that amount of time the Leak test automatically stops Running the Leak Test To run the Leak test l Press the START button to begin the Leak test The screen changes as shown in Figure 4 12 4 16 Remote Operation Main Screens and Tests ak
63. ent min max values to determine plot limits Clear Press the CLEAR soft key to reset the statistics and re start the plot The user can select the breath parameters displayed on this screen by following the instructions under Selecting Breath Parameters 3 13 VT Plus HF Operators Manual Low Pressure Screen The Low Pressure screen displays the signal and statistics for the pressure signal from the low pressure ports of the Analyzer Lou Press 186 B Statistics Min Max Auge B T cmH20 IPF 2 3 cmHz B 2 cmHz FEEF H B cmHz fec052 bmp Range Press the RANGE soft key to change between low pressure airway pressure and high pressure screens Units Press the UNITS soft key to change the units of measure for the low pressure screen Possible units of measure for this screen include mbar millibar 001 Bar bar 14 7 PSIG Barometric mmHg millimeters of mercury inHg inches of mercury cmH O centimeters of water inH O inches of water PSIG pounds per square inch atm atmospheres kPa kilopascals Re scale Press the RESCALE soft key to change the scale on the plot of data to a more appropriate window of values Note RESCALE uses the current min max values to determine plot limits Clear Press the CLEAR soft key to reset the statistics and re start the plot The user can select the breath parameters displayed on this screen by following the instructions under Selecting Breath Parameters 3 14 Oper
64. erly could void the warranty 9 9 VT Plus HF Operators Manual Shipping l 5 6 Place the Return Authorization Number m a prominent place on the outside of the packing box and refer to the number in any correspondence with Fluke Biomedical Service Enclose your return address and Return Authorization Number Insure the unit for full retail value and ship to the nearest Fluke Biomedical Service Center Appendices Appendix A Gas Ana Aer Ke eau ET een en ee eue rm B Error Messages C Troubleshooting VT Plus HF Operators Manual Appendix A Gas Analyzer Tutorial The Analyzer measures the basic signals of pressure flow and oxygen From these basic signals other parameters are computed Volume is obtained from the integration or summation of the flow signal over a period of time Pressure Measurements The Analyzer provides several pressure measurement capabilities There are two external pressure measurements and three internal pressure measurements available to the user External Pressure Measurements These measurements are called Low Pressure and High Pressure The low pressure measurement has a range of 500 mmHg about 10 psi The high pressure measurement has a range of 100 psi about 5200 mmHg Both high and low pressures are differential measurements As such the measured pressure is the pressure difference between the positive and negative ports If only one of the pressure connections is made the m
65. es of information shown on the Analyzer display are a title bar various breath detection icons statistics data plots instantaneous numeric value of plotted data and selected breath parameters as shown in Figure 3 1 and listed in Table 3 2 High Flow 166 d Statistics Min 168 T Max 154 8 Avg H Be 166 6 Tidal Mol B ml PEF Bie LPM FIF B B LP Breath Fate H bpm fec010 eps Figure 3 1 Information Shown on Analyzer Display Table 3 2 Display Components These screen options are described below Operation 3 Screen Objects Title Bar Each screen includes a title bar that shows the screen or mode name on the left number indicating the screen number is shown in a small box on the right of the title bar Parameters fec039 bmp Indicates the screen number Data Plots Except the FULL screen each screen includes a data plot that shows a measured signal flow pressure volume or O vs time fec045 bmp New data is added to the plot starting on the left and progressing to the right When the plot has progressed to the right edge the plot restarts on the left side of the plot One line of data from the previous plot is removed ahead of the new plot When a new screen is selected the plot is displayed using a default plot range Pressing the CLEAR soft key restarts the plot and clears all previously plotted data and calculated statistics Pressing the RESCALE key chang
66. es the window of the data plot to a more appropriate range based on the minimum and maximum values in the Statistics area Note After pressing CLEAR allow one full cycle to pass before pressing RESCALE Breath Parameters Every screen can display up to four breath parameters Tidal Mal 1528 8 mI FEF 52 SO LPM FIF 41 45 LPM Breath katei T 3 bpm fec047 bmp These parameters are displayed only when breath detection is enabled See Special Functions for instructions on how to enable breath detection Parameters are updated following every breath Units of measure for breath parameters are fixed See Introduction Specifications for a listing of breath parameters and units See Selecting Breath Parameters for instructions on selecting which parameters are displayed for each of the modes 3 7 VT Plus HF Operators Manual Breath Detection Icons The breath detection icon is located on the right side of the title bar Various icons and their meanings are listed in Table 3 3 Table 3 3 Breath Detection Icons A large number 0 to the right of the title bar indicates that automatic sensor zeroing mode has been selected Bi directional breath detection Use this breath detection mode when analyzing both inspired and expired breath data or when the Analyzer is connected between the load lung simulator and the Y piece in the breathing circuit Unidirectional expired only Use this breath detection mode when the Analyzer is an
67. essure value to the right of the plot Parameters below the pressure plot show the entered compliance the time of day that the test was started and the calculated test results fec062 bmp 4 Press the STOP soft key to terminate the test or let the test time elapse In either case a Leak test result displays Leak Test Compliance B B ml cmHz Vol Lost HAL Start Pressi 6 Be Kpa Leak Fate D cmH Oe s Start Times 11 16 38 Elapse Time 6 65 54 fec063 bmp 3 25 VT Plus HF Operators Manual A sample Leak Test Report is shown below Fluke Biomedical Corporation 1 2 2000 VT PLUS HF S N 166752 Control Tech Leak Test Low Press 0 02 Kpa Compliance 0 00 ml cmH20 Start Press 0 00 Kpa Start Time 03705713 Vol Lost 0 0 ml Leak Rate 0 07 cmH20 s Elapse Time 00 00 03 Parameters Minute Vol 0 000 L Breath Rate Tidal Vol 0 0 ml Ex Time PIP 0 00 LPM In Time PEP 0 00 LPM Ex Hold Base Flow 0 00 LPM Ia Hola Compliance 0 0 ml cmH20 I E Ratio O2 20 6 S PIP Baro Press 766 6 mmHg MAP Gas Air IPP PEEP 3 26 Operation 3 Special Functions Stacked Volume Test The Stacked Volume test measures the volume of multiple breaths to determine the accuracy of the ventilator in accumulating volume To access the Stacked Volume test l Aog A qu Press the MORE 4 key Use the A and V soft keys to highlight Stacked Volume Test Press the ENTER soft key Press the
68. ey to change the units of measure for the high flow screen Possible units of measure for this screen include LPM Liters per minute CFM Cubic feet per minute LPS Liters per second ml min Milliliters per minute ml sec Milliliters per second Re scale Press the RESCALE soft key to change the scale on the plot of data to a more appropriate window of values Note RESCALE uses the current min max values to determine plot limits Clear Press the CLEAR soft key to reset the statistics and re start the plot Allow one full waveform cycle to plot before pressing RESCALE The user can select the breath parameters displayed on this screen by following the instructions under Selecting Breath Parameters VT Plus HF Operators Manual Low Flow Screen The Low Flow screen displays the signal and statistics for the flow in the low flow port of the Analyzer Low Flow 148 d Statistics Mint zb 1 Max 34 3 Bug H PT 166 B Tidal Vols 1764 4 ml PEF 6 IZ LPM FIF 14 31 LPM Breath Rate 16 bpm fec050 bmp Range Press the RANGE soft key to change from a high flow screen to a low flow screen or back again Units Press the UNITS soft key to change the units of measure for the low flow screen Possible units of measure for this screen include LPM Liters per minute CFM Cubic feet per minute LPS Liters per second ml min Milliliters per minute ml sec Milliliters per second Re scale Press the RESCALE soft key to
69. ferently on different ventilators and is called by different names by the various ventilator manufactures It may be called base flow bias flow flow by blow by or many other names In the inspiratory or expiratory only breath detection modes the Analyzer can measure the base flow present The detection and calculation of base flow may take 30 to 60 seconds In expiratory only mode detection of base flow requires a sufficient end expiratory period and sufficient change in pressure The use of lower lung compliance settings improves performance in expiratory mode During expiratory only mode the base flow is subtracted from the flow signal for obtaining the ventilator parameters such as tidal volume and peak flow During inspiratory only mode the base flow is not subtracted because the base flow is typically turned of during the inspiratory phase on most ventilators Appendix P Error Messages Table B 1 lists error messages their descriptions and corrective actions Error Message Flow Out of Range Gas Settings Error Table B 1 Error Messages Description Differential pressure for the flow measurement causes a measurement greater than the maximum or less than the minimum reading of the analog to digital converter Oxygen concentration is measured at greater than 50 and the gas settings are not set to an oxygen or a balance oxygen setting This is provided as a warning to set the gas settings if measuring
70. fications Restrictions and Liabilities Information in this document is subject to change and does not represent a commitment by Fluke Biomedical Changes made to the information in this document will be incorporated in new editions of the publication No responsibility is assumed by Fluke Biomedical for the use or reliability of software or equipment that is not supplied by Fluke Biomedical or by its affiliated dealers Manufacturing Location The VT PLUS HF Gas Flow Analyzer is manufactured in Everett Washington by Fluke Biomedical 6920 Seaway Blvd Everett WA U S Table of Contents Chapter Title 1 Introduction and Specifications eese ntt od et E d yang T T Unpacking and EE D General Safety Considerations EE SOS nace sate aeaesanasaueves tense ease aeseaeesesenseaeas Wamings and agb CDS eege Instrument b AMM E gl EN Feon Pane E Right Panel NRCR Roar PAROLE ae s PS A AIA E BONG PAR EDR AS ee D D CO 1 16 e a a ee nn Bh KE e EE E Ree Tee Breath Parameter Accuracy Specifications INCOOSSOLIOS uu a ea dt a die 2 Connection and Setup ccccceeeceeeceeeeeeneecesesensseeseeensecesesonseoeseseneeees Connecune the Wd AR oe ee ee Pneumatic CONM CHONS 2 dined rrinin High Flow Inlet and Exhaust nnnnnnnnnnnennnnnennnnrrnrrerrrrrrrerrrrrrrrrerrrreen Low Flow Inlet and Evhausr High Ehe
71. flow with a gas type that has high oxygen concentrations Corrective Action Ensure that flow is within the specified range of the Analyzer The error warning occurs only once after the Analyzer is powered on If measuring flow ensure that the correct gas setting is being used for gas type being measured VT Plus HF Operators Manual Error Message Airway Pressure Out of Range Low Pressure Out of Range High Pressure Out of Range Linearization Tables Invalid Negative Flow Detected No Load Applied AD Buffer Overrun B 2 Table B 1 Error Messages cont Description Airway pressure measurement Causes a measurement greater than the maximum or less than the minimum reading of the analog to digital converter Low pressure measurement Causes a measurement greater than the maximum or less than the minimum reading of the analog to digital converter High pressure measurement Causes a measurement greater than the maximum or less than the minimum reading of the analog to digital converter Either of the linearization tables for the high and low flow sensors are invalid at startup If this condition is detected linearization tables aren t used to calculate flow Accuracy could diminish by 3 to 10 An average negative flow is detected in either inspiratory only or expiratory only breath detect mode The difference between min and max airway pressure is less than 5 0 cmH O while
