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Elisée™ 150

Clinical Manual
English
NOT013189-6 07 11
Elisée™ 150
Clinical Manual
English
NOT013189-6 07 11
ResMed Schweiz AG Viaduktstrasse, Basel, Switzerland, +41 61 564 7000. Saime SAS (Manufacturer), Z.I., 25 rue de l’Etain, 77176 Savigny-le-Temple, France.
ResMed Corp Poway, CA, USA +1 858 746 2400, ResMed Ltd Bella Vista, NSW, Australia, +61 (2) 8884 1000. ResMed has offices in Austria, Brasil, China,
Finland, France, Germany, Hong Kong, India, Japan, Malaysia, the Netherlands, New Zealand, Norway, Singapore, Spain, Sweden, Switzerland and the United
Kingdom (see www.resmed.com for details).

Protected by the following patents: FR 0303538, FR 2766568, US 6164141.


Other patents pending. Elisée is a trademark of Saime SAS.

The technical specifications may be changed without notice. © 2007 Saime SAS is a subsidiary of ResMed Inc. 0197
Foreword
Contents of the Manual
This clinical manual is for an Elisée™ 150 ventilator with a software version of 2.3X or higher. The
manual is divided into sections. A summary of the information contained in each section is given
below:
• General Safety Instructions: precautions relating to use of the ventilator;
• Introduction and Description: description of the ventilator and its accessories;
• Installation: installation of the ventilator and its accessories;
• Ventilation: description of the ventilation modes and associated parameters;
• Clinical Configuration and Use: using the ventilator - turning it on and off, entering ventilation
settings in clinical mode;
• Patient Use: using the ventilator in Patient mode - turning it on and off;
• Alarms: description of the alarms and troubleshooting guide;
• Maintenance and Disinfection: procedures for cleaning the ventilator and accessories and
preventative maintenance schedule;
• Specifications and Technical Description: description and technical specifications for the
ventilator and its accessories, relevant standards;
• Appendices: list of parts and accessories, list of ventilation settings and measurements, list of
symbols and abbreviations.

Definitions
This manual contains special terms and icons that appear in the margins. Their purpose is to draw
your attention to specific or important information.
Caution
! Explains special measures for the safe and effective use of the ventilator.
Warning
! Alerts you to possible injury.

Note: Is an informative or helpful note.

iii
iv
Contents
Foreword . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . iii
1 General Safety Instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
2 Introduction and Description . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
2.1 Purpose of the Elisée 150 13
2.2 Description of the ventilator’s exterior 14
2.3 Description of power sources 17
Mains power pack ................................................................................................................................ 17
External DC power supply ................................................................................................................... 18
External battery pack ........................................................................................................................... 19
Internal battery ..................................................................................................................................... 19
Power status information ..................................................................................................................... 20
2.4 Description of the gas supplies 21
Air inlet ................................................................................................................................................. 21
Oxygen port ......................................................................................................................................... 21
3 Installation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
3.1 Power supplies 23
Mains power pack ................................................................................................................................ 23
External DC power supply ................................................................................................................... 24
External battery pack ........................................................................................................................... 25
3.2 Gas supply 26
Air inlet ................................................................................................................................................. 26
Low-pressure oxygen ........................................................................................................................... 26
3.3 Patient circuits and accessories 28
Connection of the single limb circuit and double limb circuit expiratory supports ............................... 29
Connecting a single limb patient circuit ............................................................................................... 30
Connecting a double limb patient circuit .............................................................................................. 31
Connecting accessories ....................................................................................................................... 32
3.4 Turning the Elisée 150 on and off 35
Turning on ............................................................................................................................................ 35
Using the touch screen ........................................................................................................................ 35
Turning off ............................................................................................................................................ 36
4 Ventilation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
4.1 Ventilation parameter definitions 39
4.2 Ventilation modes 48
(Assisted) Controlled Ventilation ((A)CV and P(A)CV) ........................................................................... 48
Intermittent Assisted Controlled Ventilation (Synchronised Intermittent Mandatory Ventilation) SIMV and
PSIMV .................................................................................................................................................. 52
Spontaneous ventilation (PS.SV (PS) and PS.VT) ................................................................................. 56

v
5 Clinical Configuration and Use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63
5.1 Accessing the clinical screens 63
5.2 Manual test 65
5.3 Programming ventilation options 70
Using the new patient icon .................................................................................................................. 70
Using the P1 and P2 buttons ............................................................................................................... 72
Modifying the patient configuration ..................................................................................................... 73
Changing the ventilation mode ............................................................................................................ 74
Adjusting ventilation parameters ......................................................................................................... 75
Starting and stopping ventilation ......................................................................................................... 80
5.4 Monitoring ventilation 81
Measurements .................................................................................................................................... 82
Event log .............................................................................................................................................. 83
Preparing the settings for monitoring in Easyview 150 ........................................................................ 86
5.5 Changing mode during ventilation 89
5.6 Parameter options 91
Parameter options screen .................................................................................................................... 91
Description of the parameter options .................................................................................................. 92
5.7 Specific settings 93
Calibrating the touch screen ................................................................................................................ 93
Empty curves/filled curves .................................................................................................................. 94
Screen brightness and digital sound (volume level) ............................................................................. 95
Date and time ...................................................................................................................................... 97
Assigning program names ................................................................................................................... 99
5.8 Exiting the clinical screens 102
6 Patient use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 103
6.1 Main patient screen 103
6.2 Patient mode settings screen 104
6.3 Starting and stopping ventilation in patient mode 105
Starting ventilation in patient mode ................................................................................................... 105
Stopping ventilation in patient mode ................................................................................................. 105
6.4 Measurements screen 106
6.5 Changing ventilation program during ventilation 107
6.6 Screen brightness/Digital sound volume 108
Accessing the setting screen ............................................................................................................. 108
Setting ................................................................................................................................................ 108
6.7 Calibrating the touch screen 109
6.8 Power supply and patient timer information 110
Power supply ..................................................................................................................................... 110
Patient timer ...................................................................................................................................... 111
7 Alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113
7.1 Monitoring the alarms 113
Silencing audible alarms .................................................................................................................... 113
7.2 List of ventilation monitoring alarms 114
7.3 General alarms causes and remedies 116
7.4 Alarm checking procedure 120
Testing the mains power and external DC power alarms .................................................................. 120
Testing settings alarms for use with single or double limb circuits .................................................... 121
Testing settings alarms for use with a double limb circuit ................................................................. 124
Testing settings alarms for use with a single limb circuit ................................................................... 125

vi
8 Maintenance and Disinfection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 127
8.1 Cleaning and maintenance frequency 127
Cleaning frequency ............................................................................................................................ 127
Preventative maintenance frequency ................................................................................................ 127
8.2 Maintenance, cleaning and replacement of wearing parts 128
Patient circuit and expiratory valve clapper ........................................................................................ 128
Humidifier .......................................................................................................................................... 128
The ventilator’s exterior ...................................................................................................................... 129
Replacing the anti-dust filter .............................................................................................................. 130
Replacing the O2 cell ......................................................................................................................... 131
Double limb circuit expiratory support ............................................................................................... 133
9 Technical Specifications and Description . . . . . . . . . . . . . . . . . . . . . . . . . . . . 135
9.1 Technical description and operation 135
Technical description .......................................................................................................................... 135
Operation of the ventilator ................................................................................................................. 136
Pressurised air flow diagram – Single limb circuit .............................................................................. 137
Pressurised air flow diagram – Double limb circuit ............................................................................ 138
9.2 Technical specifications for the Elisée 150 139
Electrical specifications ...................................................................................................................... 139
Battery life .......................................................................................................................................... 139
Pressurised air specifications ............................................................................................................. 142
Specifications and performance data ................................................................................................. 142
Operating, storage and transport conditions ..................................................................................... 145
9.3 Technical specifications for accessories 146
9.4 Applicable standards 148
10 Appendices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 149
10.1 Spare parts and accessories 149
10.2 Parameters and measurements 150
Parameter interdependence .............................................................................................................. 150
Ranges of adjustment, accuracies and default values ....................................................................... 152
10.3 Abbreviations and symbols 156
List of Figures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 165
List of Tables . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 169
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 171

vii
viii
1 General Safety Instructions
The following are general safety instructions. Other specific warnings and notes can be found
throughout the text of the manual. This manual must be read and understood in full by the user
before the device is used by a patient.

Use
• The Elisée 150 must not be covered or positioned in a way which could impede ventilation.
• Before connecting the patient to the ventilator, check the whole of the patient circuit to
eliminate any risk of leaks or defective parts.
• Alarms should be checked and adjusted before the device is used for a new patient. They
should also be checked and adjusted regularly when the device is being used for home
ventilation. These checks could be included in regular servicing.
• The ventilation settings must be decided and applied under the supervision of a physician or
qualified and trained staff.
• Do not use the ventilator with antistatic or electrically conductive patient circuits.
• It is recommended that you have an alternative means of ventilation available.
• For ventilation-dependent patients, it is vitally important that you monitor the ventilator while
it is in operation. Ensure that the person caring for the patient is capable of taking the
necessary corrective action if an alarm is triggered or if the device malfunctions.
• Do not use the ventilator if there are obvious external defects or unexplained changes in
performance.
• The ventilator and its clinical manual have received CE marking (notified body: TÜV Rheinland,
CE 0197). All accessories used must be CE-marked and must comply with the relevant
standards.

Operation
• Do not use this device in the presence of flammable anaesthetic agents.
• Several different pressure measurement units are used in this manual, to correspond to the
usual measurement units. 1mbar = 1hPa = 1.016cmH2O.
• The user must ensure that the total resistance of the patient circuit and ventilation
accessories does not exceed 6hPa (= 6.096cmH2O) for a flow rate of 60 L/min in adult
ventilation, or 6 hPa for a flow rate of 30L/min in paediatric ventilation.

Technical characteristics
• The pressure in the device will not be lower than atmospheric pressure during the expiratory
phase.
• The maximum pressure delivered by the device cannot exceed 60 - 70hPa
(= 61.0 - 71.1cmH2O).
• The ventilator design ensures that, if the device were to stop, the patient would be able to
breathe spontaneously and would not rebreathe exhaled air.

NOT013189-6 General Safety Instructions 11/174


Servicing and maintenance
• The manufacturer accepts no liability for damage to the device caused by maintenance or
modifications which do not comply with the instructions provided and which do not have the
manufacturer's prior approval, or which have been carried out by unauthorised persons.
• There is a technical manual for the ventilator, which is issued at ResMed training sessions. It
must be read and understood by the technicians responsible for servicing the ventilator.
• If anything unexpected occurs,contact your ResMed representative.
• To avoid the risk of electrocution, do not open the shell. All procedures should be carried out
by a technician trained in the maintenance of the ventilator.
• Do not obstruct the vents.
• Before using the device for the first time, and also between patients, the accessories should
be cleaned and disinfected.
• Replacement fuses must be identical to the old ones, and comply with the same standards.
Replacement must be carried out by a qualified technician.

Power supply
• If there is interference on the electrical network, operate the ventilator on battery power.
• The electricity source used for the ventilator must comply with the current standards.
• Use the specific power cord supplied with the ventilator.

Electromagnetic compatibility
• The user must ensure that the operation of the ventilator is not impaired by the concurrent
use of devices such as defibrillators or diathermy, electrosurgery or radiology equipment or
mobile phones.
• The device may be affected by electromagnetic fields greater than 10V/m.

Transport and storage


• This device is not protected against water penetration (IPX0). During transportation we
recommend using the device in its bag, to provide maximum protection against accidental
splashes.
• The ventilator must not be exposed to direct sunlight.
• The ventilator must not be subjected to any violent impact.
• The ventilator must not be turned on immediately after storage or transport in conditions
different from the recommended operating conditions.

Recycling
• In accordance with directive 2002/96/EC concerning waste electrical and electronic
equipment, this device must be disposed of separately from other types of rubbish. It must
not be disposed of with ordinary municipal waste. To dispose of this device, use the
appropriate waste collection, reuse and recycling system available in your region.

12/174 NOT013189-6
2 Introduction and Description
2.1 Purpose of the Elisée 150
The Elisée 150 is a valve ventilation device delivering both pressure and volumetric ventilation,
making it suitable for ventilating adult or child patients, at home and/or in a hospital setting.
It is not designed for neonatal ventilation and should not be used with circuits with a 10mm
diameter.
The circuit type chosen should be:
• 15mm in diameter for ventilation with a tidal volume between 50 and 300mL;
• 22mm in diameter for ventilation with a tidal volume > 300mL.
The device can be used with a single limb circuit and an expiratory valve, or with a double limb
circuit.
The Elisée 150 is designed to be used for both dependent and non-dependent patients.
This ventilator is fitted with an internal battery which is automatically used if the mains power
supply or external DC power supply is lost.
The Elisée 150 is designed to ensure that the patient is not affected by device malfunctions, using
a system of automatically triggered alarms.
However, it is preferable for the patient to have a backup means of ventilation close by.
Depending on the patient's condition, a backup Elisée 150 may need to be provided.

NOT013189-6 Introduction and Description 13/174


2.2 Description of the ventilator’s exterior
1. Mains or external power supply LED (see "Power status information" on page 20).
2. Retractable handle.
3. Internal and external battery LEDs: indicate the battery charge levels.
4. Alarm Silence button.
5. Brightness sensor: automatically adjusts the screen contrast.
6. Data exchange LED: green and flashing when data is being transferred via the serial port.
7. Bluetooth LED: steady blue when a connection is established.
8. Touch screen: lets you view and adjust the various parameters.

10

7
INT. 6
1 EXT.

5
3 4

Figure 2.1: Top view.


9. Single or double limb circuit expiratory support (interchangeable).
10. Insufflation outlet.
11. Mains power pack or external battery pack (interchangeable).

9 10

11

Figure 2.2: View of left side with double limb circuit expiratory support.

9 10

11

Figure 2.3: View of left side with single limb circuit expiratory support.

14/174 NOT013189-6
12. External DC power socket 12 - 28V / 15A max.
13. On/Off push button.
14. Serial link cable connection socket for connecting to a PC.
15. Remote alarm socket.

15
14
13
12

Figure 2.4: View of right side.


16.Low-pressure O2 port connection.
17. Air inlet.
18. Access to the O2 cell (optional).

17

18

16

Figure 2.5: Rear view.

NOT013189-6 Introduction and Description 15/174


19. Manufacturer plate.
20. Ventilator serial number.
Table 2.1: Description of a specimen serial number, e.g. EL2D0701001

EL2D 07 01 001

Product Year of Month of manufacture Sequential manufacture number


code manufacture

21. Compartment for mains power pack or external battery pack.


22. Speaker.
23. Item code (e.g. PACXXXXXX).

17

22

20
19

21

23

Figure 2.6: view underneath.

16/174 NOT013189-6
2.3 Description of power sources
The Elisée 150 can operate with four different power sources. The device automatically selects
the most secure available power source according to the following order of priority:
1. Mains AC voltage: 100-230VAC / 50-60Hz / 0.6-1A (mains power pack inserted in the Elisée
compartment).
2. DC voltage from an external source: 12-28VDC / 15A max.
3. External battery pack inside the external battery pack/mains power pack compartment.
4. Internal battery.
In the event of a power cut or if the mains power cord is disconnected, an audible and visual alarm
is activated. It can be stopped by pressing the Alarm Silence button .
Mains power pack
This pack is used for connecting the ventilator to the mains supply (see "Mains power pack" on
page 23).

Figure 2.7: Mains power pack.


This pack can also be used outside of its compartment, in which case it is connected to the
ventilator using the external power cord. This arrangement enables the ventilator to operate on
mains power and recharge the external battery at the same time (see "Figure 3.2: Connecting the
mains power pack outside of its compartment." on page 24 or see "Figure 3.4: Elisée 150 with
external battery pack and DC power source." on page 25).
Note: When powered using the external power cord, the ventilator treats this supply as an
external supply, not a mains supply.

NOT013189-6 Introduction and Description 17/174


External DC power supply

External power supply cord (mains 12-28 VDC power cord


power pack/Elisée connection)

Figure 2.8: External DC power cords.


An external DC power source (in a vehicule with 12-28V, 15A max.) can be used by connecting
the external power cord to the right side of the ventilator (see "Figure 3.3: 12-28VDC power cord,
connected." on page 24).
Note: The external DC power source must have a guaranteed life of at least one hour. If the
external power supply is less than 19 +/- 1V, the batteries will not be recharged.

18/174 NOT013189-6
External battery pack

Figure 2.9: Li-Ion external battery pack.


This battery pack is attached and removed in the same way as the mains power pack (see "Mains
power pack" on page 23).
This power supply takes priority over the internal battery.
Note: The external battery pack should be disconnected when the ventilator is switched off.
The external battery is recharged when the ventilator is connected to the mains power pack using
the external power cord or to an external DC supply (see "Figure 3.4: Elisée 150 with external
battery pack and DC power source." on page 25).
Note: When the external battery charge drops below 5%, the Elisée 150 switches to the
internal battery.
Internal battery
This battery is inside the ventilator. It is used when the ventilator is not connected to the mains
supply, to an external DC supply or to the external battery.
Whenever the ventilator is connected to an external power source (mains supply or external DC
supply) of more than 19 +/- 1V, the internal battery is automatically recharged.
Note: When the charge level falls below 15%, the Battery Low alarm is triggered. Within a
minimum of 5 minutes, this alarm is followed by the Battery Empty alarm (charge less than 5)
signalling that ventilation will stop.
Once ventilation has stopped, the device will shut down completely within a minimum of 5
minutes. During this time, connecting the device to a power source (other than the external
battery) will immediately restart ventilation.

NOT013189-6 Introduction and Description 19/174


Power status information
There are three LEDs on the top of the device showing the status of the power sources.
Table 2.2: Power status information

Power source Symbol and LED status Meaning

Mains or Green. Mains power pack or external DC


external. supply present.

Off. Neither mains power pack nor


external DC supply present.

Internal battery Green. Battery charged.


or
external
battery.
Green light, flashing slowly. Battery discharging: more than 15%
capacity remaining.

Orange light, flashing slowly. Battery discharging: less than 15%


capacity remaining.

Red light, flashing slowly. Battery discharging: less than 5%


capacity remaining.

Orange light, flashing rapidly. Battery charging interrupted (battery


temperature too high).

Green light, flashing rapidly. Battery charging.

Note: If the ventilator is operating on battery power alone, you must ensure it is adequately
charged (green light, flashing slowly). If not, connect the ventilator to the mains supply.
The battery charge is displayed one minute after the ventilator is started: one stroke in the
battery symbol indicates a charge level of around 25%.

20/174 NOT013189-6
2.4 Description of the gas supplies

Air inlet for gas supply

Oxygen port

Figure 2.10: Gas supply.

Air inlet
Ambient air passes through a removable anti-dust filter before arriving in the pressurised air
circuit.
Caution
! Do not obstruct this filter.

Oxygen port
The Elisée 150 has a low-pressure oxygen port (maximum 400kPa and 15L/min).
The air is enriched with oxygen through a special detachable metal connector (see "Spare parts
and accessories" on page 149).

Figure 2.11: Metal connector.

NOT013189-6 Introduction and Description 21/174


22/174 NOT013189-6
3 Installation
3.1 Power supplies
Mains power pack

Connections

1. Insert the two lugs on the mains power pack into


their slots.

2. Push firmly on the mains power pack until the clip


locks into place.

3. Connect the mains power cord to the power port


on the side of the pack.

4. Push down the fastening clip to prevent accidental


disconnection of the cord.

Figure 3.1: Connecting the mains power cord to the mains power pack in its compartment.

NOT013189-6 Installation 23/174


Note: The power pack is operational as soon as it is connected to the mains supply.
This pack can also be used outside of its compartment, in which case it is connected to the
ventilator using the external power cord. This arrangement enables the ventilator to operate on
mains power and recharge the external battery at the same time.

Figure 3.2: Connecting the mains power pack outside of its compartment.
Note: When powered using the external power cord, the ventilator treats this supply as an
external supply, not a mains supply.
External DC power supply

DC power cord

Connection

Figure 3.3: 12-28VDC power cord, connected.


An external DC power source (such as helicopter or car batteries, 12-28V, 15A max.) can be used
by connecting the external power cord to the power port on the right side of the ventilator.
Note: The external DC power source must have a guaranteed life of at least one hour. If the
external power supply is less than 19 +/- 1V, the batteries will not be recharged.

24/174 NOT013189-6
External battery pack
This battery pack is attached and removed in the same way as the mains power pack (see "Figure
3.1: Connecting the mains power cord to the mains power pack in its compartment." on page 23).
This power supply takes priority over the internal battery.
Note: The external battery pack should be disconnected when the ventilator is switched off.
The external battery (2) is recharged through the device when it is connected either to the
mains power pack (1) using the external power cord, or to an external DC supply.

1
2

Figure 3.4: Elisée 150 with external battery pack and DC power source.
Note: When the external battery charge drops below 5%, the Elisée 150 switches to the internal
battery.

NOT013189-6 Installation 25/174


3.2 Gas supply
Air inlet
Position the Elisée 150 so that air flow is not impeded.
Note: Do not block the air vents.
Low-pressure oxygen
1. Press on the side of the low-pressure O2 port connection to insert the metal connector.
2. Connect the oxygen tube.

2
1

Figure 3.5: Rear view with low-pressure oxygen connection.


Oxygen can be delivered via:
• An oxygen bottle fitted with a pressure regulator and a rotameter;

• An O2 concentrator, or wall-mounted O2 fitted with a rotameter.


The O2 supply is regulated using a concentrator or a rotameter. The user can monitor changes by
watching the FiO2 reading on the measurements screen.
Note: Connect oxygen only when ventilation has commenced, and disconnect oxygen before
stopping ventilation.

26/174 NOT013189-6
Turning the oxygen monitoring on and off

Turning the oxygen monitoring on


1. Turn off the ventilator (see "Turning off" on page 36).
2. Fit the oxygen sensor into its compartment (see "Replacing the O2 cell" on page 131).
3. Turn on the ventilator (see "Turning on" on page 35) and perform a manual test (see "Manual
test" on page 65).
The FiO2 reading is now available (see "Measurements" on page 82) and the adjustable minimum
and maximum FiO2 alarm is activated.

