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Stephan Ventilator ABV Service
Stephan Ventilator ABV Service
A T E M Z E IT V E R H Ä L T N IS MA X.D R UCK
IN S P.: E X S P. m ba r
60 1 0
55 15
50 20
IPPV
RESPIRATO R 1 : 4 45 25
2 : 1 40 3530
EIN / A US
1 : 3 1, 5 : 1 M IN . D R U C K
m b ar
1 : 2 1 : 1 25 5
1 : 1 , 5
2 m in
20 10
6 6 0 15
S E N S I T IV I T Ä T
7 50 P m bar
8 40
9
3 0
10
25
1 2 20
1 14 6
M ANU AL
E X P IR A T IO N ( m b a IN
r ) S P IR A T IO N ( m b a r )
M AN UELL R E S P IR A T O R
m ax. m in .m a x . m in .
m bar
Service Manual
. STEPHAN GmbH · Medizintechnik · D-56412 Gackenbach · Kirchstr. 19 · Tel. (06439) 9125-0 · Fax (06439) 9125-111 · [email protected] ·
www.stephan-gmbh.com
ABV – A - U Service - Manual Page 2
Contens
Only ABV-U 5
2. FUNCTION SCHEME 9
3.1 Electronic 11
3.2 Pneumatic 12
4. SIGHT CHECK 12
5. PERFORMANCE CHECK 12
9. ERROR-FLOW DIAGRAM 19
9.1 Respirator 19
12. MAINTENANCE 23
ABV – A - U Service - Manual Page 4
The respirator module is equipped with a pneumatic and with an electronic control unit
(respirator ABV-A and patient unit), and with an electronic control monitor for breathing
pressure.
The electronic of the respirator module is supplied with line voltage (230V/50 c.p.s.), while
the pneumatic unit requires a propellant gas in form of compressed air (3 - 5 bar). The
respirator ABV-A is designed for the anaesthesia respiration of children and adults in a semi-
closed system.
The patient unit can be exchanged quickly due to its quick-release fastener and meets the
highest requirements for hygiene because of its easy dismountability (partly autoclavable with
a temperature of up to 134°C).
General description
The respirator ABV-A has to be supplied with compressed air as propellant gas with a
pressure of 3 - 5 bar (1). The various respiration parameters can be adjusted at the respirator:
A T E M Z E IT V E R H Ä LT N IS MA X.D RU CK
IN S P.: E X S P. m ba r
60 1 0
55 15
50 20
IPPV
RESPIRATO R 1 : 4 45 25
2 : 1 40 3530
EIN / A US
1 : 3 1, 5 : 1 M IN . D R U C K
1
1
: 2 1
: 1
:
,
1
5
2 m in
25
m bar
5
- breathing/time ratio (2)
5 6 6 0
20
15
10
S E N S IT IV I T Ä T
7 50 P m b ar
8 40
9
10
1
1
2 20
14 6
25
3 0
- frequency (3)
M ANU A L
E X P IR A T IO N (m b a IN
r ) S P IR A T IO N (m b a r )
M A N U E LL R E S P IR A T O R
m bar
7
- volume (5)
6
- PEEP (6)
- PLATEAU (7)
ABV – A - U Service - Manual Page 5
The respirator ABV-A is designed for controlled anaesthesia respiration with state-of-the-art
technology.
The respirator works in a pressure-gas driven, timed and volume-constant way, with the
possibility to limitate the inspiration pressure at the patient unit.
The patient unit is designed according to the "bag-in-bottle-principle", thus achieving a
separation of breathing gas and control gas. In addition, the patient unit serves as reservoir.
1 RESPIRATO R
6 respirator You find the ON/OFF- 1 : 4 2 : 1
IPPV
55
50
45 25
15
20
EIN / A US 40 3530
1 : 3 1, 5 : 1 M IN . D R U C K
m bar
switch (1). 1
1
: 2 1
: 1
: 1
, 5
2 m in
25 5
7 20 10
1 2 20
1 14 6
M AN U ELL
M ANU AL
volume flowing to the patient's
E X P IR A T IO N ( m b a IN
r ) S P IR A T IO N (m b a r )
R E S P IR A T O R
3
m ax.
m bar
m in .
dosified.
