Changing patient from NIV to INVASIVE Vent Type Table 9 shows automatic settings changes that occur when changing the same patient from NIV to INVASIVE Vent Type. Table 9: Automatic settings changes NIV to INVASIVE Current NIV setting New INVASIVE setting Ventilator settings: 2T I SPONT Alarm settings: 4P PEAK, 4V E TOT, 4V TE MAND, 4V TE SPONT D SENS N/A Alarm settings: Default to new patient values dependent upon selected INVASIVE ventilator settings. INSPIRATION TOO LONG alarm becomes available. D SENS setting defaults to INVASIVE new patient value. Warning When changing the Vent Type on the same patient, review the automatic settings changes described in Tables 8 and 9 and adjust appropriately. Update to RS-232 commands SNDF command This section updates Chapter 19 in the Technical Reference section of the 840 Ventilator Operator s and Technical Reference Manual. SNDF is a command sent from an external host device to the 840 ventilator instructing it to transmit all ventilator settings data, monitored patient data, and alarm settings and occurrences. Enter the SNDF command exactly as shown: SNDF<CR> 4-076532-00 Rev. H (01/07) 840 Ventilator Software Enhancements Addendum 37
When the ventilator receives the command SNDF<CR>, it responds with the code MISCF, followed by ventilator settings, monitored data, and alarm information. The MISCF response follows this format: MISCF 1253 173 <STX> FIELD 5,..., FIELD 173, <ETX> <CR> Terminating carriage return End of transmission (03 hex) Data field, left-justified and padded with spaces Start of transmission (02 hex) Number of data fields between <STX> and <ETX> Number of bytes between <STX> and <ETX> Response code to SNDF command Table 10 lists the SNDF message components and their descriptions. NOTE: Non-applicable fields will either contain zero or be blank. 840 Ventilator Software Enhancements Addendum 4-076532-00 Rev. H (01/07) 38
Table 10: SNDF response MISCF Response to SNDF command (5 characters) 1253 Number of bytes between <STX> and <ETX> (4 characters) 173 Number of fields between <STX> and <ETX> (3 characters) <STX> Field 5 Field 6 Field 7 Field 8 Field 9 Field 10 Field 11 Field 12 Field 13 Field 14 Field 15 Field 16 Field 17 Field 18 Field 19 Start of transmission character (02 hex) Ventilator time (HH:MM_) Ventilator ID to allow external hosts to uniquely identify each 840 ventilator (18 characters) Date (MMM_DD_YYYY_) (12 characters) Vent Type (NIV or INVASIVE_) (9 characters) Mode (A/C, SIMV, SPONT_ or BILEVL) Mandatory Type (PC, VC, VC+ ) Spontaneous Type (NONE, PS, TC, VS, PA ) Trigger Type setting (V-Trig or P-Trig) Respiratory rate setting in bpm Tidal volume setting in L Peak flow setting in L/min O 2 % setting Pressure sensitivity setting in cmh 2 O PEEP/CPAP in cmh 2 O Plateau setting in seconds 4-076532-00 Rev. H (01/07) 840 Ventilator Software Enhancements Addendum 39
Field 20 Field 21 Field 22 Field 23 Field 24 Field 25 Field 26 Field 27 Field 28 Field 29 Field 30 Apnea interval setting in seconds Apnea tidal volume setting in L Apnea respiratory rate setting in bpm Apnea peak flow setting in L/min Apnea O 2 % setting PCV apnea inspiratory pressure setting in cmh 2 O PCV Apnea Inspiratory Time setting in seconds Apnea flow pattern setting (SQUARE or RAMP) Apnea mandatory type setting (PC or VC) Inspiratory component of Apnea I:E ratio (if apnea mandatory type is PC) Expiratory component of Apnea I:E ratio (if apnea mandatory type is PC) Field 31 Support pressure setting (cmh 2 O) Field 32 Field 33 Field 34 Field 35 Field 36 Field 37 Flow pattern setting (SQUARE or RAMP) 100% O 2 Suction (ON or OFF) High inspiratory pressure alarm setting (2P PEAK ) in cmh 2 O Low inspiratory pressure alarm setting (4P PEAK ) in cmh 2 O or OFF High exhaled minute volume (2V E TOT ) alarm setting in L/min or OFF Low exhaled minute volume (4V E TOT ) alarm setting in L/min or OFF 840 Ventilator Software Enhancements Addendum 4-076532-00 Rev. H (01/07) 40
