SERVO-i WITH HELIOX OPTION

SERVO-i WITH HELIOX OPTION

GROWING WITH THE CUSTOMER’S NEEDS
SERVO-i System Version 4.0 Heliox option Low MV alarm audio off option Possibility to switch off back-up ventilation Other usability improvements

Latest addition to a wide range of options SERVO-i is has a wide range of options and can be used in many different areas: All patient categories Invasive and non-invasive ventilation Lung protective ventilation Neurally adjusted ventilatory assist – NAVA Bedside, transport and MR usage Heliox

HELIOX – GAS PROPERTIES
What is Heliox? Heliox – HeO2 – is a mixture of helium (He) and oxygen (O2) (e.g. 80/20; 70/30). Helium is an inert, low density gas (~1/7 the density of air and oxygen). Lower density leads to a more laminar flow (less turbulence) and thus reduces resistance in the airways. Helium is an inert gas present in the atmosphere ( %). It was discovered as early as 1868 by a French astronomer named Jansen. As a noble gas, helium is an unreactive, colorless, odorless, tasteless, non-toxic, monoatomic gas. Although it is the second most abundant element in the universe (after hydrogen), it is relatively rare on earth, where it is extracted from natural gas. References: Hess et al, The History and Physics of Heliox, Respir Care 2006; 51(6):

HELIOX – GAS PROPERTIES
Laminar gas flow (A) is more efficient than turbulent flow (B). Because helium is less dense than both oxygen and nitrogen, it has advantages in terms of maintaining laminar gas flow. For a given pressure difference, laminar gas flow provides a greater flow rate compared to turbulent gas flow, making it more efficient (see MAQUET’s Physiology of Respiration Carbon Dioxide, art. no , rev. 02). The lower density of the helium in Heliox leads to a lower pressure drop in obstructive airways than would be the case with air/oxygen. This improves gas distribution and facilitates expiration. The lower density and better flow conditions should also mean that patients who are experiencing difficulty breathing need to make less effort to overcome airway resistance and ventilate themselves adequately. It should be noted, however, that if one uses the same pressure when ventilating with Heliox as when administering oxygen/air, the pressure in the alveoli will be higher with Heliox. The applications for helium within respiratory care are thus related to its physical rather than its chemical properties. Heliox mixtures of helium and oxygen have been used in a medical context since the 1930s. They are typically three times less dense than air, helping the patient to breathe more freely. There are no known contraindications for the use of Heliox. References: Hess et al (see slide 3); Wigmore et al, A Review of the Use of Heliox in the Critically Ill, Critical Care and Resuscitation 2006; 8:

HELIOX – EFFECTS ON VENTILATION
Effects of Heliox therapy according to the literature Established positive effects on ventilation Reduces work of breathing Increases CO2 diffusion Potential positive effects on ventilation Reduces the peak pressure needed to maintain flow Increases CO2 elimination and improves gas exchange Increases expiratory flow Reduces respiratory rate and auto PEEP Increases drug deposition in distal parts of the airways. At a given flow, transairway pressure will be lower with Heliox than with air or air-oxygen mixtures. The higher the helium concentration, the lower the pressure. When transairway pressure is constant, the flow through the airways will be higher with Heliox, and the higher the helium concentration, the higher the flow compared to air or air-oxygen. This means that Heliox decreases the effort involved in breathing and potentially relieves dyspnea. In addition, CO2 diffuses 4-5 times better through Heliox, which should increase its elimination and improve gas exchange. It also potentially decreases air trapping (auto PEEP) and hyperinflation of the lungs, as well as transairway pressure, and improves distal airway deposition of aerosol particles. Heliox has thus been shown to reduce work of breathing and lead to a better clearance of carbon dioxide. In addition there have been a number of claims regarding its respiratory benefits, and there is considerable interest in the scientific community in further studies of both benefits and clinical applications. References: Hess et al and Wigmore et al (see slide 4); Goode et al., Improvement in aerosol delivery with helium-oxygen mixtures during mechanical ventilation, Am J Respir Crit Care Med, 2001; Gupta et al., Heliox administration in the pediatric intensive care unit: an evidence-based review, Pediatr Crit Care Med, 2005; Tassaux et al., Effects of helium-oxygen on intrinsic positive end-expiratory pressure in intubated and mechanically ventilated patients with severe chronic obstructive pulmonary disease, Crit Care Med, 2000; Jaber et al., Noninvasive ventilation with helium-oxygen in acute exacerbation of COPD, Am J Respir Crit Care Med, 1999.