72. g Remote Operation Main Screens and Tests Loop Screen The Loop or Loop Plots screen shown in Figure 4 6 displays plots of Flow vs Volume and Volume vs Airway Pressure ak 1T Plus for Windows Fille Communcetions Plote Statistics Zero Setup Help Eje Gg ao x EBl9 E Fluw vs Mul 1082 5 Mul vs Pressure 120 81 T2351 B44 1 24 22 41 625 7 D E 5 x 24 08 407 2 Clear Volume 7237 188 8 E E Clear Both Number of Loops 120 67 28 5 E 16 3 2530 5228 792 7 1062 53 5 235 165 56 6 96 6 Ej Volume Pressure Single Plat Screen amp Loop Screen A Full Test A Trend Test stacked Volume Test FILE O Bio TekVTPlusvvinkSignalsi LitenVaves vip Figure 4 6 Loop Screen fec088 bmp These plots can be independently re scaled either automatically or manually Controls located on the right hand side of the screen are used to control the appearance of the loop plots Clear Volume allows zeroing of the volume when breath detect has been turned off Clear Plots clears both of the loop plots Clear Both performs both Clear Volume and Clear Plot functions Number of Loops allows specification of the number of breaths that are drawn before the plots are cleared one to four breaths may be drawn before the plots are cleared VT Plus HF Operators Manual Full Test Screen The Full Test screen shown in Figure 4 7 displays the calculated parameters for the last breath
73. g Instructions After unpacking the Analyzer check to see if all of the standard accessories listed under Accessories have been included with the Analyzer If anything is missing contact the Fluke Biomedical Service Center General Safety Considerations Rea Symbols Tab d the Users Manual before operating the Analyzer le 1 1 describes the symbols associated with the Analyzer Table 1 1 Symbols 45 Hazardous voltage A Important information refer to manual Conforms to UL Std 3101 1 certified to Can USA Std C22 2 No 1010 1 De Conforms to European Union directives Do not dispose of this product as unsorted municipal waste Go to Fluke s website for recycling information Contains mercury Dispose properly Warnings and Cautions A Warning identifies hazardous conditions and actions that could cause bodily harm or death A Caution identifies conditions and actions that could damage the Analyzer the equipment under test or cause permanent loss of data A A Warning To avoid possible electrical shock or personal injury follow these guidelines Use this Analyzer only in the manner specified by the manufacturer Do not use the product if it operates abnormally Plug the main power cord only into a power outlet that has a protective earth contact to connect the chassis of the Analyzer to ground Do not use extension cords without earth ground or a hazardous condition may result Turn off the
74. ge the displayed signal on a plot 1 Select the plot name from the Plots menu 2 Select the name of the signal to be displayed Statistics Zero Setup Help ae PE o Monitor Plot 1 Monitor Plat 2 Volume Monitor Plat 3 Away Pressure Single Flat d Low Pressure High Pressure I y gen fec113 bmp The desired signal name should appear on the title of the plot and above the statistics to the right of the plot The statistics and the plot now reflect the new signal and are displayed in the selected units for that signal To change the units for a signal Select Signal Units from the Setup menu All statistics and plots reflect the current units for the assigned signal 4 29 VT Plus HF Operators Manual Zeroing The Analyzer can be zeroed either automatically or manually Zeroing corrects the flow and pressure sensors for offset to get a more accurate reading To switch the Analyzer between automatic and manual zeroing l From the Setup menu select the Zeroing menu The current zeroing mode has a check next to its name 2 Select the desired zeroing mode Manual or Automatic Manual Zeroing When the Analyzer is in manual zero mode no automatic zeros occur Periodically it is a good idea to zero the signals on the Analyzer to null any offset errors in the flow and pressure sensors The Analyzer has two ways to perform a manual zeroing 1 Select Zero from the menu 2 Choose Zero All or
75. gs c Choose Breath Detect and modify as needed Expiratory Testing 1 Connect the expiratory hose to the flow port on the right side of the Analyzer 2 Connect the flow exhaust port on the left to the ventilator using standard breathing hoses Inspiratory Hose Ventilator VT PLUS HF y d Expiratory Hose Outlet Inlet Figure 2 3 Connecting the Analyzer to the Expiratory Limb of the Breathing Circuit fec009 eps 2 5 VT Plus HF Operators Manual 3 Ensure that the breath detection mode 1s set to Unidirectional Expiratory a Go into Setup b Choose Settings c Choose Breath Detect and modify as needed The Analyzer displays a screen showing the flow of gas delivered by the ventilator High Flow 14 d Statistics Mint 168 T Max 154 H Avg H Hp 166 B Tidal Vol B B ml PEF Bia LFH E D LEH Breath Fate BH bpm fec049 bmp The instantaneous flow rate displays in large numbers in the upper right portion of the screen The flow statistics min max and average are shown below in the center right portion of the screen A subset of the breath parameters 1s shown below the flow plot The following adjustments can be made to the screen e Switch between the high and low flow ports Press the RANGE soft key e Change the measurement units LPM CFM LPS Press the UNITS soft key e Change the plot scaling Press the RESCALE soft key The new scaling is based on the minimum and maximum
76. he Analyzer corrects all flow measurements to conditions of ambient temperature and pressure without adjusting for the volume of water vapor The ambient pressure is obtained from the measured barometric pressure The user sets the ambient temperature by using the setup menu It should be noted that the relative humidity setting on the Analyzer is used only for the BTPS and STPD correction BTPS stands for Body Temperature and Pressure Saturated with water vapor In this compensation mode the flow rate and therefore volumes are corrected such that the reported flow 1s equal to the flow if the gas temperature and pressure were changed to body conditions 37 C and ambient pressure Further the flow is compensated to add the amount of water vapor as if to make the gas fully saturated 100 relative humidity In this correction the relative humidity setting is used to determine the amount of water vapor that must be added STPDO stands for Standard Temperature and Pressure Dry In this compensation mode the flow rate and therefore volumes are corrected such that the reported flow is equal to the flow if the gas temperature and pressure were changed to standard conditions 0 C and 760 mmHg Further the flow is compensated to subtract the amount of water vapor as if the gas were dry 0 relative humidity In this correction the relative humidity setting 1s used to determine the amount of water vapor that must be subtracted STPD21 stand
77. he BACK soft key to return to the Settings menu Entering a Barometric Pressure Value 2 10 To enter a barometric pressure value 1 From the Gas Settings menu highlight Barometric Press 2 Press the MODIFY soft key to display the value field 3 Input the desired value from the keypad Connection and Setup Setting Testing Parameters Note The Analyzer accepts barometric pressure values between 0 and 999 mmHg No decimal values or fractions are allowed 4 Press the ENTER soft key to save the change or the ESCAPE soft key to cancel the change 5 Press the BACK soft key to return to the Settings menu Breath Detection The Analyzer can be used to measure parameters on a breath to breath basis To measure breath parameters the mode of breath detection must be set The breath detection options are shown in Table 2 2 Table 2 2 Breath Detection Options Bi directional breath detection Use this breath detection mode when analyzing both inspired and expired breath data or when the Analyzer is connected between the load lung simulator and the Y piece in the breathing circuit Unidirectional inspired only Use this breath detection mode when the Analyzer is analyzing only inspired breaths or when the Analyzer is connected in the inspired limb of the ventilator breathing circuit Unidirectional expired only Use this breath detection mode when the Analyzer is analyzing only expired breaths or when the Analyzer is c
78. ied This is used when measuring very noisy signals None of the ventilator parameters are valid when the filtering is turned on Medium Filtering This indicates that the filtering option is turned on and the filter is set to medium filtering In this mode all of the signals flow and pressure have a Digital Signal Processing DSP low pass filter applied This is used when measuring very noisy signals None of the ventilator parameters are valid when the filtering is turned on Hard Filtering This indicates that the filtering option is turned on and the filter is set to hard filtering In this mode all of the signals flow and pressure have a Digital Signal Processing DSP low pass filter applied This is used when measuring very noisy signals None of the ventilator parameters are valid when the filtering is turned on L Operation 3 Screen Objects Instantaneous Numeric Data The digital value of the plotted signal is displayed to the right of each plot d LP This value is updated approximately twice a second This value is the average of the signal over the previous 500 milliseconds fec046 bmp The Analyzer allows the user to select the desired units for each of the measured signals For example pressures can be displayed in mmHg kPa bar mbar atm inH2O inHg cmH20 or mmHg Pressing the UNITS soft key changes the unit of measurement for the displayed signal value Pressing the UNITS soft key repeatedly causes the
79. in expiratory only breath detect mode The Analyzer cannot keep up with the data input The Analyzer can buffer a few seconds of data when it is busy changing screens and such Corrective Action Ensure that pressure is within the specified range of the Analyzer Ensure that pressure is within the specified range of the Analyzer Ensure that pressure is within the specified range of the Analyzer Call Service If error message repeats the Analyzer is installed in the ventilator circuit backwards Ensure the INLET flow connection on the Analyzer is nearest to the INSPIRATORY hose from the ventilator Ensure that a load Test Lung is installed in the ventilator circuit and that the circuit is not open to air i e an unconnected hose Decrease lung compliance so that the change in airway pressure is greater than 5 cmH O during the breath A better solution use the bi directional breath detect mode If the error message appears several times during normal monitoring i e no keys are being pushed call factory for service Error Message Zero Time Out Transmit Buffer Overflow No Printer Selected Printer Not Selected Printer Time out Table B 1 Error Messages cont Description A flow zero isn t complete after 150 attempts More than 1000 characters are waiting to be sent Users try to print with no printer selected The printer s select line doesn t stay high A
