MicroLab Operating Manual
Contents
1. Baseline Post1 Post2 Test Resistance Flow Resistance Flow Resistance Flow kPa l s l s kPa 1l s l s kPa 1l s l s 1 0 26 0 65 0 22 0 62 0 19 0 66 2 0 27 0 66 0 21 0 60 0 18 0 68 3 0 26 0 56 0 22 O59 OTT 0 67 4 0 26 0 65 0 22 0 62 0 19 0 66 5 Os27 0 66 0 21 0 60 0 18 0 68 6 0 26 0 56 0 22 0 59 0 17 0 67 7 0 26 0 65 0 22 0 62 0 19 0 66 8 0 27 0 66 0 21 0 60 0 18 0 68 9 0 26 0 56 0 22 05 9 0 217 0 67 edian baseline 0 26kPa 1 s Predicted 0 22kPa 1 s edian post 1 0 22kPa 1 s Percent predicted 100 Percent change 25 edian post 2 0 18kPa 1 s Percent predicted 91 Percent change 35 Notes 47 This is followed by the flow time curves and the pressure time curves at the time of occlusion Note The unit may be configured to print only the results or the results with the curves see airways resistance customisation page 14 The results may also be printed to an external printer see system customisation page 8 In this case the following screen will be displayed Option 5 End Examination Selecting this option will delete test results of the current patient if they are not already saved In this case a warning will be displayed and the option not to continue will be offered The main menu is again displayed From this menu it is possible to test a new patient as previously described or run a different test on the same patient 48 Airways resistance Print results Con2. Airways resistance results y 0 22 kPa l s The baseline and post i 120 0 15 kPa l s bronchodilator steroid results are i 99 given together with the post diezi bronchodilator steroid percentage change and the percentage of predicted Use function keys F3 and F4 to scroll through the results The Rint 0 22 kPa l s Median 0 22 kPa l s next screens show the flow time curve together with the pressure curve at interruption for each of the tests The Rint measurement for this test Base 1 and the median Rint are given CKI etete CPatie CED Any of the tests which show artefacts in the pressure or flow curves may be rejected by using F2 and will be permanently deleted and the median value may change W hen the review is complete press F1 to return to the Report Menu Option 3 Save This option can be used to save the results for future processing by uploading to a computer printing or appending a post bronchodilator test to a saved baseline result The MicroLab saves the baseline results and any post bronchodilator and post steroid tests performed 46 Option 4 Print To print the current patient s data select this option and the following printout will be obtained MicroLab Spiro VX XX Christopher Lawson TDs L23DPY55 Sex Male Age 41 Factor 100 Caucasian Height 160cm Weight 96kg BMI 37 5 Baseline Date 04 07 02 Time 09 41 Post 1 Date 04 07 02 Time 09 54 Post 2 Date 26 08 02 Time 10 13
3. MicroLab It is recommended that whilst the unit is connected to a computer the batteries are on charge with the unit connected to the mains adapter as more power is required to drive the serial interface Charging Procedure The MicroLab is fully discharged when shipped from the factory and must therefore be used with the AC adapter until the internal rechargeable batteries can be fully charged The Charging light on the keypad will be illuminated while the batteries are being charged The batteries will take about 16 hours to become fully charged however the instrument may be used continuously with the mains adapter connected The Rint transducer has its own internal battery pack that must be charged before use These batteries charged at the same time as the MicroLab batteries as long as the two are connected Note Use only the AC adapter supplied Use of my other type may cause permanent damage to the MicroLab and cause a fire or electrical hazard 49 Battery Management The microcomputer circuitry is supplied by a 7 2 volt 1000mA hour rechargeable nickel metal hydride battery pack The voltage of the battery pack is monitored continuously and low battery warning symbol is displayed with alarm when the battery starts to become discharged This warning may occur at any time except when measurements are being taken W hen this warning occurs plug in the mains adapter and continue using the instrument If the main s adapter is
4. be calculated and displayed the patient s age height and sex must be entered Note For spirometry tests the age range is from 7 to 110 years height from 110cm to 250cm depending upon the version The patient s weight must be entered if Roca predicted values are used or to obtain the body mass index BMI The dyspnea score is only entered if required see spirometry customisation page 11 For Rint tests Lombardi values the age range is 3 to 6 years height from 94 to 130cm Merkus values No age required height from 90 to 125cm The origin entry will allow the patients ethnic origin to be selected from a list and printed on the test report it is not used to adjust the patient s predicted values The factor entry is an ethnic correction factor that reduces the adult predicted values of volumetric measurements The MicroLab may also be configured to disable the race entry and correction factor entries see spirometry customisation page 7 Press Esc to cancel this option and return to the previous screen or F4 to save the details into the patient database Option 3 Select Patient ae patient ae Identity To select a patient from the 11334 Philip Chowienczy f f David Cocks MicroLab s database chose this Richard Haynes Glen Hillsley option and the display will show a John Jones A Christopher Lawso list of patient ID and names Daniel Quirke l Martin Marsh The patients will be displayed in John G
5. flow W hen this option is selected the display will show Calibration check Type the syringe volume and then press enter Syringe volume _ L 1 to 3 litres Type the syringe volume and then press enter 18 A zero flow reading of the transducer will now be taken Connect the syringe to the Rint transducer using the respiratory filter and withdraw the syringe handle fully Ensure that there is no flow through the transducer when enter is pressed The display will then show a graph of the flow generated when the syringe is emptied Try to keep the flow within the dotted lines Once emptied immediately reverse the procedure and fill the syringe to obtain both expiratory and inspiratory calibrations If the calibration drift is greater than 3 in either direction then the option to store the new value will appear If the syringe is emptied too quickly then an error message indicating that the flow was too high is displayed and the procedure should be repeated with a lower flow 19 Calibration check Connect the syringe to the transducer A zero flow reading will now bw taken Ensure that there is no flow through the transducer when enter is pressed Calibration check Calibration error 3 5 1 Store new value 2 Exit Select the required option Option 2 Calibrate pressure Pressure may be calibrated using the pressure calibration kit Calpranon check Insert pressure adapter and ap
6. litres second ATS If the child incentive is selected the ee Y PEF 9 34 1 He SE 7 lt L 1 A F glass wil appear half full initially bein and will rise and fall as the child 3 Done exhales and inhales respectively To overflow the glass with bubbles or drink the glass empty Good blow the child must exhale or inhale greater than their previous largest breath Repeat the test as described above The previous FVC loop will remain on the screen The variation between the current test and the best test is displayed Var The measurement used to calculate this variation FEV1 FVC PEF or FEVi FVC will depend upon the best test criterion selected with the spirometry customisation If best individual indices have been selected then the variation will be calculated on FEV FVC The total number of tests stored is nine the 3 best baseline post 1 and post 2 tests from any number of attempts Pressing 2 will reject clearly poor or inconsistent efforts W hen satisfied with the blows press 3 30 Method 2 With tidal breathing Instruct the patient to seal their lips around the mouthpiece Good blow and breath quietly for at least three tidal breaths but not more than 15 before attempting the forced maneouvre The patient should then breath in to TLC and then blow out as hard and as fast as possible until they cannot push any more air out and then breathe in fully immediately after the expiratory manoeuvre thus com
