Datex Ohmeda Centiva 5 User Manual
Datex Ohmeda Centiva 5 User Manual
Datex Ohmeda Centiva 5 User Manual
CAUTION U.S. Federal laws restrict this device to sale by or on the order of a
licensed medical practitioner. Outside the U.S.A. check local laws for
any restriction that may apply.
AAA B 12345
WARNING Warnings indicate a condition that can cause injury to the operator or
the patient.
On (power)
Off (power)
Earth ground
Equipotential
Type B equipment
Systems with this mark comply with the European Council Directive
(93/42/EEC) for Medical Devices when they are used as specified in
their Operation and Maintenance Manuals. The “xxxx” is the
xxxx certification number of the Notified Body used by the manufacturer’s
Quality Systems.
or AC Alternating current
or DC Direct current
2.1 Safety
Safe Operation To ensure safe operation of the Centiva/5 use the system only as
intended. Operators need to be familiar with this Operation Manual
prior to operating the system. Only trained operators are allowed to use
this system. Always ensure compliance with the requirements of this
Operation manual and with the local governmental or other authority’s
requirements for operating ICU ventilators.
Safety standards The Centiva/5 is designed with respect to the following safety
standards:
- EN 60601-1, Medical electrical equipment, General
conditions
- EN 794-1, Special requirements for lung ventilators
- EN 475, Specification for warning, advice and information in
anesthesia and critical care
- EN 60601-1-4, software controlled medical devices
- EN 60601-1-2, electro magnetic compatibility
Safety features The following safety features are built into the Centiva/5 to warn the
operator in case of risk to the patient.
Device alarms
Control of Control for
Gas supply O2 supply fail, AIR supply fail
Disconnection Disconnection of patient and breathing
system
O2 concentration O2 concentration
Electrical energy Line supply fail, battery supply fail
Device’s control system Watchdog alarm
Patient alarms
Control of Control for
High pressure High pressure alarm
Minute volume Upper and lower minute volume alarm
Rate Upper and lower rate alarm
Airway pressure Pressure sustained
Patient Safety The Centiva/5 shall be operated by or on the order of a physician. The
Centiva/5 shall only be operated by qualified medical personal, to
ensure adequate intervention in case of a device malfunction.
Constant surveillance of a patient connected to an ICU ventilator by
trained personal is required.
Ensure alarm limits are set according to the patient’s situation and
ensure alarms are activated whenever a patient is connected to the
system.
Patient Safety (cont.) Always perform the Centiva/5’s system test before using the ventilator.
This system test is designed to test all safety relevant features and
components prior to the start of ventilation.
In case of emergency the system test may be bypassed. The system will
recognize this status as “No test” and displays this status in the screen
to remind the operator to perform the system test at their earliest
convenience.
If the system test is not performed, the system does not know the
correct breathing circuit’s specifications necessary for optimized
compliance and resistance compensation. In this case the ventilator
may not work with the specified accuracy and tolerances.
Residual risk To reduce the risk of a device malfunction, redundant systems are
integrated into the Centiva/5.
High and medium risk functions are designed to provide an alternate
system in case of a first failure.
Low risk functions are tested with the power-up test each time the unit
is powered up prior to operation.
The system provides for an adjustable pressure limiter in the VCV and
SIMV –VC modes. In the VCV or SIMV-VC modes the Plimit defaults to 20
cmH2O in Pediatric and 30 cmH2O in Adult mode.
The system has an additional second level safety pressure function,
Pmax, that is active in all modes. The Pmax defaults to 30cmH2O in
Pediatric and 40 cmH2O in the Adult mode, when in the VCV or SIMV-VC
modes. The Pmax default is set to 18 cmH2O in Pediatric and 21 cmH2O
in the Adult mode, when in Bi-Level, CPAP/PSV or CPAP/Apnea modes.
Fire hazard Do not use the Centiva/5 in the presence of flammable anesthetics.
Monitoring The Centiva/5 is equipped with monitoring features that will help to
monitor and control the patient’s ventilation situation and to detect
changes in the ventilation parameters.
Changes in the ventilation parameters can be caused by:
• changes in the patient’s status
• changes in the settings
• failure in operation
• device malfunction
• changes in the electrical supply
• changes in gas supply
A resuscitator for manual ventilation shall be present to maintain
ventilation in case of a device malfunction.
Service and maintenance The Centiva/5 shall be checked at least every twelve months for safety
and proper function.
Only authorized service personal shall perform repair, service and
maintenance to the device.
The maintenance intervals and procedures are documented in section
9, ”Maintenance”.
Responsibility of the The manufacturer is not responsible for any function change, damage
manufacturer or injury to patient or operator that is caused by misuse or by disregard
of the safety advices mentioned in this manual.
The user or owner is responsible for the function of the system if the
device is serviced, maintained or repaired by unauthorized personnel.
The user or owner is responsible for the function of the system if the
device is misused or not used according to the instructions in this
Operation manual .
Notes
3.1.1 Intended use Centiva /5 is a critical care ventilator used for intensive care ventilation
of humans.
This ventilator is intended to be used for adult patients and children age
1 year + or bodyweight greater than or equal to 5 kg.
This ventilator is designed to maintain and support existing and
returning patient’s spontaneous breathing.
Bi-Level (Bi-Level)
Synchronized pressure controlled ventilation combined with patient’s
free spontaneous breathing during the entire breathing cycle.
Additional capabilities are:
- IRV - Inverse Ratio Ventilation
- PSV - Pressure Support Ventilation on lower Bi-Level pressure level
3.2 Supply
3.2.1 Electrical supply The Centiva/5 can be configured to be supplied with electrical power
from a line supply voltage of 230 V or 115 V AC.
3.2.2 Gas supply The Centiva/5 is designed to be supplied with O2 and AIR. Single gas
operation with either AIR or O2 can be selected .
Special notice Ensure clean and dry medical gas supply sources.
3.3 Positioning
The Centiva/5 is a system that can be separated into three (3) user
accessible components
• The main engine
• The control panel
• The expiration valve
These three assemblies can be separated by the user without using any
tools.
Main engine
Control panel
Expiration valve
Centiva/5
Bi-Level Tube : E 7.5 50% Adult
15 MV-E 12 Alarm lights
5.2Liter2
10
Vt-E
5
350 mL
Ppeak 21
Paw 14cmH2O
Screen
cmH2O
40
Pmin
Silencer
3cmH2O
20
Flow O2-I 25
L/min 21 18
%
-20
-40
Rate
181/min
40
8 Menu key
Fi02 Rate I:E Ramp P-Insp PEEP PS
21 12 1:2 0.2 10 3 5
% 1/min sec cmH2O cmH2O cmH2O
ComWheel
Soft keys
O
Stopper
Insp. port
Nebulizer
Exp. port
ON/OFF
Serial plate
O2
AI
tc
R
h
ga
ga
O2 AIR
si
24
Co
Gr
Lin
si
nl
m
ei
VD
et
nd
t
po
nl
C
et
rt
co
in
24V/3A DC
let
n.
Select
There are two ways to select a parameter to change, either by
soft keys or by menu.
Adjust
The adjustment is always made by turning the ComWheel
clockwise for up and counterclockwise for down.
Confirm
Confirmation of the adjusted value for the selected parameter
is made by pushing the ComWheel.
Centiva/5
Bi-Level Tube : E 7.5 50% Adult
15 MV-E 12
5.2Liter2
10
Vt-E
5
350 mL
Ppeak 21
Paw
14cmH2O
Screen
cmH2O
40
Pmin
3 cmH2O
20
Flow O2-I 25
L/min 21 18
%
-20
-40
Rate
181/min
40
8 Menu key
Fi02 Rate I:E Ramp P-Insp PEEP PS
21 12 1:2 0.2 10 3 5
% 1/min sec cmH2O cmH2O cmH2O
ComWheel
Soft keys
4.1.1 Screen content The Centiva/5 display shows all information on a color LCD screen. The
screen is divided into four different areas.
Area # 1
Softkeys for ventilation parameter settings
Area # 1
Softkeys for ventilation parameter settings
Area # 1
Softkeys for ventilation parameter settings
Area # 1
Softkeys for ventilation parameter settings
4.1.2 Soft keys By using the soft keys the operator selects a parameter to change.
Depending on the current ventilation mode the soft keys are related to
different parameters. Immediately above the soft key the parameter is
displayed in the screen showing the value and units of measure.
Fi O2 Ramp PEEP PS
Soft keys in CPAP/PSV
50%
0.20
Sec.
OFF
cmH2O
5
cmH2O
4.1.3 I : E ratio soft key For standard I : E ratio settings from 1:1 to 1:9.9 the I : E ratio soft key‘s
characters and background colors are identical to the other soft keys.
Inverse I:E ratio in SIMV-VC mode Changing the soft key parameter rate in the SIMV-
I:E
VC mode causes a change of the I:E ratio
accordingly to keep the ventilation pattern similar.
When this change in I : E ratio leads to inverse
2.0:1
values (I>E) the user will be notified by a change
of the background color from blue to white and the character color from
yellow to red. After confirming the changed value the soft key returns to
blue character on yellow background.
APRV I:E ratio in Bi-Level mode Only in Bi-Level mode Centiva/5 offers extreme 3:1.0
inverse I:E ratio values to simulate APRV (airway
pressure release ventilation). 9.9:1
I:E
When changing the I : E ratio in Bi-Level mode
beyond the inverse I:E ratio level to extreme inverse I:E ratio values
(range 4:1 to 9.9:1) the user will be notified by a change of the
background color from red to brown. After confirming the changed value
the soft key returns to blue character on yellow background.