Turning the oxygen monitoring off


1. Turn off the ventilator (see "Turning off" on page 36).
2. Remove the oxygen sensor from its compartment and use the plug to seal the hole (see
"Replacing the O2 cell" on page 131).
3. The FiO2 measurement is now no longer available (the value is replaced by dashes) and the
adjustable minimum and maximum FiO2 alarms are no longer activated (although still
displayed on the screen).
Note: When the sensor is removed, the REPLACE O2 CELL alarm is triggered. Press the Alarm
Silence button once.
After removing the oxygen sensor, remember to insert the plug to prevent leaks.

NOT013189-6 Installation 27/174


3.3 Patient circuits and accessories
The Elisée 150 can be used with a single limb or a double limb patient circuit owing to its
interchangeable expiratory valve control system. To obtain the best results from this ventilation
system, a humidification system and/or antibacterial filters may be added.
The Elisée 150 ventilator is suitable for both adults and children. It is not designed for neonatal
ventilation and should not be used with circuits with a 10mm diameter.
The circuit type chosen should be:
• 15 mm in diameter for ventilation with a tidal volume between 50 and 300mL;
• 22 mm in diameter for ventilation with a tidal volume > 300mL.
Any single limb circuit with a water trap can be used with the Elisée 150, whether it is reusable
or for single use, provided that it complies exactly with the recommended circuit specifications.
You must perform a manual test whenever the patient circuit is modified (see "Manual test" on
page 65).
Note: The Elisée 150 automatically detects the patient circuit type and characteristics during the
manual test (see "Manual test" on page 65). A manual test should therefore be performed after
any changes to the circuit (type, brand, configuration, etc.).

28/174 NOT013189-6
Connection of the single limb circuit and double limb circuit
expiratory supports
There are two supports available:
• The single limb circuit support, to which the expiratory valve control and the proximal pressure
line can be connected.

Figure 3.6: Single limb circuit support.


• The double limb circuit support, to which the expiratory limb can be connected.
The supports connect directly to the left side of the ventilator.

Figure 3.7: Double limb circuit support.

Attaching and removing

Clips

Centring lugs
Figure 3.8: Attaching and removing the expiratory support.
To remove a support
1. Press the two fastening clips
2. Pull the support.
To attach a support
1. Position the two centring lugs opposite their holes
2. Press on the support until the two fastening clips lock into place.

NOT013189-6 Installation 29/174


Connecting a single limb patient circuit
For correct operation, we recommend the use of a CIR011563 single limb circuit or equivalent.

EXHALATION
VALVE
PRESSURE

Figure 3.9: Single limb patient circuit.


1. Check that the Elisée 150 is fitted with a single limb circuit support (if not, replace it,
see "Connection of the single limb circuit and double limb circuit expiratory supports" on
page 29).
2. Connect the expiratory valve control connection. Push it in and rotate one quarter turn to the
right.
3. Connect the proximal pressure line by fitting the hose onto the notched nipple.
Note: Depending on the circuit used, it may be necessary to cut off the tip of the proximal
pressure line.
4. Connect the inspiratory limb to the insufflation outlet.
Note: The pressure line must be located as close to the patient as possible. Measuring proximal
pressure improves insufflation pressure monitoring and pressure trigger sensitivity.
If an HME filter is added to the circuit, the proximal pressure line must be fitted between the
patient and the filter.

1 2

3 4

Figure 3.10: Attaching a single limb patient circuit.

Caution
! Use of a double limb circuit is recommended for ventilation-dependent patients.
We recommend setting a VTI alarm threshold of 10 - 15% of delivered volume.

30/174 NOT013189-6
Connecting a double limb patient circuit
For correct operation, we recommend the use of a CIR009727 double limb circuit or equivalent.

2
Figure 3.11: Connecting a double limb circuit.
Check that the Elisée 150 is fitted with a double limb circuit support (if not, replace it,
see "Connection of the single limb circuit and double limb circuit expiratory supports" on page 29).
1. Connect the expiratory limb to the exhaled air inlet.
2. Connect the inspiratory limb to the insufflation outlet.
Caution
! We recommend setting a VTE alarm threshold based on measured expiratory volumes.

NOT013189-6 Installation 31/174


Connecting accessories
Note: Remember to perform a manual test after every change made to the patient circuit.

Antibacterial filter

Figure 3.12: Connecting an antibacterial filter.


The Elisée 150 can be fitted with an antibacterial filter or a heat and moisture exchange (HME)
filter. Either type of filter can be connected to the Y-coupler, to the insufflation cone or to the
exhalation cone.
Note: It is advisable to connect an antibacterial filter to the insufflation outlet or to connect an
HME filter between the Y-coupler and the patient.
The antibacterial filter needs to be fitted the right way round, as described in the manufacturer’s
instructions.

Active humidification system

Figure 3.13: Connecting a humidifier.


The ventilator can also be combined with a humidification system to improve the humidity of the
air delivered to the patient.
Connect the heated base to a power supply in accordance with the manufacturer’s instructions.
Caution
! Assemble the humidifier in accordance with the manufacturer’s instructions. Generally
speaking, the ventilator and expiratory valve should be placed above the humidifier and
water traps.

32/174 NOT013189-6
Remote control

Figure 3.14: Connecting a remote control.


A remote control is available for the Elisée 150 which can be used to start and stop ventilation
and to silence audible alarms (those that can be permanently or temporarily turned off).
The remote control connects to the serial port connection socket.
• From the standby screen (device turned off, mains power connected), you can access the
main patient screen by pressing the remote control button for two seconds.
• To start ventilation, press the button for two seconds.
• To stop ventilation, press the button for six seconds.
• To turn off an audible alarm (if it is one that can be permanently or temporarily turned off),
press the button when the alarm is triggered.
Note: The remote control will stop the audible alarm only, not the visual alarm.

NOT013189-6 Installation 33/174


Trolley
The Elisée 150 can be attached to a trolley.
First, use an Allen key to fit a multi-support adapter to the Elisée, as shown below:

Figure 3.15: Fitting a multi-support adapter.


Then attach the Elisée 150 and multi-support adapter to the trolley, using the trolley's retaining
slot.

Figure 3.16: Attaching the Elisée to the trolley.

34/174 NOT013189-6
3.4 Turning the Elisée 150 on and off
Turning on
Press the button on the right side of the ventilator.

12-28 V
15A max

Figure 3.17: Turning the ventilator on.

Using the touch screen


Press directly on the appropriate screen icons to access display screens and select parameters.

Wednesday 28 February
11: 28: 31 intern.

Mains
ACV
P1:

PS START
P2: VENTIL

1s

INT.

EXT.

Figure 3.18: Using the touch screen.

NOT013189-6 Installation 35/174


Turning off
Press the button on the right side of the ventilator.
If the ventilator is in the patient screens and not delivering ventilation, the following screen
appears.

Back

Do you want to switch off?

YES NO

Figure 3.19: "Do you want to switch off?" screen.


The question "Do you want to switch off?" appears on the screen. Press YES to turn the Elisée
150 off or NO to return to the previous screen.
If you press YES, the flashing message "Stop in progress" is displayed and the ventilator turns off.
An audible alarm will sound. It can be stopped by pressing the Alarm Silence button once.
If the ventilator is in the clinical screens and not delivering ventilation, the following screen
appears.

cm
15H2O MENU Configuration
Options ... Back
90

80

70

60

50

40
Pause (stop ventilation)
30

20
< PS
10 Stop machine

0 < PE

Figure 3.20: “Turning off the ventilator in clinical mode with ventilation stopped” screen.

36/174 NOT013189-6
If the ventilator is in the patient screens and delivering ventilation, the following screen appears.

cm
15H2O
90
Back

80

70

60

50

40
Pause (stop ventilation)
30

20
< PS
10 Stop machine

0 < PE

Figure 3.21: “Turning off the ventilator in patient mode during ventilation” screen (as Fig 3.19).
If the ventilator is in the clinical screens and delivering ventilation, the following screen appears.

cm
15H2O MENU Configuration
Options ... Back
90

80

70

60

50

40
Pause (stop ventilation)
30

20
< PS
10 Stop machine

0 < PE

Figure 3.22: “Turning off the ventilator in clinical mode during ventilation” screen (as above).
In all three cases, press "Stop machine" to turn off the Elisée 150.
The flashing message "Stop in progress" is then displayed and the ventilator turns off. An audible
alarm will sound. Press the Alarm Silence button to turn it off.
Note: If the ventilator remains connected to mains power or an external power supply, it cannot
be turned off. It must first be disconnected from the power supply.
In the event of touch screen failure, it is possible to force the ventilator to stop in the following
manner:
1. Disconnect the ventilator from mains power or the external power supply;
2. Press the button on the right side of the ventilator;
3. Simultaneously press the Alarm Silence button ;
4. Hold both buttons down until the ventilator stops (10 seconds).

NOT013189-6 Installation 37/174


38/174 NOT013189-6
4 Ventilation
4.1 Ventilation parameter definitions
Pressure support PS (cmH2O)
The pressure supplied by the device in addition to the PEEP during inspiratory phases in PS.SV
(PS) and PS.VT modes.

P
PS

PEEP t
Figure 4.1: Pressure support.

Recruitment cycles
Recruitment cycles open collapsed alveoli by maintaining a longer insufflation time during a
controlled pressure cycle.
These cycles are always pressure cycles, whether the device is in (A)CV or P(A)CV mode.

V
t

Recruitment
cycle

Figure 4.2: Recruitment cycle in (A)CV mode.

P
t

V t

Recruitment
cycle

Figure 4.3: Recruitment cycle in P(A)CV mode.

NOT013189-6 Ventilation 39/170


The device imposes respiratory cycles on the patient with the following adjustable parameters:
• the recruitment period (the interval between two recruitment cycles);
• the recruitment size (duration of insufflation in the recruitment cycle);
• the recruitment pressure (pressure insufflated during the recruitment cycle).

Max. flow Vmax


The maximum inspiratory flow delivered to the patient. It has a direct impact on the inspiratory
time required to deliver the set volume during the cycle.

Flow shape
In volumetric mode, the flow delivered by the device may be constant or decreasing. The
delivered tidal volume and the respiratory rate are unaltered.

V
Decreasing flow

Constant flow

Time
Figure 4.4: Flow shape parameter with I/E or Ti setting.

Constant flow
Vmax

Decreasing flow

Time

Figure 4.5: Flow shape parameter with Max. flow setting.

40/170 NOT013189-6
With a constant flow (1), the delivered flow is more or less constant throughout the active
inspiratory phase.
With a decreasing flow, the delivered flow decreases throughout the active inspiratory phase.
Four settings are available with I/E or Ti:
• flow with a decreasing slope setting of 2;
• flow with a decreasing slope setting of 3;
• flow with a decreasing slope setting of 4;
• flow with a decreasing slope setting of 5;

3
4

5 t
Figure 4.6: Flow shape parameter with I/E or Ti setting.
Four settings are available with max. flow ( Vmax):
• flow with a decreasing slope set at 75% (2) of the Vmax;
• flow with a decreasing slope set at 50% (3) of the Vmax;
• flow with a decreasing slope set at 25% (4) of the Vmax;
• flow with a decreasing slope set at 0% (5) of the Vmax;

Flow decreasing to 75%

Vmax
Flow decreasing to 50%

Flow decreasing to 25%

Flow decreasing to 0%

t
Figure 4.7: Flow shape parameter with Max. flow setting.

NOT013189-6 Ventilation 41/170


Respiratory rate F (bpm)
The number of breaths per minute.
The respiratory rate can be controlled by the device (controlled breaths) or by patients themselves
with the support of triggers (spontaneous or assisted controlled breaths).

Backup respiratory rate Fmini (bpm)


The minimum respiratory rate.
The backup rate ensures the patient takes a minimum number of breaths per minute.

Slope
Defines the time taken to reach the set pressure. The slope can be adjusted from 1 to 4
(1 is approximately equal to 100ms and 4 = 600ms).

P
Set pressure

1 2 3 4

t
Figure 4.8: slope.

Positive end expiratory pressure PEEP (cmH2O)


Pressure supplied by the device and maintained during exhalation.

P
PS

PEEP t
Figure 4.9: Positive end expiratory pressure.

Inspiratory pressure P Insp (cmH2O)


The pressure supplied by the device in addition to the PEEP parameter during inspiratory phases
in assisted controlled and controlled pressure modes.

P
P Insp.

PEEP t
Figure 4.10: Inspiratory pressure.

42/170 NOT013189-6
Inspiration to expiration ratio I/E
The ratio of inspiration time to expiration time for each breath.
P Insp.
P Example:
Ti = 2seconds
Te = 4seconds
t
I/E = 1/2
Ti Te

V
t

Figure 4.11: I/E ratio.

Apnea time Tapnea (s)


Period of time after which the device delivers a respiratory cycle if the patient has not breathed.
This parameter is available in spontaneous mode only (see "Spontaneous ventilation (PS.SV (PS)
and PS.VT)" on page 56).

P
Tapnea
Ex : 20 seconds

t
Figure 4.12: Apnea time.

Inspiratory time Ti (s)


Time during which the device is delivering insufflation to the patient.

P Insp.
P

t
Ti Te

V
t

Figure 4.13: Inspiratory time.

NOT013189-6 Ventilation 43/170


Maximum inspiratory time Ti Max (s)
The maximum time for which the device will maintain inspiratory pressure before cycling to
expiration. It gives the patient a window of inspiratory time in which to spontaneously cycle into
the expiratory phase. Ti Max is available in spontaneous mode only (see "Spontaneous ventilation
(PS.SV (PS) and PS.VT)" on page 56).
The following table enables you to select the Ti Max value which best fits the patient's
spontaneous respiratory rate.
Table 4.1: Ti Max setting guide

Spontaneous COPD Normal


respiratory rate (bpm) Ti Max (s) Ti Max (s)

30 0.7 1.0

29 0.7 1.0

28 0.7 1.1

27 0.7 1.1

26 0.8 1.2

25 0.8 1.2

24 0.8 1.3

23 0.9 1.3

22 0.9 1.4

21 0.9 1.4

20 1.0 1.5

19 1.0 1.6

18 1.1 1.7

17 1.2 1.8

16 1.2 1.9

15 1.3 2.0

14 1.4 2.1

13 1.5 2.3

12 1.7 2.5

44/170 NOT013189-6
Expiratory trigger Tg Exp
The value which defines the end of an inspiratory phase. It can be expressed in two ways:
• In automatic mode: Automatic cycling allows the inspiratory time to be adapted to the flow
shape, and particularly to the V max.
An imaginary line (the dotted line in the diagram) is drawn from the point where the cycle
began to the point with the coordinates '3seconds; V max'.
Cycling occurs at the point where this imaginary line intersects with the flow curve.
• In manual mode (%): The expiratory trigger is expressed as a percentage of the maximum
flow.
The expiratory phase is triggered when the decreasing flow reaches the target percentage.

Vmax 2 The expiratory trigger in automatic


mode.
V
Vmax 1

Cycling to expiration

3 Seconds

3 Seconds

The expiratory trigger in manual


Vmax mode (%).

Tg Exp. = 40%
V Tg Exp. = 25%
Tg Exp. = 10%
t

Figure 4.14: Expiratory trigger.

NOT013189-6 Ventilation 45/170


Inspiratory trigger TgI
The value which defines when an inspiratory phase is triggered. This trigger can be defined in
terms of flow or of pressure:
• Invasive inspiratory flow trigger TgI( V ): Operates with a double limb circuit only.
At the end of expiration, when the patient starts to inhale, the flow measured by the
expiratory sensor becomes lower than the flow measured by inspiratory sensor. The device
triggers an inspiratory phase when the difference between the flow measurements reaches
the set trigger value. The flow trigger is recommended for situations which require a very
sensitive trigger level.
• Invasive inspiratory pressure trigger TgI(P): Operates with a single or double limb circuit.
A depression in the respiratory circuit during the expiratory phase triggers the inspiratory
phase when the set trigger value is reached.

Figure 4.15: Invasive inspiratory triggers.


• Non-invasive inspiratory trigger TgI: Operates with a single or double limb circuit.
It operates according to the amplitude of the pressure variation when a patient inhales.
The operation of the trigger is based on an algorithm that analyses the differences in
expiratory pressure every 10ms, enabling detection of rapid and slow patient breathing.
The trigger also takes account of leaks in the circuit.
The most sensitive trigger value is 1.

TgI = 1
TgI = 2
TgI = 3
Tgl = 4
t
Figure 4.16: Non invasive inspiratory trigger.

46/170 NOT013189-6
Tidal volume VT (mL)
The volume of air received by the patient from the device (VTI), and the volume of air exhaled by
the patient (VTE).

V
VTI
t
VTE

Figure 4.17: Tidal volume (VT).

Backup tidal volume VTS (mL)


This is the minimum tidal volume delivered in each cycle.
However, this volume cannot be delivered in the following situations:
• if the set threshold for the Pmax alarm is reached (the set Pmax value must be greater than
PS + PEEP + 5 hPa + 20%(PS + PEEP));
• if the required pressure is greater than PS (or P insp) + PEEP + 5 hPa + 20% × (PS(or P insp)
+ PEEP);
• if the required pressure is greater than 60hPa.
When the pressure is not sufficient to obtain an insufflated volume greater than or equal to the
backup tidal volume (VTS), in the following cycle the pressure support is increased to ensure the
backup tidal volume is delivered.
Note: 1hPa = 1mbar = 1.016cmH2O.

NOT013189-6 Ventilation 47/170


4.2 Ventilation modes
(Assisted) Controlled Ventilation ((A)CV and P(A)CV)
In (Assisted) Controlled Ventilation, the device delivers cycles with a fixed insufflation time and
set volume ((A)CV mode) or set pressure (P(A)CV mode).
In CV and PCV modes, cycles are triggered by the device (set respiratory rate). In ACV and PACV
modes, cycles can also be triggered by the patient (flow or pressure trigger) if the patient's
respiratory rate is higher than the set respiratory rate.
The inspiratory time is set by the device and is based on adjustable parameters.
In these modes, users can set recruitment cycles.
Note: When one or both of the inspiratory triggers are deactivated, ventilation changes from
Assisted Controlled Ventilation to Controlled Ventilation. In the space on the display where the
ventilation mode is shown, the "A" in ACV or PACV is greyed out.

(A)CV
Principle of (Assisted) Controlled Volume Ventilation

The course of a cycle


In (A)CV mode, cycles are flow-controlled during a fixed inspiratory time to ensure the set volume
is delivered. Controlled cycles are delivered according to the respiratory rate set by the user. In
ACV mode, assisted controlled cycles can be triggered by the patient over and above the set
respiratory rate.
Cycling occurs at the end of the inspiratory time set by the user. The inspiratory time can be set
in a variety of ways (see "Parameter options" on page 91).
Table 4.2: Adjustable parameters in (A)CV mode

Adjustable parameters Assisted Controlled Volume Ventilation (A)CV

VT

VTS
Flow shape

Fmini

Ti

Ti, max flow or I/E

Ti Max

P insp.

PS

PEEP

Slope

Inspiratory triggers ACV mode only

Expiratory trigger

Apnea parameters

Recruitment parameters

48/170 NOT013189-6
Note: During (A)CV, the Elisée 150 delivers flow-controlled cycles. Airway pressure and alveolar
pressure then depend on the resistance and compliance of the patient’s respiratory system.
It is important to set the high-pressure alarm (Pmax) to avoid the risk of barotrauma.
The bar graph, shown on all ventilation screens, allows you to monitor airway pressure.

CC CC CC CC

t
T mecha T mecha T mecha T mecha

V Fixed Ti Fixed Ti Fixed Ti Fixed Ti

T mecha: Device period (depends on frequency)


CC: Controlled Cycle
Figure 4.18: CV mode - Controlled Volume Ventilation.

CC ACC CC CC

t
T mecha
T mecha T mecha T mecha

V Ti fixed Ti fixed Ti fixed Ti fixed

T mecha: Device period (depends on frequency)


ACC: Assisted Controlled Cycle t
CC: Controlled Cycle
Figure 4.19: ACV mode - Assisted Controlled Volume Ventilation.

NOT013189-6 Ventilation 49/170


P(A)CV
Principle of (Assisted) Controlled Pressure Ventilation

The course of a cycle


In P(A)CV mode, cycles are pressure controlled. Flow is adjusted to maintain the set pressure
during the set inspiratory time. Controlled cycles are delivered according to the respiratory rate
set by the user. In PACV mode, assisted controlled cycles can be triggered by the patient over
and above the set respiratory rate.
The tidal volume and the minute volume are based on the resistance and compliance of the
patient's respiratory system.
The set P insp is added to the PEEP, so Total inspiratory pressure = Pinsp + PEEP.
Table 4.3: Adjustable parameters in P(A)CV mode

Adjustable parameters Assisted Controlled Pressure Ventilation P(A)CV

VT
VTS

Flow shape

Fmini

Ti

Ti, max flow or I/E

Ti Max

P insp.

PS

PEEP

Slope

Inspiratory triggers PACV mode only

Expiratory trigger

Apnea parameters

Recruitment parameters

Note: In P(A)CV, the flow is adjusted to maintain a constant pressure. Consequently, the
volume delivered may vary depending on compliance and resistance. It is therefore important to
monitor the inspiratory and expiratory volumes using the max and min VTI and VTE and the min
and max minute volume alarms (the minute volume alarm is not available if the FiO2 option is
activated).

50/170 NOT013189-6
CC ACC CC CC
Set P
Fixed Ti Fixed Ti
P

t
T mecha T mecha T mecha
V T mecha

T insp T insp

t
patient effort

T mecha: Device period (depends on frequency)


CC: Controlled Cycle
ACC: Assisted Controlled Cycle
Figure 4.20: PACV mode - Assisted Controlled Pressure Ventilation.

CC Set P CC CC CC
P
Fixed Fixed Fixed Fixed
Ti Ti Ti Ti
t
T mecha T mecha T mecha T mecha

T mecha: Device period (depends on frequency)


CC: Controlled Cycle
Figure 4.21: PCV mode - Controlled Pressure Ventilation.

NOT013189-6 Ventilation 51/170


Intermittent Assisted Controlled Ventilation (Synchronised
Intermittent Mandatory Ventilation) SIMV and PSIMV
In the Intermittent Assisted Controlled Ventilation modes, the device alternates between cycles
of assisted controlled ventilation (with regulated flow (SIMV) or regulated pressure (PSIMV)) and
spontaneous cycles with pressure support (PS) triggered by the patient.
This mode allows spontaneous breathing.