7. on the report screen upon completion of a spirometry test and on the printout All the indices are stored irrespective of those selected and can be retrieved by changing the selection except for dyspnea score which will only be stored if the patient s dyspnea score is stored with the patient s details Use the up and down arrow keys to select the required indices and press F1 to toggle on or off An index will not turn on if 15 have already been selected Use F3 and F4 to page through the selection screens Press F2 when all the selections have been completed 13 Customisation option 3 Airways resistance When this option is selected the following will be displayed Airways Resistance Customisation Set trigger flow gt 0 00 Use the up and down Hei keys aA Random to select the required option and Operating mode Continuous Number of tests 10 use the delete and numeral keys Printout With graphs Display default Flow time to enter the trigger flow and F1 to Predicted value Lombardi change the other options Press F4 when all the selections Crand CO COO Cone have been completed to save your selections and return to the customisation menu Set Trigger Flow This option allows the default value of flow at which the occlusion occurs to be set When selected the following will be displayed Any value between 0 1 I s and 1 99 l s can be entered If a high value is chosen then it is possible that the unit will never occlude d
8. setting and the signal will be above any noise Note that the use of this option to change the trigger fow rate will not alter the default setting Report menu When the baseline airways 7 f Rint Report menu resistance measurement is ae Pos complete a number of options View results i Save results become available and can be Print results End examination selected from the report menu Christopher Lawson 12345ABCDE A post bronchodilator or post Male Caucasian 86cm 85kg steroid test may be performed if ecieaitns reddire opti h required Alternatively the baseline results may be saved using option 3 and recalled later to append a post bronchodilator or post steroid test The full results may be displayed using option 2 or the results printed using option 4 W hen all required actions have been taken then use option 5 to end the examination The current patient s name and ID are also displayed The results reported will then be the median of all the acceptable tests 45 Option 1 Post Bronchodilator Steroid T est To begin a Post Bronchodilator or steroid test on the current patient press 1 and repeat the test procedure as for the baseline test W hen the post 1 test is complete press 1 Done and the Report Menu screen will be re displayed As the Post 1 test is complete the first option changes to Post 2 Option 2 Display results Use this option to display the results of the current patient
9. this option Printout The printed report will contain summary results of all the occlusions occurring during a test This may be accompanied by the flow time and pressure time curves if required Display default During a test the display can be set to show the full flow volume curve Flow vol or the flow time graph Flow time In either case the display can be changed after during a test by using the left and right arrow keys Predicted value Lombardi Eiser or Merkus predicted values may be selected 15 Customisation option 4 Calibrate flow transducer The MicroLab is calibrated to read volumes in litres at body temperature barometric pressure saturated with water vapour BTPS The calibration should remain stable indefinitely unless the transducer is physically damaged and the unit should not require re calibration However as a check on the correct functioning of the unit we do recommend that the calibration be checked periodically W hen this option is selected the following options will be displayed Check calibration press 1 to check the calibration and the following will be displayed To check the calibration of the MicroLab a large syringe should preferably be used with a 30mm outlet A 3 Litre Syringe is available from Micro Medical as Cat No SM12125 The MicroLab transducer should be connected to this syringe with the minimum of adapters Type in the syringe volume and then press ent
10. use this battery is continuously monitored and the unit will display a warning and turn off automatically before the battery becomes completely discharged If however the unit is left unused for several weeks the internal battery may become completely discharged and the clock will need adjusting once the battery is recharged Dyspnea score A dyspnea score entered with the patient details may be disabled using this option Printer The option to use either the integral thermal printer or external C anon or Hewlett Packard printers Sound Select either O ff High Medium or Low pitch 7 Please note If using an external printer connect the MicroLab to the printer whilst both are switched off The MicroLab must be connected to the specified printer with a serial to parallel converter Cat No MLA 350 W ith both units switched off connect the round Mini Din plug on the serial cable to the socket in the left hand side of the MicroLab Connect the 25 way D connector to the serial to parallel converter and plug the converter into the printer Centronics type socket Serial cable Pt No CAB3217 Printer Serial to parallel converter It is recommended that whilst printing the batteries are on charge with the unit connected to the mains adapter as more power is required to drive the serial to parallel converter NOTE Keep the printer out of reach of the patient when connected to MicroLab System Customisation option 2 Se
11. Airways resistance Use the up and down arrow keys PCO TSG Spirometry 17 03 01 10 40 Airways resistance in order to scroll through the list If the required test does not appear on the screen then use F4 PgDn to quickly page down to the required screen and then use the arrow keys to highlight The selected test may then be reviewed or deleted Once reviewed the display will show the report menu for the type of test performed From this menu it is possible to perform post medication tests view or print the results see relevant section for details To delete a test press F2 A warning will be displayed to avoid the possibility of accidental erasure Press Esc to cancel this option and return to the previous screen 26 Spirometry overview In the interests of clarity the following instructions assume that all configurable options and tests Spirometry Main menu 1 Expiratory relaxed vital capacity 2 Inspiratory relaxed vital capacity 3 Forced vital capacity are enabled with the printed loops set to Both display default set to full flow volume and that the units for height and PEF are set to cm and L sec respectively See user customisation page 11 for a detailed description of all available options Christopher Lawson 12345ABCDE Male 186cm 85Kg BMI 254 Factor 100 Caucasian Dyspnea score 5 28 02 02 12 44 Relaxed inspiratory expiratory vital capacity Option 1 and 2 These options allow a
12. Good Blow 12 20 14 08 02 Variation is based on FEV1 Best Spirometry Result Base 3 Post 4 Normad a4 Base Pred PostBD Pred Chg Min Pred Max VC 4 00 L FEV1 3 62 78 3 66 TAS 1 3 79 4 63 5 47 L FVC 3 82 68 3 516 67 4 63 5 63 6 63 L PEF 520 84 585 95 12 496 616 735 L M FEV1 95 117 97 120 2 69 81 93 F50 4 78 83 4 80 83 0 3 58 5 75 7 92 L S P25 2 53 94 2 43 90 3 1 42 2 70 3 98 L S EF 4 22 86 4 26 87 0 3 21 4 92 6 63 L S 150 7 86 8 69 10 L S R50 61 55 g PIF 8 30 9 18 10 L S VV 136 EST 1 L FET 3 61 3 40 6 S Lung Age 59 years Interpretation Mild Restriction 35 The first part of the report gives the patient name ID and physical details This is followed by the baseline post 1 and post 2 results FEVi FVC and PEF for all the recorded manoeuvres performed by the patient The percentage variation VAR of each test from the best test given together with the date time and quality check The best results are then printed in full with up to 12 other measurements from the manoeuvre The percentage of predicted value percentage post 1 change and the normal range is also given If a post 2 test was performed then the baseline results are repeated together with the post 2 results The results are followed by the Flow Volume and Volume T ime curves Flow Volume 36 Flow Volume 8 Normal Values ECCS adult Zapletal Solymar Cogswell child Results at BTPS Technician Physicia
13. MicroLab O perating Manual 069 12 Revision 1 4 August 2004 Micro Medical Limited 2004 Micro Medical Ltd PO Box 6 Rochester Kent ME1 2AZ ENGLAND www micromedical co uk CONTENTS Introduction Package Contents Section 1 User Customisation System Spirometry Airways resistance Calibrate flow transducer Calibrate Rint transducer Section 2 Operation Main Menu Run test N ew patient Select patient Modify patient details Review results Spirometry Relaxed vital capacity Forced vital capacity Report menu Post medication test Display results Save results Print results End Examination page 3 page 5 page 6 page 11 page 14 page 16 page 18 page 22 page 23 page 23 page 24 page 25 page 26 page 27 page 27 page 28 page 31 page 32 page 32 page 35 page 35 page 38 Airways resistance Report menu Post bronchodilator steroid test Display results Save results Print results End examination PC connection using SPIDA Charging Procedure Battery Management Looking after the MicroLab Cleaning the Transducer Servicing Symbols Environment Electrical classification Consumables supporting products Training Specifications References page 39 page 45 page 46 page 46 page 46 page 47 page 48 page 49 page 49 page 50 page 50 page 51 page 51 page 52 page 52 page 52 page 53 page 54 page 55 page 57 Introduction The MicroLab is part of a new range of respiratory ins