80. ing or zeroing oxygen ZERO Apply Ory Air at gt 16 LPH CAL APPIlY 166 Oxygen at gt 16 LPM fec075 bmp 2 20 4 Press the ZERO soft key Connection and Setup Utilities Press OK to start 21 O calibration Allow the full 2 minute period Do not press 5 SKIP 6 Verify that the O2 reading is 20 9 0 1 7 Press the CAL soft key 8 Apply 10 lpm of dry 100 oxygen to the high flow inlet or exhaust 9 SKIP Press OK to start 100 O2 calibration Allow the full 2 minute period Do not press 10 Verify that the O reading is 100 0 1 11 Press the BACK soft key to return to the Utilities menu Note If the oxygen sensor cannot be calibrated it may need to be replaced Refer to Maintenance Service and Calibration Oxygen Sensor Replacement System Diagnostics These functions are for the technical service personnel to use while repairing the Analyzer They include Zero All AD Diagnostics and Signal Diagnostics Linearization This option is most useful to technical service personnel repairing the Analyzer There is no input but the calibration data for each sensor is stored and displayed so a checksum test can be performed to make sure the sensor data is still valid To check linearization data l From the Utilities menu highlight Linearization The Linearizaion Info screen displays Linearization Info Serial Checksum HF Valid Serial Checksum LF Valid 1004 B830h
81. ings menu Ambient Temperature This setting is the room temperature air flowing through the high or low flow ports To change ambient temperature l From the Gas Settings menu highlight Ambient Temp 2 Press the MODIFY soft key to display the value field 3 Input the desired value from the keypad Note The Analyzer accepts temperatures between 0 and 99 C No decimal values or fractions are allowed 4 Press the ENTER soft key to save the change or the ESCAPE soft key to cancel the change 5 Press the BACK soft key to return to the Settings menu Relative Humidity This setting is the relative humidity in the air flowing through the high and low flow ports and is used only for STPD and BTPS corrections The relative humidity is not used in calculating the effective viscosity on the Analyzer however the gas calculator in the VT Plus PC software does use relative humidity in determining the effective viscosity of user defined gases To change relative humidity l From the Gas Settings menu highlight Rel Humidity 2 Press the MODIFY soft key to display the value field 2 9 VT Plus HF Operators Manual Input the desired value from the keypad 4 Press the ENTER soft key to save the change or the ESCAPE soft key to cancel the change 5 Press the BACK soft key to return to the Settings menu Note Use only dry gases with the Analyzer Do not use with heated humidified gases using humidified gases at room tempe
82. ins outlet using the supplied power cord Turn the switch on Adjust screen contrast using multiple pushes of the contrast key on the side of the Analyzer display Replace fuse with one of correct rating as marked on the Analyzer rear panel or as specified in the manual If problem persists call Service If problem persists call Service Adjust screen contrast using multiple pushes of the contrast key on the side of the Analyzer display Adjust screen contrast using multiple pushes of the contrast key on the side of the Analyzer display Adjust contrast to diminish effect VT Plus HF Operators Manual Table C 1 Troubleshooting cont Problem Possible Cause Corrective Action Out of Range messages appear Measured signals out of Ensure that all pressures and specified range flow rates are within the Analyzer specified limits Units are not set to those used for the range specifications User mistakenly assumes that range is not exceeded due to readings in the different units For example monitoring pressures in psi while trying not to exceed a range specified in cmH20 Ensure the units selected are the same as the specified limits Unit calibration is incorrect If problem persists call Service Tidal Volumes are erratic in bi Breath detection threshold set Set the breath detection directional breath detect mode too low Noise from ventilator is threshold to a higher value causing false breaths Tidal volumes
83. instrument to cycle through the various possible units The selected units of measure remain in memory even if the mode has been changed or if the Analyzer has been turned off The selected gas type appears in the area below the UNITS soft key Statistics On each of the screens except Full Breath Parameters and Monitor the minimum maximum and average values of the plot are displayed to the right of the plot as shown below Statistics Min 53 5 Max 3T Z Bug B BH fec044 bmp These values are calculated continually until a new screen is selected or until the CLEAR soft key is pressed 3 9 VT Plus HF Operators Manual Selecting Breath Parameters The Analyzer calculates 17 breath parameters for every breath Parameters Breath kate Ex Time In Time Ex Hold In Hald I E Ratio FIF MAP IFF FEEF Minute vols Tidal al PIF FEF Base Flows Compliance z Bara Press Gas 000008 F3 E31 E L1 L1 L1 P1 L1 P1 L1 L1 P1 A Set all screens to the same parameters fec048 bmp The user can select up to four of these parameters to be displayed with each of the screens To select parameters for display on a specific screen 1 Select the screen for which the parameters are to be added For example to select parameters for addition to the Flow screen press the FLOW O key 2 Press the PARAMETERS S key to display all possible parameters An X in the small box adjacent to a paramete
84. ion mode and the selected flow port System messages such as ZEROING also appear here Menu Bar VT for Windows provides a menu bar with pull down options for easy access to the program functions Figure 4 2 shows the menu bar and Table 4 2 lists the menu bar options with a description of each Table 4 3 lists the options and descriptions of the Setup submenu NT Plus for Windows File Communications Plots Statistes Zem Setup Help fec082 eps Figure 4 2 VT for Windows Menu Bar 4 6 Remote Operation Menu Bar Table 4 2 Menu Bar Options Open Deseription OO This menu gives access to the file handling and printing functions of this software For a complete description see the Data and File Handling section in this chapter Communications The communications menu allows selection of the communications port and the serial data mode For a complete description see the Serial Communications section in this chapter The plot menu provides access to the plot re scaling functions It allows changing of the plot on any of the monitors and turn on or off the automatic re scaling For a complete description see the Plots section in this chapter Statistics The statistics menu gives access to the clear function for any or all statistics The CLEAR ALL function clears the statistics for all of the signals at once to clear individual signals select the option with its name The zeroing menu allows manual zeroing any or all
85. ls so that the ventilator 1s triggered by an effort negative pressure at the lung during the expiration hold period of the ventilator s breath cycle Note Use the Synchronized Intermittent Mandatory Ventilation SIMV mode or Intermittent Demand Ventilation IDV mode if the ventilator provides it 4 Check the control setting by applying upward force at the back of the test lung and observing if the ventilator triggers as desired 5 Setalow breath rate to allow the distinction to be made between a triggered assist breath and a mandatory breath 3 31 VT Plus HF Operators Manual Ensure that the ventilator is delivering breaths in a steady manner Gently lift the back of the test lung top plate during the expiratory hold period in a smooth steady pull to create negative pressure Repeat several times using different forces to approximate the minimum patient effort required to trigger the ventilator Note To carry out a more repeatable performance study such as the determination of the work of breathing attach an external motor driven cam system or a pneumatic actuator to the top plate of the test lung The Full Test screen shows all of the ventilator parameters The minimum pressure and the assist pressure are displayed on the lower left column High Frequency Oscillator Mode 3 32 The Analyzer can test high frequency flow and airway pressure To access the High Frequency Oscillator mode Press the MORE 4 key
86. most significant while the sensors for the pressure measurements are warming up If the warm up period is skipped be aware that the offset drift may be significant for the first 40 minutes of operation If the Analyzer has been through an extreme temperature change additional time may be required for the warm up If the Analyzer has only been turned off for say a minute the warm up period may be skipped The zeroing function for pressure acts as a fare function As such the applied pressure when the signal is zeroed 1s saved as the new zero reading The applied pressure during zero would then be read as zero Measured pressures would have an offset error equal to the applied pressure when the Analyzer was zeroed Airway Zeroing A Special Case The airway pressure may be zeroed manually using the ZERO 7 key while the airway pressure screen 1s active The airway pressure is also zeroed automatically when the flow zero occurs Note that the flow zero may either be performed manually or in an auto zero mode Barometric Pressure Another Special Case A 2 The offset drift can be adjusted on the barometric pressure measurement by entering the correct barometric pressure on the Setup gt Settings menu Although typically not needed it provides a means for the user to ensure that the barometric pressure measurement is as accurate as possible Appendices Gas Analyzer Tutorial Oxygen Measurements Oxygen measurement is performed using a gal
87. must cross to trigger a change in the breath phase Higher flow rate thresholds yield less sensitive breath detection Lower thresholds yield more sensitive breath detection To enter a new breath detect threshold l From the Setup menu select Breath Detect then select Threshold The following dialog box displays Breath Detect Threshold Enter a new value for the breath detect threshold 0 00 Lom E Help 7 Defaults fec115 bmp 2 Enter a new value and click OK Gas Settings Through the Gas Settings option the Analyzer can compensate for the effects of gas temperature viscosity molecular weight and relative humidity on flow measurement as well as correct flow calculations to one of several standard conditions For more information on the gas settings refer to System Setup To change the gas settings 1 From the Setup menu select GAS SETTINGS The following dialog box appears allowing changes to be made 4 31 VT Plus HF Operators Manual 4 32 ai Gas Settings Das Setting Das Type Temperature Relative Humidity Gat Correction Ambient Temperature Correction Made ATP fec116 bmp 2 Enter changes as desired 3 Ifnecessary click the Advanced button The Gas Settings Date Entry dialog box displays Gas Settings Data Entry Inhaled Gas Settings Exhaled Gas Settings Temperature Temperature iscosity Molecular Weight 0 00 g mole Molecular Weight 0
88. n To avoid damage to the Analyzer or adverse affects on its performance follow these guidelines e Pressure inside the low flow port should not exceed 120 cmH O e Measure only dry gases with the low flow port Do not use this port to measure exhaled or artificially humidified gases High Pressure and The high pressure ports are primarily designed for testing wall and tank pressurized gas sources The connector mates to standard oxygen DISS fittings as used on oxygen supply hoses Note that only the side can be used to measure fluid pressure A Caution To avoid damage to the Analyzer or adverse affects on its performance follow these guidelines e Applied differential pressure to either side of the high pressure port should not exceed 100 psi e The negative side of the high pressure port cannot be used to measure fluid pressure 2 3 VT Plus HF Operators Manual Low Pressure and The low pressure ports connect using standard luer fittings Note that only the side can be used to measure fluid pressure A Caution To avoid damage to the Analyzer or adverse affects on its performance follow these guidelines e Pressures applied to either side of the low pressure port should not exceed 500 mmHg e Negative side of the low pressure port cannot be used to measure fluid pressure Test System Setup High or low flow ranges can be used for ventilator testing One test setup is measuring ve
