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Dräger Medical

D
Savina
Intensive Care Ventilator
Instructions for Use
Software 2.n

mt78799
How to work with these
instructions for use

The header line... Bedienkonzept

contains the main chapter title.


Keys for routine and additional functions
To help you find your way rapidly around the manual. 1 Frequently used keys for routine functions are positioned D Savina
on the right-hand side of the front panel:
D Savina
Tasten
Tastefür
¨ Routine- und
2 min˙ key for Zusatzfunktionen
suppressing the audible alarm 2 1
tone for
1 Häufig 2 minutes,
benutzte Tasten für Routinefunktionen befinden D Savina
¨Alarm
sich Reset˙
auf der key Seite
rechten for resetting or acknowledging alarm
der Frontplatte: 2 1
messages and for testing the LEDs and audible alarm tone, D Savina
2 1
The page body... ¨
— Taste »lock˙2key
unauthorised
Alarms
min«forzum
protecting againstdes
Unterdrücken inadvertent
modification of the settings.
für 2 Minuten
akustischen or

— Taste »Alarm Reset« zum Rücksetzen oder Bestätigen von 2 1


contains the instructions for use 2 Alarm-Meldungen,
Keys for additionalund
Alarmtons
zum Prüfen
functions
side of the front panel:
der Lampen
are positioned onund
the des
left-hand

— Taste » Lock« zum Schutz gegen unbeabsichtigte oder


in a combination of text and illustrations. The information is unautorisierte
¨ Änderung
Nebul.˙ key for der Einstellungen.
switching the medicament
nebuliser on / off,
expressed directly in terms of actions which enable users to 2 Tasten für Zusatzfunktionen
¨O2 Y suction˙
Seite der
befinden
key to start/end
Frontplatte:
thesich auf der
oxygen linken
enrichment

003 37261
program,
familiarise themselves with the operation of the machine by ¨Insp. hold˙ key for manually activated inspiration and
— Taste »
for extendingVerneb.« zum Einschalten/Ausschalten
the inspiration time. des
Medikamentenverneblers
hands-on activity. — Taste »O2 Y Absaug.« zum Starten/Beenden des Oxyge-

003 37261
nierungsprogramms
— Taste »Insp. hold« für eine manuell ausgelöste Inspiration
und eine Verlängerung der Inspiration.
Information window on screen
During setting of a ventilation parameter, the Savina calculates
the derived parameters and displays them in the information
The left-hand column... window on the main screen page.
Info-Fenster im Bildschirm
The information
Während window eines
der Einstellung disappears when the parameter
Beatmungsparameters
contains the text setting is Savina
errechnet confirmed.
die neuen abgeleiteten Parameter und zeigt
sie im Info-Fenster am Bildschirm in der Hauptseite an.
which provides explanations and guides the user with brief Das Info-Fenster verschwindet, wenn die Einstellung des

060 37388
Parameters bestätigt wurde.
and clear instructions in an ergonomic sequence for confusion
free use of the machine. Power switch

060 37261
Bullet points indicate the working steps. In many cases, 3 To switch the apparatus on/off.
Located on the back of the apparatus.
numbers are used to highlight the relation between the Netzschalter
To switch on:
3 Zum Ein / Ausschalten des Gerätes.
Turn power switch to ¨ ˙ = ON.
working step described, the associated illustration(s) and Auf der Rückseite des Gerätes.

3
the sequence of operations. Gerät einschalten:
Netzschalter auf » « schalten = EIN.
0
3

The right-hand column...

100 37261
contains the illustration(s)

100 37261

085 37 261
which directly relate to the text opposite and show the user 12

12
where to find the items concerned. The focus is on the
elements mentioned in the text. Non-essentials are omitted.
Screen dumps are also used to guide the user and confirm
the working steps.

2
Contents

Contents

For your safety and that of your patients 5


Safety tips

Intended Use 7
Areas of use

Operating Concept 9
Controls, Parameter setting, Structure of the screen pages

Operation 17
Ventilation modes, Alarm limits and alarm priorities, Curves,
Measured values, Special functions

Configuration 47
Contrast, Volume, Measured values line, Language,
Apnoea ventilation ON/OFF

Fault – Cause – Remedy 55


Fault analysis and correction chart

Care 67
Dismantling, Cleaning, Maintenance

Preparation 79
Assembly, Checking readiness for operation

Description 97
Description of ventilation modes, Bibliography

What‘s what 109


Display, Abbreviations, Symbols

Technical data 117


Environmental conditions, Performance data, Measured value displays,
Operating data

Order List 125

Index 128

3
4
For your safety and that of your patients

For your safety and that of your


patients
Strictly follow the instructions for use Liability for proper function or damage
Any use of the apparatus requires full understanding and strict The liability for the proper function of the apparatus is
observation of these instructions. The apparatus is only to be irrevocably transferred to the owner or operator to the extent
used for purposes specified here. that the apparatus is serviced or repaired by personnel not
employed or authorized by DrägerService or if the apparatus
is used in a manner not conforming to its intended use.
Maintenance Dräger cannot be held responsible for damage caused by
This apparatus should only be inspected, serviced and non-compliance with the recommendations given above.
maintained by trained service personnel. The warranty and liability provisions of the terms of sale
We recommend that a service contract be obtained with and delivery of Dräger are likewise not modified by the
DrägerService and that all repairs also be carried out by them. recommendations given above.
Only authentic Dräger spare parts may be used for
maintenance. Observe chapter "Maintenance Intervals". Dräger Medical AG & Co. KGaA

Accessories
Do not use accessory parts other than those in the order list.

Not for use in areas of explosion hazard


This apparatus is neither approved nor certified for use in
areas where combustible or explosive gas mixtures are likely
to occur.

Safe connection with other electrical equipment


Electrical connections to equipment which is not listed in
these instructions for use should only be made following
consultation with the respective manufacturer or an expert.

5
For your safety and that of your patients

Precautions Appropriate Monitoring


This equipment must only be used under the supervision of The built-in monitoring facilities of the Savina ensure
qualified medical staff, so that if any faults or malfunctions appropriate monitoring of ventilation therapy and therefore
occur, help is available immediately. detect any undesirable changes in the following ventilation
parameters:
This equipment must not be used with flammable gases — airway pressure, Paw
or anaesthetic agents. Danger of fire! — expiratory minute volume, MV
— inspiratory O2 concentration, FiO2
Do not use the apparatus in conjunction with nuclear
— inspiratory breathing gas temperature, T
spin tomography (MRT, NMR, NMI).
— apnoea
The apparatus may malfunction, causing danger to the
— tachypnoea monitoring
patient.

Do not use the equipment in hyperbaric chambers. Changes in these parameters may be caused by:
The apparatus may malfunction, causing danger — acute changes in the patient’s condition
to the patient. — incorrect settings and faulty handling
— equipment malfunctions
Avoid pollutants in the ambient air. — failure of power and gas supplies
Savina uses ambient air for ventilation.
Pollutants would enter the patient’s body. In the event of a problem with the integrated monitoring:
● separate monitors must be used.
Interference with operation of the apparatus may be
caused by the use of high-frequency electrical surgical
equipment, defibrillators or short-wave treatment
equipment, thereby putting the patient at risk.

Do not use mobile phones within a distance of 10 metres Back-up ventilation with an independent
from the equipment. manual ventilation device
Mobile phones can cause interference with electrical
and electronic medical apparatus, thereby putting patients If a fault is detected in the Savina so that its life-support
at risk!* functions are no longer assured:
● start ventilation using an independent ventilation device
without delay, if necessary with PEEP and/or increased
inspiratory O2 concentration (e.g. with the Dräger
Resutator 2000).

The following points should be noted if ventilating while


travelling:
● Do not place Savina on the bed while travelling.
● Ensure the apparatus cannot fall or be knocked over.

● Protect the apparatus from splashes and rain, to


avoid risk of malfunction. Savina is not splashproof.

During transport conditions, e.g. in an aircraft, hoses may


start to vibrate and thus affect the flow measurement.