HELIOX – USES AND APPLICATIONS
For which patients is Heliox most commonly used? Upper airway obstruction Lower airway obstruction Heliox is used on both pediatric and adult patients, and even in neonates. Its use was initially adopted by the medical community to alleviate symptoms of upper airway obstruction, such as croup (respiratory problem, mainly pediatric, often due to a virus, that produces a harsh crowing sound during inhalation), epiglottitis (inflammation/infection of the epiglottis), laryngitis (inflammation/infection of the larynx), tracheitis (inflammation/infection of the trachea) and tumors. Since then, however, its range of medical uses has expanded to include lower airway obstruction, such as asthma (episodic reversible attacks of airway obstruction), Chronic Obstructive Pulmonary Disease (COPD, chronic obstruction of the airflow in the airways), bronchiolitis (inflammation/infection of the bronchioles) and cystic fibrosis (inherited disease that causes mucus to become thick and sticky and obstruct the airways, among others). Most of these uses relate to the low density of Heliox. So far, Heliox has primarily been used as a temporizing agent rather than a treatment. This means that it is administered to relieve discomfort and minimize patient effort while waiting for the effects of pharmacological treatment (for example corticosteroids in asthma) to be felt. In addition, Heliox treatment remains indicated for decompression illness and it is also used to determine functional residual capacity (FRC), but there are many other clinical applications within respiratory care where benefits have been observed and that are of interest for Heliox use. Some of these are summarized in the slide and scientific studies are under way. References: Hess et al. and Wigmore et al. (see slide 4); Gupta et al. (see slide 5); Ho AM et al., Heliox versus air-oxygen mixtures for the treatment of patients with acute asthma, Chest, 2003; 123: ; MedicineNet.com.

HELIOX – POTENTIAL BENEFITS
Potential benefits of Heliox therapy according to the literature Avoiding endotracheal intubation Protecting the lungs Improving patient outcome Enhancing patient comfort Customers using Heliox therapy state that they observe an improvement in their patients. In terms of clinical benefits, the slide summarizes some of the areas in which Heliox use has been suggested. Studies are being made to provide conclusive evidence to support the clinical role of Heliox (for example in relation to shortening hospital stays) and demonstrate its benefits in a variety of clinical settings and patients. For example, Grosz et al. have looked retrospectively at 42 children receiving helium-oxygen mixtures for upper airway obstruction over a three-year period. 32 of them (73%) experienced a subjective decrease in work of breathing. References: Hess et al. and Wigmore et al. (see slide 4); Grosz et al, Use of helium-oxygen mixtures to relieve upper airway obstruction in a pediatric population, Laryngoscope 2001: 111: ; Gerbeaux et al., Use of Heliox in patients with severe exacerbation of chronic obstructive pulmonary disease, Crit Care Med, 2001; Connolly et al., Avoiding intubation in the injured subglottis: the role of heliox therapy, Am Otol Rhinol Laryngol, 2001; Jolliet et al., Helium-oxygen vs. air-oxygen noninvasive pressure support in decompensated chronic obstructive disease: a prospective multicenter study, Crit Care Med, 2003.

General Available as an option for the SERVO-i Field upgrade Factory installed The option consists of: Heliox SW Heliox adapter kit All SERVO-i ventilators are easy to upgrade if the option is not factory installed. The Heliox option has 510(k) clearance. The Heliox adapter kit includes: Heliox adapter (also air adapter and proprietary inlet connector with O-ring for air inlet) Heliox adapter holder O2 cell safety catch Installation instruction.

Functionality Can be used with all pediatric and adult patients, as well as neonates Compatible with all invasive/non-invasive ventilation modes Supporting mobility from emergency room to MR environment Connection of 80/20; 79/21; 78/22 mixtures possible Adjustable O2 concentration (21 to 100%). According to studies and practical experience, the Heliox mixture should contain a minimum of 60% helium to achieve maximum benefit. (Reference: Wigmore et al., see slide 4). For use in MR environments, please refer to the appropriate local instructions. It is also important to have access to MR-approved gas cylinders. 70/30 Heliox mixture cannot be used with SERVO-i (not possible with Avea, G5 or Inspiration from Event either). If 70/30 gas is connected during ventilation, the ventilator will identify and compensate for HeO2 use, but there will probably be a constant O2 alarm due to the high O2 concentration provided via the air inlet.