14. MicroRint transducer Cat No MRT 6000 is required Airways resistance is measured by the interrupter method Rint first described by Von Neergaard and W irz in 1927 The method requires minimal subject co operation and can be carried out during spontaneous breathing It is therefore useful for measuring airway calibre in very young children and those unable to co operate with conventional lung testing It also provides a measurement of resistance that is easier quicker and more economic than any other method The basis of the measurement is that during transient interruption of airflow 100ms alveolar pressure will equilibrate rapidly with pressure at the mouth The alveolar pressure can therefore be derived from the measurement of mouth pressure immediately post occlusion If the flow is measured immediately prior occlusion then the ratio of flow to pressure gives the airway resistance Flow is measured with a pneumotachometer consisting of a stainless steel resistive element and a high frequency high fidelity solid state pressure transducer A second pressure transducer measures the mouth pressure post occlusion Occlusion occurs several times during a test and the current and median value of Rint is calculated and displayed The Rint test has many advanced features including a graphic display giving both real time tidal breathing flow and the interrupted pressure curve user customisation of instrument functions and predicted value
15. Race entry On Sort order Identity DD MM YY Date format Date separator Date 28 02 02 Time 16 10 Dyspnea score On Cmd C__ Cone and numeral keys in the case of date and time entry The arrow may be moved by using the up and down cursor keys Language A choice of up to seven languages will be available depending upon national preferences Height units The patient s height may be entered in centimetres or inches Weight units The patient s weight may be entered in kilograms or pounds Race entry The racial origin and correction factor entered with the patient details may be disabled using this option Sort order W hen selecting a patient from the database the list may be displayed in order of first name last name or patient identity number Date format The date format may be selected as DD MM YY MM DD YY or YY MM DD Date separator The date separator may be selected as or Using these options dates may be represented as 13 08 01 13 08 01 or 13 08 01 Date The current date may be entered when this setting is active If correction is required first use the delete key to remove the previous setting and then type the correct date using the numeral keys Time The current time is displayed and may be corrected as follows First use the delete key to remove the previous setting and then type the correct time using the numeral keys The main rechargeable battery powers the internal clock In normal
16. ack extrapolated volume BEV was greater than 150ml then Slow start will appear This indicates that the patient did not blast out the air quickly and evenly during the forced expiration If the time to peak flow PEFT was greater than 120msec then poor effort will appear indicating a sluggish effort during the forced expiration If the forced expiratory time FET was less than 6 seconds and the change in exhaled volume during the last half second was more than 100mL Abrupt end will appear The patient stopped exhaling prematurely If the expiratory flow exhibited a secondary peak then Cough detected will be displayed At this point using the up and Good blow down cursor keys will toggle the predicted curve on and off Use the left and right arrow keys to toggle between the full flow volume loop expiratory flow volume curve and the volume time curve The child incentive milk shake kid is only available during the spirometry manoeuvre Pressing delete will toggle the text Good blow on and off in order to allow a 109 clear view of the curves if obscured by the text The axes for all of the curves are automatically scaled for a maximum volume between 1 and 2 litres above the predicted FVC The flow axes are scaled for a maximum flow between 2 and 4 litres second above the predicted PEF If the patient details have not been entered then the scaling is set to 8 j j gt FEV1 456 litres and 15
17. al spirometry no The next screen shows the expiratory flow volume loop with the predicted baseline and post bronchodilator curves shown as dashed dotted and solid lines respectively This screen is followed by the same information displayed as expiratory flow volume and volume time curves Option 3 Save Result This option can be used to save the results for future processing by uploading to a computer printing or appending a post bronchodilator test to a saved baseline result The MicroLab saves the selected baseline and any post steroid and post bronchodilator tests together with the respective flow volume loops and volume time curves Option 4 Print Result See system customisation page 8 for external printing To print the current patient s data select this option and the following printout will be obtained MicroLab Spiro VX XX Christopher Lawson SDs L23DPL5 9 Sex Male Age 41 Factor 100 Caucasian Height 160cm Weight 96kg BMI 37 5 FEV1 FVC PEF Var Quality Time Date Base 1 53 3 68 230 3 Good Blow 15 20 03 07 02 Base 1 68 3 79 245 0 Good Blow r525 03 07 02 Base 1 53 3 69 238 1 Good Blow 15 32 03 07 02 Post 1 1 72 3 84 230 3 Good Blow 15 48 03 07 02 Post 1 1 79 3 86 230 2 Good Blow 15 51 03 07 02 Post 1 1 81 3 88 230 0 Good Blow 15 55 03 07 02 Post 2 1lavy7 3 79 230 0 Good Blow 12 04 14 08 02 Post 2 1 75 3 75 230 1 Good Blow 12 10 14 08 02 Post 2 1 76 3 68 230 2
18. and F4 to scroll through the results for up to a further 10 indices The results screens are followed by a report of Lung Age and an interpretation of the spirometry results according to the algorithm published by Enright or the ECC S4 33 The Enright and BTS algorithms relate airways obstruction and restriction to the forced expiratory ratio FER and the percent predicted of FEV and FVC The Enright and BTS algorithms are given below Enright Interpretation START Check manoeuvre quality FER below LLN yes yes borderline FEV above LLN obstruction no i yes mild FEV above 60 of predicted obstruction no FEV above 40 of predicted 2S moderate no severe obstruction no _ normal FVC below LLN gt spirometry yes s_ mild FVC above 60 of predicted esn restriction no yes moderate FVC above 50 of predicted restriction no severe restriction LLN lower limit of normality BTS Interpretation START Check manoeuvre quality FER lt 70 yes FEV lt 80 of predicted 0 gt SOFA yes FEY lt 60 of predicted 2 yes FEV lt 40 of predicted Moderate mild obstruction yes severe obstruction FEV and FVC lt 80 of predicte 2S deoder no es _ normal FEV lt 80 of predicted A spirometry no reduced FE A es _ normal FVC lt 80 of predicted 1 spirometry reduced FVQ norm
19. are maximum FEVi FVC PEF sum of FEV and FVC best individual indices The selected criterion is used to automatically select the best blow when saving printing or reporting on a series of manoeuvres If individual best is selected then the greatest individual indices from a series of manoeuvres are selected except the indices derived from the flow volume loop These indices MEF7s MEFso and MEF2s5 are measured from the composite flow volume curve by the method described by ERS Standardized Lung Function Testing The composite curve will then also be used for the printed report Note when composite flow volume curve is used only the expiratory part of the forced manoeuvre is stored and any tidal breathing pattern performed prior to the forced manoeuvre will be lost 12 The chosen criterion is also used to select for display the best baseline result when a post bronchodilator manoeuvre is performed a 7 K E z z E m lt N aga Iz lt O KA Spirometry customisation option 2 Indices selection The spirometry indices reported and available for printout upon Indices selection Max 15 completion of a test may be E SV customised using this option BEC Og All indices apart from FEV1 FVC PEMUREVG and PEF which are always MEF50 i MEF75 displayed and printed may be MMEF turned on or off Up to 15 EEE 8 ce Changg Done CPC indices from a total of 36 may be Lee enabled at one time and will appear