When using Savina in combination with other products or


during transport, the operator must secure the equipment
appropriately to comply with the relevant basic
requirements of Directive 93/42/EC.
* Dräger medical equipment fulfils the interference resistance
requirements according to the product-specific standards or
EN 60601-1-2 (IEC 601-1-2). However, depending on the design
of the mobile phone and circumstances of use, field strengths may
occur in the immediate environment of a mobile phone that exceed
the limits of the above standards and therefore cause interference.

6
Intended Use
Intended Use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

7
Intended Use

Intended Use
Savina®1 NIV – non-invasive ventilation (optional)
Long-term ventilator for intensive care. For patients requiring For ventilation with a nose or face mask to support non-
50 mL tidal volume upwards. invasive ventilation therapies.
Choice available between mask ventilation and ventilation of
With the following ventilation modes intubated patients.
IPPV
Intermittent Positive Pressure Ventilation
controlled and assisted constant-volume ventilation.
IPPVAssist Special modes:
Assisted constant-volume ventilation. Apnoea Ventilation
CPPV For switching over automatically to volume-controlled
Continuous Positive Pressure Ventilation mandatory ventilation, if breathing stops.
Ventilation with continuous positive airway pressure.
IRV
Inversed Ratio Ventilation
Ventilation with inversed inspiration/expiration ratio. With monitoring for
PLV airway pressure, Paw,
Pressure Limited Ventilation expiratory minute volume, MV,
AutoFlow®2 (optional) inspiratory O2 concentration, FiO2,
for the automatic optimization of inspiratory flow and inspiratory breathing gas temperature, T,
minimizing of the airway pressure and to permit spontaneous apnoea,
breathing throughout the breathing cycle. tachypnoea monitoring to detect rapid, shallow spontaneous
breathing.
SIMV
Synchronized Intermittent Mandatory Ventilation
Procedure for weaning patients off the ventilator after they Areas of Use
have started spontaneous breathing.
PLV In the Intensive Care ward or in the recovery room.
Pressure Limited Ventilation During secondary transport from one hospital to another.
AutoFlow® (optional) During transfer of ventilated patients within the hospital.
for the automatic optimization of inspiratory flow and During transfer flights4.
minimizing of the airway pressure and to permit spontaneous
breathing throughout the breathing cycle.

CPAP
Continuous Positive Airway Pressure
Spontaneous breathing with positive airway pressure.
SB
Spontaneous Breathing
Spontaneous breathing
ASB
Assisted Spontaneous Breathing
Pressure-assisted spontaneous breathing.

BIPAP3 (optional)
Biphasic Positive Airway Pressure
Pressure-controlled ventilation combined with free
spontaneous breathing during the complete breathing cycle,
and adjustable pressure assist on CPAP level.

1 Savina® is a registered trade mark of Dräger


2 AutoFlow® is a registered trade mark of Dräger 4 Additional permits not covered by CE certification may be
3 Licensed trade mark. necessary for mobile use (in aircraft, etc.).

8
Operating Concept
Ventilation Controls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
Setting ventilation parameters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
Selecting the ventilation mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
Screen Operating Controls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Keys for routine and additional functions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
Information window on screen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
Power switch . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
Screen Pages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Structure of the screen pages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Main page . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
"Settings" screen page . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
"Alarms" screen page . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
"Values" screen page . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
"Configuration" screen page . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
»Standby« key . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

9
Operating Concept

Operating Concept
Ventilation Controls
1 Keys for selecting the ventilation modes:
– IPPV
– SIMV
D 2 Savina

– CPAP/ASB
– BIPAP (optional)
2 Keys for selecting/setting ventilation parameters:
– Tidal volume V T
– Inspiration time Tinsp 1
– Frequency f
– O2-concentration O2 3
– Inspiratory pressure Pinsp
– Pressure support ∆ PASB
– Positive End-Expiratory Pressure PEEP
3 Central "turn and push" rotary knob for setting the
parameters and for selecting screen parameters.
To set = turn the rotary knob
To confirm setting = press the rotary knob.

001 37261
Setting ventilation parameters
2 To select a ventilation parameter = press the corresponding
parameter key.
The yellow LED in the key lights up.
3 To set the value of the ventilation parameter = turn the rotary
knob. The value is displayed next to the parameter key.
3 To confirm the value = press the rotary knob.
The yellow LED in the key goes out.
The new value of the parameter becomes effective on
confirmation.

Derived parameters are displayed in an information window


on the main screen page during the setting procedure.

Selecting the ventilation mode


1 Hold down the appropriate key for about 3 seconds
or
● press the appropriate key briefly and
3 confirm = press the rotary knob
The selected ventilation mode will now be activated.

For detailed instructions on setting the ventilation modes,


see pages 19 onwards.

10
Operating Concept

Screen Operating Controls


1 Screen page selection keys:
D Savina
— » « key for setting the screen and display brightness
to bright or dark

— »Curves « key for selecting the main page to


display the pressure/flow curve

— »Set ∆∆« key for selecting the "Setting" screen page in 2


order to set other ventilation parameters, 1
— »Alarm ∆∆« key for selecting the "Alarms" screen pages
in order to set and display the alarm limits,

— »Values ∆∆« key for selecting the "Measured values"


screen page in order to display the measured values,

— »Config. ∆∆« key for selecting the "Configuration" screen

002 37261
page, for system settings such as alarm volume, screen
brightness.

2 Central "turn and push" rotary knob for selecting and


setting the options displayed on the screen.

To select/set = turn the rotary knob,


to confirm = press the rotary knob.

Changing screen pages


To change to the next page:
● press the same key again.

To change to another page:


● press the corresponding key.

To change to the main page:


● press »Curves « key.

11
Operating Concept

Keys for routine and additional functions


1 Frequently used keys for routine functions are positioned D Savina
on the right-hand side of the front panel:
D Savina
— » 2 min« key for suppressing the audible alarm tone for 2 1
2 minutes,
— »Alarm Reset« key for resetting or acknowledging alarm 2 1
messages and for testing the LEDs and audible alarm tone,
— » lock« key for protecting against inadvertent or
unauthorised modification of the settings.

2 Keys for additional functions are positioned on the left-hand


side of the front panel:

— » Neb.« key for switching the medicament


nebuliser on / off,
— »O2 Y suction« key to start/end the oxygen enrichment
program,

003 37261
— »Insp. hold« key for manually activated inspiration and
for extending the inspiration time.

Information window on screen


During setting of a ventilation parameter, the Savina calculates
the derived parameters and displays them in the information
window on the main screen page.

The information window disappears when the parameter


setting is confirmed.

060 37388

Power switch
3 To switch the apparatus on/off.
Located on the back of the apparatus.

To switch on:
Turn power switch to » « = ON.

0
100 37261

12
Operating Concept

Screen Pages
Structure of the screen pages
1 Ventilation mode display field
2 Alarm message display field 1 2
3 Curves and measured values display field
4 Measured values display field
5 Information bar
3

107 37261
5

Main page
Displays a pressure curve and displays three measured values.
To configure combination of measured values, see page 49.

075 37388
or:
Displays a flow curve and displays three measured values.
To configure combination of measured values, see page 49.
072 37388

13
Operating Concept

"Settings" screen page


— Analog bar display of the airway pressure Paw
— Setting menu for setting the supplementary ventilation
parameters »Trigger«, »FlowAcc«, »AutoFlow«,
— Setting menu for setting apnoea ventilation, with the
parameters »VTApnoea«, »fApnoea«,
— Setting menu for setting the sigh (only in ventilation
mode IPPV).

Settings 1/1:
Menu comprises a single page.

062 37388
● To select parameters = turn rotary knob.
The selected parameter is indicated by a bold frame.
● To activate parameter for setting = press rotary knob.
The active parameter appears light on a dark background.
● To set parameter = turn rotary knob,
to confirm = press rotary knob.
For detailed instructions on setting the ventilation modes,
see pages 19 onwards.

"Alarms" screen page


— For displaying the alarm limits associated with the
measured values.

— For setting the alarm limits.

For detailed operating instructions, see "Setting alarm limits"


on page 30.

063 37388

"Values" screen page


— For displaying all the measured values in the current
ventilation mode.

Detailed instructions for use, see "Displaying Curves and


Measured Values", page 33.

