AVEA ventilator

Ventilation modes
user guide
 Table of contents

Section 1: UIM navigation........................... 1 Nasal CPAP/IMV............................................ 30

Touch-Turn-Touch™ /Touch-Turn- Standby.................................................. 31–32
Accept™ techniques.................................... 1 Section 3: Advanced settings..................... 33
Setting breath type and mode..................... 2–3 Volume Limit................................................. 33
Setting advanced settings........................... 4–5 Machine Volume..................................... 34–35
Setting alarm limits......................................... 6 Inspiratory Rise.............................................. 36
Section 2: Breath types and modes............. 7 Flow Cycle.................................................... 36
Breath types.................................................... 7 Waveform..................................................... 37
Mandatory breaths......................................... 8 Sigh.............................................................. 37
Demand breaths............................................. 9 Bias Flow...................................................... 38
Volume controlled ventilation.................. 10–12 Pres Trig........................................................ 38
Volume SIMV mode...................................... 13 Vsync®.................................................... 39–40
Pressure controlled ventilation................. 14–15 Vsync Rise..................................................... 40
Pressure SIMV............................................... 16 PSV Rise........................................................ 41
TCPL mode............................................. 17–18 PSV Cycle...................................................... 41
TCPL SIMV mode.................................... 19–22 PSV Tmax...................................................... 41
PRVC SIMV mode......................................... 23 Volume Limit................................................. 41
APRV/BiPhasic......................................... 24–26 T High PSV.................................................... 42
CPAP/PSV...................................................... 27 T High Sync................................................... 42
Apnea Backup ventilation....................... 28–29 T Low Sync................................................... 42
CPAP/PSV...................................................... 29 AVEA ventilator modes........................... 43–46

The AVEA® ventilator user guide is not intended to replace the operator manual. You must become
completely familiar with the AVEA ventilator operator manual before using the AVEA ventilator.

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Section 1: UIM navigation
Touch-Turn-Touch™/Touch-Turn-Accept™ techniques
To change most controls on the AVEA ventilator:

1. Touch the screen directly over the control to select it.

The control highlights (changes color), indicating that
it is active.

2. Turn the data dial clockwise to increase the selected

value, and turn the dial counter-clockwise to decrease
it. Turning the data dial quickly accelerates the rate of
change from one setting to another. Turning the data
dial slowly gradually changes the setting.

3. Touch the screen directly over the highlighted control

again, or press the ACCEPT membrane button to the
left of the data dial to accept your new setting.

Note: If you press the CANCEL button or do not

actively accept the new setting within 15 seconds,
ventilation continues at the previous setting.

1
Setting breath type and mode

To access the MODE SELECT screen, press the MODE indicator on the touch screen or the
MODE button on the membrane panel.

A. MODE indicator

B. MODE button
A

2
Setting breath type and mode (continued)

The MODE SELECT screen appears. Select the touch-screen button for the desired mode.

Selecting Volume A/C mode

Primary controls for the proposed mode appear at the bottom of the touch screen. Use the
techniques described on page 3 to set these controls. Press MODE ACCEPT to accept the new
mode and primary control settings.

3
Setting advanced settings

To set advanced settings, press the ADV

SETTINGS button on the lower left of the
user interface. Advanced settings refine the
breath delivery beyond the primary breath
control settings. Press the ADV SETTINGS
button for the desired primary control. Not A
all primary controls have advanced settings.
Primary controls with advanced settings are
marked with a yellow triangle.

Detailed descriptions of all advanced settings

are in section 3.

A. ADV SETTINGS button

4
Setting advanced settings (continued)

Advanced settings for volume

Use the Touch-Turn-Touch or Touch-Turn-Accept technique to modify the advanced settings

(see page 3).

5
Setting alarm limits

Press the ALARM LIMITS membrane button

(to the upper right of the UIM) to open or
close the window.

A. ALARM LIMITS button A

Alarm Limits window with Volume A/C mode selected on MODE

SELECT window

Use the Touch-Turn-Touch or Touch-Turn-Accept technique to modify the alarm limits

settings (see page 3).

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Section 2: Breath types and modes
This section describes the breath types and ventilation mode combinations available for adult,
pediatric and neonatal patients using the AVEA ventilator.

Breath types
There are two basic breath types:

• Mandatory breaths (delivered according to the set ventilator parameters)

• Demand breaths (triggered by the patient)

All breaths are defined by four variables:1

• Trigger (initiates the breath)

• Control (controls the delivery)

• Limit (terminates the breath)

• Cycle (initiates the frequency of delivery)

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Mandatory breaths

Mandatory breaths can be triggered by the machine, patient or operator. The AVEA ventilator
can deliver five mandatory breath types:

1. Volume breaths

2. Pressure breaths

3. Time cycled pressure limited (TCPL) breaths (neonatal patients only)

4. Pressure regulated volume control (PRVC/Vsync® ) breaths (adult and pediatric patients only)

5. Volume Guarantee (VG) breaths (neonatal patients only)

Note: The volume controlled breath is the default breath type for adult and pediatric
patients. The TCPL breath type is only available for neonates and the default breath type for
neonate patients.

