Savina
Intensive Care Ventilator
Instructions for Use
Software 3.n
How to work with these
instructions for use
The header line...
shows the subject of the main chapter
as a quick guide to help you find your way around the manual.
Operating Concept
Keys for routine and additional functions
1 Frequently used keys for routine functions are positioned
on the right-hand side of the front panel:
The left-hand column...
contains the text
which provides explanations and guides the user with brief
instructions in an ergonomic sequence for confusion-free use
of the machine.
Bullet points indicate the working steps. In many cases,
numbers are used to highlight the relation between the
working step described, the associated illustration(s) and
the sequence of operations.
D
D
— »
2 min« key for suppressing the audible alarm tone for
2 minutes,
— »Alarm Reset« key for resetting or acknowledging alarm
messages and for testing the LEDs and audible alarm tone,
— »
Lock« key for protecting against inadvertent or
unauthorised modification of the settings.
Savina
2
1
2
1
Savina
2 Keys for additional functions are positioned on the left-hand
side of the front panel:
003 37624
— »
Nebul.« key for switching the medicament
nebuliser on / off,
— »O2 Y suction« key to start/end the oxygen enrichment
program,
— »Insp. hold« key for manually activated inspiration and
for extending the inspiration time.
Information window on screen
During setting of a ventilation parameter, the Savina calculates
the derived parameters and displays them in the information
window on the main screen page.
The information window disappears when the parameter
setting is confirmed.
060 37625
The page body...
contains the instructions for use
in a combination of text and illustrations. The information is
expressed directly in terms of actions which enable users to
familiarise themselves with the operation of the machine by
hands-on activity.
Power switch
3 To switch the apparatus on/off.
Located on the back of the apparatus.
To switch on:
Turn power switch to »
« = ON.
3
2
14
08537625
100 37624
0
The right-hand column...
contains the illustration(s)
which directly relate to the text opposite and show the user
where to find the items concerned. The focus is on the
elements mentioned in the text. Non-essentials are omitted.
Screen dumps are also used to guide the user and confirm
the working steps.
Option Labels:
3
4
Contents
For Your Safety and that of Your Patients
7
Safety tips
Intended Use
9
Areas of use
Operating Concept
11
Controls, Parameter setting, Structure of the screen pages
Operation
19
Configuration
55
Ventilation modes, Alarm limits and alarm priorities, Curves,
Measured values, Special functions
Contrast, Volume, Measured values line, Language
Fault – Cause – Remedy
63
Fault analysis and correction chart
Care
75
Dismantling, Cleaning, Maintenance
Preparation
87
Assembly, Checking readiness for operation
Mains and battery operation
103
Power sources, Priority, Battery level display
Description
109
Description of ventilation modes, Bibliography
What‘s what
123
Display, Abbreviations, Symbols
Technical data
131
Environmental conditions, Performance data, Measured value displays,
Operating data
Order List
141
Index
144
5
6
For Your Safety and that of Your Patients
For Your Safety and that of Your
Patients
Strictly follow the instructions for use
Any use of the apparatus requires full understanding and strict
observation of these instructions. The apparatus is only to be
used for purposes specified here.
Maintenance
This apparatus should only be inspected, serviced and
maintained by trained service personnel.
We recommend that a service contract be obtained with
DrägerService and that all repairs also be carried out
by them.
Only authentic Dräger spare parts may be used for
maintenance.
Observe chapter "Maintenance Intervals".
Liability for proper function or damage
The liability for the proper function of the apparatus is
irrevocably transferred to the owner or operator to the extent
that the apparatus is serviced or repaired by personnel not
employed or authorized by DrägerService or if the apparatus
is used in a manner not conforming to its intended use.
Dräger cannot be held responsible for damage caused by
non-compliance with the recommendations given above.
The warranty and liability provisions of the terms of sale
and delivery of Dräger are likewise not modified by the
recommendations given above.
Dräger Medical AG & Co. KGaA
Accessories
Do not use accessory parts other than those in the order list.
Note: Even accessories designed to be reused after cleaning
have a limited life. Due to a number of factors connected with
handling and preparation, disinfectant residues can attack the
material more intensely during autoclaving; increased wear
can occur and service life can be markedly shortened.
Such parts should be replaced when external signs of wear
become apparent, such as cracks, deformation, discoloration,
peeling, etc.
Not for use in areas of explosion hazard
This apparatus is neither approved nor certified for use in
areas where combustible or explosive gas mixtures are likely
to occur.
Safe connection with other electrical equipment
Electrical connections to equipment which is not listed in
these instructions for use should only be made following
consultation with the respective manufacturer or an expert.
7
For Your Safety and that of Your Patients
Precautions
This equipment must only be used under the supervision
of qualified medical staff, so that help is available
immediately if any malfunctions occur.
Clearance of at least 10 cm must be ensured between
the back panel of the machine and any large obstacle or
room wall. Fire hazard due to oxygen enrichment.
This equipment must not be used with flammable gases
or anaesthetic agents. Danger of fire!
Do not use the apparatus in conjunction with nuclear
spin tomography (MRT, NMR, NMI).
The apparatus may malfunction, causing danger to the
patient.
Do not use the equipment in hyperbaric chambers.
The apparatus may malfunction, causing danger
to the patient.
Avoid pollutants in the ambient air.
Savina uses ambient air for ventilation.
Pollutants would enter the patient’s body.
● Protect the apparatus from splashes and rain, to avoid
risk of malfunction.
Savina is not splashproof.
During transport conditions, e.g. in an aircraft, hoses may
start to vibrate and thus affect the flow measurement.
When using Savina in combination with other products
or during transport, the operator must secure the
equipment appropriately to comply with the relevant
basic requirements of Directive 93/42/EC.
Appropriate Monitoring
The built-in monitoring facilities of the Savina ensure
appropriate monitoring of ventilation therapy and therefore
detect any undesirable changes in the following ventilation
parameters:
Interference with operation of the apparatus may be
caused by the use of high-frequency electrical surgical
equipment, defibrillators or short-wave treatment
equipment, thereby putting the patient at risk.
—
—
—
—
—
—
—
airway pressure, Paw
expiratory minute volume, MV
inspiratory O2 concentration, FiO2
inspiratory breathing gas temperature, T
apnoea
breathing frequency
inspiratory tidal volume
Do not use mobile phones within a distance of 10 metres
from the equipment.
Mobile phones can cause interference with electrical and
electronic medical apparatus, thereby putting patients
at risk!*
Changes in these parameters may be caused by:
— acute changes in the patient’s condition
— incorrect settings and faulty handling
— equipment malfunctions
— failure of power and gas supplies
In the event of a problem with the integrated monitoring:
The following points should be noted if ventilating while
travelling:
● separate monitors must be used.
● Do not place Savina on the bed while travelling.
● Ensure the apparatus cannot fall or be knocked over.
Back-up ventilation with an independent
manual ventilation device
Do not tilt apparatus on trolley with attached accessories
more than 5o.
Otherwise it may become unstable.
If a fault is detected in the Savina so that its life-support
functions are no longer assured:
● start ventilation using an independent ventilation
device without delay, if necessary with PEEP and/or
increased inspiratory O2 concentration (e.g. with the
Dräger Resutator 2000).
*
8
Dräger medical equipment fulfils the interference resistance
requirements according to the product-specific standards or
EN 60601-1-2 (IEC 60601-1-2). However, depending on the
design of the mobile phone and circumstances of use, field
strengths may occur in the immediate environment of a mobile
phone that exceed the limits of the above standards and therefore
cause interference.
Intended Use
Intended Use .....................................................................................................................10
9
Intended Use
Intended Use
Savina®1
Long-term ventilator for intensive care. For patients requiring
50 mL tidal volume upwards.
With the following ventilation modes
IPPV
Intermittent Positive Pressure Ventilation
controlled and assisted constant-volume ventilation.
IPPVAssist
Assisted constant-volume ventilation.
CPPV
Continuous Positive Pressure Ventilation
Ventilation with continuous positive airway pressure.
IRV
Inversed Ratio Ventilation
Ventilation with inversed inspiration/expiration ratio.
PLV
Pressure Limited Ventilation
AutoFlow®2 (optional)
for the automatic optimization of inspiratory flow and
minimizing of the airway pressure and to permit spontaneous
breathing throughout the breathing cycle.
SIMV
Synchronized Intermittent Mandatory Ventilation
Procedure for weaning patients off the ventilator after they
have started spontaneous breathing.
PLV
Pressure Limited Ventilation
AutoFlow® (optional)
for the automatic optimization of inspiratory flow and
minimizing of the airway pressure and to permit spontaneous
breathing throughout the breathing cycle.
CPAP
Continuous Positive Airway Pressure
Spontaneous breathing with positive airway pressure.
SB
Spontaneous Breathing
ASB
Assisted Spontaneous Breathing
Pressure-assisted spontaneous breathing.
NIV – non-invasive ventilation (optional)
For ventilation with a nose or face mask to support noninvasive ventilation therapies.
Choice available between mask ventilation and ventilation of
intubated patients.
LPO – Low Pressure Oxygen mode (optional)
To supply Savina with O2 from a mobile oxygen source, independently of a high-pressure O2 pipeline system.
Special modes:
Apnoea Ventilation
For switching over automatically to volume-controlled
mandatory ventilation, if breathing stops.
With monitoring for
airway pressure, Paw,
expiratory minute volume, MV,
inspiratory O2 concentration, FiO2,
inspiratory breathing gas temperature, T,
apnoea,
tachypnoea monitoring to detect rapid, shallow spontaneous
breathing.
Areas of Use
In the Intensive Care ward or in the recovery room.
During secondary transport from one hospital to another.
During transfer of ventilated patients within the hospital.
During transfer flights4.
BIPAP3 (optional)
Biphasic Positive Airway Pressure
Pressure-controlled ventilation combined with free
spontaneous breathing during the complete breathing cycle,
and adjustable pressure assist on CPAP level.
1
2
3
10
Savina® is a registered trade mark of Dräger
AutoFlow® is a registered trade mark of Dräger
Licensed trade mark.
4
Additional permits not covered by CE certification may be
necessary for mobile use (in aircraft, etc.).
Operating Concept
Ventilation Controls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
Setting ventilation parameters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
Selecting the ventilation mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
Screen Operating Controls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Keys for routine and additional functions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
Information window on screen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
Power switch . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
Screen Pages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Structure of the screen pages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Main page . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
"Settings" screen page . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
"Alarms" screen page . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
"Values" screen page . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
"Configuration" screen page . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
»
Standby« key . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
11
Operating Concept
Operating Concept
Ventilation Controls
2
D
Savina
1
3
001 37624624
1 Keys for selecting the ventilation modes:
– IPPV
– SIMV
– CPAP/ASB
– BIPAP (optional)
2 Keys for selecting/setting ventilation parameters:
– Tidal volume V T
– Inspiration time Tinsp
– Frequency f
– O2-concentration O2
– Inspiratory pressure Pinsp
– Pressure support ∆ PASB
– Positive End-Expiratory Pressure PEEP
3 Central "turn and push" rotary knob for setting the
parameters and for selecting screen parameters.
To set = turn the rotary knob.
To confirm setting = press the rotary knob.
Setting ventilation parameters
2 To select a ventilation parameter = press the corresponding
parameter key.
The yellow LED in the key lights up.
3 To set the value of the ventilation parameter = turn the rotary
knob. The value is displayed next to the parameter key.
3 To confirm the value = press the rotary knob.
The yellow LED in the key goes out.
The new value of the parameter becomes effective on
confirmation.
Derived parameters are displayed in an information window
on the main screen page during the setting procedure.
Selecting the ventilation mode
1 Hold down the appropriate key for about 3 seconds
or
● press the appropriate key briefly and
3 confirm = press the rotary knob.
The selected ventilation mode will now be activated.
For detailed instructions on setting the ventilation modes,
see pages 21 onwards.
12
Operating Concept
Screen Operating Controls
1 Screen page selection keys:
— »
« key for setting the screen and display brightness
to bright or dark
D
Savina
— »Curves
« key for selecting the main page to display
the pressure/flow curve
— »Setttings ∆∆« key for selecting the "Setting" screen page
in order to set other ventilation parameters
2
1
— »Alarms ∆∆« key for selecting the "Alarms" screen pages
in order to set and display the alarm limits
— »Values ∆∆« key for selecting the "Measured values"
screen page in order to display the measured values
002 37624
— »Config. ∆∆« key for selecting the "Configuration" screen
page, for system settings such as alarm volume, screen
brightness.
2 Central "turn and push" rotary knob for selecting and
setting the options displayed on the screen.
To select/set = turn the rotary knob,
to confirm = press the rotary knob.
Changing screen pages
To change to the next page:
● press the same key again.
To change to another page:
● press the corresponding key.
To change to the main page:
● press »Curves
« key.
13
Operating Concept
Keys for routine and additional functions
1 Frequently used keys for routine functions are positioned
on the right-hand side of the front panel:
D
— »
2 min« key for suppressing the audible alarm tone for
2 minutes
— »Alarm Reset« key for resetting or acknowledging alarm
messages and audible alarm tone
— »
Lock« key for protecting against inadvertent or
unauthorised modification of the settings.
2
Savina
1
2 Keys for additional functions are positioned on the left-hand
side of the front panel:
003 37624
— »
Nebul.« key for switching the medicament
nebuliser on/off
— »O2 Y Suction« key to start/end the oxygen enrichment
program
— »Insp. hold« key for manually activated inspiration and
for extending the inspiration time.
Information window on screen
During setting of a ventilation parameter, the Savina calculates
the derived parameters and displays them in the information
window on the main screen page.
060 37625
The information window disappears when the parameter
setting is confirmed.
Power switch
3 To switch the apparatus on/off.
Located on the back of the apparatus.
To switch on:
Turn power switch to »
« = ON.
3
100 37624
0
14
Operating Concept
Screen Pages
Structure of the screen pages
1
2
3
4
5
Ventilation mode display field
Alarm message display field
Curves and measured values display field
Measured values display field
Information bar
1
2
3
107 37624
4
5
Main page
075 37625
Displays a pressure curve and displays three measured values.
To configure combination of measured values, see page 57.
072 37625
or:
Displays a flow curve and displays three measured values.
To configure combination of measured values, see page 57.
15
Operating Concept
"Settings" screen page
Settings 1/1:
Menu comprises a single page.
● To select parameters = turn rotary knob.
062 37625
— Analog bar display of the airway pressure Paw
— Setting menu for setting the supplementary ventilation
parameters »Trigger«, »FlowAcc«, »AutoFlow« (optional)
— Setting menu for setting apnoea ventilation, with the
parameters »VTApnoea«, »fApnoea«
— Setting menu for setting the sigh (only in ventilation
mode IPPV).
The selected parameter is indicated by a bold frame.
● To activate parameter for setting = press rotary knob.
The active parameter appears light on a dark background.
● To set parameter = turn rotary knob,
to confirm = press rotary knob.
For detailed instructions on setting the ventilation modes,
see pages 21 onwards.
"Alarms" screen page
— For displaying the alarm limits associated with the
measured values.
— For setting the alarm limits.
063 37625
For detailed operating instructions, see "Setting alarm limits"
on page 32.
"Values" screen page
— For displaying all the measured values in the current
ventilation mode.
Detailed instructions for use, see "Displaying Curves and
Measured Values", page 35.
064 37625
Values 1/2:
Page 1 of 2 available pages.
16
Operating Concept
"Configuration" screen page
065 37625
For setting equipment parameters:
— Screen contrast
— Alarm volume
— Displayed measured values
— Manual calibration for the O2 sensor 2
— FiO2 and Flow Monitoring ON/OFF
— Pmax ON/OFF
— Plateau ON/OFF
— Language, date and time
— MEDIBUS protocol
— Remote Service (optional).
Configuration 1/4:
Page 1 of 4 available pages of the Configuration menu.
Changing screen pages
To change to the next page:
● press the same key again.
To change to another page:
● press the corresponding key for that page.
To change to the main page for pressure curves:
● press »Curves
« key.
Detailed instructions for use, see "Configuration", pages 55
onwards.
»
Standby« key
1 Positioned at bottom right of the front panel.
— To keep the apparatus operational,
e.g. after pre-setting.
or
D
Savina
2
— to switch on ventilation.
1
To switch to standby:
1 Hold down » Standby« key for at least 3 seconds
and
2 to confirm = press »Alarm Reset« key.
004 37624
To switch on ventilation:
1 Press » Standby« key briefly.
17
18
Operation
Starting Up . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
Setting Ventilation Modes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
IPPV, IPPVAssist, CPPV . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
SIMV, SIMV/ASB . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
BIPAP, BIPAP/ASB (Optional) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28
CPAP, CPAP/ASB . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
Apnoea ventilation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
Setting Alarm Limits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32
In the event of an Alarm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
Displaying Curves and Measured Values . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35
Displaying measured values . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35
NIV – Non-invasive ventilation Mask ventilation (optional) . . . . . . . . . . . . . . . . . . . . . 36
LPO – Low Pressure Oxygen mode (optional) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
Special functions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46
Manual inspiration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46
Medicament nebulisation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47
Oxygen enrichment for bronchial suction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49
Calibrating . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51
At high ambient temperature . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53
In the event of a power supply failure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53
In the event of a gas failure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53
19
Operation
Operation
Run equipment check according to checklist, see page 101.
Starting Up
Switching on
1 Turn the main switch on the back of the apparatus to » «
The Savina now runs through a power-up self-test
procedure.
● Wait up to 20 seconds for the test phase to be completed.
At the end of the test phase, the apparatus automatically
starts ventilation with the last ventilation mode set and the
associated ventilation parameters.
1
101 37624
0
During the self-test the start-up page appears, showing the
software version.
066
After this, the main page appears.
2 Check the settings in the display fields next to the
parameter keys and adjust as necessary.
To adjust ventilation parameters:
Either
D
2
Savina
2 Change the ventilation parameters after the Savina has
started ventilation
4
or
3
091 37624
3 Press the »
Standby« switch to set the Savina on
standby,
4 confirm = press »Alarm Reset« key.
2 Change the ventilation parameters and
3 press the »
Standby« switch to return to ventilation.
20
Operation
Setting Ventilation Modes
Setting the ventilation parameters
1 Press the appropriate ventilation mode key.
The yellow LED in the key will light up.
D
1
Savina
2 Set the desired value = turn the rotary knob,
confirm value = press the rotary knob.
The yellow LED in the key will go out.
If the setting is at the upper or lower limit of the adjustment
range for a parameter, the figure in the parameter key display
will start flashing, indicating that confirmation is required.
● Press rotary knob in order to confirm extreme values.
● To set value = turn rotary knob,
to confirm = press rotary knob.
2
Parameter settings for the active ventilation mode do not
become operative until confirmed.
118 37624
If you fail to confirm the new settings within 15 seconds,
the previous settings will remain operative.
Extreme settings
Certain ventilation parameters are limited by Savina to a
threshold value. Extreme values can only be set after
confirmation by pressing the rotary knob.
Parameter
Threshold
Range
Pinsp
Y 50 mbar
Y 50 mbar
Y 20 mbar
1 to 99 mbar
Pmax
PEEP
∆ PASB
∆ PASB+PEEP
∆ PASB+PEEP
FlowAcc
f,
*
Tinsp*
0 to 35 mbar
0 to 35 mbar
Y 30 mbar
Y 50 mbar
∆ Sigh
∆ Sigh+PEEP
1 to 99 mbar
0 to 35 mbar
Y 20 mbar
X 20 mbar/s
Y I:E > 1:1
X I:E < 1:3
5 to 200 mbar/s
2 to 80 bpm
0.2 to 10 s
Limitation of f and Tinsp is determined by I:E ratio
Confirmation is not necessary when the values are returned to
the normal range.
21
Operation
To activate the ventilation mode
1 Hold down the appropriate ventilation mode key for about
3 seconds
2
D
Savina
or
1 Briefly press the appropriate ventilation mode key
3 confirm = press the rotary knob.
1
3
The new ventilation mode selected is now operative.
Ventilation always starts with the last settings.
005 37624
To set parameters for another ventilation mode
1 Press the key for the new ventilation mode briefly.
The yellow LED will flash.
2 In the block of parameter keys, the LEDs for the additional
parameters relevant to the new ventilation mode will start
flashing.
Constantly lit parameter keys indicate ventilation parameters
that are operative in the active ventilation mode. Any change
and confirmation of these parameters immediately affects the
active ventilation mode.
2 Press the relevant parameter key which has its LED
constantly lit.
3 Set the desired value = turn the rotary knob,
confirm value = press the rotary knob,
the yellow LED for that parameter key will go out.
3 To activate ventilation mode = press rotary knob.
If parameter setting is interrupted, Savina does not reset the
parameters set and confirms back to the old value.
To protect the settings against modification
4 Press »
Lock « key; the yellow LED will light up.
The parameter keys, the ventilation mode keys and the
screen settings are now protected against alteration.
D
Savina
4
015 37624
Before setting a new value:
4 Press »
Lock « key. The yellow LED will go out.
22
Operation
IPPV, IPPVAssist, CPPV
Paw
with plateau
Tplat
FlowAcc
without plateau
FlowAcc
Pplat
PEEP
Intermittent Positive Pressure Ventilation, Assist
For patients with partial spontaneous breathing.
t
Continuous Positive Pressure Ventilation
Ventilation with continuous positive airway pressure.
This mode is not displayed on the screen as a ventilation mode.
Set IPPV by means of the keys for the ventilation parameters:
— Tidal volume »V T«
— Inspiration time »Tinsp«, (if plateau is operative)
— Frequency »f«
— O2 concentration »O2«
— Positive end-expiratory pressure »PEEP«.
If PEEP is greater than 0 the airway pressure remains
constantly in the positive range (CPPV).
Tinsp
Te
T= 1
f
Flow
t
045 37625
Intermittent Positive Pressure Ventilation
Volume-controlled ventilation with a fixed mandatory minute
volume MV, set with the tidal volume V T and frequency f.
For patients unable to breathe spontaneously, see page 110 for
details.
Pressure limit Pmax
The pressure peak can be avoided in IPPV and IPPVAssist
by setting a pressure limit. PLV mode (Pressure Limited
Ventilation) is thus effective. For further explanations, see
"Pressure limiting" on page 110.
To set the pressure limit Pmax:
● Set Pmax to »ON«, see page 59.
Pmax is displayed as a dotted line.
The alarm limit Paw
is displayed as a broken line.
If AutoFlow (optional) is active, Pmax is automatically set 5 mbar
lower than the alarm limit Paw
and cannot be altered.
13537625
If AutoFlow (optional) is not active:
● Set the pressure limit value by means of the »Pinsp« key.
● When setting the pressure limit, ensure that the tidal
volume VT is still being applied, as otherwise Savina will
display a »!! Tidal volume low« message. Then:
● Set pressure limit higher,
or
● Increase inspiration time »Tinsp«,
or
● Increase »FlowAcc«,
This can be set on-screen:
Set flow metering by means of »FlowAcc« on screen page
»Settings 1/1«.