Values 1/2:
Page 1 of 2 available pages.
128 37388

14
Operating Concept

"Configuration" screen page


For setting equipment parameters:
— Screen contrast
— Alarm volume
— Displayed measured values
— Manual calibration for the O2 sensor 2
— FiO2 and Flow Monitoring ON/OFF
— Pmax ON/OFF
— Plateau ON/OFF
— Language, date and time
— MEDIBUS protocol

065 37388
Configuration 1/4:
Page 1 of 4 available pages of the Configuration menu.

Changing screen pages


To change to the next page:
● press the same key again.

To change to another page:


● press the corresponding key for that page.

To change to the main page for pressure curves:


● press »Curves « key.

Detailed instructions for use, see "Configuration", pages 47


onwards.

»Standby« key
1 Positioned at bottom right of the front panel.

— To keep the apparatus operational, D Savina

e.g. after pre-setting.


2
or

— to switch on ventilation.
1

To switch to standby:
1 Hold down » Standby« key for at least 3 seconds
and
2 to confirm = press »Alarm Reset« key.
004 37261

To switch on ventilation:
1 Press » Standby« key briefly.

15
16
Operation
Starting Up . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
Setting Ventilation Modes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
IPPV, IPPVAssist, CPPV . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
SIMV, SIMV/ASB . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
BIPAP, BIPAP/ASB (Optional) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
CPAP, CPAP/ASB . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
Apnoea ventilation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28
Setting Alarm Limits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
In the event of an Alarm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31
Warning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31
Caution . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31
Advisory . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32
Suppressing the audible alarm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32
Displaying Curves and Measured Values . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
Displaying measured values . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
NIV – Non-invasive ventilation Mask ventilation (optional) . . . . . . . . . . . . . . . . . . . . . 34
Special functions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37
Manual inspiration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37
Medicament nebulization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38
Oxygen enrichment for bronchial suction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40
Calibrating . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42
Calibrating O2 sensors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43
At high ambient temperature . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44
In the event of a power supply failure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44
In the event of a gas failure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44

17
Operation

Operation
Run equipment check according to checklist, see page 96.

Starting Up
Switching on
1 Turn the main switch on the back of the apparatus to » «
The Savina now runs through a power-up self-test
procedure.
● Wait for the 12-second test phase to be completed.

At the end of the test phase, the apparatus automatically


starts ventilation with the last ventilation mode set and the 1
associated ventilation parameters.

101 37261
During the self-test the start-up page appears, showing the
software version.

After this, the main page appears.


2 Check the settings in the display fields next to the
parameter keys and adjust as necessary.

066 37388

To adjust ventilation parameters:


Either
D 2 Savina

2 Change the ventilation parameters after the Savina has 4


started ventilation

or
3
3 Press the » Standby« switch to set the Savina on
standby,
4 Confirm = press »Alarm Reset« key.
2 Change the ventilation parameters and
3 press the » Standby« switch to return to ventilation.
091 37276

18
Operation

Setting Ventilation Modes


Setting the ventilation parameters
1 Press the appropriate ventilation mode key.
The yellow LED in the key will light up.
D 1 Savina

2 Set the desired value = turn the rotary knob,


confirm value = press the rotary knob
The yellow LED in the key will go out.

If the setting is at the upper or lower limit of the adjustment


range for a parameter, the figure in the parameter key display 2
will start flashing, indicating that confirmation is required.
● Press rotary knob in order to confirm extreme values.
● To set value = turn rotary knob,
to confirm = press rotary knob

Parameter settings for the active ventilation mode do not


become operative until confirmed.

If you fail to confirm the new settings within 15 seconds,


the previous settings will remain operative.

118 37261
Extreme settings
Certain ventilation parameters are limited by Savina to a
threshold value. Extreme values can only be set after
confirmation by pressing the rotary knob.

Parameter Threshold Range


Pinsp Y 50 mbar 0 to 100 mbar
Pmax Y 50 mbar 0 to 100 mbar
PEEP Y 20 mbar 0 to 35 mbar
∆ PASB 0 to 35 mbar
∆ PASB+PEEP Y 30 mbar
∆ PASB+PEEP Y 50 mbar
∆ Sigh 0 to 35 mbar
∆ Sigh+PEEP Y 20 mbar
FlowAcc X 20 mbar/s 5 to 200 mbar/s
f, Tinsp* Y I:E > 1:1 2 to 80 bpm
X I:E < 1:3 0.2 to 10 s
* Limitation of f and Tinsp is determined by I:E ratio

Confirmation is not necessary when the values are returned to


the normal range.

19
Operation

To activate the ventilation mode


1 Hold down the appropriate ventilation mode key for about
3 seconds
D 2 Savina

or

1 Briefly press the appropriate ventilation mode key


3 confirm = press the rotary knob

1 3
The new ventilation mode selected is now operative.
Ventilation always starts with the last settings.

To set parameters for another ventilation mode


1 Press the key for the new ventilation mode briefly.
The yellow LED will flash.

005 37261
2 In the block of parameter keys, the LEDs for the additional
parameters relevant to the new ventilation mode will start
flashing.
Constantly lit parameter keys indicate ventilation parameters
that are operative in the active ventilation mode. Any change
and confirmation of these parameters immediately affects the
active ventilation mode.
2 Press the relevant parameter key which has its LED
constantly lit.

3 Set the desired value = turn the rotary knob,


confirm value = press the rotary knob,
the yellow LED for that parameter key will go out.
3 To activate ventilation mode = press rotary knob.
If parameter setting is interrupted, Savina does not reset the
parameters set and confirms back to the old value.

To protect the settings against modification


D Savina
4 Press » Lock « key; the yellow LED will light up.
The parameter keys, the ventilation mode keys and the
screen settings are now protected against alteration.
4
Before setting a new value:
4 Press » Lock « key. The yellow LED will go out.
015 37261

20
Operation

IPPV, IPPVAssist, CPPV


Intermittent Positive Pressure Ventilation
Paw
Volume-controlled ventilation with a fixed mandatory minute with plateau without plateau
volume MV, set with the tidal volume V T and frequency f. Tplat
For patients unable to breathe spontaneously, see page 98 for
details. FlowAcc FlowAcc
Pplat
PEEP
Intermittent Positive Pressure Ventilation, Assist
For patients with partial spontaneous breathing.
t

Continuous Positive Pressure Ventilation Tinsp Te Tinsp


Ventilation with continuous positive airway pressure.
This mode is not displayed on the screen as a ventilation mode. T= 1
f
Flow
Set IPPV by means of the keys for the ventilation parameters:
— Tidal volume »V T«,
— Inspiration time »Tinsp«,
— Frequency »f«, t
— O2 concentration »O2«,
— Positive end-expiratory pressure »PEEP«.

045 37388
If PEEP is greater than 0 the airway pressure remains
constantly in the positive range (CPPV).

Pressure limit Pmax


The pressure peak can be avoided in IPPV and IPPVAssist by
setting a pressure limit. Thereby the PLV ventilation mode can
be reached (Pressure Limited Ventilation).

To set the pressure limit Pmax:


● Set Pmax to ON, see page 51.
● Set pressure limit value by means of »Pinsp« key.
● When setting the pressure limit, ensure that the tidal
volume VT is still being applied, as otherwise Savina will
display a "!! Tidal volume low" message. Then:
● Set pressure limit higher,
or
● Increase inspiration time »Tinsp.«,
or
● Increase »FlowAcc«,
This can be set on-screen:
Set flow metering by means of »FlowAcc« on screen page
»Settings 1/1«.
075 37388

21
Operation

Flow Acceleration FlowAcc


By setting the FlowAcc, the pressure and flow increase at the
start of inspiration can be changed.

To set FlowAcc:
● Press »Settings ∆∆«key,
screen page »Settings 1/1« appears.
● Select line »FlowAcc« on screen = turn rotary knob,
to confirm = press rotary knob.
● To set value = turn rotary knob
Setting range: 5 to 200 mbar/sec
FlowAcc high: steep pressure and flow increase
● To confirm setting = press rotary knob.

A recommended start-up setting for FlowAcc is 35 mbar/s.

103 37388
IPPV can be extended using the following ventilation
parameters:
— Trigger
— Sigh
— AutoFlow (optional)

Trigger (IPPVAssist)
To synchronize the mandatory ventilation strokes with the
patient’s efforts to breathe in. The actual frequency may be 1 Savina

higher than the ventilation frequency f set.

