1. 3100B Theory of Operation and Controls

2. VIASYS Healthcare, Inc. 3100B Theory of Operation and Controls Approved for sale outside the US in 1998 for patients weighing > 35 kg failing CMV Approved September 24, 2001 by the FDA for sale in the US

3. VIASYS Healthcare, Inc. SensorMedics 3100B Electrically powered, electronically controlled piston-diaphragm oscillator Paw of 5 - 55 cmH 2 O Pressure Amplitude from 8 - 130 cmH 2 O Frequency of 3 - 15 Hz Inspiratory Time 30% - 50% Flow rates from 0 - 60 LPM

4. VIASYS Healthcare, Inc. Paw is created by a continuous bias flow of gas past the resistance (inflation) of the balloon on the mean airway pressure control valve.

5. VIASYS Healthcare, Inc. Principle of the SM 3100A HFOV “Super-CPAP” system to maintain lung volume

6. VIASYS Healthcare, Inc. To pressurize the patient circuit, the Reset / Power Fail button must be pressed and held until the mean airway pressure is at least 5 cmH 2 O

7. VIASYS Healthcare, Inc. Oxygenation The Paw is used to inflate the lung and optimize the alveolar surface area for gas exchange. Paw = Lung Volume

8. VIASYS Healthcare, Inc. Optimizing Hemodynamics PVR is increased with: – Atelectasis Loss of support for extra- alveolar vessels –Over expansion Compression of alveolar capillary bed The lung must be recruited, but guard against over expanding.

9. VIASYS Healthcare, Inc. Primary control of CO 2 is by the stroke volume produced by the Power Setting.

10. VIASYS Healthcare, Inc. Alveolar ventilation during CMV is defined as: F x Vt Alveolar Ventilation during HFV is defined as: F x Vt 2 Therefore, changes in volume delivery have a more significant affect on CO 2 elimination than frequency

11. VIASYS Healthcare, Inc. Pressure transmission Gerstmann D.

12. VIASYS Healthcare, Inc. Pressure transmission HFOV P T proximal trachea alveoli

13. VIASYS Healthcare, Inc. The % Inspiratory Time also controls the time for movement of the piston, and therefore can assist with CO 2 elimination. Increasing % Inspiratory Time will also affect lung recruitment by increasing delivered Paw.

14. VIASYS Healthcare, Inc. Inspiratory / Expiratory Ratio I/E Ratio adjustable with Inspiratory time control Inspiratory time = Forward movement piston Expiratory time = Backward movement piston Backward movement piston = active exhalation ! Recommended Insp. time = 33% + -- 30% 70% Inspiratory time adjustable: 30% - 50%

15. VIASYS Healthcare, Inc. Secondary control of PaCO 2 is the set Frequency.

16. VIASYS Healthcare, Inc. Regulation of stroke volume Stroke volume The stroke volume will increase if –The amplitude increases (higher delta P) –The frequency decreases (longer cycle time)

17. VIASYS Healthcare, Inc. Piston Centering is automatically regulated by the instrument and requires no operator intervention.

18. VIASYS Healthcare, Inc. The Start / Stop button is used to start and stop the oscillator. The oscillator may be stopped without a complete loss of mean airway pressure.

19. VIASYS Healthcare, Inc. Alarms

20. VIASYS Healthcare, Inc. Preset High and Low mean airway pressure alarms. Upon activation the oscillator will stop and the circuit pressure will vent to ambient.

21. VIASYS Healthcare, Inc. Activation of the high mean pressure alarm will trigger the Auto Limit System. The Auto Limit System will open the “blue” limit valve on the circuit and vent pressure. The valve will then repressurize to it’s normal operational state.

22. VIASYS Healthcare, Inc. After resolution of the fault condition the visual alarm can be cleared by pressing the Reset / Power Fail Button

23. VIASYS Healthcare, Inc. Activation of the low mean airway pressure alarm will only provide audible and visual alarms. The visual alarm will automatically reset after the fault condition has resolved

24. VIASYS Healthcare, Inc. The source gas low alarm will provide only a visual indicator if either of the high pressure gas supplies falls below 30 psi.

25. VIASYS Healthcare, Inc. The battery low alarm will provide only a visual indicator when the nine volt alarm battery needs replacement.

26. VIASYS Healthcare, Inc. The oscillatory overheated alarm will provide only a visual indicator if the linear motor temperature exceeds 150 degrees Centigrade.

27. VIASYS Healthcare, Inc. The oscillator stopped alarm will provide audible and visual indicators if the oscillatory amplitude is at or below 7 cmH 2 O and the oscillatory subsystem is energized, (as indicated by the illumination of the green LED on the start stop button)