23
Operation
FlowAcc (Flow Acceleration)
By setting the FlowAcc, the pressure and flow increase at the
start of inspiration can be changed.
To set FlowAcc:
● Press »Settings ∆∆«key,
screen page »Settings 1/1« appears.
● Select line »FlowAcc« on screen = turn rotary knob,
to confirm = press rotary knob.
● To set value = turn rotary knob
Setting range: 5 to 200 mbar/sec
FlowAcc high: steep pressure and flow increase
● To confirm setting = press rotary knob.
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A recommended start-up setting for FlowAcc is 35 mbar/s.
IPPV can be extended using the following ventilation
parameters:
— Trigger
— Sigh
— AutoFlow (optional)
Trigger (IPPVAssist)
To synchronize the mandatory ventilation strokes with the
patient’s efforts to breathe in. The actual frequency may be
higher than the ventilation frequency f set.
1 The green LED lights up if the Savina detects attempted
spontaneous breathing by the patient.
1
Savina
108 37624
The trigger can be switched off if spontaneous breathing
by the patient is not expected or desired.
To set the trigger, see page 25.
Leakage compensation of up to 10 L/min applies in the case
of trigger detection (see also page 117).
24
Operation
Activating/setting the trigger
1 Press »Settings ∆∆« key.
2 To release »Trigger« for setting = press rotary knob.
The field appears bright against a dark background.
2 To set value = turn rotary knob
Low value = high sensitivity
To confirm = press rotary knob.
3
Savina
1
2
The ventilation mode IPPVAssist is displayed on the screen.
092 37624
3 The green LED lights up if the Savina detects attempted
spontaneous breathing.
When changing over from IPPV to SIMV, BIPAP or CPAP/ASB,
the last active trigger value remains effective.
To switch off the trigger:
● Set a value less than 1. Display in »Trigger« field: »OFF«
2 To confirm = press rotary knob.
068 37625
The ventilation mode IPPV is displayed on the screen.
Sigh
To prevent atelectasis.
Atelectasis can be prevented by activating the sigh function
and setting the sigh in the form of an intermittent PEEP.
When the sigh function is activated, the end-expiratory
pressure is increased by the set intermittent PEEP for
2 ventilation strokes every 3 minutes.
Activating/setting the sigh
● Press »Settings ∆∆« key.
● On the screen, to select the »∆ Sigh« line = turn the rotary
knob.
● To release »∆ Sigh« for setting = press the rotary knob.
The field appears bright against a dark background.
● Set a value between 1 and 35 mbar = turn rotary knob,
to confirm = press rotary knob.
069 37625
The sigh set is added to the PEEP.
25
Operation
12137625
Deactivating the sigh
● Set a value less than 1. »OFF« appears in the »∆ Sigh« field,
to confirm = press rotary knob.
The sigh function is deactivated.
AutoFlow® (optional)
Automatic optimization of the inspiration flow.
The inspiration flow is decelerated and regulated by
AutoFlow*, so that at the selected tidal volume V T, with the
current compliance a minimum airway pressure is reached and
pressure peaks are avoided.
Savina supplies additional inspiration flow when the patient
breathes in – restricted by the alarm limit V Ti
.
The patient can also breathe out during the inspiratory plateau
phase.
The inspiratory pressure is limited by the Paw
alarm limit.
To switch AutoFlow ON and OFF
Press »Settings ∆∆« key.
Select line »AutoFlow« on screen = turn rotary knob.
To release »AutoFlow« for setting = press rotary knob.
To set »AutoFlow ON« = turn rotary knob,
to confirm = press rotary knob.
13137625
●
●
●
●
● To set alarm limits, see page 32.
*
26
For a detailed description of AutoFlow, page 112.
Operation
SIMV, SIMV/ASB
Fixed mandatory minute volume MV, set with the tidal volume V T
and frequency f. The patient can breathe spontaneously
between the mandatory ventilation strokes. Spontaneous
breathing can be assisted by ASB.
FlowAcc
with ASB
pressure support
FlowAcc
high
FlowAcc
low
PEEP
t
For patients with insufficient spontaneous breathing or patients
being weaned from artificial ventilation by progressive
reduction of the mandatory proportion of the total minute
volume.
Trigger window
Tinsp
Flow
Set SIMV by means of the ventilation parameter keys:
— Tidal volume »V T«
— Inspiration time »Tinsp«
— Frequency »f«
— O2 concentration »O2«
— Positive end-expiratory pressure »PEEP«.
without ASB
pressure support
Paw
T= 1
f
t
046 37625
Synchronized Intermittent Mandatory Ventilation*
Assisted Spontaneous Breathing**
062 37625
The following can be set on the screen:
— Sensitivity »Trigger« (for synchronization of mandatory
ventilation strokes) on screen page »Settings 1/1«
— Set flow metering by means of »FlowAcc« on screen page
»Settings 1/1«.
— AutoFlow (optional) ON/OFF.
Pressure limit Pmax
The pressure peak can be avoided in SIMV and SIMV/ASB
by setting a pressure limit.
To set the pressure limit Pmax, see page 23.
For further explanations, see "Pressure limiting" on page 110.
Additional functions:
— Pressure support »∆ PASB above PEEP«
— Apnoea ventilation
● To set apnoea ventilation, see page 30.
* For a detailed description of SIMV, see page 114.
** For a detailed description of ASB, see page 115.
27
Operation
BIPAP, BIPAP/ASB (Optional)
Biphasic Positive Airway Pressure
Assisted Spontaneous Breathing
Pressure-controlled ventilation combined with free
spontaneous breathing during the complete breathing cycle,
supported by adjustable additional pressure at CPAP level.
The mandatory proportion of the total minute volume MV is
set by means of the inspiration pressure Pinsp, PEEP and
frequency f.
Paw
FlowAcc
high
FlowAcc
with spontaneous breathing
FlowAcc
low
FlowAcc
Pinsp
ASB
pressure support
FlowAcc
high
FlowAcc
low
PEEP
t
Trigger window
Tinsp
Flow
1
f
t
027 37625
Adaptable to a wide range of patients, from those unable to
breathe spontaneously at all to those breathing spontaneously
before extubation. Suitable for weaning patients from artificial
ventilation by progressively reducing the mandatory fraction of
the minute volume MV and by reducing the additional artificial
pressure support ∆ PASB above PEEP.
For details see "BIPAP" description, page 116.
without spontaneous breathing
Set BIPAP by means of the ventilation parameter keys:
—
—
—
—
—
Inspiration time »Tinsp«
Frequency »f«
O2 concentration »O2«
Inspiration pressure »Pinsp«
Positive end-expiratory pressure »PEEP«.
The following can be set on the screen:
— Sensitivity »Trigger« (for synchronization with spontaneous
breathing)
To set the trigger, page 25
— »FlowAcc«
can be set on screen on screen page
»Settings 1/1«.
FlowAcc is effective both for BIPAP strokes and pressure
support »∆ PASB above PEEP«
— Additionally for BIPAP/ASB:
Pressure support »∆ PASB above PEEP«
BIPAP, BIPAP/ASB can be supplemented with apnoea
ventilation:
● To set apnoea ventilation, see page 30.
● To set alarm limits, see page 32.
28
Operation
CPAP, CPAP/ASB
Continuous Positive Airway Pressure
Assisted Spontaneous Breathing
For patients breathing spontaneously in an adequate manner.
Spontaneous breathing at a raised pressure level, to increase
the functional residual capacity FRC. Spontaneous breathing
can be assisted with additional pressure by ASB.
Set CPAP by means of the ventilation parameter keys:
— O2 concentration »O2«
— Positive end-expiratory pressure »PEEP«
Additionally, for CPAP/ASB:
— Pressure support »∆ PASB above PEEP«
The following can be set on the screen:
— »FlowAcc« for pressure support ASB on screen page
»Settings 1/1«
— Sensitivity »Trigger« (for synchronising attempted
spontaneous breathing with ASB pressure support)
on screen page »Settings 1/1«.
CPAP, CPAP/ASB can be supplemented with the following
ventilation parameters and ventilation modes:
Trigger
By setting the trigger sensitivity, the assisting ventilator
support is synchronised with the patient’s own spontaneous
breathing attempts.
● To set the trigger, see page 25.
Apnoea ventilation
● To set apnoea ventilation, see page 30.
● To set alarm limits, see page 32.
29
Operation
Apnoea ventilation
Paw
FlowAcc
t
1
t=
Apnoea alarm time
f
Apnoea
TApnoea >
Start of
apnoea ventilation
Flow
t
009 37625
For automatic switchover to volume-controlled mandatory
ventilation if the patient stops breathing.
Apnoea ventilation can be activated in the following modes:
— SIMV
— SIMV/ASB
— SIMV/ASB/AutoFlow (optional)
— SIMV/AutoFlow (optional)
— CPAP
— CPAP/ASB
— BIPAP (optional) and
— BIPAP/ASB (optional).
If the patient stops breathing, Savina activates an alarm after
the set apnoea alarm time TApnoea
and starts volumecontrolled mandatory ventilation. Apnoea ventilation is identical
to SIMV (see page 27) with the following parameters:
— Tidal volume »VTApnoea«
— Frequency »fApnoea«
— Inspiration / expiration ratio I:E = 1:2 (if plateau is active;
otherwise determined by the »FlowAcc« parameter).
The patient can breathe spontaneously during apnoea
ventilation.
Spontaneous breathing during expiration can be assisted by
ASB.
The following parameters are active: Flow Acceleration
»FlowAcc«, »PEEP«, »FiO2«, pressure assist »∆ PASB above
PEEP«, »Trigger« and AutoFlow (optional).
To set apnoea ventilation
● Press »Settings ∆∆« key. Screen page »Settings 1/1«
appears.
If apnoea ventilation is activated, the »VTApnoea« and »fApnoea«
lines are visible.
In this case A = apnoea ventilation standby appears at the right
on the main screen page.
To activate apnoea ventilation:
118 37625
If apnoea ventilation is deactivated, instead of the »fApnoea« line
the display shows:
»Apn-Vent. OFF«.
● Select »Apn-Vent. OFF« line = turn rotary knob
Activate = press rotary knob.
● Set a value of at least 2 bpm = turn rotary knob.
The »VTApnoea« and »fApnoea« lines appear.
● To select lines = turn rotary knob,
activate = press rotary knob.
● To set value = turn rotary knob,
confirm = press rotary knob.
070 37625
To deactivate apnoea ventilation:
● Set a value less than 2 in the »fApnoea« line
= turn rotary knob,
confirm = press rotary knob.
30
Operation
Setting apnoea time TApnoea
page
on the "Alarms" screen
● Press »Alarms ∆∆« key.
071 37625
Display: screen page »Alarms 1/1«.
On the screen select the line »TApn.
«=
turn rotary knob,
activate = press rotary knob.
● Set the desired value = turn rotary knob,
confirm = press rotary knob.
D
Savina
047 37624
To end apnoea ventilation:
● Press the »Alarm Reset« key.
Savina carries on ventilating in the original ventilation mode and
associated ventilation parameters.
119 37625
During Savina settings, the status of switched on apnoea
ventilation is displayed for 6 seconds by a special information
page where, in principle, apnoea ventilation is possible.
— when changing over the ventilation mode,
— when switching on Savina,
— when reducing the frequency, if the cycle time is then
longer than TApnoea
.
● To set alarm limits, see page 32.
31
Operation
Setting Alarm Limits
● Press »Alarms ∆∆« key.
Example display: screen page »Alarms1/1«
Alarm
Setting Range
Paw
10 to 100 mbar
MV
2 to 41 L/min
MV
0.5 to 40 L/min
TApn.
15 to 60 sec
ftot
10 to 120 bpm
V Ti
0.06 to 4 L
063 37625
This page displays all the alarm limits that can be set.
= lower alarm limit
= upper alarm limit
Example; setting the upper alarm limit for Paw.
● On the screen, select the line »Paw
«=
turn the rotary knob,
to release for setting = press rotary knob.
● Set the desired value = turn the rotary knob,
confirm = press the rotary knob.
— The upper alarm limit for Paw is shown as a broken line.
The O2 alarm limits do not have to be set in HPO mode,
because they are automatically coupled to the O2
concentration setting. These limits are automatically coupled to
the O2 concentration setting:
075 37625
The lower alarm limit does not have to be set for the airway
pressure Paw, because it is automatically coupled to the
PEEP setting.
Lower alarm limit:
Setting –4 vol. % (at settings up to 60 vol. %)
Setting –6 vol. % (at settings from 60 to 100 vol. %)
Upper alarm limit:
Setting +4 vol. % (at settings up to 60 vol. %)
Setting +6 vol. % (at settings from 60 to 100 vol. %)
138
A specific screen page »Alarms 2/2« appears in the optional
mode Mask/NIV and in the optional LPO mode.
Example: LPO mode
32
Operation
In the event of an Alarm
1 the red or yellow LED flashes.
2 the alarm message is displayed in the right-hand corner
of the top line of the screen.
D
1
2
Savina classifies the alarm in three priority classes, marks the
text with exclamation marks according to the priority class and
generates various alarm tone sequences.
!!!
!!
!
= Warning (red LED flashes)
= Caution (yellow LED flashes)
= Advisory (yellow LED lights up and
remains continuously lit)
007 37624
Savina displays a message for your guidance in the information
line when certain alarm messages occur.
Warning
Top priority message
1 Red LED flashes.
Warning messages are marked with three exclamation marks
and appear white on a dark background.
Example: !!! Apnoea
Savina generates a five-tone sequence that is sounded twice
and repeated every 7.5 seconds.
Caution
Medium priority message
1 Yellow LED flashes.
Caution messages are marked with two exclamation marks.
Example: »!! Check settings«
Savina generates a 3-tone sequence that is repeated every
20 seconds.
Advisory
Low priority message
1 Yellow LED lights up and remains lit.
Advisory messages are marked with one exclamation mark.
Example: »! Flow monitoring off«
Savina generates a two-tone sequence that sounds only once.
To remedy the faults, please refer to the "Fault – Cause –
Remedy" section starting on page 64.
33
Operation
When the fault has been remedied
— the audible alarm is switched off.
— Caution messages (!!) and advisory messages (!) disappear
automatically from the screen.
Warning messages (!!!) remain black on a white background on
the screen and need to be acknowledged:
1 Press the »Alarm Reset« key.
2 The message is erased from the screen.
D
2
3
1
If you wish to reactivate the audible alarm before the end of this
time:
3 Press the » 2 min« key again (yellow LED will now go
out). The message remains on the screen.
The alarm tone sounds only once when a higher priority alarm
occurs during the period, when the audible alarm is muted.
34
008 37624
Suppressing the audible alarm
for max. 2 minutes:
3 Press the » 2 min« key (yellow indicator LED lights up).
The audible alarm is muted for about 2 minutes. If the cause
of the alarm has not yet been remedied, the audible alarm
will sound again after about 2 minutes.
Operation
Displaying Curves and Measured Values
On the main page
the airway pressure curve, or flow curve and three relevant
measured values are displayed.
To change the curve display
● Press »Curves
« key.
Example: flow curve
072 37625
The combination of measured values in the measured value line
can be configured, see page 57.
Displaying measured values
● Press »Values ∆∆« key. The screen page »Values 1/2«
123 37625
appears or, in »Mask/NIV« mode, screen page
»Values 1/3«.
The airway pressure is indicated by a bar display.
The other measured values are displayed numerically.
124 37625
Displaying other measured values
● Press »Values ∆∆« key again. The screen page
»Values 2/2« appears or, in »Mask/NIV« mode, screen
page »Values 2/3«.
When ventilating without plateau, the value Tinsp will appear
instead of Tplat.
125 37625
In »Mask/NIV« mode, another page can be displayed
»Values 3/3«.
See page 118 for an explanation of the measured values.
35
Operation
NIV – Non-invasive ventilation
Mask ventilation (optional)
Installing the NIV option
This should only be done by experts, following the
corresponding installation instructions.
Using NIV
See page 118 for a detailed description of NIV.
Never ventilate an intubated patient in the »Mask/NIV«
mode!
In the »Mask/NIV« mode, the alarm system is adapted
to mask ventilation.
Use only with patients who can breathe adequately on
their own, especially if alarms have been manually
deactivated.
When masks are used, the dead space increases.
● Follow the mask manufacturer’s directions.
● Avoid high airway pressures.
Risk of aspiration!
Never operate Savina without a water trap on the
expiration valve.
● Due to overcompensation for leakage, there is a risk of
unintentionally high airway pressures.
● Mis-triggering may occur.
● After changing over from »Mask/NIV« to »Tube« mode,
check the alarm limits!
Savina is always in »Tube« mode at switch-on.
All ventilation modes are selectable in »Mask/NIV« mode.
Selecting »Mask/NIV« mode
● Switch apparatus to standby = hold down »
126 37625
●
●
●
●
Standby«
key for about 3 seconds.
Press »Alarm Reset« to switch off the audible alarm.
Select »Patient Connection« line = press rotary knob,
Select »Mask/NIV« line = press rotary knob,
Confirm = press rotary knob.
36
Operation
127 37625
● The following advisory message appears briefly:
Setting the ventilation parameters
● Proceed as in »Tube« mode.
In the »Mask/NIV« mode, the »Tinsp« key has an extended
function:
In addition to setting the inspiration time in the mandatory
ventilation modes IPPV, SIMV or BIPAP, it is also used to set
the maximum duration of the ASB strokes during pressuresupported ventilation.
● Set Tinsp or the maximum duration of the ASB strokes,
0.2 to max. 10 s.
Automatic trigger leakage compensation
Savina compensates for detection of trigger leakage caused by
the patient up to 25 L/min.
For further details, see page 117.
Automatic compensation of set tidal volume
Savina compensates up to 100 % of the measured minute
volume for leaks detected.
For further details, see page 117.
Never operate Savina without a water trap on the
expiration valve!
● Due to overcompensation for leakage, there is a risk of
unintentionally high airway pressures.
● Mis-triggering may occur.
Leakage compensation suppressed
If no flow sensor is fitted or if flow monitoring is not activated,
there is no leakage compensation.
Monitoring in the »Mask/NIV« mode
● Only switch off alarms if the safety of the patient will
not be compromised by the absence of an alarm!
To avoid artefacts in the case of very big leaks, the following
alarms may be switched off:
— MV
minute volume lower alarm limit
— V Ti
inspiratory tidal volume upper alarm limit
— TApnoea
apnoea monitoring upper alarm limit
37
Operation
To switch off (for example MV
):
● Reduce »MV
« until the message appears:
»MV
off?
Press and turn rotary knob«.
● Confirm = press rotary knob.
● Continue turning the rotary knob until »OFF« appears in the
display.
● Confirm = press rotary knob.
If an alarm limit has been switched off, an advisory message will
constantly be displayed, e.g.:
»! MV low Alarm off«
The apparatus does not display the following warning
messages in the »Mask/NIV« mode:
— ASB > 4 s
— Leakage
129 37625
Setting TDisconnect
A delay »TDisconnect« from 0 to 60 seconds can be set for the
»Airway pressure low« alarm in the »Mask/NIV« mode. In the
event of disconnection, this delays the activation of the alarm by
the time set. The default value for the delay »TDisconnect« is
10 seconds after activating »Mask/NIV« mode.
● Press the »Alarms ∆∆« key until the screen page
»Alarms 2/2« appears.
● Activate the »TDisconnect« line to set.
● Set TDisconnect = turn the rotary knob,
confirm = press the rotary knob.
Selecting »Tube« mode
● Switch apparatus to standby = hold down »
●
●
●
●
●
Standby«
key for about 3 seconds.
Press »Alarm Reset« to switch off the audible alarm.
To select, activate »Patient Connection« line =
press rotary knob,
Select »Tube« = turn rotary knob,
Confirm = press rotary knob.
The advisory message appears briefly.
● Check alarm limits after changing from »Mask/NIV«
mode to »Tube« mode!
38
130 37625
When switching over to »Tube« mode, Savina automatically
selects the default alarm limits for the alarms previously
switched off in »Mask/NIV« mode.
Operation
LPO – Low Pressure Oxygen mode (optional)
Definition of LPO and HPO
LPO (Low Pressure Oxygen)
Low pressure oxygen mode – O2 supply from an external low
pressure oxygen source (e.g. O2 concentrator) connected to
the O2 low pressure inlet on Savina.
HPO (High Pressure Oxygen)
High pressure oxygen mode – O2 supply from the pipeline system or from an O2 cylinder connected to the O2 high pressure
inlet on Savina.
Installing the LPO option
This must only be installed by specialists, with reference to the
corresponding installation instructions.
Using LPO
See page 120 for a detailed description of LPO.
Only O2 sources complying with the following requirements should be connected:
O2- flow: 0.5 to 10 L/min
O2 pressure: 0.1 to 2 bar
The O2 source must be approved for medical purposes
and suitable for supplying the patient directly.
Follow the Instructions for Use the O2 source used,
e.g. O2 concentrator.
Ensure adequate ventilation at the rear of Savina. Do not
use an O2 source that delivers more than 10 L/min flow.
Switch off the O2 source, e.g. O2 concentrator, when
Savina is not in ventilating mode, to prevent an increased
fire hazard due to oxygen enrichment.
When supplying Savina with O2 from an O2 concentrator,
never operate concentrator with a humidifier.
Any humidifier system supplied with the O2 concentrator
must be drained or removed before starting use.
Only hose systems approved for medical purposes and
for use with oxygen are to be used between Savina and
the O2 source.
Savina must not be operated in HPO mode with an O2
concentrator connected.
● Supplying O2 from the pipeline system or cylinder and
from the O2 concentrator at the same time can cause the
oxygen control to malfunction.
39
Operation
In the event of an LPO (low pressure O2) source failure,
ensure that an emergency back-up oxygen supply (e. g.
from an O2 cylinder) is provided for patients requiring a
higher oxygen concentration level.
After switching on LPO mode, the FiO2 alarm limits need
to be set manually (screen page »Alarms 2/2«).
The O2 sensors are calibrated in ambient air in LPO mode.
The accuracy of O2 measurement is reduced.
● If very accurate O2 measurement is necessary, the O2
sensors should be calibrated in HPO mode.
See page 52.
O2 sensors should be calibrated manually once a month
in LPO mode.
The automatic O2 control function of Savina is not operational in LPO mode.
The O2 concentration can only be set via the following parameters:
● Flow setting on the O2 concentrator
and/or
● Minute volume MV on Savina (product of adjustable parameters VT and f).
A tolerance (+/–) is displayed along with the FiO2 measured value.
● The patient’s O2 concentration fluctuates when moderate
to large volumes are applied.
Nebulising is only possible in LPO mode if high pressure
O2 is also connected.