1 The green LED lights up if the Savina detects attempted


spontaneous breathing by the patient.

The trigger can be switched off if spontaneous breathing


by the patient is not expected or desired.
To set the trigger, see page 23.
108 37261

22
Operation

Activating/setting the trigger


1 Press »Settings ∆∆« key.
2 To release »Trigger« for setting = press rotary knob. 3 Savina

The field appears bright against a dark background.


2 To set value = turn rotary knob
Low value = high sensitivity
To confirm = press rotary knob.

1 2
The ventilation mode IPPVAssist is displayed on the screen.

3 The green LED lights up if the Savina detects attempted


spontaneous breathing.

092 37261
When changing over from IPPV to SIMV, BIPAP or CPAP/ASB,
the last active trigger value remains effective.

To switch off the trigger:

● Set a value less than 1. Display in trigger field: OFF


2 To confirm = press rotary knob.

The ventilation mode IPPV is displayed on the screen.

068 37388
Sigh
To prevent atelectasis.
Atelectasis can be prevented by activating the sigh function
and setting the sigh in the form of an intermittent PEEP.
When the sigh function is activated, the end-expiratory
pressure is increased by the set intermittent PEEP for
2 ventilation strokes every 3 minutes.

Activating/setting the sigh


● Press »Settings ∆∆« key.
● On the screen, to select the »∆ Sigh« line = turn the rotary
knob.
● To release »∆ Sigh« for setting = press the rotary knob.
The field appears bright against a dark background.
● Set a value between 1 and 35 mbar = turn rotary knob,
to confirm = press rotary knob.

The sigh set is added to the PEEP.


069 37388

23
Operation

Deactivating the sigh


● Set a value less than 1. OFF appears in the "∆ Sigh",
to confirm = press rotary knob.
The sigh function is deactivated.

AutoFlow® (optional)

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Automatic optimization of the inspiration flow.
The inspiration flow is decelerated and regulated by
AutoFlow*, so that at the selected tidal volume V T, with the
current compliance a minimum airway pressure is reached and
pressure peaks are avoided.
Savina supplies additional inspiration flow when the patient
breathes in – restricted by the alarm limit V Ti >.
The patient can also breathe out during the inspiratory plateau
phase.
The inspiratory pressure is limited by the Paw > alarm limit.

To switch AutoFlow ON and OFF


● Press »Settings ∆∆« key.
● Select line »AutoFlow« on screen = turn rotary knob.
● To release »AutoFlow« for setting = press rotary knob.
● To set »AutoFlow ON« = turn rotary knob,
to confirm = press rotary knob.

121 37388

● To set alarm limits, see page 30.

* For a detailed description of AutoFlow, page 100.

24
Operation

SIMV, SIMV/ASB
Synchronized Intermittent Mandatory Ventilation*
without ASB with ASB
Assisted Spontaneous Breathing** Paw pressure support pressure support

Fixed mandatory minute volume MV, set with the tidal volume V T
FlowAcc FlowAcc
and frequency f. The patient can breathe spontaneously high low
between the mandatory ventilation strokes. Spontaneous FlowAcc
PEEP
breathing can be assisted by ASB.

For patients with insufficient spontaneous breathing or patients t


Trigger window
being weaned from artificial ventilation by progressive Tinsp
reduction of the mandatory proportion of the total minute
volume. T= 1
Flow f

Set SIMV by means of the ventilation parameter keys:


— Tidal volume »V T«,
— Inspiration time »Tinsp«, t
— Frequency »f«,

046 37388
— O2 concentration »O2«,
— positive end-expiratory pressure »PEEP«.

The following can be set on the screen:


— Sensitivity »Trigger« (for synchronization of mandatory
ventilation strokes) on screen page »Settings 1/1«
— Set flow metering by means of »FlowAcc« on screen page
»Settings 1/1«.
— AutoFlow (optional) ON/OFF.

Pressure limit Pmax


The pressure peak can be avoided in SIMV and SIMV/ASB by
setting a pressure limit.

062 37388
To set the pressure limit Pmax:
● Set Pmax to ON, see page 51.
● Set pressure limit value by means of »Pinsp« key.
● When setting the pressure limit, ensure that the tidal
volume VT is still being applied, as otherwise Savina will
display a "!! Tidal Volume low". Then:
● Set pressure limit higher by means of »Pinsp«,
or
● Increase inspiration time »Tinsp«,
or
● Increase FlowAcc

Additional functions:
— Pressure support »∆ PASB above PEEP«
— Apnoea ventilation
● To set apnoea ventilation, see page 28.

* For a detailed description of SIMV, see page 102.


** For a detailed description of ASB, see page 103.

25
Operation

BIPAP, BIPAP/ASB (Optional)


Biphasic Positive Airway Pressure
Assisted Spontaneous Breathing

Pressure-controlled ventilation combined with free


without spontaneous breathing with spontaneous breathing
spontaneous breathing during the complete breathing cycle,
supported by adjustable additional pressure at CPAP level. Paw ASB
FlowAcc FlowAcc
pressure support
The mandatory proportion of the total minute volume MV is high low
FlowAcc FlowAcc FlowAcc
set by means of the inspiration pressure Pinsp, PEEP and FlowAcc
Pinsp high low
frequency f.
PEEP
Adaptable to a wide range of patients, from those unable to t
breathe spontaneously at all to those breathing spontaneously Tinsp Trigger window
before extubation. Suitable for weaning patients from artificial 1
ventilation by progressively reducing the mandatory fraction of f
Flow
the minute volume MV and by reducing the additional artificial
pressure support ∆ PASB above PEEP.
For details see "BIPAP" description, page 104. t

027 37388
Set BIPAP by means of the ventilation parameter keys:

— Inspiration time »Tinsp«,


— Frequency »f«,
— O2 concentration »O2«,
— Inspiration pressure »Pinsp«,
— Positive end-expiratory pressure »PEEP«.

The following can be set on the screen:

— Sensitivity »Trigger« (for synchronization with spontaneous


breathing)
To set the trigger, page 23
— FlowAcc
can be set on screen on screen page
»Settings 1/1«.
FlowAcc is effective both for BIPAP strokes and pressure
support »∆ PASB above PEEP«

— Additionally for BIPAP/ASB:


Pressure support »∆ PASB above PEEP«

BIPAP, BIPAP/ASB can be supplemented with apnoea


ventilation:
● To set apnoea ventilation, see page 28.

● To set alarm limits, see page 30.

26
Operation

CPAP, CPAP/ASB
Continuous Positive Airway Pressure
Assisted Spontaneous Breathing

For patients breathing spontaneously in an adequate manner.

Spontaneous breathing at a raised pressure level, to increase


the functional residual capacity FRC. Spontaneous breathing
can be assisted with additional pressure by ASB.

Set CPAP by means of the ventilation parameter keys:


— O2 concentration »O2«
— Positive end-expiratory pressure »PEEP«

Additionally, for CPAP/ASB:


— Pressure support »∆ PASB above PEEP«

The following can be set on the screen:


— FlowAcc for pressure support ASB on screen page
»Settings 1/1«
— Sensitivity »Trigger« (for synchronising attempted
spontaneous breathing with ASB pressure support)
on screen page »Settings 1/1«.

CPAP, CPAP/ASB can be supplemented with the following


ventilation parameters and ventilation modes:

Trigger
By setting the trigger sensitivity, the assisting ventilator
support is synchronised with the patient’s own spontaneous
breathing attempts.
● To set the trigger, see page 23.

Apnoea ventilation
● To set apnoea ventilation, see page 28.

● To set alarm limits, see page 30.

