fabian Therapy

evolution

Preparation and Start-Up

 INITIAL SET-UP

CONNECTIONS: MAIN POWER CORD, GAS SUPPLY HOSES

Connect power cord with respective power source. The device can be operated within
a range of 100VAC to 240VAC at 50/60Hz. No manual switch-over is required.
Connect medical gas hoses (air and Oxygen) to the corresponding wall/bottle plug
connectors. Gas supply pressure required must be in the range from 2,0 up to to 6,5
bar.
AIR & OXYGEN connectors are of NIST type.
 INITIAL SET-UP

FRONT CONNECTIONS
 NIV with fabian
Non Invasive Ventilation (NIV)
in Open Valveless System :

• nCPAP
• duoPAP
• nAPRV
• HHFNC
 Infant Flow® variable flow
Clinical performance

Reduction in imposed work of breathing

Moa G, Nilsson K. Crit Care Med. 1988;16:1238–1242

 PATIENT CIRCUIT SET-UP

Patient circuit for NIV (i.e. Infant Flow)

• nasal CPAP
• nasal DuoPAP

Patient circuit for HFNC – High Flow Nasal Cannula

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 Neonatal patient circuit for NIV
i.e. by using Inspire/Infant Flow Generator and Circuit*

* P/N 7195: includes P/N 5292 (NIV breathing circuit) and P/N 7186 (generator + nasal prongs)
 Neonatal patient circuit for NIV
i.e. by using Inspire/Infant Flow Generator and Circuit

Generator and nasal prongs (P/N 7186)

 Neonatal patient circuit for NIV
i.e. by using Inspire/Infant Flow Generator and Circuit*

* P/N 5292, NIV breathing circuit, compatible with F&PMR850 humidifier

* P/N 5291 same as 5292 but includes also humidity chamber
 Neonatal patient circuit for NIV
i.e. by using Inspire/Infant Flow Generator and Circuit*

* P/N 5292, NIV breathing circuit, compatible with F&PMR850 humidifier

* P/N 5291 same as 5292 but includes also humidity chamber
 Neonatal patient circuit for NIV
i.e. by using Inspire/Infant Flow Generator and Circuit*

* P/N 5291 or P/N 5292, NIV breathing circuit, compatible with F&PMR850 humidifier
 ASSEMBLY of NIV DISPOSABLE CIRCUIT*

connect Infant Flow connecting tube:

from NIV port to the humidifier chamber inlet

* P/N 5291 or P/N 5292, NIV breathing circuit, compatible with F&PMR850 humidifier
 ASSEMBLY of NIV DISPOSABLE CIRCUIT*

connect inspiratory heated tube

onto the humidifier chamber outlet

* P/N 5291 or P/N 5292, NIV breathing circuit, compatible with F&PMR850 humidifier
 ASSEMBLY of NIV DISPOSABLE CIRCUIT*

connect a green connector connect the other end of

to one end of proximal proximal pressure line to the
pressure line Prox connector on fabian

* P/N 5291 or P/N 5292, NIV breathing circuit, compatible with F&PMR850 humidifier
 ASSEMBLY of NIV DISPOSABLE CIRCUIT*

connect the HEATER WIRE cable

for the HEATING of the RESISTANCE inside the breathing circuit

* P/N 5291 or P/N 5292, NIV breathing circuit, compatible with F&PMR850 humidifier
 ASSEMBLY of NIV DISPOSABLE CIRCUIT*

INSERT the TEMPERATURE SENSORS into the breathing circuit:

the dual pronged sensor at the chamber outlet and the single pronged sensor at the
patient end. The dual pronged sensor measures both flow and temperature as gas
leaves the chamber. The patient sensor controls the heated wires to maintain gas
temperature throughout the circuit.
* P/N 5291 or P/N 5292, NIV breathing circuit, compatible with F&PMR850 humidifier
 ASSEMBLY of NIV DISPOSABLE CIRCUIT*

INSERT the TEMPERATURE SENSORS onto the breathing circuit

Push the airway probe into the breathing circuit.
Make sure the airway probe is correctly located in its hole and that it’s pushed
home.