Note When changing the ventilation mode from Bi-Level to any other mode,
APRV I:E ratios will not transfer automatically, but the user will be
notified to correct the I:E ratio accordingly by a message “I :E > 4:1 !”.
4.1.4 Timing parameter The Centiva/5’s timing parameter in all ventilation modes are:
- ventilation rate (rate)
- inspiration to expiration time ratio (I:E)
50%
10
1/Min
1:2.0 110 mL
30
cmH2O
Off
cmH2O
6.6
L/Min
Changing the I-Flow setting in the ventilation modes VCV and SIMV-VC
has an impact on the timing, too. In this case the inspiratory pause will
be affected by this parameter.
All timing parameters are relative parameters and do not directly set
absolute times. During changing the setting of one of the timing
parameters Centiva/5 will display the absolute time information on the
screen in the format:
I=xx s, P=yy %, E= zz s
„I“ is inspiration time (Tinsp) in seconds
„P“ is inspiratory pause in % of inspiration time (Tpause / Tinsp)
„E“ is expiration time (Texsp.) in seconds.
After confirming made changes to one of the timing parameters this
absolute time message in the screen disappears automatically.
4.1.5 Graphics The Centiva/5 displays two graphical waveforms on the screen:
- current airway pressure versus time
- current airway flow versus time
The upper waveform shows the airway pressure and contains markers
for the pressure settings, such as PEEP, Pinsp or Plimit.
The lower waveform shows the airway flow.
The display will automatically change to scale to maximize readability of
the waveform.
The graphic waveform data is real time and both waveforms are
synchronized on the same time base.
15
10
Paw
cmH2O
40
20
Flow
L/min
-20
-40
4.1.6 Numerical patient The Centiva/5 displays measured patient data in a numeric format.
data
The expiratory minute volume is measured MV-E 12.0
over a period of 60 secs or 10 breaths. 2.5
3.0 Liter
If alarm limits for this particular parameter are available, the upper limit
(UL) and the lower limit (LL) are displayed in the same data field.
4.1.7 Status information The Centiva/5 shows status information in the top portion of the
display. The following describes the status information in order from left
to right appearing on the screen.
System Test When the System test is not performed and the
ventilator is started by bypassing the system test, No Test
the “No Test” is displayed. If the system test was
performed prior to the start of the ventilation this status information
field is not present.
Single gas supply If the operator has confirmed single gas operation
during the system test, this status information Only O2
field displays “Only AIR” for single gas supply with
AIR or “Only O2” for single gas supply with O2. If dual gas supply with
O2 and AIR is confirmed this status information field is not present.
4.1.8 ComWheel The ComWheel is turned to change the selected parameter values .
Special notice When a screen message asks for “<Enter>”, the system asks the
operator to push the ComWheel to confirm an action.
4.1.10 Menu button To select additional functions or infrequently used parameters push the
menu button.
4.1.11 Selecting a menu To select a specific menu topic turn the ComWheel to select the menu
topic option and push the ComWheel to confirm the selection.
4.1.12 Activating a menu The following shows how to activate a menu selection.
function
Open the main menu by pushing the menu button.
Stand-by ON
The main menu will appear in the screen. ASR ON
Parameter menu
Alarm limits
Alarm AUTOSET
Vent. modes
ARC
Nebulizer ON
System test
Exit
Stand-by ON
ASR ON
The selected function will be highlighted in the Parameter menu
menu. Alarm limits
Alarm AUTOSET
Vent. modes
ARC
Nebulizer ON
System test
Exit
4.1.13 Submenus The following selections in the main menu open the submenus :
• Parameter menu
• Alarm limits
• Ventilation modes (Vent. Modes)
• Airway Resistance Compensation (ARC)
These submenus open upon selecting the topic in the main menu.
Stand-by ON
ASR ON
Parameter menu Parameter menu I-flow 10.0 L/m
Alarm limits PS ramp 0.20 s
Alarm AUTOSET Trigg. 3.0 L/m
Vent. modes ByFlow 3.0 L/m
ARC Time window 60%
Nebulizer ON PS endflow 25%
System test Buzzer 100%
Exit Previous menu
Exit
Stand-by ON
ASR ON
Parameter menu
Stand-by ON
ASR ON
Parameter menu
Alarm limits
Alarm AUTOSET
Vent. modes Vent. modes VCV
ARC SIMV - VC
Nebulizer ON Bi-Level
System test CPAP/PSV
Exit CPAP/Apnea
Previous menu
Exit
Stand-by ON
ASR ON
Parameter menu
Alarm limits
Alarm AUTOSET
Vent. modes
Exit Compensat. 75 %
Previous menu
Exit
4.1.14 Open a submenu Push the Menu button to open the main menu,
Stand-by ON
VCV
4.1.15 Change a The following shows how to change the parameter “MV max” in the
parameter in a sub menu alarm limit submenu.
Stand-by ON
The main menu will appear in the screen. ASR ON
Parameter menu
Alarm limits
Alarm AUTOSET
Vent. modes
ARC
Nebulizer ON
System test
Exit
Stand-by ON
The selected function will be highlighted in the ASR ON
menu. Parameter menu
Alarm limits
Alarm AUTOSET
Vent. modes
ARC
Nebulizer ON
System test
Exit
MV max 1.7 L
MV min 0.5 L
Leakage 25%
MV max 1.7 L
MV min 0.5 L
Leakage 25%
MV max 1.7 L
MV max 2.5 L
MV max 2.5 L
MV min 0.5 L
Selecting the “Previous menu” selection returns Leakage 25%
you to the main menu. Confirming the “exit” Pmax 40cmH2O
function will close the menu window or if left open Apn.del. 20 Sec
for 30 secs the menu will automatically close.
Rate max 40/Min
Rate min 8/Min
Previous menu
Exit
4.1.16 Alarm silence Pushing the alarm silence button during a high priority
alarm silences the audible alarm for two (2) minutes. A
clock in the screen starts displaying the remaining alarm
silence time. When an alarm becomes inactive , the alarm message
stays on the screen, but changes color from red to yellow and the
audible alarm turns OFF. This is to remind the operator that an alarm
situation had occurred . Pushing the alarm silence button again will
remove the yellow alarm message from the screen.
The system will treat all of these supply sources as a main supply.
5.1.1 Mains Supply Verify your local mains supply voltage matches the rated device’s
voltage on the serial plate (rear side).
Serial plate
O2 AIR
Lin
24V/3A DC
Connect the power cord to the mains inlet on the rear of the device.
Connect the power cord to the wall outlet.
Switch ON the mains switch.
External battery Place the external battery (option) below the Centiva/5 housing and
lock the battery housing to the Centiva/5 housing .
O2 AIR
24
24V/3A DC
let
Locking
Connect the DC supply power cord from the external battery pack to the
blue inlet and verify proper locking of the connector.
Verify the external battery is fully charged prior to usage. When fully
charged the battery’s charging indicator is lit permanently in green.
For more details to the external battery refer to the operation manual of
this accessory.
5.1.2 Back-up battery The Centiva/5 is equipped with an internal back-up battery supply that
supply provides at least 30 minutes of operation upon loss of electrical main
supply.
This back-up supply will automatically switch on whenever the main
supply is lost and will maintain uninterrupted operation of the
Centiva/5.
When operating on the back-up battery, the system will display a
message in the operation screen (no line supply).
At the same time the battery status in the
status line of the screen will display the
Battery 28 min
remaining operation time on battery.
When operating on back-up battery the system reduces power
consumption to save energy for extended battery life by turning off the
expiration valve heating system and by reducing the screen brightness.
Upon restoring line (main) supply the system automatically switches
back to the line supply and changes the message in the screen (no line
supply) from red to yellow.
Upon restoring line (main) supply the system automatically starts
recharging the internal battery.
Special notice Whenever the Centiva/5 is supplied by any main supply (line, 24 VDC
or external battery) and the system is turned ON, the internal back-up
battery is recharged. The recharging process is indicated by the battery
status displayed in the status line of the screen (with the timer counting
up ). The re-charger is not active when the system is turned OFF.
5.2.1 Dual gas supply The Centiva/5 is equipped with an electronic O2/AIR mixer to provide a
wide range of inspiratory oxygen concentrations. This requires the
supply of both O2 and AIR gases. The gas supply range for both gases
ranges from 40 to 80 PSI. The Centiva/5 is protected against
overpressure up to 140 PSI. The Centiva/5 provides high peak flow
capability for optimized pressure support ventilation. This capability
requires a flow of 120 l/min per gas.
Verify your gas supply pressure matches the pressure range mentioned
above.
AI
R
ga
ga
O2 AIR
si
si
nl
et
t
24V/3A DC
Connect the O2 gas supply hose to the O2 gas inlet on the rear of the
device. Connect the O2 gas supply hose to the wall outlet and check
the connection for leaks.
Connect the AIR gas supply hose to the AIR gas inlet on the rear of the
device. Connect the AIR gas supply hose to the wall outlet and check
the connection for leaks.
WARNING Use only gas supply hoses in compliance with the local
standards. Incorrect connecting of O2 and AIR supply can result
in risk to the patient.
WARNING Only supply the system with dry and clean gases to prevent water,
oil or particles to enter the system. Dirt, water or oil can damage
the system and may result in risk to the patient.
5.2.2 Single gas supply The Centiva/5 needs at least 40 PSI from the gas supply for proper
operation. If this pressure level is not sufficient from one gas source the
system automatically switches to the gas supply which has sufficient
pressure and displays an alarm message on the screen.
The Centiva/5 can operate with a single gas supply without alarms.
When the system recognizes the single gas supply during the system
test it prompts a message on the screen and asks for single gas
operation.
In the event of a single gas supply (e.g. AIR) the following screen will
appear during system test.