Key benefits of using SERVO-i for Heliox therapy Unique solution for automatic gas identification Automatic compensation of flow delivery Automatic compensation of CO2 and volume monitoring Due to the gas properties of Heliox, flow delivery needs to be compensated. The compensation involved is relatively small (+ 15%) and is designed to ensure the delivery of the correct flow with Heliox when using the SERVO-i gas module for air. The size of the automatic compensation of CO2 monitoring is also relatively small, up to 11% of the value displayed.

Key benefits of using SERVO-i for Heliox therapy Quick and easy start of therapy Quick and easy switch from air to Heliox (and vice versa) without going to standby User friendly interface Cost efficient Heliox therapy thanks to the SERVO-i’s low gas consumption. The screen clearly indicates when Heliox is being administered and clear information is given via the user interface when necessary. In terms of cost efficiency, SERVO-i’s gas consumption is low in comparison with other ventilators. The example below illustrates this: Gas consumption SERVO-i Gas consumption L/min = (Vt*RR/1000) + (bias flow* (1- Ti*RR/60)), where the bias flow is 2 L/min for adult range and 0.5 L/min for infant range. Gas consumption AVEA (internal information only) Gas consumption L/min = (Vt*RR/1000) + (bias flow* (1- Ti*RR/60)) L/min bleed flow, where the bias flow is adjustable between 0.4 L/min to 5L/min. The major difference between the ventilators is the large bleed flow in the Avea, which is ~15.7L/min (according to Solna measurements). Example: Vt=500ml RR=15 b/min I:E=1:2, which gives Ti = 4/3 s Bias flow: 2L/min for both SERVO-i and Avea. This would give a gas consumption for SERVO-i of 8.83L/min and for Avea of L/min = 24.5 L/min. Using this example, Avea will consume almost 3 times as much gas as SERVO-i.

Heliox adapters Four different adapters are available: DISS (both air (A) and Heliox (B)) NIST/NIST AGA/NIST French/NIST The adapter shown in the slide is the DISS adapter. The MAQUET Heliox adapter has a built-in pressure regulator, which ensures that the HeO2 inlet pressure to the ventilator will be around 2.8 bar (40 psi). The reason that the Heliox adapter is fitted with this regulator is that the HeO2 pressure in the ventilator must not exceed 2.8 bar (40 psi) to ensure proper performance.

Heliox adapters Color marked for Heliox Brown/green for Heliox DISS Brown/white for Heliox NIST Attached to ventilator with safety wire Attach to air module when using Heliox The Heliox adapter should be regarded as part of the ventilator. As such, it is not supposed to be removed from the ventilator. For each SERVO-i equipped for Heliox, there should therefore be one software item and one Heliox adapter kit. This is why the adapter is attached with a safety wire. The AGA (left) and French (right) adapters are shown below for reference.

Connecting Heliox to the ventilator – Heliox adapters NIST / AGA / French Remove adapter from holder. Connect adapter to Heliox high pressure hose. Connect adapter to air module inlet. The holder for the Heliox adapter is mounted on top of the hatch where the alarm output connection is installed, The two options can however co-exist without problems.

Connecting Heliox to the ventilator – Heliox and air adapters DISS Remove adapter from holder. Connect adapter to Heliox high pressure hose. Remove air adapter from air inlet. Connect Heliox adapter to air inlet. Note: When the DISS adapter kit is installed on the SERVO-i, the gas inlet connector on the air module is changed to a proprietary connector (AGA). One adapter will always be in use, the air adapter when air is used and the Heliox adapter when HeO2 is used.

Preparations before using Heliox with SERVO-i Make sure that: the Heliox option (adapter and SW) is installed; an approved Heliox mixture is used: 80/20, 79/21, 78/22: the Heliox inlet pressure is between 3.4 and 6.5 bar (49-94 psi). The pressure from the Heliox gas cylinder must be between 3.4 and 6.5 bar ( psi) compared to air, where the limits are 2.0 and 6.5 bar (29-94 psi). As mentioned previously, a regulator is integrated in the Heliox adapter to regulate the pressure down to around 2.8 bar. An alarm – “Check Heliox Adapter” – will be triggered if the pressure measured in the ventilator is higher than 3.5 bar. This may occur if the adapter is not being used or if it is faulty. The adapter itself will carry information about the permitted inlet pressure ( kPa x 100). Typical pressures from Heliox cylinder regulators are 50 psi in the US and bar in the EU. If Heliox is used with a SERVO-i with software version 4.0 or later that does NOT have the Heliox option installed, the user will be informed that an upgrade is needed to make the ventilator Heliox-compatible and ensure accurate performance and that they should contact their MAQUET representative.