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Demand breaths

All demand breaths are patient triggered, pressure controlled and flow or time cycled. Demand
breaths can be either pressure supported (PSV) or spontaneous. All demand breaths are
accompanied by the yellow patient demand indicator, which flashes in the upper left of the
touch screen. The AVEA ventilator delivers two demand breath types:

1. PSV: Active when CPAP/PSV, synchronized intermittent mandatory ventilation (SIMV) and
airway pressure release ventilation (APRV)/BiPhasic modes are selected.

2. Spontaneous breath: For adult and pediatric patients during a spontaneous demand breath,
inspiratory pressure is pre-set at positive end-expiratory pressure (PEEP) + 2 cmH2O. For
neonatal patients, a spontaneous breath is a demand flow breath delivered at the
pre-set PEEP.

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Volume controlled ventilation

AVEA ventilator intra-breath demand system

The AVEA ventilator features a unique intra-breath demand system in volume controlled
ventilation designed to provide additional flow to the patient during periods of demand.

The AVEA ventilator measures the peak inspiratory pressure (Ppeak) every 2 ms throughout
the breath cycle and sets a virtual pressure support target at the greater of PEEP + 2 cmH2O
or Ppeak–2 cmH2O.

The minimum virtual pressure support level is set PEEP + 2 cmH2O, and the maximum is
two times the set PEEP. Simultaneously, the ventilator monitors and compares the Ppeak
measurement to its previous value. If the Ppeak decreases by 2 cmH2O, the ventilator recognizes
the patient demand and automatically switches over to deliver a pressure support breath at the
virtual pressure support target. This allows flow to exceed the set peak flow, thereby meeting
patient demand.

Once the set tidal volume has been delivered, the ventilator looks at the inspiratory flow.
Should the peak inspiratory flow be greater than set peak flow, the ventilator determines that
the patient continues to demand flow. The breath then cycles when inspiratory flow falls to 25%
of the peak inspiratory flow. If the peak inspiratory flow is equal to the set flow, the ventilator
determines the patient is not demanding flow and ends the breath as a volume control breath.

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Volume breaths are controlled by inspiratory flow, limited by a pre-set volume or maximum
inspiratory pressure and cycled by volume or time. During mandatory breaths, the demand
system can provide additional flow if needed. The mode for this breath type is Volume Assist
Control (A/C) mode.

All breaths are mandatory breaths

at the set tidal volume. Breaths are
triggered when a patient effort is
detected, the breath interval elapses
when no patient effort is detected
or the MANUAL BREATH key
is activated. The initiation of a
breath by any means resets the
breath interval. The patient may
initiate all breaths. Without patient
effort, breaths deliver at the set
breath rate. Volume A/C with decelerating flow pattern

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In a volume breath, airway pressure increases until the set tidal volume delivers. Flow delivers at
the set flow rate for the duration of the inspiratory time (with a square waveform selected) or
can decelerate to 50% of the set peak flow during the inspiratory phase of the breath (with a
decelerating waveform selected).

Primary controls: Active in Volume A/C mode are Rate, Volume, Peak Flow, Inspiratory Pause,
PEEP, Flow Trigger and %O2.

Advanced settings: Available in Volume A/C mode are Vsync*, Vsync Rise*, Volume Limit++,
Demand Flow, Flow Cycle ++, Sigh*, Waveform, Bias Flow and Pressure Trigger.
*Available for adult and pediatric patients only.

++ Only available when Vsync is active.

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Volume SIMV mode

In synchronized intermittent mandatory ventilation (SIMV), mandatory and demand breath

types can deliver. Mandatory breaths deliver when the SIMV Time window is open as a
patient effort is detected, the breath interval elapses when no patient effort is detected or
the MANUAL BREATH key is activated.

Primary controls: Active in Volume

SIMV mode are Rate, Volume, Peak
Flow, Inspiratory Pause, PSV, PEEP,
Flow Trigger and %O2.

Advanced settings: Available in

Volume SIMV mode are Vsync*,
Vsync Rise*, Volume Limit, Sigh*,
Waveform, PSV Rise, PSV Cycle,
PSV Tmax, Demand Flow, Bias
Flow, Flow Cycle ++, Waveform
Volume SIMV with mandatory (1) and
and Pressure Trigger. assisted (2) breaths
*Available for adult and pediatric

patients only.
++ Only available when Vsync is active.

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Pressure controlled ventilation
Pressure breaths are controlled by pressure (inspiratory + PEEP), limited by pressure (inspiratory
+ PEEP) and cycled by time or flow. The mode for this breath type is Pressure Assist Control
(A/C) mode.