Restoring the O2
supply at this time in Centiva/5
the system test
System test Rev. x.nn
removes the message
automatically and the No O2 gas supply
Check O2 gas supply or
system test proceeds. for single gas AIR-supply press <Enter>
Special notice Restoring the missing gas during operation allows the unit to operate in
the dual gas supply mode . The system will still display the selected
single gas supply mode until a new system test is performed with both
gases available.
The Centiva/5’s expiration valve is removable from the device for easy
cleaning. Upon re-insertion it will lock in automatically for safe
operation.
Verify the PEEP membrane assembly is inserted in the valve block with
the note “TOP” facing you.
Special notice The expiration valve assembly should be inserted smoothly . If you feel
a high resistance when inserting the assembly do not force it in but
check for proper assembly of the expiration valve.
CAUTION Do not use active and passive humidification at the same time in
the same breathing circuit !
HME.
10 Vt-E
5
350 mL
Ppeak 21
Paw 14cmH2O
40 Pmin
3cmH2O
20
Flow O2-I 25
all connections.
L/min 21 18
%
-20
Rate 40
-40 121/min8
Fi02 Rate I:E Ramp P-Insp PEEP P-ASB
21 12 1:2 0.2 10 3 5
% 1/min sec cmH2O cmH2O cmH2O
5
350 mL
Ppeak 21
Paw
mbar
14cmH2O
Place the active humidifier onto the rail and properly fix it there.
Fill humidifier chamber or use a Centiva/5
according to manufacturer’s
10
Vt-E
5
350 mL
Ppeak 21
Paw
14cmH2O
advice.
mbar
40
Pmin
3cmH2O
20
Flow O2-I 25
L/min 21 18
%
-20
Rate 40
-40 121/min8
Fi02 Rate I:E Ramp P-Insp PEEP P-ASB
21 12 1:2 0.2 10 3 5
% 1/min sec cmH2O cmH2O cmH2O
the y-piece.
10
Vt-E
5
350 mL
Ppeak 21
Paw
mbar
14cmH2O
40
Pmin
3cmH2O
20
Flow O2-I 25
L/min 21 18
%
-20
Rate 40
-40 121/min8
Fi02 Rate I:E Ramp P-Insp PEEP P-ASB
21 12 1:2 0.2 10 3 5
% 1/min sec cmH2O cmH2O cmH2O
Water trap
CAUTION When using active humidifiers do not use HMEs between y-piece
and patient at the same time. This may result in increased
breathing resistance and risk to the patient .
Special notice Active humidifiers in general increase the resistance of the breathing
system. Care should be taken to keep the resistance as low as possible.
5.6.1 Control panel For better visibility and easy handling the Centiva/5 control panel can
be adjusted to optimize the viewing angle.
To adjust the viewing angle, the
upper part of the control panel
can be moved forward or
backward.
The control panel can be detached from the main engine and mounted
a distance of up to 3 meters away from the main engine.
Centiva/5
Bi-Level / ASB Tube : E 7.5 50% Adult
15 MV-E 12
4.2Liter2
10 Vt-E
5
350 mL
Ppeak 21
Paw
mbar
14cmH2O
40
Pmin
3cmH2O
20
Flow O2-I 25
L/min 21 18
%
-20
Rate 40
-40 121/min8
Fi02 Rate I:E Ramp P-Insp PEEP P-ASB
21 12 1:2 0.2 10 3 5
% 1/min sec cmH2O cmH2O cmH2O
For this application use the optional extension cable and mounting
accessories.
To mount the Centiva/5 control panel away from the Centiva/5 main
engine , follow the instructions below.
Reconnect the control panel and main engine using the extension
cable.
Turn ON the Centiva/5 and check for proper function by passing the
“power-up” test.
WARNING Do not disconnect the control panel during operation. This may
result in risk to the patient.
5
350 mL
Ppeak 21
receptacles.
Flow O2-I 25
L/min 21 18
%
-20
Rate 40
-40 121/min8
ot
n
fo
fo
pi
g
g
ng
n
n
si
si
i
ck
ou
ou
Lo
H
CAUTION Always ensure proper seating of the system and activated locking
mechanism, when applicable.
Turn ON The Centiva/5’s ON-OFF button is located on the lower right side of the
ventilator engine .
When supplied with line (mains) power (line switch on the rear should
always be turned ON) the ON-OFF button is illuminated by a green light
and the unit turns ON when the ON-OFF button is pressed.
If no mains supply is
present, or the mains
Centiva/5
Bi-Level Tube : E 7.5 50% Adult
MV-E 12
ON/OFF
Centiva/5 will not go into
normal operation when the main supply is missing.
Turn OFF The Centiva/5 can only be turned OFF when the patient is not being
ventilated and is disconnected (Status: System open ?).
In the non-ventilating Turn OFF device? Yes= Enter, No= any button
“System open ?” Centiva /5
mode, or in any other System test Rev. 2.1n
non-ventilating mode, System test OK. To start ventilation <Enter>
press and hold the ON-
Compliance 2.3 ml/cmH2O
OFF button for Resistance 0.8 cmH2O/L/s
approximately 3 secs.
Leakage 15 ml/min
Adult Pediatric
A message appears asking the user to either turn off the system by
confirming with the enter key (ComWheel) or returning to the current
status by pressing any other key.
10
MV-E
5.2Liter2
Vt-E
12
assembly.
Fi02 Rate I:E Ramp P-Insp PEEP PS
21 12 1:2 0.2 10 3 5
% 1/min sec cmH2O cmH2O cmH2O
O
Stopper
5.8.2 System test Push the ComWheel to confirm the <Enter> command.
During the system test, the system will check the proper function of all
pneumatic and electronic components together with the function of the
attached breathing circuit . If any malfunction is identified during this
system test, the corresponding message appears in the message box
area. For details of error messages refer to section 8 “Alarms and
messages”.
Adult
CAUTION Do not perform the system test with a filter or HME on the
breathing circuit. Inappropriate pressure and flow compensation
may result.
Other breathing circuit designs, such as co-axial systems, may increase
the measured resistance values.
5.8.3 In-operation test During operation the Centiva/5 continuously checks all safety relevant
functions and parameters. If a malfunction is identified, the system will
display alarms or messages on the screen. For details of error
messages refer to section 8 “ Alarms and messages”.
types.
Adult Pediatric
Activating the new patient type changes the color of the button in the
screen from gray to yellow to prompt the change.
The selected patient type is displayed during system test in the screen’s
lower left corner and during operation within the status information
area.
Bypass system test The required system test is bypassed with Bypass system test
this function. Unlock expiration valve
Calibrate O2 sensor
Exit
CAUTION In this situation the system uses the compliance and resistance
data from the last system test for all internal compensations. If
the current breathing circuit differs significantly to the past circuit,
differences in ventilation parameters due to changes in the
compensation process are possible. This may result in risk to the
patient.
Starting the ventilator without having performed the system test will
result in a status display “no test” to remind the user that the system
was started without a system test and to perform the system test as
soon as possible.
Unlock expiration valve This function releases the expiration valve Bypass system test
Unlock expiration valve
assembly. Calibrate O2 sensor
Exit
Releasing the
expiration valve is Centiva/5
necessary for cleaning
System test Rev. x.nn
purposes only.
Expiration valve unlocked
Ready to be removed from device
O2 sensor calibration This function starts an automatic O2 sensor calibration procedure. For
details refer to section 9 “Maintenance”.
Adult
6.1.1 Select a ventilation The Centiva/5 uses the “Bi-Level” as the default mode.
mode The system uses default settings according to the selected patient type
to provide a minimum level of ventilation performance.
Stand-by ON
ASR ON
Parameter menu
VCV
SIMV - VC
The ventilation modes menu appears. Bi-Level
CPAP/PSV
Make your selection with the ComWheel for the CPAP/Apnea
desired ventilation mode and confirm the selection Previous menu
by pushing the ComWheel. Exit
Adjust the ventilation parameter settings to the patient’s needs and set
the alarm limits accordingly.
6.1.2 Default ventilation When starting the Centiva/5 the system will provide default ventilator
values settings to enable easy preparation of the patient.
These settings are designed for the selected patient range to maintain a
minimum ventilation performance . The default ventilation mode is
“Bi-Level”.
6.1.3 Changing ventilation When changing from an active ventilation mode to another mode, the
modes Centiva/5 will transfer the settings for identical parameters (e.g. FiO2)
to the new mode.
For those non-transferable parameters algorithm are used to calculate
settings for the new ventilation mode based on measured data. These
algorithm are based on a calculation taking into account that the lung’s
compliance and resistance will not change significantly when changing
the mode.
VCV
Example: SIMV - VC
CAUTION Ensure all parameter settings and alarm limits are set according
to the patient’s situation.
Example: VCV
Change from VCV (or SIMV-VC) mode SIMV - VC
Bi-Level
CPAP/PSV
CPAP/Apnea
Previous menu
Exit
The data used is stored in the Centiva/5 as long as the system is not
turned OFF. That provides automatic access to this data when
ventilation is restarted after standby. Whenever the system is turned
OFF and is turned ON again, the default settings are used.
Paw
P max
P limit
PEEP
0 t
Spontaneous breathing
Insp.
Pause
T insp T exp
60/rate
Flow
I-Flow
0 t
The desired minute volume is determined by the set tidal volume (Vt)
and the set rate (rate).
The pressure and flow waveforms are influenced by the timing for
inspiratory and expiratory times (I:E) and by the inspiratory flow (I-Flow).
The system automatically provides an inspiratory pause depending on
timing and flow. The higher the I-Flow the longer the plateau time.