5 The number of respiration cycles
can be varied from 6 to 60
breaths per minute at the
11 potentiometer "frequency"(3),
while the ratio of inspiration and
10 expiration can be preselected
9 from 1 : 4 to 2 : 1 with the switch
"breathing/time ratio"(4).
An excess-pressure proof
respiration manometer (5)
indicates the pressure in the
system within a range from -10 -
60 millibar. The patient pressure
can be controlled by setting of pressure alarm limits . Max.-pressure (6) and min.- pressure
(7) can be varied with potentiometers. In the case of exceeding the alarmlimits an optical
and visual (8) alarm is released.
In the event of a power outage, an acoustic signal sets off a warning for at least 30 sec. With
the change lever (9) of the patient unit, either respirator respiration or manual respiration can
be selected.
The PEEP-valve (10) serves to increase the pressure at the end of expiration to a maximum of
10 millibar. With the use of the plateau valve (11), You achieve a respiration with a constant
upper pressure limited to a maximum of 60 millibar.
Only ABV-U
The respirator ABV-U can support spontaneouse ventilation of a patient. For that reasons is
an additional membran key („assist.-control“) on the frontplate. The trigger sensitivity can be
adjusted with the potentiometer „Sensitivity“ (12).
ABV – A - U Service - Manual Page 6
In principle, it is possible to vary the inspiration flow at the flow-control valve in order to
reach a tidal volume of 0 - 1500 ml. In relation with the plateau pressure however, certain
respiration curves can be generated.
The frequency (breaths per minute) can be adjusted for values between 6 and 60 breaths per
minute.
When adjusting the frequency, take into account, that with an increased frequency the breath
minute-volume remains constant, but that the tidal volume will be reduced.
The breathing/time ratio, the ratio of inspiration and expiration, can be preselected from
1 : 4 to 2 : 1 as the case might require, without influencing the respiration frequency.
Maximum pressure
The pressure-measurement range for the maximum pressure has a potentiometer which is to
be used to smoothly adjust the upper respiration-pressure limit for values between 6 and 60
millibar.
In the event, that the pressure for the patient exceeds the adjusted maximum pressure, the
pressure monitor sets off an optical and acoustic alarm until this pressure is no longer
exceeded.
The pressure-measurement range for the minimum pressure has a potentiometer, which is to
be used to smoothly adjust the minimum respiration-pressure limit-value for values between 5
and 25 millibar.
During one respiration cycle, the adjusted minimum-pressure limit-value has to be exceeded
once and fallen short of once, if this is not the case, an optical and acoustic alarm is set off.
By pressing the STAND-BY foil button of the pressure monitor, the acoustic alarm can be
suppressed for 2 minutes.
The pressure monitor is to be set in operation with the operating switch of the respirator.
In case of an artificial respiration without the respirator, the pressure monitor is not working.
Respirator "ABV-U"
In order to be able to work more successful in cases where the spontaneous respiration of the
patient has not yet failed completely or is showing signs of coming back, we offer a "ABV-U"
put-in respirator with integrated pressure monitor for assisted/controlled or pressure-
controlled respiration.
Caused by the inspiration efforts of the patient, a below atmospheric pressure is generated
inside the system, causing the respirator to carry out an additional and completely controlled
respiration lift in accordance with the preselected respiration parameters.
In the event, that the spontaneous respiration of the patient ceases completely, the respiration
frequency will be reduced to the preselected values and controlled respiration will be
continued automatically.
The suction, that has to be generated by the patient to trigger respiration in this mode, can be
varied with a sensitivity of 0.2 - 2 millibar of pressure difference at the adjusting knob for
sensitivity.
In the event, that the respirator is operated with a positive pressure at the end of expiration,
the trigger level is adapted to this value automatically.
ABV – A - U Service - Manual Page 8
1.4.1 PEEP-adjustment
The so-called "positive end expiratory pressure" is to be adjusted with the left control of the
patient unit.
The reason for this increase of the pressure curve during expiration is to prevent the collapse
of alveoli, or even to inflate collapsed alveoli again in order to make their participation in the
gas exchange possible.
This PEEP is smoothly adjustable from 0 to 10 millibar, existing however a certain
dependence from the fresh-gas flow, which has to be taken into account for the adjustment.
The maximum inspiration pressure is to be adjusted at the right control of the patient unit.
The purpose of this so-called plateau is to keep the breathed gas inside the lungs for a short
moment and at a constant pressure, in order to improve the alveolar gas exchange.