89. n 25 hour format 0 to 23 and MM 1s the minutes a number between 0 and 59 Note For hour and minute values less than 10 enter a leading zero For example if the time is 9 05 enter 0905 2 13 VT Plus HF Operators Manual 4 Press the ENTER soft key to save the change or the ESCAPE soft key to cancel the change 5 Press the BACK soft key to return to the Settings menu Note For hour and minute values less than 10 enter a leading zero For example if the time is 9 05 enter 0905 Date The Analyzer displays the date with MM as the month DD as the date and YYYY as the year To enter the date 1 Highlight Date 2 Press the MODIFY soft key to display the value field 3 Input the desired value from the keypad Enter the date with MM the number between 1 and 12 corresponding to the month DD the number between 1 and 31 corresponding to the day of the month and YYYY the year See Date Format below Note For values of month and date less than 10 enter a leading zero For example if the month is February enter 02 4 Press the ENTER soft key to save the change or the ESCAPE soft key to cancel the change 5 Press the BACK soft key to return to the Settings menu Date Format The Analyzer has two date formats as shown below MM DD YYYY and DD MM YYYY To change the format 1 Highlight Date Format 2 Press the MODIFY soft key to toggle to the desired value 3 Press the ENTER soft key to save the
90. n Analyzer System Operation Manual from Allied Healthcare Products Inc for the format of serial commands The RT200 Functions supported by the Analyzer are listed in Table 3 6 Table 3 6 Supported RT200 Functions a Han Pressure Measurement Gong pm Low Flow Measurement O 6 N RE ET E NN Low Flow Measurement 0 NO Er High Flow Measurement 0 N me High Flow Measurement Air _ High Flow Measurement 0 NO Tidal Volume O N e pee BENTL Minute Volume O N eee o P LE o PU Liege rasa 3 29 VT Plus HF Operators Manual The soft keys for the RT200 screen are SETUP RS232 displays a screen for setting the baud rate number of data bits and the terminator character au ATP Baud Rate 3600 Data Bits bits Terminator CR Only fec071 bmp These settings affect only the RT200 emulation mode and not the other serial communication modes The default settings are 9600 baud 7 bits and a termination character of carriage return only PEAK toggles the RT200 peak detect mode on and off for flow and pressure signals when in peak detect mode the peak of the current signal flow or pressure is shown for each breath RESET resets the RT200 mode turning off any active functions and resetting the special functions FCTN displays a menu that allows the user to start a RT200 function and enter the special function values associated with that RT2
91. n to the previous menu Setting Testing Parameters To adjust the settings l From the Setup screen highlight Settings and press the ENTER soft key The Settings menu displays Change settings to pre selected options or to numeric values by highlighting the option and pressing the MODIFY soft key For example if one selects Correction Mode then presses MODIFY he can scroll through the available Correction Mode options If one selects an option that requires a numeric entry such as BD Threshold and press MODIFY the entered data is cleared and the field can accept numeric input from the keypad until the ENTER key is pressed 2 7 VT Plus HF Operators Manual Note The option displayed when exiting the settings screen is saved and used for future measurements The following is a description of each setting Gas Settings This setting tells the Analyzer what type of gas 1s flowing through the high and low flow ports The Analyzer uses this information to improve the accuracy of the flow calculations Note Failure to enter the correct value causes the flow and volume calculations to be in error To modify the gas settings 1 From the Setup menu highlight Settings and press the ENTER soft key 2 Highlight Gas Settings and press the MODIFY soft key Depending on the option a value can be pre selected or input from the keypad The following is a description of each of the options Gas Type The possible values f
92. ntilator parameters using a test lung Either a bi directional flow mode as shown in Figure 2 1 or a unidirectional flow mode as shown in Figures 2 2 and 2 3 below can be chosen however the bi directional mode is preferred Bi directional Flow Mode 1 Connect the ventilator using a Y piece adapter to the flow inlet port on the right of the Analyzer 2 Connect the flow exhaust port on the left to the test lung using standard breathing hoses f Inspiratory Hose Ventilator Analyzer FA Outlet V Expiratory Hose Figure 2 1 Connecting the Analyzer in a Bi Directional Flow Mode fec002 eps 3 Ensure that the breath detection mode is set to bi directional a Go into Setup b Choose Settings c Choose Breath Detect and modify as needed 2 4 Connection and Setup Connecting the Analyzer Unidirectional Flow Mode Alternatively the Analyzer can be used to measure only inspiratory or expiratory gas flow as described below Inspiratory Testing 1 Connect the inspiratory hose to the flow port on the right of the Analyzer 2 Connect the flow exhaust port on the left to the test lung using standard breathing hoses Inlet Outlet Inspiratory Hose VT PLUS HF Ventilator Expiratory Hose Figure 2 2 Connecting the Analyzer to the Inspiratory Limb of the Breathing Circuit fec008 eps 3 Ensure that the breath detection mode is set to Unidirectional Inspiratory a Go into Setup b Choose Settin
93. ode using RS232 serial port for special applications use of Analyzer with VT for Windows PC software for recording graphs and logging data to a computer Output Ports RS232 serial port and parallel printer port Operating Environmental Conditions Temperature Range 10 C to 40 C Ambient Humidity 0 80 non condensing to 31 C decreasing to 50 at 40 C Barometric Pressure 8 to 18 psia Vibration ene Devices intended to be used on tabletop or other stable surface Storage Environmental Conditions Temperature Range 25 to 50 C im Viggo EE 0 to 95 non condensing C Power Requirements Maximum Over voltage 264 V ac Input Voltage Range 100 to 240 V ac Input Frequency Range 50 60 Hz Introduction and Specifications 1 Specifications Power Consumption 132 VA Fuse RUNG D 0 5 Slo Blo Performance Specifications Low Pressure Port Maximum Applied Pressure 60 psi Operating Pressure Differential 500 mmHg 10 psi Common mode 30 psi Span Accuracy seseeeeeee 0 80 of reading or 1 5 mmHg whichever is greater Frequency Response 210 Hz E ifo o PME SN 0 1 mmHg Sample Rate 100 H
94. of 21 C and a standard barometric pressure of 760 mmHg BTPS Conversion for gas flow and volume to body temperature of 37 C with 100 relative humidity Special Functions Trend Test The Analyzer provides an automated Trend test that checks a single breath parameter over an extended period of time to see if it deviates from limits set by the user The limits are set as a percent variation from the initial measured value To access the Trend test screen use either of the following procedures 1 Press the FULL 5 key to display the breath parameters 2 Press the soft key TREND soft key Or 1 Press the MORE 4 key 2 Use the A and V soft keys to highlight Trend Test 3 Press the soft key ENTER soft key The Trend Test Setup screen displays Trend Test Test Parameter Minute Vol Limit 5 5 Current Value 0 000 L Use Printer Ho fec057 bmp To set test parameters 3 21 VT Plus HF Operators Manual 3 22 12 2 4 E XA Use the A and soft keys to highlight Test Parameter Press the MODIFY soft key until the desired breath parameter displays The most recent measurement of the selected parameter is displayed as the Current Value Use the A and V soft keys to highlight 9o Limit Press the MODIFY soft key then use the keypad to enter the percent change representing a deviation from acceptable limits Percent values range from 1 to 99 Remember to enter leading zeros for values less than 10 Fo
95. oftware l Select File then Load Flash from the menu The Analyzer operating software is stored on two layers 1 flash code file operating code and 2 text Click the Browse button to point to the file FLASH hex as the code file and to the file VP TEXT hex as the text file Click OK to begin downloading When communications are established the Analyzer splash screen displays and a Loading Flash dialog appears on VT for Windows with a status bar When the download is complete the Analyzer returns to the default screen The download version can be verified by going to the information screen on the Analyzer 4 27 VT Plus HF Operators Manual Plots Automatically Re scaling Plots By default VT for Windows attempts to re scale plots so that the entire plot is visible When a re scale occurs the high and low ranges on the plots are determined by the min and max statistics for the signal shown on the plot The monitor plots and the single plot are re scaled every time they reach the end of the plot The loop plots are re scaled on every breath Automatic re scaling may be turned off by unchecking the box next to the plot name in the Plots Scaling Auto Scale menu as shown below Statistics era Setup Help Scaling He Scale Ctri A Monitor Plot Auto 5 cale Auto Scale Al Cit Monitor Plat 3 Manual Scale d epo 7 BE GN ER Monitor Plot 2 SE d m Monitor Plot 3 v Single Plot m Loop Plat 1
96. ol 2975 6 nl l E Ratio fec053 bmp The volume signal is the integral of the flow signal measured in either the high or low flow ports The flow port that is integrated is selected by selecting the high or low flow range from within the flow screen Flow Zero Press the FLOW ZERO soft key to zero the flow reading Units Press the UNITS soft key to change the units of measure for the volume screen Possible units of measure for this screen include l Liters ml Milliliters CF Cubic Feet Re scale Press the RESCALE soft key to change the scale on the plot of data to a more appropriate window of values Note RESCALE uses the current min max values to determine plot limits Clear Press the CLEAR soft key to reset the statistics and re start the plot The user can select the breath parameters displayed on this screen by following the instructions under Selecting Parameters Note The volume signal is integrated from either the high or low flow signals To select which flow signal is used to calculate volume 1 Press the FLOW O key 2 Press the RANGE soft key until the screen corresponding to the desired flow signal high or low displays 3 16 Operation 3 Oxygen Screen Oxygen Screen The Oxygen screen displays the signal and statistics for the oxygen sensor T3 B JB B Statistics Mint 28 9 23 B Maxi 26 9 Avgi zB High Flow Ba H 81 LPM Base Flow B D LPH Gas Air Baro Press 638 1 mmHg
97. onnected in the expired limb of the ventilator breathing circuit Off Use this mode to measure continuous flow and volume without attempting to detect breaths Use this mode to integrate a flow over a long period of time Setting Breath Detection Mode To select the breath detection mode l From the Gas Settings menu highlight Breath Detect 2 Press the MODIFY soft key to toggle to the desired value 3 Press the ENTER soft key to save the change or the ESCAPE soft key to cancel the change 4 Press the BACK soft key to return to the Settings menu Setting Breath Detect Threshold The Analyzer breath detection algorithm uses a flow rate threshold that the flow must cross to trigger a change in the breath phase Higher flow rate thresholds yield less sensitive breath detection Lower thresholds yield more sensitive breath detection To enter the breath detect threshold l From the Gas Settings menu highlight LF Threshold to adjust the low flow threshold or BD Threshold to adjust the high flow threshold 2 Press the MODIFY soft key to display the value field 3 Input the desired value from the keypad VT Plus HF Operators Manual 4 Press the ENTER soft key to save the change or the ESCAPE soft key to cancel the change 5 Press the BACK soft key to return to the Settings menu Inspiratory Expiratory Tidal Volumes The Analyzer measures tidal volume when performing ventilator measurements This option allows the use