Suction is not possible in LPO mode, not even if high
pressure O2 is connected.
300
Connecting the O2 supply
● Connect the O2 supply hose from the O2 source, e.g. an O2
concentrator, to the LPO low pressure inlet.
● The O2 source, e.g. O2 concentrator, should be prepared
and connected up in accordance with the relevant Instructions for Use.
40
Operation
Switching on LPO mode
This can be done while Savina is operating*.
∆∆« key repeatedly until
»Configuration 2/4« appears.
● Select »LPO-mode« line = turn rotary knob,
to activate for setting = press the rotary knob.
● Set »LPO-mode ON« = turn rotary knob,
confirm = press the rotary knob.
136
● Press »Config.
137
The following cautionary message appears briefly:
»Attention !
Connect concentrator
check alarm limits !«
● Connect the O2 connecting hose to Savina and to the O2
concentrator.
Automatic scroll down to page
»Alarms 2/2«
● Set FiO2 alarm limits.
138
Setting the FiO2 alarm limits
● Press »Alarms ∆∆« key repeatedly until the page
»Alarms 2/2« appears.
● Select the line »FiO2
« = turn the rotary knob,
activate to set = press the rotary knob.
● Set the value = turn rotary knob,
confirm = press the rotary knob.
● Select the line »FiO2
« = turn the rotary knob,
activate to set = press the rotary knob.
● Set the value = turn rotary knob,
confirm = press the rotary knob.
*
LPO mode cannot be switched on if O2 calibration or suction is
active.
41
Operation
Setting the O2 concentration
It is not possible to set the O2 concentration on Savina in
LPO mode!
The patient’s O2 concentration is affected by:
— O2 concentration delivered by the O2 concentrator used
— O2 flow set on the O2 concentrator (LPO flow)
— Minute volume (MV) applied on Savina.
The patient’s O2 concentration is set for specified ventilation
parameters only by means of the flow control on the
O2 concentrator.
Refer to the diagram on page 121 to estimate flow control.
● Select the measured value display for O2 and MV on Savina
– refer to “Configuring the measured values line” on
page 57.
● Observe the O2 measured value indicated for about 30 to
60 seconds.
If the O2 reading is too low: increase the concentrator flow.
If the O2 reading is too high: reduce the concentrator flow.
● Wait for the new O2 measured value indication to stabilise.
● Set the upper and lower alarm limits for FiO2 in accordance
with the patient’s requirements.
In the case of larger tidal volumes, due to the constant flow
supplied by the O2 concentrator the patient does not receive a
constant O2 concentration*. The possible range of variation of
the patient’s O2 concentration is indicated in the form of a
measured value and a tolerance value:
with small tidal volumes, the resulting measuring error is small
and with large tidal volumes, correspondingly greater*.
Using the medicament nebuliser in LPO mode
Medicament nebulisation is still possible in LPO mode.
● Connect an oxygen cylinder or O2 pipeline system to the
O2 high pressure inlet on Savina.
● See page 47 for further information about nebulising.
*
42
Refer to page 120 for a detailed description.
141
Displaying the FiO2 measured value
A tolerance (+/–) is displayed along with the FiO2 measured
value.
Operation
Calibrating O2 sensors in LPO mode
Automatic calibration of O2 sensors does not take place in
LPO mode. Sensors have to be calibrated manually:
— once per month
— if the message »!!! O2 measurement inop.« appears.
It is easier to carry out calibration without a patient connected
to Savina.
During calibration ensure that there are no O2 sources
(such as concentrator hose, nearby ventilator) closer than
1 m to the rear of the Savina apparatus. Otherwise,
O2 calibration may malfunction.
Manual calibration can be carried out in any ventilation mode.
The patient is disconnected for approximately 90 seconds for
calibration purposes.
∆∆« key repeatedly until »Configuration
2/4« appears.
● Select »O2 calib.« = turn rotary knob,
activate to set = press rotary knob.
● Start O2 calibration = turn rotary knob and select »ON«,
confirm = press rotary knob.
144
● Press »Config.
139
The following message is displayed:
»Attention!
Disconnect concentrator
confirm: press «.
● Disconnect concentrator within 30 seconds
and confirm = press rotary knob.
Message displayed in information line on the screen:
»Disconnect patient«.
● Disconnect patient within the next 30 seconds.
● Continue ventilating the patient, using a different ventilator.
Message displayed in information line on the screen:
»O2 calibration active«.
43
Operation
Message displayed in information line on the screen:
»Reconnect concentrator«.
● Reconnect the concentrator.
142
After about 85 seconds, the following message appears in the
information line:
»Reconnect patient«.
● Reconnect the patient immediately
Finally, the following message appears in the information line
on the screen:
»O2 calibration ok«.
O2 calibration is now completed and Savina continues
ventilating at the original settings.
While calibration is taking place, Savina switches off the
alarms triggered by disconnection and the altered
O2 concentration.
If reconnection does not take place within 30 seconds of the
message »Reconnect patient« appearing, Savina continues
ventilating and all the alarms are active again.
If the following alarm appears after calibration
»!!! O2 measurement inop.«:
● Check whether an operating error has occurred
If not,
● Replace the O2 sensor, refer to page 85.
After replacing the O2 sensor wait for up to 20 minutes
before calibrating.
143
Calibration is not possible in LPO mode during the following
times:
— for at least 10 minutes after switching on Savina
— for up to about one hour if Savina is exposed to a big
change in temperature, for example due to moving from a
cold room to a heated room or due to extreme ventilation
settings.
Only O2 sensor calibration is disabled during this time.
FiO2 measurement is fully operational, unless an O2 alarm
occurs.
44
Operation
Switching off FiO2 monitoring in LPO mode
Function as in HPO mode, see page 58.
The FiO2 measured value along with its tolerance are disabled.
Switching off LPO mode
145
This can be done while Savina is operating but only if O2
calibration is not active.
● Press »Config. ∆∆« key repeatedly until
»Configuration 2/4« appears.
● Select »LPO-mode« line = turn rotary knob,
to activate for setting = press the rotary knob.
● Set »LPO-mode OFF« = turn rotary knob,
confirm = press the rotary knob.
140
The following message is displayed for 15 seconds:
»Attention!
Disconnect concentrator«.
● Disconnect concentrator.
45
Operation
Special functions
Manual inspiration
This function may be used in all modes except CPAP
spontaneous breathing without ASB pressure support.
A ventilation stroke with a minimum duration of Tinsp and a
maximum duration of 15 seconds can be applied. Manual
inspiration can be superimposed over a mechanical stroke
already triggered, or can occur between two automatic
ventilation strokes.
The pattern of the manually started ventilation stroke depends
on the ventilation mode in use.
For IPPV, SIMV:
volume-controlled ventilation stroke, defined by the »V T« and
»Tinsp« settings.
For BIPAP:
pressure-controlled ventilation stroke, defined by the »Pinsp«
and »Tinsp« settings.
For CPAP/ASB:
pressure-assisted ventilation stroke, defined by the
»∆ PASB above PEEP« setting.
1 Press and hold down the »Insp. hold« key for as long as
inspiration is required.
D
1
010 37624
Either an automatic ventilation stroke that has just begun will be
accordingly prolonged. The duration of manual inspiration is
least equal to Tinsp. If »Insp. hold« is held for longer, the
duration of inspiration can be extended to a maximum of
15 seconds.
Savina
46
Operation
Medicament nebulisation*
Applicable in every ventilation mode.
Will only function with O2 supply between 2.7 to 6 bar.
An inspiratory flow of at least 18 L/min is necessary.
Savina applies the medicament aerosol in synchronization
with the inspiration only in the inspiratory flow phase and
automatically maintains the minute-volume constant.
Savina automatically turns the nebuliser off after 30 minutes.
The flow sensor will be automatically heat-cleaned and
calibrated after the aerosol treatment to prevent false results
during flow measurement.
● Danger of fire! Do not nebulise flammable
medicaments.
Since Savina uses pure oxygen for the medicament
nebulisation, an increase of the desired inspiratory
O2 concentration may be caused.
Due to the inability of Savina to measure this O2 concentration
increase, an incorrect O2 reading will be displayed.
Only use medicament nebuliser 84 12 935 (white
centerpiece).
Use of other pneumatic medicament nebulisers may
result in considerable discrepancies in the minute-volume
reading!
● Connect your O2 supply 2.7 to 6 bar – from the medical O2
04337624
pipeline system or from a cylinder, to the side of Savina.
● Prepare the medicament nebuliser in accordance with the
accompanying instructions for use.
1 Connect the nebuliser to the inspiratory side of the Y-piece
(temperature sensor side).
2 Connect the inspiration hose to the medicament nebuliser.
2
● Swivel the medicament nebuliser to the vertical position.
1
011 37624
● Using clamps, route the nebuliser hose back to the
ventilator along the ventilation hose.
3 Connect the nebuliser hose to the spigot at the front side of
Savina.
● Fill the medicament nebuliser in accordance with the
accompanying instructions for use.
*
017 37624
3
If LPO mode is active, refer to page 42.
47
● During medicament nebulisation do not use a heat and
moisture exchanger (HME). Risk of increased
breathing resistance!
1 Hold down »
up.
Nebul.« key, until the yellow lamp lights
On-screen advisory message:
»! Nebuliser on«
D
Savina
1
The nebuliser is in operation for 30 minutes; nebulisation only
in the inspiratory flow phase.
If medicament nebulisation needs to be stopped prematurely:
1 Press »
Nebul.« key again. The yellow lamp goes out,
the nebuliser is switched off.
On-screen information:
»Flow calibration«
● Remove any left-over medicament from the medicament
nebuliser.
● Follow the instructions for use of the medicament
nebuliser.
● Take into account the effect of aerosols on sensors and
filters.
The measuring function of the flow sensor may be impaired.
The flow resistance of filters is liable to increase and may impair
ventilation.
● Do not place microbial filters on the nebuliser outlet
during nebulisation!
Risk of increased breathing resistance!
48
013 37624
The flow sensor will be automatically heat-cleaned and
calibrated by Savina.
Operation
Oxygen enrichment for bronchial suction*
Will only function with O2 supply between 2.7 to 6 bar.
To prevent hypoxia during bronchial suction, an O2 enrichment
program during removal of secretions is provided with Savina.
After the program has started, during the oxygen enrichment
phase Savina ventilates in the selected ventilation mode for up
to 180 seconds with 100 vol.% oxygen.
When the ventilator is disconnected for suction, Savina automatically interrupts ventilation. During the suction phase, the
alarms »!!! Apnoea«, »!!! Fail to cycle«, »!!! Airway pressure low«
and »!!! MV low« are suppressed so that the suction routine is
not disrupted.
After suction and automatically recognized reconnection,
Savina ventilates 120 seconds with 100 vol.% O2. During
suction and for two minutes afterwards, the lower alarm limit
for the minute volume is disabled.
043 37624
● Connect your O2 supply 2.7 to 6 bar – from the medical
pipeline system or from the O2 cylinder – to Savina.
Before suction
1 Hold down »O2 Y Suction« key until the yellow lamp lights
up.
In the set ventilation mode, Savina ventilates with
100 vol.% O2.
In case PEEP has not been set higher than 4 mbar, an
automatic setting of 4 mbar will come into effect.
This PEEP will enable Savina to detect any subsequent
disconnection.
The other ventilation parameters remain unchanged.
D
Savina
1
Message in the information line on screen:
»O2 enrichment 100% 180 s«
*
014 37624
The remaining time is continuously displayed on screen.
The oxygen enrichment lasts for a maximum of 180 seconds.
During this time, Savina waits for the suction to be
disconnected.
If there is no disconnection after 180 seconds, Savina will
terminate the oxygen enrichment program.
If the tidal volume is low, the patient does not receive the
displayed O2 concentration right away. The maximum
O2 enrichment time should therefore be used.
Suction is not possible in LPO mode, not even if high pressure O2
is connected.
49
Operation
After suction disconnection
During the period of disconnection Savina supplies a minimal
flow of 100 vol.% O2 in order to automatically detect the end of
the disconnection phase. The time available for suction is
continuously displayed in the information line on screen
(example):
»Execute suction and reconnect 120 s«
If suction is ended and the system is reconnected within the
displayed time, Savina starts the final O2 enrichment.
After reconnection
After reconnection has taken place, Savina ventilates once
more in the set ventilation mode, however, for final O2
enrichment 120 seconds more with 100 vol.% O2.
Message in the information line on screen:
»Final O2 enrichment 100% 120 s«
The remaining time is continuously displayed on screen.
In case the O2 enrichment has to be interrupted:
1 Press the »O2 Y Suction« key again.
D
Savina
014 37624
1
Automatic discontinuation of oxygen enrichment
If after 120 seconds no reconnection follows, Savina stops the
O2 enrichment program.
All alarms are immediately reactivated. Savina immediately
continuous ventilating in the set ventilation mode.
50
Operation
Calibrating
The saved calibration/zeroing values remain stored even when
the machine is switched off.
Automatic calibration of the pressure sensors
The pressure sensors for measuring the airway pressure
are calibrated automatically.
Automatic calibration of the flow sensor
The flow sensor will be automatically calibrated in the following
circumstances:
—
—
—
—
—
—
when the apparatus is switched on
every 24 hours during operation
after changing the flow sensor
after medicament nebulisation
after bronchial suction
after changing the O2 concentration.
Savina uses a full inspiration phase for calibration. Short
inspiration times are extended to about one second.
Message in the information line on the screen:
»Flow calibration in progress«
104 37625
After calibration is complete, the following message appears in
the information line:
»Flow calibration ok«
If calibration is unsuccessful, the following message appears:
»Flow calibration failed«
The expiratory part of the flow curve does not appear and no
measured values are displayed for V Te, MV or PEEP.
Then
● Exchange flow sensor.
● Always pay special attention to successful flow
calibration. Without a usable flow measurement,
neither O2 calibration nor O2 enrichment for bronchial
suction nor leakage compensation are possible.
Optimum ventilation is not achieved.
51
Operation
Calibrating O2 sensors*
Savina uses one O2 sensor for O2 control and display
(sensor 1) and a second, separate O2 sensor for O2 monitoring
(sensor 2).
The O2 sensor for O2 control and display (sensor 1)
is automatically calibrated by Savina:
— after 8 hours’ operation
— when the O2 sensor is replaced
— if sensor 1 and sensor 2 differ from each other by more
than 2 % by volume
— when the air pressure changes by more than 200 hPa,
e.g. during transfer flights by helicopter
— when the temperature changes by more than 10 oC.
During automatic calibration, the following message appears in
the information line on the screen:
»O2 calibration active«
After calibration is complete, the following message appears:
»O2 calibration ok«
The O2 sensor for O2 monitoring (sensor 2) has to be
calibrated manually:
— once per month,
— if the following alarm occurs:
»!!! O2 measurement inop.«
● Manual calibration can be carried out in any ventilation
mode, see page 57.
*
52
If LPO mode is active, refer to page 43.
Operation
At high ambient temperature
In ambient temperatures over 35 oC Savina displays an
advisory message:
»! Temperature high«
To prevent the breathing gas becoming too hot, Savina reduces
the maximum speed of the built-in blower as the ambient
temperature rises. If high inspiratory pressures are set at the
same time, e.g. over 80 mbar, the result may be that high flows,
e.g. 180 L/min, can no longer be achieved.
Even at slower speeds, the breathing gas delivered by the
blower is warmed. To ensure that the breathing gas
temperature at the Y-piece remains under 41 oC, an inspiratory
hose length of not less than 1.1 m should be maintained as a
cooling section.
If the inspiratory breathing gas temperature is too high, an
alarm will be activated:
»!!! Temperature high«
If an operational temperature sensor* is used in the Y-piece,
Savina will warn of breathing gas temperatures of 40 oC or
higher by activating the alarm
»!!! Breathing gas temp. high«
In both cases, Savina continues ventilating the patient.
● Lower the ambient temperature.
In the event of a power supply failure
If all external and internal power sources fail, an intermittent
audible alarm sounds.
● Either immediately reconnect power supply
or
● Disconnect patient and continue ventilating using an
independent ventilator.
In the event of a gas failure
In normal operating mode, Savina uses ambient air to ventilate
the patient with the aid of a blower and O2 from the medical gas
pipeline system or from an O2 cylinder.
In the event of O2 failure
Savina replaces the missing proportion of O2 with ambient air
and generates an alarm.
The minute volume remains constant.
The inspiratory O2 concentration FiO2 drops to 21 vol.%.
*
See "Order List" on page 142. Only use temperature sensors with
blue leads.
53
Operation
If the patient needs an inspiratory O2 concentration higher
than 21 vol.%:
● reconnect the O2 supply without delay.
In the event of blower failure Savina cannot carry on
ventilating!
● Continue ventilating without delay, using an
independent ventilator!
54
Configuration
Setting the screen contrast . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56
Adjusting the volume of the audible alarm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56
Configuring the measured values line . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57
Manual calibration for O2 sensor 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57
FiO2- or flow monitoring ON/OFF . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58
Pmax ON/OFF . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59
Plateau ON/OFF . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60
Selecting the language . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60
Setting the date and time . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60
Configuring the MEDIBUS protocol . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61
Displaying the device values . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61
Configuring Remote Service (optional) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62
55
Configuration
Configuration
The following settings for use can be selected in
»Configuration« mode:
—
—
—
—
—
—
—
—
—
—
Screen contrast
Alarm volume
Measured values line
Manual calibration for O2 sensor 2
FiO2 and flow monitoring ON/OFF
Pmax ON/OFF
Plateau ON/OFF
Language, date and time
MEDIBUS protocol
Remote Service (optional).
The settings selected in »Configuration« mode remain stored
until the equipment is switched off.
The following information about the equipment can be
displayed in »Configuration«:
— Total operating hours
— Operating hours since the last inspection and
maintenance
— Software version
— Device identification number.
Setting the screen contrast
● Press »Config. ∆∆« key repeatedly until
»Configuration 1/4« appears.
● Select the »Contrast« line = turn the rotary knob,
activate = press the rotary knob
● To set the contrast = turn the rotary knob.
077 37625
The contrast changes.
Confirm = press the rotary knob.
The contrast set will now be activated.
Adjusting the volume of the audible alarm
After the setting has been confirmed, the alarm tone
is sounded once to enable you to judge the volume.
56
122 37625
Display (example):
● Press »Config. ∆∆« key repeatedly until
»Configuration 1/4« appears.
● Select »Volume« line = turn the rotary knob,
activate = press the rotary knob.
● To adjust the volume = turn the rotary knob,
confirm = press the rotary knob
Configuration
Configuring the measured values line
078 37625
Select one of 6 possible combinations of measured values:
● Press »Config. ∆∆« key repeatedly until
»Configuration 1/4« appears.
● Select »Meas. values« line = turn the rotary knob,
activate = press the rotary knob.
● To set the measured values combination =
turn the rotary knob,
confirm = press the rotary knob.
The following combinations of measured values can be
selected:
1.
V Te
ftot
MV
2.
FiO2
V Te
MV
3.
Ppeak
V Te
MV
4.
Pmean
FiO2
MV
5.
Pmean
V Te
MV
6.
Ppeak
Pmean
V Te
Manual calibration for O2 sensor 2*
— once per month,
— if the following alarm occurs:
»!!! O2 measurement inop.«
Make sure that the O2 supply system is delivering 100 % O2
(see page 95).
Manual calibration can be carried out in the respective
ventilation mode:
● Press »Config. ∆∆« key repeatedly until
»Configuration 2/4« appears.
● Select »O2 calib.« line = turn rotary knob,
to release for setting = press rotary knob.
● To start O2 calibration = turn rotary knob and select
*
076 37625
»ON«,
to confirm = press rotary knob.
Message in the information line on screen:
»Disconnect patient«
● Disconnect patient within the next 30 seconds.
● If necessary continue ventilating the patient using a
separate ventilating appliance.
If LPO mode is active, see page 43.
57
Configuration
Message in the information line on screen:
»O2 calibration active«
After 60 seconds the following appears in the information line:
»Reconnect patient«
● Immediately reconnect patient.
The O2 calibration is completed, Savina ventilates once more
using the original settings.
Disconnection and change of O2 concentration would activate
the alarms. For this reason Savina turns the alarms off during
calibration.
If the patient is not reconnected within 30 seconds, Savina
continues ventilating and all the alarms are reactivated.
115 37625
Thereafter appears:
»O2 calibration ok«
If the following alarm appears after calibration:
»!!! O2 measurement inop.«
● Replace O2 sensor, see page 85.
After replacing the O2 sensor:
● Allow about 20 minutes warm-up time to elapse,
120 3625
then calibrate.
For instance, when a used O2 or flow sensor cannot be
replaced immediately.
● Use alternative monitoring, as otherwise there will be a
restricted monitoring function.
● Press »Config. ∆∆« key repeatedly until
»Configuration 2/4« appears.
● Select the desired line = turn the rotary knob,
confirm = press the rotary knob
● Set to »ON« = turn the rotary knob,
confirm = press the rotary knob.
The corresponding monitoring is activated.
● Set to »OFF« = turn the rotary knob,
confirm = press the rotary knob.
O2 monitoring and flow monitoring and associated
alarms are permanently deactivated!
● Provide alternative monitoring.
Display in Alarm line:
»! Flow monitoring off«
or
»! O2 monitoring off«
58
080 37625
FiO2- or flow monitoring ON/OFF
Configuration
Display in information bar:
»Replace flow monitoring«
or
»Replace O2 monitoring«
or
»Replace flow monitoring and O2 monitoring«
Flow monitoring is automatically activated each time Savina is
switched on.
When flow monitoring is deactivated, Savina does not
determine the following measured values:
— MV
— MVspn
— MVleak
— VTpat
The flow volume may be inaccurate when flow monitoring
is deactivated.
Even when O2 monitoring is deactivated, the devices requires
at least sensor 1 for accurate O2 control. Otherwise it delivers
inaccurate O2/air mixes.
O2 monitoring should only be deactivated when Savina is
supplied with air only.
O2 monitoring remains deactivated even when the device
is switched on again.
Display in alarm line:
»!! O2 monitoring off«
On acknowledging by pressing the »Alarm Reset« key,
display:
»! O2 monitoring off«
● Reactivate the monitor function after replacing the sensor.
Pmax ON/OFF
079 37625
To use the pressure limit Pmax in the IPPV, IPPVAssist and
SIMV, SIMV/ASB ventilation modes.
These settings are disabled in AutoFlow, BIPAP and CPAP
modes.
The pressure limit value is set by means of the »Pinsp« key.
Savina limits the airway pressure to that set value.
● Press »Config. ∆∆« key repeatedly until
»Configuration 2/4« appears.
● Select »Pmax« line = turn rotary knob,
to release for setting = press rotary knob.
● To set »ON« = turn rotary knob,
confirm = press rotary knob.
The pressure limit »Pmax« is activated.