Automatic gas identification Performed by the ultrasonic expiratory flow sensors Available during Pre Use Check and during ventilation Active as long as the set O2 concentration is 75% or below Time for identification is determined by tidal/minute volume and O2 concentration used The ultrasonic expiratory flow sensors are not gas-specific. They are used to identify the gas in use. For more details about the sensors, please see the SERVO-i Study Guide (art. no , rev. 00), from which the illustration above is taken. The sensor calculates sound-wave velocity in the gas in use, be it Heliox or other gas mixtures. Because of its lower density, sound-wave velocity in Heliox is around twice that in air (which is why Heliox also causes a characteristically squeaky voice; see Hess et al., slide 4) and this can then be used to identify the gas. It should be noted that if the oxygen concentration in the mixture is higher than 75%, the SERVO-i cannot identify Heliox. In addition, the time taken to identify the gas in use may be prolonged when the tidal/minute volume is low and the oxygen concentration high.

Pre Use Check Pre Use Check can be performed with either air or Heliox, offering full flexibility. Gas type used is automatically identified during the Pre Use Check. 70/30 Heliox mixtures and 100% helium will be identified as unapproved gases. For optimum O2 calibration, use Heliox gas with 21% O2 during the Pre Use Check. After the Pre Use Check has been performed with Heliox, the Heliox icon is displayed on the screen next to the patient category icon.

Automatic identification when changing from air to Heliox during ventilation Connect Heliox gas via the Heliox adapter/air inlet. When the SERVO-i identifies Heliox, the system instantly compensates for the chosen gas type in terms of both flow delivery and monitoring of volumes and CO2. The user is informed that the system is automatically compensated for HeO2 trigger sensitivity and O2 alarm limits have been automatically adjusted ventilator settings should be checked. Please note that the O2 limits cannot be adjusted by the user. The O2 alarm limits are raised automatically from + 5% (as for air) to + 7% to avoid nuisance alarms. This is because the degree to which the gases have been mixed in the inspiratory channel may vary and the measurements might otherwise (depending on the settings) occasionally have increased inaccuracy in the infant range. It is however important to note that this does not affect the delivered oxygen concentration.

Gas type change – manually initiated compensation for Heliox gas Possible both in standby and during ventilation. Access via Menu > Compensate > Gas Type. Connect Heliox gas via Heliox adapter/air inlet. Confirm dialog.

Gas type change – manually initiated compensation for Heliox gas When the dialog has been confirmed, the system instantly compensates for the chosen gas type, both in terms of flow delivery and in terms of monitoring volumes and CO2.

Gas type change – manually initiated compensation for Heliox gas Incorrectly chosen gas type compensation is automatically identified by the SERVO-i. After identification, the system is instantly reset according to the gas used. User is informed via a dialog. If not confirmed within one minute, a medium priority alarm is triggered.

Things to bear in mind when using Heliox with SERVO-i When system is compensated for Heliox: Flow trigger sensitivity is automatically reduced to a level of 1 if set to a more sensitive level. O2 alarm limits are automatically adjusted from 5% to 7%. When ventilating below 100 ml in infant range, it is recommended to use additional patient monitoring. Flow trigger sensitivity is automatically reduced to 1 when using Heliox so as to avoid autotriggering. This might otherwise occur because of the gas properties of Heliox. The flow trigger level remains at a level of 1 when going back to air. When the ventilator is set to infant range and Heliox use, a dialog appears and additional patient monitoring should be used. This monitoring (primarily SpO2 and CO2 monitoring) is recommended because the inaccuracy of the expiratory measurement may be greater than 15%. Delivery accuracy is however good down to small tidal volumes.