In addition, the plateau can be used as upper pressure-limit value or as a security device
against excess pressure.
The plateau value can be varied within a range from 10 to 60 millibar.
The plateau is only to be regarded as a pressure limitation and is not meant to be regarded as
part of a pressure-controlled respirator.
If a electrical power failure occurs , you can switch over to manual ventilation by moving the
handle at the left side of the patient-unit from „Respirator“ to „manual“. A rebreathing-bag
has to be connected at the outlet „Handbeatmung / manual“ of the patient-unit and the excess-
valve at the circle-system has to be adjusted to the max. patient-pressure.
To evacuate the excess gas a tube can be connected at the outlet GAS EVAC .The connector
is a Iso-cone of 30 mm.
In order to allow the use of the anaesthesia apparatus for paediatric respiration without having
to carry out greater modifications, we designed a special plexiglass dome with an inner tube.
A rubber bellows developed for the artificial respiration of children is to be introduced in this
inner tube.
This plexiglass dome with rubber bellows can be exchanged easily in next to no time. The
volume of this paediatric system can be varied from 0 to 400 ml.
ABV – A - U Service - Manual Page 9
2. Function scheme
Funktionschema Press.
P Power
Inspiration Gauge P
CPU supply
Test
Solenoid
lung Volume-valve
Driving- Valve
gas Driving-
Air / (O2) gas
exhaust
Gas Evac PEEP
Inspiration
Valve
Valve
0-
12mbar
Exspiration PLATEAU
Valve Ventilator Valve
/ manual 15 -
65 mbar
Excess-valve
for manual
Freshgas
At the beginning of inspiration, the solenoid valve of the respirator opens and remains open
during the period of time, that has been preselected for inspiration.
In the patient unit , the system is made tight with respect to the ejector and the surrounding
area by pressure applied to the PEEP-diaphragm, and the pressure is limited at the plateau
valve.
The pressure built-up in the plexiglass dome presses the fresh gas and the breathing gas for
the patient out of the bellows, thus bringing it to the patient.
The respiration pressure, that is building up, can be read simultaneously from the manometers
of the respirator and the circular system .
In the event, that the respiration pressure reaches the adjusted plateau pressure limit before
the time for inspiration is over, the plateau valve opens and propellant gas is emitted to the
surrounding area. A continuous control of pressures during inspiration is guaranteed by the
pressure monitor . In the event of exceeding a preselected pressure limit, an optical and
acoustic alarm is set off .
ABV – A - U Service - Manual Page 10
Expiration P
CPU Alimentation
P
When the selected inspiration time is over, the solenoid valve cuts the gas supply and opens
the system towards the surrounding area.
The excess pressure in the lungs of the patient closes the inspiration valve and opens the
expiration valve . The patient breathes through the expiration valve into the inflating bellows,
which is pressed down.
The superfluous consumed breathing air is conducted through the diaphragm of the PEEP-
valve to the anaesthesia gas extraction. During this process, the diaphragm keeps up as much
pressure in the system, as is determined by the adjusted PEEP-value .
The reduction of the respiration pressure and the remaining pressure at the end of expiration
are displayed by the manometer of the circular system and that of the respirator .
By switching to hand/respirator , the manual respiration bag is directly connected with the
system, thus allowing manual artificial respiration.
Note : If switched over to manual respiration , the PLATEAU valve is out of function
and the excess valve has to be opened to control the max. pressure of the patient .
ABV – A - U Service - Manual Page 11
Outle
driving
gas
Solenoi
valv I Control
ON /
Switc
3.1 Electronic
The electronic of the ABV-A is according to the different tasks divided in 4 printed circuits ,
connected via a SPI - Bus or wire.
3.2 Pneumatic
Volume valve
Check volume valve for leakage. If leakage occurs at the spindle change the inner O - rings
( 4 x 1,5 mm ). Lubricate eventually using silicone grease .
The volume valve is adjusted so , that in the closed position a minimal volume ( max. 100 ml
) is given to the system to avoid incorrect adjustments.
Solenoid valve
Check solenoid valve for leakage while the volume valve is complete open and the ventilator
is switched off . At the outlet of the solenoid valve should be no gas flow. If a leakage occurs
, change solenoid valve.