Use the soft keys to adjust the ventilation settings, described above
according to the patient’s needs
Fi O2 Rate I:E Vt Plimit PEEP I-Flow
50
%
10
1/Min
1:2.0 110 mL
30
cmH2O
OFF
cmH2O
6.6
L/Min
Leakage compensation A leak can occur when ventilating patients. To compensate for such
leakage, the Centiva/5 is equipped with an automatic leakage
compensation.
This leakage compensation is always active and compensates for
temporary as well as permanent leaks.
The compensation covers a maximum leak of up to 50% of the desired
tidal volume.
For more details refer to section “NIV” in this chapter.
Pressure limited Changes in a patient’s lung compliance or resistance can alter the peak
ventilation pressure at given settings.
When in the VCV mode, the Plimit setting provides the ability to perform
Pressure Limited Ventilation (PLV).
Paw
PEEP
0 t
When Plimit is reached the flow is decelerated to limit the pressure to the
set Plimit level. A low priority message “Plimit reached” will appear on the
screen.
When pressure limitation causes a tidal volume of less than 80% of the
set tidal volume to be delivered an alarm will indicate this with the “Vt
not delivered” message.
Beyond the “Plimit” level there is a second pressure safety barrier “Pmax“
for additional safety. The Pmax is automatically set to 10 cmH2O over the
Plimit (default). When the Pmax level is reached all inspiratory flow is
stopped and the over pressure release valve is activated, reducing the
pressure to the PEEP level.
The Pmax safety pressure level can be adjusted manually in the alarm
limits menu.
Paw
P max
Spontaneous breathing
without pressure support
P limit
Short Long
Ramp Ramp
P ASB
PEEP
0 t
60/rate
Flow
I-Flow
0 t
Mandatory parameters The desired mandatory minute volume is determined by the set tidal
volume (Vt) and the set rate (rate).
The pressure and flow waveforms are influenced by the timing for
inspiratory and expiratory times (I:E) and by the inspiratory flow (I-Flow).
The system automatically provides an inspiratory pause depending on
timing and flow. The higher the I-Flow the longer the pause (plateau)
time.
PSV parameter Pressure support ventilation is a pressure support (PS) function that will
increase the tidal volume or decrease the work of breathing)of a
spontaneous breathing patient. When a pressure supported breath is
initiated the ventilator delivers the required flow to increase the
pressure to the set PS pressure above the PEEP level. The pressure
support breath ends when the flow to the patient decreases to the set
PS end flow measured in % of the peak PSV flow. 25% is the default
setting.
The rise time between the PEEP level and the PS pressure level can be
modified by the PS- ramp time (ramp). The shorter the ramp time the
higher the initial PS flow.
The Centiva/5 allows spontaneous breathing on the PEEP pressure
level if the PSV function is turned off (PS set to 0 cmH2O).
Settings Use the soft keys to adjust the ventilation settings according to the
patient’s needs.
Fi O2 Rate I:E Vt Plimit PEEP PS
50%
10
1/Min
1:2.0 110 mL
30
cmH2O
OFF
cmH2O
10
cmH2O
Exit
can be set in the parameter menu.
Leakage compensation A leak can occur when ventilating patients. To compensate for such
leakage, the Centiva/5 is equipped with an automatic leakage
compensation.
This leakage compensation is always active and compensates for
temporary as well as permanent leaks.
The compensation covers a maximum leak of up to 50% of the desired
tidal volume.
For more details refer to section “NIV” in this chapter.
Pressure limited In the SIMV-VC mode the Plimit setting also allows for Pressure Limited
ventilation Ventilation (PLV).
Paw
PEEP
0 t
Paw
P max
short long
ramp ramp
P insp
PEEP
0 t
T insp T exp
ramp time
60/rate
Flow
Use the soft keys to adjust the ventilation settings, described above
according to the patient’s needs.
Fi O2 Rate I:E Ramp P-Insp PEEP PS
50
%
10
1/Min
1:2.0 0.20 Sec.
10
cmH2O
OFF
cmH2O
0
cmH2O
Leakage compensation A leak can occur when ventilating patients. To compensate for such
leakage, the Centiva/5 is equipped with an automatic leakage
compensation.
This leakage compensation is always active and compensates for
temporary as well as permanent leaks.
For more details refer to section “NIV” in this chapter.
Paw
P max
PS
P insp
PEEP
0 t
Spontaneous breathing time window Spontaneous breathing
without pressure support with pressure support
60/rate
with spontaneous
breathing
Flow
Mandatory parameters The mandatory parameters are identical to the previous section
“Bi-Level without spontaneous breathing”.
The desired minute volume is determined by the set pressure difference
between the upper and lower CPAP level (Pinsp) and the set rate (rate)
and is dependent on the patient’s lung compliance and resistance.
The pressure and flow waveform is influenced by the timing for the
inspiratory and expiratory times (I:E) and the ramp time (ramp) between
the lower und upper pressure level.
The base pressure level is adjusted with the positive end expiratory
pressure (PEEP) setting.
PSV parameter Pressure support ventilation is a pressure support (PS) function that will
increase the tidal volume or decrease the work of breathing of a
spontaneous breathing patient. When a pressure supported breath is
initiated the ventilator delivers the required flow to increase the
pressure to the set PS pressure above the PEEP level. The pressure
support breath ends when the flow to the patient decreases to the set
PS end flow measured in % of the peak PSV flow. 25% is the default
setting.
The rise time between the PEEP level and the PS pressure level can be
modified by the PS- ramp time (ramp). The shorter the ramp time the
higher the initial PS flow.
The Centiva/5 allows spontaneous breathing on the PEEP pressure
level if the PSV function is turned off (PS set to 0 cmH2O).
Settings Use the soft keys to adjust the ventilation settings, described above,
according to the patient’s needs.
50
%
10
1/Min
1:2.0 0.20 Sec.
10
cmH2O
OFF
cmH2O
10
cmH2O
Leakage compensation A leak can occur when ventilating patients. To compensate for such
leakage, the Centiva/5 is equipped with an automatic leakage
compensation.
This leakage compensation is always active and compensates for
temporary as well as permanent leaks.
For more details refer to section “NIV” in this chapter.
Paw
short long
ramp ramp
P ASB
PEEP
0 t
ramp time
Flow
ASB endflow
25 %
t
The base pressure level is adjusted with the positive end expiratory
pressure (PEEP) setting.
PSV parameter Pressure support ventilation is a pressure support (PS) function that will
increase the tidal volume or decrease the work of breathing of a
spontaneous breathing patient. When a pressure supported breath is
initiated the ventilator delivers the required flow to increase the
pressure to the set PS pressure above the PEEP level. The pressure
support breath ends when the flow to the patient decreases to the set
PS end flow measured in % of the peak PSV flow. 25% is the default
setting.
The rise time between the PEEP level and the PS pressure level can be
modified by the PS- ramp time (ramp). The shorter the ramp time the
higher the initial PS flow.
The Centiva/5 allows spontaneous breathing on the PEEP pressure
level if the PSV function is turned off (PS set to 0 cmH2O).
Settings Use the soft keys to adjust the ventilation settings, described above
according to the patient’s needs.
Fi O2 Ramp PEEP PS
50
%
0.20 Sec.
OFF
cmH2O
5
cmH2O
6.2.6 CPAP/Apnea Continuous Positive Airway Pressure with APNEA mandatory back-up
ventilation.
Setting CPAP/PSV When starting this mode “CPAP/PSV” is activated with the
corresponding soft keys highlighted.
Use the soft keys to adjust the ventilation settings, described above
according to the patient’s needs.
Fi O2 Rate I:E Ramp P-Insp PEEP PS
50
%
10
1/Min
1:2.0 0.20 Sec.
10
cmH2O
OFF
cmH2O
10
cmH2O
Setting the Back-up When Apnea is detected, the system switches automatically to the
ventilation mode ventilation mode “Bi-Level”. The settings of this mode are displayed ,
but the soft keys are grayed to indicate that the settings can be set but
are not active until the back up ventilation mode is activated.
Fi O2 Rate I:E Ramp P-Insp PEEP PS
50
%
10
1/Min
1:2.0 0.20 Sec.
10
cmH2O
OFF
cmH2O
10
cmH2O
• Stand-by Stand-by ON
6.3.1 Stand-by The standby function allows for the temporary interruption of the
Centiva/5 ventilator without alarming. All patient related settings are
saved and available upon reconnecting the patient to the ventilator.
To activate the standby function the user must disconnect the patient
from the system and wait for the “System open?” message on the
screen.
Notice the change in the menu from “Standby ON” Stand-by OFF
to “Stand-by OFF”.
ASR ON
The status line in the screen indicates the “Stand- Parameter menu
by” mode is active. Alarm limits
Ventilation is stopped and all alarms are silenced. Alarm AUTOSET
All ventilation settings are stored. Vent. modes
ARC
Nebulizer ON
System test
Close the main menu either with “Exit” or the menu
Exit
will close automatically after 30 secs.
To turn OFF the stand-by mode and to return to the former ventilation
mode reconnect the patient to the Centiva/5.
To manually turn OFF the stand-by mode and ventilate using current
settings :
• open the main menu with the menu button
• select the “Stand-by OFF” with the ComWheel
• confirm the selection
• close the menu with “Exit”.
6.3.2 ASR (Automatic To perform bronchial suction the user needs access to the patient’s
Suction Routine) tube.
Using a breathing circuit with a bronchial suction access port the user
can perform this therapy while in the ventilation mode .
To gain access to the tube on most breathing circuits the patient needs
to be disconnected from the ventilator.
ASR can be activated in all ventilation modes via the main menu.