Things to bear in mind when using Heliox with SERVO-i When changing gas type from air to Heliox and vice versa: When changing from air to Heliox or vice versa, measured values relating to expiratory flow may be affected for a short while. Changing gas during ventilation may trigger O2 concentration high and/or Gas supply pressure low alarms. After O2 concentration is changed stabilization of expiratory measurements may be delayed. During nebulization there may be a higher deposition of drugs used compared to when ventilating with air. For details of how to switch from air to Heliox and vice versa, please refer to the User Manual. It should be noted that the flow curve may also be temporarily affected when changing gases. In addition, if a gas change is made during ventilation when using the NIST or French Heliox adapters, it is recommended to temporarily disconnect the high-pressure air/HeO2 hose from the gas source (cylinder/wall) to avoid the escape of high-pressure gas. References (for nebulization): Goode et al. (see slide 6); Venkataraman, Heliox During Mechanical Ventilation, Respir Care, 2006; Piva et al., The use of helium-oxygen mixture in the ventilation study of children with chronic obstrcutive lung disease, J Pediatr (Rio J) 2000.

Non-invasive application It should be noted that the mask used for non-invasive ventilation must be adjusted with care so as to avoid leakage, as Heliox is more volatile than other gas mixtures.

Infant application As stated previously, additional patient monitoring should be used when ventilating below 100 ml in infant range.

Order information Part Description Part Number Heliox software, SERVO-i 66 75 580 Heliox adapter kit, new SERVO-i DISS NIST/NIST AGA/NIST French/NIST 66 75 585 66 75 582 66 75 590 Heliox adapter kit, onsite upgrade French/ NIST 66 77 552 66 77 555 66 55 560 SERVO-i up to serial number also requires: PC board 1784 rev 16 or later PC board 1785 rev 3 or later 64 67 984 High pressure Heliox hose DISS, 5 m High pressure Heliox hose NIST, 5 m 66 75 607 The Heliox option is only compatible with the O2 cell, not the O2 sensor. A technical error is generated if the Heliox option is used while the O2 sensor is installed (the ventilator cannot be used). In addition, Y sensor measuring is disabled when Heliox is used, and the measuring is performed internally instead. A technical alarm will also be triggered if the PC board 1784 is not revision 16 or later. Please note that MAQUET does not supply Heliox gas, which is obtained from different local suppliers in the different countries. The Heliox option is not compatible with the O2 Sensor and Y Sensor measuring.

SERVO-i 4.0 – OTHER IMPROVEMENTS/CHANGES
Low Minute Volume alarm audio off The possibility of permanently muting the Low Minute Volume alarm for neonates is activated in the following way: A serial number specific software option (Part number ) needs to be installed on the ventilator. The function is only available in the Infant range and can thus only be installed on SERVO-i Infant and Universal. The possibility to permanently mute the Low MV alarm is configured as disabled or enabled via the start-up configuration. The option to permanently mute the alarm is always disabled as default, meaning that the user or a service technician actively needs to change the start-up configuration to “enabled” if one wishes to be able to permanently mute the alarm.

Low Minute Volume alarm audio off When the Low MV audio off function is enabled, the alarm can be permanently muted via the alarm profile window. The bell symbol with an arrow pointing down indicates that it is ONLY the Low MV alarm that is muted and not the Upper MV alarm. The Low MV alarm can only be permanently muted when the Upper MV alarm limit has been set to 1 l/min or less. This limitation has been made in order to limit the patient category for which the Low MV alarm can be permanently muted.

Low Minute Volume alarm audio off When the upper minute volume alarm limit is set to 1.0 l/min or lower, the mute touch pad can be pressed. When the user has accepted the set alarm profile, a dialog informs the user that additional patient monitoring shall be used when permanently muting the Low MV alarm.

SERVO-i/s 4.0 – OTHER IMPROVEMENTS/CHANGES
Possibility to disable back-up ventilation The possibility of deactivating the back-up ventilation is configured as disabled or enabled via the start-up configuration. The option to deactivate back-up ventilation is always disabled as default, meaning that the user or a service technician actively needs to change the start- up configuration to “enabled” if one wishes to be able deactivate the back-up ventilation.

Possibility to disable back-up ventilation When the function is enabled, it is possible to disable the back-up function in invasive Pressure Support and Volume Support. A “Back-up” touch pad is shown in the mode window next to the ventilation mode touch pad. Back-up ventilation is always activated when the ventilator is turned on or is in Standby mode (also when returning to Standby mode from running mode). For safety reasons, the back-up ventilation can only be deactivated during ventilation to avoid situations in which different users might not be aware of how the ventilator is set when in Standby mode. To deactivate the back-up ventilation, the Back-up touch pad must be pressed. This will be followed by a dialog where the user needs to confirm that he/she wants to deactivate the back-up. When the back-up has been deactivated, the back-up settings are not shown (right hand column in the set ventilation mode window).