● To set »OFF« = turn rotary knob,
confirm = press rotary knob.
The pressure limit »Pmax« is deactivated.
59
Configuration
Plateau ON/OFF
116 37625
To switch on and off the inspiratory pause in the following
modes: IPPV, IPPVAssist, SIMV, SIMV/ASB. These settings
are disabled in AutoFlow, BIPAP and CPAP modes.
When the plateau is deactivated, Savina switches to expiration
after application of the tidal volume V T. The inspiration time
setting Tinsp does not apply. Savina establishes a minimum
expiration time of 500 ms and limits the resulting I:E ratio to
max. 4:1.
● Press »Config. ∆∆« key repeatedly until
»Configuration 2/4« appears.
● Select »Plateau« line = turn rotary knob,
to release for setting = press rotary knob.
● To set »ON« = turn rotary knob,
confirm = press rotary knob.
Plateau is activated.
● To set »OFF« = turn rotary knob,
confirm = press rotary knob.
Plateau is deactivated.
Selecting the language
The following languages can be selected:
— German
– Japanese
— English
– Russian
— US-English
– Greek
— French
– Romanian
— Italian
– Polish
— Spanish
— Portuguese
— Chinese
081 37625
Display (example):
● Press »Config. ∆∆« key until
»Configuration 3/4« appears.
● Select »Language« line = turn the rotary knob,
to release for setting = press rotary knob.
● Select language = turn the rotary knob,
confirm = press the rotary knob.
The new language selected is activated immediately.
Setting the date and time
This has to be done when using the MEDIBUS interface
● Press »Config. ∆∆« key repeatedly until
»Configuration 3/4« appears.
● Select »dd.mm.yy« line = turn the rotary knob,
to release for setting = press rotary knob.
● Set the day (dd) = turn the rotary knob,
confirm = press the rotary knob.
in the same way.
60
082 37625
● Set the month (mm), year (yy), hour (h) and minutes (m)
Configuration
Configuring the MEDIBUS* protocol
The following parameters can be set:
— Baudrate
— Parity check bits
— Number of stop bits
● Press »Config. ∆∆« key repeatedly until
»Configuration 3/4« appears.
● Select line for the corresponding interface parameters,
083 37625
e.g. select baudrate = turn the rotary knob,
to release for setting = press rotary knob.
● Set value = turn the rotary knob,
confirm = press the rotary knob.
Displaying the device values
● Press »Config. ∆∆« key repeatedly until
*
106 37625
»Configuration 4/4« appears.
Savina displays:
— SW
Software version of the device
— Device-ID
specific device identification number
— Working hours
the total number of hours the device has been operating,
and
— h since service
the number of working hours since the last inspection
and service by trained service personnel.
● Release code:
Numerical code for release of options
MEDIBUS:
Dräger communications protocol for medical appliances.
61
Configuration
Configuring Remote Service (optional)
Remote Service allows test and service functions to be
performed by a central remote server, via a modem/telephone
line. Release by DrägerService and special accessories are
required in order to use the Remote Service option.
When Remote Service has been released, the on-line
connection mode can be set:
— Remote Service
On-line connection mode, with the following values:
— Off
Possibility of a connection between Savina and the
remote server is disabled.
— Call
Savina calls the remote server.
— Listen
Savina waits for a call from the remote server.
— Task
This parameter is only available if »Call« or »Listen«
has been selected under Remote Service.
Remote Service use mode, with the following values:
— Problem Call
Remote Service is provided when a fault occurs.
— Routine Call
Remote Service is performed for routine machine
maintenance.
For operation of the Remote Service function, please refer to
the separate instructions for use.
● Keep pressing the »Config. ∆∆« key until
»Configuration 4/4« appears.
● Select line for the corresponding Remote Service
13437625
parameters = turn the rotary knob,
activate to set = press the rotary knob.
● Set value = turn the rotary knob,
confirm = press the rotary knob.
62
Fault – Cause – Remedy
Fault – Cause – Remedy...............................................................................................64
63
Fault – Cause – Remedy
Fault – Cause – Remedy
Alarm messages in the alarm display field are displayed in hierarchical order.
For example, if two faults are detected at the same time, the more critical of the two is displayed.
The priority level of the alarm messages is identified by exclamation marks:
Warning
= !!! Message with top priority
Caution
= !!
Message with medium priority
Advisory
= !
Message with low priority
Savina displays a message for your guidance in the information line when certain alarm messages occur.
The messages are listed in the table in alphabetical order.
In the event of an alarm, this table is designed to enable you to identify the cause and take rapid
corrective action.
Message
Cause
Remedy
!!! Airway pressure high
The upper alarm limit for the airway
Check patient condition.
pressure has been exceeded. The patient Check ventilation pattern.
is "fighting" the ventilator; cough.
Correct alarm limit if necessary.
Ventilation hose kinked.
Check hose system and tube.
Leaking cuff.
Inflate cuff and perform leak test.
Leak or disconnection.
Check hose system for tight connections.
Check that the expiration valve
is properly engaged.
!!! Ambient press. meas. inop.
Internal absolute pressure sensor faulty.
Due to a fault in the ambient pressure
measurement, Savina calculates the tidal
volume V T and minute volume MV values on
the basis of 1013 mbar, in the absence of
current measurements.
If the »Airway pressure high« alarm is correctly
set and the incorrect tidal volume V T and
minute volume MV values are tolerable, Savina
can continue to be used.
Keep a check on the patient’s condition.
Call DrägerService.
!!! Apnoea
Patient’s spontaneous breathing has
stopped.
Apply controlled ventilation.
Flow sensor not calibrated or faulty.
Calibrate flow sensor.
Replace if necessary.
is set
Apnoea alarm time TApnoea
less than time for one respiration phase
(TApnoea
< 60/f).
Extend apnoea alarm time TApnoea
Disconnection.
Reconnect.
!!! Airway pressure low
64
.
Fault – Cause – Remedy
Message
Cause
Remedy
!
Apnoea monitoring has been switched
off.
Reset the apnoea alarm time TApnoe
to
the desired monitoring value if necessary.
!! Apnoea ventilation
Due to detected apnoea, Savina automatically switched over to mandatory
ventilation.
Check the ventilation process.
To return to the original ventilation mode:
Press the »Alarm Reset« key.
!!! ASB > 4 s
Not displayed in »Mask/NIV«
mode.
The ASB cycle has been switched off
3 times due to exceeding time limit.
Test ventilation system for leaks.
!
ASB > 4 s
Not displayed in »Mask/NIV«
mode.
The ASB cycle has been switched off due Test ventilation system for leaks.
to exceeding time limit.
!
Atmospheric pressure high
The device is being used at too high
atmospheric pressure.
Apnoea Alarm off
Only in »Mask/NIV« mode
(optional)
Use Savina inside of the given atmospheric
pressure range,
see Technical data, page 132.
One of the pressure sensors is defective. Due to a fault in the ambient pressure
measurement, Savina calculates the tidal
volume V T and minute volume MV values on
the basis of 1013 mbar, in the absence of
current measurements.
If the »Airway pressure high« alarm is correctly
set and the incorrect tidal volume V T and
minute volume MV values are tolerable, Savina
can continue to be used.
Keep a check on the patient’s condition.
Call DrägerService.
!
Atmospheric pressure low
The device is being used at too low
atmospheric pressure.
Use Savina inside of the given atmospheric
pressure range, see Technical data, page 132.
One of the pressure sensors is defective. Due to a fault in the ambient pressure
measurement, Savina calculates the tidal
volume V T and minute volume MV values on
the basis of 1013 mbar, in the absence of
current measurements.
If the »Airway pressure high« alarm is correctly
set and the incorrect tidal volume V T and
minute volume MV values are tolerable, Savina
can continue to be used.
Keep a check on the patient’s condition.
Call DrägerService.
!!! Breathing gas temp. high
Breathing gas temperature is over 40 oC. Switch off humidifier. Use longer inspiration
hoses.
!! Check settings
Due to an internal data loss, Savina is
operating with factory settings.
Acknowledge message by pressing
»Alarm Reset«. Check settings and adjust.
65
Fault – Cause – Remedy
Message
Cause
Remedy
!!! Device failure XX.YYYY
Device faulty.
If the alarm message disappears on pressing
the »Alarm Reset« key, ventilation with Savina
can be continued.
If the alarm message does not disappear on
pressing the »Alarm Reset« key, disconnect
the patient from Savina and continue
ventilation without delay, using another
independent ventilator. Use PEEP and/or an
increased O2 concentration if necessary.
Call DrägerService.
If Savina cannot be switched off:
Turn the power switch to » «.
Press the »
Standby« key for 3 seconds
and press »Alarm Reset« to confirm.
This switches Savina off.
Call DrägerService.
!! Device over temperature
Temperature inside the device is too high. Check condition of the dust filter and replace
if necessary, page 84.
!!! Exp. valve inop.
Expiration valve not properly connected to Fit expiration valve correctly.
socket.
Flow sensor defective.
Replace flow sensor.
Expiration valve faulty.
Replace expiration valve.
!! Ext. DC ?
External battery defective
or not sufficiently charged,
on-board supply does not match the specification or
battery voltage is too high.
Press »Alarm Reset« to acknowledge the
message. Disconnect Savina from the external
battery and connect to another charged battery with the permissible voltage.
If using an on-board supply, ensure the voltage
is adequate.
!
Ext. DC ?
External battery defective
or not sufficiently charged,
on-board supply does not match the specification or
battery voltage is too high.
Disconnect Savina from the external battery
and connect to another charged battery with
the permissible voltage.
If using an on-board supply, ensure the voltage
is adequate.
!
Ext. DC supply active
Due to lack of a mains power source,
Savina is operating with an external
battery or DC on-board supply
Reconnect to mains power supply if
necessary.
Note capacity of DC power source.
!!! FiO2 high
HPO mode
Due to a low minute volume MV, the mixer Message disappears after a short time.
is not yet completely steady.
Faulty mixer function.
66
In order to continue ventilating with Savina:
Use external O2 monitoring and switch off
the built-in O2 monitoring, page 58.
Call DrägerService
Fault – Cause – Remedy
Message
Cause
!!! FiO2 high
LPO mode:
The upper alarm limit for the O2 concentration has been reached or exceeded.
!!! FiO2 low
!!! Flow measurement inop.
Check condition of patient,
check concentrator setting and pattern of ventilation,
correct alarm limits if necessary.
HPO mode:
Due to a low minute volume MV, the mixer Message disappears after a short time.
is not yet completely steady.
Faulty mixer function.
!!! FiO2 low
Remedy
LPO mode:
The lower alarm limit for the O2 concentration has been reached or passed.
In order to continue ventilating with Savina:
Use external O2 monitoring and switch off the
built-in O2 monitoring, page 58.
Call DrägerService.
Check condition of patient,
check concentrator setting and pattern of ventilation,
correct alarm limits if necessary.
Water in flow sensor.
Dry flow sensor.
Flow measurement malfunction.
To continue ventilation with Savina:
Use external alternative flow monitoring
and deactivate the built-in flow monitoring,
see page 58. The flow volume may be
inaccurate.
Call DrägerService.
Flow monitoring is switched off.
Switch flow monitoring on again, see page 58,
or immediately provide adequate external
monitoring.
!!! Flow sensor?
Flow sensor not fully inserted in
rubber lip of expiration valve.
Insert flow sensor correctly.
!!! Flow sensor INOP
Flow sensor malfunction.
Replace flow sensor.
!!! High frequency
Patient is breathing at a high
spontaneous frequency, therefore the
monitored overall frequency is too high.
Check condition of patient.
Check pattern of ventilation.
Correct alarm limit if necessary.
!!! Insp / Exp cycle failure
The device does not deliver any gas.
Set an IPPV frequency of at least 4/min.
Apnoea alarm time TApnoea
is set
less than time for one respiration phase
(TApnoea
< 60/f).
Extend apnoea alarm time TApnoea
Disconnection.
Reconnect.
The »Insp. hold« key was held down
longer than 15 seconds.
Release »Insp. hold« key.
!
!
Flow monitoring off
Insp. hold interrupted
.
67
Fault – Cause – Remedy
Message
Cause
Remedy
!!! Int. batt. almost discharged
Total working time when running on the
internal battery has almost expired.
Remaining available battery capacity is
less than 10 %. Savina is about to stop
working.
Immediately connect supply via mains, external
battery or vehicle DC on-board network.
!
Mains power or external DC connected;
internal battery almost discharged.
Do not switch over Savina to operation via
internal battery. Charge battery.
!! Int. battery activated
Savina is being supplied via the internal
battery as there is no mains supply or
external battery and no DC on-board
voltage. See "Operation with internal
battery" on page 106.
Restore mains power or supply from external
battery or DC on-board network. This alarm
can be acknowledged by pressing
»Alarm Reset«. It will then appear as an
advisory message (!).
!
Savina is being supplied via the internal
battery as there is no mains supply or
external battery and no DC on-board
voltage. See "Operation with internal
battery" on page 106.
Restore mains power or supply from external
battery or DC on-board network.
!!! Int. battery failed
Internal battery has failed.
If there is a reliable mains or external DC
supply, ventilation with Savina can be
continued. This alarm can be acknowledged
by pressing the »Alarm Reset« key; it will
then appear as an advisory message (!).
Call DrägerService.
!
Internal battery has failed.
If there is a reliable mains or external
DC supply, ventilation with Savina can be
continued.
Call DrägerService.
!! Int. battery low
Total operating time when running on
the internal battery is about to expire.
Remaining available battery capacity is
less than 30 %. The message is repeated
if the remaining capacity falls below 20 %.
Immediately restore mains power or supply
from external battery or DC on-board network.
This alarm can be acknowledged by pressing
»Alarm Reset«. It will then appear as an
advisory message (!).
!
When running on internal battery:
The remaining available battery capacity
is less than 30 %.
Immediately restore mains power or supply
from external battery or DC on-board network.
If mains power or an external DC supply
is available:
Internal battery is not yet sufficiently
charged.
Continue charging battery.
xx key (e.g. »
be pressed.
Disconnect patient from Savina and continue
ventilation without delay, using another
independent ventilator. Use PEEP and/or an
increased O2 concentration if necessary.
Call DrägerService.
Int. batt. almost discharged
Int. battery activated
Int. battery failed
Int. battery low
!! Key xx failed
68
2 min«) can no longer
Fault – Cause – Remedy
Message
Cause
Remedy
!! Key xx overused
Keys pressed very frequently within
a short time (e.g. » 2 min« key).
Acknowledge message by pressing
»Alarm Reset«.
If this message appears again:
Disconnect patient from Savina and continue
ventilation without delay, using another
independent ventilator. Use PEEP and/or an
increased O2 concentration if necessary.
Call DrägerService.
!
Leaking cuff.
Inflate cuff and perform leak test.
Leakage
Not displayed in »Mask/NIV«
mode.
Leak in breathing system. The calculated Check hose connection is tight. Check that
leak minute volume MVleak is greater than the water trap collecting jar is connected to
the measured expiratory minute volume.
the expiration valve.
!!! Mains switch inop.
Savina has not clearly detected the
switch position.
Acknowledge message by pressing
»Alarm Reset«.
If Savina has to be switched off:
First turn the power switch to » « and then
switch off Savina.
If message appears again:
Ventilation with Savina can be continued.
If Savina cannot be switched off after
ventilation:
Turn the power switch to » «.
Press the »
Standby« key for 3 seconds
and press »Alarm Reset« to confirm.
This switches Savina off.
Call DrägerService.
!! Main switch overused
Savina has detected very frequent
operation of the switch within
a short time.
Acknowledge message by pressing
»Alarm Reset«.
If Savina has to be switched off:
First turn the power switch to » « and then
switch off Savina.
If message appears again:
Ventilation with Savina can be continued.
If Savina cannot be switched off after
ventilation:
Turn the power switch to » «.
Press the »
Standby« key for 3 seconds
and press »Alarm Reset« to confirm.
This switches Savina off.
Call DrägerService.
!!! Malfunction fan
Fan failure.
Savina uses the fan to cool the interior of the
device and to avoid increased fire risk in the
event of an O2 leak.
If the »!!! Malfunction fan« alarm message
occurs:
Disconnect patient from Savina and continue
ventilation without delay, using another
independent ventilator. Use PEEP and/or an
increased O2 concentration if necessary.
Call DrägerService.
69
Fault – Cause – Remedy
Message
Cause
Remedy
!!! MEDIBUS COM. inop.
The connector of the MEDIBUS cable has Reconnect the connector and secure against
disconnection with the two screws.
been unplugged during operation.
MEDIBUS cable defective.
Use a new MEDIBUS cable.
Interface defective.
Ventilation with Savina can be continued.
Call DrägerService.
!! Microfilter blocked
Microfilter clogged.
Change microfilter, see page 83.
!!! Microfilter missing
Microfilter is missing or is not
correctly fitted.
Fit microfilter, see page 83.
!!! MV high
The minute volume has exceeded the
upper alarm limit.
Check condition of patient.
Check pattern of ventilation.
Correct alarm limit if necessary.
Flow sensor faulty.
Replace flow sensor.
Water in flow sensor.
Drain water trap,
dry flow sensor.
Machine malfunction.
Disconnect patient from Savina and continue
ventilation without delay, using another
independent ventilator. Use PEEP and/or an
increased O2 concentration if necessary.
Call DrägerService.
The minute volume has fallen below
the lower alarm limit.
Check condition of patient.
Check pattern of ventilation.
Correct alarm limit if necessary.
Leak in breathing system.
Ensure that the breathing system is leakproof.
Check that the water trap collecting jar is connected to the expiration valve.
Flow sensor faulty.
Replace flow sensor.
Machine malfunction.
Disconnect patient from Savina and continue
ventilation without delay, using another
independent ventilator. Use PEEP and/or an
increased O2 concentration if necessary.
Call DrägerService.
Reset MV
alarm limit to the desired
monitoring value if necessary.
!!! MV low
!
MV low Alarm off
Only in »Mask/NIV« mode
(optional)
The minute volume lower alarm limit
MV
has been switched off.
!
Nebuliser on
The medicament nebuliser is
switched on.
70
Fault – Cause – Remedy
Message
Cause
Remedy
!!! No battery charging
Battery not charging due to excessive
temperature.
Operate Savina at a lower temperature. If
there is a reliable mains supply, ventilation
with Savina can be continued. This alarm can
be acknowledged by pressing »Alarm Reset«.
It will then appear as an advisory message (!).
Battery not charging due to excessive
voltage at external sources (mains or
external DC supply).
Use external sources with correct voltage.
If there is a reliable mains supply, ventilation
with Savina can be continued. This alarm can
be acknowledged by pressing »Alarm Reset«.
It will then appear as an advisory message (!).
Call DrägerService.
Battery not charging due to excessive
temperature.
Operate Savina at a lower temperature.
If there is a reliable mains supply, ventilation
with Savina can be continued.
Battery not charging due to excessive
voltage at external sources (mains or
external DC supply).
Use external sources with correct voltage.
If there is a reliable mains supply, ventilation
with Savina can be continued.
Call DrägerService.
Internal battery discharged.
Do not switch over Savina to operation via
internal battery. Charge battery.
!
No battery charging
!!! No int. battery
Internal battery is missing, defective or not This alarm can be acknowledged by pressing
connected or fuse has failed.
»Alarm Reset«. It will then appear as an
advisory message (!).
If there is a reliable mains supply, ventilation
with Savina can be continued.
Call DrägerService.
!
No int. battery
Internal battery discharged.
Do not switch over Savina to operation via
internal battery. Charge battery.
Internal battery is missing, defective or not If there is a reliable mains supply, ventilation
connected or fuse has failed.
with Savina can be continued.
Call DrägerService.
!
No nebulisation
The patient’s inspiratory flow is too low
and therefore a nebuliser flow cannot
be applied.
If necessary, increase the ventilation
parameter Flow Acceleration »FlowAcc«
or pressure limit »Pinsp« so that a higher
inspiratory flow is applied.
71
Fault – Cause – Remedy
Message
Cause
Remedy
!!! O2 measurement inop.
O2 sensor provides invalid measured
values.
Calibrate O2 sensor, see page 57.
Replace if necessary, page 85.
In LPO mode: calibrate O2 sensors, page 43,
if necessary in HPO mode, see page 57.
O2 sensor consumed or not fitted.
Fit new O2 sensor, see page 85.
Calibrate, see page 57.
O2 measurement malfunction.
In order to continue ventilating with Savina:
Use external O2 monitoring and switch off
the built-in O2 monitoring, page 58.
Call DrägerService.
!! O2 monitoring off
On switching on, Savina notifies that
O2 monitoring is switched off.
Reactivate O2 monitoring, see page 58, or
immediately connect adequate external
monitoring function.
This alarm can be acknowledged by pressing
»Alarm Reset«. It will then appear as an
advisory message (!).
!
O2 monitoring is switched off.
Switched-off state has been confirmed.
Switch O2 monitoring on again, see page 58,
or immediately ensure adequate external
monitoring.
!!! O2 supply down
O2 supply pressure too low.
Ensure pressure is greater than 2.7 bar.
!
O2 supply pressure too low.
O2 supply pressure is not required
when FiO2 = 21 Vol.%.
Ensure pressure is greater than 2.7 bar.
!! O2 supply pressure high
O2 supply pressure too high.
Make sure pressure is less than 6 bar.
!
O2 supply pressure too high.
O2 supply pressure is not required
when FiO2 = 21 Vol.%.
Make sure pressure is less than 6 bar.
Expiration tract incorrectly positioned.
Check hose system and expiration valve.
Increased expiratory resistance.
Check bacterial filter.
Replace if necessary.
PEEP set not reached.
Check system for leaks.
O2 monitoring off
O2 supply down
O2 supply pressure high
!!! PEEP high
!!! PEEP inop.
Ventilation with Savina can be continued,
though the PEEP set will not be reached.
Observe the patient closely.
Call DrägerService.
!!! Pressure meas. inop.
72
Fluid in expiration valve.
Replace expiration valve,
then disinfect/clean and dry,
see page 79.
Pressure measurement malfunction.
Disconnect patient from Savina and continue
ventilation without delay, using another
independent ventilator. Use PEEP and/or an
increased O2 concentration if necessary.
Call DrägerService.
Fault – Cause – Remedy
Message
Cause
!! Rotary knob failed
Rotary knob cannot be turned or pressed. Disconnect patient from Savina and continue
ventilation without delay, using another
independent ventilator. Use PEEP and/or an
increased O2 concentration if necessary.
Call DrägerService.
!! Rotary knob overused
Rotary knob has been pressed very
frequently within a short time.
Press »Alarm Reset« to acknowledge
message.
If this message appears again:
Disconnect patient from Savina and continue
ventilation without delay, using another
independent ventilator. Use PEEP and/or an
increased O2 concentration if necessary.
Call DrägerService.
!!! Service mode active
Savina has been switched to
Remote Service mode.