* P/N 5291 or P/N 5292, NIV breathing circuit, compatible with F&PMR850 humidifier
 ASSEMBLY of NIV DISPOSABLE CIRCUIT*

If needed, CONNECT the EXTENSION tube onto the breathing circuit

The extension tube is prepared also for inhaled NO (Nitric Oxide) with Luer-lock connection for sampling line)

* P/N 5291 or P/N 5292, NIV breathing circuit, compatible with F&PMR850 humidifier
 ASSEMBLY of NIV DISPOSABLE CIRCUIT*

The NIV
breathing circuit
is now ready to
be connected to
nCPAP/duoPAP
generator (i.e
Inspire
nCPAP™)
* P/N 5291 or P/N 5292, NIV breathing circuit, compatible with F&PMR850 humidifier
 ASSEMBLY of NIV DISPOSABLE CIRCUIT*

INSERT the nCPAP GENERATOR onto the connectors of breathing

circuit
 ASSEMBLY of NIV DISPOSABLE
CIRCUIT
i.e. Infant Flow generator

INSERT the sized nasal prongs or nasal mask to the nCPAP

GENERATOR
Follow the Instruction for Use
ASSEMBLY of NIV DISPOSABLE
CIRCUIT
i.e. Infant Flow generator
Neonatal patient circuit for NIV
i.e. by using Inspire/Infant Flow Generator and Circuit

The Fixation Technique

 Neonatal patient circuit for NIV
i.e. by using Inspire/Infant Flow Generator and Circuit

41/51
Generator and nasal prongs
Sized bonnets color coded by Inspiration Healthcare
“Colored sizing guide” for Bonnets by Carefusion Healthcare
Every hour…

Perform a “final check” as before in order to

ensure a correct and stable positioning of the
Generator.

The baby is receiving the appropriate level of

comfort during nCPAP.

Advantages: fabian NIV stabilizes the prescribed

pressure of nCPAP.
Every 3 – 4 hours…

Perform a comprehensive inspection of the baby

and their interfaces: ties, bonnet, prongs or mask.
Massage the nares and re-evaluate for correct
sizing of the interface and change if necessary.
Feeding during nCPAP…

Orogastric tube free to potentially minimise gastric

distension

In “gavage” incentive pacifier

NIV with Infant Flow /
Inspire
 SWITHING ON FABIAN
The FABIAN is switched on with the ON / OFF green button.
 START UP SCREEN
The START SCREEN appears when you turn on the FABIAN.
The device SELF TEST is carried out.
All acoustic alarms are suppressed automatically for two minutes.
 START UP SCREEN
The CALIBRATION Menu appears after the system Self Test.

The automatic O2 calibration begins after leaving the calibration menu and
automatically every 24h.

However if desired, O2 sensor calibration ca be carried out at any time from this
Menu,
 nCPAP
nasalCPAP mode provides an automatic leak compensation in case of
leaks around mask or prongs; the leak flow is compensated up to +25%
!
Unique feature !

Easy control
Selectable generators like
Medijet,
InfantFlow/Inspire,
InfantFlow LP

without Exp. Valve !!

 nCPAP
nasalCPAP mode provides an automatic leak compensation in case of
leaks around mask or prongs; the leak flow is compensated up to +25%
! Unique feature !

Easy control
Selectable generators like
Medijet,
InfantFlow/Inspire,
InfantFlow LP

without Exp. Valve !!

 nCPAP
nasalCPAP mode has an automatic leak compensation in case of leaks
around mask or prongs; the leak flow is compensated up to +25% !
Unique feature !

In nCPAP Mode the patient

breaths spontaneously
through a nasal mask or
nasal prongs/cannula.
If an apnea occurs it is
necessary and strongly
recommended an additional
patient monitoring, i.e.
Impedance measurement
ECG, SpO2 and PCO2
 nCPAP

nasalCPAP mode

Digital flowmeter
on screen for
better evaluation
of delivered flow
* Unique feature *
 nCPAP
* Unique feature *
 nCPAP
* Unique feature *
* Unique feature *
 duoPAP
Nasal duoPAP mode has an automatic leak compensation in case of
leaks around mask or prongs; the leak flow is compensated up to +25%
!
Unique feature !
Like in nCPAP Mode the
patient breaths spontaneously
through a nasal mask or nasal
prongs/cannula. But there is
the possibility to increase
additional positive pressure
(PDUO) at a certain frequency
and Inspiration time.

If an apnea occurs it is necessary and

strongly recommended an additional
patient monitoring, i.e. Impedance
measurement ECG, SpO2 and PCO2
 duoPAP
Nasal duoPAP mode has an automatic leak compensation in case of
leaks around mask or prongs; the leak flow is compensated up to +25%
!
Unique feature !