Stand-by ON
ASR ON
Parameter menu
Alarm limits
Alarm AUTOSET
Vent. modes
ARC
Nebulizer ON
System test
Exit
Pre-Oxygenation phase The status line in the screen shows “Pre-Ox 1:59” System test
The soft key for the FiO2 setting changes from the
previous setting to 100 Vol %. The soft key color
changes from yellow to red to indicate that this is a
temporary change during the ASR procedure.
This FiO2 setting for the pre-oxygenation of 100 Vol % can be adjusted
to any desired FiO2 by the user.
Suction phase After 2 minutes the pre-oxygenation phase ends and the suction phase
starts. The status line in the screen shows “Suct 1:59” to indicate the
start of the suction phase and to show the remaining time in this phase.
The ventilator is stopped and the pressure is relieved to zero to allow
hygienic opening of the patient’s tube connection.
The screen shows the message “System open?”.
All alarms are silenced, but the Centiva/5 gives a short audible signal
to indicate the start of the suction phase. This audible signal is
repeated every 5 secs to remind the operator ventilation is not active.
Post-Oxygenation phase The status line in the screen shows “Post-Ox 1:59” to indicate the start
of the post-oxygenation phase and to show the remaining time in this
phase.
The ventilator starts back in the set mode with the previous ventilation
pattern and settings. PEEP pressure will build up again. All alarms are
activated .
The soft key for FiO2 setting is still set to the value of the
pre-oxygenation phase. The color of the soft key is still
red to indicate this temporary change by the ASR
procedure.
This FiO2 default setting for the post-oxygenation of 100 Vol % can be
adjusted to any desired FiO2 by the user.
WARNING Ensure sufficient patient oxygenation if the FiO2 pre and post
suction concentration is changed from 100 Vol % to any other
value.
ASR can be activated by a short cut. For more details refer to section
“short cuts” in this chapter.
6.3.3 Parameter menu Frequently used settings for the different ventilation modes are
accessible via the soft keys on the screen. Centiva/5 offers additional
setting options. To keep the interface easy to use these other settings
are accessible in the parameter menu.
The parameter menu provides access to certain settings depending on
the current ventilation mode. For details refer to the “Adjust ventilation
parameters” in this section.
This allows the setting of the inspiratory flow in the PS ramp 0.20 s
Trigg. Available in the following ventilation modes: SIMV- I-flow 10.0 L/m
Time window Available in the ventilation modes: SIMV-VC, I-flow 10.0 L/m
Bi-Level and CPAP/Apnea. PS ramp 0.20 s
This is a trigger window that provides the time Trigg. 3.0 L/m
with the mandatory or PSV ventilation. This time Time window 60%
The drawing below shows the time window as a % of the expiration time
for a setting of 50%.
Paw
P insp
PEEP
0 t
Time
window = 50%
Expiration
time = 100%
This is the setting for the flow criteria to end the Trigg. 3.0 L/m
of 10 % to 60 %.
Buzzer 100%
Previous menu
The PS endflow allows for fine adjustment of the
Exit
pressure support to a patient’s lung dynamic.
The default setting is 25%.
The drawing below shows the PS endflow as a % of the PSV peak flow
for a setting of 10% and 60%.
Paw
PS
PEEP
t
Flo
w
Peak flow
End of support
60%
End of support
10%
t
PS PS
Endflow = 10% Endflow = 60%
Buzzer Available in all ventilation modes: VCV, SIMV-VC, I-flow 10.0 L/m
This is the volume setting for the alarm speakers in Trigg. 3.0 L/m
Previous menu This function leads back to the previous (main) I-flow 10.0 L/m
menu. PS ramp 0.20 s
Trigg. 3.0 L/m
ByFlow 3.0 L/m
Time window 60%
PS endflow 25%
Buzzer 100%
Previous menu
Exit
Exit This function closes the parameter menu. I-flow 10.0 L/m
PS ramp 0.20 s
Without any activity (button or the ComWheel) all Trigg. 3.0 L/m
6.3.4 Alarm limits Adequate monitoring of a patient’s breathing and the device function is
supported by the internal monitoring capabilities of the Centiva/5.
Alarm limits must be set appropriately according to the patient’s
condition and the set ventilator parameter ranges.
Alarm limits must represent a safe area for the patient. When the
current value of a parameter increases beyond the upper limit or
decreases below the lower limit the alarm will activate.
Depending on the parameter and the level of priority, the Centiva/5
prompts with either a high or low priority alarm. For details about alarm
modalities and messages refer to section 8 “Alarms and messages”.
A high priority audible alarm can be silenced for 2 minutes by
pushing the alarm silence button. A clock indicating the
alarm silence time starts simultaneously on the screen.
New alarms occurring while the alarm silence is activated will restart the
audible alarm.
When a high priority alarm condition no longer exists, the alarm
message turns from red to yellow and the flashing red alarm light and
audible alarm are turned off.
The yellow alarm message stays on the screen until the alarm silence
button is pressed again. This allows for the monitoring of alarms that
have occurred and have reset.
When several alarms occur concurrently, the alarm messages are
displayed in order of appearance.
After the patient has been placed on the ventilator and the settings are
stable the alarm limits need to be reset to a level that is appropriate for
the patient’s condition.
TV-E
limits exist:
• Upper alarm limit for expiratory minute
volume MV-E
361 mL
Ppeak
21
• Lower alarm limit for expiratory minute
volume MV- E 14 cmH2O
O2-I
26
• Lower alarm limit for inspiratory O2
concentration 21 18 %
Alarm limits when starting Selecting a patient default level pre-adjusts the ventilator settings and
sets the alarm limits. When ventilator settings are adjusted to the
patient’s needs , alarm limits need to be set accordingly.
Alarm limits for FiO2 The user does NOT make the upper and lower alarm limits for the
inspiratory oxygen concentration. The alarm limits for the measured
inspiratory O2 concentration are set automatically based on the set
concentration .
Set alarm limits To access the alarm limit menus open the main menu by
pushing the menu button.
Close the alarm limit menu and the main menu by MV max 1.7 L
either selecting “Exit” or let the menus close MV min 0.5 L
automatically after 30 secs. Leakage 25%
Pmax 40cmH2O
Apn.del. 20 Sec
Rate max 40/Min
Rate min 8/Min
Previous menu
Exit
MV max The upper limit for minute volume has an MV max 1.7 L
adjustable range from 99 to 0.5 L/min. Measured MV min 0.5 L
minute volume exceeding the adjusted maximum Leakage 25%
minute volume “MV max” triggers the alarm. The Pmax 40cmH2O
alarm is reset when the measured minute volume Apn.del. 20 Sec
falls below the adjusted “MV max”. “MV max” Rate max 40/Min
cannot be set below “MV min”. 8/Min
Rate min
The default setting is 12 L/Min (Adult) and 5 L/min Previous menu
(Pediatric) Exit
MV min The lower limit for minute volume has an MV max 1.7 L
adjustable range from 0.5 to 99 L/min. Measured MV min 0.5 L
minute volume falling below the adjusted Leakage 25%
minimum minute volume “MV min” triggers the Pmax 40cmH2O
alarm. The alarm is reset when the measured Apn.del. 20 Sec
minute volume exceeds the adjusted “MV min”. Rate max 40/Min
“MV min” cannot be set above “MV max”. Rate min 8/Min
The default setting is 2.5 L/min (Adult) and 1.2 Previous menu
L/min (Pediatric) Exit
P max The upper limit for the absolute airway pressure MV max 1.7 L
has an adjustable range of 21 to 70 cmH2O. The MV min 0.5 L
Pmax alarm limit follows the highest pressure Leakage 25%
setting, according to the set ventilation mode, with Pmax 40cmH2O
the set difference (set diff.): Apn.del. 20 Sec
Pmax = Plimit + set diff. in VCV, SIMV-VC Rate max 40/Min
pressure relief valve. The alarm is reset when the Pmax 40cmH2O
Apnea del. The upper limit for the apnea time (no breathing
MV max 1.7 L
activity) has an adjustable range from 10 to 60
MV min 0.5 L
secs. Measured time without any breathing activity
exceeding the maximum apnea time triggers an
Leakage 25%
Rate max The upper limit for the breathing rate is adjustable MV max 1.7 L
from 200 to 4 /min. Measured rates exceeding the MV min 0.5 L
adjusted maximum rate “Rate max” triggers the Leakage 25%
alarm. The alarm resets when the measured rate Pmax 40cmH2O
falls below the adjusted “Rate max”. “Rate max” Apn.del. 20 Sec
cannot be set below “Rate min”. Rate max 40/Min
The default setting is 40/Min (Adult) and 60/min Rate min 8/Min
(Pediatric). Previous menu
Exit
Rate min The lower limit for the breathing rate has an MV max 1.7 L
adjustable range from 4 to 200 /min. A measured MV min 0.5 L
rate falling below the adjusted minimum rate “Rate Leakage 25%
min” triggers the alarm. The alarm resets when the Pmax 40cmH2O
measured rate exceeds the adjusted “Rate min”. Apn.del. 20 Sec
“Rate min” cannot be set above the “Rate max”. Rate max 40/Min
The default setting is 8/min (Adult) and 14/min Rate min 8/Min
(Pediatric). Previous menu
Exit
Previous menu The function leads back to the previous (main) MV max 1.7 L
menu.
MV min 0.5 L
Leakage 25%
Pmax 40cmH2O
Apn.del. 20 Sec
Rate max 40/Min
Rate min 8/Min
Previous menu
Exit
6.3.5 Alarm AUTOSET For those cases when the patient’s “clinical picture” matches the
measured data Centiva/5 offers a fast way to set all alarm limits
according to the “clinical picture“ using the AUTOSET function.
AUTOSET establishes the alarm limits according to the measured
parameters. Whenever the ventilator parameters are changed new
alarm limits can be set to match the “clinical picture” by activating
AUTOSET.