Principle
Controlled ventilation cycles (CC) are triggered according to the respiratory rate, or "mechanical
respiratory rate (frequency)" (Fmecha). The mechanical respiratory rate (frequency) dicates the
mechanical cycle time Tmecha (seconds) = 60/Fmecha. One minute of ventilation is therefore
divided into fixed mechanical cycle times, and the mechanical respiratory rate (frequency) is
unchanged.
To allow patient-ventilator synchronisation, a triggering window (Wsync) of assisted controlled
cycles (ACC) is defined before the start of each controlled ventilation cycle. This window lasts for
5 seconds in adult mode and 1.5 seconds in paediatric mode. If the patient triggers a cycle during
this window, or zone, the cycle will be an assisted controlled cycle (ACC) with either the pressure
(PSIMV) or the volume (SIMV) regulated (zone 1).
Following each trigger window (Wsync) (assisted or controlled), is an interval of time (WVS) during
which the patient can trigger a cycle of spontaneous ventilation with pressure support (5 cmH2O
minimum) (zone 3). The delivered cycle will be a pressure support cycle. The parameters for the
cycles of spontaneous ventilation with pressure support (PS) can be adjusted.
Cycles of spontaneous ventilation are always delivered with pressure support. If pressure support
was not provided with spontaneous ventilation, the patient would have to work harder to
overcome the resistance of the tubing and the ventilator. By adding a minimum pressure support
of 5 - 8cmH2O, the ventilator can effectively relieve the patient of the portion of the respiratory
effort needed to overcome the combined resistance of the machine-circuit-filter-water trap.
If after an assisted controlled cycle (ACC) is triggered the patient does not trigger a cycle within
the next trigger window (Wsync), the Elisée 150 will deliver a controlled cycle based on the
mechanical respiratory rate (frequency) (Fmecha) defined by the user (zone 2). This means that
the expiratory time (Texp) of the assisted controlled cycle is extended by the anticipated time ΔT
allowed prior to triggering of the controlled cycle. The set mechanical respiratory rate (frequency)
remains unchanged.
However, the value of ΔT is limited by the value of ΔTmax: 5s for adult ventilation, 1.5s for
paediatric ventilation.

52/170 NOT013189-6
P Patient triggering of Device controlled Triggering of a Support
an assisted controlled cycle cycle cycle by the patient

Zone 1 Zone 2 Zone 3

ΔT T exp ΔT

t
T mecha T mecha T mecha T mecha

Wvs: Window for the triggering of spontaneous PS cycles

Wsync: Window for the triggering of assisted controlled cycles (5 or 1.5 s)

T mecha: Device period defined by the frequency

Figure 4.22: Operation of SIMV mode.


Note: In zone 1, the patient can trigger only assisted controlled cycles (ACC), and only within the
synchronisation window (Wsync).
Depending on the respiratory rate and the I/E ratio settings, if the expiratory time is less than the
length of the Wsync (5s or 1.5s), the Wsync will last for the whole of the expiratory phase. The
patient will not be able to trigger cycles of spontaneous ventilation with pressure support
between controlled cycles (PS).

1.2 s 4.8 s

Wsync: Window for the triggering of assisted controlled cycles (5 or 1.5 s)

T mecha: Device period defined by the frequency

Figure 4.23: SIMV mode.


Note: In adult ventilation for example, it is important to use this mode with a respiratory rate of
less than 10 bpm if you want to keep a window for triggering spontaneous ventilation with
pressure support (WVS).
At that respiratory rate, the cycle time is 6s (60/10). If you set a Ti of 1.2 s, the Te will be 4.8s.
This means that Te < 5s (Wsync) and so the WVS value is zero.
With a respiratory rate of 8bpm and an inspiratory time of 1.2s, the Te will be 6.3s, leaving
1.30s available for the WVS.

NOT013189-6 Ventilation 53/170


Note:
• During SIMV it is important that you monitor the level of pressure in the patient's airway
through the high pressure alarm, to avoid barotrauma.
• During PSIMV, for both assisted controlled cycles and spontaneous cycles with pressure
support, the tidal volume is not set but results from the set pressure gradient and from the
patient's respiratory mechanics. It is therefore important that you monitor the inspiratory and
expiratory spirometry through the high and low VTI and high and low minute volume alarms.
Table 4.4: Adjustable parameters in SIMV mode

Synchronised intermittent mandatory ventilation,


Adjustable parameters
SIMV

VT
VTS

Flow shape

Fmini

Ti

Ti, max flow or I/E

Ti Max

P insp.

PS

PEEP

Slope

Inspiratory triggers

Expiratory trigger

Apnea parameters

Recruitment parameters

Table 4.5: Adjustable parameters in PSIMV mode

Pressure Synchronized Intermittent Mandatory


Adjustable parameters
Ventilation PSIMV

VT
VTS

Flow shape

Fmini

Ti

Ti, max flow or I/E

Ti Max

P insp.

PS

PEEP

54/170 NOT013189-6
Pressure Synchronized Intermittent Mandatory
Adjustable parameters
Ventilation PSIMV

Slope

Inspiratory triggers

Expiratory trigger

Apnea parameters

Recruitment parameters

NOT013189-6 Ventilation 55/170


Spontaneous ventilation (PS.SV (PS) and PS.VT)
The Elisée 150 offers two modes of spontaneous ventilation: pressure support with backup
volume and pressure support with minimum volume. Both modes include apnea ventilation as
backup ventilation for the patient.

PS.SV (PS)
Principle of Pressure support
Pressure support is a pressure mode which supports the patient's spontaneous respiration.

Inspiratory phase
Once it has detected that the patient is inhaling, the Elisée 150 pressurizes the inspiratory circuit
to reach the target pressure. The time taken to reach this pressure depends on the Slope setting,
which determines the peak flow delivered by the device.
In the pressure maintenance phase the flow is delivered and adjusted according to the patient’s
needs and the resistance and compliance of the patient’s respiratory system.
The start of each cycle is triggered by the patient.
However, the Elisée 150 has a backup rate setting (Fmini): if the number of cycles triggered by
the patient is less than the backup rate, support cycles will be triggered by the device.
PS.SV (PS) mode also allows you to set an apnea time, at the end of which the ventilator
switches to apnea ventilation if the patient does not trigger a cycle (see "Principle of Apnea
ventilation" on page 62). The patient can still trigger a cycle after the device has commenced
apnea ventilation. If the patient triggers three consecutive cycles, ventilation switches back to
pressure support.
Note: Apnea ventilation is available only when "Fmini = No".
A backup tidal volume VTS can be set: the ventilator increases the level of pressure cycle by cycle
until this volume is reached. In this case, the set level of pressure support will be ignored.
However, if the pressure required to reach the backup volume is greater than "PS max = PS +
PEEP + 5hPa + 20%(PS + PEEP) of the target pressure support" or is greater than 60hPa or the
Pmax value reached (the set Pmax value must be higher than the PS max value), the backup
volume will not be able to be delivered. The new level of pressure support is reached by
increments of PS max - (PS/2), until VTI = VTS.
Note: 1 hPa = 1 mbar = 1.016cmH2O.

56/170 NOT013189-6
PS max = PS + PEEP + 5 hPa +20% (PS + PEEP)

PS + PS max/2

P PS PS

PEEP PEEP t

V
t
VTI < VTS VTI < VTS VTI = VTS

Figure 4.24: Mode PS.SV (PS), pressure increased to reach VTS.

Expiratory phase
The device cycles into the expiratory phase:
• When the expiratory trigger setting is reached. The setting may be:
• based on the peak flow drop (Scenario No. 1);
• an automatic setting based on the intersection of the flow curve with the 3s line
(Scenario No. 2).
• If the set pressure of 2cmH2O is exceeded during the decreasing flow stage, the patient may
have initiated active exhalation (Scenario No. 3).
• When the maximum inspiratory time set by the user is reached (Scenario No. 4), if none of
the above conditions are met. This scenario can occur if there are leaks in the circuit, or if the
flow doesn't decrease sufficiently to reach the expiratory trigger setting.

Scenario No. 3: Pressure


exceeded by > 2 cmH2O
Pressure parameter

t
Scenario No. 2:
V Scenario No. 1: Peak
Intersection of the
flow curve with the
flow drop of XX%
3 second line

t
3 seconds Scenario No. 4: Ti Max
value reached

Figure 4.25: Expiratory phases in PS.SV (PS) mode.


Note: The set PS level is added to the PEEP level.

NOT013189-6 Ventilation 57/170


Table 4.6: Adjustable parameters for PS

Adjustable parameters Pressure support with backup tidal volume PS.SV (PS)

VT

VTS

Flow shape

Fmini

Ti

Ti, max flow or I/E

Ti Max

P insp.

PS

PEEP

Slope

Inspiratory trigger

Expiratory trigger

Apnea parameters

Recruitment parameters

58/170 NOT013189-6
PS.VT
Principle of pressure support with minimum tidal volume

Inspiratory phase
The start of each cycle is triggered by the patient. However, the Elisée 150 has a backup rate
setting (Fmini): if the number of cycles triggered by the patient is less than the backup rate,
support cycles will be triggered by the device.
PS.VT mode also allows an apnea time to be set, at the end of which the ventilator commences
apnea ventilation if the patient does not trigger a cycle (see "Principle of Apnea ventilation" on
page 62). The patient can still trigger a cycle after the device has commenced apnea ventilation.
If the patient triggers three consecutive cycles, ventilation switches back to pressure support.
Apnea ventilation is available only when "Fmini = No".
The delivered cycle begins with pressure support ventilation. The Elisée 150 constantly
calculates, from the VT already delivered and the inspiratory time remaining, whether the target
minimum tidal volume (VT) will be able to be delivered.
If it calculates that the target minimum VT will be reached, the Elisée 150 continues the cycle in
pressure support mode (see "Figure 4.26: PS.VT curve - Minimum tidal volume (Vt) delivered
without switching to volumetric mode." on page 59). However, if it calculates that the VT will not
be reached by staying in pressure support mode, the ventilator will switch to volumetric mode.
The Elisée 150 then delivers the remaining part of the minimum tidal volume while maintaining a
constant flow at an appropriate level until the target minimum tidal volume is reached (see "Figure
4.27: PS.VT curve - Minimum tidal volume delivered with switch to volumetric mode." on page
60). Switching to volumetric mode means that the set pressure will be exceeded during that cycle
in order for the minimum tidal volume to be delivered. Setting a Pmax alarm value limits the
extent to which the set pressure will be exceeded.
Note: To ensure optimum comfort, the minimum VT should be set to a lower value than the VTE
established in pressure support mode. If it is set too close to the established VTE, a volumetric
mode will be triggered too often. This note is only an indication; the minimum VT should be set
based on a balance between benefit and comfort.

V
t
Figure 4.26: PS.VT curve - Minimum tidal volume (VT) delivered without switching to volumetric
mode.
The target minimum tidal volume is delivered through pressure support alone. The ventilator
doesn't switch to volumetric mode while in PS.VT mode. The inspiratory flow progressively
reduces until the expiratory trigger threshold is reached.

NOT013189-6 Ventilation 59/170


P
A
t
1 2
Timax
V

t
B

V
t
I E I E
Figure 4.27: PS.VT curve - Minimum tidal volume delivered with switch to volumetric mode.
Based on its analysis of the fixed pressure support and Ti Max parameters, the device detects,
during the course of the cycle, that the target minimum tidal volume VT cannot be delivered. The
device then activates volumetric mode during the cycle. A constant ventilatory flow is calculated
and delivered until Ti Max is reached.
The so-called "volumetric" or "controlled flow" phase occurs between vertical lines 1 and 2.
Circle A shows the peak in pressure, which is higher than the set pressure. Circle B shows the
phase during which the device maintains a constant flow, until the end of the Ti.
Caution
! In certain situations, the minimum VT cannot be delivered:
• when the delivered pressure reaches the Pmax value;
• when certain parameter settings are reached (low Ti, low PS and high VT).

60/170 NOT013189-6
Reaching the minimum tidal volume (VT)
V
Vinst

Ti(inst) Trem

Ti max

Ti(inst) = Time since the start of inspiration


Vadm = Tidal volume already administrated (Air flow integrated during Ti(inst))

Figure 4.28: Minimum tidal volume (Vt) calculation in PS.VT mode.


At any given moment:
Ti Max - Ti(inst) = Trem
where
Trem = time remaining in the cycle
The following calculation is constantly applied to determine whether maintaining the
instantaneous flow ( Vinst) until the end of the cycle will allow a volume higher than the target
minimum tidal volume to be reached.
V inst x Trem > minimum VT – delivered VT
As soon as this expression ceases to be true, the calculated instantaneous flow must be
maintained until the end of the cycle to ensure the target minimum VT is reached.

Expiratory phase
When the cycle is entirely spontaneous (the device does not switch to volumetric mode), cycling
to expiration occurs in the same way as in PS.SV (PS) mode (see "Figure 4.25: Expiratory phases
in PS.SV (PS) mode." on page 57):
• When the expiratory trigger setting is reached; the setting may be:
• based on the peak flow drop (Scenario No. 1);
• an automatic setting based on the intersection of the flow curve with the 3 second line
(Scenario No. 2).
• If the set pressure of 2cmH2O is exceeded during the decreasing flow stage, the patient may
have initiated active exhalation (Scenario No. 3).
• When the maximum inspiratory time set by the user is reached (Scenario No. 4), if none of
the above conditions are met. This scenario can occur if there are leaks in the circuit, or if the
flow doesn't decrease sufficiently to reach the expiratory trigger setting.
When the ventilator switches to volumetric mode (constant ventilatory flow) in order to reach the
target tidal volume within the time allowed (Ti Max), cycling occurs:
• at the end of the maximum inspiratory time (Ti Max).
• or if the pressure in the circuit reaches the Pmax safety threshold and the inspiratory flow is
maintained at a constant level, causing a peak in pressure.
Generally speaking, this function provides a high level of safety, particularly for patients receiving
invasive ventilation. The purpose of this mode is to address the main disadvantage of PS.SV (PS)

NOT013189-6 Ventilation 61/170


mode: being unable to deliver a minimum VT in each cycle when the patient's inspiratory effort is
reduced, the patient's compliance is altered and/or the patient's resistance is increased.
Table 4.7: Adjustable parameters in PS.VT mode

Adjustable parameters Pressure support with backup tidal volume PS.VT

VT
VTS

Flow shape

Fmini

Ti

Ti, max flow or I/E

Ti Max

P insp.

PS

PEEP

Slope

Inspiratory triggers

Expiratory trigger

Apnea parameters

Recruitment parameters

Principle of Apnea ventilation


At the end of the apnea time (set Tapnea, timed from the start of the expiratory phase), if the
patient has not breathed, the ventilator switches to backup apnea ventilation. This ventilation can
be either pressure or volumetric.
The adjustable parameters are:
• in volumetric mode: apnea time (Tapnea), tidal volume (VT), respiratory rate (F) and inspiratory
time (Ti) (or V max or I/E).
• in pressure mode: apnea time (Tapnea), inspiratory pressure (P insp.), respiratory rate (F) and
inspiratory time (Ti).
Note: During apnea ventilation the patient can still trigger a pressure support cycle through the
inspiratory trigger. If the patient triggers three consecutive cycles, the apnea ventilation will
change to pressure support ventilation.

62/170 NOT013189-6
5 Clinical Configuration and Use
5.1 Accessing the clinical screens
Warning
! Only physicians and competent nursing and technical staff are permitted to access the
clinical screens. The patient must never be told how to access these screens.

U Monday 18 June
Last test the 18/06/07
9:58:46 Intern.
In tern. TEST
Double circuit : PASS

ACV P1: ACV


P1:
U
P2: PS
PS START
P2: VENTIL
NEW
1s PATIENT

Figure 5.1: Accessing the clinical screens.


U
To access the clinical screens, press the closed padlock icon :
• Pressing the icon for 5seconds (1 beep) will unlock access for a period of 4 minutes from the
last action on the screen (pressing the Alarm Silence button, the touch screen or the On/Off
U

button will reset the timer) ;


• Pressing the icon for 8seconds (2 beeps) will unlock access for a period of 60 minutes from
the last action on the screen (pressing the Alarm Silence button, the touch screen or the

U
On/Off button will reset the timer). The time remaining is displayed on the padlock ; 60

• Pressing the icon for 11seconds (3 beeps) will unlock access permanently. The infinity symbol
U

can be seen on the padlock ∞ .


Caution
! To relock the screen, press the open padlock icon or disconnect the ventilator from the
mains supply and switch it off.

NOT013189-6 Clinical Configuration and Use 63/174


As soon as the clinical mode is accessed, the program selection screen appears.

TEST Last test the 18/06/07


Double circuit : PASS

P1: ACV

U
P2: PS

NEW
PATIENT
Figure 5.2: Main clinical mode screen.
From this screen you can:
• Perform a manual test to adjust the sensors and ascertain the patient circuit type;
• Modify the P1 program (or the P2 program if the P2 activation option is set to YES – see "P2
activation" on page 92);
• Program the device for a new patient.

Caution
! If you exit the clinical screens while ventilation is in progress without stopping ventilation,
the graphs screen will appear if you later return to the clinical screens.

64/174 NOT013189-6
5.2 Manual test
A manual test is always required before the device is programmed for a new patient or the patient
circuit is modified. To perform a manual test, go to the Main clinical screen (see "Accessing the
clinical screens" on page 63).

TEST Last test the 18/06/07 Press here to display the


Double circuit : PASS test screen

P1: ACV

U
P2: PS

NEW
PATIENT
Figure 5.3: Accessing the manual test.

Last test Press to return to the main


the 12/06/07 at 14 : 50 : 35 Back screen
Circuit test : PASS
Kind of circuit : DOUBLE
Ctot = 1.2 ml/cmH2O
Ri = 0.2 cmH2O (30 l/min)
Ri = 0.2 cmH2O (60 l/min)
Re = 0.2 cmH2O (30 l/min)
Re = 0.2 cmH2O (60 l/min)

RESTART Press to restart test

Figure 5.4: Main screen with manual test results.


The results of the last test are displayed. You can choose to return to the main clinical screen or
perform a new test.

NOT013189-6 Clinical Configuration and Use 65/174


Press to cancel test
Cancel

Disconnect oxygen!!

Unplug patient circuit !

When done, press :

CONTINUE Press to continue test

Figure 5.5: Stage 1 of the manual test.


Follow the instructions: disconnect the oxygen supply, and the patient circuit and its accessories.
When you press CONTINUE, the ventilator measures the sensor offsets.

Press to cancel test


Cancel

Obstruct the air outlet

When done, press :

CONTINUE Press to continue test

Figure 5.6: Stage 2 of the manual test.

66/174 NOT013189-6
Press to cancel test
Cancel

Attach your circuit to the machine.

Leave the other end of the circuit

loose

When done, press :

CONTINUE Press to continue test

Figure 5.7: Stage 3 of the manual test.

NOT013189-6 Clinical Configuration and Use 67/174


Press to cancel test
Cancel

Obstruct the end of the


patient circuit

When done, press :

CONTINUE Press to continue test

Figure 5.8: Stage 4 of the manual test.


The ventilator detects the circuit type and the resistance and compliance of the patient circuit,
and calibrates the expiratory spirometry.

Last test Press to return to the main


the 12/06/07 at 14 : 50 : 35 Back screen
Circuit test : PASS
Kind of circuit : DOUBLE
Ctot = 1.2 ml/cmH2O
Ri = 0.2 cmH2O (30 l/min)
Ri = 0.2 cmH2O (60 l/min)
Re = 0.2 cmH2O (30 l/min)
Re = 0.2 cmH2O (60 l/min)

RESTART Press to restart test

Figure 5.9: Results of the manual test.


The results of the test are displayed. The results show whether or not the test was successful,
the type of circuit connected and the resistance and compliance values of the patient circuit.

68/174 NOT013189-6
The test is very fast (about 1 minute) and consists of three stages:
• Measuring the sensor offsets;
• Measuring the inspiratory resistance of the circuit;
• Measuring the expiratory resistance and calibrating the expiratory flow (for double circuit),
circuit compliances and O2 sensor gain.
Note: This test checks the O2 sensor; if the sensor is found to be faulty, a message will appear
at the bottom of the test results screen.
These measurements must be performed with all the accessories that will be used during
ventilation (expiratory valve, water trap, humidifier, etc.). Every time an accessory is added or
removed, this test must be repeated.
Caution
! The event log records the time and results of each manual test.
Warning
! During the test, the ventilator must not be connected to the patient.
If the test is unsuccessful, stop using the ventilator and contact the technician.

NOT013189-6 Clinical Configuration and Use 69/174


5.3 Programming ventilation options
The Elisée 150 allows you to save two sets of ventilation parameters. From the main clinical
screen you can modify the P1 and P2 programs (if the P2 activation option is set to yes,
see "Parameter options screen" on page 91) or set the parameters for one or more ventilation
options for a new patient.
When you have entered a program you can make the desired modifications. These modifications
are automatically saved when you exit the clinical screens.
Caution
! When the clinician enters the parameters for a new patient ventilation with the P2 activation
option selected, the parameters are saved in both P1 and P2. The parameter and alarm
settings are then saved in P1, whereas the parameter settings recorded in P2 will be the
default values.

Using the new patient icon


On the main clinical screen, press the NEW PATIENT icon.

TEST Last test the 18/06/07


Double circuit : PASS

P1: ACV

U
P2: PS

NEW
PATIENT
Figure 5.10: Main clinical mode screen.

NON
INVASIVE
INVASIVE

PAEDIATRIC ADULT
<25Kg – 50 to 500ml 300ml to 2,5 l

Select the patient configuration!

Figure 5.11: New patient stage 1- Patient types display.

70/174 NOT013189-6
Choose between INVASIVE and NON INVASIVE ventilation and between PAEDIATRIC and ADULT
ventilation by pressing the corresponding buttons.

NON Selected patient configuration


INVASIVE
INVASIVE

PAEDIATRIC ADULT
<25kg – 50 to 500ml 300ml to 2,5 l

VALIDATE Press to confirm

Figure 5.12: New patient stage 2 - Configuration type selection.


Once you have made this selection, press the VALIDATE icon to confirm your choice.