Easy control
Selectable InfantFlow
generator like InfantFlow
or Inspire, InfantFlow LP
or MediJet
 duoPAP

Nasal duoPAP mode

Digital flowmeters
on screen for
better adjustment
of CPAP level
 Nasal APRV

Nasal Airway Pressure Release Ventilation

Nasal APRV is
possible in duoPAP
mode by selecting
appropriate timing
(Thigh up to 15
seconds) and inverse
I:E ratio. In APRV
mode there are very
short period of
exhalation in order to
improve CO2 washout.
 PATIENT CIRCUIT SET-UP

Patient circuit for NIV (i.e. Infant Flow)

• nasal CPAP
• nasal DuoPAP

Patient circuit for HFNC – High Flow Nasal Cannula

HIGH FLOW THERAPY
POSITIONING
 Neonatal patient circuit for HFNC
i.e. by using nasal Cannula and Circuit*

* P/N 5292, NIV breathing circuit, compatible with F&PMR850 humidifier

 Neonatal patient circuit for HFNC
i.e. by using nasal Cannula and Circuit*

* P/N 5292, NIV breathing circuit, compatible with F&PMR850 humidifier

* P/N 5291 same as 5292 but includes also humidity chamber
 Neonatal patient circuit for HFNC
i.e. by using nasal Cannula and Circuit*

* P/N 5291 or P/N 5292, NIV breathing circuit, compatible with F&PMR850 humidifier
 ASSEMBLY of NIV DISPOSABLE CIRCUIT for HFNC*

connect Infant Flow connecting tube:

from NIV port to the humidifier chamber inlet

* P/N 5291 or P/N 5292, NIV breathing circuit, compatible with F&PMR850 humidifier
 ASSEMBLY of NIV DISPOSABLE CIRCUIT for HFNC*

connect inspiratory heated tube

onto the humidifier chamber outlet

* P/N 5291 or P/N 5292, NIV breathing circuit, compatible with F&PMR850 humidifier
 ASSEMBLY of NIV DISPOSABLE CIRCUIT for HFNC*

connect the HEATER WIRE cable

for the HEATING of the RESISTANCE inside the breathing circuit

* P/N 5291 or P/N 5292, NIV breathing circuit, compatible with F&PMR850 humidifier
 ASSEMBLY of NIV DISPOSABLE CIRCUIT for HFNC*

INSERT the TEMPERATURE SENSORS into the breathing circuit:

the dual pronged sensor at the chamber outlet and the single pronged sensor at the
patient end. The dual pronged sensor measures both flow and temperature as gas
leaves the chamber. The patient sensor controls the heated wires to maintain gas
temperature throughout the circuit.
* P/N 5291 or P/N 5292, NIV breathing circuit, compatible with F&PMR850 humidifier
 ASSEMBLY of NIV DISPOSABLE CIRCUIT for HFNC*

INSERT the TEMPERATURE SENSORS onto the breathing circuit

Push the airway probe into the breathing circuit.
Make sure the airway probe is correctly located in its hole and that it’s pushed
home.

* P/N 5291 or P/N 5292, NIV breathing circuit, compatible with F&PMR850 humidifier
 ASSEMBLY of NIV DISPOSABLE CIRCUIT for HFNC*

CONNECT the special adaptor (included in the blister) for nasal cannula
onto the breathing circuit.
If necessary, even the extension tube (prepared also for inhaled NO) can be added.

* P/N 5291 or P/N 5292, NIV breathing circuit, compatible with F&PMR850 humidifier
 ASSEMBLY of NIV DISPOSABLE CIRCUIT for HFNC*

* Nasal cannulas are available in different sizes, S, M, L:

P/N 5303 for preemies (S)
P/N 5304 for neonates (M)
P/N 5305 for infants (L)
O2 Therapy - HFNC

O2 Therapy with
fabian is possible with
standard systems and
tubes and cannula
(RAM cannula
included).
The caregiver sets
desired Flow and FiO2.
fabian will show the
measured values.
Mean Airway Pressure
can be measured.
O2 Therapy as HHFNC

O2 Therapy with
fabian can be
achieved also as
HHFNC.
Exceeding 5 L/min the
therapist must
confirm for higher
values of Flow
(maximal 19 L/min).
 READY FOR USE
Fabian is ready for use.
Before patient application, perform the device check.
Refer to the fabian Therapy evolution User Manual.
fabian Therapy
evolution