98. onnected to the currently selected flow channel Both flow channels can be tested however the appropriate channel must be selected using the RANGE function in the Flow Mode screen 3 To enter the compliance of the test chamber test lung press the A and F soft keys to highlight Compliance 4 Press the MODIFY soft key Use the keypad to enter the compliance in l cmH 0 Be sure to use leading zeros so that a number is entered for all five digits 5 To enter the duration of the test press the A and V soft keys to highlight Test Time 6 Press the MODIFY soft key 3 24 Operation 3 Special Functions 7 Use the keypad to enter the duration of the Leak test in hours minutes and seconds Six digits must be entered to set the test time The time is entered in the following format HHMMSS HH is the hours 0 99 MM is the minutes 0 59 and SS is the seconds 0 59 Be sure to use leading zeros to enter values less than 10 For example to enter a time of 1 09 05 press the following sequence of keys 0 1 0 9 0 5 To run the test 1 After all of the test parameters are set pressurize the test chamber test lung 2 Press the START soft key to begin testing A screen similar to the one shown is displayed Leak Test Compliance B B ml cmHz Vol Lost HAL Start Pressi 6 Be Kpa Leak Rates D Crol tleds Start Time 11 15 38 Time Left BH z3 zb RESCRLE 3 The display shows a pressure plot and instantaneous pr
99. or Gas Type are shown in Table 2 1 Table 2 1 Gas Type Values 100 Nitrogen 100 Nitrous Oxide 100 Carbon Dioxide 100 Oxygen 30 Oxygen and 70 Helium blend User Defined User selects custom gas mixture This option requires the VT for Wondows PC software Note For balance gas settings the oxygen concentration is measured using the Analyzer oxygen sensor located on the high flow port If the low flow port is to be used allow gas to flow through both high and low flow ports so that the oxygen can be measured To modify the gas type 2 8 Connection and Setup Setting Testing Parameters l From the Gas Settings menu highlight Gas Type 2 Press the MODIFY soft key until the desired value displays 3 Press the BACK soft key to return to the Settings menu Gas Temperature This setting is the temperature of the gas flowing through the high or low flow port The Analyzer uses this information to improve the accuracy of the flow measurements All temperatures are in C To enter a gas temperature l From the Gas Settings menu highlight Gas Temperature 2 Press the MODIFY soft key to display the value field 3 Input the desired value from the keypad Note The Analyzer accepts temperatures between 0 and 99 C No decimal values or fractions are allowed 4 Press the ENTER soft key to save the change or the ESCAPE soft key to cancel the change 5 Press the BACK soft key to return to the Sett
100. or products which are not in as new and resalable condition are not eligible for credit return and will be returned to the customer The Return Procedure see below must be followed to assure prompt refund credit Restocking Charges Products returned within 30 days of original purchase are subject to a minimum restocking fee of 15 Products returned in excess of 30 days after purchase but prior to 90 days are subject to a minimum restocking fee of 20 Additional charges for damage and or missing parts and accessories will be applied to all returns Return Procedure All items being returned including all warranty claim shipments must be sent freight prepaid to our factory location When you return an instrument to Fluke Biomedical we recommend using United Parcel Service Federal Express or Air Parcel Post We also recommend that you insure your shipment for its actual replacement cost Fluke Biomedical will not be responsible for lost shipments or instruments that are received in damaged condition due to improper packaging or handling Use the original carton and packaging material for shipment If they are not available we recommend the following guide for repackaging m Use a double walled carton of sufficient strength for the weight being shipped Use heavy paper or cardboard to protect all instrument surfaces Use nonabrasive material around all projecting parts Use at least four inches of tightly packed industry approve
101. ot is captured for printing BEGINNING Rewinds the data file to its beginning this OF FILE only affects data playback All recording is done at the end of the data file D REWIND Backs up the data file during playback to the previous event marker in the file automatic event markers provide periodic events for the file to be rewound or forwarded to CONTINUOUS May be enabled during data playback to allow for continuous play in continuous play the data file automatically rewinds to the beginning of the file as soon as the end of the file is reached D FORWARD Advances the data file during playback to the next event marker in the file automatic event markers provide periodic events for the file to be rewound or forwarded to END OF FILE Advances the data file to its end this affects only data playback Speed Control 30 SPEED Adjusts the playback speed the number CONTROL shown is the time in milliseconds ms between waveform samples The data sample rate for the Analyzer is 20 ms Therefore a number larger than 20 results in slower than normal playback and smaller numbers yield a fast playback speed Remote Operation Data and File Handling Event Markers Two buttons allow placement of event markers into a file assisting the user during data collection Annotate and Time During file recording these events appear in the Event panel Pressing the Time button during recording places a time stamp in the data file
102. pm Lee 2 0 of range Resolution 0 01 lpm VT Plus HF Operators Manual Frequency Response 225 Hz or t10 90 40 ms whichever is greater Sample Rate 100 Hz Dynamic Resistance 2 00 cmH5O 60 Ipm Low flow Dropout 25 pm Breath Detect Threshold user settable 2 0 lpm Volume Range gt 60 Notes e Tidal Volume Accuracy 3 of reading or 10 ml whichever is greater e Volume Accuracy tested to 7 liters e Flow accuracy is specified for dry air or oxygen e Do not use with humidified gases Low Flow Port Maximum Flow Hate absolute value 50 Ipm Operating Flow Range 25 Ipm ACCUTACV n 1 0 of range ISesolullon rrr rennen e 0 01 lpm flow gt 1 lpm 0 001 Ipm flow 1 lpm Frequency Response gt 25 Hz or t10 90 40 ms whichever is greater Sample Rate 100 Hz Dynamic Resistance 2 5 cmH20 5 Ipm Low flow Dropout 0 01 lpm Breath Detect Threshold user settable 0 50 lpm Volume Range gt 60 Note e Tidal Volume Accuracy 3 of reading or 5 ml whichever is greater e Volume Accuracy tested to 1 liter e Flow accuracy is specified for dry air or oxygen e Do not use with humidified gases e Below 0 25 lpm me
103. quency ventilators Packing A Caution To avoid damage to the Analyzer or adverse affects on its performance adhere to the following e Service of the Analyzer other than replacement of minor components such as the fuse and O sensor service should be done only by qualified service personnel e Internal flow port filters for protecting the flow sensors are only to be changed by qualified service personnel e Use high low flow protective caps when transporting to keep foreign debris from entering high low flow ports e Calibration of the tester should be left to qualified Fluke Biomedical Service personnel to ensure that the Analyzer remains under warranty If repairs or calibration are required return the Analyzer to the factory or the nearest service center l pe d x a d dM Before returning the Analyzer for factory service contact Fluke Biomedical Service Center for a required Return Authorization Number Provide the following information The Analyzer serial number The specific steps that reproduce your problem A daytime phone number Your name company A fax number if available Pack the instrument carefully using the original shipping container and packing materials supplied by Fluke Biomedical If the original packing materials are not available refer to Return Procedures for a list of preferred materials or contact Fluke Biomedical for replacement packing Note Failure to pack the instrument prop
104. r defined gases Therefore when a new flowing gas temperature 1s entered by the user the Analyzer calculates the new viscosity For air the sensitivity to temperature is about 0 25 of reading per C The Analyzer viscosity calculation for the gas settings assumes that dry gas is being used Increased water vapor content can slightly affect the flow accuracy At room temperature a flow measurement error of 0 5 of reading can occur if the relative humidity of the flowing gas is 50 A 3 VT Plus HF Operators Manual Note Never apply humidified gases to the Analyzer flow sensors Condensation on the flow sensors causes errors in the flow readings until it 1s dried off Balance Gas Settings The gas settings allow for gas combinations with oxygen For example the Analyzer can be set to use Helium balance Oxygen In this mode the Analyzer uses the oxygen measurement to determine the oxygen concentration and then assumes the balance of the gas concentration is helium The Analyzer calculates the effective viscosity for the combination gas at the specified temperature The oxygen concentration used in the gas setting for the balance gases is automatically updated every second Note For air oxygen mixtures use the nitrogen balance oxygen N bal O2 gas setting The flowing gas is assumed to be dry and therefore the relative humidity used in the viscosity calculation is assumed to be zero percent BTPS and STPD Corrections T
105. r example 5 96 is entered as 05 95 Press the ENTER soft key Use the A and VW soft keys to highlight Use Printer Press the MODIFY soft key If Yes is selected a report is printed that list all breath parameters with a time date stamp every time an incident occurs To run the test l 2 Ensure that the ventilator 1s on and that steady state conditions are reached Monitor the Current Value displayed to ensure that the breath parameter 1s as expected Press the START soft key to begin testing While the test is in progress the Trend Test screen displays the parameter being tested the current and starting values and the 96 difference between the two values The allowable 96 deviation limit the number of tests taken and the number of breaths incidents in which the limit has been exceeded is also displayed Trend Test Test Parameter Minute Vol Current Value L Starting Value L ra K Z Difference Limit of Tests of Incidents Elapsed Time 00 13 fec059 bmp To terminate the test press the STOP soft key A sample Trend Test report is shown below Operation 3 Special Functions TREND TEST REPORT 6 13 2000 VT PLUS HF S N 4294967295 Control Tech Incident Report Test Parameter Minute Vol Elapsed Time Current Value 40 333 L Starting Value Difference 41 x Limit of Tests 1 of Incidents Parameters Minute Vol L Breath Rate Tidal Vol ml Ex Time Pip
106. r name indicates that the parameter is to be added An empty box indicates that the parameter is not to be added Use the soft keys labeled A and V to highlight parameters 4 Press the ENTER soft key to select add or deselect not add a parameter Only four parameters can be viewed on a screen therefore an existing parameter must be deselected from the list before a new parameter can be selected 5 Repeat steps 3 and 4 above for each additional parameter to be changed Selecting the Set all screens to the same parameters option in the parameters screen displays the currently selected parameters on all screens If this option is deselected after having been in effect previous parameter selections for each screen must be reselected 6 Press the EXIT soft key to return to the previous screen Note Parameter selections are retained even after the Analyzer has been powered off 3 10 Operation 3 Flow Screens Flow Screens There are two types of flow screen high flow and low flow based on which Analyzer flow port is used High Flow Screen The High Flow screen displays the signal and statistics for flow in the high flow port of the Analyzer High Flow l d Statistics Min Max Aug 166 B Tidal Vol A A ml PEF mia LPM H D LEM Breath Fate D bpm fec049 bmp Range Press the RANGE soft key to change from a low flow screen to a high flow screen or back again Units Press the UNITS soft k