20. ation for motivating smoking cessation James F Morris MD and W illiam Temple Preventative Medicine 14 655 662 1995 2 Enright 3 BTS Guidelines for the management of Chronic Obstructive Pulmonary Disease The COPD Guidelines Group of the Standards of Care Committee of the BTS 57 Thorax 1997 53 Suppl 5 S4 6 ECCS European Community for Coal and Steel Standardisation of Lung Function tests ERS Standardized Lung Function Testing Chronic Obstructive Pulmonary Disease Management of chronic obstructive pulmonary disease in adults in primary and secondary care 58
21. cer housing 4 AC Adapter Cat No PSU7800 Together with mains supply lead and disposable cardboard mouthpieces SPIDA 5 software is available separately Section 1 User Customisation To customise the MicroLab hold down the enter key turn the unit on and then release the enter key after the display goes blank The following screen will then be displayed Customisation option 1 System Customisation System Spirometry Airways resistance Calibrate flow transducer Calibrate Rint transducer Exit Memory 99 Free 28 02 02 12 30 W hen this option is selected the following will be displayed From this menu system settings such as date format and language may be changed the required tests may be selected records may be cleared from memory and a user name may be entered Customisation 1 System settings 2 Select tests 3 Clear records 4 Delete patients 5 Delete old records 6 Refresh patient order 7 User name 8 System information 9 Exit Memory 99 Free 28 02 02 12 38 System Customisation option 1 System settings W hen the system settings option is selected the following will be displayed The current settings are shown on the right hand side with an arrow pointing to the active entry The active entry may be changed by pressing F1 in the case of multiple selections or by using the delete System Customisation Language English Height units centimeters Weight units kilograms
22. complete The display will then return to the system customisation menu System Customisation option 8 System information issue status shown on either the display or as a print option 10 Customisation option 2 Spirometry When this option is selected the following will be displayed From this menu the spirometry oan ae settings such as peak flow units ao and display default may be changed and the required indices to be displayed and printed may be selected Spirometry Setup 28 02 02 12 25 Spirometry customisation option 1 Configuration W hen this option is selected the following will be displayed eats aaa oye The current settings are shown on rotation Enright i i i Predicted values ECCS the right hand side with an arrow Display default Full Elow Vol inti i 2nd printed page O pointing to the active entry Best criteria Indiviual best Pressing F1 will change the active entry Cane Coe The arrow may be moved by using the up and down cursor keys Flow Units This option is used to change the displayed units of peak expiratory flow from litres per minute L min to litres per second L sec Interpretation The interpretation displayed at the end of a spirometry test may be set to Enright2 BTS3 NICES or none Predicted curve The dashed predicted curve and dotted baseline curve displayed when performing a post bronchodilator test may be configured to appear as default using this optio
23. d transient oscillation is close to zero It is therefore possible to check the quality of the test automatically and the instrument will reject any tests with a large slope on the pressure curve indicating a cough or irregular breathing pattern If the trigger level is set at a constant flow rate then this test is disabled as much greater slopes will occur The MicroRint will continue until the pre set number of acceptable tests have occurred or if the test is terminated by pressing 1 Done The test should be terminated if the subject becomes distressed and starts to pant or breathe erratically Upon completion of the test the Report menu is displayed Option 2 Expiration test The procedure for the expiration test is identical to that for the inspiration test 44 Option 3 Trigger level Peak The default flow trigger level is set by the Airways Resistance customisation see page 14 and is shown in brackets However this may be changed before a test is started by using this option Any value between 0 1 l s and 1 99 I s can be entered If a high value is chosen then it is possible that the unit will never occlude during a test as the subject may never reach the set flow rate If a very low value is set then inconsistent values of Rint may be obtained as the signal may be lost in physiological noise If zero is entered then the unit will trigger on the peak of the flow curve The instrument will always occlude using this
24. dicted values If predicted values are not required press delete or F4 to continue Option 2 New Patient Select this option to enter a patient s details not previously stored in the MicroLab Type the patient s identity up to 15 characters using the keypad see system customisation page 10 When the identity has been Select test 1 Spirometry 2 Airways resistance 3 Exit Christopher Lawson 12345ABCDE Male 186cm 85Kg BMI 254 Factor 100 Caucasian Dyspnea score 5 28 02 02 12 34 see System Quick patient information Sex Male Age Height cm Factor New patient gt CD C O CO Dore entered press enter and the cursor will move down to the first name This is followed by the patient s second name sex date of birth height weight racial origin correction factor and dyspnea score The first and second name may be up to 12 characters long and must be abbreviated if longer names are required 23 A dyspnea score of 1 to 5 should be entered however if the dyspnea score is not required then leave blank When entering these details the keys will be numeric only Please note that in order to store the patient s test results the first and last names may be omitted but all other data fields must be completed The patient s name may be picked up from the SPIDA database if the results are uploaded at any time or added to the MicroLab database subsequently In order for predicted values to
25. e left and right arrow keys will toggle between the full flow volume loop expiratory flow volume curve and volume time curves Complete the tests as described above for the Forced Vital Capacity test When a valid series of post bronchodilator tests is complete press 3 Done The Report Menu screen is then re displayed As the Post 1 test is then complete the first option is replaced with Post 2 Option 2 View results Use this option to display the results of the current patient ETE EAA Firstly however a choice is 2 Select blow offered to use the best blow for the report or to manually select the best blow Spirometry Report menu Select the required option 32 If manual selection is chosen a summary of the manoeuvres is displayed showing the blow number FEV PEF and FVC for 2 Set best the baseline test The best 3 Done selection is marked but can simply be changed by pressing 1 to move to the required test and then using option 2 set best After baseline selection the Post 1 blows are offered for selection if applicable If the best test criterion was set to best individual results then the choice to select the best blow will not be offered Once the selection is complete the report appears giving the results for up to 15 spirometry indices The baseline post 1 and post 2 results are given together with the percentage change and the percentage of predicted Use function keys F3
26. ent when the patients are listed in incorrect order when selecting a patient from the database listed by name 9 Using this option will correct the patients name order System Customisation option 7 User name A two line hospital or surgery name may be entered and will System Customisation appear on the heading of the Enter heading two lines printed report The lines may be pe 2 up to 30 characters long each W hen this option is selected the following will be displayed Type the required name using the C OC d keypad The numerals 2 to 9 are ascribed letters of the alphabet in groups For example 2 is ascribed the letters a b c 2 and when pressed System Customisation the following will be displayed Pressing 2 again will change the letter to the next one on the list at the bottom of the screen Use the Fl key to change from lower to upper case To type the next letter simply press the key with the required letter and the cursor will automatically move one place to the right If the next letter is on the same key then wait for two seconds and the cursor will move to the right automatically If a mistake is made then use the delete key to go back To insert a space in the text use the right arrow key Continue until the required name is complete and then press enter The second line may now be entered in the same way Use the numeral keys together with the delete key to correct any mistakes and press F4 when
