Parameters / Settings

%MinVol: Desired minute ventilation, in % of normal values

HAMILTON MEDICAL AG 2006. All rights reserved. ASV is a trademark of HAMILTON MEDICAL.

ASV guidelines for adult patients

The guidelines below are suggestions based on evaluations by clinicians within and outside HAMILTON MEDICAL and are intended to serve as an example. They do not replace the clinical judgment of a physician and should not - on their own - be used for clinical decision making.

Alarm Pmax: Upper pressure limit in the the Alarms window Body Wt: ETS: fControl: FiO2: fSpont: fTarget: P0.1: Patients ideal body weight, in kg (IBW) Expiratory trigger sensitivity Mandatory breathing frequency Fraction of inspired oxygen Spontaneous breathing frequency Targeted total breathing frequency Airway occlusion pressure (GALILEO only) Tube resistance compensation Patients inspiratory effort, either flow or pressure, that causes the ventilator to deliver a breath.

Startup

Alarm Pmax: 45 cmH2O (50 cmH2O in COPD) Body Wt: %MinVol: IBW (+10% if using HME) normal: 100% COPD: 90% ARDS: 120% others: 110%

TRC: Trigger:

i
Trigger: ETS: TRC:

add 20 if body temperature > 38.5C 2l/min 25% (40% in COPD) on (100%)

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624072/00

View back cover for an explanation of the parameters and settings.

Adjustments / Weaning

fSpont = 0 patient is fSpont > stable*** > 60 min AND fTarget*+10 b/min (Longer period for PaCO2 < 40 mmHg OR hard to wean patients) (45 mmHg on COPD) PaCO2 > 45 mmHg NO NO (50 mmHg in COPD) NO OR P0.1 > 3 cmH2O**

YES

YES

YES

Escalation

%MinVol plus 20

De-escalation

%MinVol minus 10
(%MinVol not lower than 70%)

(%MinVol not higher than 300%)

FiO2 < 40% AND PEEP < 8 cmH2O

NO

YES

?
Target value on the ASV numerical screen ** Only with the GALILEO and on P-trigger *** stable is: fControl = 0 AND PaCO2 45 mmHg (50 mmHg on COPD) AND P0.1 3 cmH20 *

Pinsp 10 cmH2O

NO

Push to wean

%MinVol minus 10
(%MinVol not lower than 70%)

YES

consider extubation