107. r to choose between the expiratory or the inspiratory tidal volume The default setting is inspiratory Note This setting applies only when the bi directional breath detection mode is selected To change between inspiratory and expiratory tidal volume l From the Gas Settings menu highlight Bi Dir Tidal Vol 2 Press the MODIFY soft key to toggle to the desired value 3 Press the ENTER soft key to save the change or the ESCAPE soft key to cancel the change 4 Press the BACK soft key to return to the Settings menu Zero Mode All pressure and differential pressure flow sensors in the Analyzer must be periodically zeroed or calibrated to a zero reference This zero function can be set to occur automatically at pre determined intervals or only when the user requests the function by pressing the key labeled ZERO 7 When a zero occurs valves inside the device open the sensors to ambient pressure and measure the zero value to be subtracted from future measurements Note Because no breath parameters are calculated for any breath in which a zero occurs it may be desirable to turn off automatic zeroing for a short while during a critical test To turn automatic zeroing on or off l From the Gas Settings menu highlight Zero Mode 2 Press the MODIFY soft key to toggle to the desired value 3 Press the ENTER soft key to save the change or the ESCAPE soft key to cancel the change 4 Press the BACK soft key to return to the Set
108. rature may cause flow measurement errors of up to 1 of reading for near saturated non condensing gases Correction Mode This setting calculates the flow volume of the air flowing through the high or low flow ports This value should match the correction mode of the device under test DUT To change correction mode l From the Gas Settings menu highlight Correction Mode 2 Press the MODIFY soft key to toggle to the desired value 3 Press the ENTER soft key to save the change or the ESCAPE soft key to cancel the change 4 Press the BACK soft key to return to the Settings menu Barometric Pressure The Analyzer constantly measures the barometric pressure and displays it on the Full Test screen This setting allows the user to fine tune the barometric pressure measurement The difference between the value measured by the Analyzer and the entered value is applied to future Analyzer measurements as a offset correction factor The correction factor is stored in nonvolatile memory and is remembered when the Analyzer is turned off and on Setting Barometric Pressure Units These settings represent the various units available to measure barometric pressure such as mmHg To change the barometric pressure units l From the Gas Settings menu highlight Baro Press Units 2 Press the MODIFY soft key to toggle to the desired value 3 Press the ENTER soft key to save the change or the ESCAPE soft key to cancel the change 4 Press t
109. ressure D CIO srctieaccacuicznuinsactivacoscuisgusiosaceeainacuiozatastctanvoreroranesaceaatoronnans Volume SO E geen ODA UE CBG E Full Breath Parameters Test Screen ler Unis E E TER De EE Ee NET U T E aM ES E Stacked Volume EE RT200 Emulation Mode Ae T S High Frequency Oscillator Mode 3 1 VT Plus HF Operators Manual 3 2 Operation 3 Measured Signals Measured Signals The Analyzer measures the following signals e High flow e Low flow e Airway pressure e Low pressure e Barometric pressure e High Pressure e Oxygen concentration e Calculated breath parameters High Flow The Analyzer has a high flow 300 LPM bi directional flow measurement Flow measurements can be either static flows no breath variations or ventilator waveforms 1 e both an expiratory and an inspiratory phase The flow measurement is made using a differential pressure drop across a resistive screen mesh This flow measurement can be used for pediatric adult ventilators or for determining the performance of many types of flow meters Valves switch between the low flow and the high flow measurements depending on the range selected in the display flow screens Low Flow The Analyzer has a low flow 25 LPM bi directional flow measurement The flow measurements can be either static no breath variations or ventilator waveforms 1 e both an expiratory and an inspiratory phase Flow measurements ar
110. s LPM In Time PEP LPM Ex Hold Base Flow LPM In Hold Compliance ml cmH20 I E Ratio O2 PIP Baro Press mmHg MAP Gas IPP PEEP O O O FPF N O O nM O O O O O0 eE O O H o Final Report Test Parameter Minute Vol Starting Value 28 686 L Starting Time 10245230 Ending Time 10 45 37 Elapsed Time 00007 Limit 5 S of Incidents of Tests 1 3 23 VT Plus HF Operators Manual Leak Test The Analyzer allows the user to test the leak rate of a sealed vessel or test lung A Leak test can be done using the high pressure low pressure or airway pressure signals to measure the leak rate of a sealed vessel or test lung A Caution To avoid damage to the Analyzer be sure that maximum pressure ratings are not exceeded when performing a Leak test See Specifications for absolute maximum pressure ratings for each pressure port To access the Leak test screen 1 Press the MORE 4 key 2 Use the A and V soft keys to highlight Leak Test 3 Press the ENTER soft key The Leak Test Setup screen displays Leak Test Current Pressure 7 74 Pressure Channel Low Press Pressure Unit Kpa Compliance 0 0 ml cmH2o Test Time 0 30 00 fec061 bmp To set test parameters 1 On the Leak Test Setup screen press the A and V soft keys to highlight Pressure Channel 2 Press the MODIFY soft key until the desired pressure channel is selected Note If Airway is selected the airway transducer is c
111. s for Standard Temperature and Pressure Dry In this compensation mode the flow rate and therefore volumes are corrected such that the reported flow is equal to the flow if the gas temperature and pressure were changed to standard conditions 21 C and 760 mmHg Further the flow is compensated to subtract the amount of water vapor as if the gas were dry 1 e 0 relative humidity In this correction the relative humidity setting 1s used to determine the amount of water vapor that must be subtracted Flow Zeroing The differential pressure transducer used to measure the flow rate is subject to baseline offset drift This is most pronounced during the Analyzer warm up period The Analyzer provides both a manual and an automatic zero function for zeroing the flow In measuring flow the same pressure transducer is used for both high and low flow ports A set of valves selects between high and low flow ranges Because one pressure transducer is used for both zeroing one flow range also zeros the other A 4 Appendices Gas Analyzer Tutorial In the manual zero mode if the user presses the ZERO 7 key when the Analyzer is at the Flow screen a message appears indicating that the flow must be removed from the currently selected flow port The user must remove the flow so that a correct zero reading can occur In the auto zero mode the Analyzer uses the valves that switch between the high and low flow ports to obtain a zero reading It
112. s the RT200 Emulation mode use either of the following procedures 1 Press the MORE 4 key 2 Use the A and V soft keys to highlight RT200 Emulation Mode 3 Press the ENTER soft key Or 1 Press the SETUP 8 key 2 Use the A and V soft keys to highlight SYSTEM 3 Press the ENTER soft key 4 Use the A and V soft keys to highlight Serial Mode 5 Press the MODIFY soft key until RT200 displays 6 Press the BACK soft key to return to the Setup screen 7 Press the BACK soft key again to exit the Setup screen and display the RT200 screen RT 200 5 43 Fi Cie F2 HS D ASE Command Fal 3 lit O2 H2 Received String Fdi x z Climm H5 nm5mREB5BF1BiBaH fec069 bmp In the emulation mode serial RS232 commands can be sent to the Analyzer in the format of the communication protocol used by the RT200 The status of the RT200 special functions are displayed in the boxes 00 01 F1 F2 The meaning of the special functions can vary depending on the active function Refer to the RT200 Calibration Analyzer Operation Manual from Allied Healthcare Products Inc The Command box displays the active command and the units of the command F41 3 lit O2 N2 If the peak mode is active the Command box displays peak at the end of 3 28 Operation 3 Special Functions the command string When a command is received it is displayed in the box named Received String Refer to Serial Interface for the R7200 Calibratio
113. sts the sound level of that beep To adjust the sound level of the keypad l Highlight Keypad and press the MODIFY soft key to toggle between Low High or Off Press the ENTER soft key to save the change or the ESCAPE soft key to cancel the change Press the BACK soft key to return to the Settings menu VT Plus HF Operators Manual 2 18 Errors When an error is made the Analyzer signals it with a beep This option adjusts the sound level of that beep To adjust the sound level of errors 1 Highlight Errors and press the MODIFY soft key to toggle between Low High or Off 2 Press the ENTER soft key to save the change or the ESCAPE soft key to cancel the change 3 Press the BACK soft key to return to the Settings menu Restore Defaults This option returns all values to the factory defaults listed below but does not change the device calibration To restore defaults From the System menu highlight Restore Defaults The Analyzer restores system values to the default displays a Restoring to defaults Please wait message After a few seconds a beep indicates defaults are restored and the display returns to the System menu Factory defaults are shown in Table 2 4 Table 2 4 Factory Defaults System Date Format MM DD YYYY Demo Data O Filtering None Display Cal Date Yes Serial Mode None Printer Options Printer Type None Graphics Text Only Audio Levels General Ke
114. t key to toggle between YES and NO 3 Press the ENTER soft key to save the change or the ESCAPE soft key to cancel the change 4 Press the BACK soft key to return to the Settings menu Serial Mode Use this option to control what data is available through the Analyzer serial port The possible options are shown in Table 2 3 Table 2 3 Serial Port Options Option Description O Comp Ctrl Computer Control specialized serial communications used by the VT for Windows PC Software contact your sales representative for the protocol if needed A serial mode that emulates the Allied RT200 serial communications 2 15 VT Plus HF Operators Manual To select the serial mode options follow these steps 1 Highlight Serial Mode 2 Press the MODIFY soft key to toggle to the desired value 3 Press the ENTER soft key to save the change or the ESCAPE soft key to cancel the change 4 Press the BACK soft key to return to the Settings menu Printer Options This setting allows selection of the print format for information The Analyzer can be connected to various printers and the following printer languages are supported e HP PCL 3 graphics text or text only e Epson PI graphics text or text only e ASCII printers in both 40 and 80 characters per line text only Read the printer user manual to determine if it is compatible with these printer languages Note A printer may require a special dip switch setting to