P(A)CV (A)CV

PSIMV PSIMV

PS.SV PS.VT

Select the ventilation mode !

Figure 5.13: New patient stage - Ventilation mode selection.


The ventilation mode selection screen appears. Select the desired ventilation mode and press
VALIDATE to confirm.

The parameter setting screen will appear.

0 H2O
cm
U

PS M
od
P1 parameters setting es
90
info

80

70 PS PEEP
60
Vts 15 cm
H2O 0 cm
H 2O
50
NO
40 ml Slope Fmini V
30
3 15 bmp
S E
TN
20
<PS AT
10 R I
0 <PE
Apnea 1/2 TL

Figure 5.14: New patient stage 4 - Setting the ventilation mode parameters.

NOT013189-6 Clinical Configuration and Use 71/174


Using the P1 and P2 buttons
On the main clinical screen, press the P1 icon to modify the P1 option or the P2 icon to modify
the P2 option.

TEST Last test the 18/06/07


Double circuit : PASS

P1: ACV

U
P2: PS

NEW
PATIENT
Figure 5.15: The main clinician mode screen for programming ventilation via the P1 or P2 buttons.
The parameter setting screen will appear.
P1 or P2 will be automatically saved as soon as you exit clinical mode.

72/174 NOT013189-6
Modifying the patient configuration
From the ventilation parameter setting screen, you can modify the selected patient data by doing
the following before starting ventilation:
1. Press the button on the right side of the ventilator.
2. Select New configuration.

cm
15H2O MENU Configuration
Options ... Back
90

80

70

60

50

40
New configuration
30

20
< PS
10 Stop machine

0 < PE

Figure 5.16: New patient configuration screen.


3. The main clinical screen will appear.
You can select new settings.

NOT013189-6 Clinical Configuration and Use 73/174


Changing the ventilation mode
After selecting the patient configuration, you may change the selected ventilation mode at any
time.
1. Press the Modes icon to go to the modes screen.

0 H2O
cm
U
PS M
od
es Press to access the mode change
90 P1 parameters setting screen
info

80

70 PS PEEP
60
Vts 15 cm
H2O 0 cm
H 2O
50
NO
40 ml Slope Fmini V
30
3 15 bmp
S E
TN
20
<PS AT
10 R I
0 <PE
Apnea 1/2 TL

Figure 5.17: Accessing the mode change screen.


The highlighted icon corresponds to the currently selected ventilation mode.
2. Press the icon which corresponds to the desired ventilation mode.

33.6 H2O
U

cm
ACV
90 Select mode Cancel
info

80

70
P(A)CV (A)CV
60

50

40 HP
PSIMV SIMV
30

20

10 PS.SV PS.VT
<PE
0

Figure 5.18: Ventilation mode selection screen.

74/174 NOT013189-6
Adjusting ventilation parameters
To adjust a value, press on the relevant icon.

U
0 H2O
cm
ACV
90 P1 parameters setting Cancel
info

80

70 VT PEEP
60 670 ml 5 cm
H2O
50

40 HP
F Vmax V
S E
30
13 bmp 24 l/
min TN
20
AT
10 R I
<PE
0 1/3 TL Press to access the second and third
parameter setting screens
Figure 5.19: Ventilation parameters screen.
Adjust the parameters by pressing "+" or "-", then press "OK" when you have reached the desired
value.
U

0 H2O
cm
ACV
90 P1 parameters setting Cancel
info

80

70 VT PEEP OK
60 670 ml 5 cm
H2O
50

40 HP
F Vmax
30
13 bmp 24 l/min
20

10
<PE
0 1/3

Figure 5.20: Ventilation parameters adjustment screen.

NOT013189-6 Clinical Configuration and Use 75/174


Adjusting the pressure support parameters
This function is available in the Synchronised Intermittent Mandatory Ventilation modes (SIMV
and PSIMV).
Press "PS" to display the pressure support settings screen.

U
0 H2O
cm
SIMV M
od
es
90 P1 parameters setting
info

80

70 VT PEEP
60 670 ml 5 cm
H2O
50

40 HP
F Vmax V
S E
30
13 bmp 24 l/min TN
20
AT
10 R I
<PE
SV TL PS icon
0 1/2
PS 15
Figure 5.21: “Accessing the pressure support settings” screen.
Then select the parameter you want to modify. Use "+" or "-" to adjust the parameters, then press
"OK" when you have reached the desired value.
Once all pressure support parameters have been set, press "OK" again to confirm. The parameter
setting screen will appear.
U

0 H2O
cm
SIMV M
od
es
90 Spontaneous setting
info

80

70 PS Slope
60 15 cm
H2O 3
50

40 HP
Tg I(P) Tg I(V)
30
NO 10.0 L/min OK
20

10
<PE
Tg Exp. Ti max
0
25 %V
max 1.2 s
Figure 5.22: “Pressure support parameters” screen.

76/174 NOT013189-6
Adjusting the apnea ventilation parameters
This function is available in the pressure support modes (PS.SV (PS) and PS.VT) when the Fmini
parameter has been set to no.
1. Press the Apnea icon to access the apnea ventilation settings screen.

0 H2O
cm U
PS
90 P1 parameters setting Cancel
info

80

70 PS PEEP OK
60
Vts 15 cm
H 2O 0 cm
H 2O
50
NO
40 ml Slope Fmini
30
3 NO
20
<PS
10
Apnea
0 <PE 1/2 Apnea icon
15 CV
Figure 5.23: “Accessing the apnea settings” screen.
2. Select the type of Apnea ventilation desired: volumetric (V) or pressure (P).
3. Then select the parameter you want to modify.
4. Use "+" or "-" to adjust the parameters, then press "OK" when you have reached the desired
value.

0 H2O
cm
U

PS
90 Ti = 1.7, I/E = 1/1.60 Cancel
info

80
Apnea alarm activation/
deactivation icon
70 OK
60
V P
Ventilation selection icon –
50 volumetric (V) or pressure (P)
40 VT
Tapnea
30
15 s 670 ml
20
<PS
10
F Vmax
0 <PE

13 bmp 24 min
l/

Figure 5.24: Apnea ventilation settings screen.

NOT013189-6 Clinical Configuration and Use 77/174


5. Press "OK" to confirm the apnea ventilation configuration.
The parameter setting screen will appear.

0 H2O
cm

U
PS M
od
es
90 Ti = 1.7, I/E = 1/1.60
info

80

70

60
V P
50

40 VT
Tapnea
30
15 s 670 ml OK
20
<PS
10
F Vmax
0 <PE

13 bmp 24 min
l/

Figure 5.25: Apnea ventilation validation screen.

Adjusting the alarm thresholds

0 H2O
cm
U

PS M
od
P1 parameters setting es
90
info

80

70 PS PEEP
60
Vts 15 cm
H2O 0 cm
H 2O
50
NO
40 ml Slope Fmini V
30
3 15 bmp
S E
TN
20
<PS AT
10 R I
0 <PE
Apnea 1/2 TL

Figure 5.26: “Accessing the alarm threshold settings” screen.


Press the icon to access the ventilation alarms settings screen.
To change alarm thresholds, press the value you want to modify.

78/174 NOT013189-6
U
0 H2O
cm
PS M
od
P1 parameters setting es
90 info

80
99 40 NO
70 Pa
F Pmax Leak ra Press to return to parameter
60
0 0 -- m setting screen
50
bmp cmH2O %
40
2400 100 V
S E
Example of alarm trigger
30 threshold
20 <PS
VTe FiO2 TN
0 --- AT
10 R I
ml % Press to start ventilation
<PE
0 TL
10 17
Figure 5.27: Alarm thresholds screen.
Set the values by pressing "+" or "-", then press "OK" when you have reached the desired value.
You can then adjust another value, return to the parameter setting screen or start ventilation.
U

0 H2O
cm
PS
90 P1 parameters setting Cancel
info

Parameter to be changed
80
99 40 NO
70 OK
F Pmax Leak
60
0 0 --
50
bmp cmH2O %
40
2400 100
30

20 <PS
VTe FiO2
0 ---
10
<PE
ml %
0
10 17
Figure 5.28: "Alarm threshold to be changed" screen.

NOT013189-6 Clinical Configuration and Use 79/174


Starting and stopping ventilation
Ventilation can be started from the alarm thresholds screen or the parameter setting screen by
pressing START VENTIL.
The device will begin to deliver ventilation and the curves screen will appear.

0 H2O
cm
U
PS M
od
P1 parameters setting es
90
info

80

70 PS PEEP
60
Vts 15 cm
H 2O 0 cm
H 2O
50
NO
40 ml Slope Fmini V
30
3 15 bmp
S E
TN
20
<PS AT Press to start ventilation
10 R I
0 <PE
Apnea 1/2 TL

Figure 5.29: Start Ventilation screen.


To stop ventilation, press the button on the right side of the ventilator.
The following screen will appear:

cm
15H2O MENU Configuration
Options ... Back
90

80

70

60

50

40
Pause (stop ventilation)
30

20
< PS
10 Stop machine

0 < PE
Press to stop ventilation

Figure 5.30: Stop Ventilation screen.


Press the icon next to the words "Pause (stop ventilation)".
Ventilation will stop and the parameter setting screen will appear.
Note: As a safety feature, the icon needs to be pressed for at least 3 seconds for ventilation
to stop.

80/174 NOT013189-6
5.4 Monitoring ventilation
You can monitor ventilation continuously using the following tools on the curves screen:
• Bar graph;
• Pressure and flow curves;
• Four ventilation measurements;
• The symbol which appears below the bar graph when the trigger initiates a cycle.

23 cm
U

H2O ACV Mo
de
90
info
s
P
>

80

70 16 Pa Pressure curve
ra
60 0 m
50
>

v
40 HP 28
Flow curve
0
30

20

10 Measurements always displayed


<PE Ppeak I/E FTOT VE
0
23.2
cm
H2O 1/3.3 13
bmp
6.3l/
min

Instantaneous pressure bar graph

Figure 5.31: Curves screen.

NOT013189-6 Clinical Configuration and Use 81/174


Measurements
To access the measurements screen, press one of the four measurements displayed at the
bottom of the screen.

23 cm
U ACV
H2O Mo
de
90
info
s
P
>

80

70 16 Pa
ra
60 0 m
50
>

v
40 HP 28
0
30

20

10 Measurements always displayed


<PE Ppeak I/E FTOT VE
0
23.2
cm
H2O 1/3.3 13 bmp
6.3l/
min

Figure 5.32: Accessing the measurements display screen.


All measurements are displayed on this screen. The four measurements displayed on the curves
screen are highlighted.

23 cm
U

H2O ACV Mo
de
90 4 measures to select s
info
Values always displayed on
80
FTOT TI TE I/E curves
70 Pa
13
bmp
1.05 s 3.56 s 1/3.3 ra
60 m
50 VTI VTE VE VE SP.
40 HP 380 ml 380 ml 6.3 l/
min 0.0 l/
min

30
PEEP Ppeak Pmean
20
5.1cm
H2O23.2 cm
H2O 7.9 cm
H2O

10

0
<PE FiO2
%

Figure 5.33: Measurements display screen.


You can change which four measurements are displayed by pressing on other measurements.

23 cm
U

H2O ACV Mo
de
90 4 measures to select s
info
New values to be always
80
FTOT TI TE I/E displayed on curves
70 Pa
13
bmp
1.05 s 3.56 s 1/3.3 ra
60 m
50 VTI VTE VE VE SP.
40 HP 380 ml 380 ml 6.3 l/
min 0.0 l/
min

30
PEEP Ppeak Pmean
20
5.1cm
H2O23.2 cm
H2O 7.9 cm
H2O

10

0
<PE FiO2 Press to return to curves screen
%

82/174 NOT013189-6
Event log
A black box records the last 1,170 events.
Note: Only ResMed technicians have access to the full log.

23 cm
H2O Monday 18 June 2007
90 11 : 00 : 48 Pb ON/OFF 1 Back
80 10 : 57 : 48 + - PEEP 0
70 10 : 56 : 32 + - PEEP 5
60
10 : 56 : 22 Padlock 1
50
10 : 48: 55 + - Vt 67
40 HP
10 : 49: 38 MODE Change 2
30
10 : 49: 38 MODE Change 7
20
10 : 49: 23 MODE Change 7
10
10 : 49: 08 MODE Change 7
0
<PE 10 : 47: 59 Pb ON/OFF 1
10 : 47: 47 Pb ON/OFF 1
Figure 5.34: Event log screen.
The log lists, day by day, every triggering of an alarm and every action carried out on the ventilator.
The log also records the times and results of manual tests performed.

NOT013189-6 Clinical Configuration and Use 83/174


Clinician's log
The clinician's log provides clinicians with a filtered version of the Elisée 150 history contained in
the full log.
This screen can be accessed from any P1 or P2 clinical screen by pressing the button located
on the right side of the device.
Then press the buttons as shown in the screens below:
cm
15H2O MENU Configuration
Options ... Back
90 Press to access menu
80

70

60

50

40
Pause (stop ventilation)
30

20
< PS
10 Stop machine

0 < PE

23 cm
U

H2O ACV Mo
de
90 Select one menu s
info

80

70 Pa
ra
60 m
Press to access clinician's log
50

40 HP

30

20 Config. Trends
10 Setting
<PE
0

Figure 5.35: Screens used to access the clinician's log.


Note: If the Elisée 150 is delivering ventilation, there is no need to stop ventilation before
accessing the clinician's log.

84/174 NOT013189-6
The clinician's log sets out the following information, day by day:
• Every triggering of an alarm;
• The times when ventilation began and ended;
• The type of power supply used;
• The times when the ventilator was turned on and off.
23 cm
H2O Monday 18 June 2007
90 11 : 47: 14 Start Ventil 0 Back
80 10 : 06: 56 Pb Silence 1
70 10 : 06: 54 REPLACE O2 CELL Press to access page for
60
10 : 06: 54 Pb Silence 1 previous day
50
10 : 05: 55 REPLACE O2 CELL

40 HP
9: 58: 43 Pb Silence 1
9: 56: 37 Press to scroll up
30
Pb Silence 1
20
9: 56: 04 MODE Change 0
9: 53: 07 Pb Silence 1
10
<PE 9: 53: 06 REPLACE O2 CELL Press to scroll down
0
9: 53: 06 Pb Silence 1
Table 5.1: Examples of log events

Event displayed Description of the event

The Maximum Pressure alarm was triggered at


11:47:14.
11 : 47: 14 MAXI P inspi

The Minimum Tidal Volume alarm stopped at 11:34:14.

11 : 34: 14 MINI Vt

The High Pressure alarm threshold was modified at


11:02:49. Its previous value was 60cmH2O.
11 : 02: 49 + - al HP 60

NOT013189-6 Clinical Configuration and Use 85/174


Preparing the settings for monitoring in Easyview 150
The Elisée 150 can record all ventilation measurements.
The measurements are recorded over a period based on the recording time chosen by the user:
Table 5.2: Trends sampling: the relationship between the recording time and the recording interval

Recording time Recording interval

1 day 1 second

7 days 5 seconds

15 days 10 seconds

30 days 20 seconds

90 days 60 seconds

180 days 120 seconds

This data is retrieved using the EasyView 150 software.

Accessing the setting screens for Easyview 150 monitoring


From any of the clinical screens, or from P1 or P2, press the button on the right side of the
ventilator.
Then press the buttons as shown in the screens below:
cm
15H2O MENU Configuration
Options ... Back Press to access menu
90

80

70

60

50

40
Pause (stop ventilation)
30

20
< PS
10 Stop machine

0 < PE

23 cm
U

H2O ACV Mo
de
90 Select one menu s
info

80

70 Pa
ra
60 m
50

40 HP

30

20 Config. Trends
Press to access trends
10 Setting programming settings
<PE
0

Figure 5.36: Screens used to access the trends programming.


Note: If the Elisée 150 is delivering ventilation, there is no need to stop ventilation before
accessing the trends screens.

86/174 NOT013189-6
Programming the trends
Note: This screen does not appear when the trends are programmed for the first time.
The screen shows:
• Whether the trends are in progress or completed;
• The recording start date;
• The recording time.
If the trends have been completed, an additional line indicates whether or not the data has been
downloaded.
To program a new recording, press the New Trends icon. Otherwise press CANCEL.

23 cm
H2O Trends on the way
90
Date and duration of current (or
80 Beginning = 18/06/07
previous) recording
70 Duration = 7 d
60

50

40 HP

30
New
20 CANCEL
Trends
10
<PE
0

Figure 5.37: Trends in progress screen.


Note: When you program a new recording, the previous trends data is deleted.
23 cm
H2O Choice of the recording time
90

80
Press to record measurements
70 1d 15 d 90 d for 90 days
60

50

40 HP 7d 30 d 180 d
30

20

10
<PE CANCEL
0

Figure 5.38: "Trends: recording time selection" screen.


This screen allows you to choose the recording time for the measurements.
Press the icon for the desired recording time.

NOT013189-6 Clinical Configuration and Use 87/174


23cm
H2O

90

80

70
Be careful all former data will be erased !
60

50

40 HP Do you want to continue ?


30

20 YES NO
10
<PE
0

Figure 5.39: "Trends: former data will be erased" screen.


As a precaution, a final screen appears, reminding you that the former data will be erased if a new
recording is programmed.
• Press NO to retain the data from the previous recording;
• Press YES to confirm the settings for the new recording.
The new recording commences as soon as you press YES.

Retrieving compliance data


The data is retrieved using the EasyView 150 software.

88/174 NOT013189-6
5.5 Changing mode during ventilation
This option allows you to change the ventilation mode without stopping ventilation.
Mo
Press the de
s
icon to change mode during ventilation.

23 cm
H2O U ACV Mo
de
90
info
s
P
>

80

70 16 Pa
ra
60 0 m
50
>

v
40 HP 28
0
30

20

10
<PE Ppeak I/E FTOT VE
0
23.2 1/3.3
cm
H2O 13 bmp
6.3 l/
min

Figure 5.40: "Changing mode during ventilation" screen.


The highlighted icon corresponds to the current ventilation mode.
Press the icon which corresponds to the desired ventilation mode.

23 cm
U

H2O ACV
90 Selection mode info
Cancel

80

70
P(A)CV (A)CV
60

50

40 HP
PSIMV PSIMV
30

20

10 PS.SV PS.VT
<PE
0

Figure 5.41: "New ventilation mode selection" screen.


The default parameters for the selected mode are displayed.

NOT013189-6 Clinical Configuration and Use 89/174


24 H2O
cm

U
ACV PS Press to return to previous
screen
90 Mode setting/validate Cancel
info

80
Shows the previous ventilation
mode and the new ventilation
70 PS PEEP mode selected
60
Vts 15 cm
H2O 0 cm
H2O
50
NO
40 ┘HP ml Slope Fmini Mo
30
3 12 bmp de
20

10
OK
<PE
0 Apnea 1/2

Figure 5.42: New mode settings screen.


To adjust a value, press the icon for the corresponding parameter.
Adjust the parameters by pressing "+" or "-", then press "OK" when you have reached the desired
value.

24 H2O
cm
U

ACV PS
Cancel
90
info

80

70 PS PEEP OK
60
Vts 15 cm
H2O 0 cm
H2O
50
NO
40 ┘HP ml Slope Fmini
30
3 12 bmp
20

10
<PE Press to view other adjustable
0
Apnea 1/2 parameters

Figure 5.43: "Adjusting parameters in the new mode" screen.


Once the appropriate ventilation mode and parameters are set, press "Mode OK".

24 H2O
cm
U

ACV PS
90 Mode setting/validate Cancel
info

80

70 PS PEEP
60
Vts 15 cm
H2O 0 cm
H2O
50
NO
40 ┘HP ml Slope Fmini Mo
30
3 NO de
20 Press to start new mode
10
OK
<PE Apnea
0 1/2
15 CV
Figure 5.44: New mode activation screen.
The Elisée 150 changes to the new ventilation mode.

90/174 NOT013189-6
5.6 Parameter options
Parameter options screen

Accessing the parameter options screen


To reach this screen, press the button on the right side of the ventilator.
Then press the buttons as shown in the screens below:
cm
15H2O MENU Configuration
Options ... Back
90

80
Press to access menu
70

60

50

40
Pause (stop ventilation)
30

20
< PS
10 Stop machine

0 < PE

23 cm
U

H2O ACV Mo
de
90 Select one menu s
info

80

70 Pa
ra
60 m
50

40 HP

30

20 Config. Trends
10 Setting Press to access settings
<PE configuration screens
0

33.6 H2O
U

cm
ACV
90 Select one menu Cancel
info

80

70

60 PROG. Custom. Press to access parameter


NAME
50 Setting options screen
40 HP

30

20

10
<PE
0

Figure 5.45: Accessing the parameter options screen.


Note: If the Elisée 150 is delivering ventilation, there is no need to stop ventilation before
changing the parameter options.

NOT013189-6 Clinical Configuration and Use 91/174


Parameter options screen

0 H2O
cm

U
PS
90 Parameters option Cancel
info

80
BTPS correction YES NO
70

60 P2 activation
50
YES NO O
40

30
K
20
<PS
10
Select ACV parameter:
0 <PE
Ti Vmax I/E
Figure 5.46: Parameter options screen.
Press "YES" to activate an option or "NO" to deactivate it.
To select the ACV parameter, press the Ti, V max or I/E icon.
The icons for the selected options are highlighted.
Once all parameters are set, confirm by pressing "OK".
If OK is not pressed, none of the new settings will be saved.
Description of the parameter options

BTPS correction
When ventilating a patient, you must correct the BTPS (body temperature, ambient pressure,
saturated with water vapour). The correction is applied only to the measured expiratory volume
(VTE). This option must be deactivated for ventilation not involving a patient. Measurements are
taken in ATPD (ambient temperature and pressure, dry) conditions.
This option is activated by default. It is deactivated when the technical menu is accessed.

P2 activation
Allows you to program two ventilation options (P1 and P2). The patient can choose one of these
ventilation options. When the clinician configures a new patient ventilation with the P2 activation
option selected, the new configuration is saved in both P1 and P2.

Ti, max flow and I/E settings in volumetric (ACV) mode


This option allows the clinician to choose the set parameter to be used in volumetric ventilation.
The available options are inspiratory time (Ti), maximum flow ( V max) and I/E ratio.
Note: Modifying any one of these parameters can change the ventilation settings.