27. er and the display will change to Calibration check 1 Check calibration 2 Print report 3 Enter calibration values 4 Exit 28 02 02 14 34 Calibration check Syringe volume 1 to 3 litres 3 Type the syringe volume and then press enter Empty and fill syringe Ke oN BR ogo O W ith the syringe connected press a key and empty the syringe evenly without pausing and avoid banging the syringe against the end stop Once emptied immediately reverse the procedure and fill the syringe to obtain both expiratory and inspiratory calibrations 1 Reject 2 Accept If the syringe was not emptied smoothly and without banging against the end stop press 1 to reject the calibration and repeat the procedure W hen a satisfactory manoeuvre has been performed press 2 to accept Upon completion the inspiratory _ gt and expiratory calibration errors will be displayed If the calibration error is greater than 3 in either direction then the following warning will be displayed If the calibration error was negative check the syringe for leaks and the flow transducer for Calibration check Expiratory calibration 4 8 Inspiratory calibration 5 6 WARNING large error detected refer to instruction manual ECT EED i a ee ee free rotation of the vane If a fault is found then press F4 to reject the calibration Once the calibration check has been successfully completed press F1 and the new cal
28. fe Pulmonary Filters 10 filter casings and 250 replacement pads PeraSafe Sterilising Powder 81g to make up 5 litres of solution N ose Clips pack of 5 Alkaline PP3 Battery 3 Litre Calibration Syringe Spida Software Rint Filters 50 per box Rint Filters 250 per box Face Mask 53 Training Micro Medical run spirometry training courses throughout the UK sessions include Anatomy and Physiology of Respiratory System Lung Volume Terminology O bjectives of Spirometry Setting up the test amp performing a good manoeuvre Errors of technique Interpretation of results Using Spirometry as an aid to diagnosing airways disease Choosing a Spirometer Case Studies x amp amp K To place an order for consumables supporting products for details of training course dates and locations or for general enquiries please contact Micro Medical on Tel 44 0 1634 893500 Fax 44 0 1634 893600 Email sales micromedical co uk product support micromedical co uk W ebsite www micromedical co uk Or contact your local Micro Medical dealer 54 Specification of the MicroLab General Storage Printer Output Display Power supply Battery Pack Dimensions Weight 1000 tests including Flow Volume loops and Volume T ime curves All IBM Proprinter compatible Canon bubble jet printers e g BJC 250 BJC 4400 BJC 80 and BJC 50 All PLC3 compatible Hewlett Packard printers e g Deskje
29. from the housing 3 The transducer may now be immersed in warm soapy water for routine cleaning or immersed in cold sterilising solutions e g Perasafe for a maximum of 10 minutes Alcohol and chloride solutions should be avoided After cleaning sterilising the transducer should be rinsed briefly in distilled water and dried Perasafe is available from Micro Medical in convenient 81g containers Cat No SSC5000 4 Re assemble the mouthpiece holder Locating pip Servicing A full service manual including circuit diagrams and parts list is available upon request 51 Symbols Type B device 3 In accordance with Directive 93 42 EEC 0120 Environment This instrument complies with directive EN 60601 1 2 electromagnetic compatibility but can be affected by cellular phones and by electromagnetic interference exceeding levels specified in EN 50082 1 1992 Electrical classification Class equipment 52 Consumables Supporting Products Cat No PSA1600 PSA1900 rolls PSA1000 SST 1000 PSA1200 PSA1100 SPF6050 SPF6250 SSC 5000 VO L2104 BAT 0300 SM12125 SD 5000 FIL6050 FIL6250 AFM1153 Description Thermal Printer Paper pack of 5 rolls Archive Printer Paper 25 Year Anti Fade pack of 5 Adult Disposable Mouthpieces 500 per box O ne way Safety Mouthpieces 500 per box Paediatric Disposable Mouthpieces 250 per box Paediatric Adaptor Spiro Safe Pulmonary Filters 50 per box SpiroSa
30. ibration values will be stored Print report Press enter to start printing or ESC to cancel A calibration report giving details of the last calibration check will be produced Calibration values This option is only used when a replacement flow transducer is supplied by Micro Medical with ATS calibration factors Customisation option 5 Calibrate Rint transducer The Rint value is calculated from the measurements of flow prior to occlusion and the pressure during occlusion Both flow and pressure can be independently calibrated Flow is measured using the pressure differential across a stainless steel resistive element A high fidelity high frequency pressure transducer is used with a long term drift of 0 5 per annum It is only necessary therefore to perform the pressure calibration yearly Micro Medical can supply a pressure calibration kit Cat No CAL6000 The stability of the flow calibration depends on the pressure transducer and on the characteristics of the resistive element These characteristics will remain stable for at least 50 tests as long as no physical Calibration check damage has occurred and that the Flow Exp 10 09 01 Ins 10 09 01 Pressure disposable filter is always used Print report When calibration is selected the zkactory calibration Exit following options will be displayed together with the dates of the last calibrations Select the required option Option 1 Calibrate
31. iles order of their ID first name or EDEMEN last names depending upon the sort order selected with the system configuration settings The current patient selection is highlighted The sort order is displayed on the top line 24 If long ID s and names are used then text on the right hand side of the display may be truncated By pressing F1 the data will be re sorted and the truncated text will become visible as the order is changed Use the up and down arrow keys in order to scroll through the list If the required patient does not appear on the screen then use F4 PgDn to quickly page down to the required screen and then use the arrow keys to highlight Use F1 to re order the list by patient name or ID as required To search the database for a patient press F2 and the following will be displayed Typing the first letters of the required name or patient identity will search the list After each letter is typed the display will shift to the nearest match Press enter when the required patient has been highlighted and the main menu will be displayed with the full patient details Note Check that the patient s height weight and dyspnea score are correct as these may have changed since the data was last entered modify before proceeding Option 4 Modify Patient Details To adjust any of the patient s details select this option and the current patient details will be displayed If no patient has been
32. is displayed with a maximum flow of 2 L s For clarity the sensitivity of the display should now be increased using the up and down keys until the tidal flow occupies more than half of the vertical axis The scaling of the graph has no effect on the measurement taken W hen the patient is breathing quietly and consistently press 2 to start the test 1 Done The point at which an occlusion pe Next test occurs may be set to a fixed flow or to the peak of inspiration If the random trigger method has been chosen when customising the airways resistance measurement then occlusions will occur automatically every few breaths until the specified number has been reached and option 2 will not be shown see airways resistance customisation page 14 This will occur in a random pattern to avoid the anticipation of an occlusion by the subject 43 When an occlusion takes place os the Rint value obtained will be 2 Next test displayed on the bottom of the display and the 100ms interruption of the flow will be visible The median value from all the tests completed is also displayed If the instrument has been customised for discrete operation the flow profile and the pressure at interruption will be displayed after each occlusion Press F1 of F2 to either accept or reject the test and continue with the examination When the airways are occluded on the peak of the tidal flow the slope of the pressure curve after the initial step an