115. ta files by the user VT for Windows provides an interface for the user to mark events during data collection and generates three different file types as described in Table 4 6 Table 4 6 Generated File Types IS Description Extension E Generated when the user selects to save data to a file these files contain signal parameters and event information Signal file of raw waveforms the sig files are generated from the vtp files using a file conversion program This is done by selecting GENERATE A SIGNAL FILE from VT for Windows FILE menu bar Files must be closed to enable this option The sig files are in ASCII format and can easily be imported into your favorite spreadsheet Breath by breath calculated ventilator parameters the par files are generated from the vtp files using a file conversion program This is done by selecting GENERATE A PARAM FILE from the VT for Windows file menu bar Files must be closed to enable this option The par files are in ASCII format and can easily be imported into your favorite spreadsheet Events VT for Windows has a simple means to annotate data files Each of the annotations 1s marked as an event in the data file When a data file is played back the annotated text and the time of the event are displayed on the screen VT for Windows supports six different types of events e Start of file e Beginning of a recording e Time stamp e Annotation e End of file e Automatic event
116. tem Setup for Zero Mode Descriptions This key is also the 7 key for numeric data entry SETUP 8 Key This key accesses the Analyzer configuration and setup screens When this key is pressed a menu is displayed The soft keys are used to navigate the menu From this menu other sub menus are accessible to adjust the various configuration settings The details of this menu and its sub menus are described later This key is also the 8 key for numeric data entry ep PARAMETERS 9 Key This key selects which of the breath parameters are displayed in the various modes Each mode screen has space to display 4 of the breath parameters Using the parameters function the four breath parameters can be selected Note that if 4 parameters are already selected then no more can be selected until one of the previously selected parameters is cleared Also note that the parameters that are selected only apply to the screen that the Analyzer was in when the parameters key was pressed This key is also the 9 key for numeric data entry Specifications The following are general performance breath parameter accuracy specifications for the Analyzer General Specifications RI 320 x 240 LCD with CFL backlight Viewing Area 3 in x 4 in 10 1 cm x 8 2 cm Blue on white background Operational Modes Manual mode for simple tests or troubleshooting computer control m
117. the Leak test VT Plus HF Operators Manual Ending the Leak Test To end the Leak test 1 Either click the STOP button or let the Leak test end by the time running out When the Leak test is over a report is prepared showing the final values for the calculated parameters 2 Click the Print button to print a final report for the Leak test Click the New Test button to start a new Leak test Stacked Volume Test Screen The Stacked Volume test measures tidal volumes over a given number of breaths and calculates the average tidal volume Setting Stacked Volume Test Parameters The Stacked Volume test setup screen shown in Figure 4 13 allows the user to enter the number of breaths to be averaged lt 4 1 Plus for Windows fec095 bmp Figure 4 13 Stacked Volume Test Setup Screen 4 18 Remote Operation Main Screens and Tests Running the Stacked Volume Test To run the stacked volume test 1 Click the START button to begin testing The screen changes as shown in Figure 4 14 an WT Plus for Windows Mei File Communications Flots Statistics Zero Setup Help Qc le E El4 HE Total Volume 0 0 ml Last Volume 0 0 ml Average volume 0 0 ml Humber of Breaths 5 Breath Count Mew Test Print Single Plot Screen Full Test Stacked Volume Test No File Selected Manual Zero ATP Lowy Flo Figure 4 14 Stacked Volume Screen Testing Underway fec096 bmp When the stacked volume test b
118. time out occurs while trying to write to the printer Appendices Error Messages B Corrective Action Attempt to zero again Ensure that no flow or pressure is on either the high or low flow ports If message does not go away after several attempts with no flow or pressure applied call service HS232 serial communications is probably awaiting hardware handshaking If using a terminal program ensure the hardware handshaking is enabled Ensure that the RS232 cable is the cable supplied with the Analyzer Select a printer using the setup menu Ensure the correct printer type is selected Refer to your printer s user manual to ensure the printer is setup correctly for the printer language set on the Analyzer i e HP PCL 3 Note your printer may require special dip switch settings for a given printer language support Ensure the printer cable is correctly installed Ensure the correct printer type is selected Refer to your printer s user manual to ensure the printer is setup correctly for the printer language set on the Analyzer ue HP PCL 3 Note your printer may require special dip switch settings for a given printer language support Ensure the printer cable is correctly installed B 3 VT Plus HF Operators Manual Table B 1 Error Messages cont Description Corrective Action Printer Busy The printers busy line is set Ensure that the printer is selected refer to printer s user manual
119. tings menu Connection and Setup Setting Analyzer Operating Parameters Setting Analyzer Operating Parameters To adjust system information 1 From the Setup screen highlight System and press the ENTER soft key The System menu displays Systen POL ATP Date 057037200 Date Format MM DD YYYY Demo Data Off Filtering None Display Cal Date Yes Serial Mode None Printer Options Audio Levels Restore Defaults fec032 bmp 2 Change settings to pre selected options or to numeric values by highlighting the option and pressing the MODIFY soft key For example if one selects Filtering then presses MODIFY he can scroll through the available Filtering options If one selects an option that requires a numeric entry such as Time and presses MODIFY the entered data is cleared and the field can accept numeric input from the keypad until the ENTER key is pressed Note The option displayed when exiting the settings screen is saved and used for future measurements The following is a description of how to change each system setting All of these options are accessed from the System menu of the Setup screen Time The Analyzer displays hours minutes and seconds on the display However the user can set only hours and minutes To set the time 1 Highlight Time 2 Press the MODIFY soft key to display the value field 3 Input the desired value from the keypad Enter time in the HHMM format where HH is the hours i
120. ts the leak rate of a sealed vessel or test lung e Tests whether a predetermined parameter deviates from limits set by the user e Useful for pre purchase evaluations of ventilators incoming and routine performance verification troubleshooting clinical problems and teaching principles of mechanical ventilation Unpacking and Inspection Use the following checklist when unpacking the Analyzer There are no special unpacking instructions but be careful not to damage the instrument when unpacking it e Inspect the shipping carton for damage If the shipping carton is damaged carefully continue unpacking the instrument and note any dents and scratches on the Analyzer Save the damaged shipping carton and packing material for the carrier s inspection e fthere is no shipping damage continue removing the Analyzer from the shipping case Save the box and packing materials Note This box contains specifically designed inserts to ensure safe shipment of the Analyzer Please save these for return of the unit for service or calibration 1 3 VT Plus HF Operators Manual 1 4 Perform a visual inspection to ensure that the Analyzer is intact and if there is any physical damage such as bent or broken parts dents or scratches If the Analyzer has been damaged call the Fluke Biomedical Service Center immediately If the Analyzer be returned to Fluke for service follow the procedure given under Maintenance Service and Calibration Packin
121. ts too close to user events 4 25 VT Plus HF Operators Manual File Information Panel The File Information panel is shown in Figure 4 17 File Information rss 7 51 48 AM Subject Patient 1 Investigator Dir Gas D Man Sample file forthe manual fec108 bmp Figure 4 17 File Information Panel The first line in the File Information panel contains the open file name The next line is the time that the file was first created The remaining lines contain the information that the user provided when the file was created Event Panel During file playback the software checks for event markers in the data files The Event panel displays information from the data file regarding the last event that was played back This information remains displayed until another event is reached Generating Signal sig Files A signal file is a data file of raw waveforms The sig files are in ASCII format and can easily be imported into a spreadsheet They contain raw flow pressure volume auxiliary pressure and differential pressure time series collected at 20 ms time increments 50 Hz sample rate The sig files are generated from the vtp files using a file conversion program initiated by clicking Generate Signal File on the File menu bar Files must be closed to enable this option Generating Parameter par Files Parameter files store the breath by breath calculated ventilator parameters The par files are in ASCII format and can be
122. tware checks the serial communication ports also called Comm Ports listed in the Windows Registry If the software cannot find the Analyzer the following screen appears allowing the Analyzer communication port to be designated fec079 bmp Once the software has established communication with the Analyzer an initialization file is created that is read by the software during future use The software uses the information in the initialization file to know where to check for the Analyzer An error can occur if the communication port is in use by another device and or software application If the communication port is already open the following error is shown YT Plus for Windows e e Open device already open fec080 bmp To solve this error simply close the application that is using the desired communication port It should be noted that opening the VT for Windows PC software multiple times would also cause the same error message 4 4 Remote Operation Overview of VT for Windows PC Software 4 Finally if the communication port for the Analyzer must be manually set or changed start VT for Windows PC software and select Communications gt Comm Port from the pull down menu Select the appropriate communication port Communications are established when the software displays waveforms and the displayed values for flow and pressure are changing Overview of VT for Windows PC Software VT for Windows PC software provides
123. uffer temporary file If a file is not open and the software is recording no data is saved 4 22 Remote Operation Data and File Handling File Control Interface The File Control interface shown in Figure is a sub screen used for recording annotating and playback of data files It is accessed by clicking the File Control button on the toolbar or by selecting File Controls from the File menu i Stopped Playback Controls Fwrril el r elo Markers Fy cope ef Annet Sp Cuir B Time Pr d File Information LAR rogram keo Floste ignalsy Lit Just Testing Tiles Investigator DIraaks 2 15 22 PM Figure 4 16 File Control Interface fec098 bmp The four main elements of the File Controls interface are Playback Controls Event Markers File Information panel Event panel 4 23 VT Plus HF Operators Manual Playback Controls 4 24 Playback controls are provided to facilitate data review and recording Table 4 7 lists the controls their icons and a description of each Table 4 7 Playback Controls O om coma O neseno OO D RECORD Initiates writing data to the open data file a TIME STAMP event marker is placed in the data file indicating the beginning of recording PLAY Initiates data playback from an open file STOP Terminates data recording or playback the data file is left open Stops data playback temporarily files should be paused before printing so that the desired pl