92/174 NOT013189-6
5.7 Specific settings
Calibrating the touch screen
1. Go to the main clinical screen.

TEST Last test the 18/06/07


Double circuit : PASS

P1: ACV

U
P2: PS

NEW
PATIENT
Figure 5.47: Main Clinical mode screen.
2. Press the button and the Alarm Silence button simultaneously until the following
screen appears.

<< press here

CALIBRATION CALIBRATION

press there >>

Figure 5.48: Calibration screens.


3. Press the first place indicated until you hear a beep.
4. Press the second place indicated until you hear a beep.
The touch screen is now calibrated.
The main patient screen reappears.

NOT013189-6 Clinical Configuration and Use 93/174


Empty curves/filled curves
During ventilation, you can choose to view pressure and flow curves empty or filled in.
To make your selection, go to the alarms or parameters screens. Once ventilation has started,
press the icon for two seconds. When you release the icon, the curves screen will appear and
the curves configuration can be changed.
23 cm
H2O
U
ACV Mo
de
90 4 measures to select s
info

80
FTOT TI TE I/E
70 Pa
13 1.05 s
bmp
3.56 s 1/3.3 ra
60 m
50 VTI VTE VE VE SP.
40 HP 380 ml 380 ml 6.3 l/
min 0.0 l/
min

30
PEEP Ppeak Pmean
20
5.1 23.2
cm
H2O
cm
H2O 7.9 cm
H2O

10

0
<PE FiO2 Press for 2 seconds
%

23 cm 23 cm
U

H2O ACV Mo
de
H2O ACV Mo
de
90
info
s 90
info
s
P P
>

>

80 80

70 16 Pa 70 16 Pa
ra ra
60 0 m 60 0 m
50 50
>

>

v v
40 HP 28 40 HP 28
0 0
30 30

20 20

10 10
<PE Ppeak I/E FTOT VE <PE Ppeak I/E FTOT VE
0
23.2
cm
H2O 1/3.3 13 bmp
6.3 l/
min
0
23.2
cm
H2O 1/3.3 13bmp
6.3l/
min

Figure 5.49: Screens showing empty/filled curves.

94/174 NOT013189-6
Screen brightness and digital sound (volume level)

Accessing the setting screen


The brightness, the screen orientation, the touch screen beeps and the digital sound volume can
all be adjusted on the setting screens.
To access these screens, press the button on the right side of the ventilator.
Then press the buttons as shown in the screens below:
cm
15H2O MENU Configuration
Options ... Back
90

80
Press to access menu
70

60

50

40
Pause (stop ventilation)
30

20
< PS
10 Stop machine

0 < PE

23 cm
U

H2O ACV Mo
de
90 Select one menu s
info

80

70 Pa
ra
60 m
50

40 HP

30

20 Config. Trends Press to access settings


10 Setting configuration screens
<PE
0

33.6 H2O
U

cm
ACV
90 Select one menu Cancel
info

80

70

60 PROG. Custom.
NAME
50 Setting
40 HP

30

20 Press to access the digital


10 sound screen
<PE
0

Figure 5.50: Accessing the digital sound screen.


Note: If the Elisée 150 is delivering ventilation, you do not need to stop ventilation to adjust the
brightness and volume.

NOT013189-6 Clinical Configuration and Use 95/174


Setting
cm
0 H2O

U
ACV
90
Back
info

80

70 Screen orientation modified


MAX MAX
60

50

40 HP
Turning on or off the touch
30 screen beeps
MIN
20
Screen brightness adjustment
10 AUTO
0
MIN Digital sound adjustment

Figure 5.51: Digital sound adjustment screen.


Press the scales to obtain the desired values for brightness and volume.
If automatic screen brightness adjustment is selected (using the AUTO icon) the Elisée 150
automatically adjusts the screen brightness according to the ambient lighting. It also turns it off
automatically if 2 minutes go by without any alarm being triggered and without you pressing the
Alarm Silence button, the On/Off button or any touch screen buttons.
On the screen brightness and digital sound volume adjustment screen you can also:
• Invert the orientation of the screen in relation to the Elisée;
• Activate or deactivate a beep sound each time a icon is pressed on the touch screen.

Caution
! The picture on each icon shows the action associated with it, but provides no information
on current settings.
• The icon allows you to activate a beep sound;

• The icon allows you to deactivate the beep sound;

• The icon allows you to invert the orientation of the screen.

Note: Once the patient configuration has been set, you can access this screen directly from any
screen by pressing the Alarm Silence button for at least three seconds.
The screen brightness is reduced to its lowest level as soon as the Internal Battery Low alarm is
triggered.

96/174 NOT013189-6
Date and time

Accessing the setting screen


To access these screens, press the button on the right side of the ventilator.
Then press the buttons as shown in the screens below:
cm
15H2O MENU Configuration
Options ... Back
90

80
Press to access menu
70

60

50

40
Pause (stop ventilation)
30

20
< PS
10 Stop machine

0 < PE

23 cm
U

H2O ACV Mo
de
90 Select one menu s
info

80

70 Pa
ra
60 m
50

40 HP

30

20 Config. Trends Press to access settings


10 Setting configuration screens
<PE
0

33.6 H2O
U

cm
ACV
90 Select one menu Cancel
info

80

70

60 PROG. Custom.
NAME
50 Setting
40 HP

30

20
Press to access date and time
10 screen
<PE
0

Figure 5.52: Accessing the date and time settings.


Note: If the Elisée 150 is delivering ventilation, there is no need to stop ventilation before
setting the date and time.

NOT013189-6 Clinical Configuration and Use 97/174


0 H2O
cm

U
PS
Cancel
90
info

80

70
Monday 18 June
OK
60 Date and time display
50
2007
40 ┘HP
13: 02 :03
30

20 Press these icons to position


10 cursor
0 <PE

Soft version : 2.36


Figure 5.53: Date and time setting screen.
Position the cursor on the value to be changed.
Press "+" or "–" to reach the appropriate value. Then position the cursor on the next value.
Once all the values have been set, press "OK" to confirm.

98/174 NOT013189-6
Assigning program names
The clinician can assign names to programs P1 and P2 to help the patient distinguish between
them.

Accessing the program naming screen


To access these screens, press the button on the right side of the ventilator.
Then press the buttons as shown in the screens below.

cm
15H2O MENU Configuration
Options ... Back
90

80 Press to access menu


70

60

50

40
Pause (stop ventilation)
30

20
< PS
10 Stop machine

0 < PE

23 cm
U

H2O ACV Mo
de
90 Select one menu s
info

80

70 Pa
ra
60 m
50

40 HP

30

20 Config. Trends Press to access settings


10 Setting configuration screens
<PE
0

33.6 H2O
U

cm
ACV
90 Select one menu Cancel
info

80

70

60 PROG. Custom. Press to access program


50
NAME
Setting naming screen
40 HP

30

20

10
<PE
0

Figure 5.54: Accessing the ventilation program naming screen.

NOT013189-6 Clinical Configuration and Use 99/174


Note: If the Elisée 150 is delivering ventilation, there is no need to stop ventilation before
naming the programs.

Naming the programs

0 H2O
cm

90 Replace the program name?: Back

80

70
P1: ACV
60

50

P2: ACV
40

30

20
<PS
10 Press to exit this screen
0 <PE
CANCEL

Figure 5.55: Accessing the program name replacement screen.


On the first screen, select the program to be named.
Press the P1 icon to replace or assign a name to P1 and press the P2 icon to replace or assign a
name to P2.
Note: You can assign a name to the P2 program even if it is not activated.

0 H2O
cm

P1: PS Cancel
Information about the selected
program
90
Program Name?:
80 >DAY <
70
Press to move the cursor left or
60
right
50 O
40

30
0 0 A A K Press to select a number or
letter
9 9 Z Z
20
<PS
10 Full stop, slash, space and enter
0 <PE
. / buttons

Figure 5.56: Program naming screen.


Enter or change the program name using the icons on this screen.
When you have entered the name, press OK to confirm.

100/174 NOT013189-6
U Monday 18 June
9:58:46 Intern.
In tern.

P1: ACV Customised ventilation program


DAY names

ACV START
P2: NIGHT VENTIL

1s

Figure 5.57: Ventilation program names screen.


Naming the ventilation programs helps patients to familiarise themselves more quickly with their
different ventilation options.

NOT013189-6 Clinical Configuration and Use 101/174


5.8 Exiting the clinical screens
To return to the patient screens from any clinical screen, press the padlock icon.
Note: As a safety measure, the icon must be pressed for at least 1 second.

23 cm
H2O U ACV Mo
de Press padlock to access patient
90
info
s screens
P
>

80

70 16 Pa
ra
60 0 m
50
>

v
40 HP 28
0
30

20

10
<PE Ppeak I/E FTOT VE
0
23.2
cm
H2O 1/3.3 13
bmp
6.3l/
min

Figure 5.58: Exiting clinical mode.


Note: The patient screens appear automatically four minutes after the last time you press the
Alarm Silence button, the On/Off button or the touch screen.

102/174 NOT013189-6
6 Patient use
6.1 Main patient screen
From the main patient screen, the patient can choose between P1 and P2 ventilation (if "P2
activation" is set to YES – see "Parameter options" on page 91).

U Monday 18 June
9:58:46 Intern.
In tern.

Example of selected
P1: ACV pre-programmed option

PS START
P2: VENTIL

1s

Figure 6.1: Main patient mode screen.

NOT013189-6 Patient use 103/174


6.2 Patient mode settings screen
To see the ventilation settings for a pre-programmed option, press the relevant icon twice.

U Monday 18 June
9:58:46 Intern.
In tern.

ACV Press the selected icon to see


P1: the corresponding settings

PS START
P2: VENTIL

1s

Figure 6.2: "Access to parameter review" screen.


The screen below appears, showing the ventilation settings for the selected pre-programmed
option.
Press the touch screen to return to the main patient screen.

Patient meter : 00000163H

VT PEEP
cm
500 ml 0 H2O

F I/E Flowshape
15 bmp 1/2.0 1

TgI (V)
l/
3 min

Back

Figure 6.3: "Parameter review in patient mode, ventilation on standby" screen.


Note: The main patient screen reappears automatically 30 seconds after the settings screen is
displayed.

104/174 NOT013189-6
6.3 Starting and stopping ventilation in patient mode

Starting ventilation in patient mode


To start ventilation, select the desired pre-programmed ventilation option, then press "START
VENTIL".
Note: As a safety measure, the icon must be pressed for at least 1 second to start ventilation.

U Monday 18 June
9:58:46 Intern.
In tern.

P1: ACV

START Press this icon to start the


P2: PS selected ventilation program
VENTIL

1s

Figure 6.4: "Starting ventilation in patient mode" screen.

Stopping ventilation in patient mode


To stop ventilation, press the On/Off button on the side of the device and follow the instructions
on the screen.

12-28 V
15A max

Figure 6.5: Stopping ventilation.

NOT013189-6 Patient use 105/174


6.4 Measurements screen
To see the current settings and measurements, press the icon for the ventilation option currently
in operation.
33.6 H2O
cm

Wednesday 28 February
90
11: 28: 31 intern.
80

70 Mains
ACV Press this icon to see the
60
P1: corresponding settings
50

40 < HP

30
PS
20 P2:
10

0 < PE

Figure 6.6: "Access to parameter review in patient mode during ventilation" screen.
Note: The main patient screen reappears automatically 30 seconds after the measurements
screen is displayed.
The following screen appears, showing:
• the ventilation settings;
• the four measurements selected on the relevant clinician screen.
Press the touch screen to return to the main patient screen.
cm Patient meter : 00000163H
16 H2O
90
VT PEEP
cm
500 ml 0 H2O
80

70
F I/E Flowshape
60
15 bmp 1/2.0 1
50

40 ┘HP
TgI (V)
30 l/
20
3 min

10

0 < PE PEEP VTI VTE Ppeak


4.2 H2O
cm
501 ml 499 ml 16 H2Ocm

Figure 6.7: "Parameter review in patient mode during ventilation" screen.

106/174 NOT013189-6
6.5 Changing ventilation program during ventilation
Note: The ventilation program can be changed during ventilation only if the "P2 activation" option
is set to "YES" (see "Parameter options" on page 91).
On the patient ventilation screen, the icon for the current ventilation option is greyed out. To
change the selected program, press the icon which is not greyed out.
The ventilation will change immediately.
33.6 H2O
cm

Wednesday 28 February
90
11: 28: 31 intern.
80

70 Mains
ACV
60
P1:
50

40

30 New ventilation program


PS
20 P2: selected
< PS
10

0 < PE

Figure 6.8: "Changing ventilation option during ventilation" screen.


Note: As a safety measure, the icon must be pressed for at least 1 second for the ventilation to
be changed.

NOT013189-6 Patient use 107/174


6.6 Screen brightness/Digital sound volume

Accessing the setting screen


The brightness and orientation of the screen can be adjusted. You can also activate the emission
of a beep each time the touch screen is pressed, and adjust the volume of the digital sound.
To access this screen, press and hold the Alarm Silence button for at least three seconds.
Note: If the Elisée 150 is delivering ventilation, you do not need to stop ventilation to adjust the
brightness and volume.

Setting
Press the scales to obtain the desired values for brightness and volume.
cm
0 H2O
90
Back

80

70 Screen orientation modified


MAX MAX
60

50

40 HP
Turning on or off the touch
30 screen beeps
MIN
20
Screen brightness adjustment
10 AUTO
0
MIN Digital sound adjustment

Figure 6.9: "Contrast and brightness in patient mode" screen.


When the automatic screen brightness setting is selected (AUTO icon) the Elisée 150 will adjust
screen brightness depending on the brightness of the room. The screen will dim automatically
after two minutes if no alarms are triggered, the Alarm Silence button is not pressed, the On/Off
button is not pressed and the screen is not touched.
Note: The screen brightness is reduced to its lowest level as soon as the internal battery low
alarm is triggered.
On the screen brightness and digital sound volume adjustment screen you can also:
• Invert the screen orientation (top - bottom);
• Activate / Deactivate the emission of a beep each time a icon is pressed on the touch screen.
Note: The picture on each icon shows the action associated with it, but provides no information
on current settings.

• Press to activate the touch screen beeps.

• Press to deactivate the touch screen beeps.

• Press to invert the screen orientation.

108/174 NOT013189-6
6.7 Calibrating the touch screen
1. Go to the main patient screen and stop ventilation.
U Monday 18 June
9:58:46 Intern.
In tern.

P1: ACV

PS START
P2: VENTIL

1s

Figure 6.10: "Access to screen calibration in patient mode" screen.


2. Press the button and the Alarm Silence button simultaneously until the left-hand
screen below appears.
<< press here

CALIBRATION CALIBRATION

press there >>

Figure 6.11: Calibration screens.


3. Press the first place indicated until you hear a beep.
4. Press the second place indicated until you hear a beep.
The touch screen is now calibrated.
The main patient screen reappears.

NOT013189-6 Patient use 109/174


6.8 Power supply and patient timer information

Power supply
On the main patient screen the user can see the power status of the ventilator.
U Monday 18 June
9:58:46 Intern.
In tern. Power status information

P1: ACV

PS START
P2: VENTIL

1s

Figure 6.12: Main patient mode screen.


The screen shows information on available power sources and on the charge status of the
batteries (internal and external).
If a type of power supply is available to the ventilator, the corresponding icon is shown on the
screen.
The arrow shows whether the battery is charging or discharging.
Table 6.1: Power supply icons in patient mode

Icon Meaning

Internal battery present

intern.

External battery present

Extern.

External power supply present


Extern.
Mains supply present
Mains
Battery charging
>
Battery discharging
>

110/174 NOT013189-6
Patient timer
On the patient settings and measurements screens the user can see the total length of time for
which the patient has received ventilation.
The timer ticks over during ventilation and is reset to zero when the device is reprogrammed for
a new patient.
Patient meter : 00000163H Patient timer display

VT PEEP
cm
500 ml 0 H2O

F I/E Flowshape
15 bmp 1/2.0 1

TgI (V)
l/
3 min

Back

Figure 6.13: "Patient timer in patient mode" screen.

NOT013189-6 Patient use 111/174


112/174 NOT013189-6
7 Alarms

7.1 Monitoring the alarms


To ensure the patient's safety, when an alarm is triggered the user is alerted by:
• An audible alert: the alert depends on the alarm priority. The beeps are made by two buzzers
(86dBA at 1m and 78dBA at 3m) and a digital sound system with adjustable volume.
• Visual alerts:
• The name of the triggered alarm is displayed at the top of the touch screen;
• In clinical mode, the alarm page icon flashes;
• In clinical mode, on the alarm page, the threshold responsible for triggering the alarm
flashes;
• One of the two LEDs on the front of the Elisée 150 flashes (red or orange depending on the
priority of the triggered alarm).
Table 7.1: Alarm categories

Category Definition Visual alert Audible alert

High-priority alarms. Indicates an urgent Red LED flashes. Sequence of 5 beeps


situation requiring an + digital sound
immediate response. message, repeated
every 10 seconds.
Medium-priority Indicates a Orange LED flashes. Sequence of 3 beeps
alarms. dangerous situation + digital sound
requiring a rapid message, repeated
response. every 25 seconds.
Low-priority alarms. Indicates that user Orange LED lit, not Sequence of 2 beeps
attention is required. flashing. + digital sound
message, repeated
every 30 seconds.

Alarms are also divided into three categories according to whether or not they can be turned off:
• Audible alarms which cannot be turned off.
• Audible alarms which can be turned off temporarily.
Pressing the Alarm Silence button blocks the audible alert for 120 seconds. The visual alarm
remains activated.
• Audible alarms which can be turned off.
Pressing the Alarm Silence button turns off the audible and visual alerts.
Note: The user cannot change the alarm priority.

Silencing audible alarms


To prevent alarms being triggered during an aspiration procedure on the patient, press the Alarm
Silence button to prevent audible alarms from being triggered for two minutes.
During this time any triggered alarms will be detectable only through the alarm message
displayed on the screen. The following symbol shows that audible alarms have been blocked
for two minutes. Press this button again to unmute the alarms.

NOT013189-6 Alarms 113/174


7.2 List of ventilation monitoring alarms
Note: The BATTERY EMPTY and BATTERY LOW alarms stop once the batteries start charging (i.e. as
soon as the Elisée 150 is connected to the mains supply or an external DC supply).
Table 7.2: List of ventilation monitoring alarms

Alarm Trigger
Alarm Icon Message Time to trigger
priority threshold

Minimum MINI Vt. High priority. Alarm setting. 5 consecutive


Expiratory cycles below
Tidal Volume
(double V alarm
threshold.
circuit).

Maximum MAXI Vt. High priority. Alarm setting. 5 consecutive


Expiratory cycles above
Tidal Volume
(double V alarm
threshold.
circuit).

Minimum MINI Vt. High priority. Alarm setting. 5 consecutive


Inspiratory cycles above
Tidal Volume
(single circuit). V alarm
threshold.

Maximum MAXI Vt. High priority. Alarm setting. 5 consecutive


Inspiratory cycles below
Tidal Volume
(single circuit). V alarm
threshold.

Maximum MAXI P inspi*. High priority Alarm setting. 3 consecutive


inspiratory cycles above
pressure.
HP alarm
threshold.

Maximum MAXI P expi. High priority. 10mbar + 300ms above


expiratory PEEP. alarm
pressure.
HP threshold.

Minimum CIRCUIT High priority. 3mbar. ****


Pressure OPEN.
(volumetric
mode, double LP
circuit).

Minimum CIRCUIT High priority. ΔPi setting***. ****


Pressure OPEN.
(volumetric
mode, single LP
circuit).

Minimum CIRCUIT High priority. (Pinsp or ****


Pressure OPEN. Pressure
(pressure
mode). LP support) -
2mbar.

114/174 NOT013189-6
Alarm Trigger
Alarm Icon Message Time to trigger
priority threshold

Minimum MINI FiO2. High priority. Alarm setting. 30 seconds


FiO2. below alarm

O2 threshold.

Maximum MAXI FiO2. High priority. Alarm setting. 30 seconds


FiO2. above alarm

O2 threshold.

Leak. MAXI Leaks. High priority. Alarm setting. 6 consecutive


cycles above
alarm
threshold.

Apnea. PATIENT Medium Tapnea. Immediate.


APNEA. priority.

Minimum LOW PEEP**. Medium PEEP - 1mbar. 30 cycles


Expiratory priority. below alarm
Pressure.
LP threshold.

Maximum MAXI F. Low priority. Alarm setting. 4 consecutive


Respiratory cycles
Rate.
F above alarm
threshold.

*In pressure mode, the Pmax alarm threshold cannot be set to a value lower than the delivered
Pinsp (or the delivered pressure support). If the user sets an alarm threshold lower than this
pressure value, the alarm threshold setting will be ignored. In this situation, the delivered Pinsp
(or pressure support) becomes the Pmax alarm threshold.
**When using a single circuit in a non-invasive mode, there is no Low PEEP alarm.
***When using a single circuit, the ΔPinsp (Pmax - PEEP) target must be set at a level at which
disconnection of the patient circuit will be detected.
****Adult: 15s below the threshold. Paediatric: 15s – (Measured respiratory rate/5), min. 5s
below the threshold.

NOT013189-6 Alarms 115/174


7.3 General alarms causes and remedies
Table 7.3: Audible alarms which cannot be turned off

Message Icon Alarm priority Cause Remedy

INT BATT EMPTY. High priority. Internal battery Change power


charge less than supply.
INT. 5%.

MINI FiO2. High priority. Supplied FiO2 too Adjust rotameter


low. value or Minimum

O2 FiO2 alarm
threshold.

MAXI FiO2. High priority. Supplied FiO2 too Adjust rotameter


high. value or

O2 Maximum FiO2
alarm threshold.

NiMH Low priority. Connection of Connect


BATTERY. unknown external compatible
battery pack. external battery
pack (Li-Ion-type).

Table 7.4: Alarms which can be turned off temporarily (for 120 seconds after Alarm Silence button
pressed)

Message Icon Alarm priority Cause Remedy

REPLACE Low priority. FiO2 cell fault. Change external


O2 CELL. sensor and
perform manual
test to measure
new sensor
characteristics, or
turn off O2 option.
PATIENT Medium priority. No spontaneous Adjust inspiratory
APNEA. cycles initiated trigger value.
during Tapnea
starting from end
of previous
expiratory phase.