All breaths are mandatory breaths.

Breaths may be triggered when a
patient effort is detected, the breath
interval times out when no patient
effort is detected or the MANUAL
BREATH key is activated.

The initiation of a breath resets the

breath interval. Patients may initiate
all breaths. Without patient effort,
breaths deliver at the set breath
rate. During mandatory breaths,
the demand system can provide Pressure A/C, mandatory breaths
additional flow if needed.

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In a pressure breath, a variable flow delivers to reach the set inspiratory pressure above
baseline. Once the set pressure level is achieved, flow is regulated to maintain this pressure for
the duration of the set inspiratory time. The monitored peak pressure is equal to the sum of the
inspiratory pressure and PEEP settings.

Primary controls: Active in Pressure A/C mode are Rate, Inspiratory Pressure, Inspiratory Time,
PEEP, Flow Trigger and %O2.

Advanced settings: Available in Pressure A/C mode are Machine Volume, Volume Limit,
Inspiratory Rise, Flow Cycle, Bias Flow and Pressure Trigger.

Volume Guarantee breaths* (neonatal patients only): When Volume Guarantee is

selected, the control Insp Pres becomes an advanced setting, the Volume setting displays as a
primary control and the ventilator delivers a test breath at the set inspiratory pressure.

The inspiratory pressure for subsequent breaths adjusts breath-to-breath. The pressure adjusts
separately for time triggered breaths, patient triggered breaths, apnea backup breaths and
manual breaths to maintain monitored expired tidal volume close to the set target.

*Requires wye flow sensor.

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Pressure SIMV

In SIMV mode, the ventilator can deliver mandatory and demand breath types. Mandatory
breaths deliver when the SIMV Time window is open as a patient effort is detected, the breath
interval has elapsed when no patient effort is detected or the MANUAL BREATH key is activated.

Primary controls: Active in

Pressure SIMV mode are Rate,
Inspiratory Pressure, Inspiratory
Time, Pressure Support, PEEP, Flow
Trigger and %O2.

Advanced settings: Available in

Pressure SIMV mode are Machine
Volume, Volume Limit, Inspiratory
Rise, Flow Cycle, Pressure Support
Rise, Pressure Support Cycle, Pressure SIMV with mandatory (1) and assisted
Pressure Support Tmax, Bias Flow (2) breaths
and Pressure Trigger.

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Volume Guarantee breaths (neonatal patients only): * When Volume Guarantee is
selected, the control Insp Pres becomes an advanced setting, the Volume setting displays as
a primary control and the ventilator delivers a test breath at the set inspiratory pressure.

The inspiratory pressure for subsequent breaths is adjusted breath-to-breath. The pressure
adjusts separately for time triggered breaths, patient triggered breaths, apnea backup breaths
and manual breaths to maintain monitored expired tidal volume close to the set target.

TCPL mode
TCPL breaths are controlled by inspiratory flow,
limited by pressure (inspiratory + PEEP) and cycled
by time, inspiratory flow or volume (Volume Limit).
The mode for this breath type is TCPL Assist
Control (A/C) mode.**

All breaths are mandatory breaths. Breaths can be

triggered when a patient effort is detected, the
breath interval times out when no patient effort
TCPL A/C, mandatory breaths
is detected or the MANUAL BREATH key
is activated.
*Requires wye flow sensor.
**Available for neonatal patients only.

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The initiation of a breath resets the breath interval. Patients may initiate all breaths. Without
patient effort, breaths deliver at the set breath rate. During mandatory breaths, the demand
system can provide additional flow if needed.

In a TCPL breath, the inspiratory flow is used to achieve a set inspiratory pressure. During
the inspiratory phase of the breath, inspiratory pressure maintains while flow is allowed
to decelerate.

Primary controls: Active in TCPL A/C mode are Rate, Inspiratory Pressure, Peak Flow,
Inspiratory Time, PEEP, Flow Trigger and %O2.

Advanced settings: Available in TCPL mode are Volume Limit*, Flow Cycle, Bias Flow and
Pressure Trigger.

Volume Guarantee breaths (neonatal patients only):* When Volume Guarantee is

selected, the control Insp Pres becomes an advanced setting, the Volume setting displays as
a primary control and the ventilator delivers a test breath at the set inspiratory pressure.

The inspiratory pressure for subsequent breaths is adjusted breath-to-breath. The pressure
adjusts separately for time triggered breaths, patient triggered breaths, apnea backup breaths
and manual breaths to maintain monitored expired tidal volume.
*Requires wye flow sensor.

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TCPL SIMV mode*

In SIMV mode, the ventilator can deliver mandatory and demand breath types. Mandatory
breaths deliver when the SIMV Time window is open as a patient effort is detected, the breath
interval has elapsed when no patient effort is detected or the MANUAL BREATH key is activated.