Possibility to disable back-up ventilation When the back-up has been deactivated, the text “Back-up ventilation off” will be displayed in white text in the ventilation mode touch pad. IMPORTANT! For safety reasons, deactivating the back-up ventilation will not deactivate the apnea alarm (this cannot be deactivated). When the set apnea time (alarm profile) has passed, the apnea alarm will be triggered. This alarm can, like all alarms, be muted for 2 minutes at a time.

Showing previous Pre Use Check/Suction Support FiO2 retention Showing previous Pre Use Check Under “Status < General”, it will be possible to view the result and time stamp of the previous Pre Use Check (i.e. the two latest Pre Use Check results are shown). Many customers perform a Pre Use Check in the biomed area/storage room and then switch the ventilator off when moving it to the ICU. The improvement allows the user to see the result of the Pre Use Check made before the ventilator was switched off. Please note! To guarantee that the ventilator is OK to use on patients, a Pre Use Check must be performed after the ventilator has been switched off. This is why the latest Pre Use Check status is shown on the Standby screen as “Not performed” when the ventilator has been switched off and is then turned on again. Suction Support FiO2 retention In Software Version 4.0, the oxygen concentration set by the user in the Suction Support function will be used as long as the ventilator is not put in standby and as long as the FiO2 setting on the ventilator is not changed. Previously, the oxygen concentration suggested in the Suction Support function was always FiO2 set on the ventilator + default offset of 30% or the offset chosen in the start-up configuration.

Maintenance notifications/Changed calculation of time for next PM Maintenance notifications With 4.0, the user will be notified when it is time for the next preventive maintenance (5000 h maintenance). The notifications are shown after a Pre Use Check has been performed. A first notification will show when there is 200 hours or less to the next preventive maintenance, saying that it is soon time for next PM. Another notification, saying that it is time for the next PM, is shown when there is 0 hours to the next preventive maintenance. These notifications are active by default but can be disabled via the FSS menu under “Service > PM Reminder”. Changed calculation of time for next PM The calculation of the next preventive maintenance (5000 h) has been changed so that it only includes running hours and not standby hours as before. Maintenance shall still be performed at least once a year if 5000 running hours have not been reached during that time. The maintenance notifications ONLY monitor running hours and not the absolute time over a single year.

Previous mode information/Initiating a Pre Use Check Previous mode information The text on the Previous mode touch pad has been changed from “Show Previous Mode” to “Previous Mode” to allow larger letters. This makes it easier for the user to spot the function. Also, the name of the mode previously used is shown next to the Previous Mode touch pad along with a time stamp. Initiating a Pre Use Check To avoid accidental activation of the Pre Use Check, which would change the Pre Use Check result, the user will from now have to confirm that he/she really wants to start a Pre Use Check.

New alarm symbol/Clearer difference between medium and high priority alarms New alarm symbols The symbols indicating temporarily and permanently silenced alarms have been changed according to IEC : Temporarily silenced - bell crossed over with two dotted lines Permanently silenced – bell crossed over with two solid lines The “mute alarm” button on the panel has also been updated accordingly. More distinct difference between medium and high priority alarms More distinct audio and visual differences have also been introduced between the high and medium priority alarms, where the pause has been prolonged for the medium priority alarm, while the high priority alarm blinks with a higher frequency than before.

New patient category symbols New patient category symbols The patient category symbols indicating whether the ventilator is used in Infant or in Adult range are replaced by ISO symbols in Software Version 4.0. The color of the symbols remains the same to minimize the difference for current SERVO-i users. These symbols have already been used physically on the SERVO-i and in printed MAQUET materials for some time now. The change is due to a dispute with a US company about the rights to the Infant symbol, but can also be seen as an opportunity to renew the way we present the SERVO-i models.

Time scale on the waveforms Time scale on the waveforms A time scale has been added to the waveforms to make it easier for the user to have a reference for the pressure, flow, volume, CO2 and Edi waveforms. The time scale is only shown when sweep speed is set to 20 mm/s, which is by far the most commonly used sweep speed in SERVO-i. Each marking on the waveforms represents one second, the middle marking is somewhat larger to indicate the center of the scale. The time scale is not shown when a recording is made since a cursor is available in this situation. Art. no rev. 01

SERVO-i WITH HELIOX OPTION

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