EXT BATT Low priority. External battery Connect device to


EMPTY. charge less than mains supply or
EXT. 5%. change external
battery pack.

EXT BATT Low priority. External battery Connect device to


LOW. charge less than mains supply or
EXT. 15%. change external
battery pack.

116/174 NOT013189-6
Message Icon Alarm priority Cause Remedy

INT BATT Medium priority. Internal battery Change power


LOW. charge less than supply.
INT. 15%.

CIRCUIT High priority. Faulty connection Reconnect patient


OPEN. of patient circuit. circuit.

LP
CIRCUIT High priority. Defective patient Change patient
OPEN. circuit. circuit.

LP
TEST FAILED. High priority. Manual test was Repeat manual
interrupted. test.

MAXI F. Low priority. Respiratory rate Check that


higher than upper Respiratory Rate

F threshold for
Respiratory Rate
alarm.
alarm and
inspiratory trigger
settings are
correct.

MAXI Leaks. High priority. Leak higher than Check that High
the High Leak Leak alarm
alarm threshold. threshold setting
is correct and
check patient
circuit integrity.

WRONG CIRCUIT. High priority. Type of patient Check circuit and


circuit used is repeat test.
different from the
one determined
by the test.

LOW PEEP. Medium priority. PEEP delivered to Check patient


patient is lower circuit integrity.

LP than target PEEP.

MAXI P expi. High priority. Expiratory Check expiratory


pressure too high valve control and

HP compared to
target PEEP.
check patient
circuit for
blockage.

NOT013189-6 Alarms 117/174


Message Icon Alarm priority Cause Remedy

MAXI P inspi. High priority. Pressure in circuit Check alarm


higher than High threshold is

HP Pressure alarm
threshold.
correctly set and
patient's airway is
clear, and check
patient circuit
integrity.

MAXI Vt. High priority. Tidal volume Check alarm


higher than upper threshold is

V Tidal Volume
alarm threshold.
correctly set and
check patient
circuit integrity
and expiratory
valve function.

MINI Vt. High priority. Tidal volume Check alarm


lower than lower threshold is

V Tidal Volume
alarm threshold.
correctly set and
check patient
circuit integrity
and expiratory
valve function.

Table 7.5: Audible alarms which can be turned off

Message Icon Alarm priority Cause Remedy

EXT BATT Low priority. External battery Reinstall external


MISSING. pack battery pack or
EXT. disconnected. confirm
disconnection by
pressing Alarm
Silence button.

EXT MISSING. Low priority. Loss of external Check external


DC supply. DC supply
connection or
confirm
disconnection by
pressing Alarm
Silence button.

EXPI Resist. Low priority. Abnormal Change patient


expiratory circuit and repeat
resistance in manual test.
patient circuit.

INSPI Resist. Low priority. Abnormal Change patient


inspiratory circuit and repeat
resistance in manual test.
patient circuit.

118/174 NOT013189-6
Message Icon Alarm priority Cause Remedy

MAINS MISSING. Low priority. No mains power Check connection


in compartment between mains
under device or at power socket and
external power mains power
socket. pack, or if mains
power pack is
connected to
external power
socket, check this
connection, or
confirm
disconnection of
mains power by
pressing Alarm
Silence button.

REPLACE Low priority. Turbine Return device to


BLOWER. maintenance. ResMed service
centre.

ADJUST Low priority. Time setting lost. Set the time.


CLOCK.

Note: When the ventilator is powered by the mains power pack using an external power cord
(with the pack outside its compartment), this is treated as an external power supply. When this
power supply configuration becomes disconnected, it is the External Power Supply alarm which
is triggered rather than the Mains Power Supply alarm.
Warning
! If the alarm persists after the remedies have been tried, stop using the ventilator and call
technical support.

NOT013189-6 Alarms 119/174


7.4 Alarm checking procedure
Before using the ventilator, check that all critical alarms are properly adjusted according to the
ventilation parameters.
All visual and audible alarms must be tested regularly to ensure they are working properly,
particularly prior to connection to a patient and before continuous ventilation.

Testing the mains power and external DC power alarms


Connect a patient circuit (single or double limb) fitted with a MAQUET test lung to the ventilator
and perform the manual test. Go to the clinical screens (by pressing the padlock) and set up ACV
mode, non-invasive, adult ventilation.
Turn off any alarms which may be triggered (by pressing the Alarm Silence button twice).
Perform the following test for each power supply type (mains, external DC and external battery):
Table 7.6: Power supply tests

Action Visual alarm Audible alarm

Connect power supply. Off Off

Disconnect power supply. Flashing Sounding

Reconnect power supply. Steady Off

Press the Alarm Silence button. Off Off

120/174 NOT013189-6
Testing settings alarms for use with single or double limb circuits
Connect a patient circuit (single or double limb) fitted with a MAQUET test lung to the ventilator
and perform the manual test (see "Manual test" on page 65).
Set up ACV mode, non-invasive, adult ventilation.
Set the ventilation parameters as follows:
• VT = 500mL;
• PEEP = 0cmH2O;
• F = 15 bpm;
• Max flow ( V ) = 23L/min (Ti = 1.3 or I/E = 1/2.0);
• Trigger = NO;
• Flow shape = constant;
• Start ventilation and perform the following operations.
Note: Some alarms may have a reaction time of several seconds before triggering or stopping.
Table 7.7: Testing settings alarms for use with single or double limb circuits

Visual alarm Audible alarm Time taken for


Alarm Action
status status alarm to trigger

CIRCUIT OPEN. Disconnect Flashing. Sounding. 15 seconds.


patient circuit
expiratory limb.

Reconnect patient Steady. Off.


circuit expiratory
limb.

Press Alarm Off. Off.


Silence button.

MAXI F. Adjust alarm Flashing. Sounding. 4 cycles.


upper threshold to
F = 10bpm.

Adjust alarm Steady. Off.


upper threshold to
F = 35bpm.

Press Alarm Off. Off.


Silence button.

MAXI P Adjust alarm Flashing. Sounding. 3 cycles.


upper threshold to
Pmax =
10cmH2O.
Adjust alarm Steady. Off.
upper threshold to
Pmax =
60cmH2O.
Press Alarm Off. Off.
Silence button.

Connect a supply of oxygen to the Elisée 150 with FiO2 = 40%.

NOT013189-6 Alarms 121/174


Table 7.8: Testing oxygen settings alarms for use with single or double limb circuits

Visual alarm Audible alarm Time taken for


Alarm Action
status status alarm to trigger

MAXI FIO2 Adjust alarm Flashing. Sounding. 30 seconds.


upper threshold to
FIO2 = 30%.

Adjust alarm Steady. Off.


upper threshold to
FIO2 = 100%.

Press Alarm Off. Off.


Silence button.

MINI FIO2 Adjust alarm Flashing. Sounding. 30 seconds.


lower threshold to
FIO2 = 60%.

Adjust alarm Steady. Off.


lower threshold to
FIO2 = 17%.

Press Alarm Off. Off.


Silence button.

Disconnect the oxygen supply and change the ventilation mode to PS.SV (PS).
Set the ventilation parameters as follows:
• Pressure support = 15cmH2O;
• PEEP = 5cmH2O;
• VTS = 500mL;
• Slope = 3;
• Fmini = no;
• Trigger = 2;
• Tg Exp. = auto;
• Ti Max = 1.2 s.
Set up volumetric apnea ventilation (with Alarm set to Yes) with the following settings:
• Tapnea = 15s;
• VT = 500mL;
• F = 15bpm;
• I/E = 1/2.0 ( Vmax = 23L/min, Ti = 1.3s);
• Start ventilation and perform the following operations.

122/174 NOT013189-6
Table 7.9: Testing apnea ventilation settings alarms for use with single or double limb circuits

Visual alarm Audible alarm Time taken for


Alarm Action
status status alarm to trigger

PATIENT APNEA. Trigger pressure Sounding. Sounding. Tapnea = 15s.


support cycle
then wait without
triggering an
inspiratory phase.

Trigger 4 Steady. Off.


inspiratory
phases.

Press Alarm Off. Off.


Silence button.

NOT013189-6 Alarms 123/174


Testing settings alarms for use with a double limb circuit
Connect a double limb patient circuit fitted with a MAQUET test lung to the ventilator and perform
the manual test.
Set up ACV mode, non-invasive, adult ventilation.
Set the ventilation parameters as follows:
• VT = 500mL;
• PEEP = 0cmH2O;
• F = 15bpm;
• Max flow ( V ) = 23L/min (Ti = 1.3 or I/E = 1/2.0);
• Trigger = NO ;
• Flow shape = constant;
• Start ventilation and perform the following operations.
Table 7.10: Testing settings alarms for use with a double limb circuit

Visual alarm Audible alarm Time taken for


Alarm Action
status status alarm to trigger

MAXI Leaks. Adjust alarm Flashing. Sounding. 6 cycles.


upper threshold to
Leak = 20% then
create a slight
leak in the circuit
(e.g. by slightly
loosening the
expiratory limb of
the circuit).

Adjust alarm Steady. Off.


upper threshold to
Leak = 80% and
stop the leak.

Press Alarm Off. Off.


Silence button.

MINI Vt. Adjust alarm Flashing. Sounding. 5 cycles.


upper threshold to
VTE = 2000mL
and lower
threshold to VTE =
800mL.

Adjust alarm Steady. Off.


lower threshold to
VTE = 150mL.
Press Alarm Off. Off.
Silence button.

MAXI Vt. Adjust alarm Flashing. Sounding. 5 cycles.


upper threshold to
VTE = 250mL.
Adjust alarm Steady. Off.
upper threshold to
VTE = 2000mL.
Press Alarm Off. Off.
Silence button.

124/174 NOT013189-6
Testing settings alarms for use with a single limb circuit
Connect a single limb patient circuit fitted with a MAQUET test lung to the ventilator and perform
the manual test.
Set up ACV mode, non-invasive, adult ventilation.
Set the ventilation parameters as follows:
• VT = 500mL;
• PEEP = 0cmH2O;
• F = 15bpm;
• Max flow ( V ) = 23L/min (Ti = 1.3 or I/E = 1/2.0);
• Trigger = no;
• Flow shape = constant;
• Start ventilation and perform the following operations.
Table 7.11: Testing settings alarms for use with a single limb circuit

Visual alarm Audible alarm Time taken for


Alarm Action
status status alarm to trigger

MAXI P expi. Block the single Flashing. Sounding. 1 cycle.


circuit valve
outlet.

Unblock the single Steady. Off.


circuit valve
outlet.

Press Alarm Off. Off.


Silence button.

MINI Vti. Adjust alarm Flashing. Sounding. 5 cycles.


upper threshold to
VTE = 2000mL and
lower threshold to
VTE = 800mL.

Adjust alarm Steady. Off.


lower threshold to
VTE = 150mL.

Press Alarm Off. Off.


Silence button.

MAXI Vti. Adjust alarm Flashing. Sounding. 5 cycles.


upper threshold to
VTE = 250mL.

Adjust alarm Steady. Off.


upper threshold to
VTE = 2000mL.

Press Alarm Off. Off.


Silence button.

NOT013189-6 Alarms 125/174


126/174 NOT013189-6
8 Maintenance and Disinfection
Caution
! The device should be cleaned and disinfected before it is used for the first time, and also
between patients.
Note: In a hospital environment, we recommend the ventilator be disinfected regularly and also
whenever contamination occurs.

8.1 Cleaning and maintenance frequency

Cleaning frequency
Any recommendations regarding the frequency for cleaning and replacing disposable parts will be
given by the manufacturers of those parts.
As an indication, the following table sets out the parts of the pressurised air system which should
be washed before reuse.
Table 8.1: Cleaning frequency

For the same patient Between patients

Patient circuit Hospital protocol or Yes


manufacturer's
instructions

Antibacterial filter (1) Yes

Double limb circuit Hospital protocol or Yes


expiratory support manufacturer's
instructions

Anti-dust filter Maximum 6 months Yes

Humidifier Hospital protocol or Yes


manufacturer's
instructions
Outside of the -- Yes
ventilator

(1) If the antibacterial filter is being used to protect against bacteria and viruses, follow the filter
manufacturer's instructions on replacement frequency. If it is being used to filter dust, it should
be replaced weekly.

Preventative maintenance frequency


Table 8.2: Preventative maintenance

Servicing Frequency People qualified to perform service

O2 cell 6 months(2) Trained technicians

Preventative Yearly Trained technicians


maintenance

Preventative 10,000 hours Trained technicians


maintenance

(2) This period will vary depending on the oxygen concentration used and the ambient
temperature.

NOT013189-6 Maintenance and Disinfection 127/174


8.2 Maintenance, cleaning and replacement of wearing parts

Patient circuit and expiratory valve clapper


For guidance on disinfecting and cleaning patient circuits, refer to the manufacturer's
instructions.
However, if a reusable patient circuit is being reused for the same patient, it can be cleaned
regularly with soapy water, rinsed in clean water and then dried before use.

For a single limb circuit

EXHALATION
VALVE
PART. A
PRESSURE

Figure 8.1: Diagram of single limb circuit.


It is not necessary to clean the part of the circuit connected to the expiratory valve (see "Figure
8.1: Diagram of single limb circuit." on page 128).
We recommend you remove this part of the circuit before cleaning to prevent water from
entering the device and possibly causing a malfunction.
Make sure the patient circuit is completely dry before reconnecting it. Also check that the
expiratory valve clapper is dry.
Only the silicone tubes can be autoclaved. The expiratory valve and its control tube must not be
autoclaved.
Cold immersion decontamination may be performed using a bactericidal, fungicidal and virucidal
solution, in accordance with the manufacturer's instructions.

Humidifier
We recommend the use of single-use disposable chambers.
Cold immersion decontamination may be performed on reusable chambers using a bactericidal,
fungicidal and virucidal solution, in accordance with the manufacturer's instructions.
Note: Do not use solutions of phenols, ketones, formaldehyde, hypochlorite, chlorinated
hydrocarbons, aromatic hydrocarbons or organic acids.

128/174 NOT013189-6
The ventilator’s exterior
Clean the outside of the ventilator with a dry cloth or, if necessary, with a damp sponge.

Figure 8.2: Cleaning the outside of the ventilator.


Note: The ventilator may be decontaminated using current procedures approved by the service
centres. However, users are strongly advised not to use abrasive powders or solvents.
Caution
! If other products are used, they must comply with the conditions set by the French
pharmacopoeia, must be known not to leave any residue and must not affect ventilator
operation.

NOT013189-6 Maintenance and Disinfection 129/174


Replacing the anti-dust filter
The filter is located at the rear of the ventilator.
To replace it:
1. Use tweezers to pull the filter out of its compartment.
2. Insert the new filter into the compartment and push it in until flush with the casing.
Note: RESMED product ref. MOU010645 is a filter which must be changed every six months as
well as between patients.

Figure 8.3: Replacing the anti-dust filter.

130/174 NOT013189-6
Replacing the O2 cell
Caution
! The replacement frequency for the O2 cell varies from 6 to 12 months. This frequency is
given as an indication only and varies depending on the duration of ventilation, the oxygen
concentration used and the ambient temperature.
The O2 cell is located at the rear of the ventilator.

To replace it:
1. Remove the protective cap from the O2 cell.

Figure 8.4: Removing the protective cap from the O2 cell.


2. Pull out the connector so that it does not obstruct the O2 cell, then use the disassembly key
(see reference on page 149) to unscrew the O2 cell (see reference on page 149). Replace it
with a new one.

Figure 8.5: Removing the O2 cell.


Note: After opening the bag, wait 15 minutes before changing the O2 cell.
Check the expiry date (month and year) on the label of the O2 cell. The cell can be installed on or
before the date on the label.
3. Screw the O2 cell back in place, plug the connector back in, and then put the protective cap
back on.
4. Perform a manual test to ensure the cell is functioning correctly (see "Manual test" on
page 65).

NOT013189-6 Maintenance and Disinfection 131/174


TEST Last test the 18/06/07
Double circuit : PASS

P1: ACV

U
P2: PS

NEW
PATIENT
Figure 8.6: Main clinical mode screen.
The results of the last test are displayed. Press RESTART and follow the instructions displayed.

Last test
the 12/06/07 at 14 : 50 : 35 Back
Circuit test : PASS
Kind of circuit : DOUBLE
Ctot = 1.2 ml/cmH2O
Ri = 0.2 cmH2O (30 l/min)
Ri = 0.2 cmH2O (60 l/min)
Re = 0.2 cmH2O (30 l/min)
Re = 0.2 cmH2O (60 l/min)

RESTART

Figure 8.7: Manual test results screen.


Once the test is completed, the results are displayed. Check that the message "replace O2 cell"
is not displayed before starting ventilation.

132/174 NOT013189-6
Double limb circuit expiratory support

Replacing the expiratory valve clapper


The clapper must be replaced every time the support is sterilised or decontaminated.
Note: RESMED product ref. CLA007829.
1. To replace the clapper, dismantle the support as follows:
Holding the two metal pins, press and turn to the left while holding the other end of the support
steady.

Figure 8.8: Dismantling the double limb circuit support.


2. Once the support has been autoclaved (or decontaminated), fit a new valve clapper, making
sure that it goes in the right way round.

67

clapper fitted correctly clapper upside down

Figure 8.9: Fitting the valve clapper correctly.


3. To put the support back together, insert the three lugs into the slots, push firmly and turn to
the right as far as the limit stop.

NOT013189-6 Maintenance and Disinfection 133/174


Autoclaving
The supports may be autoclaved at 134°C for 18 minutes.
Note: Before autoclaving the support, remove the clapper valve inside it.

Decontamination
Cold immersion decontamination may also be performed using a bactericidal, fungicidal and
virucidal solution.

134/174 NOT013189-6
9 Technical Specifications and Description

9.1 Technical description and operation

Technical description
Caution
! This section is intended for qualified technicians trained by ResMed.
The Elisée 150 is a volumetric and pressure ventilator. The air flow is generated by a turbine from
ambient air flowing through the air inlet. The Elisée 150 can therefore operate without a
pressurised air supply. Closed-loop control between the turbine and a valve allows the pressure
and the volume of air delivered to the patient to be monitored accurately.
The low-pressure oxygen port allows enrichment of delivered air.
The ventilator body consists of a printed circuit board and a pressurised air assembly connected
to a turbine.

Printed circuit board


Controls the operation of the ventilator through the main microcontroller. The main
microcontroller controls:
• Power supply switching;
• Ventilation measurements and controls;
• Alarms;
• User interfaces.
A second microcontroller monitors the activity of the main microcontroller.

Pressurised air assembly


The pressurised air assembly consists of:
• A main turbine for ventilation;
• A PEEP microturbine to maintain positive end expiratory pressure;
• A rotary slide valve providing closed-loop control of flow rates and pressures;
• An I/E solenoid valve which controls the inspiratory and expiratory phases;
• A spontaneous inspiration valve.
Table 9.1: Sensors used to control pressurised air assembly ventilation, with their measurement
ranges

Sensor Measurement range

Proximal pressure sensor. 0 – 100 hPa

Proximal pressure sensor for pressure -10 to +40 hPa


triggering.

Expiratory flow sensor for monitoring 0 – 120 L/min


exhaled air in double circuits.

Inspiratory flow sensor for monitoring 0 – 180 L/min


inhaled air.

Safety outlet pressure sensor. 0 – 100 hPa


Chemical sensor measuring the oxygen 0 – 100%
concentration in the air delivered to the
patient (optional).

NOT013189-6 Technical Specifications and Description 135/174


Sensor Measurement range

Internal temperature sensor. 0 – 100°C

Hall-effect turbine speed sensor. 0 – 65,000rpm

Operation of the ventilator


Outside air is sucked in through an anti-dust filter.
It may be enriched with oxygen using the low-pressure oxygen port (max 400kPa). The FiO2 is
monitored using a dedicated chemical sensor (if the oxygen monitoring option is activated).
The turbine then compresses the oxygen/air mixture. The turbine enables closed-loop control of
the required pressures and flow rates.
The turbine speed is regulated by the microprocessor on the basis of the set parameters. It is
controlled either by the inspiratory flow sensor in the volumetric modes, or by the proximal
pressure sensor in the pressure modes.
At the turbine outlet, a valve controlled by a stepper motor accurately controls the level and shape
of air pressure and flow.
An I/E solenoid valve controls the expiratory valve, which in turn controls the inspiratory and
expiratory times.
There is also a microturbine which can generate a counter-pressure during the expiratory phase
to maintain the level of PEEP.
A sensor dedicated to triggering detects pressure demands.
For safety reasons, an inspiratory valve allows the patient to breathe spontaneously regardless of
the status of the ventilator.
A temperature sensor monitors increases in internal temperature, and controls the cooling fans.
Two solenoid valves (auto offset) enable automatic recalibration of the inspiratory flow sensor
offset.

136/174 NOT013189-6
Pressurised air flow diagram – Single limb circuit

Patient

Expiratory
valve

Paw
Auto offset SV

sensor
Expiratory
Trigger flow
Inspiratory flow
sensor (Ptrig) sensor e
sensor i

Safety
valve Output pressure
sensor (Pout)

Insufflated air
temperature sensor

Stepper motor Printed


Ventilation valve
circuit board
Optical sensor

I/E
solenoid
valve

PEEP
microturbine

Closed-loop turbine
speed control

External
FiO2
sensor

Ambient temperature
Filter sensor

Air inlet
LP O2 port

NOT013189-6 Technical Specifications and Description 137/174


Pressurised air flow diagram – Double limb circuit

Patient

Expiratory
valve

Paw
Auto offset SV

sensor
Expiratory
Inspiratory flow Trigger
sensor (Ptrig) flow
sensor i sensor e

Safety Output pressure


valve sensor (Pout)

Air temperature
sensor

Stepper motor Printed


ventilation valve
circuit board
Optical sensor

I/E
solenoid
valve

PEEP
microturbine

Closed-loop turbine
speed control

External
FiO2
sensor

Ambient temperature
sensor
Filter

Air inlet
LP O2 port

138/174 NOT013189-6
9.2 Technical specifications for the Elisée 150

Electrical specifications
• Device class: Class II, type BF.
• Mains supply: 100VAC / 1 A to 230VAC / 0.6A – 50/60Hz.
• External DC power supply: 12-28VDC, max 15A.
• Internal Battery: Li-Ion; 14.4VDC; 6.3AH.
• External battery: Li-Ion; 14.4VDC; 6.3AH.
• Power consumption: Max 75VA.