Manometer
Check the O - Rings of the connection block for damages. Change O - Rings ( 10 x 2,5 mm )
if necessary . Lubricate eventually using silicone grease .
4. Sight check
5. Performance check
On the upper left side of the respirator You find the ON/OFF-switch .
Depressing it starts a test program with an automatic self-test, which checks all keys, switches
and potentiometers. Furthermore the functioning of magnetic valve,pressure sensors and parts
of the hard- and software and digital switching circuits is tested. If a fault is detected the
respirator gives off an audible signal and switches itself off.
If a defect occurs, the display on the electronic block inside of the ventilator gives an
information about the type of the defect.
To look onto the display you have to remove the cover.
„ I “ = Inspiration
„ E „ = Expiration
Errorcodes
Different errorcodes can be generated on the display.
Reading „ 0 “ - Fault in the circuit of the potentiometers. Check connecting wires or poti .
Reading „ 1 “ - Fault in the circuit of the pressure sensors. Check tubes for leakage.
Reading „ 2 “ - Fault in the circuit of the solenoid valve . Check connecting wires .
The respirator is adjusted so, that no pressure alarms or stenosis alarms are released.
Respiratory frequency ( BPM ) is set at 6 min-1 and the respiratory time ratio I : E at 1 : 4. The
values for inspiration time and expiration time must then be measured by hand (stopwatch).
Frequency must be calculated accordingly. The calculated frequency must correspond with
the set frequency. If this is not the case an error exists in the software of the respirator. In this
case the manufacturer must be notified. All measured and calculated values must be
registered in the test records.
From the measured values for inspiration and expiration the set value of respiratory frequency
must result by calculation.
Furthermore the set respiratory time ratio must result by calculation from the measured values
for inspiration and expiration.
The calculatory check of respiratory frequency and respiratory time ratio must be repeated, in
the same mode as described above, with the following settings:
Note : In the IPPV - mode the time for inspiration can be shorter than adjusted because
of the change-over to expiration when the set pressure is reached . Otherwise
the time for expiration is as adjusted . The result is a increasing of the respiratory
frequency taking into consideration the lost inspiratory time after change-over to
expiration .
The respirator ABV-A is provided with devices for recognition of disconnection and stenosis.
The respiratory pressure is picked up in the expiration branch on the patient component. For
this purpose a pressure-measuring tube in the respirator is connected with the patient
component ABV-A via the gas connection nipple. This pressure measuring tube is conducted
directly to the manometer. By the manometer the pressure measuring tube is connected with
the two pressure sensors on the board.One sensor is only used to control the signal of the
other sensor.With the help of the electronics of the board the analogous pressure signal is
converted into digital signals and processed.
The software installed on the board of the processor evaluates these signals and checks them
for validity and appropriate limit values.
The pressure alarm limit is set by means of the potentiometer for „ Max. Pressure“. If the
measured pressure exceeds the set maximum pressure limit, an audible and visual alarm is
immediately released.
The disconnection alarm limit is set by means of the potentiometer for „Min. Pressure“. If the
measured pressure does not exceed the set minimum pressure limit, an audible and visual
alarm is immediately released.
To test the correct performance of the pressure alarm the Y-piece must be connected to a test
lung with the respirator switched on. Maximum pressure is set at 40 mbar, minimum pressure
at 10 mbar and plateau pressure at 50 mbar (PEEP = 5 mbar). If the set maximum pressure
limit is exceeded, an audible and visual alarm must be activated immediately and continue for
duration of exceeding. When the measured pressure falls below the set pressure audible and
visual alarm are cancelled.
ABV – A - U Service - Manual Page 15
Disconnectionalarm
To test the correct performance of the disconnection alarm the corrugated tube of the
narcotic-system has to be pulled off from the patient component with respirator switched on,
so no more built-up of pressure can take place. Maximum pressure is set at 50 mbar,
minimum pressure at 10 mbar and plateau pressure at 40 mbar (PEEP = 5 mbar). A
disconnection alarm is released after a delay time (length of delay time depends on the set
expiration time plus 15 sec.
After slipping the corrugated tube back onto the patient component and according built-up of
pressure in the patient tube system, the alarm must be automatically cancelled.
Stenosis alarm
A stenosis alarm is released, if after a delay time (length of delay time depends on the set
expiration time plus 15 s. s.ab.) the respiratory pressure does not fall below the set minimum
pressure limit.