Press »Alarm Reset« to confirm Remote
service mode.
To continue ventilation with Savina:
Disconnect cable from serial interface.
Then switch Savina off and on again.
!!! Standby activated
Savina has been switched to standby.
Confirm standby by pressing
»Alarm Reset«.
!!! Temperature high
The temperature of the inspiratory
breathing gas is too high. .
Reduce ambient temperature. Switch off
humidifier to protect the patient and use
longer inspiration hoses.
!
Due to high ambient temperatures
(35 to 40 oC), the device has reached its
peak pressure, but not its peak flow.
Lower the ambient temperature.
!!! Temperature meas. inop.
Temperature sensor faulty.
Fit new temperature sensor.
!!! Temperature sensor ?
Temperature sensor probe has been
disconnected during operation.
Reconnect probe.
Sensor cable broken.
Fit new temperature sensor.
Temperature high
!!! Tidal volume high
!
Tidal volume high
Remedy
The upper alarm limit of the applied
Check the condition of the patient.
inspiratory tidal volume V T has been
Check the ventilation pattern.
exceeded during three ventilation strokes. If necessary, correct the alarm limit.
Leakage or disconnection.
Check that the connections of the hose
system are leakproof.
The upper alarm limit of the applied
inspiratory tidal volume V T has been
exceeded once.
Check the condition of the patient.
Check the ventilation pattern.
If necessary, correct the alarm limit.
Leakage or disconnection.
Check that the connections of the hose
system are leakproof.
73
Fault – Cause – Remedy
Message
Cause
Remedy
!! Tidal volume low
Because of pressure or time limitations,
the set tidal volume V T was not applied
in 4 ventilation strokes.
Extend inspiration time »Tinsp«, raise
»FlowAcc«,
raise pressure limit using »Pinsp« key.
This alarm can be acknowledged by pressing
»Alarm Reset«. It will then appear as an
advisory message (!).
Because of pressure or time limitations,
the set tidal volume V T was not applied
in 4 ventilation strokes.
Extend inspiration time »Tinsp«, raise
»FlowAcc«,
increase upper alarm limit for airway pressure
Paw
.
This alarm can be acknowledged by pressing
»Alarm Reset«”. It will then appear as an
advisory message (!).
Because of pressure or time limitations,
the set tidal volume V T was not applied
in 2 ventilation strokes.
Extend inspiration time »Tinsp«, raise
»FlowAcc«,
raise pressure limit using »Pinsp« key.
Because of pressure or time limitations,
the set tidal volume V T was not applied
in 2 ventilation strokes.
Extend inspiration time »Tinsp«, raise
»FlowAcc«,
increase upper alarm limit for airway
pressure Paw
.
The inspiratory tidal volume
upper alarm limit V Ti
has been
switched off.
Reset alarm limit V Ti
to desired
monitoring value if necessary.
!
!
74
Tidal volume low
VTi high Alarm off
Only in »Mask/NIV« mode
(optional)
Care
Dismantling . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76
Removing parts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76
Disinfecting/Cleaning/Sterilising . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79
Disinfecting/cleaning/sterilising schedule
for Savina Intensive Care Ventilator . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81
Maintenance Intervals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 82
Replacing the microfilter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83
Replacing the dust filter set . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 84
Replacing the O2 sensors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85
Using an external battery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 86
Correct disposal of batteries and O2 sensors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 86
Correct disposal of internal battery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 86
Important when storing Savina . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 86
Correct disposal of apparatus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 86
75
Care
Care
To avoid risks to hospital staff and other patients, disinfect
and clean the machine after use. When disinfecting
contaminated parts, follow the hospital hygiene
regulations (protective clothing, eye protection, etc.)
● Clean and prepare the machine after each patient.
Recommendation:
● Change the hose system and expiration valve every week.
Keep the replacement systems ready.
Dismantling
Removing parts
● Switch off the ventilator and breathing gas humidifier,
and remove their power plugs.
1 Drain condensate from water traps and ventilation hoses.
Drain the water trap on the expiration valve.
2 Drain the water container of the humidifier.
1
1
10937624
2
1
Ventilation hoses
● Remove ventilation hoses from the device ports.
● Remove the water traps from the ventilation hoses.
3
11037624
Remove the water containers from the water traps and
the expiration valve.
● Prepare the ventilation hoses, water traps and associated
water jars, and the Y-piece for disinfection and cleaning
by autoclaving.
3 Remove the bacterial filter and treat it in accordance with
the accompanying instructions for use.
76
Care
● When removing the ventilation hoses, always grasp
09337624
them by the sleeve, never by the hose itself, to avoid
possibly tearing the hose at the sleeve or ripping it out
of the sleeve.
Medicament nebuliser (optional)
1 Remove nebuliser hose from the medicament nebuliser and
from the spigot on the device.
2 Pull medicament nebuliser out of the adult hose set, or
2
01637624
1
5
3
4
2
1
02137624
2 dismantle medicament nebuliser from the paediatric hose
set.
3 Pull catheter connector (ISO cone ø15 / ø11) out of the
input.
4 Pull spigot (ISO cone ø22 / ø11) out of the output.
5 Pull corrugated hose out of the spigot.
● Dismantle and prepare medicament nebuliser in
accordance with the accompanying instructions for use.
77
Care
Flow sensor
1 Push the flow sensor to the left as far as it will go and
2 pull out.
D
Savina
● The flow sensor cannot be autoclaved or
steam-sterilised. It is not temperature-stable
and would be destroyed.
● Disinfect flow sensor for about 1 hour in 70 % ethanol
solution.
● Leave sensor to dry in air for at least 30 minutes.
Residual alcohol could otherwise cause the sensor to fail
during calibration.
● The flow sensor may be re-used as long as automatic
calibration can be carried out successfully.
1
05837624
2
Expiration valve
3 Remove collecting jar from water trap.
4 Turn knurled sleeve to the left and
5 remove expiration valve.
4
05937624
5
3
6 Remove diaphragm.
7 Remove rubber bushing.
● Do not disassemble the expiration valve any further.
● The expiration valve together with the diaphragm, rubber
bushing and dismantled water trap collecting jar are
suitable for disinfection and cleaning by autoclaving or
sterilising.
7
04837624
6
Breathing gas humidifier
● Dismantle according to the relevant Instructions for Use
and prepare for disinfection/sterilisation.
78
Care
Disinfecting/Cleaning/Sterilising
Use surface disinfectants. For surface compatibility, use
disinfectants based on:
— aldehydes,
— quaternary ammonium compounds.
Due to possible damage to the materials, do not use any
preparations based on:
— Compounds containing alkylamine
— Compounds containing phenol
— Halogen-releasing compounds
— Strong organic acids
— Oxygen-releasing compounds
For users in the Federal Republic of Germany, we recommend
that only disinfectants on the current DGHM list are used
(DGHM: German Society for Hygiene and Microbiology).
The DGHM list (published by mhp-Verlag, Wiesbaden) also
classifies each disinfectant by its active agents. For countries
where the DGHM list is not available, we recommend the types
of disinfectant given above.
Disinfectants often contain – besides their main active agents
– additives that can also damage materials.
● If in doubt, ask the supplier/manufacturer of the
disinfectant/cleaning agent.
● Do not sterilise parts in ethylene oxide!
Ethylene oxide can diffuse into the parts.
Danger to health!
To avoid risks to hospital staff and other patients, disinfect
and clean the machine after use. When disinfecting
contaminated parts, follow the hospital hygiene
regulations (protective clothing, eye protection, etc.)
79
Care
— Savina basic device with trolley
— Hinged arm
— Medical gas hose
● Wipe disinfect.
—
—
—
—
—
—
Ventilation hoses
Y-piece
Water traps and collecting jars
Expiration valve casing
Expiration valve diaphragm
Containers for water traps
● Hot-steam disinfect in the autoclave (93 oC/10 minutes)
using detergent only.
—
—
—
—
—
—
—
Ventilation hoses
Y-piece
Water traps and collecting jars
Expiration valve casing
Expiration valve diaphragm
Containers for water traps
Temperature sensor
● are thermo-stable and can be steam-sterilised at 134 oC.
— Prepare medicament nebuliser
● in accordance with the accompanying instructions for use.
— Handle bacterial filter
● in accordance with the accompanying instructions for use.
80
Care
Disinfecting/cleaning/sterilising schedule for
Savina Intensive Care Ventilator
Applicable for use with non-infectious patients.
For infectious patients, all parts that conduct breathing gas
must be additionally sterilised after disinfecting and
cleaning.
The parts that conduct breathing gas listed here can be
steam-sterilised at 134 oC. See "Sterilising" column.
This schedule contains guideline values only. The protocols
of the responsible hospital hygiene official remain
unaffected!
Part
How often
Reusable
components
Recommended
cleaning
intervals
Autoclaving at
93 oC 10 minutes
Wiping
Bath
immersion
Steam
134 oC
10 minutes
Savina
basic device
per patient
no
outside
no
no
Trolley
Hinged arm
Medical gas hose
per patient
no
outside
no
no
Ventilation hoses,
Y-piece,
Water traps and
Collecting jars
per patient/
weekly
yes
no
possible
yes
Expiration valve
per patient/
weekly
yes
no
possible
yes
Flow sensor
per patient/
weekly
no*
outside
possible*
no
Temperature sensor
per patient/
weekly
no
yes
no
yes
*
How
Disinfecting and cleaning
Sterilising
Special treatment, bath disinfect in 70 % ethanol, see page 78
81
Care
Maintenance Intervals
Clean and disinfect equipment and/or components
before any maintenance procedures – and before returning
for repair!
O2 sensors
replace when the following message is displayed:
»!!! O2 measurement inop.«
in case of calibration is no longer possible.
Used O2 sensors can be returned to
Dräger Medical for disposal.
Microfilter
Replace after 1 year, see page 83.
Dispose of with normal domestic waste.
Dust filter set
Replace after 1 year, see page 84.
Dispose of with normal domestic waste.
Blower unit
To be replaced by trained service personnel after
20,000 hours’ operation or after 8 years – whichever is earlier.
Lead-gel battery
To be replaced by trained service personnel after 2 years.
This applies to both the internal and the external battery
(optional).
Lead-gel batteries should be disposed of as special waste,
see page 86.
Filter in O2 inlet
To be replaced by trained service personnel every 6 years.
Real-time clock
To be replaced by trained service personnel every 6 years.
Pressure reducer
To be replaced by trained service personnel every 6 years.
Equipment inspection
and service
Should be carried out for the first time after 2 years or
12,000 hours’ operation, whichever is earlier.
Thereafter annually or after 6,000 hours’ operation, whichever
is earlier.
Only original Dräger parts should be used.
82
Care
Replacing the microfilter
— This should be replaced once a year.
1 Hold down both latches,
2 lift filter cover and remove.
1
1
09737624
2
3 Remove used microfilter from its housing.
● Slide new microfilter into housing as far as it will go.
● Dispose of used microfilter with domestic waste.
● Do not operate Savina without a microfilter, as the
inspiration side will get dirty!
09937624
3
4 Insert filter cover with two lugs into rear panel.
5 Position power cable under filter cover.
6 Push latches into housing until they engage.
4
4
5
6
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6
83
Care
Replacing the dust filter set
— Inspect after 4 weeks for soiling, clean or replace as
necessary.
1 Hold down both latches,
2 lift filter cover and remove.
1
1
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2
3 Remove used dust filter from filter cover.
● Fit new dust filter.
● Dispose of used dust filter with domestic waste.
3
3
09837624
3
4 Insert filter cover with two lugs into rear panel.
5 Position power cable under filter cover.
6 Push latches into housing until they engage.
4
4
5
Breathing air and cooling air are drawn in through the
filter cover.
● Do not cover, do not place up against a wall –
risk of device overheating.
6
11437624
6
84
Care
Replacing the O2 sensors
Only use O2 sensors type Oxytrace VE (MX 01 049).
Confusion with the Oxytrace INCU O2 sensor is possible, as
they are externally similar. However, the measuring processes
are different.
— If the following message appears:
»!!! O2 measurement inop.
Exchange O2 sensor 1«
or
»!!! O2 measurement inop.
Exchange O2 sensor 2«
or
— if calibration is no longer possible.
Savina uses one O2 sensor for O2 control* and display
(sensor 1) and a separate O2 sensor for O2 monitoring
(sensor 2).
1
2
Swivel inspiration port downwards.
Unscrew screw, using a coin or similar object, and remove
cover plate.
3/4 Remove used O2 sensor from housing.
3/4 Slide new O2 sensor into respective housing for
"Sensor 1" or "Sensor 2". Turn using light pressure
until the O2 sensor slides further into the housing.
2 Screw cover plate into place.
3
HPO mode:
Sensor 1:
is automatically calibrated after fitting.
Sensor 2:
● Allow not more than 20 minutes warm-up time to elapse,
then
● calibrate manually, see page 57.
4
1
LPO mode:
● calibrate both sensors, see page 43.
05437624
2
The internal battery supplies the two O2 sensors with current
even when Savina is switched off. This enables Savina to
supply valid O2 measured values as soon as it is switched on.
If the internal battery is discharged, Savina does not supply any
O2 measured values for the first 20 minutes after switching on.
The O2 dosage operates at reduced accuracy during this time.
*
O2 control only in HPO mode
85
Care
Using an external battery
Either 12 V batteries or 24 V batteries can be connected as
the external battery. The use of 24 V batteries (two 12 V
batteries arranged in series) with a minimum capacity of 15 Ah
each is recommended. With batteries of this type, the
efficiency of the DC power supply and, consequently, the
operating time is considerably greater than with 12 V batteries
of comparable capacity.
Correct disposal of batteries and O2 sensors
Batteries and O2 sensors:
● Do not incinerate or throw in fire; risk of explosion.
● Do not open using force; risk of caustic burns.
Batteries must be disposed of as special waste:
● Information may be obtained from the local environmental
and public health authorities or from approved waste
disposal companies.
O2 sensors:
● can be returned to Dräger Medical.
Correct disposal of internal battery
Savina contains permanent batteries that contain harmful
substances.
● The permanent batteries containing harmful substances
that are fitted in Savina should be removed and disposed of
by Dräger Service.
Important when storing Savina
If Savina is stored for longer than 14 days without power:
● Remove fuse for internal battery. This avoids undesirable
total discharge of the internal battery, which would
otherwise constantly supply the O2 sensors with current.
● Charge internal battery before removing fuse.
Even with the fuse removed, the battery runs down,
and therefore the internal batteries should be recharged
after 6 months at most.
● Avoid storing the ventilator for extended periods at
temperatures over 50 oC.
00637624
The internal battery and O2 sensors may be damaged,
or equipment life may be shortened.
Correct disposal of apparatus
— at the end of its useful life.
● After contacting the competent waste disposal company,
hand over Savina for appropriate disposal. The applicable
legal regulations must be observed.
86
Preparation
Assembling . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 88
Mounting the expiration valve . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 88
Inserting the expiration valve . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 88
Fitting the flow sensor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89
Fitting the bacterial filter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89
Note on the use of expiratory bacterial filters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 90
Note on the use of heat and moisture exchangers . . . . . . . . . . . . . . . . . . . . . . . . . . . 90
Positioning the humidifier . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91
For ventilating infants . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91
Fitting the Aquapor humidifier . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91
Fitting the Fisher & Paykel humidifier . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 92
Electrical power supply . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 93
O2 supply . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 95
Expected operating time when using an O2 cylinder supply . . . . . . . . . . . . . . . . . . 95
Nurse call system . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 97
Checking readiness for operation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 98
Moving Savina around the hospital . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100
Checklist . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 101
87
Preparation
Preparation
Assembling
Only use the duly prepared components!
Mounting the expiration valve
1 Attach diaphragm to expiration valve.
2 Attach rubber bushing to port.
2
05237624
1
Inserting the expiration valve
3
4
3
5
Turn knurled sleeve to left as far as it will go.
Insert expiration valve.
Turn knurled sleeve to right.
Fit container for water trap.
3
4
02837624
5
Never operate Savina without a water trap on the
expiration valve.
● Due to tidal volume overcompensation in »Mask/NIV«
mode (optional), there is a risk of unintentionally high
airway pressures.
● Mis-triggering may occur.
88
Preparation
Fitting the flow sensor
1 Push the socket to the left as far as it will go.
1
2
2 Insert the flow sensor, with the probe facing towards the
ventilator, into the mounting and push it into the socket
as far as it will go.
Then:
3 Push flow sensor to the right as far as it will go into the
rubber lip of the expiration valve.
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3
Fitting the bacterial filter
An inspiratory bacterial filter should always be used to
protect the patient from contamination from the ambient
air drawn in.
03437624
● Push bacterial filter on to inspiration port.
89
Preparation
Note on the use of expiratory bacterial filters
The use of expiratory bacterial filters on the ventilator is not
recommended.
However, if a bacterial filter is used on the expiration side, an
undesirable increase in breathing resistance may occur.
Especially during medicament nebulisation and humidifying,
the resistance of the bacterial filter may increase gradually.
For the patient, the effect may be increased breathing effort
and intrinsic PEEP.
If PEEP is unacceptably high, the unit signals the
»!!! PEEP high« alarm.
The current PEEP is then approximately 8 mbar higher than
the PEEP set.
● Check the bacterial filter and replace it if it is the cause of
the PEEP alarm.
Note on the use of heat and moisture
exchangers
The use of a heat and moisture exchanger (HME) in the patient
connection of the Y-piece can considerably increase breathing
resistance.
An increase in breathing resistance will in turn lead to greater
effort in spontaneous breathing and/or greater trigger effort
during assisted ventilation. Under unfavourable conditions, an
increase in breathing resistance can lead to an unwanted
intrinsic PEEP.
This breathing resistance in the patient connection cannot be
directly monitored by the ventilator.
Therefore:
● The condition of the patient and the ventilator's measured
values for air volume must be checked more frequently.
● Follow the Instructions for Use of the heat and moisture
exchanger (HME).
● Do not use the heat and moisture exchanger (HME)
together with a medicament nebuliser or humidifier!
This can increase the breathing resistance.
● The inspiratory breathing gas is warmed by the built-in
blower. To ensure appropriate cooling of the breathing
gas, the total length of the inspiratory hoses must be
not less than 1.2 m. If shorter hoses are used, the
breathing gas temperature at the Y-piece may exceed
the permissible limit, thus putting the patient at risk.
90
Flow
1
t
04037624
1 An intrinsic PEEP can be recognised by the fact that the
expiratory flow does not return to "0" before the end of
expiration.
Preparation
Positioning the humidifier
Depending on the desired position of the ventilator in relation
to the bed, the hinged arm can be fitted to either side of the
machine.
Attachment on right-hand side:
● Turn both ports to the left.
● Turn Aquapor to the left.
The following description applies when the ventilation hoses
have been attached to the left-hand side.
For ventilating infants
● Use a suitable humidifier, e.g. Fisher & Paykel MR 730 with
humidifier chamber MR 340
and
● use suitable ventilation hoses, see Order List on page 142.
If using heated paediatric hoses with internal hot wires,
please note:
In the event of Savina failure, the patient can continue
breathing through the inspiratory relief valve. Due to the
small internal diameter of the ventilation hoses, increased
breathing resistance is to be expected.
Fitting the Aquapor humidifier
● Aquapor should only be used at ambient temperatures
below 30 oC, to avoid the risk of overheating of the
breathing gas in the event of Aquapor failure.
● Prepare Aquapor in accordance with the separate
instructions for use.
● Monitor the breathing gas temperature.
1 Hang the Aquapor with a bracket to the mounting and
tighten the screws.
2 Insert elbow connector into Aquapor.
3 Insert double nozzle into elbow connector.
● Fill Aquapor tank with sterile distilled water to the upper
level.
3
2
● Do not use an additional heat and moisture exchanger
1
03037624
(HME) at the same time as a humidifier.
Risk of increased breathing resistance because of
condensation.
91
Preparation
Connecting the ventilating hoses
Do not use anti-static or conductive hoses*.
1 Hang the hinged arm from the rail on the left-hand side
and tighten screws.
● Push bacterial filter on to inspiration port.
● Connect ventilation hoses, and note length of hoses
(in metres).
● The total length of the inspiratory hoses between
Aquapor and the Y-piece must be not less than 1.1 m,
to avoid the risk of overheating the breathing gas.
2 Turn ports in direction of hoses.
3 Install water traps in vertical position at the lowest point
of their hose lines.
● Connect the Y-piece, with the rubber sleeve of the Y-piece
on the inspiratory side.
● Insert Y-piece into bracket of hinged arm.
1
2
2
0,6m
0,4m
0,6m 3
0,6m
0,6m
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3
Fitting the Fisher & Paykel humidifier
● Prepare the humidifier in accordance with the separate
instructions for use.
1 Hang the humidifier with bracket to the humidifier holder
rail and tighten the screws.
● Do not use an additional heat and moisture exchanger
(HME) at the same time as a humidifier.
Risk of increased breathing resistance because of
condensation.
11137624
1
*
92
DIN VDE 0750 Part 215:
The use of anti-static or electrically conductive material in the
breathing system of the lung ventilator is not considered to
contribute any improvement in safety. On the contrary, the use
of these materials increases the danger of electric shock to the
patient and of fire due to the presence of oxygen.
Preparation
Fitting ventilation hoses
1 Hang the hinged arm with a bracket to the rail on the
left-hand side, and tighten the screws.
● Push bacterial filter on to inspiration port.
● Connect the ventilation hoses as described in the
Instructions for Use of the humidifier, and note their
length (in metres).
● Do not use shorter ventilation hoses than specified,
to avoid the risk of overheating the breathing gas.
1
0,4m
1,1m
03637624
1,2m
Electrical power supply
The ventilator is designed for a mains voltage of:
100 V to 240 V, 50/60 Hz
10237624
The built-in power adapter of the Savina automatically adapts
to the mains supply.
● Insert the plug into the mains socket.
93
Preparation
Connecting to DC on-board network or external battery
Note requirements for external battery, see "Technical Data",
page 132 onwards.
● Only rechargeable batteries should be used.
The charging function of the DC power supply may cause
non-rechargeable batteries to explode during mains use.
● Do not connect DC power supplies to the DC socket.
● Connect external battery to device via DC battery cable S
(84 14 092) or connect DC on-board network to device via
DC on-board network cable S (84 14 048).
The plug on the connecting cable that plugs into the Savina
is coded. This enables Savina to detect whether an external
battery or a DC on-board network is connected.
● Ensure polarity is correct.
black = –
red = +
If an external battery or DC on-board network is wrongly
connected, the device will ignore it.
● For on-board operation, connect to on-board power
supply.
● Before transport, check that the external battery is
sufficiently charged.
See "Mains and Battery Operation" page 104 onwards.
Internal batteries
In the event of a mains power failure and if the external battery
is discharged or not connected or in the event of failure of the
DC on-board network, Savina automatically switches over to
power from its own internal batteries.