Primary controls: Active in TCPL

SIMV mode are Rate, Inspiratory
Pressure, Peak Flow, Inspiratory
Time, PEEP, Flow Trigger and %O2.

Advanced settings: Available in

TCPL SIMV mode are Volume
Limit, Flow Cycle, Bias Flow and
Pressure Trigger.

Volume Guarantee breaths

(neonatal patients only):** TCPL SIMV with mandatory (1) and assisted (2) breaths
When Volume Guarantee is
selected, the control Insp Pres becomes an advanced setting, the Volume setting displays as a
primary control and the ventilator delivers a test breath at the set inspiratory pressure.
*Available for neonatal patients only.
**Requires wye flow sensor.

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The inspiratory pressure for subsequent breaths is adjusted breath-to-breath. The pressure
adjusts separately for time triggered breaths, patient triggered breaths, apnea backup breaths
and manual breaths to maintain monitored expired tidal volume.

PRVC Mode

In pressure regulated volume control (PRVC) breaths, the pressure level modulates up or down
to achieve a pre-set tidal volume. Breaths are controlled by pressure (inspiratory + PEEP) and
volume, limited by pressure (inspiratory + PEEP) and cycled by time.

When PRVC is selected, the ventilator delivers a decelerating flow, volume controlled test breath
to the set tidal volume with a 40 msec pause. It sets the target pressure at the end inspiratory
pressure for the first pressure control breath. The next breath and all subsequent breaths deliver
as pressure control breaths.

Inspiratory pressure adjusts automatically to maintain the target volume based on the dynamic
compliance of the previous breath. The maximum step change between two consecutive breaths
is 3 cm of water pressure. The maximum tidal volume delivered in a single breath is determined by
the Volume Limit setting.

The test breath sequence initiates when:

• Entering the PRVC mode

• Changing the set tidal volume while in PRVC

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• Reaching the Volume Limit setting

• Reaching a delivered tidal volume > 1.5 times the set volume

• Terminating the flow of the test breath

• Activating the:

- High Peak Pressure alarm

- Low Peak Pressure alarm

- Low PEEP alarm

- Patient Circuit Disconnect alarm

- I-Time Limit

- I:E Limit

- When exiting Standby

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The mode for the PRVC breath type is PRVC Assist Control (A/C) mode.*

All breaths are mandatory breaths. A breath can be triggered by the detection of a patient
effort, the breath interval timing out or the MANUAL BREATH key being activated. The
initiation of a breath resets the breath interval. A patient may initiate all breaths. Without
patient effort, breaths deliver at the set breath rate. During mandatory breaths, the demand
system can provide additional flow
if needed.

Primary controls: Active in PRVC

A/C mode are Rate, Volume,
Inspiratory Time, PEEP, Flow Trigger
and %O2.

Advanced settings: Available in

PRVC A/C mode are Volume Limit,
Inspiratory Rise, Flow Cycle, Bias
Flow, PSV Rise, PSV Cycle, PSV Tmax
and Pressure Trigger.
PRVC A/C with test breath (1) and step changes (2–4)
* Available for adult and to achieve target volume

pediatric patients only.

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PRVC SIMV mode*

In SIMV mode, the ventilator can deliver mandatory and demand breath types. Mandatory
breaths deliver when the SIMV Time window is open as a patient effort is detected, the breath
interval has elapsed when no patient effort is detected or the MANUAL BREATH key is activated.

Primary controls: Active in PRVC

SIMV mode are Rate, Volume,
Inspiratory Time, Pressure Support,
PEEP, Flow Trigger and %O2.

Advanced settings: Available in

PRVC SIMV mode are Volume Limit,
Pressure Support Rise, Pressure
Support Cycle, Pressure Support
Tmax, Bias Flow, Flow Cycle and
Pressure Trigger.
* Available for adult and PRVC SIMV with mandatory (1) and assisted
pediatric patients only. (2–4) breaths

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APRV/BiPhasic mode*

Airway pressure release ventilation (APRV)/BiPhasic is a time cycled pressure mode that cycles
between two different baseline pressures based on time, which can be synchronized with
patient effort. Controlled ventilation can be maintained by time cycling the transitions between
baseline pressures. Pressure support can be added to improve comfort for the spontaneously
breathing patient.

In this mode, the patient can breathe spontaneously at two pre-set pressure levels. These are
set using the Pres High and Pres Low controls. The maximum duration at each pressure during
time cycling is set with the Time High and Time Low controls. The operator can also adjust
the length of the respective trigger (Sync) windows with the Time High and Time Low Sync
controls, which are advanced settings of Time High and Time Low. The Sync windows are
adjustable from 0% to 50%, in 5% increments of set Time High and Time Low. The change
synchronizes from Pressure Low to Pressure High with the detection of inspiratory flow or first
inspiratory effort within the T Low Sync window. Transition from Pressure High to Pressure Low
occurs with the first end of inspiration detected after the T High Sync window opens.