Field 38 Field 39 High exhaled mandatory tidal volume (2V TE MAND ) alarm setting in ml or OFF Low exhaled mandatory tidal volume (4V TE MAND ) alarm setting in ml or OFF Field 40 High exhaled spontaneous tidal volume (2V TE SPONT ) alarm setting in ml or OFF Field 41 Low exhaled spontaneous tidal volume (4V TE SPONT ) alarm setting in ml or OFF Field 42 Field 43 Field 44 Field 45 Field 46 Field 47 Field 48 Field 49 Field 50 Field 51 Field 52 Field 53 Field 54 Field 55 High respiratory rate (2f TOT ) alarm setting in bpm or OFF High inspired tidal volume (2V TI ) alarm setting in ml Base flow setting in L/min Flow sensitivity setting in L/min PCV inspiratory pressure (P I ) setting in cmh 2 O PCV inspiratory time (T I ) setting in seconds Inspiratory component of I:E ratio setting or High component of H:L ratio setting Expiratory component of I:E ratio setting or Low component of H:L ratio setting Constant during rate change setting (I-time, I/E, or E-time) Tube I.D. setting in mm Tube type setting (ET or TRACH) Humidification type setting (Non-Heated Exp, Heated Exp, or HME) (18 characters) Humidifier volume setting in L O 2 sensor setting (Enabled or Disabled) (9 characters) 4-076532-00 Rev. H (01/07) 840 Ventilator Software Enhancements Addendum 41
Field 56 Field 57 Field 58 Field 59 Field 60 Field 61 Field 62 Field 63 Field 64 Disconnect sensitivity setting in % or OFF Rise time % setting PAV+ percent support setting Expiratory sensitivity (E SENS ) setting in % or L/min for PA breath type IBW setting in kg Target support volume (V T SUPP ) setting in L High PEEP (PEEP H ) setting in cmh 2 O Low PEEP (PEEP L ) setting in cmh 2 O High PEEP time (T H ) setting in seconds Field 65 High spontaneous inspiratory time limit (2T I SPONT ) setting in seconds Field 66 Field 67 Field 68 Field 69 Field 70 Field 71 Field 72 Field 73 Field 74 Field 75 Circuit type setting (ADULT, PEDIATRIC, or NEONATAL) (9 characters) Low PEEP time (T L ) setting in seconds Expiratory time (T E ) setting in seconds End inspiratory pressure (P I END ) in cmh 2 O Respiratory rate (f TOT ) in bpm Exhaled tidal volume (V TE ) in L Patient exhaled minute volume (V E TOT ) in L/min Peak airway pressure (P PEAK ) in cmh 2 O Mean airway pressure (P MEAN ) in cmh 2 O Expiratory component of monitored value of I:E ratio, assuming inspiratory component of 1 840 Ventilator Software Enhancements Addendum 4-076532-00 Rev. H (01/07) 42
Field 76 Field 77 Field 78 Field 79 Field 80 Field 81 Field 82 Field 83 Field 84 Field 85 I:E ratio Delivered O 2 % Inspired tidal volume (V TI ) in L Intrinsic PEEP (PEEP I ) in cmh 2 O Estimated total resistance (R TOT ) in cmh 2 O/L/s Estimated patient resistance (R PAV ) in cmh 2 O/L/s Estimated patient elastance (E PAV ) in cmh 2 O/L Estimated patient compliance (C PAV ) in ml/cmh 2 O Normalized rapid shallow breathing index (f/v T/ /kg) Rapid shallow breathing index (f/v T ) Field 86 Spontaneous percent inspiratory time (T I /T TOT ) Field 87 Field 88 Field 89 Field 90 Field 91 Field 92 Monitored PEEP in cmh 2 O Spontaneous inspiratory time (T I SPONT ) in seconds Exhaled spontaneous minute volume (V E SPONT ) in L/min Intrinsic PEEP (PEEP I ) from expiratory pause maneuver in cmh 2 O Total PEEP (PEEP TOT ) from expiratory pause maneuver in cmh 2 O Static compliance (C STAT ) from inspiratory pause maneuver in ml/cmh 2 O 4-076532-00 Rev. H (01/07) 840 Ventilator Software Enhancements Addendum 43