● Before transport, check that the internal battery is
sufficiently charged.
See "Mains and Battery Operation" page 104 onwards.
94
02537624
● Insert plug into DC socket on rear of device.
Preparation
O2 supply*
Compressed O2 must be free of dust and oil and must
be dry. Gas pressure must be 2.7 to 6 bar.
Only compressed O2 supply sources with 100 % O2 should
be used.
Brief interruptions to the concentration will cause incorrect
calibration.
● Screw the O2 hose on to the side of Savina. Connect up O2
from the medical gas pipeline system or an O2 cylinder.
In the case of a supply from an O2 cylinder, the reserve gas
should be calculated. See "Expected operating time when
using an O2 cylinder supply".
A 90o connector is available for the O2 threaded
connection on the device; see order list.
05337624
Due to the mixing process the set concentration is not
available immediately.
The mixing process may take longer with minute volumes less
than 2 L/min.
The »!!! FiO2 high« or »!!! FiO2 low« alarm indicates that the
O2 concentration set has not yet been reached.
Expected operating time when using an O2
cylinder supply
When using an increased O2 concentration (greater than
21 % by vol.) Savina ventilates with a mixture of air (delivered by
a blower) and O2.
When using an O2 cylinder supply, the maximum possible
operating time depends on the O2 reserve (as well as on the O2
concentration and the ventilation parameters).
For example:
Cylinder pressure measured at the pressure regulator on the
O2 cylinder: 200 bar
O2 cylinder capacity: 3 L
O2 reserve: 200 bar x 3 L = 600 L
Expected operating time with the following parameters:
— Ventilation mode
: IPPV
— Frequency »f «
: 10 bpm
— Tidal volume »V T«
: 600 mL
— Minute volume »MV«
: 10 bpm x 0.6 L = 6 L/min
— Selected O2 concentration
»O2«
: 50 % by vol. = O2 fraction: 0.5
The device allows for the O2 concentration of 21 % by vol. in the
air.
*
If LPO mode is active, see page 40.
95
Preparation
Expected operating time
=
Gas reserve [L]
(O2 fraction – 0.21) x MV [L/min]
=
600 L
(0.5 – 0.21) x 6 L/min
=
600
0.29 x 6
= approx. 340 min
= approx. 5.6 h
With a higher O2 concentration, the operating time is reduced
accordingly.
Once the reserve O2 from the cylinder has been used up, the
O2 concentration is reduced to 21 % by vol. Otherwise, the
ventilation parameters are unchanged.
● Do not place any liquid container (e.g. infusion
container) above or on top of Savina.
Any leak, spill or seepage could prevent it working
properly, and endanger the patient.
96
Preparation
Nurse call system
Optional
Connection for transmitting alarm signals to a central alarm
system at the hospital can be found at the rear of Savina.
● Installation of the supplementary equipment should be
5
carried out by experts.
● The 6-pin round plug (female) should be connected to the
clinic-internal central alarm by experts.
● Push the plug into the »
02237624
3
When Savina displays an alarm message, the connection 3-5 is
closed and the nurse call system is active.
1
« socket at the back and screw
in tightly.
Only Warnings (top priority alarm signals, see page 33)
will be transmitted.
1
5
3
Warning messages appear with 3 exclamation marks in the
upper line on the screen; see page 33. Caution and advisory
messages will not be transferred. The nurse call system will
also be activated when the original alarm tone device is
defective.
● Test the connected nurse call system for proper
functioning.
02337624
The installation of the nurse call system does not replace
the regular Savina screen surveillance.
● Regularly check on-screen messages.
A fault in any component of the connection between
nurse call and the hospital alarm system (for instance,
in the Savina nurse call electronics, in the Savina power
unit, in the hospital alarm system alarm transmitter, etc.)
can cause the nurse call system to fail.
Hospital central alarm system connections are usually singlechannel design. The nurse call electronics are therefore also
single-channel design.
Technical data
Potential-free DC contact
Input voltage
Input current
Switching power
max. 40 V =
max. 500 mA
max. 15 W
97
Preparation
Checking readiness for operation
● to be carried out after preparation.
The following functions are tested during this check:
— Operation of lamps/LEDs, displays and the audible alarm
— Ventilation function
— PEEP function
— Expiratory volume measurement MV
— Measurement of inspiratory O2 concentration FiO2
— Lower alarm limit MV
— Upper alarm limit Paw
— Mains power failure alarm
— O2 alarm
Switching on
● To switch on = power switch on the back panel of the
device to » «.
Savina runs through its self-test procedure.
● Wait for up to 20 seconds for the test phase to be
completed.
Savina automatically matches the speed of its blower to the
patient’s gas requirement. A slight whine may be heard
temporarily at the start of ventilation or when setting the
ventilation parameters.
Checking the lamps and audible alarm
At the end of the test phase of up to 20 seconds, the device
activates all the LEDs, all the lamps in the keys, and the trigger
and power supply lamps. The audible alarm is tested briefly.
The lamp indicating the power source in use at any given time
is lit continuously.
98
03537624
Connecting test lung
The test lung consists of a mask elbow for connection to the
Y-piece, a 7 mm diameter catheter connector to simulate the
resistance of the airway, and a 2-litre breathing bag 84 03 201
to simulate lung compliance.
● Attach mask elbow to patient connection of Y-piece.
Preparation
Testing the ventilation function
1 Ventilation mode »IPPV«
2 »V T« 800 mL
3 »Tinsp« 2 s
4 »f« 10 bpm
5 »O2« 60 vol.% (only in HPO mode)
6 »PEEP« 10 mbar
7 »Trigger« 5 L/min (in screen »Settings 1/1«)
● »FlowAcc« 35 mbar/s (in screen »Settings 1/1«)
● »Pmax« (in screen »Configuration 2/4«)
● »Plateau« (in screen »Configuration 2/4«)
● LPO mode OFF (in screen »Configuration 2/4«)
D
Savina
2
3
4
5
7
6
8
1
Savina ventilates the test lung using the ventilation pattern set.
03737624
8 Press »Values ∆∆« key to select »Values 1/2«
The bar display on the screen shows the inspiratory
pressure and the end-expiratory pressure, alternating
between inspiration and expiration.
PEEP display:
PEEP 10 mbar
±2 mbar tolerance
Minute volume display:
MV 7.8 L/min
±1.0 L/min tolerance
073 37625
O2 concentration display:
(only in HPO mode)
FiO2 60 Vol.%
±3 vol.% tolerance
● Detach test lung from Y-piece
The following message is displayed:
»!!! Airway pressure low«.
Display after about 45 seconds:
MV 0 L/min
+0.5 L/min tolerance
● Reconnect test lung to the Y-piece.
99
Preparation
Checking mains power failure
● Disconnect mains plug, or disconnect DC supply plug.
The device switches over to the internal battery and
continues ventilating.
Display:
»!! Int. battery activated«
Wait about 30 seconds. The remaining capacity display (on
the main screen page) shows the internal battery charge level,
see page 107.
● Reconnect mains plug or DC supply plug.
Checking the O2 alarm (only in HPO mode)
● Disconnect O2 compressed gas hose connector:
Intermittent audible alarm and display:
»!!! O2 supply down«
Savina ventilates with air.
● Reconnect O2 compressed gas hose connector.
A warning »!!! FiO2 low« may appear briefly.
● Press »Alarm Reset«.
After successful testing of readiness for operation, Savina is
ready to use.
● Do not use device unless all the test steps have been
completed.
Moving Savina around the hospital
Do not tilt apparatus on trolley with attached accessories
more than 5o.
Otherwise it may become unstable.
For greater stability, move accessories into their optimal
position for transportation:
● Move hinged arm to its smallest extension.
● Close the drawers.
● Keep hoses as close to the trolley as possible.
● Hang the humidifier on the trolley, do not attach to the
apparatus.
● In this condition, stability is preserved even when tilted
at 10o.
100
Preparation
Checklist
● To be carried out every time before using the device.
Device is complete and ready for operation.
The test lung is connected.
What
How
What should happen
Operation of lamps/
Switch device on:
LEDs and audible alarm
All lamps (except the lamps for power supply)
and LEDs light up, audible alarm sounds.
Operation of audible
alarm for mains power
failure
Hold down »Alarm Reset« for about
3 seconds:
Audible alarm sounds.
"Apnoea" alarm
Set ventilation mode CPAP,
set PEEP 10 mbar,
steadily inflate and deflate the test lung to
simulate spontaneous breathing, then stop
simulation:
At the end of the apnoea alarm time TApnoea,
audible alarm sounds, the warning »!!! Apnoea«
appears on the screen.
Press »Alarm Reset«.
"PEEP high" alarm
Set ventilation mode IPPV, set Paw
100 mbar, keep flow sensor tight:
to
Airway pressure is reduced, audible alarm
sounds, red lamp flashes, the warning
»!!! PEEP high«
appears on the screen
Press »Alarm Reset«.
"Airway pressure high"
alarm
If AutoFlow is active: switch off AutoFlow.
Set pressure limit Pmax to OFF, set Paw
below the current max. airway pressure:
Audible alarm sounds. The warning
»!!! Airway pressure high« appears on
the screen.
Set Paw
to 100 mbar.
Press »Alarm Reset«.
If necessary, set pressure limit Pmax to ON.
"MV low" alarm
Set MV
higher than the current MV
measured value:
Audible alarm sounds, the red alarm lamp
flashes, the warning »!!! MV low« appears on
the screen.
Set MV
lower than the current MV
measured value again.
Press »Alarm Reset«.
Tightness of breathing
system
Set high flow acceleration FlowAcc, press and
hold down the »Insp. hold« key and observe
pressure curve:
Plateau pressure remains constant.
When the check has been completed successfully, Savina is
ready for use.
● Do not use device unless all the test steps have been
completed.
● Adapt all settings and alarm limits to hospital’s values.
101
102
Mains and Battery Operation
Active power supply indicator . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 104
Use of power sources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 104
Mains power operation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 105
Operation with external battery or with DC on-board network . . . . . . . . . . . . . . . . 105
Operation with internal battery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 106
103
Mains and Battery Operation
Mains and Battery Operation
Active power supply indicator
The power supply status is shown by three LEDs to the right
of the rotary knob.
1 Mains power supply LED »N«
2 DC on-board network LED »ext. J«, e.g. in ambulance
or helicopter, or external battery, e.g. on trolley
3 Internal battery LED »int. J«
N 1
ext.
int.
J 2
J 3
LED colour code
Power source is available,
battery is charging or trickle charge is active.
Yellow: Power source is available,
battery is charging
Off:
Power source is not available,
battery is not charging
Red:
Excessive temperature or excessive voltage
Use of power sources
Savina automatically prioritises the use of power sources.
Mains power:
If mains power is available, Savina automatically switches to
mains power supply and charges the internal and external
batteries.
External battery or DC on-board network:
In case of mains power failure, if DC voltage is connected
Savina automatically switches over to the external battery or
the DC on-board network.
Internal battery:
If neither mains power nor an external battery nor the
DC on-board network is available.
● Machine must always be sited in a well-ventilated area
when connected to mains power.
Electrolytic gas can occur when the external battery is
charging. In the right concentration, this can cause an
explosion.
104
09437624
Green:
Mains and Battery Operation
Mains power operation
Display (example):
1 Savina on mains power: LED »N« shows steady green.
2 External battery not yet fully charged:
middle LED »ext. J« shows steady yellow.
3 Internal battery fully charged: bottom LED »int. J« shows
steady green.
N 1
ext.
int.
J 2
J 3
05537624
Both batteries charge automatically when operating on mains
power.
Savina automatically detects the external battery voltage
(12 V or 24 V).
Once the respective battery is fully charged, trickle charging
takes place:
Savina charges the battery to compensate for spontaneous
discharge.
Operation with external battery or with
DC on-board network
In the event of mains power failure, Savina switches over
without interruption to the external DC voltage connected.
There are two supply modes:
— Supply from the external battery
or
— Supply from DC on-board network
Savina detects whether an external battery or the DC on-board
network is connected (see page 94). This prevents Savina
charging the DC on-board network.
Display (example):
4 No mains power:
top LED »N« is out.
5 Supply from external battery:
middle LED »ext. J« shows steady green.
N 4
ext.
int.
J 5
J 6
05637624
6 Internal battery fully charged:
bottom LED »int. J« shows steady green.
105
Mains and Battery Operation
Total operating time with an external battery depends on the
charge level and type of battery connected. For details of
operating time, refer to "Technical Data" on page 137.
If the external battery is discharged or if there is no
DC on-board network, Savina switches over to the internal
battery.
See "Operation with internal battery" on page 106.
If mains power is restored, Savina automatically switches back
to mains power and charges both batteries.
The on-board network only charges the internal battery while
Savina is switched on.
Operation with internal battery
In the event of mains power failure when no external battery is
connected or if the external battery is discharged or in case of
failure of the DC on-board network, Savina switches over
without interruption to the internal battery and is able to supply
the machine for a length of time that depends on the charge
level. For details of operating time, refer to "Technical Data" on
page 137.
Display:
The following caution message appears on switching over
automatically to the internal battery:
»!! Int. battery activated«
● To acknowledge message, press »Alarm Reset«.
The following advisory message continues to be displayed:
»! Int. battery activated«
106
N
ext.
int.
1
J 2
J 3
05737624
1 No mains power: top LED »N« out.
2 No external battery or no DC on-board network:
middle LED »ext. J« out.
3 Supply from internal battery: bottom LED »int. J«
shows steady green.
Mains and Battery Operation
Battery level display
About 15 seconds after switching over to the internal battery,
a battery charge display (remaining capacity display) is
activated.
— The internal battery charge level is displayed on the main
screen page as hatching within a battery symbol. This
indicator can be used to assess the remaining operating
time for Savina.
13337625
Remaining capacity is only displayed when operating from
the internal battery.
The battery charge symbol is not displayed when operating
from the external battery.
The remaining capacity display follows an even course during
constant ventilation (constant blower speed). For example,
a change in the reading from 70 % to 50 % takes roughly the
same time as a change in the reading from 30 % to 10 %.
An uneven course over time indicates that the battery
is insufficiently charged or defective.
In this case, the remaining capacity can be expected
to be used up at any moment.
When the remaining capacity reaches 30 % and 20 %
respectively, a warning
»!! Int. battery low«
is triggered.
This can be acknowledged by pressing »Alarm Reset«.
If the remaining capacity falls below 10 %, the
»!!! Int. batt. almost discharged«
warning appears.
13237625
● Immediately reconnect Savina to the mains power supply,
a charged external battery or vehicle DC on-board network,
to prevent any interruption to ventilation.
If the »!!! Int. batt. almost discharged« warning appears,
then Savina will stop working at any moment.
107
Mains and Battery Operation
Notes on running time when operating from the internal
battery
The total running time is the time from switching over to the
internal battery until device failure.
Total running time depends on the internal battery charge
level. For the total running time of a new, fully charged battery,
see page 137.
To ensure a long total device running time, do not set
»FlowAcc« to unnecessarily high values in battery operation.
Total running time depends on the blower speed. Upon
switching over to the internal battery, a speed limit is activated
which reduces the flow delivery capability.
Remaining capacity may be rapidly reduced if the blower is
under increased load, e.g. due to increased ventilation
pressure.
When the blower is under reduced load, the remaining
capacity may be increased due to physical effects on the
battery. This extends the total device running time.
If remaining capacity of considerably less than 100 % is
indicated on changing over to the internal battery, the
internal battery was not sufficiently charged beforehand or
has exceeded its life. If the internal battery has not been
used for some time and its capacity is reduced, battery
capacity may be restored by one or two cycles of allowing
it to discharge almost totally then charging it fully.
After operating Savina with the internal battery
● Reconnect Savina to the mains supply to fully charge the
internal battery again and the external battery, if connected.
While Savina is switched on, the internal battery is charged by
the external battery or the on-board network. When Savina is
switched off, charging only takes place if connected to the
mains supply.
For charging times, refer to "Technical Data" on page 138.
● Always ensure the internal battery is charged with mains
power or from the DC on-board network. The internal
battery powers the two O2 sensors, even while Savina is
switched off. Savina thus delivers valid O2 readings even at
switch-on. When the internal battery is discharged, Savina
does not provide any O2 readings for the first 20 minutes
after switching on. O2 mixing operates at reduced accuracy
during this time.
108
Description
IPPV . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 110
Flow Acceleration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 110
Pressure limiting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 110
IPPVAssist . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111
Sigh (intermittent PEEP) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111
AutoFlow® (optional) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 112
SIMV . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 114
ASB . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 115
BIPAP (optional) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 116
Automatic leakage compensation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 117
NIV – Non-invasive ventilation (optional) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 118
LPO – Low Pressure Oxygen mode (optional) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 120
LPO flow setting diagram . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 121
Bibliography . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 122
109
Description
Description
IPPV
Volume-constant mandatory ventilation stroke
The ventilation pattern is specified by the settings for tidal
volume V T, frequency f, inspiration time Tinsp, PEEP, and
FlowAcc.
Paw
with plateau
Tplat
FlowAcc
At the end of the flow phase, the expiration valve remains
closed until the end of the inspiration time Tinsp. This phase,
the inspiratory pause, can be identified as the plateau Pplat
in the curve Paw (t). The values for plateau pressure Pplat and
plateau time Tplat are shown on Values screens 1/2 and 2/2.
FlowAcc
Pplat
PEEP
t
Tinsp
Te
T= 1
f
Flow
t
045 37625
When the plateau is turned off Savina immediately changes to
expiration as soon as the set tidal volume V T is applied. In this
case the inspiration time is not adjustable, but it is the result of
the compliance and resistance of the patient’s lungs together
with the set values tidal volume V T and flow acceleration. The
value for Tinsp is shown on Values screen 2/2. Savina
establishes a minimum expiration time of 500 ms and limits the
resulting I:E ratio to max. 4:1.
without plateau
Flow Acceleration
With the parameter »FlowAcc« the pressure and flow increase
can be influenced. A greater Flow acceleration produces a
steeper pressure and flow increase. Flow acceleration (and
the inspiration time) can be used to adapt the pressure and
flow curve to suit the individual patient’s needs.
Pressure limiting
Pressure Limited Ventilation (PLV)
Savina can limit the peak pressure in IPPV, IPPVAssist and
SIMV and SIMV/ASB modes. The »Pinsp« ventilation
parameter is used to set the limit.
The value of Pinsp remains effective until Savina has applied
the set tidal volume V T or until the inspiration time has elapsed.
If the set tidal volume V T cannot be delivered with the set
values, a »! Tidal volume low« alarm will be displayed.
Paw
Pinsp
Tinsp
110
Te
11737624
t
Description
IPPVAssist
Assisted ventilation with continuous positive airway pressure.
The mandatory ventilation stroke begins when the patient
reaches an inspiratory flow corresponding at least to the flow
trigger set.
The current ventilation frequency may be greater than the set
frequency for the same trigger.
Sigh (intermittent PEEP)
Paw
Sigh phase
interm.
PEEP
PEEP
t
111
038 37628
"Sigh", in the form of intermittent PEEP, is operative in IPPV
and IPPVAssist modes.
The purpose of the expiratory sigh during ventilation is to open
collapsed areas of the lung, or to keep open "slow" areas of
the lung.
Since atelectatic alveoli have a longer time constant – also
caused by obstructed bronchioles – increased airway
pressure maintained over a longer period is required to
open them.
In many cases, the sigh function is achieved by increasing
the ventilation stroke; however, due to the short time available,
this form of sigh only marginally improves the filling of the
"slow" alveoli.
In Savina, the sigh operates during expiration with an
intermittent PEEP. It is set relative to PEEP (∆ sigh).
The average airway pressure is higher, and a longer filling
time is normally available.
When the sigh is activated, the end-expiratory pressure
increases every 3 minutes by the intermittent PEEP set
for 2 ventilation strokes.
Description
AutoFlow® (optional)
The AutoFlow function can be activated in the »Settings«
menu.
FlowAcc
high
FlowAcc
FlowAcc
low
Pplat
Paw >
Pmax
FlowAcc
PEEP
Always set the alarm limit »Paw
« as well as »V T
« in
order to set off an alarm in the event of an increase in
airway pressure or tidal volume V T with change of
compliance.
t
Te
Tinsp
1
f
Flow
VT
t
Typically, the selected inspiration time Tinsp is noticeably
longer than the filling time of the lungs. The inspiration
pressure Pinsp corresponds to the minimum value resulting
from both tidal volume V T and compliance C of the lungs.
without spontaneous breathing
024 37625
With AutoFlow, the inspiration flow is automatically adjusted to
changes in lung conditions (C, R) and to the spontaneous
breathing demand of the patient.
Paw
with spontaneous breathing
Savina automatically controls the inspiration flow so that there
is no pressure peak caused by the resistances of the tube and
the airways. The plateau pressure Pplat varies with changes in
compliance C, as is normal in all constant-volume ventilation
strokes. With AutoFlow, these variations occur in maximum
steps of 3 mbar between ventilation strokes. The plateau
pressure Pplat is automatically limited by the pressure
limitation Pmax = Paw
–5 mbar.
If the tidal volume V T is reached (inspiration flow = 0) before
the inspiration time has elapsed, the patient can breathe in and
out during the remaining inspiration time at the level of the
plateau pressure Pplat.
If the patient breathes in or out during mandatory inspiration,
the plateau pressure Pplat is not changed for this ventilation
stroke. Only the inspiration and expiration flow are adapted to
the patient’s demand. The individually applied tidal volume V T
may differ from the set tidal volume V T in specific ventilation
strokes, but on average over time a constant tidal volume V T is
supplied.
A set inspiration time Tinsp which is shorter than the filling time
of the lungs can be recognized from the flow curve: the flow at
the end of the inspiration time has not yet returned to zero. The
»! Tidal volume low« or »!! Tidal volume low« alarms indicate
that the settings selected do not permit full delivery of the tidal
volume V T. It must now be decided whether the current
condition of the patient permits prolongation of the inspiration
time Tinsp or an increase of the flow acceleration, in order to
apply the set tidal volume V T.
112
Paw
Paw >
Pplat
PEEP
t
Tinsp
Te
1
f
Flow
VT
t
without spontaneous breathing
with spontaneous breathing
033 37625
The exceeding increase of the tidal volume V T can be
restricted by the alarm limit »V Ti
«. If the set alarm limit is
exceeded one time, Savina sets of an advisory message (!);
if the alarm limit is exceeded three times, Savina sets of a
warning message (!!!). The volume is actively limited to the
alarm limit value »V Ti
« by switching over to the PEEP level.
Description
A stenosis can also cause the filling time of the lungs to
become longer than the set inspiration time Tinsp.
Starting behavior of AutoFlow
Upon switching on the function AutoFlow Savina applies
the set tidal volume V T using a volume-controlled breathing
stroke.