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Note: Time High and Time Low are the maximum time settings for a time cycled transition.
Actual times may vary depending on the patient’s spontaneous breathing pattern and Sync
window setting. Setting the Sync to 0% cycles the transition between pressure levels on time
only and does not synchronize with patient efforts. The MANUAL BREATH button is not active
in APRV/BiPhasic.

APRV/BiPhasic mode features

adjustable PSV. The PSV delivers
above the current phase baseline
pressure. PSV breaths are available
during Time High and by activating
T High PSV, which is an advanced
setting of Time High. If activated,
the same PSV level for both Pressure
Low and Pressure High delivers
during Time High.
1 - Time High, Pressure High
2 - Time Low, Pressure Low APRV/BiPhasic mode

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Apnea ventilation is available in APRV/BiPhasic mode. If the patient does not initiate a
spontaneous effort or the ventilator does not time cycle between pressure levels before the
apnea interval has elapsed, the ventilator alarms for apnea and begins apnea ventilation at the
apnea ventilation settings. A spontaneous effort from the patient or a transition in baseline
pressure resets the apnea alarm and timer and returns the ventilator to APRV/BiPhasic ventilation.

Primary controls: Active in APRV/BiPhasic mode are Time High, Pressure High, Time Low,
Pressure Low, Pressure Support, Flow Trigger and %O2.

Advanced settings: Available in APRV/BiPhasic mode are T High PSV, T High Sync, T Low Sync,
Volume Limit, Pressure Support Rise, Pressure Support Cycle, Pressure Support Tmax, Bias Flow
and Pressure Trigger.
*APRV/BiPhasic mode is available for adult and pediatric patients only.

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CPAP/PSV*

Continuous positive airway pressure with pressure support ventilation (CPAP/PSV) breaths are
demand breaths with the pressure level during inspiration equal to the pre-set PSV level plus
PEEP. This breath type is controlled by pressure (pre-set PSV level + PEEP), limited by pressure
(pre-set PSV level + PEEP) and cycled by
time (PSV Tmax) or flow (PSV cycle).

All breaths are patient-initiated demand

breaths unless the MANUAL BREATH
key is pressed. When the MANUAL
BREATH key is pressed in CPAP/PSV,
a single breath delivers at the apnea
backup control settings.

Primary controls: Active in CPAP/PSV

mode are Pressure Support, PEEP, Flow
CPAP/PSV
Trigger and %O2.

Advanced settings: Available in CPAP/PSV are Volume Limit, Pressure Support Rise, Pressure
Support Cycle, Pressure Support Tmax, Bias Flow and Pressure Trigger.

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Apnea Backup ventilation

Apnea Backup ventilation is available in Assist Control (A/C), SIMV, APRV/BiPhasic and
CPAP/PSV modes.

Apnea Backup in Assist Control or SIMV

The set mandatory breath rate or the Apnea Interval setting (whichever provides the highest
respiratory rate) determines the apnea backup rate.

When the Apnea Interval setting (found in the Alarm Limits window) determines the backup
rate, the ventilator continues to ventilate at this rate until the apnea has been resolved. All
other controls for apnea ventilation in Assist Control (A/C) and SIMV are the current active
primary controls.

Apnea ventilation ends when a patient initiates a spontaneous breath, a manual breath is
delivered or the rate control is increased above the Apnea Interval setting.

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Apnea Backup in APRV/BiPhasic and CPAP/PSV

When these modes are selected, you must:

1. Set the primary and advanced settings for CPAP/PSV or APRV/BiPhasic.

2. Select the breath type for Apnea Backup mode (Volume or Pressure in adult and pediatric
patients or Volume, Pressure or TCPL in neonatal patients) by pressing the Apnea
Settings button.

3. Set the primary controls appearing at the bottom of the touch screen, for the selected apnea
breath type before pressing the MODE ACCEPT button.

Note: The controls for apnea backup ventilation are not visible once the MODE ACCEPT
button has been pressed. Only the controls that are active and required for the selected mode
display on the main screen once the MODE ACCEPT button is pressed.

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nCPAP/IMV
Nasal CPAP (nCPAP) is a spontaneous ventilation. In this mode, no mechanical positive pressure
breaths deliver. Nasal IMV is a time triggered, time cycled mode of pressure control ventilation
provided via nasal prongs as an enhancement to the nCPAP mode. When a rate is set greater
than zero, time triggered, time cycled mandatory breaths deliver. Each breath comprises an
inspiratory phase, during which the delivered pressure increases from baseline (PEEP) to
PEEP + Inspiratory Pressure, and an expiratory phase, during which the delivered pressure
returns to PEEP.