27
Operation

Apnoea ventilation
For automatic switchover to volume-controlled mandatory
ventilation if the patient stops breathing. Apnoea ventilation Paw
can be provided for all ventilation modes with spontaneous FlowAcc
breathing. If the patient stops breathing, Savina activates an
alarm after the set apnoea alarm time TApnoea and starts
volume-controlled mandatory ventilation with:
— inspiration /expiration ratio I:E = 1:2
and the set ventilation parameters: 1
Apnoea alarm time t= t
— Frequency »fApnoea« TApnoea > fApnoea
— Tidal volume »VTApnoea« Start of
The patient can breathe spontaneously during apnoea apnoea ventilation
ventilation. The frequency »fApnoea« remains constant.
Flow

009 37388
To set apnoea ventilation
● Press »Settings ∆∆« key. Screen page 1/1 appears.
If apnoea ventilation is activated, the »VTApnoea« and »fApnoea«
lines are visible.
In this case A = apnoea ventilation standby appears at the right
on the main screen page.

If apnoea ventilation is deactivated, instead of the »fApnoe« line


the display shows:
»Apn-Vent. OFF«.

To activate apnoea ventilation:

118 37388
● Select »Apn-Vent. OFF« line = turn rotary knob
Activate = press rotary knob.
● Set a value of at least 2 bpm = turn rotary knob.
The »VTApnoea« and »fApnoea« lines appear.
● To select lines = turn rotary knob,
activate = press rotary knob.
● To set value = turn rotary knob,
confirm = press rotary knob.

To deactivate apnoea ventilation:


● Set a value less than 2 in the »fApnoea« line
= turn rotary knob,
confirm = press rotary knob.
070 37388

28
Operation

Setting apnoea time TApnoea on the "Alarms" screen


page

● Press »Alarms ∆∆« key. Display: screen page


»Alarms 1/1«
On the screen select the line »TApnoea «=
turn rotary knob,
activate = press rotary knob.

● Set the desired value = turn rotary knob,


confirm = press rotary knob.

071 37388
To end apnoea ventilation:
● Press the »Alarm Reset« key.
Savina carries on ventilating in the original ventilation mode and
D Savina
associated ventilation parameters.

047 37261
During Savina settings, the status of switched on apnoea
ventilation is displayed for 6 seconds by a special information
page where, in principle, apnoea ventilation is possible.
— when changing over the ventilation mode,
— when switching on Savina,
— when reducing the frequency, if the cycle time is then
longer than TApnoea .

● To set alarm limits, see page 30


119 37388

29
Operation

Setting Alarm Limits


● Press »Alarms ∆∆« key.

Example display: screen page »Alarms1/1«

This page displays all the alarm limits that can be set.
< = lower alarm limit
> = upper alarm limit

Alarm Setting Range

Paw > 10 to 100 mbar

MV > 2 to 41 L/min

063 37388
MV < 0.5 to 40 L/min

TApn. > 15 to 60 sec

ftot > 10 to 120 bpm

V Ti > 0.06 to 4 L

Example; setting the upper alarm limit for Paw.


● On the screen, select the line »Paw «=
turn the rotary knob,
to release for setting = press rotary knob.
● Set the desired value = turn the rotary knob,
confirm = press the rotary knob.

The lower alarm limit does not have to be set for the airway
pressure Paw, because it is automatically coupled to the
PEEP setting.

The alarm limits do not have to be set for the O2 concentration.


These limits are automatically coupled to the O2 concentration
setting:

Lower alarm limit:


Setting –4 vol. % (at settings up to 60 vol. %)
Setting –6 vol. % (at settings from 60 to 100 vol. %)
Upper alarm limit:
Setting +4 vol. % (at settings up to 60 vol. %)
Setting +6 vol. % (at settings from 60 to 100 vol. %)

A specific screen page »Alarms 2/2« appears in the optional


mode »Mask/NIV«. See "NIV – Non-invasive ventilation",
page 34.

30
Operation

In the event of an Alarm


1 the red or yellow LED flashes.
2 the alarm message is displayed in the right-hand corner
D
of the top line of the screen. 1
2
Savina classifies the alarm in three priority classes, marks the
text with exclamation marks according to the priority class and
generates various alarm tone sequences.

!!! = Warning (red LED flashes)


!! = Caution (yellow LED flashes)
! = Advisory (yellow LED lights up and
remains continuously lit)

Savina displays a message for your guidance in the information


line when certain alarm messages occur.

007 37261
Warning
Top priority message

1 Red LED flashes.


Warning messages are marked with three exclamation marks
and appear white on a dark background.
Example: !!! Apnoea

Savina generates a five-tone sequence that is sounded twice


and repeated every 7.5 seconds.

Caution
Medium priority message

1 Yellow LED flashes.


Caution messages are marked with two exclamation marks.
Example: !! Check settings

Savina generates a 3-tone sequence that is repeated every


20 seconds.

31
Operation

Advisory
Low priority message

1 Yellow LED lights up and remains lit.


Advisory messages are marked with one exclamation mark.
Example: ! Flow monitoring off D 1
3 4
Savina generates a two-tone sequence that sounds only once. 2
To remedy the faults, please refer to the "Troubleshooting"
section starting on page 56.

When the fault has been remedied


— the audible alarm is switched off.
— Caution messages (!!) and advisory messages (!) disappear
automatically from the screen.

Warning messages (!!!) remain black on a white background on


the screen and need to be acknowledged:

2 Press the »Alarm Reset« key.

008 37261
3 The message is erased from the screen.

Suppressing the audible alarm


for max. 2 minutes:
4 Press the » « key. Its yellow indicator LED lights up and
the alarm tone will be muted for about 2 minutes. If the
cause of the alarm has not yet been remedied, the audible
alarm will sound again after about 2 minutes.

If you wish to reactivate the audible alarm before the end of this
2-minute muting period:
4 Press the » « key again. The yellow LED will now go out.
The message remains on the screen.

The alarm tone sounds only once when a higher priority alarm
occurs during the period, when the audible alarm is muted.

32
Operation

Displaying Curves and Measured Values


On the main page
the airway pressure curve, or flow curve and three relevant
measured values are displayed.

To change the curve display


● Press »Curves « key.

Example: flow curve

The combination of measured values in the measured value line


can be configured, see page 49.

072 37388
Displaying measured values
● Press »Values ∆∆« key. The screen page »Values1/2«
appears or, in »Mask/NIV« mode, »Values 1/3«.
The airway pressure is indicated by a bar display.
The other measured values are displayed numerically.

123 37388

Displaying other measured values


● Press »Values ∆∆« key again. The screen page
»Values2/2« appears or, in »Mask/NIV« mode,
»Values 2/3«.
When ventilating without plateau, the value Tinsp will appear
instead of Tplat.
124 37388

33
Operation

In »Mask/NIV« mode, another page can be displayed


»Values 3/3«.

125 37388
NIV – Non-invasive ventilation
Mask ventilation (optional)

Installing the NIV option


This should only be done by experts, following the
corresponding installation instructions.

Using NIV*
When masks are used, the dead space increases.
● Follow the mask manufacturer’s directions.

Never ventilate an intubated patient in the »Mask/NIV«


mode.

● After changing over from »Mask/NIV« to »Tube« mode,


check the alarm limits.

● Avoid high airway pressures.


Risk of aspiration.

All ventilation modes are selectable in »Mask/NIV« mode.

Selecting »Mask/NIV« mode


● Switch apparatus to standby = hold down » Standby«
key for about 3 seconds.
● Press »Alarm Reset« to switch off the audible alarm.
● Select »Patient Connection« line = press rotary knob,
● Select »Mask/NIV« line = press rotary knob,
● Confirm = press rotary knob.
126 37388

* For a detailed description of NIV, see page 106.

34
Operation

● The following advisory message appears briefly:

127 37388
Setting the ventilation parameters
● Proceed as in »Tube« mode.

In the »Mask/NIV« mode, the »Tinsp« key has an extended


function:
In addition to setting the inspiration time in the mandatory
ventilation modes IPPV, SIMV or BIPAP, it is also used to set
the maximum duration of the ASB strokes during pressure-
supported ventilation.
● Set Tinsp or the maximum duration of the ASB strokes,
0.2 to max. 4 s.

Automatic trigger leakage compensation


Savina compensates for detection of trigger leakage caused by
the patient up to 25 L/min.

Automatic compensation of set tidal volume


Savina compensates up to 100 % of the measured minute
volume for leaks detected.

Monitoring in the »Mask/NIV« mode


● Only switch off alarms if the safety of the patient will
not be compromised by the absence of an alarm.