Battery life

Guaranteed battery life in the following conditions (environmental


conditions, settings and patient circuit)
Minimum 6 hours per battery.
Environmental conditions
Temperature: 20°C.
Altitude: 100m.
Ventilator settings
Automatic brightness; BTPS = YES; Adult and Invasive; P(A)CV mode; Pinsp = 20cmH2O;
PEEP = 0cmH2O; F = 15bpm; Slope = 3; I/E = 1/2; Trigger = NO.
Patient circuit setup
Double limb patient circuit: CIR009727, Maquet 190 test lung with a measured VTE of
approximately 425mL.

Additional information on battery life


The battery life depends on the settings, the environmental conditions (particularly temperature)
and also the physiological characteristics of the patient.
Table 9.2: Effect of PEEP on battery life

Temperature = 20°C; Altitude = 100m; Automatic brightness; Invasive mode; Slope = 1; (A)CV
mode; I/E = 1/2; Trigger = NO; CIR009727 double limb circuit; Maquet 190 test lung (except
for the test with VT = 100 mL), BTPS = NO.
PEEP = 0 PEEP = 5

Paediatric mode; VTI = 5 hours 50 minutes 5 hours


100mL; F = 30bpm; Pmax =
16cmH2O; Michigan test lung
with C = 10 and R = 20.

Paediatric mode; VTI = 4 hours 40 minutes 3 hours 50 minutes


300mL; F = 20bpm; Pmax =
19 mH2O.
Adult mode; VTI = 300mL; F = 6 hours
20bpm; Pmax = 19cmH2O.

Adult mode; VTI = 500mL; F = 6 hours 30 minutes 5 hours 20 minutes


15bpm; Pmax = 24cmH2O.

NOT013189-6 Technical Specifications and Description 139/174


Note: The batteries (internal and/or external) need to be fully charged before use.
The batteries (internal and/or external) reach optimal life after three charge/discharge cycles.

Recharging
5 - 6 hrs per battery. With an external power supply of < 19 +/- 1volts, the batteries do not
recharge during ventilation.

External power supply


Characteristics: FRB DB315 female fixed connector
12 to 28VDC / max. 15A

12-28 V max
15 A

Figure 9.1: External power supply electrical connection.

Serial link
LEMO connector 3-pin female – 3-pin male

12-28 V max
15 A

3 4

2 5

1 6

Figure 9.2: Serial link electrical connection.


1. TXD
2. RXD
3. GND
4. +5V
5. Digital input/output 0/5V
6. NC

140/174 NOT013189-6
Remote alarm
Binder 3-pin female serial 712 connector

12-28 V max
15 A

Imax

Vmax

1 (NC)
3 (NO)
Ω
2 (COMMON)
Figure 9.3: Remote alarm electrical connection.
Remote alarm relay:
• Interrupting capacity: Max. 10VA.
• Max intensity: 0.5A.
• Max voltage: 24VDC relative to earth or 0V for the device.
Table 9.3: Configuration of the relay according to the operating status of the device

Ventilator running with no Ventilator running with alarm


Ventilator off
alarm active active

NO NO NO

NC NC NC

COMMON COMMON COMMON

Table 9.4: Operating principles for the RESMED BOI010525 remote alarm box

Ventilator status Alarm box status

Off

On

On + Alarm

The alarm relay is not electrically polarised. It has its own power supply.

NOT013189-6 Technical Specifications and Description 141/174


Pressurised air specifications

Low-pressure O2 port
• Maximum input pressure = 400kPa.
• Maximum input flow = 15L/min.

Pressurised air interface


• Female connection (built-in): 1.8 NPT threaded with clapper valve. CPC reference: MCD10-02.
• Male connection (cord): CPC reference: MC22-03.

Specifications and performance data

Performance data
• Ventilator weight: 3.7kg (9.9lbs).
• Mains power pack weight: 0.45kg (0.88lbs).
• External battery pack weight: 0.75kg (2.42lbs).
• Dimensions: 290 x 250 x 130mm (11.41’’ x 9.84’’ x 5.11’’).
• Sound level: < 40dBa (at 1metre).
• Mechanic and pressurised air performance: 0 – 60hPa (= 61.0cmH2O) at a flow rate
of 0 - 180L/min.
• Air pressure supply (minute volume) adjustment range: Adult: 0.20 – 30L/min.
• Paediatric: 0.20 - 20L/min.
• Monitoring device: black box (events data storage).

Ventilation modes
• Volume-Controlled Ventilation (CV).
• Pressure-Controlled Ventilation (PCV).
• Assisted Volume-Controlled Ventilation ACV.
• Pressure Assisted Controlled Ventilation PACV.
• Intermittent Assisted Volume-Controlled Ventilation (Synchronised intermittent mandatory
ventilation, SIMV).
• Intermittent Assisted Pressure-Controlled Ventilation (Pressure Synchronized Intermittent
Mandatory Ventilation, PSIMV).
• Pressure Support PS.SV (PS).
• Pressure Support with Minimum Tidal Volume PS.VT.

Display
• Built-in touch screen.
• Liquid Crystal Display (LCD).

142/174 NOT013189-6
Pressure
• Maximum pressure:
• 60hPa (= 60.96cmH2O) in volumetric ventilation;
• 60hPa (= 60.96cmH2O) in pressure ventilation.

To obtain these maximum pressures:


• For pressure ventilation:
Set up PACV with Pinsp = 50cmH2O and PEEP = 10cmH2O, and connect a double limb
patient circuit fitted with a Maquet lung test to the device. Start ventilation.
• For volumetric ventilation:
Set up adult, non-invasive ACV and set VT = 0.65L and Pmax alarm = 60hPa (=
60.96cmH2O). Connect a double limb patient circuit and block the other end. Start
ventilation and check that the HP alarm is triggered.
• Maximum pressure in single-fault conditions: 70hPa (= 71.12cmH2O).
• Negative pressure during exhalation: None.
• The High Pressure alarm is triggered when the inspiratory proximal pressure is higher than
the High Pressure alarm threshold.
• As a safety feature, if the turbine output pressure is greater than 60 – 70hPa (= 61.0 –
71.1cmH2O), the 30V power supply to the turbine is cut. This is achieved by means of an
electronic pressure switch which is independent of both the microprocessor and the proximal
pressure sensor.

Resistance
Ventilator with double patient circuit (Ø22 mm) ref. CIR009727
• Inspiratory resistance at 60L/min: 0.7 hPa (= 0.711cmH2O).
• Expiratory resistance at 60L/min: 1.7 hPa (= 1.727cmH2O).
• Inspiratory resistance at 30L/min: 0.4 hPa (= 0.406cmH2O).
• Expiratory resistance at 30L/min: 1.0 hPa (= 1.016cmH2O).
Ventilator with double patient circuit (Ø22 mm) ref. CIR009727 & accessories
(tubing, filter, humidifier)
• Device volume: 1,700mL.
• Device compliance: 1.7mL/hPa (= 1.727mL/cmH2O).
• Inspiratory resistance at 60L/min: 4.3hPa (= 4.369cmH2O).
• Expiratory resistance at 60L/min: 3.0hPa (= 3.048cmH2O).

NOT013189-6 Technical Specifications and Description 143/174


Materials
Materials used
• Anodised aluminium
• Stainless steel
• ABS
• Brass
• Delrin
• Silicone
• Teflon
• PPI foam
• EPDM, Viton and PTFE seals.
Material in contact with inhaled air
• Anodised aluminium
• Stainless steel
• Delrin
• Silicone
• Teflon
• PPI foam
• EPDM seal.
Materials in contact with oxygen
• Anodised aluminium
• Stainless steel
• Delrin
• Silicone
• Teflon
• EPDM and PTFE seals.

144/174 NOT013189-6
Operating, storage and transport conditions

Normal operating conditions


• Ambient temperature when the device is battery-powered: -10°C to +40°C (14 - 104°F).
• Ambient temperature required for recharging the batteries during operation: 5°C to +40°C.
• Relative humidity: 10 - 95%.
• Atmospheric pressure: 600hPa (= 609.6cmH2O) to 1100hPa (= 1117.6cmH2O).
Note: When the environmental and power supply conditions are modified one parameter at a
time within the limits below, the ventilator will continue to operate normally provided the other
parameters remain within normal limits.
• Temperature: 5 - 50°C;
• Relative humidity: 10 - 95%;
• Atmospheric pressure: 600hPa (= 609.6 cmH2O) to 1100hPa (= 1117.6cmH2O);
• Mains voltage: -20% to +10% nominal;
• External power supply: 26V (-20% to +10%);
• Combination: +45°C and 75% RH.

Storage
• Temperature: -10°C to +50°C (14 - 122°F);
• Relative humidity: 10 - 90%;
• Atmospheric pressure: 500hPa (= 508cmH2O) to 1100hPa (= 1117.6cmH2O).
• The device is fragile. Keep dry and store in its operating position.
Note: It is preferable to store the device in its packaging or in its bag. If the device is stored
outside of its packaging, it must rest flat on its feet.

Conditions for transport without ventilation


When returning to the service centre, the ventilator and its accessories must be transported
inside the ResMed packaging. They must be transported in the following conditions:
• Transport temperature: -10°C to +50°C;
• Relative humidity: 10 - 90%;
• Atmospheric pressure: 500hPa (= 508cmH2O) to 1100hPa (= 1117.6cmH2O).
Note: The device is fragile.

Conditions for transport during ventilation


If the ventilator is to be used during transport, it should be kept inside its RESMED bag.
The position of the ventilator during ventilation has no influence on the functioning of the device.
Normal operating conditions apply.

Fire prevention
In single-fault conditions, the flammable materials have an ignition temperature higher than the
minimum required by the relevant standards.

NOT013189-6 Technical Specifications and Description 145/174


9.3 Technical specifications for accessories
Caution
! All accessories used must comply with CE marking and meet the specifications
recommended by the manufacturer.

Patient circuit with water traps


• Maximal internal volume of circuit: 1000mL.
• Compliance: 1.0mL/hPa (= 1.016mL/cmH2O).
• Inspiratory resistance at 30L/min: 0.5hPa (= 0.508cmH2O).
• Inspiratory resistance at 60L/min: 1.3hPa (= 1.321cmH2O).
• Expiratory resistance at 30L/min: 0.5hPa (= 0.508cmH2O).
• Expiratory resistance at 60L/min: 1.3hPa (= 1.321cmH2O).
• Diameter of the connector: 22mm.

Patient circuit with humidifier


• Maximum internal volume of circuit: 1500mL.
• Average compliance of circuit: 1.4mL/hPa (= 1.422mL/cmH2O).

Antibacterial filter
• Filter: antibacterial / antiviral.
• Connector: 22 female and 22 male / 15 female.
• Bacterial and viral retention > 99.999%.
• Resistance at 30L/min: 1.1hPa (= 1.118cmH2O).
• Resistance at 60L/min: 2.2hPa (= 2.235cmH2O).
• Compliance: 0.2mL/hPa (= 0.203mL/cmH2O).
• Compressible volume: 66mL.
• Internal volume: 200mL.
• Usage time: 24 hours.

Humidifier
CE-marked equipment. The humidifier used must meet the following requirements:
• Maximum pressure during operation > 80hPa.
• Max. flow: 180L/min.
• Pressure drop at 180L/min: < 3hPa.
• During spontaneous breathing: < 3hPa.
• Air loss at maximum pressure: < 20mL/min.
• Average compliance: 0.3 - 0.5mL/hPa.
• Liquid flow rate: 10 - 25mg/L.

Anti-dust filter
Specific ResMed equipment, ref. MOU010645.
Note: The manufacturer accepts no liability for damage to the device caused by the use of a
filter which does not comply with the recommendations.

Remote alarm
Specific ResMed equipment, ref. BOI010525.
Note: The manufacturer accepts no liability for damage to the device caused by connection to a
remote alarm which does not comply with the specifications provided.

146/174 NOT013189-6
Serial link
Specific ResMed equipment, ref. CAB012527.
Note: The manufacturer accepts no liability for damage to the device caused by the connection
of a cable which does not comply with the specifications provided.

NOT013189-6 Technical Specifications and Description 147/174


9.4 Applicable standards
The ventilator meets the following standards:
• EN 60601-1:1990 / A1:1993 / A2:1995 / A13:1996: Medical Electrical Equipment. General
Requirements for Safety;
• EN 60601-1-2:2001: Electromagnetic Compatibility for Medical Electrical Equipment;
• EN 55011, Class B,
• EN 61000-4-2,
• EN 61000-4-3,
• EN 61000-4-4,
• EN 61000-4-5,
• EN 61000-4-6,
• EN 61000-4-8,
• EN 61000-4-11,
• IEC 801-3,
• EN 61000-3-2,
• EN 61000-3-3,
• IEC 60601-1-4:1996 / A1:1999: Programmable Electrical Medical Systems;
• NF EN ISO 14971: Medical Devices – Application of Risk Management to Medical Devices;
• EN ISO 10651-6:2004: Lung Ventilators for Medical Use – Special Requirements for Basic
Safety and Essential Performance – Part 6: Home Care Ventilatory Support Devices;
• European Directive WEEE 2002/96/EC - Proper disposal of waste electrical and electronic
equipment;
• Directive 93/42/EC, notified body TÜV Rheinland, CE0197;
• EN ISO 5356-1:2004: Anaesthetic and Respiratory Equipment - Conical Connectors - Part 1:
Cones and Sockets.
For ventilators used with a double circuit:
• ISO 10651-2:2004: Lung ventilators for medical use - Part 2: Home care ventilators for
ventilator-dependent patients.

148/174 NOT013189-6
10 Appendices
10.1 Spare parts and accessories
Table 10.1: List of spare parts and accessories

Description Reference

Li-Ion external battery pack S/E013665

12-28V external power cord S/E012528

External power cord (linking mains power S/E011930


pack to Elisée)

Double limb patient circuit with water trap CIR009727

Double limb circuit expiratory support S/E012629

Single limb patient circuit CIR011563

Single limb circuit expiratory support S/E012488

Remote control COR012624

Remote alarm box BOI010525

Remote alarm cable, 3 metres S/E012117

Remote alarm cable, 10 metres S/E014062

Remote alarm cable, 20 metres S/E014063

Dust filter MOU010645

O2 cell S/E014134

O2 cell disassembly key CLE012188

Expiratory valve clapper CLA007829

Serial link cable CAB012527


Multi-support adapter S/E012398

Metal connector EMB012443

Trolley PAC012653

NOT013189-6 Appendices 149/174


10.2 Parameters and measurements

Parameter interdependence

Interaction between parameters and measurements (volumetric ventilation)


The following table shows the interdependence between the parameters and measurements, or
in other words all of the measurements which are affected when one parameter is changed.
Table 10.2: Measurement interdependence
Parameter
Max
Flow Inspi
VT PEEP F flow I/E Ti
shape trigger
( V max)
Measurement
Ti

Te

I/E

VTI

VTE

Ve

V evs
PEEP

Ppeak

Pmean

Interaction between parameters and measurements (pressure ventilation)


The following table shows the interdependence between the parameters and measurements, or
in other words all of the measurements which are affected when one parameter is changed.
Table 10.3: Interaction between parameters and measurements
Parameter
Pinsp. PEEP F Ti Trigger
Measurement
Ti

Te

I/E

VTI

VTE

Ve

V evs
PEEP

Ppeak

Pmean

150/174 NOT013189-6
Implicit (calculated) parameters
Some parameters are adjustable, while others are calculated from the adjustable parameters. The
latter are implicit parameters (e.g. Ti and F are adjustable parameters; the implicit setting
Te = 60/F – Ti).
The adjustable parameters are: Max flow ( Vmax), Ti, Te and I/E.
Note: Ti, I/E and Vmax can be either adjustable or implicit parameters depending on the original
configuration selected for the volumetric modes (parameter options). If a beep sounds while the
user is setting the parameters, it means the I/E ratio has been inverted because of an
adjustment to one of the parameters.

Implicit parameter limits


Table 10.4: Implicit parameter limits

Minimum Maximum

Max flow Adult 10L/min 120L/min


( V max)
Paediatric 5L/min 40L/min

Ti 5 L/min 3.0s

I/E 1 / 0.4

Te 0.45s

Total inspiratory pressure control


The threshold for total inspiratory pressure is: Pressure support + PEEP = 60cmH2O, or Pinsp. +
PEEP = 60cmH2O, or Pinsp. + Precruit. + PEEP = 60cmH2O.
It is impossible to set a pressure higher than this value; even if a value higher than 60cmH2O is
displayed, this limitation is always observed.

NOT013189-6 Appendices 151/174


Ranges of adjustment, accuracies and default values

Ventilation parameters
Table 10.5: Range of adjustment for ventilation parameters
Default values Range of adjustment Accuracy

Incre-
Value Minimum Maximum
ment

Patient type Paediatric Adult Paediatric Adult Paediatric Adult

Ventilation type

F (bpm) 25 15 2 2 80 50 1 +/- 1
Ti (s) 0.6 1.0 0.3 3.0 0.1 +/- 0.1

I/E* 1/3.0 1/2.0 1/0.4 1/9.9 1/0.1

Ti Max (s) 1.2 1.0 3.0 0.1

Tapnea (s) 10 15 5 10 20 60 1 +/- 0.1

P insp (cmH2O) 12 20 3 5 60 40 60 1 +/- 5%

PS (cmH2O) 12 15 3 5 60 40 60 1 +/- 5%

PEEP (cmH2O) 0 0 20 25 1 +/- 5%

50 300 500 1000 10 10 mL or


VT (mL) 100 500
1000 2500 100 +/- 10%

Max. flow (L/min)


10 50 5 10 40 120 1
max

Rise time (slope) 3 1 4 1


Flow shape 1 1 5 1

Recruitment period
no 1 – no 60 1 1/F
(min)

0.2 0.3 3 3 0.1


Recruitment size (s) 2.0 +/- 0.1
3 3 40 40 1
Recruitment pressure
15 5 60 1 +/- 5%
(cmH2O)

no -50 no -300 500 1000 10 10 mL or


VTS (mL) no no
1000 2500 100 +/- 10%

Fmini (bpm) 25 15 no -3 no -6 80 50 1 +/-1

*: If a beep sounds, it means that the I/E ratio has been inverted during adjustment of the
parameters.

152/174 NOT013189-6
Table 10.6: Range of adjustment for triggers with double limb circuit
D e fa u lt v a lu e s M in im u m M a x im u m
P a e d i a t r ic A d u lt P a e d i a t r ic A d u lt P a e d i a t r ic A d u lt

T r ig g e r In c re -
m ent

A CV, PACV 5 .9 - 5 .9 -
0 .5 1 .0 0 .2 0 .2 0 .1
In s p . no no
p re s s u re S IM V ,
t r ig g e r P S IM V ,
0 .5 1 .0 0 .2 0 .2 6 .0 6 .0 0 .1
(c m H 2O ) P S . S V (P S ),
P S .V T

A CV, PACV 9 .9 - 9 .9 -
1 .5 3 .0 0 .2 0 .2 0 .1
I n s p . f lo w no no
t r ig g e r S IM V ,
( L /m in ) P S IM V , 1 .5 3 .0 0 .2 0 .2 10 1 0 .0 0 .1
P S . S V , P S .V T .

A CV, PACV 2 3 a u to -1 a u to -1 5- no 5- no 1

S IM V ,
N I V t r ig g e r P S IM V ,
2 3 a u to -1 a u to -1 5 5 1
P S . S V (P S ),
P S .V T ).

S IM V ,
E x p . t r ig g e r
P S IM V ,
(% m a x . 25 a u to 25 a u to 10 10 9 0 - a u to 9 0 - a u to 1
P S . S V (P S ),
e x p . f lo w )
P S .V T ).

Table 10.7: Range of adjustment for triggers with single limb circuit.
D e fau lt v alu es M in im u m M a xim u m
P a ed iatric A d u lt P ae d ia tric A d u lt P a ed iatric A d u lt
T rig g e r In c re-
m en t

A C V, P A C V 5 .9 - 5 .9 -
0.5 1 .0 0 .2 0.2 0.1
Ins p. no no
p res s ure S IM V,
trigge r P S IM V,
0.5 1 .0 0 .2 0.2 6.0 6.0 0.1
(cm H 2 O ) P S .SV (P S ),
P S .V T).

A C V, P A C V 2 3 a uto-1 a uto-1 5- no 5- no 1

S IM V,
N IV trigge r P S IM V,
2 3 a uto-1 a uto-1 5 5 1
P S .SV (P S ),
P S .V T).
S IM V,
E x p. trigg er
P S IM V,
(% m ax . ex p. 25 a uto 25 a uto 10 10 90 - a u to 90 - a u to 1
P S .SV (P S ),
flow )
P S .V T).