Field 93 Field 94 Field 95 Field 96 Field 97 Field 98 Field 99 Field 100 Field 101 Field 102 Field 103 Field 104 Field 105 Field 106 Static resistance (R STAT ) from inspiratory pause maneuver in cmh 2 O/L/s Plateau pressure (P PL ) from inspiratory pause maneuver in cmh 2 O High spontaneous inspiratory time (ALERT_ or blank) Dynamic compliance (C DYN ) in ml/cmh 2 O Dynamic resistance (R DYN ) in cmh 2 O/L/s Peak spontaneous flow (PSF) in L/min Peak expiratory flow (PEF) in L/min End expiratory flow (EEF) in L/min Negative inspiratory force (NIF) in cmh 2 O P 0.1 pressure change in cmh 2 O Vital capacity (VC) in L Alarm Silence (ON or OFF) Apnea ventilation alarm* Field 107 High exhaled minute volume alarm* (1V E TOT ) Field 108 Field 109 Field 110 Field 111 Field 112 High exhaled tidal volume alarm* (1V TE ) High O 2 % alarm* High inspiratory pressure alarm* (1P PEAK ) High ventilator pressure alarm* (1P VENT ) High respiratory rate alarm* (1f TOT ) * Possible responses are: NORMAL, LOW, MEDIUM, HIGH, or RESET. 840 Ventilator Software Enhancements Addendum 4-076532-00 Rev. H (01/07) 44
Field 113 Field 114 Field 115 Field 116 AC power loss alarm* Inoperative battery alarm* Low battery alarm* Loss of power alarm* Field 117 Low exhaled mandatory tidal volume alarm* (3V TE MAND ) Field 118 Low exhaled minute volume alarm* (3V E TOT ) Field 119 Low exhaled spontaneous tidal volume (3V TE SPONT ) alarm* Field 120 Field 121 Field 122 Field 123 Field 124 Field 125 Field 126 Field 127 Field 128 Low O 2 % alarm* Low air supply pressure alarm* Low O 2 supply pressure alarm* Compressor inoperative alarm* Disconnect alarm* Severe occlusion alarm* Inspiration too long alarm* Procedure error* Compliance limited tidal volume (V T ) alarm* Field 129 High inspired spontaneous tidal volume* (1V TI SPONT ) alarm Field 130 Field 131 High inspired mandatory tidal volume (1V TI MAND ) alarm* High compensation limit (1P COMP ) alarm* * Possible responses are: NORMAL, LOW, MEDIUM, HIGH, or RESET. 4-076532-00 Rev. H (01/07) 840 Ventilator Software Enhancements Addendum 45
Field 132 Field 133 Field 134 Field 135 Field 136 Field 137 Field 138 Field 139 Field 140 Field 141 Field 142 Field 143 Field 144 Field 145 Field 146 Field 147 Field 148 Field 149 Field 150 Field 151 Field 152 Field 153 Field 154 PAV startup too long alarm* PAV R and C not assessed alarm* Volume not delivered (VC+) alarm* Volume not delivered (VS) alarm* Low inspiratory pressure (3P PEAK ) alarm* Technical malfunction A5* Technical malfunction A10* Technical malfunction A15* Technical malfunction A20* Technical malfunction A25* Technical malfunction A30* Technical malfunction A35* Technical malfunction A40* Technical malfunction A45* Technical malfunction A50* Technical malfunction A55* Technical malfunction A60* Technical malfunction A65* Technical malfunction A70* Technical malfunction A75* Technical malfunction A80* Technical malfunction A85* * Possible responses are: NORMAL, LOW, MEDIUM, HIGH, or RESET. 840 Ventilator Software Enhancements Addendum 4-076532-00 Rev. H (01/07) 46
Field 155 Field 156 Field 157 Field 158 Field 159 Field 160 Field 161 Field 162 Field 163 Field 164 Field 165 Field 166 Field 167 Field 168 Field 169 Field 170 Field 171 Field 172 Field 173 4-076532-00 Rev. H (01/07) 840 Ventilator Software Enhancements Addendum 47
SNDA command When the SNDA command is sent to the 840 ventilator from an external host device, fields that were previously unused in the MISCA response now contain calculated values associated with Respiratory Mechanics. Refer to Chapter 19 of the Technical Reference portion of the 840 Ventilator Operator s and Technical Reference Manual to see the complete MISCA response table. The following table lists the updated fields: Table 11: Updated MISCA response Field 63 Field 64 Static compliance (C STAT ) from inspiratory pause maneuver in ml/cmh 2 O Static resistance (R STAT ) from inspiratory pause maneuver in cmh 2 O/L/s Field 65 Dynamic compliance (C DYN ) in ml/cmh 2 O* Field 66 Field 67 Field 68 Field 69 Dynamic resistance (R DYN ) in cmh 2 O/L/s* Negative inspiratory force (NIF) in cmh 2 O* Vital capacity (VC) in L* Peak spontaneous flow (PSF) in L/min* * These fields will contain data only if the RM software option is installed. 840 Ventilator Software Enhancements Addendum 4-076532-00 Rev. H (01/07) 48