33. lect tests When this option is selected the following will be displayed The MicroLab is capable of Re n on performing two types of respiratory function test It is recommended that only the required tests be activated to reduce the selections required during operation The spirometry test may be performed with a single forced expiration and inspiration or with tidal breathing prior to the forced manoeuvre Please note that the airways resistance test may only be performed using a MicroRint transducer Use the up and down cursor keys to move the arrow to the required test and then use F1 to turn the test on or off Select Tests System Customisation option 3 Clear records This option is used to remove all patient records from memory A warning will be displayed when selected to avoid the possibility of accidental erasure An individual patient s records may be deleted when a patient is selected during normal operation see Operation page 25 System Customisation option 4 Delete patients This option will delete all patients from the database who have no test results stored System Customisation option 5 Delete old records This option will delete all old records The period from 3 to 36 months for which records must be kept is specified when this option is used System Customisation option 6 Refresh patient order In some circumstances the order of the patients in the database may become disarrayed This will be evid
34. n The predicted baseline and post 1 and post 2 curves are shown where applicable N ote The unit may be configured to print only the Flow Volume loop or the Volume Time curve or neither and the printout will be reduced accordingly 37 The results may also be printed to an external printer see system customisation page 8 In this case the following screen will be displayed Option 5 End Examination Selecting this option will delete test results of the current patient if they are not already saved In this case the following warning will be displayed To save the results press 1 Press 2 to end the examination and discard the current patient s results The main menu is again displayed From this menu it is possible to test a new patient as previously described or run a different test on the same patient Spirometry Print results Connect to a printer using the serial to parallel convertor MLA350 and then press enter Press Esc to termimate printing Reminder Results not saved 1 Save results 2 Exit Christopher Lawson 12345ABCDE Male Caucasian 186cm 85kg Select the required option Main Menu 1 Run Test 2 New Patient 3 Select Patient 4 Modify Patient Details 5 Review Results Christopher _Lawson 12345ABCDE Male 186cm 85Kg BMI 254 Factor 100 Caucasian Dyspnea score 5 Memory 99 Free 28 02 02 12 34 38 Airways resistance overview Note to make this measurement a
35. n However regardless of default setting they may be turned on and off during a spirometry test by using the up and down arrow keys Predicted values U p to five sets of predicted values will be available depending upon national preferences 11 Note If Roca Spanish predicted values are selected then a weight entry will appear and must be entered on the patient details screen Display default D uring a spirometry test the display can be set to show the full flow volume curve Full Flow vol the expiratory part of the flow volume curve flow vol the volume time Vol time graphs or the child incentive as the default In either case the display can be changed after a spirometry manoeuvre has been performed by using the left and right arrow keys 2nd printed page There are four settings for this option which control the content of a full report Off a single page report showing all the results together with the Flow volume and Volume time curves will be produced Flow vol a two page report will be produced with the second page giving a large Flow volume loop exceeding ATS recommendations Vol time a two page report with a large Volume time curve exceeding ATS recommendations Both atwo page report giving both Flow volume and Volume time curves to ATS recommendations Best test criterion The criterion for the automatic selection of the best manoeuvre from a series of spirometry tests may be selected The options
36. n menu 1 Inspiration test 2 Expiration test 3 Trigger level Peak Christopher Lawson 12345ABCDE Male Caucasian 186cm 85kg Dyspnea score 5 Auto Zero Ensure that there is no flow through the transducer and then press enter The patient should breathe quietly through the transducer before the start of the test Use the up and down keys to adjust the scale if necessary Press shutter to demonstrate its operation Ga CO CT CED to lay the tongue on the floor of the mouth so that no obstruction can occur to the airflow The cheeks should be supported with one hand to reduce the effect of the mouth compliance and the transducer held with the other The subject should then breathe as normally as possible with no panting or forced expiration For children a facemask may be used instead of the 42 mouthpiece and adapter The facemask must be held firmly to the face to ensure that there are no leaks When the subject is breathing normally through the transducer the shutter may be operated by pressing Fl on the keypad in order to accustom the subject to the shutter action No measurements are taken during the shutter demonstration Excessive use of this function will cause the batteries to discharge prematurely and therefore a maximum of 5 operations is recommended Once the subject is accustomed to the shutter action press F4 and r cB 1 Shutter the following screen is displayed 2 Start test The tidal flow
37. ndicated MVV inay Forced inspired volume in 1 second FIV1 Forced inspiratory Vital Capacity FIVC Peak Inspiratory Flow Rate PIF FIV as a percentage of FIVC FIV1 FIVC Forced inspiratory flow at 25 of inhaled volume FIF25 Forced inspiratory flow at 50 of inhaled volume FIF50 Forced inspiratory flow at 75 of inhaled volume FIF75 Forced expiratory flow at 50 of volume as a percentage of FIF50 FEF50 FIF50 56 The time taken between 25 and 75 of the forced expired volume MET 2575 Forced Expiratory Time FET Tidal Volume TV Expiratory reserve volume ERV Inspiratory reserve volume IRV Inspiratory capacity IC Tests per subject VC unlimited best reported FVC unlimited best 3 from baseline post 1 and post 2 tests Predicted Values Various depends upon national preference Transducer Micro Medical Bi Directional Digital Volume Resolution 10ml volume 0 031 s flow Accuracy 3 To ATS recommendations Standardisation of spirometry 1994 update for flows and volumes Airways Resistance Predicted Values Percent predicted and normal range reported Transducer type Flow Pneumotachometer Pressure Piezo resistive Accuracy 3 for flow and volume Resolution 0 01 I s Flow range 0 to 2 l s Transducer battery Rechargeable NiC ad 6V 50mA hours Transducer dimensions 160x65x40mm Shipping W eight 2 75Kg including accessories References 1 Spirometric Lung Age estim
38. nect to a printer using the serial to parallel convertor MLA350 and then press enter Press Esc to termimate printing Reminder Results not saved 1 Save results 2 Exit Christopher Lawson 12345ABCDE Male Caucasian 186cm 85kg Select the required option Patient Selection 1 New patient 2 Select patient from memory 3 Modify patient details 4 Review append test 5 Run test Christopher Lawson 12345ABCDE Male Caucasian 186cm 85Kg Dyspnea score 5 Select the required option PC connection using SPIDA 5 SPIDA is an easy to use PC based windows application that interfaces to the MicroLab via a serial port It incorporates a database into which patient details can be entered and downloaded to the MicroLab or test results may be uploaded from the MicroLab Using SPIDA and the MicroLab live blows can be performed with the PC directly controlling the operation of the MicroLab The results and graphs produced are displayed directly on the PC screen The spirometer is connected from the serial port on the PC to the port on the side of the instrument using the serial cable provided Connect the MicroLab to the P C whilst the MicroLab is turned off Note the MicroLab should only be connected to a computer that is manufactured in accordance with EN60950 1992 1993 Safety of Information Technology Equipment including Electrical Business Equipment Keep the PC out of reach of the patient when connected to the
39. nected with the serial lead provided using SPIDA spirometry software SPIDA is a fully Windows compatible spirometry system that can interface to the spirometer in either of two ways Firstly tests recorded with the spirometer can be uploaded to SPIDA and appended to the integral database for subsequent storage and analysis Secondly live spirometry may be performed with the instrument connected to a computer running SPIDA In this case MicroLab becomes a powerful respiratory laboratory tool with many display options including powerful reporting and database facilities Stored data may be printed to the integral thermal printer or to an external printer using the serial to parallel interface Cat No MLA350 3 The manual is divided into two sections The first section deals with the customisation of the instrument functions and the second with the Operation It is highly recommended that the MicroLab be configured prior to use as many of the MicroLab s functions can be customised by the user to suit their own requirements The defaults set by the user are stored permanently in the spirometer and will remain unchanged until customisation is repeated Thereafter the user may refer to the second section only Package C ontents The MicroLab is packaged in a sturdy carrying case containing this manual and the following items Fig 1 1 MicroLab microcomputer unit with graphic display 2 Micro Medical D igital Volume Transducer 3 Transdu