The plateau pressure Pplat derived from this breathing stroke
serves the function AutoFlow as starting value for the
inspiration pressure.
Settings to suit the patient’s needs
The Start of the mandatory inspiration can be synchronized
with the patient’s inhalation effort with the help of the variable
flow trigger. The flow trigger can only be completely turned off
in IPPV (IPPVAssist –> IPPV).
The steepness of the pressure increase from PEEP level to the
inspiration level can further be adapted with the ventilation
parameter FlowAcc in SIMV, BIPAP, CPAP/ASB and IPPV
to suit the patient’s needs.
113
Description
SIMV
Synchronized Intermittent Mandatory Ventilation
Combination of mandatory ventilation and spontaneous
breathing.
Paw
This minimum ventilation is defined by two set values, tidal
volume (V T) and ventilation frequency (f). The minimum
ventilation is the product of V T x f.
The ventilation pattern is set by the ventilation parameters
tidal volume V T, frequency f, inspiration time Tinsp and flow
acceleration FlowAcc.
To prevent the mandatory ventilation stroke being applied
during spontaneous expiration, the Flowtrigger of the machine
ensures that the ventilation stroke is triggered within a "trigger
window" and synchronised with the patient's spontaneous
inspiration.
The "trigger window" is no longer than 5 seconds. If the
expiration times are less than 5 seconds, the trigger window
covers the entire expiration time, less a minimum expiration
time of 500 ms.
Since the synchronisation of the mandatory ventilation stroke
reduces the effective SIMV time and therefore would normally
result in an undesirable increase in the effective IMV
frequency, Savina adds in the reduced SIMV time by
prolonging the subsequent spontaneous breathing phase by
the SIMV time difference ∆ T – thus preventing an increase in
SIMV frequency. The frequency parameter f remains constant.
This parameter, in combination with the tidal volume V T, sets
the minimum ventilation. If the patient has breathed in a
considerable inspiratory volume at the beginning of the trigger
window, the machine reduces the subsequent mandatory
ventilation stroke by shortening the time for the inspiratory flow
phase and the inspiration time. In this way, the tidal volume V T
remains constant, and over-inflation of the lungs is avoided.
During the spontaneous breathing phases, the patient can be
assisted by ASB pressure support.
In the course of progressively weaning the patient from
artificial ventilation, the ventilation frequency f is further
reduced while the spontaneous breathing time is increased,
so that the required total minute volume is supplied more and
more by spontaneous breathing.
The ventilation frequency can be reduced to 2/min.
114
FlowAcc
FlowAcc
PEEP
Trigger
window Tinsp spontaneous
breathing time
set IMV time
1
f
t
spontaneous
breathing time
+ T
set IMV time 1
f
041 37625
SIMV enables the patient to breathe spontaneously in regular
prescribed intervals between mandatory ventilation strokes
that ensure a minimum ventilation.
synchronised
mandatory
ventilation stroke
unsynchronised
mandatory
ventilation stroke
Description
ASB
Assisted Spontaneous Breathing
Pressure support for insufficient spontaneous breathing.
The function of the machine in assisting insufficient
spontaneous breathing is similar to that of the anaesthetist
who manually assists and monitors the patient's spontaneous
breathing by feeling the breathing bag.
FlowAcc
The machine takes over part of the inhalation function, with
the patient maintaining control of spontaneous breathing.
The CPAP system supplies the spontaneously breathing
patient with breathing gas, even if the inspiration effort is
weak.
042 37625
The pressure support of the ASB system is started:
— when the spontaneous inspiration flow reaches the set
value of the Flowtrigger,
or at the latest
— when the spontaneous inspired volume exceeds 25 mL.
The machine then produces an increase in pressure up to
the preselected ASB pressure ∆ PASB above PEEP, which is
adjustable to the breathing requirement of the patient.
The flow supply can be adjusted using »FlowAcc« to meet the
individual needs of the patient.
— In case of high flow acceleration
Savina supports the insufficient spontaneous breathing
of the patient with a high peak flow.
— In case of low flow acceleration
Savina begins smoothly with even inspiratory flow.
ASB is terminated:
— when the inspiration flow returns to zero during phase I,
i.e. when the patient exhales or fights the ventilator,
or
— when the inspiration flow in phase II falls below 25 % of
the last inspiration flow supplied (∆ PASB above PEEP is
thus reached)
or
— at the latest after 4 seconds if the two other criteria have
not come into operation.
If this time criterion occurs, the advisory message
»! ASB > 4 s« is displayed.
If this time criterion occurs three times in succession,
Savina displays a warning message »!!! ASB > 4 s« and
warns of a possible leak in the ventilation system.
In »Mask/NIV« mode the »Tinsp« key is used to set the
maximum duration of the ABS stroke.
115
Description
BIPAP (optional)
Biphasic Positive Airway Pressure
The BIPAP ventilation mode is a pressure-controlled/timecycled ventilation mode in which the patient can always
breathe spontaneously. BIPAP is therefore often described
as a timed alternation between two CPAP levels.*
The time-cycled change of pressure produces controlled
ventilation corresponding to the pressure-controlled ventilation
PCV. However, the constant option of spontaneous breathing
allows the transition from controlled breathing to independent
spontaneous breathing to take place smoothly over the course
of the weaning phase, without requiring any change in the
ventilation mode. To adapt easily to the patient's spontaneous
breathing pattern, the change-over from expiratory pressure
level to inspiratory pressure level, and also the change-over
from inspiratory pressure level to expiratory pressure level, are
synchronised with the patient's spontaneous breathing.
The frequency of the change-over is kept constant, even with
patient synchronisation, by defining a trigger time window with
a fixed time constant.
This smooth adaptation to the patient's spontaneous breathing
requires less sedation, so that the patient returns to
spontaneous breathing more rapidly.
As in all pressure-controlled ventilation modes, the patient is
not prescribed a fixed tidal volume (V T). The tidal volume
results principally from the pressure difference between the
settings for PEEP and Pinsp and also lung compliance.
The display of the tidal volume measured on expiration, V Te, is
used to set the required difference between the two pressure
levels. Any increase in this difference will cause an increased
BIPAP ventilation stroke.
Changes in lung compliance and airways, as well as active
"fighting" by the patient can lead to changes in tidal volume.
This is a desired effect in this ventilation mode.
With the knowledge that the tidal volume, and therefore the
minute volume, are not constant, the alarm limits for minute
volume must be adjusted with care.
*
Bibliography (1), (2), (3), page 122.
116
Description
When switching over from volume controlled ventilation to
BIPAP mode – while retaining the time pattern – only the Pinsp
setting needs to be changed.
The steepness of the pressure increase is controlled by the
»FlowAcc« setting.
During the lower pressure level phase, spontaneous breathing
can be assisted by ASB.
The steepness of the pressure increase to ASB pressure
∆ PASB above PEEP is also controlled by the »FlowAcc«
setting.
The transition from controlled ventilation via the weaning
phase to fully spontaneous breathing is achieved by a
gradual reduction of the inspiratory pressure Pinsp and/
or frequency f.
Paw
mandatory
BIPAP stroke spontaneous breathing
synchronised
BIPAP stroke
FlowAcc
PEEP
Trigger
window
t
Tinsp
026 37625
Using BIPAP
As with SIMV, the time pattern is set using the basic setting
parameters of frequency f and inspiration time Tinsp. The
lower pressure level is set with the PEEP parameter, while
the upper level is set with Pinsp.
1
f
Automatic leakage compensation
Savina determines the difference between the inspiratory
metered flow and the expiratory measured flow. The difference
provides an indication of the extent of leakage and is
designated leak minute volume, MVleak. The leak minute
volume MVleak is taken into account for trigger detection, for
optimum synchronisation of the ventilator with the patient.
Automatic leakage compensation for trigger detection
In order to synchronize with the patient’s efforts to breathe in
and out, Savina detects volume and flow values caused by the
patient. In order to optimize synchronisation, the measured
flow values are automatically corrected to take account of the
leakage flow, up to a maximum of 10 L/min.
Monitoring leakage
In »Tube« mode if Savina detects a major leak in the system,
the message »! Leakage« appears. In this case the tube and
patient hose system connections should be checked for
tightness.
117
Description
NIV – Non-invasive ventilation (optional)
With the NIV option, Savina offers an application mode
optimized for non-invasive ventilation using a nose or face
mask. Greater leakage generally occurs with non-invasive
ventilation than with ventilation via a tube. In »Mask/NIV«
mode, therefore, automatic leakage compensation for trigger
detection, alarms and monitoring are adjusted to these special
conditions. Additionally, in volume-controlled ventilation modes
Savina automatically compensates for volume lost due to
leaks.
Automatic leakage compensation for trigger detection
As with invasive ventilation with Savina, automatic leakage
compensation takes place with respect to the trigger criteria in
»Mask/NIV« mode. Savina takes account of leakage up to
25 L/min for trigger detection purposes.
Alarms
During non-invasive ventilation in »Mask/NIV« mode, some
alarm limits are not needed in certain circumstances or cannot
be monitored due to big artefacts. For example, in the case of
very big leaks it is often not possible to measure any expiratory
minute volume. If this alarm were not switched off, the device
would generate alarms all the time. The following alarms can
therefore be deactivated in »Mask/NIV« mode:
— Minute volume low
— Tidal volume high
— Apnoea detection.
Non-invasive ventilation with the alarms switched off is only
permissible if the patient’s safety is not put at risk.
The »!!! Airway pressure low« alarm can be delayed by up to
60 seconds. This is done by setting a delay time TDisconnect
from 0 to 60 seconds on an additional screen page
»Alarms 2/2«. For example, with a setting of 10 seconds the
patient can remove the mask for up to 10 seconds before
Savina activates an »!!! Airway pressure low« alarm.
Because leaks are normal in non-invasive ventilation, the
messages »! Leakage«, »! ASB >4s« and »!!! ASB > 4s« are
not displayed in this mode.
Monitoring
Savina provides an additional Values page in »Mask/NIV«
mode. Among other things, this shows the leak minute volume
MVleak as a percentage of the measured minute volume.
The tidal volume V Tpat indicates the volume actually reaching
the patient. V Tpat is the delivered tidal volume less the volume
lost due to leakage during inspiration.
118
Description
Automatic volume compensation
If volume-controlled ventilation modes (IPPV, SIMV) are
applied in »Mask/NIV« mode, Savina increases the applied
tidal volume V T by the amount lost due to leakage during
inspiration. If a tidal volume V T of 500 mL has been set and
50 mL are lost during inspiration, Savina will automatically
deliver 550 mL. Because unlimited leakage compensation is
not advisable, Savina compensates for leakage up to 100 % of
the set tidal volume.
119
Description
LPO – Low Pressure Oxygen mode (optional)
The LPO option allows Savina to be connected to an external
low pressure oxygen source, such as an O2 concentrator.
Savina can thus operate independently of a piped compressed
air supply and also independently of an O2 supply system. The
oxygen required is generated by the O2 concentrator. The
compressed air needed is delivered by the internal blower
inside Savina.
The oxygen flow from the O2 concentrator is fed directly into
the mixing chamber via the LPO inlet valve at the rear of
Savina. A mixture of oxygen and air is then created in the chamber for supply to the patient.
O2 monitoring
The gas mixture is drawn from Savina’s mixing chamber in time
with the ventilation strokes, at the rhythm of the ventilation frequency. The oxygen from the O2 concentrator is fed in at a
constant flow, however. This leads to a range of variation of the
O2 concentration in the mixing chamber. This depends on the
following factors:
— Ventilation settings
— Lung parameters
— O2 concentrator flow
The resulting range of variation is indicated as an additional
tolerance (+/–) for the measured value FiO2. With small tidal
volumes, the tolerance reading is small and with large tidal
volumes, correspondingly greater.
O2 calibration
Both the O2 sensors on Savina are calibrated in LPO mode in
ambient air at approx. 21 vol. % O2. The O2 concentration
(approx. 21 vol. %) depends on the air humidity and the temperature. As Savina does not measure the humidity of the ambient air, assumptions are made for the purpose of calibration:
temperature = 25 oC, relative humidity = 50 %.
If the ambient conditions at the time of calibration differ from
these figures, a calibration error occurs. An estimate of this
value is already included in the FiO2 measured value tolerance
displayed.
If the calibration error in LPO mode due to extreme ambient
conditions at the time of calibration is unacceptable, calibration should be carried out in HPO mode with 100 vol. % O2.
This can be done with either oxygen from the medical pipeline
system or with the aid of an O2 cylinder.
120
Description
LPO flow setting diagram
The diagram permits a "rough" estimate for setting the desired
patient O2 concentration. This depends on the concentrator
flow (LPO flow) and the applied minute volume (MV).
100
Estimated O2 concentration (vol. % O2)
90
80
70
60
LPO flow 10 L/min
50
LPO flow 8 L/min
LPO flow 6 L/min
40
LPO flow 4 L/min
30
LPO flow 2 L/min
LPO flow 1 L/min
20
0
2
4
6
8
10
12
14
Measured patient minute volume (L/min)
16
18
20
Example:
What flow has to be set on the O2 concentrator in order to
attain the desired O2 concentration FiO2 = 70 % O2 for the
specified minute volume MV = 7.8 L/min?
Read off from the diagram:
Intersection of MV = 7.8 L/min and FiO2 = 70 % O2
Result: LPO flow = 6 L/min
121
Description
Bibliography
(1) Baum, M., Benzer, H., Putensen, Ch., Koller, W., Putz,G.:
Biphasic Positive Airway Pressure (BIPAP) – eine neue
Form der augmentierenden Beatmung
Anaesthesist 38 (1989), 452-458
(2) Vincent, J.-L.:
Yearbook of Intensive Care and Emergency Medicine
Springer-Verlag 1993
(3) Sydow, M.:
Biphasic Positive Airway Pressure (BIPAP) und Airway
Pressure Release Ventilation (APRV)
in: Kuhlen, R., Guttmann, J., Rossaint, R. (Hrsg.):
Neue Formen der assistierten Spontanatmung
Urban & Fischer 2000
122
What‘s what
Control unit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 124
Front connection block . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 125
Back panel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 126
Abbreviations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 127
Symbols . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 129
123
What's what
What's what
Control unit
20
1
2
D
Savina
Trigger
19
3
Nebul.
O2 Y
18
Suction
17
Insp.
hold
VT
Pinsp
mL L
mbar
Tinsp.
∆PASB
s
above PEEP
f
PEEP
bpm
mbar
g
2 min
Alarm
Reset
Lock
O2
16
Settings
Alarms
Values
Config.
ext.
int.
IPPV
SIMV
10
J
J
O
BIPAP
7
8
9
084 37625
15 14 13 12 11
CPAP
ASB
5
6
N
Vol.%
Curves
4
1 Screen for displaying application-specific screen pages.
11 »Config. ∆∆« key for system settings.
2 Parameter keys for setting the ventilation parameters and
displaying the settings.
12 »Values ∆∆« key for displaying measured values.
3 Red and yellow lamps for alarms and advisory messages.
14 »Settings ∆∆« key for setting other ventilation parameters
on the screen.
4 » 2 min« key for suppressing the audible alarm tone
for 2 minutes.
13 »Alarms ∆∆« key for setting and displaying alarm limits.
5 »Alarm Reset« key for acknowledging alarm messages.
15 »Curves
« key for changing to the main page
and for switching the curve displayed (Flow or Paw).
6 » Lock« key for protecting against unauthorised
modification.
16 »
« key for switching the screen brightness between
bright/dark.
7 Power supply indicators
17 »Insp. hold« key for manual inspiration.
Mains power
18 »O2 Y Suction« key for bronchial suction.
ext. J
External battery or DC on-board network
int. J
19 »
Nebul.« key for switching the pneumatic
medicament nebuliser on/off.
Internal battery
N
8 » Standby« key for changing between ventilation
and standby.
9 Central "turn and press" rotary knob for selecting
and confirming settings.
10 Mode keys for IPPV, SIMV, CPAP/ASB, BIPAP
124
20 Trigger indicator.
What's what
Front connection block
2
1
3
4
8
5
6
088
7
1 Flow sensor
2 Expiration valve with expiration port (GAS RETURN)
3 Socket for breathing gas temperature sensor plug
4 Inspiration port (GAS OUTPUT)
5 Gas supply port for the medicament nebuliser
6 Bacterial filter
7 Protective cover for O2 sensors
8 Gas outlet (EXHAUST)
125
What's what
Back panel
6
7
5
4
8
3
2
1
9
10
1 RS 232 serial interface
2 Nurse call socket (optional)
3 Power switch
4 Fuse for internal battery
5 Power unit socket
6 DC inlet (external battery or DC on-board network)
7 Potential equilisation connector
8 Filter cover
9 Rating plate
10 LPO low pressure O2 inlet (optional)
11 In side panel: connection for O2 pressure hose
126
089 37624
11
What's what
Abbreviations
Abbreviation
Definition
ASB
Assisted Spontaneous Breathing
Pressure-supported spontaneous breathing
Autoflow
Automatic optimising of the inspiratory flow
BIPAP
Biphasic Positive Airway Pressure
Ventilation mode for spontaneous breathing at continuous
positive airway pressure with two different pressure levels
bpm
breaths per minute
BTPS
Body Temperature, Pressure, Saturated
Measured values based on the conditions of the patient’s
lungs, with body temperature 37 oC, atmospheric pressure,
steam-saturated gas
C
Compliance
CPAP
Continuous Positive Airway Pressure
Breathing with continuous positive pressure in the airways
∆ PASB above
PEEP
Setting for pressure support ASB above PEEP
f
frequency
fApnoea
Frequency setting for apnoea ventilation
fspn
spontaneous breathing frequency
ftot
total breathing frequency
Fail to cycle
Machines detects no inspiration
FiO2
Inspiratory O2 concentration
FlowAcc
Flow acceleration
FlowPeak
Peak flow
HPO
High Pressure Oxygen
Savina’s O2 supply via the high pressure O2 inlet
Int. PEEP
Intermittent Positive End-Expiratory Pressure = Sigh
IPPV
Intermittent Positive Pressure Ventilation
IPPVAssist
Assisting Intermittent Positive Pressure Ventilation
IRV
Inversed Ratio Ventilation
Ventilation with inversed inspiration/expiration ratio
I:E
Ratio of Inspiration time to Expiration time
LPO
Low Pressure Oxygen
Savina’s O2 supply via the low pressure O2 inlet
127
What's what
Abbreviation
Definition
MV
Minute volume
MVleak
Leak minute volume
MVspn
Spontaneous fraction of minute volume
NIV
Non-invasive ventilation
O2
Setting for inspiratory oxygen concentration
Paw
Airway pressure
Paw high
Airway pressure high
PEEP
Positive End-Expiratory Pressure
Pinsp
Setting of the upper pressure level in BIPAP
Plateau
An inspiratory pause
PLV
Pressure Limited Ventilation
Pmax
Maximum airway pressure
Pmean
Mean airway pressure
Ppeak
Peak pressure
Pplat
End-inspiratory airway pressure
R
Resistance
SIMV
Synchronized Intermittent Mandatory Ventilation
TDisconnect
Delay time for "Airway pressure lower alarm limit" alarm
(only in »Mask/NIV« mode)
Temp
Inspiratory breathing gas temperature
Te
Expiration time
Tinsp
Setting for the inspiratory time
Tplat
Plateau time
VT
Setting for tidal volume
V TApnoea
Setting for tidal volume of apnoea ventilation
V Te
Expiratory tidal volume
V Ti
Inspiratory tidal volume
V Tpat
Leakage-compensated inspiratory measured tidal volume
128
What's what
Symbols
Symbol
Nebul.
O2 Y
Suction
Explanation
Switch medicament nebuliser on/off
Activate/deactivate oxygen enrichment for bronchial suction
Start manual inspiration and hold
∆∆
Select settings page
∆∆
Configure system settings
∆∆
Display alarm limits
∆∆
Display measured values
Switch between flow/pressure curve
Bright/dark screen brightness setting
Mute audible alarm for 2 minutes
Acknowledge alarms
Lock ventilation parameters and ventilation mode
Standby
Standby
Upper alarm limit
Lower alarm limit
Lower/upper alarm limit
Follow instructions for use!
m
Protection class Type B
m
Protection class Type BF
º
Insert flow sensor
129
What's what
Symbol
Explanation
Exp.
Expiration port (GAS RETURN)
Insp.
Inspiration port (GAS OUTPUT)
Gas outlet (EXHAUST)
130
Technical Data
Environmental conditions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 132
Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 132
Performance data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 133
Measured value displays . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 134
Monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 136
Operating data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 137
Classification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 139
131
Technical Data
Technical Data
Environmental conditions
In operation
Temperature
Atmospheric pressure
Rel. humidity
5 to 40 oC
700 to 1060 hPa
5 to 95 %, no dew
In storage and transit
Temperature
Atmospheric pressure
Rel. humidity
–20 to 70 oC
600 to 1200 hPa
10 to 95 %, no dew
Settings
Ventilation modes
IPPV / IPPVAssist,
SIMV, SIMV / ASB
BIPAP, BIPAP / ASB
CPAP, CPAP / ASB
Ventilation frequency f
2 to 80 bpm
Inspiration time Tinsp
0.2 to 10 s
Tidal volume V T
Accuracy**
0.05 to 2.0 L, BTPS*
±10 % of set value or ±25 mL, whichever is greater.
Inspiratory pressure Pinsp
0 to 99 mbar***
O2 concentration
Accuracy****
21 to 100 vol.%
±3 vol.%
The accuracy of the inspiratory O2 concentration is appreciably
reduced when operating Savina without O2 sensors.
Positive end-expiratory pressure PEEP
or interm. PEEP
0 to 35 mbar
Trigger sensitivity
can be switched off in IPPV ventilation mode
Accuracy
1 to 15 L/min
Pressure assist ∆ PASB above PEEP
0 to 35 mbar (relative to PEEP)
Flow Acceleration FlowAcc
Accuracy
5 to 200 mbar/s
±10 % of set value
*
±8 % of set value or ±0.5 L/min, whichever is greater
BTPS
Body Temperature, Pressure, Saturated.
Measured values with reference to the conditions of the patient’s lung,
body temperature 37 oC, ambient pressure, steam-saturated gas.
** Valid for 25 oC ambient temperature and 50 % relative humidity.
At higher humidity levels, the flow-dependent variables are up to 8.3 % less than the values indicated.
(This concerns: setting for tidal volume V T, reading for Flowpeak, alarm limit for insp. tidal volume).
*** 1 mbar = 100 Pa
****Valid for 25 oC ambient temperature and 50 % relative humidity.
At higher humidity levels, the oxygen percentage of the dry gas is up to 2.5 vol. % higher than the measured value.