To avoid artefacts in the case of very big leaks, the following


alarms may be switched off:
— MV minute volume lower alarm limit
— V Ti inspiratory tidal volume upper alarm limit
— TApnoea apnoea monitoring upper alarm limit

To switch off (for example MV ):


● Reduce »MV « until the message appears:
»MV off? Press and turn rotary knob«.
● Confirm = press rotary knob.
● Continue turning the rotary knob until OFF appears in the
display.
● Confirm = press rotary knob.

35
Operation

If an alarm limit has been switched off, an advisory message will


constantly be displayed, e.g.:
! MV low Alarm off

The apparatus does not display the following warning


messages in the »Mask/NIV« mode:
— ASB > 4 s
— Leakage

Setting TDisconnect
A delay »TDisconnect« from 0 to 60 seconds can be set for the
»Airway pressure low« alarm in the »Mask/NIV« mode. In the
event of disconnection this delays the activation of the alarm by
the time set.
● Press the »Alarms ∆∆« key until the screen page
»Alarms 2/2« appears.
● Activate the »TDisconnect« line to set.
● Set TDisconnect = turn the rotary knob,
confirm = press the rotary knob.

129 37388
Selecting »Tube« mode
● Switch apparatus to standby = hold down » Standby«
key for about 3 seconds.
● Press »Alarm Reset« to switch off the audible alarm.
● To select, activate »Patient Connection« line =
press rotary knob,
● Select »Tube« = turn rotary knob,
● Confirm = press rotary knob.
● The advisory message appears briefly.

When switching over to »Tube« mode, Savina automatically


130 37388

selects the default alarm limits for the alarms previously


switched off in »Mask/NIV« mode.

● Check alarm limits after changing from »Mask/NIV«


mode to »Tube« mode.

36
Operation

Special functions
Manual inspiration
This function may be used in all modes except CPAP
spontaneous breathing without ASB pressure support.
Regardless of the start time, an automatic ventilation stroke
can be prolonged by up to a maximum of 15 seconds.
Or:
Between two automatic ventilation strokes, a ventilation
stroke can be manually started and held for a maximum
of 15 seconds.

The pattern of the manually started ventilation stroke depends


on the ventilation mode in use.

For IPPV, SIMV:


volume-controlled ventilation stroke, defined by the »V T« and
»Tinsp« settings.

For BIPAP:
pressure-controlled ventilation stroke, defined by the »Pinsp«
and »Tinsp« settings.

For CPAP/ASB:
pressure-assisted ventilation stroke, defined by the
»∆ PASB above PEEP« setting.

1 Press and hold down the »Insp. hold« key for as long as
inspiration is required.
D Savina

Either an automatic ventilation stroke that has just begun will be


accordingly prolonged, or a new ventilation stroke can be
started and held for a maximum of 15 seconds. 1

010 37261

37
Operation

Medicament nebulization
Applicable in every ventilation mode.

Will only function with O2 supply between 2.7 to 6 bar.

Savina applies the medicament aerosol in synchronization


with the inspiration only in the inspiratory flow phase and
automatically maintains the minute-volume constant.
Savina automatically turns the nebulizer off after 30 minutes.
The flow sensor will be automatically heat-cleaned and
calibrated after the aerosol treatment to prevent false results
during flow measurement.

● Danger of fire! Do not nebulize flammable


medicaments.

Since Savina uses pure oxygen for the medicament


nebulization, an increase of the desired inspiratory
O2 concentration may be caused.

Due to the inability of Savina to measure this O2 concentration


increase, an incorrect O2 reading will be displayed.

Only use medicament nebulizer 84 12 935 (white


centerpiece).
Use of other pneumatic medicament nebulizers may result

04337261
in considerable discrepancies in the minute-volume
reading!

● Connect your O2 supply 2.7 to 6 bar – from the medical O2


pipeline system or from a cylinder, to the side of Savina.

● Prepare the medicament nebulizer in accordance with the


accompanying instructions for use. 2
1 Connect the nebulizer to the inspiratory side of the Y-piece
(temperature sensor side).
2 Connect the inspiration hose to the medicament nebulizer.
1
011 37261

● Swivel the medicament nebulizer to the vertical position.

● Using clamps, route the nebulizer hose back to the


ventilator along the ventilation hose.

3 Connect the nebulizer hose to the spigot at the front side of


Savina.

● Fill the medicament nebulizer in accordance with the 3


accompanying instructions for use.
017 37261

38
Operation

● During medicament nebulization do not use a heat and


moisture exchanger (HME). Risk of increased
breathing resistance.

1 Hold down » Neb.« key, until the yellow lamp lights up.
D Savina
On-screen advisory message:
1
! Nebulizer on

The nebulizer is in operation for 30 minutes; nebulization only


in the inspiratory flow phase.

If medicament nebulization needs to be stopped prematurely:


1 Press » Neb.« key again. The yellow lamp goes out,
the nebulizer is switched off.

The flow sensor will be automatically heat-cleaned and


calibrated by Savina.

On-screen information:

013 37261
Flow calibration

● Remove any left-over medicament from the medicament


nebulizer.
● Follow the instructions for use of the medicament nebulizer.

● Take into account the effect of aerosols on sensors and


filters.
The measuring function of the flow sensor may be impaired.
The flow resistance of filters is liable to increase and may impair
ventilation.
● Do not place microbial filters on the nebulizer outlet
during nebulization!
Risk of increased breathing resistance!

39
Operation

Oxygen enrichment for bronchial suction


Will only function with O2 supply between 2.7 to 6 bar.

To prevent hypoxia during bronchial suction, an O2 enrichment


program during removal of secretions is provided with Savina.

After the program has started, during the oxygen enrichment


phase Savina ventilates in the selected ventilation mode for up
to 180 seconds with 100 Vol.% oxygen.

When the ventilator is disconnected for suction, Savina


automatically interrupts ventilation. During the suction phase,
the alarms "!!!Apnoea", "!!!Fail to cycle", "!!!Airway pressure low"
and "!!!MV low" are suppressed so that the suction routine is
not disrupted.

After suction and automatically recognized reconnection,


Savina ventilates 120 seconds with 100 Vol.% O2. During
suction and for two minutes afterwards, the lower alarm limit for
the minute volume is disabled.

● Connect your O2 supply 2.7 to 6 bar – from the medical


pipeline system or from the O2 cylinder – to Savina.

043 37261
Before suction
1 Hold down »O2 Y suction« key until the yellow lamp lights
up.
D Savina
In the set ventilation mode, Savina ventilates with
100 Vol.% O2.
In case PEEP has not been set higher than 4 mbar, an 1
automatic setting of 4 mbar will come into effect.
This PEEP will enable Savina to detect any subsequent
disconnection.
The other ventilation parameters remain unchanged.

Message in the information line on screen:

O2 enrichment 100% 180 s

The remaining time is continuously displayed on screen.


The oxygen enrichment lasts for a maximum of 180 seconds.
During this time, Savina waits for the suction to be
disconnected.
014 37261

If there is no disconnection after 180 seconds, Savina will


terminate the oxygen enrichment program.

40
Operation

After suction disconnection


During the period of disconnection Savina supplies a minimal
flow of 100 Vol.% O2 in order to automatically detect the end of
the disconnection phase. The time available for suction is
continuously displayed in the information line on screen
(example):

Execute suction and reconnect 120 s

If suction is ended and the system is reconnected within the


displayed time, Savina starts the final O2 enrichment.

After reconnection
After reconnection has taken place, Savina ventilates once
more in the set ventilation mode, however, for final O2
enrichment 120 seconds more with 100 Vol.% O2.

Message in the information line on screen:

Final O2 enrichment 100% 120 s

The remaining time is continuously displayed on screen.

In case the O2 enrichment has to be interrupted:


1 Press the »O2 Y suction« key again
D Savina

014 37261

Automatic discontinuation of oxygen enrichment


If after 120 seconds no reconnection follows, Savina stops the
O2 enrichment program.
All alarms are immediately reactivated. Savina immediately
continuous ventilating in the set ventilation mode.

41
Operation

Calibrating
The saved calibration/zeroing values remain stored even when
the machine is switched off.

Automatic calibration of the pressure sensors


The pressure sensors for measuring the airway pressure
are calibrated automatically.