Nasal IMV breaths are:

• Controlled by pressure

• Limited by pressure

• Cycled by time

Primary controls: nCPAP level, Inspiratory Pressure, Inspiratory Time, FiO2% and Rate

Advanced settings: Inspiratory Rise*

*No advanced settings appear when Rate is set to off.

nCPAP/IMV is only available in the neonatal patient size setting.

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Standby

When activated, Standby retains the primary controls,

advanced settings and alarm limits when the patient
is away from the ventilator. To initiate Standby, press
the screen’s membrane button.

The Standby Check message appears, asking you to

confirm your intent to stop ventilation. The patient
should be disconnected from the ventilator
prior to the user initiating Standby.

If YES is selected, ventilation stops, the safety valve

closes and the ventilator supplies 2 L/min of gas
continuously to the circuit. This supply reduces the
risk of an overheated circuit if an active humidifier
is in use and left on.

31
Standby (continued)

Note: The patient wye must be blocked for

this flow to be directed through the full length
of the patient circuit.

The STANDBY NOT VENTILATING message

displays. Press Resume to restart ventilation at
the current settings.

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Section 3: Advanced settings
Volume Limit
The Volume Limit (Vol Limit) setting sets the volume limit for a pressure limited breath. When
the volume delivered to the patient meets or exceeds the pre-set volume limit, the inspiratory
phase of the breath terminates.

The volume limit is active for Pressure, PRVC/Vsync, TCPL and PSV breaths only. In neonatal
applications, the volume limit requires a wye flow sensor. Whenever a proximal flow sensor is
used (neonatal, pediatric or adult applications), the volume limit activates by the inspiratory tidal
volume measured by the wye flow sensor. In adult and pediatric applications that do not use a
wye flow sensor, the volume limit is determined by the calculated inspiratory wye flow. When
the volume limit threshold has been reached, the ventilator alarm status indicator changes to
yellow and displays Volume Limit. The alarm status indicator cannot be reset until the ventilator
has delivered a breath, which does not meet the volume limit threshold. To reset the alarm
status window, use the ALARM RESET button.

Note: Excessive inspiratory flow rates or highly compliant ventilator circuits may allow tidal
volume delivery that exceeds the Volume Limit setting. This is due to the ventilator circuit
recoiling and providing additional tidal volume to the patient. Delivered tidal volumes should
be closely monitored to ensure volume limit accuracy.

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Machine Volume

The Machine Volume (Mach Vol) control sets the minimum tidal volume delivered as the control is
activated in a pressure control breath. This control is always used with the time cycling criterion
in pressure control ventilation. The machine volume is circuit compliance compensated in adult
and pediatric applications.

Once you set the machine volume, the ventilator calculates the decelerating inspiratory flow
required to deliver the machine volume in the set inspiratory time. When a pressure control
breath delivers and peak flow decelerates to this calculated peak inspiratory flow, if the
machine volume has not been met, the ventilator automatically transitions to a continuous flow
until the machine volume has been delivered. Once the set machine volume has been delivered,
the ventilator cycles into exhalation. Upon meeting or exceeding the machine volume or pressure
control breath delivery, the ventilator completes the breath as a normal pressure control breath.

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During this transition in flow, the inspiratory time remains constant and the Ppeak increases to
reach the set machine volume. The maximum Ppeak is determined by the High Peak Pressure
alarm setting.

Note: Pmax disables when the machine volume is set. If flow cycling is active in pressure control,
the ventilator does not cycle the flow until meeting the machine volume. The machine volume is
circuit compliance compensated in adult and pediatric applications.

To set the machine volume in adult and pediatric applications (with circuit compliance
compensation active), simply set the minimum desired tidal volume.

In neonatal applications with proximal flow sensor in use:

1. Adjust the peak inspiratory pressure to reach the desired tidal volume.

2. Select Vdel as one of the monitored parameters. Read the Vdel (uncorrected tidal volume
delivered from the machine) during a pressure control breath.

3. Set the machine volume to or slightly below the Vdel measurement. This sets the machine
volume to provide more consistent tidal volume delivery for slight decreases in lung compliance.

Note: To protect against larger changes in lung compliance, the machine volume should be
set higher and volume limit should be added.

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Inspiratory Rise
The Inspiratory Rise (Insp Rise) setting controls the slope of the pressure rise during a mandatory
breath. This control is a relative control with fast at a setting of 1 and slow at a setting of 9. The
Insp Rise control is not active for TCPL breaths.

Flow Cycle
The Flow Cycle setting sets the percentage of the peak flow that terminates the inspiratory
phase of a pressure control or TCPL breath. Flow cycling is active for pressure or TCPL
breaths only.

Note: If flow cycling is active during a pressure control breath, monitored airway pressures
(inspiratory) are higher than active automatic airway compensation (AAC). An Inspiratory
Pressure setting of zero AAC still provides an elevated airway pressure, which compensates for
the resistance of the
endotracheal tube.