132
Technical Data
Performance data
Control principle
Time-cycled, volume-constant, pressure-controlled
Intermittent PEEP frequency
2 cycles every 3 minutes
Medicament nebulisation
(with O2 supply only)
For a maximum of 30 minutes, in the inspiratory flow phase,
2 bar, max. 10 L/min,
Savina takes the nebuliser flow into account and keeps the
minute-volume constant.
Oxygen enrichment for bronchial suction
(with high pressure O2 supply only)
disconnection detection
reconnection detection
oxygen enrichment
active suction phase
final oxygen enrichment
automatic
automatic
max. 3 minutes with 100 vol.% O2
max. 2 minutes
2 minutes with 100 vol.% O2
Supply system for spontaneous breathing and ASB
max. inspiratory flow
Blower with quick-action pressure control valve
180 L/min, BTPS*
Device compliance
(with bacterial filter, 2.3 – 2.8 m patient hose system
for adult patients, with or without heated hoses and
water traps)
– Fisher & Paykel humidifier MR 730 with
empty F&P humidifier chamber MR 370 F
≤2 mL/mbar
– Aquapor humidifier with empty
humidifier chamber
≤3.2 mL/mbar
Device resistance
Inspiratory resistance (adults)
Expiratory resistance (adults)
≤1.0 mbar/60 L/min
≤3.7 mbar/60 L/min
Device compliance
(with bacterial filter, 2.7 – 2.8 m patient hose
system for paediatric use, Fisher & Paykel
humidifier MR 730 with empty F&P humidifier
chamber MR 340, with or without heated hoses
and water traps)
≤1 mL/mbar
Device resistance
Inspiratory resistance (paediatric)
Expiratory resistance (paediatric)
≤2.0 mbar/30 L/min
≤6.0 mbar/30 L/min
Additional functions
Inspiratory relief valve
Safety valve
opens breathing system in case of failure.
opens the breathing system at 100 mbar.
*
BTPS
Body Temperature, Pressure, Saturated.
Measured values with reference to the conditions of the patient’s lung,
body temperature 37 oC, ambient pressure, steam-saturated gas.
133
Technical Data
Measured value displays
Airway pressure measurement
(resistive relative pressure sensor)
Max. airway pressure
Plateau pressure
Pos. end-exp. pressure
Mean airway pressure
Range
Resolution
Accuracy
Ppeak
Pplat
PEEP
Pmean
0 to 99 mbar
1 mbar
±2 mbar
Inspiratory O2 measurement:
(maintenance-free electrochemical sensor)
Inspiratory O2 concentration FiO2
Range
Resolution
Accuracy with calibration in HPO mode
Accuracy with calibration in LPO mode
18 to 100 vol.% O2
1 vol.% O2
±3 vol.% O2*
±8 vol.% O2*
Flow measurement
(hot-wire sensor)
Inspiratory peak flow Flowpeak
Range
Resolution
Accuracy
0 to 196 L/min
1 L/min
±8 % of measured value or ±0.5 L/min, whichever is greater
Minute volume MV
Spontaneous breathed minute volume MVspn
Range
Resolution
Accuracy
T0...90
0 to 99 L/min, BTPS**
0.1 L/min
±8 % of measured value or ±0.3 L/min, whichever is greater
approx. 35 s
Leakage minute volume MVleak
based on the inspiratory minute volume
(only in »Mask/NIV« mode)
Range
Resolution
Accuracy
0 to 100 %
1 %. Leakage under 10 % cannot be indicated with sufficient
resolution. 0 % is displayed.
±18 % of measured value or ±0.3 L/min, whichever is greater
Measured expiratory tidal volume V Te
Range
Resolution
Accuracy
0 to 3999 mL, BTPS**
1 mL
±8 % of measured value or ±10 mL, whichever is greater
Leakage-compensated inspiratory measured tidal
volume V Tpat
(only in »Mask/NIV« mode)
Range
Resolution
Accuracy
0 to 3999 mL, BTPS**
1 mL
±18 % of measured value or ±20 mL, whichever is greater
*
Maximum possible basic measuring error in O2 measurement with a nominal concentration of 100 vol.% O2
and assuming the worst-case ambient conditions in the hospital.
** BTPS
Body Temperature, Pressure, Saturated. Measured values with reference to the conditions of the patient’s lung,
body temperature 37 oC, ambient pressure, steam-saturated gas.
134
Technical Data
Frequency Measurement
Spontaneous breathing frequency fspn
Total frequency ftot
Range
Resolution
Accuracy
T0...90
0 to 150 /min
1 /min
±1 /min
approx. 35 s
Inspiration/expiration ratio I:E
Range
Resolution
Accuracy
0 : 150 to 150 : 1
0.1
±6 % of measured value
Inspiration time Tinsp
Range
Resolution
Accuracy
0 to 15 s
0.1 s
0.1 s
Plateau time Tplat
Range
Resolution
Accuracy
0 to 10 s
0.1 s
0.1 s
Resistance R
Range
Resolution
Accuracy
3 to 100 mbar/L/s
1mbar/L/s
±2.5 mbar/L/s or ±20 %, whichever is greater
Compliance C
Range
Resolution
Accuracy
3 to 200 mL/mbar
1 mL/mbar
±2 mL/mbar or ±20 %, whichever is greater
Breathing gas temperature measurement
(NTC sensor)
Range
Resolution
Accuracy
18 to 48 oC
1 oC
±1 oC
Curve displays
Airway pressure Paw (t)
Flow (t)
–5 to 100 mbar
–200 to 200 L/min
135
Technical Data
Monitoring
Expiratory minute volume MV
Upper alarm limit alarm
Setting range
Lower alarm limit alarm
Setting range
Airway pressure Paw
Upper alarm limit alarm
Setting range
Lower alarm limit alarm
Delay time TDisconnect for
"Airway pressure lower alarm limit" alarm
(only in »Mask/NIV« mode)
Insp. O2 concentration FiO2
(HPO mode)
Upper alarm limit alarm
when MV exceeds the upper alarm limit.
41 to 2 L/min, in 0.1 L/min steps
when MV falls below the lower alarm limit.
0.5 to 40 L/min, in 0.1 L/min steps
when the "Paw high" value is exceeded.
10 to 100 mbar
when the value "PEEP +5 mbar" (coupled with the PEEP set value) is
not exceeded for at least 0.1 s in two successive ventilation strokes
0 to 60 s
if FiO2 exceeds the upper alarm limit for at least 20 seconds.
Lower alarm limit alarm
if FiO2 falls below the lower alarm limit for at least 20 seconds.
Range
both alarm limits are automatically allocated to the set value:
below 60 vol.% with ±4 vol.%
above 60 vol.% with ±6 vol.%
Insp. O2 concentration FiO2
(LPO mode)
Alarm limits
manual adjustment
Tachypnoea monitoring
Alarm
Adjustment range
if the total frequency is exceeded during spontaneous breathing.
10 to 120/min
Apnoea alarm time
Alarm
Adjustment range
if no breathing activity is detected.
15 to 60 s, adjustable in 1 second steps.
Insp. tidalvolume
Alarm
Setting range
if the delivered tidal volume V T exceeds the alarm limit
0.06 to 4 L
136
Technical Data
Operating data
Mains power connection
100 V to 240 V, 50/60 Hz
Current input
at 230 V
at 100 V
max. 1.3 A
max. 3.4 A
Machine fuses
Range 100 V to 240 V
Protection class
F 5 H 250 V IEC 127-2/I (2x)
I, Type B
DC fuse for internal battery
Plug-in fuse 1 SA/32 V
External DC supply from on-board network
min. 10.5 V DC, max. 36 V DC
Supply from external batteries
12 or 24 V
Input current (DC)
12 V battery
24 V battery
typically 10 A, max. 30 A
typically 5 A, max. 15 A
Total running time if mains supply is down, with a
charged external battery and typical ventilation*
Examples:
12 V battery 36 Ah
24 V battery 17 Ah
approx. 3 hours (e.g. with 1 lead-gel battery 12 V/36 Ah)
approx. 4 hours (e.g. with 2 lead-gel batteries 12 V/17 Ah)
Total running time if mains supply is down and no
external DC supply is available (new, charged internal
battery)
60 min (±12 min), with typical ventilation*.
External battery
The external battery is located in the Savina Mobil
trolley (84 14 335).
Sourcing information:
Standard rechargeable lead or lead-gel batteries can
be used, e.g.
Sonnenschein
A212/36 A (1 or 2 batteries)
Panasonic
LCL 12 V 17P (2 batteries)
LCL 12 V 33AP (1 or 2 batteries)
LCL 12 V 38P (1 or 2 batteries)
Batteries that use other chemical systems
(such as NiCd, NiMH) must not be used.
Battery charging
Savina automatically detects the voltage of the
external battery connected.
When the battery is fully charged, the charging
system switches to trickle charging.
Trickle charging is effected by short current pulses.
*
IPPV mode, V T = 700 mL, FiO2 = 21 %, FlowAcc = 30 mbar/s, Tinsp = 2 s, f = 12 bpm,
PEEP = 5 mbar, 7 mm tube connector, Clung = Dräger bag 2 L
137
Technical Data
Charging times
The charging times indicated refer to immediate charging of the external battery after discharge.
Several successive partial discharges or intermediate
mains charging can extend the charging time.
Type
lead-gel batteries, maintenance-free, sealed
Minimum capacity
12 V battery
24 V battery
33 Ah
17 Ah
Charging time
12 V battery
24 V battery
<48 hours (about 20 hours at 80 % charge)
<24 hours (about 15 hours at 80 % charge)
Charge current
12 V battery
24 V battery
2A
2A
Internal battery
Type
Charging time
Protection class
Machine
Temperature sensor AWT01 (sensor fitted)
Gas supply
O2 gauge pressure
O2 connection thread
Dew point
Oil content
Particles
LPO inlet
Connecting hose
Return valve
O2 operating pressure
O2 flow
Recommended concentrator
lead-gel batteries, maintenance-free, sealed
Charging time <3 hours, including from external DC on-board network
(about 2 hours at 80 % charge)
Class I
Type BF
3 bar –10 % to 6 bar
NIST
5 oC below ambient temperature
<0.1 mg/m3
Dustfree air (filtered with mesh size <1 micron)
max. ø 7 mm
Resistance approx. 50 mbar at flow 10 L/min
100 mbar – max. 2 bar
0.5 L/min – max. 10 L/min
Permox SilentCare without humidifier
O2 flow approx. 0.5 L/min – approx. 5 L/min at approx. 90 vol.% O2;
Outlet pressure approx. 700 mbar
Output for pneumatic medicament nebuliser
O2, max. 2 bar, max. 10 L/min
Sound pressure level
(for free-field measurement over a
reflecting surface)
≤45 dB (A) for typical ventilation* at 1 m distance in front
*
IPPV mode, V T = 700 mL, FiO2 = 21 %, FlowAcc = 30 mbar/s, Tinsp = 2 s, f = 12 bpm,
PEEP = 5 mbar, 7 mm tube connector, Clung = Dräger bag 2 L
138
Technical Data
Dimensions (W x H x D)
Basic machine
Machine with trolley
380 x 383 x 358 ±2 mm
550 x 1347 x 559 ±5 mm
Weight
Basic machine
approx. 24 kg
Machine outputs
Digital output
Output and reception via an RS 232 C interface
for MEDIBUS protocol
Classification
as per EC Directive 93/42/EEC Annex IX
Class IIb
UMDNS-Code
Universal Medical Device
Nomenclature System –
nomenclature for medical products
17 – 429
Relevant standards
EN 794-1, Lung ventilators –
Part 1: Special requirements for intensive care
ventilators
EN 60601-1, Medical electrical appliances –
Part 1: General safety rules (IEC 601-1, 1996)
EN 60601-1-2, Medical electrical appliances –
Part 1: General safety rules –
Second supplementary standard: Electromagnetic
compatibility – Requirements and testing
(IEC 601-1-2 1993)
RTC/DO-160D, Environmental Conditions and Test
Procedures for Airborne Equipment, Section 21:
Emissions of radio frequency energy, 29.7.1997
MIL-STD-461, Requirements for the control of
electromagnetic interference emissions and
suspectability, RE 101, CS 114, RS 101
139
140
Order List
Order List ........................................................................................................................ 142
141
Order List
Order List
Designation/Description
Part No.
Basic machine
Savina
84 13 600
Accessories required for operation
O2 connecting hose 3 m (NIST)
M 34 402
non-colour coded or
O2 connecting hose 5 m (NIST)
Designation/Description
Part No.
Paediatric hose set, Fischer & Paykel
for MR 730, comprising:
Hose heater 84 11 045,
patient hoses, water traps, Y-piece,
catheter connector
84 12 081
Disposable hose set (paediatric)
Cleartube for MR 850
84 14 986
M 34 403
Special accessories
non-colour coded
Pneumatic medicament nebuliser
84 12 935
84 09 609
2M 85 706
Temperature sensor
84 05 371
Articulated bracket
or
Quick-fit articulated bracket 2
Aquapor humidifier
84 05 020
SavinaMobil trolley
84 14 335
Aquapor humidifier EL
84 14 698
SavinaMobil trolley, low
84 14 676
Aquapor patient connection
84 05 029
Bracket set
84 03 345
For manual ventilation:
Hose set adult
comprising:
Patient hoses, water traps, Y-piece,
catheter connector
84 13 146
Resutator 2000
21 20 046
Paediatric Resutator 2000
21 20 984
Resutator hook
M 26 349
For adult ventilation
HME hose set (adult)
84 12 860
Humidifier basic unit MR 730
(Fisher & Paykel)
84 18 285
Adult test lung
84 03 201
Humidifier basic unit MR 850
(Fisher & Paykel)
84 14 720
MEDIBUS cable
83 06 488
Fastening set (rail bracket)
84 11 074
DC battery cable S (ext. battery)
84 14 092
Humidifier chamber MR 370 (adult)
84 12 217
Ext. lead-gel battery 12 V/17 Ah
(2 batteries needed)
18 43 303
Hose set (adult),
Fisher & Paykel for MR 730
84 12 108
DC on-board network cable S
84 14 048
Disposable hose set (adult)
Cleartube for MR 730
MX 22 780
o
For paediatric ventilation with MR 730
or MR 850
84 18 286
Double temperature sensor for MR 730
84 11 048
Single-strand wire 1.5 m
84 11 050
142
84 13 641
Set of side rails
84 14 358
Permox SilentCare
57 30 289
Options
Humidifier chamber MR 340 (paediatric)
including humidifier chamber filter paper
(set of 100)
Bacterial filter SecuRed L, ST
90 O2 connector
MX 02 652
AutoFlow kit
84 14 130
BIPAP kit
84 14 131
NIV kit
84 14 072
Option LPO
84 15 719
Nurse call option
84 13 631
Plug to connect nurse call system to
ventilator
18 46 248
Savina TransportMobil
84 14 530
Savina TransportMobil, low
84 14 540
Order List
Designation/Description
Part No.
Savina TransportMobil kit
84 15 550
Coupling for Savina TransportMobil
84 15 522
Designation/Description
Paediatric spiral hose,
silicone rubber 22/10, 0.40 m
21 65 856
Corrugated hose flex., 0.13 m
84 09 634
Catheter connector size 11 (set of 10)
Cap
Replacement parts
Paediatric adapter
For Savina:
Part No.
M 19 490
84 01 645
90o
84 03 075
O2 sensor (Oxytrace VE)
MX 01 049
Double cone
84 09 897
Expiration valve
84 13 660
Temperature sensor inputs
84 11 044
Expiratory condensate trap
84 09 627
Hose heater 1.10 m
84 11 045
Hose heater adapter
84 11 097
For articulated bracket:
Holder
84 09 746
Hose clamp
84 09 841
Consumables
For adult ventilation:
Aquapor E-set cover
84 06 135
Spirolog flow sensor (set of 5)
84 03 735
Aquapor tank
84 04 739
Microfilter
67 37 545
Aquapor float
84 04 738
Set of dust filters S
84 14 057
84 11 073
21 65 627
Filter paper for humidifier chamber F&P
(100 pieces)
Hose set for humidifier F&P (disposable)
MX 22 780
HME hose set (disposable)
MX 22 750
Adult spiral hose,
Silicone rubber 0.6 m
Adult spiral hose,
Silicone rubber 0.35 m
21 65 619
Water trap
84 04 985
Pot
84 03 976
Hose set Aquapor (disposable)
MX 22 777
Hose clamp
84 03 566
Bacterial filter SecuRed Big, ST*
MX 02 650
Bacterial filter SecuRed L, ST*
MX 02 652
Mask size 1, disposable*
MX 22901
Nozzle
Y-piece (with thermometer sleeve)
Catheter connector, straight, size 12.5
(set of 10)
M 25 647
84 05 435
M 23 841
Mask size 2, disposable*
MX 22902
Corrugated hose
84 02 041
Mask size 3, disposable*
MX 22903
Adult adapter
84 03 076
Mask size 4, disposable*
MX 22904
Catheter connector set, adult
84 03 685
Mask size 5, disposable*
MX 22905
Humidifier chamber MR 370 (adult)
(Fisher & Paykel)
84 12 217
Mask size 6, disposable*
MX 22906
Cap set (set of 5)
84 02 918
Mask, round, disposable*
MX 22907
Elbow connector ISO
M 25 649
For paediatric ventilation:
Paediatric spiral hose,
silicone rubber 22/10, 1.10 m
21 65 651
Paediatric spiral hose,
silicone rubber 22/10, 0.60 m
21 65 821
Paediatric spiral hose,
silicone rubber 10/10, 0.60 m
21 65 848
Technical Documents on request
*
Not available in all countries. Contact your local distributor for
information.
143
Index
Index
Dust filter set . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 84
Abbreviations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 127
Accessories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Advisory . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
Alarm limits
Factory settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32
Alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16, 17, 33
Ambient temperature . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53
Apnoea alarm time . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32
Apnoea ventilation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
Appropriate Monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
ASB . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 115
Assembling . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 88
Audible alarm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34
AutoFlow . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26, 112
Back panel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 126
Bacterial filters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 90
Battery operation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 104
Battery, external . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 94
Bibliography . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 122
BIPAP . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28, 116
BIPAP/ASB . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28
Bronchial suction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49
Calibrating . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51
Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76
Caution . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
Checklist . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 101
Cleaning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79
Configuration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17, 56
Configuring the measured values line . . . . . . . . . . . . . . . . . 57
Connection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Contrast . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56
Control unit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 124
Controls
Screen operating . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Ventilation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
CPAP . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
CPAP/ASB . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
CPPV . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
Curves . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35
Date . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60
DC on-board network . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 105
Description . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 110
Device values . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61
Device-ID . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61
Diagramm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 121
Disinfecting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79
Disinfecting/cleaning/sterilising schedule . . . . . . . . . . . . . 81
Dismantling . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76
Disposal . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 86
144
Electrical power supply . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Event of an alarm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Event of gas failure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Expiration valve . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 78,
External battery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Extreme settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
93
33
53
88
86
21
Fault – Cause – Remedy . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64
FiO2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58
Flow Acceleration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 110
FlowAcc . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
Flow monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58
Flow sensor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 78, 89
Front connection block . . . . . . . . . . . . . . . . . . . . . . . . . . . . 125
Heat and moisture exchanger . . . . . . . . . . . . . . . . . . . . . . . .
HME . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Hose set, adult . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Hose set, paediatric . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
HPO, definition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Humidifier
Aquapor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Fisher & Paykel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
90
90
89
93
39
91
92
Information window . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
Inspiration time . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 135
Intended Use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
Intermittent PEEP . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25, 111
Internal battery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 86
IPPV . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23, 110
IPPVAssist . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23, 111
Keys for routine and additional functions . . . . . . . . . . . . . . 14
Language . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60
Leakage compensation . . . . . . . . . . . . . . . . . . . . . . . 37, 117
Locking the keys . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
Low Pressure Oxygen mode . . . . . . . . . . . . . . . . . . . 39, 120
LPO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39, 120
LPO mode, switching on . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41
Main page . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Mains operation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 104
Mains power failure . . . . . . . . . . . . . . . . . . . . . . . . . . 53, 100
Maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Maintenance Intervals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 82
Manual inspiration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46
Manual ventilation device . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Index
Mask ventilation . . . . . . . . . . . . . . . . . . . . 36, 37, 88, 118
Measured values . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16, 35
MEDIBUS protocol . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61
Medicament nebulization . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47
Medicament nebulizer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77
Microfilter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83
Nebulization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Nebulizer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
NIV – Non-invasive ventilation . . . . . . . . . . . . . . . . . . . . . . . .
Nurse calling system . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
47
47
36
97
O2 monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58
O2 reserve . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 95
O2 sensor
Calibrating . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52
Calibration in LPO mode . . . . . . . . . . . . . . . . . . . . . . . . 43
Disposal . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 86
Fitting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85
O2 sensor 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57
O2 supply . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 95
Operating concept . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
Operating time . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 95
Operation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
Order List . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 142
Oxygen enrichment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49
Special functions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46
Standby . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
Sterilising . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79
Storing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 86
Suction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49
Supply . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 93
SW . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61
Switching on . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
Symbols . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 129
TDisconnect . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38
Technical data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 132
Time . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60
Trigger . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24, 25
Values . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
Ventilating infants . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91
Ventilation hoses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76
Ventilation Modes . . . . . . . . . . . . . . . . . . . . . . . 21, 23, 110
Volume . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56
Volume-controlled ventilation . . . . . . . . . . . . . . . . . . . . . . . . 110
What's what . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 124
Working hours . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58, 61
Patient hose set, adult . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89
Patient hose set, paediatric . . . . . . . . . . . . . . . . . . . . . . . . . . 93
Plateau . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26, 60
Plateau pressure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 110
Plateau time . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 110, 135
PLV . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 110
Pmax ON/OFF . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59
Power sources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 104
Power supply . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 93
Power supply failure . . . . . . . . . . . . . . . . . . . . . . . . . . 53, 100
Power switch . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
Preparation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 88
Pressure limiting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 110
Readiness for operation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 98
Release code . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61
Remote Service . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62
Screen pages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Structure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Selecting the ventilation mode . . . . . . . . . . . . . . . . . . . . . . . 12
Setting new parameters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
Setting ventilation parameters . . . . . . . . . . . . . . . . . . . . . . . . 12
Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
Sigh . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25, 26, 111
SIMV . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27, 114
SIMV/ASB . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
145
146
147
These Instructions for Use apply only to
Savina
with Serial No.:
If no Serial No. has been filled in by
Dräger, these Instructions for Use are
provided for general information only
and are not intended for use with any
specific machine or device.
ç
Directive 93/42/EEC
concerning Medical Devices
Dräger Medical AG & Co. KGaA
Germany
z Moislinger Allee 53 – 55
D- 23542 Lübeck
y +49 451 8 82-0
FAX +49 451 8 82-20 80
! http://www.draeger.com
90 37 957 - GA 5664.919 en
© Dräger Medical AG & Co. KGaA
2nd edition – March 2004
Subject to alteration