Preparation
82
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.
1 An intrinsic PEEP can be recognised by the fact that the
expiratory flow does not return to "0" before the end of
expiration.
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 nebulizer or humidifier!
This can increase the breathing resistance.
● The inspiratory breathing gas warmed by the built-in
blower is appropriately cooled when using the
ventilation hoses indicated. If shorter hoses are used,
the breathing gas temperature at the Y-piece may
exceed the permissible limit, thus putting the patient at
risk.
04037388
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