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Humidification Humidifier Settings

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Please visit www.philips.com/respironics to find out more

BiPAP AVAPSBiPAP S/T

MCI4105612 1106444 R02

JJB 03/20/2013

LCD display screen

Number settings

Humidifier icon

Control wheel/Push button

In order to activate the Preheat mode, the blower must be off and a humidifier must be attached. From the Home screen, select Therapy, then press and hold down the control wheel for 5 seconds. There will be a single beep and the device will now be in preheat mode. The humidifier icon ( ) will illuminate during this time.

Guidelines for Ventilation Set-upConversion table to set the Inspiratory Time for controlled breaths

Set back up breath rate (BPM)

I/E 1/3, Ti/Ttot 25%

I/E 1/2, Ti/Ttot 33%

I/E 1/1, Ti/Ttot 50%

10 1.5 s 2.0 s 3.0 s11 1.4 s 1.8 s 2.7 s12 1.3 s 1.7 s 2.5 s13 1.2 s 1.5 s 2.3 s14 1.1 s 1.4 s 2.1 s15 1.0 s 1.3 s 2.0 s16 0.9 s 1.3 s 1.8 s17 0.9 s 1.2 s 1.7 s18 0.8 s 1.1 s 1.6 s19 0.8 s 1.1 s 1.5 s20 0.8 s 1.0 s 1.5 s21 0.7 s 1.0 s 1.4 s22 0.7 s 0.9 s 1.3 s23 0.7 s 0.9 s 1.3 s24 0.6 s 0.8 s 1.2 s25 0.6 s 0.8 s 1.2 s

Set the Inspiratory Time in seconds: Ti (Second) = 60/Respiratory rate x % Ti

Conversion table to set the target Tidal Volume in relation to the ideal weight

Height Calculated ideal weight (if BMI = 23)

Target Vte if 8 ml/kg

Target Vte if 10 ml/kg

1.50 m 52.0 kg 410 ml 520 ml1.55 m 55.0 kg 440 ml 550 ml1.60 m 59.0 kg 470 ml 590 ml1.65 m 62.5 kg 500 ml 620 ml1.70 m 66.5 kg 530 ml 660 ml1.75 m 70.5 kg 560 ml 700 ml1.80 m 74.5 kg 600 ml 740 ml1.85 m 78.5 kg 630 ml 780 ml1.90 m 83.0 kg 660 ml 830 ml

Calculated with an ideal Body Mass Index of 23 kg/m2 (BMI = weight/height2)

Important: Guidelines are intended to serve only as a reference. They shall be used only in conjunction with the instructions and/or protocol set forth by the physician and institution in which the assist device is being used. The guidelines are not intended to supersede established medical protocols.

Initial Settings

IPAP = 8 to 10 cmH2O, EPAP = 4 cmH2O and RR = 10 to 12 BPM

IPAP Increase IPAP if the patient wants more air, targeting patient tidal volume at 8 ml/kg of ideal weight

EPAP • without OSAS (Obstructive Sleep Apnea Syndrome): 4 – 5 cmH2O• with OSAS: increase EPAP to remove obstructive apnea events• with intrinsic PEP (stable chronic COPD): 5 – 6 cmH2O

BPM Set to 2 – 3 BPM under patient’s spontaneous frequencyRise Time

Obstructive patients prefer short rise time: from 1 to 4 (100 ms to 400 ms)Restrictive patients prefer long rise time: from 3 to 6 (300 ms to 600 ms)

Ti Set Ti between 25% and 33% for obstructive patientsSet Ti between 33% and 50% for restrictive patients (refer to table opposite)

AV

AP

S

OHS COPD Other restrictive diseases (NMD, etc.)

Vt Target 8 to 10 ml/kg of ideal body weight (refer to table opposite)IPAP Window (IPAPmin and IPAPmax)

Allow a wide range of pressure variation to ensure the right pressure at the right time.• IPAPmin = EPAP• IPAPmax =

25 – 30 cmH2O

Allow a more restrictive pressure window to combine comfort and efficacy.• IPAPmin =

comfortable IPAP• IPAPmax =

IPAPmin + 5 cmH2O

Allow a more restrictive pressure window to combine comfort and safety.• IPAPmin =

efficient IPAP• IPAPmax =

IPAPmin + 5 cmH2O

AVAPS Rate

AVAPS Rate setting depends on patient needs and clinical condition:0.5 cmH2O/min to 3 cmH2O/min so target tidal volume is reached smoothly 3 cmH2O/min to 5 cmH2O/min so target tidal volume is reached more rapidly

Check patient arterial blood gases (PaCO2 and PaO2) and oxygen saturation (SpO2)

Undocking humidifier, connecting bacteria filterHold entire unit at each end and slide release latch to the right.

With device turned off, remove and fill chamber with water.1. (a) Lift humidifier door until it locks in place. Do

not force door higher than the locked position. (b) Grasp front of chamber and slide toward you.

2. (a) Gently push tab located inside round opening on top of chamber. (b) Separate top and bottom of chamber.