To test the correct performance of the alarm, the PEEP-value, with the respirator switched on
and the complete patient tube system connected, must be set higher than the minimum
pressure-limit , so that the measured pressure does not fall below the minimum pressure-limit.
After the delay time an audible and visual alarm is released. When the PEEP-value is reduced,
so that the minimum
pressure limit is remaining under again, the stenosis alarm ceases.
Proceed as for disconnection alarm. Wait until disconnection alarm activates, depress stand-
by key and measure duration of muting of audible alarm.
Failure-of-current-alarm
With the respirator switched on, pull mains plug from socket and so simulate a failure of
current supply. Now an audible alarm must be activated.
With every semi-annual check, the O-rings of the gas-connection nipples on the connecting
unit must be exchanged.
Furthermore the front panel of the patient component should be loosened and removed semi-
annually. All removable accessible parts should be cleaned with alcohol.
We especially point out, that the inner part require intensive control and ,if necessary
,cleaning. In case of considerable wear (mechanical actuation) the PEEP-valve-disc must be
exchanged.
The valve spindles must be tested for smooth working (lubricate eventually using silicone
grease). The O-rings of the valve spindles (O-ring 12 x 1) must be checked for intactness and
must be exchanged if necessary.
If this has been completed, put the front panel back on. In doing so, care has to be taken that
the springs are placed correctly in the fairleads of the spring spindles.
Performance of the patient component must be tested prior to the final tightening of the front
panel, an eventual slight adjustment of the front panel on the basic body may be necessary
(align with the outer edge).
Finally the patient component attached to the respirator is operated with a flow of
approximately 5 litres and with a narcotic- system with a testlung. Hereby the control knobs
have to be checked and eventually readjusted.
The plateau-control knob has to be installed so that at its right-hand stop a pressure of 65
mbar is just reached.
The PEEP-control knob has to be installed so, that at its right-hand stop a pressure of 12 mbar
is reached.
M ANU A L
E X P IR A T I O N ( m b a IN
r ) S P IR A T IO N (m b a r )
M A N U E LL R E S P IR A T O R
m ax. m in . m a x . m in .
m bar
ABV – A - U Service - Manual Page 17
The ventilator can be cleaned using normal cold sterilisation solutions or soapy water.
Don`t use volatile solvents.
Disassembly
M A N U A L
E X P I R AI N T SI O P NI R (A m T bI O a N
r ) ( m b a r )
M A N R UE S EP I R L A L
T O R
m a x . m mi n a. x . m i n .
m b a r
All parts, except of the base part of the patient unit, should undergo a precleaning or a
predesinfection, which is to be carried out as follows:
Sterilisation
The rubber bellows (4) and the O-ring (3) have to undergo a superheated-steam sterilisation at
121°C (glove program).
The base part of the patient unit (2) and the clamp climp (6) have to be sterilised in the
autoclave at 134°C.
The base part of the patient unit must not be cleaned with compressed air.
Assembly
Now that the parts are perfectly hygienic, reverse order of disassembly for assembly.
Before putting on the patient unit, lubricate the thread of the knurled screw (1) with a bit of
grease.
ABV – A - U Service - Manual Page 19
9. Error-flow diagram
9.1 Respirator
Measurements:
Width: 530 mm
Height: 120 mm
Weight: 12 kg
Absorption of power: 18 VA
Pressure monitor
Alarm for
- excess pressure: LED, red , visual
PEEP-valve: 0 - 10 millibar
PLATEAU-valve: 10 - 60 millibar
(upper pressure limitation)
ABV – A - U Service - Manual Page 22
Outlet
driving -
gas
Solenoid
valve Control Display
I
ON / OFF
Switch
7 1 2
153 61 000 Patient component ABV-A (Adult)
9
1 153 61 016 knurled screw
8
2 153 40 024 base part 3
4
3 950 60 022 O-ring , 105 x 3,5 mm
12. Maintenance
Such an inspection has to be carried out exclusively by authorised persons (service personnel)
of the supplier of the equipment.
You achieve the best guarantee by concluding a maintenance agreement, which includes
regular inspections every six months with automatic replacement of parts with a risk of wear.
In the event, that maintenance is carried out by unauthorised personnel without the necessary
expertise, the liability of the manufacturer for the secure function of the equipment ceases
immediately.