Stand-by ON
ASR ON
Parameter menu
Alarm limits
Alarm AUTOSET
Vent. modes
ARC
Nebulizer ON
System test
Exit
The alarm AUTOSET function is activated and sets the alarm limits
according to the measured patient data, valid at the moment of
activation.
Close the main menu either with “Exit” or let the menus close
automatically after 30 secs.
MV max (AUTOSET) Upper limit for minute volume is set to the measured patient minute
volume + 150%.
Measured minute volume exceeding the adjusted maximum minute
volume “MV max” triggers the alarm. The alarm is reset when measured
minute volume falls below the “MV max” setting.
MV min (AUTOSET) Lower limit for minute volume is set to the measured patient minute
volume – 50%.
Measured minute volume falling below the adjusted minimum minute
volume “MV min” triggers the alarm. The alarm is reset when measured
minute volume exceeds the “MV min” setting.
6.3.6 ARC (Airway The components of the patient breathing circuit and the patient’s
Resistance Compensation) artificial airway add a large amount of resistance to spontaneous
breathing.
During mechanical ventilation this resistance does not generally affect
the patient. But during spontaneous breathing this resistance becomes
important for the patient during weaning due to increased work of
breathing.
Pressure support (PSV) can be used to partially compensate for this
resistance.
The Centiva/5 also offers a special flow compensation for this airway
resistance with respect to the flow/pressure relationship of the
endotracheal and tracheal tubes. This Airway Resistance
Compensation (ARC) is adjustable according to the type of tube, tube
size and level of compensation. ARC operates in pressure controlled
modes (Bi-Level) and spontaneous modes (CPAP/PSV) for both the
mandatory and the spontaneous breaths. The ARC compensates for the
inspiratory and the expiratory resistance.
To access the ARC menu open the main menu by pushing the
menu button.
Stand-by ON
ASR ON
Parameter menu
Alarm limits
Alarm AUTOSET
Vent. modes
ARC
Nebulizer ON
System test
Exit
Endot.tube OFF
The ARC menu opens and allows adjustment of Trach.tube OFF
the specific parameters.
Diameter 7.5
Compensat. 50%
Previous menu
Trach.tube Tracheal tube (T). ON identifies that this type of tube is being used.
Diameter This is the tube’s diameter, marked on the outside of the tube or
packaging. The diameter is adjustable in a range from 4 to 10 mm.
Compensat. This is the level of compensation for the flow dependent resistance in %
of the total compensation. The compensation is adjustable in a range
from 25 to 100%.
Previous menu The function leads back to the previous (main) menu.
WARNING Always set the tube diameter to the size of the tube being used.
Setting the ARC tube diameter value smaller than the tube being used
will cause overcompensation. This may result in risk to the patient.
Due to the airway pressure being measured within the Centiva/5 the
pressure graph will show an overshoot at the beginning of inspiration,
showing the inspiratory ARC compensation. During expiration the
pressure graph shows an undershoot which shows the expiratory
compensation. The expiratory compensation’s lowest level of pressure
is zero.
Special notice These over- and undershoots are shown on the screen because the
airway pressure is measured within the Centiva/5. Due to the nature of
ARC these over- and undershoots are not applied beyond the patient’s
airway .
The following graph shows the change in the pressure graph (e.g. Bi-
Level mode) when ARC is activated.
Paw
Inspiratory
compensation
Expiratory
compensation
PEEP
0 t
Special notice Be aware that using high levels of compensation can cause auto
triggering of PSV breaths. To avoid this situation reduce the trigger
window, if necessary.
6.3.7 Nebulized drug During ventilation Centiva/5 allows drug delivery to the patient via the
delivery breathing circuit by means of so called “jet nebulizers”.
Jet nebulizers which have been tested to properly work with Centiva/5 are
listed in the accessory list. However any jet nebulizer which complies with
the following minimum requirements should function correctly:
- Nebulizer flow in between 4 to 12 l/min at a supply pressure of
1,8 bar (25 PSI).
- Pressure stable up to a breathing pressure of 80 cmH2O.
- Leakage under 200 ml/min at a breathing pressure of 60 cmH2O.
Ventilation modes During adult ventilation drug nebulization will be available in all
ventilation modes: VCV, SIMV-VC, Bi-Level, CPAP/PSV, CPAP/Apnea.
During pediatric ventilation drug nebulization will be available in pressure
controlled ventilation modes: Bi-Level, CPAP/PSV, CPAP/Apnea
The Nebulizer system can be activated in volume controlled modes (VCV
and SIMV-VC), too, but limited volume measurement accuracy of
20 ml ± 15% for tidal volumes below 300 ml may result.
For testing purpose the nebulizer can be turned on in Stand-By mode as
well.
To activate the nebulizer function open the main menu by
pushing the menu button.
Stand-by ON
ASR ON
Parameter menu
Alarm limits
Alarm AUTOSET
Vent. modes
ARC
Nebulizer ON
System test
Exit
Notice the change in the menu from “Nebulizer ON” Alarm AUTOSET
Nebulizer modes At measured breathing rates < 15 /min the nebulizer is controlled in
synchrony with the inspiratory flow.
At measured breathing rates ≥ 15 /min the nebulizer is operated
continuously. In both modes the minute volume is kept constant
compared to the application without nebulizer activity, because
Centiva/5 measures the nebulizer flow during the system test and uses
this for proper compensation of the total flow.
Nebulizer and O2 Concentration Depending on the set FiO2 the nebulizer is supplied with either AIR or
O2 to keep the deviation of supplied O2 concentration (O2 – I) in a range
of ± 4 Vol. %.
Connect the other end of the nebulizer pressure supply hose to the
nebulizer connection on the front
side of the Centiva/5.
WARNING Do not use filter or HME between patient and nebulizer during
activated nebulization mode. Risk of increasing breathing
resistance.
Nebulizer test Centiva/5 provides capabilities in the System test to measure the
selected nebulizer’s characteristics and compensate accordingly. To do
so connect the nebulizer according to the instructions given above and
perform the system test.
Centiva/5 will
automatically detect if
a nebulizer system is Centiva /5
connected and will System test Rev. x.nn
measure the
System test OK. To start ventilation <Enter>
for internal
compensations.
6.3.8 System test The system test is started automatically when the Centiva/5 is turned
ON. The system test checks for proper function of the system and
measures the compliance, resistance and leakage of the breathing
circuit.
In case the breathing circuit is changed the Centiva/5 needs the new
breathing circuit’s data so, the system test should be activated at the
earliest possibility.
This can be achieved by turning the ventilator OFF and then ON again.
This menu function allows fast access to the system test.
Special notice This function is only accessible when there is no ventilation mode
active. (System open? screen message)
Stand-by ON
ASR ON
Parameter menu
Alarm limits
Alarm AUTOSET
Vent. modes
ARC
Nebulizer ON
System test
Exit
The Centiva/5 moves to the system test screen. For details refer to
section 5.8.2 “System test”.
6.3.9 NIV (Non Invasive This function provides the ability to ventilate patients when airways
Ventilation) such as uncuffed tubes for pediatric applications and mask ventilation
are used.
The NIV function maintains sufficient ventilation even with a leak until
the maximum compensation is reached.
The current leakage (leak) Centiva/5
5
Vt-E
350 mL
the ventilator to
% 1/min sec cmH2O cmH2O cmH2O
Leak E - flow
I - flow
The leakage compensation is active in all modes.
In VCV and SIMV-VC mode the leak compensation increases the
inspiratory flow up to 50 % of the set tidal volume, according to the
measured leak. The maximum of 50% is set due to safety reasons e.g.
with intubated patients. In case of mask ventilation this compensation
can be increased beyond 50% by increasing the I-flow.
In Bi-Level, CPAP/ASB and CPAP/Apnea mode the leak compensation
increases the inspiratory flow up to the maximum I-Flow setting,
according to the measured leak.
For safety reasons the compensation takes four breaths to activate
when a leak is detected . When the leak disappears the leakage
compensation is reset within one breath to the non-leaking value.
WARNING For safety reasons it is important that the pressure limit (Plimit)
and the leakage alarm limit are set appropriately for the patient’s
condition.
5
Vt-E
350 mL
Ppeak 21
6.3.10 APD (Automatic Centiva/5 uses the Byflow in the breathing system to automatically
Patient Detection) detect when a patient is connected to the breathing system.
In the following modes this function is used to start or restart the set
ventilation mode with an inspiration:
• Start up waiting phase
• Standby
• ASR suction phase
When the Centiva/5 is set up for a new patient and a breathing circuit
has been attached and has passed the system test it is recommended
that the Centiva/5 be left in the system test end screen.
This will maintain the seal of the y-piece preventing the activation of the
APD.
Centiva /5
System test Rev. x.nn
System test OK. To start ventilation <Enter>
Adult
6.3.11 OCV (Online O2 To online calibrate the O2 sensor in any ventilation mode Centiva/5
sensor calibration) provides an online-O2-sensor calibration function. This function may be
necessary when in long-term ventilation and having an aging O2 sensor.
The function requires setting the FiO2 to 100%. The entire process will
last at least 5
minutes. Centiva/5
soft key
10 Vt-E
5
350 mL
Ppeak 21
simultaneously will 14
Paw
mbar cmH2O
40 Pmin
3
start the Online-O2-
cmH2O
20
Flow O2-I 25
L/min 21 18
%
sensor calibration in
-20
Rate 40
-40 12 8
1/min
6.3.12 Short cuts The Centiva/5 has several short cuts that allow activation of functions
by soft keys without entering a menu.
simultaneously will
15
4.2Liter2
10 Vt-E
350 mL
start the ASR Paw
5
mbar
Ppeak
14cmH2O
21
function in any 40
20
Pmin
O2-I
3cmH2O
25
ASR mode.
simultaneously will
15 MV-E
4.2Liter2
10 Vt-E
350 mL
freeze the Paw
5
mbar
Ppeak
14cmH2O
21
waveforms. A 40
20
Pmin
3cmH2O
25
message in the
Flow O2-I
L/min 21 18
%
-20
Rate 40
121/min8
screen “Freeze” will
-40
simultaneously will 10
5
Vt-E
350 mL
function in any
40
3cmH2O
20
Flow O2-I 25
L/min 21 18
sensor calibration
40 Pmin
3cmH2O
20
Flow O2-I 25
21 18
in any mode.