40. not plugged in then the battery will continue to discharge until a voltage is reached which could impair the integrity of the microprocessor At this point the unit will turn itself off The MicroLab also has an auto turn off battery saving function whereby the unit will turn itself off if no keys are pressed for about 10 minutes This function is only active with the main menu displayed and is intended to save power in the event of the unit being turned on accidentally The Rint transducer is supplied by a 6 volt 50mA hour rechargeable nickel cadmium battery pack Looking after your MicroLab Spirometer Please observe the following precautions Avoid exposing the MicroLab to direct sunlight during use Avoid operating the spirometer in dusty conditions or near to heating appliances or radiators Do not keep the spirometer in a damp place or expose it to extremes of temperature Do not direct the transducer holder towards a strong light source whilst operating the spirometer Check the AC charger for compatibility with local power rating 50 Cleaning the T ransducer The transducer requires no routine maintenance or servicing However if you wish to sterilise or clean the transducer it may be removed by means of the following procedure 1 Rotating the turbine transducer anti clockwise until the locating pip lines up with the small rectangular cut out in the housing as shown below 2 Gently pull the transducer away
41. pleting the flow volume loop The display will show the tidal breathing manoeuvre as well as the forced expiration and inspiration W hen the tidal breathing method is used the full flow volume loop display is recommended to display the full tidal loop Report menu Now that the baseline spirometry test is complete a number of Spirometry Report menu options become available and can RY R View results be selected from the report menu Save results A post bronchodilator Post 1 Print results f a ereauired End examination maybe per oome q Christopher Lawson Alternatively the baseline results 12345ABCDE i Male Caucasian 186cm 85kg may be saved using option 3 and Select the required option recalled later to append a post bronchodilator or post steroid test The full results may be displayed using option 2 or the results printed using option 4 W hen all required actions have been taken then use option 5 to end the examination The current patient s name and ID are also displayed 31 Option 1 Post medication test To begin a Post Bronchodilator or steroid test on the current patient press 1 The Forced Vital Capacity screen is displayed with the best baseline loop or composite loop displayed as a dotted line The criterion for the best can be defined by the operator see spirometry customisation page 12 The predicted curve can be toggled on and off by using the up and down arrow keys Using th
42. ply CAL6000 5cm water gauge pressure 0 49 kPa When selected instructions for to the transducer and then press enter the auto zero procedure are displayed followed by Connect the free end of the tubing to the electronic manometer and connect a syringe to the T piece as shown below 22mm Female Connecting Female T Disposable Line filter Blanking Adapter Interrupter Transducer Manometer Carefully close the syringe until 5cm of water gauge pressure is obtained and remains stable and then press enter 20 If the calibration error is greater than 3 then the option to store the new value will appear Calibration check Calibration error 3 5 1 Store new value 2 Exit Select the required option Option 3 Print report Press enter to start printing or ESC to cancel A calibration report giving details of the last calibration check will be produced Option 4 Factory calibration This option is only used when a replacement Rint transducer is supplied by Micro Medical with factory calibration flow and pressure values 21 Section 2 Operation Connect the transducer to the MicroLab unit using the socket located at the rear of the instrument and turn on An introductory screen giving the software version will be displayed momentarily MAKING A DIFFERE Main Menu Overview The main menu will appear From this menu the details of a Main Menu new patient may be entered in
43. relaxed vital capacity measurement to be made prior to performing a forced vital capacity manoeuvre if required Insert the disposable or clean reusable mouthpiece into the transducer holder Instruct the patient to breathe in until their lungs are completely full seal their lips around the mouthpiece and blow out at a comfortable rate until they cannot push out any more air When the patient has sealed their lips around the mouthpiece and is ready to blow press a key to initiate the test The use of a nose clip is advised A solid moving bar on a volume axis is displayed together with a volume time curve as the patient breathes through the transducer The Relaxed Vital Capacity of this blow and the best blow for the current patient is displayed A line will appear on the volume Blow now This VC 4 62 Best VC 4 62 1 Again 2 Done axis to mark the best VC value obtained The test may be repeated as many times as is necessary to achieve an acceptable result To repeat the test press 1 To complete the VC test press 2 and the best result will be stored The FVC test will start automatically Forced vital capacity Option 3 The forced vital capacity test is selected either as option 3 from the spirometry main menu or after completion of a Relaxed VC test If the forced vital capacity test is not required after a VC test then press Esc and the report screen will be displayed with the added option
44. s 39 Rint transducer The Rint transducer is packaged in a sturdy carrying case containing this the following items Micro Medical interrupter transducer 2 off caps Disposable filters Mouthpiece adapter Facemask N oseclip D OLT ec The Rint transducer is fully discharged when shipped from the factory and must be charged by connecting to the MicroLab supplied by the mains using the AC adapter The MicroRint transducer will require 14 hours to become fully charged Connect the transducer to the MicroRint unit using the socket located at the rear of the instrument The disposable filter is connected between the facemask or mouthpiece adapter and the transducer as shown below 40 Facemask J Cardboard Mouthpiece Mouthpiece Adapter l fig 2 The filter provides protection against bacterial and viral cross infection between subjects It also protects the resistive element inside the transducer from contamination A new filter must be used for each patient tested The MicroRint will measure the total airway resistance of the subject including any added resistance between the subject and the transducer The small resistance of the Micro Medical breathing filter is automatically subtracted from the measurement Use only the filter type supplied by Micro Medical as other types with different values of resistance will give erroneous results The filter will gradually absorb moisture from the breath causing i
45. selected then the patient selection screen Select patient Sort Identity 113345 Philip Chowienczy 23H67 David Cocks 7FF33 Richard Haynes 77789H4 Glen Hillsley 8765432 John Jones ABCDE Christopher Lawso JNNB Daniel Quirke Search by J Use the numeral keys to type letter Be Sor PgUp_ Pabn_ Main Menu 1 Run Test 2 New Patient 3 Select Patient 4 Modify Patient Details 5 Review Results fale her Lawson BCDE Male 860m 85Kg BMI ee Factor 100 Caucasian Dyspnea score 5 Memory 99 Free 28 02 02 12 34 If incorrect use option 4 to Modify patient 12345ABCDE First name gt Christopher Last Name Lawson Date of birth 12 05 53 Male 186 75 Caucasian 100 5 CaS xa Core will be displayed first To adjust the data use the up and down arrow keys to highlight the required field and type the correction Please note that the patient ID cannot be altered To delete a patient from the database press F2 A warning will displayed to the effect that all stored results associated with the patient would also be deleted To accept the data and return to the main menu press F4 Press Esc to cancel this option and return to the previous screen Option 5 Review Results Once a patient has been selected any of their stored test results may Select test 03 03 01 10 23 Spiromet be retrieved The tests will be 93 03 01 11 30 Aways resistance A A y pirometry displayed In chronological order 11 03 01 15 32