124. umeric Data ISLE LOS AN E E EE E ET Selecting Breath Parameters sssssesseesssesessessesnsessesssessssssecersesescscessaseessess PON SO EG E OE CUS a E E E E NET ETA Low F low SCT EN EEN PROS DES On e te Hig REP ESS SO S CECETI eege Contents continued Low PES SSSR a eRe ree UE Airway e aee tenta sans sssersenss certes OARE Volume SO EE EE Eeer Full Breath Parameters Test Screen erte Unisol VAS EE Special De EE dE rc ORE E ra Es EE Stacked Re nk EE RT200 Emulation Mode PIE Re a D on a High Frequency Oscillator Mode Remote Operation oem Gelina CAI ES E E eaneauaesoneseacsoseemeesonenene to 4 3 System REQUILE MONTS ea eue ea an NEUSS 4 3 Connecting to EEN 4 3 SA NE e G ones tresses ces oser ioms reel ace 4 3 Starting TE 4 4 Overview of VT for Windows PC Software 4 5 fett dar RR RE m 4 6 Kee UI Tm 4 8 Main Screens and Tests E 4 9 MODOR SCOR ee ee 4 9 BOS PIOL SCE ern 4 10 LOC SR a eet DI rier eer 4 11 Full Test CRG Cll tee 4 12 EN ON To P 4 12 I ic M 4 16 Stacked Volume Test e den anse terii rte tuse ane 4 18 Serial Commumntcatons nennen eene ener nnn nnne nene 4 20 eis senis COM OLE NR a 4 20 Selecting the Serial Communications Mode 4 20 Data and File el et 4 21 BV OTIS de 4 21 Opening and Closing Data Fles 4 22 UE ug Eet 4 23 Playback CONTO Seetee eee ee 4 24 Vert MARS a ere ee 4 25 File TOO
125. upport or answers to technical questions either email techservices flukebiomedical com or call 1 800 850 4608 ext 2560 or 1 440 498 2560 Claims Our routine method of shipment is via common carrier FOB origin Upon delivery if physical damage is found retain all packing materials in their original condition and contact the carrier immediately to file a claim If the instrument is delivered in good physical condition but does not operate within specifications or if there are any other problems not caused by shipping damage please contact Fluke Biomedical or your local sales representative Standard Terms and Conditions Refunds and Credits Please note that only serialized products and their accessory items 1 e products and items bearing a distinct serial number tag are eligible for partial refund and or credit Nonserialized parts and accessory items e g cables carrying cases auxiliary modules etc are not eligible for return or refund Only products returned within 90 days from the date of original purchase are eligible for refund credit In order to receive a partial refund credit of a product purchase price on a serialized product the product must not have been damaged by the customer or by the carrier chosen by the customer to return the goods and the product must be returned complete meaning with all manuals cables accessories etc and in as new and resalable condition Products not returned within 90 days of purchase
126. urisdictions do not allow the exclusion or limitation of an implied warranty or of incidental or consequential damages this limitation of liability may not apply to you If any provision of this warranty is held invalid or unenforceable by a court or other decision maker of competent jurisdiction such holding will not affect the validity or enforceability of any other provision 07 07 Notices All Rights Reserved Copyright 2008 Fluke Biomedical No part of this publication may be reproduced transmitted transcribed stored in a retrieval system or translated into any language without the written permission of Fluke Biomedical Copyright Release Fluke Biomedical agrees to a limited copyright release that allows you to reproduce manuals and other printed materials for use in service training programs and other technical publications If you would like other reproductions or distributions submit a written request to Fluke Biomedical Unpacking and Inspection Follow standard receiving practices upon receipt of the instrument Check the shipping carton for damage If damage is found stop unpacking the instrument Notify the carrier and ask for an agent to be present while the instrument 1s unpacked There are no special unpacking instructions but be careful not to damage the instrument when unpacking it Inspect the instrument for physical damage such as bent or broken parts dents or scratches Technical Support For application s
127. us HF Operators Manual 2 2 Oxygen Sensor Calibration System Diag hosli OS aessa nE EEA EEOAE EEATT Linearization Unlock Calibration cccccc ccc cccccccccccccecceccecccceccescescescecceeccecseceesceseuseescaseass Information Connection and Setup Connecting the Analyzer Connecting the Analyzer The Analyzer can be connected to a ventilator and a test load in either a bidirectional or unidirectional flow configuration Pneumatic Connections The following 1s a description of various pneumatic connections on the Analyzer High Flow Inlet and Exhaust The outer diameter of the high flow ports is a standard 22 mm fitting to allow connection using patient hoses The inner diameter of the high flow ports is designed to accept a 15 mm male respiratory fitting such as endotracheal tubes gas sampling adapters etc A Caution To avoid damage to the Analyzer or adverse affects on its performance follow these guidelines e Pressure inside the high flow port should not exceed 120 cmH O e Measure only dry gases with the high flow port Do not use this port to measure exhaled or artificially humidified gases Low Flow Inlet and Exhaust The outer diameter of the low flow ports is a standard 15 mm to allow connection with standard respiratory fittings such as gas sampling Y pieces and gas sampling adapters The inner lumen of the low flow ports are threaded to accept a standard 4 in NPT fitting A Cautio
128. vanic oxygen cell on the high flow port near the exhaust The Analyzer interprets the measurement from the oxygen sensor as a partial pressure of the total pressure in the high flow circuit The total pressure is the airway pressure plus the barometric pressure The oxygen percentage is calculated as the fraction of the partial pressure of oxygen relative to the total pressure It should be noted that changes in the total pressure airway pressure result in a change in the partial pressure of the measured oxygen even though the percentage of oxygen 1s the same Because the pressure can change much faster than the response time of the oxygen sensor a small transient 1 to 2 of full scale error can occur in the oxygen measurement when there is a fast change in the pressure at the oxygen sensor Whenever an oxygen measurement is made or when the oxygen sensor is calibrated or zeroed there should be sufficient gas flow past the oxygen sensor Only a small flow of gas say 10 LPM is needed to ensure that the oxygen concentration at the oxygen sensor is as expected For example just opening the high flow exhaust to room air does not ensure that the oxygen sensor detects 20 9 oxygen The oxygen concentration at the sensor does not equilibrate with the room air unless a small amount of flow is present to ensure gas mixing The oxygen sensor should last for more than one year and is replaced during an annual calibration of the unit Sensor life is
129. wait for the auto scale to re scale them For more information see the Re scale Plots section This button allows selection of a given type of breath detection mode such as bi directional This button brings up a dialog box for entering the breath detection flow threshold For more information see the Setup Functions Remote Operation Main Screens and Tests Main Screens and Tests VT for Windows has seven main screens that are accessed through the Screen tabs these are listed below e Monitor screen e single Plot screen e Loop Plots screen e Full Test screen e Trend Test screen e Leak Test screen e Stacked Volume Test screen Monitor Screen The Monitor screen shown in Figure 4 4 allows observation of three of the signals at the same time ak T Plus for Windows File Communcetions Plote Statistics Zero Setup Help Eje e amp mgmes x i9r I E Flu low 17 16 LPM hin 90 16 blax 158 87 Aw 2 99 0 5 10 15 2l Airway Pressure Airway Pressure 0 6 cmH20 SE 55 4 Min Max Volume Max 1011 8 Aw au 3 10 15 20 Monitor Screen A Single Plat Screen Full Test A Trend Test stacked Volume Test FILE CaPragram FilesWwTPlustsignalst LitnVaves vip Figure 4 4 Monitor Screen fec086 bmp Each plot can be configured to display any of the signals flow volume airway pressure low pressure high pressure and oxygen Each plot can be independentl
130. y set to auto scale or manually re scaled to the user s desired range of values On the right hand side of the screen the statistics for the selected signals are displayed These statistics show the min max average and current value for the signal that is currently displayed For more information on configuring plots refer to Signal Selection Automatic Rescaling and Manual Re scaling 4 9 VT Plus HF Operators Manual Single Plot Screen The Single Plot screen shown in Figure 4 5 allows observation of one of the signals ak 1T Plus for Windows File Communecetions Plots Statistics Zero Setup Help Eje ec g lse x EBl9 E Flu 155 81 0 00 LPM Min 90 16 Max 158 87 Aud 1 55 9 92 3 10 15 20 Single Flot Screen Full Test A Trend Test stacked Volume Test FILE CaPragram FilesWwTPlustsignalst Liter aves vtp Figure 4 5 Single Plot Screen fec087 bmp The plot can be configured to display any of the signals flow volume airway pressure low pressure high pressure and oxygen This plot can be set to auto scale or it can be manually re scaled to the user s desired range of values On the right hand side of the screen the statistics for the selected signal are displayed These statistics show the min max average and current value for the signal that is currently displayed For more information on configuring plots refer to Signal Selection Automatic Rescaling and Manual Re scalin
131. ypad Errors Gas Settings Gas Type Gas Temperature Ambient Temperature Connection and Setup Setting Analyzer Operating Parameters Table 2 4 Factory Defaults cont Settings cont Displays Flow Range High Flow Units LPM Air Scale 100 00 to 100 00 Pressure Range Airway Units cmH20 EC C C C Units lom Air Middle Zone Airway Pressure Units cmH20 Bottom Zone Volume Units L Air Parameters Tidal Vol Base Flow O2 Gas selected checked All others de selected un checked VT Plus HF Operators Manual Utilities Note These settings are required by service technicians in servicing the Analyzer To access the utility functions 1 From the Setup screen highlight Utilities and press the ENTER soft key The Utilities menu displays Utilities Oxygen Calibration System Diagnostics Linearization Unlock Calibration fec035 bmp Oxygen Sensor Calibration Recalibrate the oxygen sensor with 100 oxygen and dry air at the beginning of any day in which oxygen concentrations are to be measured To calibrate the oxygen sensor 1 Apply 10 lpm of dry air to the high flow inlet or exhaust 2 Use the A and V soft keys to highlight Oxygen Calibration 3 Press the ENTER soft key The O2 Calibration screen displays Oe Calibration Oxygen Precent qug z Barometric Pressure 640 3 mmHg Flow Rate 0 00 LFM Please ensure that barometric pressure is correct before calibrat
132. z Note Fluid pressure may be applied to the positive port however fluids should be kept from entering the pressure port by using a suitable length of connection tubing High Pressure Port Maximum Applied Pressure 150 psi Operating Pressure 100 psi Span Accuracy 1 9o of reading or 0 3 psig whichever is greater Frequency Response 210 Hz Hesoluton 0 1 psi Sample Hate 100 Hz Note Fluid pressure may be applied to the positive port however fluids should be kept from entering the pressure port by using a suitable length of connection tubing Airway Pressure Maximum Applied Pressure 20 psi Operating Pressure 120 cmH20 Span Accuragy 0 75 of reading or r 0 5 cmH5O whichever is greater Frequency Response 225 Hz or t10 90 40 ms whichever is greater Resolution 0 1 cmH2O Sample rate 100 Hz Note Airway pressure is internally tapped off the proximal flow sensor port which is the port closest to the exhaust port on the Analyzer Continuous Flow Low Flow 2 of reading and 1 of range High al 2 of reading and 1 of range Volumetric Flow High Flow Port Maximum Flow Hate absolute value 500 Ipm Operating Flow Range 300 I

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