NOT013189-6 Appendices 153/174


Alarms
Table 10.8: Range of adjustment and default values for alarm thresholds
Default values Range of adjustment

Value Minimum Maximum Increment

Patient type Paediatric Adult Paediatric Adult Paediatric Adult

Ventilation type
Max. resp. rate
99 99 15 10 99 1
(bpm)
Max. pressure
30 40 5 60 1
(cmH2O)
50 200 10

Max. VTE (mL) 600 no 2400 no 200 600-no 1000 50

1000 2400-no 100

no-10 500 1000 10


Max. VTE (mL) 10 no 10 no
1000 2300 100

50 200 10

Max. VTI (mL) 600 no 2400 no 200 600-no 1000 50

1000 2400-no 100

no-10 500 1000 10


Min. VTI (mL) 10 no 100 no
1000 2300 100
P insp (cmH2O)
3 1 20 1

Max. leak (%) no 10 80-no 1

Max. FiO2 (%) 100 30 100 1

Min. FiO2 (%) 17 17 80 1

154/174 NOT013189-6
Measurements
Table 10.9: Ranges and accuracy of measurements

Measurement (unit) Range Accuracy Display accuracy


PEEP (cmH2O) 0 to 100 +/- 5% 0.1

Pmean (cmH2O) 0 to 100 +/- 5% 0.1

Ppeak (cmH2O) 0 to 100 +/- 5% 0.1

FiO2 (%) with 100mL < Vt < 500mL 0 to 100 +/- 10% 1

FiO2 (%) with 500mL < Vt <1000mL 0 to 100 +/- 5% 1

Ftot (bpm) 1 to 99 +/- 1 or 5% 1

0.1 to 9.99 +/- 0.02 0.01


Ti (s)
10.0 to 99.9 +/- 0.02 0.1

Te (s) 0.1 to 9.99 +/- 0.02 0.01

1/9.9 to 1/0.1 +/- 0.04 1/0.1


I/E
1/99 to 1/9.9 +/- 0.04 1/1

e (L/min) 0.1 to 99.9 +/- 15% 0.1

esp (L/min) 0.1 to 99.9 +/- 15% 0.1

Double circuit

0 to 100 +/- 10% 1


Vte (mL)
> 100 +/- 10% 1

Single circuit

0 to 100 +/- 10% 1


Vti (mL)
> 100 +/- 10% 1

NOT013189-6 Appendices 155/174


10.3 Abbreviations and symbols
Table 10.10: Definitions of abbreviations

Abbreviation Definition

PS.SV (PS) Pressure support with backup tidal volume

PS.VT Pressure support with minimum tidal volume

auto Automatic

config. Configuration

START VENTIL Start ventilation

F Respiratory rate

FiO2 Fraction of insufflated oxygen

Ftot Total respiratory rate

I/E Ratio of inspiratory time to expiratory time

inspi. Inspiratory

max. Maximum

min. Minimum

Custom. Setting Customised Setting

P Pressure

P1 Program 1

P2 Program 2

Param Parameter

P(A)CV Pressure (Assisted) Controlled Ventilation

PSIMV Intermittent Assisted Controlled Ventilation (Pressure


Synchronized Intermittent Mandatory Ventilation)

PEEP Positive End Expiratory Pressure

Delta Pi ( ΔPi) Difference between maximum pressure and Positive


End Expiratory Pressure (PEEP)

Pinsp. Inspiratory pressure

Pmean Mean pressure

Ppeak Peak pressure

recruit. Recruitment

T Period

Te Expiratory time

TgE Expiratory trigger

TgI(P) Inspiratory pressure trigger

TgI( V ) Inspiratory flow trigger

Ti Inspiratory time

Ti Max Maximum inspiratory time

(A)CV Assisted volume-controlled ventilation

156/174 NOT013189-6
Abbreviation Definition

SIMV Intermittent Assisted Volume-Controlled Ventilation


(Synchronised Intermittent Mandatory Ventilation)

Ve Expired minute volume

Ventil. Ventilation

V evs Minute volume expired during spontaneous cycles

V max Maximum flow

SV Spontaneous ventilation

VT Tidal volume

VTS Backup tidal volume

VTE Expired tidal volume

VTI Inspired tidal volume

NOT013189-6 Appendices 157/174


Table 10.11: Definitions of symbols

Symbols Definitions

External battery charge greater than 25%

External battery charge greater than 50%

External battery charge greater than 75%

External battery full

External battery missing

Internal battery charge greater than 25%

Internal battery charge greater than 50%

Internal battery charge greater than 75%

Internal battery full

Internal battery empty

Internal battery missing

Mains power connected

External DC power connected


E
X
T

Triggering

158/174 NOT013189-6
Symbols Definitions

Adult

Paediatric

Invasive

Non invasive

Slope 1
1
Slope 2
2

Slope 3
3
Slope 4
4
Manufacturer’s address

Recycling

Constant flow rate

Decreasing flow rate

Mains supply or external DC supply LED

Internal battery LED


- +
INT.
External battery LED
- +
EXT.

NOT013189-6 Appendices 159/174


Symbols Definitions

On/Off button

Air insufflation

Air return

BF-type device

Class II device

Read the accompanying manuals

DC voltage

AC voltage

CE-marked device

Transport and storage position

Fragile

Keep dry

Do not block (air inlet/outlet)

160/174 NOT013189-6
Symbols Definitions

Expiratory valve control

Serial link

Oxygen port

Alarm

Alarm Silence

Serial number

SN
Relative humidity
90

10

Proximal pressure line

NOT013189-6 Appendices 161/174


162/174 NOT013189-6
NOT013189-6 Appendices 163/174
164/174 NOT013189-6
List of Figures
Figure 2.1: Top view. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
Figure 2.2: View of left side with double limb circuit expiratory support. . . . . . . . . . . . . . . . . . . . . . . 14
Figure 2.3: View of left side with single limb circuit expiratory support. . . . . . . . . . . . . . . . . . . . . . . . 14
Figure 2.4: View of right side. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Figure 2.5: Rear view. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Figure 2.6: view underneath. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
Figure 2.7: Mains power pack. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
Figure 2.8: External DC power cords. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
Figure 2.9: Li-Ion external battery pack. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
Figure 2.10: Gas supply. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
Figure 2.11: Metal connector. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
Figure 3.1: Connecting the mains power cord to the mains power pack in its compartment. . . . . . . 23
Figure 3.2: Connecting the mains power pack outside of its compartment. . . . . . . . . . . . . . . . . . . . . 24
Figure 3.3: 12-28VDC power cord, connected. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
Figure 3.4: Elisée 150 with external battery pack and DC power source. . . . . . . . . . . . . . . . . . . . . . . . 25
Figure 3.5: Rear view with low-pressure oxygen connection. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
Figure 3.6: Single limb circuit support. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
Figure 3.7: Double limb circuit support. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
Figure 3.8: Attaching and removing the expiratory support. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
Figure 3.9: Single limb patient circuit. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
Figure 3.10: Attaching a single limb patient circuit. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
Figure 3.11: Connecting a double limb circuit. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31
Figure 3.12: Connecting an antibacterial filter. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32
Figure 3.13: Connecting a humidifier. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32
Figure 3.14: Connecting a remote control. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
Figure 3.15: Fitting a multi-support adapter. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34
Figure 3.16: Attaching the Elisée to the trolley. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34
Figure 3.17: Turning the ventilator on. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35
Figure 3.18: Using the touch screen. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35
Figure 3.19: "Do you want to switch off?" screen. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36
Figure 3.20: “Turning off the ventilator in clinical mode with ventilation stopped” screen. . . . . . . . . 36
Figure 3.21: “Turning off the ventilator in patient mode during ventilation” screen (as Fig 3.19). . . . 37
Figure 3.22: “Turning off the ventilator in clinical mode during ventilation” screen (as above). . . . . 37
Figure 4.1: Pressure support. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
Figure 4.2: Recruitment cycle in (A)CV mode. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
Figure 4.3: Recruitment cycle in P(A)CV mode. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
Figure 4.4: Flow shape parameter with I/E or Ti setting. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40
Figure 4.5: Flow shape parameter with Max. flow setting. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40
Figure 4.6: Flow shape parameter with I/E or Ti setting. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41
Figure 4.7: Flow shape parameter with Max. flow setting. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41
Figure 4.8: slope. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42
Figure 4.9: Positive end expiratory pressure. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42
Figure 4.10: Inspiratory pressure. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42
Figure 4.11: I/E ratio. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43
Figure 4.12: Apnea time. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43
Figure 4.13: Inspiratory time. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43
Figure 4.14: Expiratory trigger. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45
Figure 4.15: Invasive inspiratory triggers. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46
Figure 4.16: Non invasive inspiratory trigger. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46
Figure 4.17: Tidal volume (VT). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47
Figure 4.18: CV mode - Controlled Volume Ventilation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49
Figure 4.19: ACV mode - Assisted Controlled Volume Ventilation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49
Figure 4.20: PACV mode - Assisted Controlled Pressure Ventilation. . . . . . . . . . . . . . . . . . . . . . . . . . . . 51
Figure 4.21: PCV mode - Controlled Pressure Ventilation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51
Figure 4.22: Operation of SIMV mode. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53

NOT013189-6 List of Figures 165/174


Figure 4.23: SIMV mode. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53
Figure 4.24: Mode PS.SV (PS), pressure increased to reach VTS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57
Figure 4.25: Expiratory phases in PS.SV (PS) mode. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57
Figure 4.26: PS.VT curve - Minimum tidal volume (Vt) delivered without switching to volumetric
mode. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59
Figure 4.27: PS.VT curve - Minimum tidal volume delivered with switch to volumetric mode. . . . . . 60
Figure 4.28: Minimum tidal volume (Vt) calculation in PS.VT mode. . . . . . . . . . . . . . . . . . . . . . . . . . . . 61
Figure 5.1: Accessing the clinical screens. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63
Figure 5.2: Main clinical mode screen. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64
Figure 5.3: Accessing the manual test. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65
Figure 5.4: Main screen with manual test results. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65
Figure 5.5: Stage 1 of the manual test. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66
Figure 5.6: Stage 2 of the manual test. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66
Figure 5.7: Stage 3 of the manual test. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67
Figure 5.8: Stage 4 of the manual test. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68
Figure 5.9: Results of the manual test. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68
Figure 5.10: Main clinical mode screen. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 70
Figure 5.11: New patient stage 1- Patient types display. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 70
Figure 5.12: New patient stage 2 - Configuration type selection. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71
Figure 5.13: New patient stage - Ventilation mode selection. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71
Figure 5.14: New patient stage 4 - Setting the ventilation mode parameters. . . . . . . . . . . . . . . . . . . . . 71
Figure 5.15: The main clinician mode screen for programming ventilation via the P1 or P2 buttons. 72
Figure 5.16: New patient configuration screen. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73
Figure 5.17: Accessing the mode change screen. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74
Figure 5.18: Ventilation mode selection screen. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74
Figure 5.19: Ventilation parameters screen. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75
Figure 5.20: Ventilation parameters adjustment screen. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75
Figure 5.21: “Accessing the pressure support settings” screen. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76
Figure 5.22: “Pressure support parameters” screen. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76
Figure 5.23: “Accessing the apnea settings” screen. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77
Figure 5.24: Apnea ventilation settings screen. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77
Figure 5.25: Apnea ventilation validation screen. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 78
Figure 5.26: “Accessing the alarm threshold settings” screen. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 78
Figure 5.27: Alarm thresholds screen. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79
Figure 5.28: "Alarm threshold to be changed" screen. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79
Figure 5.29: Start Ventilation screen. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80
Figure 5.30: Stop Ventilation screen. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80
Figure 5.31: Curves screen. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81
Figure 5.32: Accessing the measurements display screen. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 82
Figure 5.33: Measurements display screen. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 82
Figure 5.34: Event log screen. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83
Figure 5.35: Screens used to access the clinician's log. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 84
Figure 5.36: Screens used to access the trends programming. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 86
Figure 5.37: Trends in progress screen. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 87
Figure 5.38: "Trends: recording time selection" screen. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 87
Figure 5.39: "Trends: former data will be erased" screen. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 88
Figure 5.40: "Changing mode during ventilation" screen. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89
Figure 5.41: "New ventilation mode selection" screen. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89
Figure 5.42: New mode settings screen. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 90
Figure 5.43: "Adjusting parameters in the new mode" screen. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 90
Figure 5.44: New mode activation screen. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 90
Figure 5.45: Accessing the parameter options screen. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91
Figure 5.46: Parameter options screen. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 92
Figure 5.47: Main Clinical mode screen. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 93
Figure 5.48: Calibration screens. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 93
Figure 5.49: Screens showing empty/filled curves. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 94
Figure 5.50: Accessing the digital sound screen. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 95
Figure 5.51: Digital sound adjustment screen. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 96

166/174 NOT013189-6
Figure 5.52: Accessing the date and time settings. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 97
Figure 5.53: Date and time setting screen. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 98
Figure 5.54: Accessing the ventilation program naming screen. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 99
Figure 5.55: Accessing the program name replacement screen. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100
Figure 5.56: Program naming screen. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100
Figure 5.57: Ventilation program names screen. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 101
Figure 5.58: Exiting clinical mode. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 102
Figure 6.1: Main patient mode screen. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 103
Figure 6.2: "Access to parameter review" screen. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 104
Figure 6.3: "Parameter review in patient mode, ventilation on standby" screen. . . . . . . . . . . . . . . . 104
Figure 6.4: "Starting ventilation in patient mode" screen. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 105
Figure 6.5: Stopping ventilation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 105
Figure 6.6: "Access to parameter review in patient mode during ventilation" screen. . . . . . . . . . . . 106
Figure 6.7: "Parameter review in patient mode during ventilation" screen. . . . . . . . . . . . . . . . . . . . 106
Figure 6.8: "Changing ventilation option during ventilation" screen. . . . . . . . . . . . . . . . . . . . . . . . . . 107
Figure 6.9: "Contrast and brightness in patient mode" screen. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 108
Figure 6.10: "Access to screen calibration in patient mode" screen. . . . . . . . . . . . . . . . . . . . . . . . . . . 109
Figure 6.11: Calibration screens. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 109
Figure 6.12: Main patient mode screen. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 110
Figure 6.13: "Patient timer in patient mode" screen. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111
Figure 8.1: Diagram of single limb circuit. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 128
Figure 8.2: Cleaning the outside of the ventilator. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 129
Figure 8.3: Replacing the anti-dust filter. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 130
Figure 8.4: Removing the protective cap from the O2 cell. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 131
Figure 8.5: Removing the O2 cell. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 131
Figure 8.6: Main clinical mode screen. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 132
Figure 8.7: Manual test results screen. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 132
Figure 8.8: Dismantling the double limb circuit support. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 133
Figure 8.9: Fitting the valve clapper correctly. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 133
Figure 9.1: External power supply electrical connection. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 140
Figure 9.2: Serial link electrical connection. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 140
Figure 9.3: Remote alarm electrical connection. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 141

NOT013189-6 List of Figures 167/174


168/174 NOT013189-6
List of Tables
Table 2.1: Description of a specimen serial number, e.g. EL2D0701001 . . . . . . . . . . . . . . . . . . . . . . . 16
Table 2.2: Power status information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
Table 4.1: Ti Max setting guide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44
Table 4.2: Adjustable parameters in (A)CV mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48
Table 4.3: Adjustable parameters in P(A)CV mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50
Table 4.4: Adjustable parameters in SIMV mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54
Table 4.5: Adjustable parameters in PSIMV mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54
Table 4.6: Adjustable parameters for PS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58
Table 4.7: Adjustable parameters in PS.VT mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62
Table 5.1: Examples of log events. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85
Table 5.2: Trends sampling: the relationship between the recording time and the recording
interval . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 86
Table 6.1: Power supply icons in patient mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 110
Table 7.1: Alarm categories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113
Table 7.2: List of ventilation monitoring alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 114
Table 7.3: Audible alarms which cannot be turned off . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 116
Table 7.4: Alarms which can be turned off temporarily (for 120 seconds after Alarm Silence button
pressed) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 116
Table 7.5: Audible alarms which can be turned off . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 118
Table 7.6: Power supply tests . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 120
Table 7.7: Testing settings alarms for use with single or double limb circuits . . . . . . . . . . . . . . . . . 121
Table 7.8: Testing oxygen settings alarms for use with single or double limb circuits . . . . . . . . . . 122
Table 7.9: Testing apnea ventilation settings alarms for use with single or double limb circuits . . 123
Table 7.10: Testing settings alarms for use with a double limb circuit . . . . . . . . . . . . . . . . . . . . . . . . 124
Table 7.11: Testing settings alarms for use with a single limb circuit . . . . . . . . . . . . . . . . . . . . . . . . . 125
Table 8.1: Cleaning frequency . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 127
Table 8.2: Preventative maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 127
Table 9.1: Sensors used to control pressurised air assembly ventilation, with their measurement
ranges. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 135
Table 9.2: Effect of PEEP on battery life . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 139
Table 9.3: Configuration of the relay according to the operating status of the device. . . . . . . . . . . 141
Table 9.4: Operating principles for the ResMed BOI010525 remote alarm box. . . . . . . . . . . . . . . . . 141
Table 10.1: List of spare parts and accessories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 149
Table 10.2: Measurement interdependence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 150
Table 10.3: Interaction between parameters and measurements . . . . . . . . . . . . . . . . . . . . . . . . . . . . 150
Table 10.4: Implicit parameter limits. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 151
Table 10.5: Range of adjustment for ventilation parameters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 152
Table 10.6: Range of adjustment for triggers with double limb circuit . . . . . . . . . . . . . . . . . . . . . . . . 153
Table 10.7: Range of adjustment for triggers with single limb circuit. . . . . . . . . . . . . . . . . . . . . . . . . 153
Table 10.8: Range of adjustment and default values for alarm thresholds . . . . . . . . . . . . . . . . . . . . . 154
Table 10.9: Ranges and accuracy of measurements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 155
Table 10.10: Definitions of abbreviations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 156
Table 10.11: Definitions of symbols . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 158

NOT013189-6 List of Tables 169/174


170/174 NOT013189-6
Index

Symbols Apnea
(A)CV 48, 156 adjusting parameters 77
principle 48 alarm 115
principle 62
Apnea time 43, 56
Apnea ventilation 77
Numerics Assisted controlled volume ventilation 48
12 18
12-28V DC power cord 18
connection 24
12-28V external power cord B
reference 149 Backup tidal volume 47, 157
Bar graph 81
Battery 16
alarm 114
A LEDs 20
Abbreviations 156 life 139
Accessories 11, 28 recharging 140
connecting 32 switching 17
manual test 69 Battery life 25
references 149 BTPS 92
technical specifications 146
Active humidification system 32
Air inlet 21, 26, 160
Alarm thresholds C
adjusting 78 Cleaning 128
Alarms 11 frequency 127
adjusting thresholds 78 outside of the ventilator 129
causes and remedies 116 Clinical screen
event log 85 accessing 63
high priority 113 exiting 102
low priority 113 Clinician's log 84
medium priority 113 Curves
monitoring 113 empty 94
programming ventilation options 70 filled 94
range of adjustment 154
ventilation monitoring 114
Antibacterial filter D
cleaning frequency 127 Data retrieval 88
connecting 32 Date and time 97
technical specifications 146 Decontamination 134
Anti-dust filter 21 Delta Pi
cleaning frequency 127 definition 156
reference 149 Disinfection 127
replacing 130 Display
technical specifications 146
174
NOT013189-6 Index 171/174
technical specifications 142 F
Double limb circuit expiratory support 14, F 42
29 Flow shape 40
maintenance 133 Fmini 42
maintenance frequency 127
reference 149
Double limb patient circuit
reference 149 G
Gas supply 21

E
Event 85 H
Events 69, 83 HME 30, 32
Expiratory support HME filter 30
attaching and removing 29 Humidifier 128
Expiratory time 156 cleaning frequency 127
Expiratory trigger 156 connecting 32
Expiratory valve clapper Humidifier with patient circuit
maintenance 128 technical specifications 146
reference 149
replacing 133
Expired minute volume 157 I
Expired tidal volume 157
I/E 43
External battery
Implicit parameters 151
compartment 14, 16
Inspiration/expiration ratio 43
connection 25
Inspiratory flow trigger 156
description 19
Inspiratory pressure trigger 156
electrical specifications 139
Inspiratory time 43, 156
recharging 25
Inspired tidal volume 157
reference 149
Internal battery
weight 142
description 19
External battery pack
electrical specifications 139
compartment 16
description 19
reference 149
External DC power supply 18 L
connection 24 Life
specifications 139 of batteries 139
symbol 158 Log 83
test 120 Low-pressure oxygen 26
External power cord
description 18
External power cord (linking mains power
pack to Elisée) 18 M
reference 149 Mains power cord
External power supply connection 23
technical specifications 140 Mains power pack
compartment 14
connection 23

172/174 NOT013189-6
description 17 Parameters
Mains power supply interdependence 150
test 120 Patient circuit 65, 128
Maintenance 12, 127 maintenance 127
Materials Patient configuration
in contact with inhaled air 144 modifying 73
in contact with oxygen 144 PEEP 42
used 144 Power
Max. flow 92 of external DC supply 18, 24
Maximum flow 157 Power consumption 139
Maximum inspiratory time 44, 156 Power supply 12, 20, 23
Measurements 82 description 17
ranges and accuracy 155 in patient mode 110
Metal connector 21, 26 Pressure support
Monitoring 30, 86, 88 adjusting parameters for SIMV and
data retrieval 88 PSIMV 76
Multi-support adapter definition 39
reference 149 Pressurised air assembly 135
Pressurised air interface 142
Printed circuit board 135
Program names 100
O assigning 99
O2 cell Programming ventilation options 70
access 15 PS.SV (PS) 56
disassembly key reference 149 definition 156
maintenance 127 principle 56
reference 149 PS.VT 56
replacing 131 definition 156
Oxygen 26 principle 59
Oxygen monitoring PSIMV
turning on and off 27 principle 52
Oxygen port 21, 161
technical specifications 142

R
Recharging 140, 145
P Recording time 86
P insp 42 Recruitment 39
P(A)CV Remote alarm
principle 50 electrical specifications 141
P1 70, 72, 84, 156 reference 149
modifying 64 socket 15
P2 70, 72, 84 technical specifications 146
activation 92 Remote control
modifying 64 connecting 33
Parameter 150 reference 149
Parameter options 91 Resistance 68
accessing 91
description 92
screen 92
174
NOT013189-6 Index 173/174
S Turning on 35
Serial link
symbol 161
technical specifications 140, 147 V
Serial link cable 15, 149 Valve clapper
reference 149 fitting 133
Serial number 16 Ve 157
symbol 161 Ventilation
Serial port 14 measurements 82
Servicing 12 monitoring 81
frequency 127 starting 80
SIMV 157 Ventilation mode
principle 52 changing 74
Single limb circuit expiratory support 14, 29 Ventilation modes 48, 142
reference 149 Ventilation parameters 152
Single limb patient circuit adjusting 75
connecting 30 definitions 39
reference 149 Ventilator
Slope 42
operation 136
Spontaneous ventilation 56, 157 Vevs 157
Standards 148 Vmax 157
Storage 12, 145, 160 Vt 47, 157
SV 157 Vte 157
Symbols 156 Vti 157
Vts 47, 157

T
Tapnea 43 W
Tg Exp 45 Weight 142
TgI 46
TgI(P) 46
TgI(V) 46
Threshold 143
Ti 43
Tidal volume 47, 157
Time 97
Touch screen 37
beeps 95, 108
calibrating 93, 109
using 35
Transport
conditions 145
Trends
programming 87
sampling 86
Trolley
reference 149
Turning off 36

174/174 NOT013189-6
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