L/min
%
-20
Rate 40
-40 121/min8
7.2 Disassembly
7.2.1 Used with HME Disconnect patient from the ventilator and wait for the “System open?”
message and turn OFF the Centiva/5.
Centiva/5
Bi-Level / ASB Tube : E 7.5 50% Adult
MV-E 12
15
4.2Liter2
10
Vt-E
5
350 mL
Ppeak 21
Paw
mbar
14cmH2O
40
Pmin
3cmH2O
20
Flow O2-I 25
L/min 21 18
%
-20
Rate 40
-40 121/min8
Fi02 Rate I:E Ramp P-Insp PEEP P-ASB
21 12 1:2 0.2 10 3 5
% 1/min sec cmH2O cmH2O cmH2O
7.2.2 Used with active Disconnect the patient from the ventilator and wait for the “System
humidifier open ?” message and turn OFF the Centiva/5.
Turn OFF the active humidifier and remove the electrical connection.
5
350 mL
Ppeak 21
Paw
mbar
14cmH2O
40 Pmin
3cmH2O
20
Flow O2-I 25
L/min 21 18
%
-20
Rate 40
-40 121/min8
Fi02 Rate I:E Ramp P-Insp PEEP P-ASB
21 12 1:2 0.2 10 3 5
% 1/min sec cmH2O cmH2O cmH2O
Water trap
7.3.1 Removing expiration The Centiva/5 uses a removable expiration valve assembly for easy
valve assembly cleaning.
No main supply In case there is no main supply available, the internal back-up battery
will release the expiration valve assembly by turning the Centiva/5 on.
Turn OFF the Centiva/5 and disconnect it from the line supply, if
applicable.
7.3.2 Disassemble The expiration valve is easy to take apart. Remove the stainless steel
expiration valve assembly plate and then remove the PEEP membrane assembly.
7.4.1 Housing and control Turn OFF the Centiva/5 and ensure that the mains power cord and the
panel 24 V DC external supply power cord are disconnected.
Use a soft towel to clean the housing and control panel. When using
fluid cleaners use a mild detergent and do not permit liquids to go into
the equipment housing.
Ensure that the housing and control panel are dried completely before
reconnecting the Centiva/5 to an electrical supply or prior to turning the
device on.
7.4.2 Expiration valve The expiration valve assembly and its components can be cleaned and
disinfected with cleaning solvents, such as CIDEX. CIDEX plus is not
recommended.
7.5 Reassembly
7.5.1 Reassemble Insert the PEEP membrane assembly (B) into the block with the note
expiration valve assembly “TOP” facing you.
When inserting the PEEP membrane assembly into the expiration valve
block make sure the PEEP silicone membrane faces the valve seat and
verify the proper assembly by looking for the “TOP” mark on top of the
PEEP membrane assembly after insertion.
7.5.2 Reinsertion of Slide the entire assembly into the expiration valve locking mechanism
expiration valve assembly slot with the expiration port to the front.
Special notice Do not try to overcome a high resistance or try to force the assembly
back into the slot. If problems occur with reinsertion check for proper
assembly of the expiration valve.
The Centiva/5 will automatically recognize the insertion and lock the
expiratory valve assembly in, if powered by a main supply. After proper
locking the system performs a power-up test to verify proper operation.
Adult Pediatric
Important note Be aware that system test messages may appear because of artifacts
during the system test sequence. These artifacts could be moving ,
manipulating and handling of accessories and breathing circuit
components while performing the tests.
In this case no malfunction of Centiva/5 has created the message
performing the system test again will allow to pass the system test
successfully.
High priority
Activity Screen Red alarm light Audible alarm
Alarm is active - Display alarm message in red color ON, flashing ON
Confirming the - Display alarm message in red color. ON, continuous OFF
alarm by activating - Start “2min” silence.
the alarm silence - Start timer in screen
button
Alarm is still active - Display alarm message in red color. ON, flashing ON
after the “2min”
silence time
Alarm is reset - Display alarm message in yellow OFF OFF
color
Confirming the - Displayed alarm message in yellow OFF OFF
alarm reset by color removed from screen.
activating the alarm
silence button
Low priority
Activity Screen Yellow alarm light Audible alarm
Alarm is active - Display alarm message in red color ON, continuous OFF
Confirming the - Display alarm message in red color. ON, continuous OFF
alarm by activating - Start timer in screen
the alarm silence
button
Alarm is reset - Display alarm message in yellow OFF OFF
color
Confirming the - Displayed alarm message in yellow OFF OFF
alarm reset by color removed from screen.
activating the alarm
silence button
“Fan failure. The internal fan is not System may not be Call authorized service
Call service specialist” operable. operated specialist
“Temperature sensor The inspiratory System may not be Call authorized service
insp. Flow malfunction. temperature sensor is operated specialist
Call service specialist” not operable.
“Watchdog does not turn The heater is not System may not be Call authorized service
off heater. Call service operable. operated specialist
specialist.”
“Exp. flow sensor heater The heater is not System may not be Call authorized service
cannot be switched on. operable. operated specialist
Call service specialist.”
“Heater or heater current The heater is not System may not be Call authorized service
limiter failure. Call operable. operated specialist
service specialist.”
“Heater or heater current The heater is not System may not be Call authorized service
limiter failure. Call operable. operated specialist
service specialist.”
“Heater temperature The heater is not System may not be Call authorized service
sensor malfunction. Call operable. operated specialist
service specialist.”
“Expiration valve missing The expiration valve System may not be Re-insert expiration
or not in proper assembly is not inserted operated valve assembly
position.” and locked.
“Expiration valve The expiration valve Remove the expiration Re-insert expiration
unlocked. Ready to be assembly is unlocked valve assembly. valve assembly
removed from device.” and can be removed
“Expiratory valve data Expiratory valve data Check breathing circuit Expiratory valve data in
not matching. Check does not match with for kinked hoses or proper range
breathing circuit. Press resistance and components causing Or proceed with system
<Enter>.” compliance data high resistance test by pushing <Enter>
P= yy %
inspiratory pause = yy %
of inspiration time
E= zz s
expiration time = zz
seconds
“Switch off device? Yes: System in Standby Software switch off of Push any button to
Enter, No: any button” Or system open ? Centiva /5 by activating return to normal
And On/Off button the <Enter> button operation
activated for more than 3
secs
“System error # ” Any system error System error # has Shut down system,
detected during occurred. restart and perform
permanent system check power up test
Or call authorized service
specialist
9.1 General
The Centiva/5 uses a galvanic fuel cell type oxygen sensor to measure
the inspiratory oxygen concentration. Fuel cells have an aging effect
that requires periodic re-calibration as it is exposed to oxygen.
The oxygen sensor calibration is an automatic procedure that needs
only to be started by the operator.
Re-calibrate the Oxygen sensor on a two weeks basis or whenever the
set FiO2 differs by more than 5 Vol% with the measured FiO2 value.
9.2.1 Start calibration Turn ON the Centiva/5 and wait for the power-up test to finish.
The calibration
procedure takes up to Centiva/5
60 secs. The remaining
Oxygen sensor calibration
test time counts down
Calibration time 42 s
on the screen. O2-Concentration 21 %
Message box
Stop
The system flows approx. 10 L/min in the inspiratory line to stabilize the
O2 sensor at 100% O2. The measured O2 concentration is displayed on
the screen.
When calibration is
successfully completed Centiva/5
the system prompts Oxygen sensor calibration
with a screen message Calibration succesfully finished
and returns to the
power-up test screen.
9.2.2 Stop calibration Pushing the “Stop” button during the calibration procedure ends the
calibration. The system returns to the power-up test screen and uses
the previous calibration data.
9.3.1 Remove expiration valve Turn ON the Centiva/5 and wait for the power-up test to finish.
assembly
After having successfully passed the power-up test and the
system test, the system test menu can be activated by
pressing the menu button.
This process works with main power supply and with internal back-up
battery supply as well.
device.
9.3.2 Replace components The expiration valve is easy to take apart. Remove the stainless steel
plate and then remove the PEEP membrane assembly.
F E C D B A
CAUTION Handle carefully the silicone PEEP membrane assembly and the
flow screen.
9.3.3 Reassembly Insert the PEEP membrane assembly (B) into the block with the note
“TOP” facing you.
9.3.4 Reinsertion of Slide the entire assembly into the expiration valve locking mechanism
expiration valve assembly slot with the expiration port to the front.
The Centiva/5 will automatically recognize the insertion and lock the
expiratory valve assembly in, if powered by a main supply. After
proper locking the system performs a power-up test to verify proper
operation.
Adult Pediatric
9.4.1 Every twelve (12) Perform the following every twelve months:
months 1) Remove all user level breathing system assemblies and
components from the breathing system.
2) Remove the expiration valve form the main engine.
3) Open the main engine according to service manual.
4) Inspect the Centiva /5 ICU Ventilator and the removed
components for distortion, deterioration and/or cracks .
5) Inspect and replace, if necessary, the expiration valve
components according to service manual.
6) Replace the O2 sensor, if necessary, according to service
manual.