Automatic calibration of the flow sensor


The flow sensor will be automatically calibrated in the following
circumstances:

— when the apparatus is switched on


— every 24 hours during operation
— after changing the flow sensor
— after medicament nebulisation
— after bronchial suction
— after changing the O2 concentration.

Savina uses a full inspiration phase for calibration. Short


inspiration times are extended to about one second.

Message in the information line on the screen:


Flow calibration in progress

After calibration is complete, the following message appears in


the information line:

Flow-calibration ok
104 37388

If calibration is unsuccessful, the following message appears:


"Flow-calibration failed". The expiratory part of the flow curve
does not appear and no measured values are displayed for VTe,
MV or PEEP.

Then
● Exchange flow sensor.

● Always pay special attention to successful flow


calibration. Without a usable flow measurement,
neither O2 calibration nor O2 enrichment for bronchial
suction is possible.

42
Operation

Calibrating O2 sensors
Savina uses one O2 sensor for O2 control and display
(sensor 1) and a second, separate O2 sensor for O2 monitoring
(sensor 2).

The O2 sensor for O2 control and display (sensor 1)


is automatically calibrated by Savina:
— when the apparatus is switched on
— after 8 hours’ operation
— when the O2 sensor is replaced
— if sensor 1 and sensor 2 differ from each other by more
than 2% by volume
— when the air pressure changes by more than 200 hPa,
e.g. during transfer flights by helicopter
— when the temperature changes by more than 10 oC.

During automatic calibration, the following message appears in


the information line on the screen:
O2 calibration active

After calibration is complete, the following message appears:


O2 calibration ok

The O2 sensor for O2 monitoring (sensor 2) has to be


calibrated manually:
— once per month,
— if the following alarms occur:
!!! FiO2 high
or
!!! FiO2 low
or
!!! O2 measurement inop.

● Manual calibration can be carried out in any ventilation


mode, see page 49.

43
Operation

At high ambient temperature


In ambient temperatures over 35 oC Savina displays an
advisory message:
! Temperature high
To prevent the breathing gas becoming too hot, Savina reduces
the maximum speed of the built-in blower as the ambient
temperature rises. If high inspiratory pressures are set at the
same time, e.g. over 80 mbar, the result may be that high flows,
e.g. 180 L/min, can no longer be achieved.
Even at slower speeds, the breathing gas delivered by the
blower is warmed. To ensure that the breathing gas
temperature at the Y-piece remains under 41 oC, an inspiratory
hose length of not less than 1.1 m should be maintained as a
cooling section.
If the temperature sensor built into Savina reaches over 40 oC,
an alarm will be activated
!!! Temperature high
If an operational temperature sensor* is used in the Y-piece,
Savina will warn of breathing gas temperatures of 40 oC or
higher by activating the alarm
!!! Breathing gas temp. high
In both cases, Savina continues ventilating the patient.
● Lower the ambient temperature.

In the event of a power supply failure


If all external and internal power sources fail, an intermittent
audible alarm sounds.
● Either immediately reconnect power supply
or
● Disconnect patient and continue ventilating using an
independent ventilator.

In the event of a gas failure


In normal operating mode, Savina uses ambient air to ventilate
the patient with the aid of a blower and O2 from the medical gas
pipeline system or from an O2 cylinder.

In the event of O2 failure


Savina replaces the missing proportion of O2 with ambient air
and generates an alarm.
The minute volume remains constant.
The inspiratory O2 concentration FiO2 drops to 21 Vol.%.

* See Order List on page 126. Only use temperature sensors with
blue leads.

44
Operation

If the patient needs an inspiratory O2 concentration higher


than 21 Vol.%:
● reconnect the O2 supply without delay.

In the event of blower failure Savina cannot carry on


ventilating.
● Continue ventilating without delay, using an
independent ventilator.

45
46
Configuration
Setting the screen contrast . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48
Adjusting the volume of the audible alarm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48
Configuring the measured values line . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49
Manual calibration for O2 sensor 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49
FiO2- or flow monitoring ON/OFF . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50
Pmax ON/OFF . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51
Plateau ON/OFF . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52
Selecting the language . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52
Setting the date and time . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52
Configuring the MEDIBUS protocol . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53
Displaying the device values . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53

47
Configuration

Configuration
The following settings for use can be selected in
»Configuration« mode:

— Screen contrast
— Alarm volume
— Measured values line
— Manual calibration for O2 sensor 2
— FiO2 and flow monitoring ON/OFF
— Pmax ON/OFF
— Plateau ON/OFF
— Language, date and time
— MEDIBUS protocol.

The settings selected in »Configuration« mode remain stored


until the equipment is switched off.

The following information about the equipment can be


displayed in »Configuration«:
— Total operating hours
— Operating hours since the last inspection and
maintenance.
— software version
— device identification number

Setting the screen contrast


● Press »Config. ∆∆« key repeatedly until
»Configuration 1/4« appears.
● Select the »Contrast« line = turn the rotary knob,
activate = press the rotary knob
● To set the contrast = turn the rotary knob.
The contrast changes.
Confirm = press the rotary knob.
The contrast set will now be activated.
077 37388

Adjusting the volume of the audible alarm


Display (example):

● Press »Config. ∆∆« key repeatedly until


»Configuration 1/4« appears.
● Select »Volume« line = turn the rotary knob,
activate = press the rotary knob.
● To adjust the volume = turn the rotary knob,
confirm = press the rotary knob

After the setting has been confirmed, the alarm tone


is sounded once to enable you to judge the volume.
122 37388

48
Configuration

Configuring the measured values line


Select one of 6 possible combinations of measured values:
● Press »Config. ∆∆« key repeatedly until
»Configuration 1/4« appears.
● Select »Measured values« line = turn the rotary knob,
activate = press the rotary knob.
● To set the measured values combination =
turn the rotary knob,
confirm = press the rotary knob.

078 37388
The following combinations of measured values can
be selected:
1. VTe ftot MV
2. FiO2 VTe MV
3. Ppeak VTe MV
4. Pmean FiO2 MV
5. Pmean VTe MV
6. Ppeak Pmean V Te

Manual calibration for O2 sensor 2


— once per month,
— if the following alarms occur:
!!! FiO2 high
or
!!! FiO2 low
or
!!! O2 measurement inop.

Manual calibration can be carried out in the respective


ventilation mode:
● Press »Config. ∆∆« key repeatedly until
»Configuration 2/4« appears.
● Select »O2 calib.« line = turn rotary knob,
to release for setting = press rotary knob.

● To start O2 calibration = turn rotary knob and select


»Start«,
to confirm = press rotary knob.
Message in the information line on screen:
Disconnect patient
076 37388

● Disconnect patient within the next 30 seconds.


● If necessary continue ventilating the patient using a
separate ventilating appliance.

49
Configuration

Message in the information line on screen:


O2 calibration active
After 60 seconds the following appears in the information line:
Reconnect patient
● Immediately reconnect patient.

Thereafter appears:
O2 calibration ok

The O2 calibration is completed, Savina ventilates once more


using the original settings.

115 37388
Disconnection and change of O2 concentration would activate
the alarms. For this reason Savina turns the alarms off during
calibration.
If the patient is not reconnected within 30 seconds, Savina
continues ventilating and all the alarms are reactivated.

If the following alarm appears after calibration:


!!! O2 measurement inop.
or
!!! FiO2 low

● Replace O2 sensor, see page 77.

After replacing the O2 sensor:


● Allow about 20 minutes warm-up time to elapse,
then calibrate.

120 37388
FiO2- or flow monitoring ON/OFF
For instance, when a used O2 or flow sensor cannot be
replaced immediately.
● Use alternative monitoring, as otherwise there will be a
restricted monitoring function.
● Press »Config. ∆∆« key repeatedly until
»Configuration 2/4« appears.
● Select the desired line = turn the rotary knob,
confirm = press the rotary knob
● Set to »ON« = turn the rotary knob,
confirm = press the rotary knob.
The corresponding monitoring is activated.
● Set to »OFF« = turn the rotary knob,
confirm = press the rotary knob.
080 37388

O2 monitoring and flow monitoring and associated


alarms are permanently deactivated.
● Provide alternative monitoring.