46. t 420 695 340 880C and 895C xi Graphic LCD 240x160 pixels Input 100 to 240V 50 to 60Hz Output 9V 1 12A Class 1 Rechargeable NiMH 7 2V 1000mA hours 134x274x51 5 mm Transducer 50x60x90mm 829g 2 75kg with carry case and accessories Operating Temperature 0 to 40 C Operating Humidity 30 to 90 RH Storage Temperature 20 to 70 C Storage Humidity 10 to 90 RH 55 Spirometry Measurements A maximum of 15 indices may be selected from the following Relaxed Expiratory Vital C apacity VC Forced Expired Volume in 0 75 seconds FEV 75 Forced Expired Volume in 1 second FEV1 Forced Expired Volume in 3 second FEV 3 Forced Expired Volume in 6 seconds FEV6 Forced Vital C apacity FVC Peak Expiratory Flow Rate PEF FEV 7 as a percentage of VC FEV 75 VC FEV as a percentage of FVC FEV 75 FVC FEV as apercentage of VC FEV1 VC FEV as a percentage of FVC FEVI FVC FEV as apercentage of VC FEV3 VC FEV as apercentage of FVC FEV3 FVC FEV as a percentage of FEV6 FEV 75 FEV6 FEV1 as a percentage of FEV6 FEV1 FEV6 Maximum Expired Flow at 75 of FVC remaining MEF75 Maximum Expired Flow at 50 of FVC remaining MEF50 Maximum Expired Flow at 25 of FVC remaining MEF25 Mean Mid Expiratory Flow Rate MM EF Forced expiratory flow at 50 of volume as a percentage of VC FEF50 VC Forced expiratory flow at 50 of volume as a percentage of FVC FEF50 FVC Maximal voluntary ventilation i
47. to New Patient the MicroLab database or an 3 pesa Fannt Beka existing entry may be retrieved or 5 Review Results modified No patient details entered A stored test may be retrieved in order to review or delete A retrieved test may have a post bronchodilator or post steroid test appended to the baseline test A test may be performed with no patient selected In this case only the patient s age height and sex need be entered if predicted values are required Memory 99 Free 14 03 01 09 30 Note The current date and time and the amount of memory available are displayed at the bottom of the display If the date or time is incorrect they may be altered If the free memory is below 5 then more memory may be made available by deleting stored records If a permanent record is required the stored results my be uploaded to a PC running SPIDA 5 software see PC connection using SPIDA 5 page 49 22 Option 1 Run test W hen this option is selected the test selection screen will be displayed The patient details will appear only if they have been entered or retrieved from the patient database using options 2 or 3 Please note that if only one test has been enabled then this screen will be skipped Customisation page 6 A test may be performed with or without a patient selected If no patient has been selected then the following screen will appear when Run Test is selected These details must be entered to obtain pre
48. to perform a baseline FVC manoeuvre see report menu page 31 The spirometry screen is displayed showing the predicted Flow Volume curve as a dashed line The predicted curve will only be displayed if the patient details have been entered The arrows in the top right hand corner of the screen indicate that the left and right cursor keys are active In this case they are used to change the display between the full or expiratory only flow volume loop the full or expiratory only volume time curve or the child incentive display A spirometry test may be performed with or without tidal breathing through the transducer 28 Method 1 No tidal breathing Instruct the patient to breathe in until their lungs are completely full seal their lips around the mouthpiece and blow out as hard and as fast as possible until they cannot push any more air out and then breathe in fully immediately after the expiratory manoeuvre thus completing the Flow Volume loop The Flow Volume loop is displayed as the patient performs the manoeuvre At the end of the test values for FEVi FVC and PEF are displayed together with the Flow Volume loop and a manoeuvre quality check to allow Good blow a decision to be made to accept or reject this blow There are four quality checks performed on each spirometry manoeuvre to determine its acceptability If the patient performs an acceptable manoeuvre Good blow is displayed at the top of the screen If the b
49. trumentation with the most comprehensive range of features to be found in spirometers of their size and price The MicroLab amp capable of performing spirometry with or without tidal breathing before the forced manoeuvre and airways resistance measurements It is fully portable and can be operated directly from the mains power or from the integral rechargeable NiMH battery pack The MicroLab uses the Micro Medical Digital Volume Transducer an extremely stable form of volume transducer which measures expired air directly at B T P S Body Temperature and Pressure with Saturated water vapour thus avoiding the inaccuracies of temperature corrections This transducer is insensitive to the effects of condensation and temperature and avoids the need for individual calibration prior to performing a test The MicroLab has many advanced features including a high resolution graphic display giving real time respiratory traces user customisation of instrument functions predicted values patient database and the ability to carry out pre and post bronchodilator and post steroid testing The MicroLab may also be used with the MicroRint transducer to perform airways resistance measurements by the interrupter method The MicroLab can be used to make and record a minimum of 1000 complete respiratory tests depending on type The recorded tests can be uploaded to a computer or printed by direct connection to a printer To upload to a computer the unit is con
50. ts resistance to rise This rise will be negligible if used for one subject only but will give significant errors if re used on another subject Ensure that the side stream cap is firmly in place blanking off the upper 22mm port This port is only used when the transducer is used for measurement of airways flow limitation with negative expiratory pressure applied and must be sealed when performing an airways resistance test Before performing an airways resistance test enter a new patient s details to the MicroLab database or retrieve an existing patient see patient selection page 24 41 Select run test from the patient selection screen and then airways resistance from the test selection screen and the following will be displayed From the menu an airways resistance test may be initiated on inspiration or expiration The flow at which the occlusion occurs can also be set Option 1 Inspiration test Select option 1 and the display will show Place the red 22mm end cap over the free end of the filter holder and then press enter The instrument will now establish a zero calibration for the flow and pressure sensors The display will then show For adult subjects the use of a disposable cardboard mouthpiece is recommended The mouthpiece and adapter are assembled as shown on page 41 The subject should be instructed to wear the nose clip provided seal their lips firmly around the mouthpiece and Airways resistance Mai
51. uring a test as the subject may never reach the set flow rate If a very low value is set then inconsistent values of Rint may be obtained as the signal may be lost in physiological noise If zero is entered then the unit will trigger on the peak of the flow curve The instrument will always occlude using this setting and the signal will be above any noise The trigger level can also be adjusted from the airways resistance main menu prior to performing a test Trigger method This option sets the default for the trigger method random or user If random is selected then occlusion of the patients tidal breathing will occur automatically in a random pattern until the required number of tests have been performed If user is selected then no occlusions will occur until the user initiates a test with a key press Operating mode The airways resistance test may be operated in discrete or continuous mode 14 W ith discrete mode each occlusions has the associated pressure and flow waveforms displayed immediately after the occlusion The user may then choose to accept or reject the measurement before proceeding In continuous mode the flow and pressure waveforms may be reviewed upon completion of the test and spurious results deleted Number of tests The airways resistance measurement is taken as the median of the results obtained from a number of occlusions up to a maximum of 15 The maximum number of occlusions per test may be set using
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