7) Replace O-ring on NIST connector (if applicable) at supply hose
for AIR and O2.
8) Perform calibration of sensors for AIR flow, O2 Flow, Expiration
flow, Airway pressure and of over pressure relief valve and battery
charging voltage according to service manual.
9) Reassemble and close the main engine.
10) Perform the Post-service checkout according to service manual.
11) Perform the electrical safety test for
• Ground resistance (< 0.2 Ω )
• Leakage current (< 500 uA)
• Insulation resistance (> 10 MΩ)
9.4.2 Every twenty four (24) In addition to the 12 month requirements, perform the following every
months twenty-four months:
10.1 General
10.2 Supplies
Parameter menu
ByFlow: 3.0 to 30 L/min
Buzzer: 20 to 100 %
Parameter menu
I-Flow: 2 to 99,9 L/min
PS ramp: 0,2 to 0,5 sec
Trigg.: 0.5 to 20 L/min
ByFlow: 3 to 30 L/min
Time window: 20 to 90 % of expiration time
PS end flow: 10 to 60 % of peak PS flow
Buzzer: 20 to 100 %
Parameter menu
PS ramp: 0,2 to 0,5 sec
Trigg.: 0.5 to 20 L/min
ByFlow: 3 to 30 L/min
Time window: 20 to 90 % of expiration time
PS end flow: 10 to 60 % of peak PS flow
Buzzer: 20 to 100 %
Parameter menu
Trigg.: 0.5 to 20 L/min
ByFlow: 3 to 30 L/min
PS end flow: 10 to 60 % of peak PS flow
Buzzer: 20 to 100 %
CPAP/Apnea Mode CPAP/PSV Mode with Bi-Level back-up mode, in case of apnea
Parameter menu
Trigg.: 0.5 to 20 L/min
ByFlow: 3 to 30 L/min
PS end flow: 10 to 60 % of peak PS flow
Buzzer: 20 to 100 %
Parameter menu
PS ramp: 0,2 to 0,5 sec
Trigg.: 0.5 to 20 L/min
ByFlow: 3 to 30 L/min
Time window: 20 to 90 % of expiration time
PS end flow: 10 to 60 % of peak PS flow
Buzzer: 20 to 100 %
Apnea time Upper alarm limit: Apnea time (time without breathing
activity)
Alarm upper limit: no breathing activity in set apnea
time
Adjustment range: 10 to 60 secs
Notes
For a period of twelve (12) months from the date of original delivery to
Buyer or to Buyer’s order, but in no event for a period of more than two
years from the date of original delivery by Datex-Ohmeda to a Datex-
Ohmeda Authorized Dealer, this Product, other than its expendable
parts, is warranted against functional defects in materials and
workmanship and to conform to the description of the Product
contained in this operation manual and accompanying labels and/or
inserts, provided that the same is properly operated under the
conditions of normal use, that regular periodic maintenance and
service is performed and that replacements and repairs are made in
accordance with the instructions provided. This same warranty is made
for a period of thirty (30) days with respect to expendable parts. The
foregoing warranties shall not apply if the Product has been repaired
other than by Datex-Ohmeda or in accordance with written instructions
provided by Datex-Ohmeda, or altered by anyone other than Datex-
Ohmeda, or if the Product has been subject to abuse, misuse,
negligence, or accident.
W-1
Corporate Office Datex-Ohmeda Pte. Ltd. Malaysia France
Room 1602, GIE Tower Datex-Ohmeda Pte. Ltd. Datex-Ohmeda S.A.S.
403 Huan Shi Dong Road Level 2 Bangunan O'Connor ZAC de Sans-Souci
Guangzhou, 510095, PR China 13 Jalan 223 1211 Chemin de la Bruyère
Tel 86 20 8732 2521 46100 Petaling Jaya F-69760 Limonest
Fax 86 20 8732 2518 Selangor, West Malaysia France
Datex-Ohmeda Pte. Ltd. Tel 60 3 754 7872 Tel 33 (0) 4 78 66 62 10
Datex-Ohmeda Division Fax 60 3 757 6948
Instrumentarium Corp. Room 2509, Lippo Plaza Fax 33 (0) 4 78 43 26 58
PO Box 900 No. 222 Huaihai Road (M)
Singapore Germany
FIN-00031 Helsinki Shanghai 200021, P.R. China
Datex-Ohmeda Pte. Ltd. Datex-Ohmeda GmbH
Finland Tel 86 21 5382 5657
152 Beach Road Dr. Alfred-Herrhausen-Allee 24
Tel 358 10 394 11 Fax 86 21 5382 1619
#12-05/07 Gateway East D-47228 Duisburg
Fax 358 9 146 3310 Datex-Ohmeda Pte. Ltd. Singapore 189721 Germany
Room 809, Truroll Plaza Tel 65 391 8618 Tel 49 2065 691-0
Wusheng Road Fax 65 291 6618
North America Fax 49 2065 691-236
Wuhan 430033, PR China
Tel 86 27 8571 2536 Taiwan and Philippines Italy
United States Fax 86 27 8571 2655 Datex-Ohmeda Pte. Ltd.
Customer Service, Technical Support Datex-Ohmeda S.p.A.
2nd Floor, No. 85, Chien-Kuo North Via Cassanese 100
and Distribution Center India Road, Sec. 2
Datex-Ohmeda, Inc. 20090 Segrate, Milan
Datex-Ohmeda (India) Pvt. Ltd. Taipei, Taiwan
PO Box 7550 Italy
Block EP & GP, Sector V Republic of China
Madison, WI 53707-7550, USA Tel 39 2 21693431
Plot XI-16, Salt Lake City Tel 886-2 2515 0457
Tel 1 800 345 2700 Fax 39 2 26926226
Calcutta 700091 Fax 886-2 2501 9136
Fax 1 608 221 4384 India Netherlands
Tel 91 33 357 4002 Thailand Datex-Ohmeda B.V.
Equipment Service Center Fax 91 33 357 4001 Datex-Ohmeda Pte. Ltd. Kantemarsweg18
Datex-Ohmeda, Inc. 12th Floor (Unit F) Grand Amarin Tower Post Box 22
22011 SE 51st Street Indonesia 1550 New Petchburi Road, Makasan, 3870 CA Hoevelaken
Issaquah, WA 98029, USA Datex-Ohmeda Pte. Ltd. Rajathevi, Netherlands
Tel 1 800 287 7108 Wisma Danamon Aetna Life 19th Floor Bangkok 10320, Thailand Tel 31 33 253 5404
Fax 1 425 657 7232 Jln. Jend Sudirman Kav. 45-46 Tel 66 2 2071012/13 Fax 31 33 253 7223
Jakarta 12930, Indonesia Fax 66 2 207 1014
Canada Tel 62 21 575 0864 Spain
Datex-Ohmeda (Canada) Inc. Fax 62 21 575 0865 Vietnam Datex-Ohmeda S.L.
1093 Meyerside Drive, Unit 2 Datex-Ohmeda Pte. Ltd. C/Manuel Tovar 26
Mississauga, Ontario Japan 522G Nguyen Tri Phuong St. 28034 Madrid
L5T 1J6 Datex-Ohmeda K. K. Ho Chi Minh City, Dist. 10 Vietnam Spain
Canada TRC Annex 9F Tel 848 865 5875 Tel 34 1 334 26 00
Tel 800 268 1472 6-1-1 Heiwajima Fax 848 862 5501 Fax 34 1 358 12 84
Tel 905 565 8572 Ohta-ku, Tokyo 143-0006
Fax 905 565 8592 Japan United Kingdom
Tel 81 3 5763 6801 Australia Datex-Ohmeda Ltd.
Fax 81 3 5763 6838 Ohmeda House
Datex-Ohmeda Pty. Ltd.
Asia/Pacific Datex-Ohmeda K. K. Units 1 & 2 71 Great North Road
Technical Center 149 Arthur Street Hatfield Hertfordshire
China TRC A Bldg. AE 4-8 AL9 5EN England
Datex-Ohmeda Pte Ltd Locked Bag 356
6-1-1 Heiwajima Homebush NSW 2140 Tel 44 1707 263570
Room B416, COFCO Plaza Ohta-ku, Tokyo 143-0006 Fax 44 1707 260191
8 Jianguomennei Avenue Australia
Japan Tel 61 132 229
Beijing 100005, PR China Tel 81 3 5763 6850
Tel 86 10 6526 9773 Fax 61 297 461796 Latin America,
Fax 81 3 5763 6852
Fax 86 10 6526 0653 Caribbean
Datex-Ohmeda Pte. Ltd. Korea Europe
Room 1708, Yunlong Mansion Datex-Ohmeda Pte. Ltd. Datex-Ohmeda
No. 122 Luoguo Street 10th Floor, Sam Sung Building CIS/Baltics 9155 South Dadeland Blvd.
Chengdu 610017, PR China 36 - 1, Yoido-Dong, Youngdeungpo-Ku Datex-Ohmeda Suite 1218
Tel 86 28 661 4424 Seoul, Korea Regional Head Office Miami, FL 33156, USA
Fax 86 28 676 2703 Tel 82 2 786 7421 PO Box 70071 Tel 1 305 670 8540
Fax 82 2 786 7420 GR-16610 Glyfada - Athens Fax 1 305 670 2316
Greece
Tel +30 10 962 5136-7
Fax +30 10 962 3687 Middle East/Africa
Datex-Ohmeda
Regional Head Office
PO Box 70071
GR-16610 Glyfada - Athens
Greece
Tel +30 10 962 5136-7
Fax +30 10 962 3687
The addresses listed on this cover are current as of 6/03. For any location changes,
please visit our website at www.datex-ohmeda.com and click on the Contacts button.