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Waveform
During the delivery of a volume breath, flow can be delivered in one of two user-selectable
waveforms: Square Wave or Decelerating Wave. The default waveform is Decelerating Wave.

Square Wave (Square)

With this waveform selected, the ventilator delivers gas at the set peak flow for the duration
of the inspiration.

Decelerating Wave (Decel)

With this waveform selected, the ventilator delivers gas starting at the peak flow and
decreasing until the flow reaches 50% of the set peak flow.

Sigh
The ventilator delivers sigh volume breaths when this setting is on. A sigh volume breath
delivers every 100th breath in place of the next normal volume breath.

Sigh breaths are only available for volume breaths in Assist and SIMV modes for adult and
pediatric patients.

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Bias Flow

The Bias Flow control sets the background flow available between breaths. Additionally, this
control establishes the base flow for flow triggering.

Note: To ensure adequate bias flow for inspiratory triggering, the Bias Flow setting should
be at least 0.5 L per minute greater than the flow trigger threshold. Consult the ventilator
circuit manufacturer to ensure the Bias Flow setting can sufficiently prevent overheating the
ventilator circuit.

Pressure Trigger
The Pressure Trigger (Pres Trig) control sets the level below PEEP that activates the inspiratory
trigger mechanism. When the pressure in the patient circuit falls below PEEP by the set pressure
trigger level, the ventilator cycles to inspiration. Pres Trig is also used to activate the inter-breath
demand system in volume controlled ventilation.

Note: Setting the Pres Trig to excessively high levels can impair the patient’s ability to activate
the inter-breath demand system in volume controlled ventilation.

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Vsync*

When Vsync is selected, a decelerating flow, volume test breath to the set tidal volume with
a 40 msec pause delivers to the patient. The ventilator sets the target pressure at the end
inspiratory pressure for the first pressure control breath. The next breath and all subsequent
breaths deliver as pressure control breaths. Inspiratory pressure adjusts automatically to
maintain the target volume based on the dynamic compliance of the previous breath. The
maximum step change between two consecutive breaths is 3 cm of water pressure. The
maximum tidal volume delivered in a single breath is determined by the Volume Limit setting.

This test breath sequence initiates when:

• Entering the mode (Vsync)

• Changing the set tidal volume while in Vsync

• Reaching the Volume Limit setting

• Reaching a delivered tidal volume > 1.5 times the set volume

39
Vsync* (continued)

• Terminating the flow the test breath

• Activating the:

- High Peak Pressure alarm

- Low Peak alarm

- Low PEEP alarm

- Patient Circuit Disconnect alarm

- I-Time Limit

- I:E Limit
*Vsync is only available for adult and pediatric patients.

Note: The Peak Flow control sets the flow rate, which is used for the test breath only. The
ventilator uses the Peak Flow setting and inspiratory pause to determine the maximum
inspiratory time during Vsync ventilation.

Vsync Rise
With Vsync active, this control sets the slope of the pressure rise during the PRVC/Vsync breath.
It is a relative control ranging from fast at a setting of 1 to slow at a setting of 9.

40
PSV Rise

The PSV Rise setting sets the slope of the pressure rise during a pressure-supported breath.
It is a relative control with a range from fast at a setting of 1 to slow at a setting of 9.

PSV Cycle
The PSV Cycle setting sets the percentage of peak inspiratory flow that terminates the
inspiratory phase of a PSV breath.

PSV Tmax
The PSV Tmax setting controls the maximum inspiratory time of a pressure-supported breath.

Note: PSV Rise, PSV Cycle and PSV Tmax are active even if the PSV level is zero.

Volume Limit
The Vol Lim setting sets the volume limit for a pressure limited breath. When the volume
delivered to the patient meets or exceeds the pre-set volume limit, the inspiratory phase of
the breath terminates.

41
T High PSV

The T High PSV setting sets the volume limit for a pressure limited breath. When the volume
delivered to the patient meets or exceeds the pre-set volume limit, the inspiratory phase of the
breath terminates.

T High Sync
The T High Sync setting sets the length of the Time High trigger (Sync) window. The Sync
window adjusts from 0% to 50%, in 5% increments of set Time High, and synchronizes the
change from Pressure High to Pressure Low with the first end of inspiration detected after the
T High Sync window opens. If no patient effort detected, the transition occurs when the set
Time High has elapsed. Setting the T High Sync window to 0% provides time cycling only.