3. Fill bottom chamber with distilled water.4. Observe maximum fill lines located on sides of

chamber.5. Do not overfill. Reassemble the chamber by placing the hinges on lid over the two tabs on back of chamber. Close lid until it locks in place with an audible click. Insert filled chamber into humidifier.

1. When blower is activated, the humidification icon and numerical setting will light up on the device. This icon lights up (different colors) when the optional humidifier and/or heated tube is attached and heat is being applied.

• White - classic humidification is selected. • Blue - System One humidification is selected. • Orange - the heated tube is attached.

2. Turn control wheel to adjust humidifier number to the desired setting (0 to 5) and press. The settings represent relative humidity levels that will remain consistent throughout the night even if room temperature changes.

Quickstart Guide• Set-up Device• Start Therapy• Stop Therapy• View Information• Comfort Settings• Menus• Humidification• Humidifier Settings• Guidelines for Ventilation Set-up

Filling the humidifier chamber

Release latch

Bacteria filter*

Heated Tubing(optional)

Air outlet port

Release latch(bottom view)

Preheat Mode

*Note: Connect bacteria filter at end of tube when using the optional heated tube.

View Information Menus

Provider Setup Menu

Therapy settingsMode CPAP, S, S/T, T, PCCPAP 4-20AVAPS (not available on BiPAP S/T)

Off (0), On (1)

Tidal Volume (only when AVAPS is enabled)

200-1500

IPAP Max (only when AVAPS is enabled)

4-30

IPAP Min (only when AVAPS is enabled)

4-30

IPAP 4-30EPAP 4 to IPAPBPM 0-30Inspiratory Time 0.5-3.0

Set-up Device

1. From the main menu, highlight Setup.

2. Press and hold ramp button and control wheel simultaneously for 4-5 seconds until beep.

3. Provider Setup screen then appears.

How to start

To program device:

To access provider settings:

1. Press and hold the control wheel for 2 seconds to turn the device off.

Note: You must be on the Main Menu screen or in Therapy mode to turn off the device.

How to stop

1. From the main menu, turn the control wheel to Therapy and press.

2. The monitoring screen will be displayed and the device will start.

Note: You can select the measured parameter to display on the Monitor Pressure screen. Choose from Leak, RR (Respiratory Rate), MinVent, or Vte (Tidal Volume).

Provider Setup Menu (cont.)Provider Setup Menu (cont.)

Comfort settingsFlex Lock Off (0), On (1)Flex Off (0), 1, 2, 3Rise Time Lock Off (0), On (1)Rise Time 1 (fastest) to 6 (slowest)Ramp Time Off (0) to 45 minutesRamp Start Pressure 4 to CPAP or EPAP setting

(depending on therapy mode)Heated Tube Humidification(only when using heated tube)

Disable (0), Enable (1)

Humidity Level(only when using heated tube)

1, 2, 3

Tube Temperature(only when using heated tube)

Off (0), 1, 2, 3, 4, 5

System One humidification Off (0) (classic mode),On (1) (System One humidity control)

Humidifier Off (0), 1 (coolest) to 5 (warmest)Tubing Type Lock Off (0) (patient can adjust tubing size

diameter), On (1) (patient cannot adjust tubing size diameter)

Tubing Type 15 mm / 22 mmSystem One Resistance Lock Off (0) (patient can set mask type),

On (1) (patient cannot set mask type)System One Resistance (mask type) 0, X1, X2, X3, X4, X5

1. Setup Parameter Display You can select which measured parameters will display on the Monitor Pressure screen. Choose from Leak, RR (Respiratory Rate), MinVent, or Vte (Tidal Volume). See the Measured Parameter section of the User Manual for more information.

2. Provider Mode You can choose “on” or “off” to enable or disable provider mode. Selecting “on” will put the device in provider mode (and the device will not automatically return to user mode when the screen times out or you select the Back option). Selecting “off” keeps the device in user mode.

1. Turn control wheel to specific setting and press.

2. Turn control wheel to desired option and press control wheel to select.

3. Turn control wheel to next setting and repeat.

4. To exit, turn control wheel to Back and press.

Start Therapy

In provider screen:1. Turn the control wheel to Info

and press.

2. Turn the control wheel to desired option and press to view the information identified.

3. To exit out of any option, turn the control wheel to Back and press.

1. From the main menu, highlight Comfort.

The Flex, Ramp Time, and Rise Time comfort features will be shown in this menu selection, if enabled.

2. Turn control wheel to specific setting and press.

3. Turn control wheel to desired option and press to select.

4. To exit, turn control wheel to Back and press.

Comfort Settings

Alarm settingsPatient Disconnect Alarm Off (0), 15 or 60 seconds

Apnea Alarm Off (0), 10, 20 or 30 seconds

Low Minute Ventilation Alarm Off (0), 1 to 99 lpmLow Tidal Volume Alarm (only when AVAPS is enabled)

Off (0), On (1)

System settingsBacklight Off, OnLanguage Display language or Icon mode

hPa/cm H2O hPa, cm H2OSetup Parameter Display1 Leak, RR, MinVent, VteReset Blower Hours Yes, NoProvider Mode2 Off, OnClear Patient Data Yes, NoStop Therapy