T Low Sync
The T Low Sync setting sets the length of the Time Low trigger (Sync) window. The Sync
window adjusts from 0% to 50%, in 5% increments of the set Time Low, and synchronizes
the change from Pressure Low to Pressure High when detecting inspiratory flow or the first
inspiratory effort within the T Low Sync window. If no patient effort is detected, the transition
occurs when the set Time Low has elapsed. Setting the T Low Sync window to 0% provides
time cycling only. The Volume Limit setting sets the volume limit for a pressure limited breath.
When the volume delivered to the patient meets or exceeds the pre-set volume limit, the
inspiratory phase of the breath terminates.
42
 AVEA ventilator modes, primary controls and
advanced settings
Breath type and mode Vol A/C Vol SIMV Pres A/C Press SIMV
Primary controls

Rate BPM * * * *

Volume mL * *

Insp Pres cmH2O * *

Peak flow L/min * *

Insp time sec * *

Insp pause sec * *

PSV cmH2O * *

PEEP cmH2O * * * *

Flow trig L/min * * * *

% oxygen %O2 * * * *

Pres High cmH2O

Time High sec

*Available with Vsync activated for adult or pediatric patients only.

**Available for adult and pediatric patients only.

43
 AVEA ventilator modes, primary controls and
advanced settings (continued)
Breath type and mode Vol A/C Vol SIMV Pres A/C Pressure SIMV
Time Low sec

Pres Low cmH2O

Advanced settings available • Vsync* • Vsync* • Mach Vol • Mach Vol

within each mode • Vsync Rise* • Vsync Rise* • Vol Limit • Vol Limit
• Sigh** • Sigh** • Insp Rise • Insp Rise
• Waveform • Waveform • Flow Cycle • Flow Cycle
• Bias Flow • Vol Limit • Bias Flow • PSV Rise
• Pres Trig • PSV Rise • Pres Trig • PSV Cycle
• Vol Limit (when • PSV Cycle • PSV Tmax
Vsync = On) • PSV Tmax • Bias Flow
• Flow Cycle (when • Bias Flow • Pres Trig
Vsync = On) • Pres Trig
• Demand Flow • Flow Cycle (when
Vsync = On)
• Demand Flow

VG breaths N/A N/A Available in neonatal Available in neonatal

patient type patient type

*Available with Vsync activated for adult or pediatric patients only.

**Available for adult and pediatric patients only.

44
 AVEA ventilator modes, primary controls and
advanced settings (continued)
Breath type PRCV A/C PRVC SIMV CPAP/PSV APRV/ TCPL A/C TCPL SIMV
and mode BiPhasic
Primary controls

Rate BPM * * Apnea mode* Apnea mode* * *

Volume mL * * Apnea mode* Apnea mode*

Insp Pres cmH2O Apnea mode* Apnea mode* * *

Peak flow L/min Apnea mode* Apnea mode* * *

Insp time sec * * Apnea mode* Apnea mode* * *

Insp pause sec Apnea mode* Apnea mode*

PSV cmH2O * * * * *

PEEP cmH2O * * * * * *

Flow trig L/min * * * * * *

% oxygen %O2 * * * * * *

Pres High cmH2O *

Time High sec *

*Available with Vsync activated for adult or pediatric patients only.

**Available for adult and pediatric patients only.

45
 AVEA ventilator modes, primary controls and
advanced settings (continued)
Breath type PRCV A/C PRVC CPAP/PSV APRV/ TCPL A/C TCPL nCPAP/IMV
and mode SIMV BiPhasic SIMV
Time Low sec *

Pres Low *
cmH2O

Advanced • Insp Rise • Vol Limit • Vol Limit • Vol Limit • Vol Limit • Vol Limit • Insp Rise***
settings • Bias Flow • PSV Rise • PSV Rise • PSV Rise • Flow Cycle • Flow Cycle
available • Pres Trig • PSV Cycle • PSV Cycle • PSV Cycle • Bias Flow • PSV Rise
within • Vol Limit • PSV Tmax • PSV Tmax • PSV Tmax • Pres Trig • PSV Cycle
each mode • Flow • Bias Flow • Bias Flow • Bias Flow • PSV Tmax
Cycle • Pres Trig • Pres Trig • Pres Trig • Bias Flow
• Flow Cycle • T High Sync • Pres Trig
• Insp Rise • T High PSV
• T Low Sync

VG breaths N/A N/A N/A N/A Available Available N/A

in neonatal in neonatal
patient type patient type

*Available with Vsync activated for adult or pediatric patients only.

**Available for adult and pediatric patients only.
***Not available when rate is set to OFF.

46
Notes

47
Notes

48
Notes

49
 References
1 Branson, R., Chatbum, R. Proceedings of consensus conference on the essentials of mechanical ventilators, Cancun,
Mexico, February 1992.

WARNING—U.S. Federal Law restricts this device to sale by or on the order of a physician.

CareFusion
22745 Savi Ranch Parkway
Yorba Linda, CA 92887
800.231.2466 toll-free
714.283.2228 tel
714.283.8493 fax

carefusion.com
© 2014 CareFusion Corporation or one of its subsidiaries. All rights reserved.
AVEA, Touch-Turn-Accept, Touch-Turn-Touch, CareFusion and the CareFusion
logo are trademarks or registered trademarks of CareFusion Corporation or
one of its subsidiaries. RC3859 (0814/2000)

50