Display in Alarm line:


! Flow monitoring off
or
! O2 monitoring off

50
Configuration

Display in information bar:


Replace flow monitoring
or
Replace O2 monitoring
or
Replace flow monitoring and O2 monitoring
Flow monitoring is automatically activated each time Savina is
switched on.

When flow monitoring is deactivated, Savina does not


determine the following measured values:
— MV
— MVspont

Even when O2 monitoring is deactivated, the devices requires


at least sensor 1 for accurate O2 control. Otherwise it delivers
inaccurate O2/air mixes.
O2 monitoring should only be deactivated when Savina is
supplied with air only.

O2 monitoring remains deactivated even when the device


is switched on again.
Display in alarm line:
!! O2 monitoring off

On acknowledging by pressing the »Alarm Reset« key,


display:
! O2 monitoring off

● Reactivate the monitor function after replacing the sensor.

Pmax ON/OFF
To use the pressure limit Pmax in the IPPV, IPPVAssist and
SIMV, SIMV/ASB ventilation modes.
The pressure limit value is set by means of the »Pinsp« key.
Savina limits the airway pressure to that set value.
● Press »Config. ∆∆« key repeatedly until
»Configuration 2/4« appears.
● Select »Pmax« line = turn rotary knob,
to release for setting = press rotary knob.
● To set »ON« = turn rotary knob,
confirm = press rotary knob.
The pressure limit »Pmax« is activated.
● To set »OFF« = turn rotary knob,
confirm = press rotary knob.
The pressure limit »Pmax« is deactivated.
079 37388

51
Configuration

Plateau ON/OFF
To switch on and off the inspiratory pause.
When the plateau is deactivated, Savina switches to expiration
after application of the tidal volume V T. The inspiration time
setting Tinsp does not apply. Savina establishes a minimum
expiration time of 500 ms and limits the resulting I:E ratio to
max. 4:1.
● Press »Config. ∆∆« key repeatedly until
»Configuration 2/4« appears.
● Select »Plateau« line = turn rotary knob,
to release for setting = press rotary knob.
● To set »ON« = turn rotary knob,

116 37388
confirm = press rotary knob.
Plateau is activated.
● To set »OFF« = turn rotary knob,
confirm = press rotary knob.
Plateau is deactivated.

Selecting the language


Display (example):

● Press »Config. ∆∆« key until


»Configuration 3/4« appears.
● Select »Language« line = turn the rotary knob,
to release for setting = press rotary knob.

The following languages can be selected:


— German – Japanese
— English – Russian
— US-English – Greek

081 37388
— French – Romanian
— Italian – Polish
— Spanish
— Portuguese
— Chinese

● Select language = turn the rotary knob,


confirm = press the rotary knob.
The new language selected is activated immediately.

Setting the date and time


This has to be done when using the MEDIBUS interface

● Press »Config. ∆∆« key repeatedly until


»Configuration 3/4« appears.
● Select »dd.mm.yy« line = turn the rotary knob,
to release for setting = press rotary knob.
● Set the day (dd) = turn the rotary knob,
confirm = press the rotary knob.
● Set the month (mm), year (yy), hour (h) and minutes (m)
in the same way.
082 37388

52
Configuration

Configuring the MEDIBUS* protocol


The following parameters can be set:

— Baudrate
— Parity check bits
— Number of stop bits

● Press »Config. ∆∆« key repeatedly until


»Configuration 3/4« appears.
● Select line for the corresponding interface parameters,
e.g. select baudrate = turn the rotary knob,
to release for setting = press rotary knob.

083 37388
● Set value = turn the rotary knob,
confirm = press the rotary knob.

Displaying the device values


● Press »Config. ∆∆« key repeatedly until
»Configuration 4/4« appears.
Savina displays:
— SW
Software version of the device
— Device-ID
specific device identification number
— Working hours
the total number of hours the device has been operating,
and
— h since service

106 37388
the number of working hours since the last inspection
and service by trained service personnel.
● Release code:
Numerical code for release of options

Return to main page


● Press the »Curves « key. The main page showing a
curve appears.

* MEDIBUS:
Dräger communications protocol for medical appliances.

53
54
Fault – Cause – Remedy
Fault – Cause – Remedy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56

55
Fault – Cause – Remedy

Fault – Cause – Remedy


Alarm messages in the alarm display field are displayed in hierarchical order.
For example, if two faults are detected at the same time, the more critical of the two is displayed.
The priority level of the alarm messages is identified by exclamation marks:
Warning = !!! Message with top priority
Caution = !! Message with medium priority
Advisory = ! Message with low priority

Savina displays a message for your guidance in the information line when certain alarm messages occur.
The messages are listed in the table in alphabetical order.
In the event of an alarm, this table is designed to enable you to identify the cause and take rapid
corrective action.

Message Cause Remedy

!!! Airway pressure high The upper alarm limit for the airway Check patient condition.
pressure has been exceeded. The patient Check ventilation pattern.
is "fighting" the ventilator; cough. Correct alarm limit if necessary.

Ventilation hose kinked. Check hose system and tube.

!!! Airway pressure low Leaking cuff. Inflate cuff and perform leak test.

Leak or disconnection. Check hose system for tight connections.


Check that the expiration valve
is properly engaged.

!!! Ambient press. meas. inop. Internal absolute pressure sensor faulty. Due to a fault in the ambient pressure
measurement, Savina calculates the tidal
volume V T and minute volume MV values
on the basis of 1013 mbar, in the
absence of current measurements.
If the »Airway pressure high« alarm is
correctly set and the incorrect tidal
volume V T and minute volume MV values
are tolerable, Savina can continue to be
used.
Keep a check on the patient’s condition.
Call DrägerService.

!!! Apnoea Patient’s spontaneous breathing has Apply controlled ventilation.


stopped.

Flow sensor not calibrated or faulty. Calibrate flow sensor.


Replace if necessary.

Apnoea alarm time TApnoea is set Extend apnoea alarm time TApnoea .
less than time for one respiration phase
(TApnoea < 60/f).

Disconnection. Reconnect.

56
Fault – Cause – Remedy

Message Cause Remedy

! Apnoea Alarm off Apnoea monitoring has been switched Reset the apnoea alarm time TApnoe
Only in »Mask/NIV« mode (optional) off. to the desired monitoring value if
necessary.

!! Apnoea ventilation Due to detected apnoea, Savina auto- Check the ventilation process.
matically switched over to mandatory To return to the original ventilation mode:
ventilation. Press the »Alarm Reset« key.

!!! ASB > 4 s The ASB cycle has been switched off Test ventilation system for leaks.
Not displayed in »Mask/NIV« mode. 3 times due to exceeding time limit.

! ASB > 4 s The ASB cycle has been switched off due Test ventilation system for leaks.
Not displayed in »Mask/NIV« mode. to exceeding time limit.

! Atmospheric pressure high The device is being used at too high Use Savina inside of the given
atmospheric pressure. atmospheric pressure range,
see Technical data, page 118.

One of the pressure sensors is defective. Due to a fault in the ambient pressure
measurement, Savina calculates the tidal
volume V T and minute volume MV values
on the basis of 1013 mbar, in the
absence of current measurements.
If the »Airway pressure high« alarm is
correctly set and the incorrect tidal
volume V T and minute volume MV values
are tolerable, Savina can continue to be
used.
Keep a check on the patient’s condition.
Call DrägerService.

! Atmospheric pressure low The device is being used at too low Use Savina inside of the given
atmospheric pressure. atmospheric pressure range,
see Technical data, page 118.

One of the pressure sensors is defective. Due to a fault in the ambient pressure
measurement, Savina calculates the tidal
volume V T and minute volume MV values
on the basis of 1013 mbar, in the absence
of current measurements.
If the »Airway pressure high« alarm is
correctly set and the incorrect tidal
volume V T and minute volume MV values
are tolerable, Savina can continue to be
used.
Keep a check on the patient’s condition.
Call DrägerService.

!!! Breathing gas temp. high Breathing gas temperature is over 40 oC. Switch off humidifier. Use longer
inspiration hoses.

!! Check settings Due to an internal data loss, Savina is Check settings and adjust.
operating with factory settings.

57
Fault – Cause – Remedy

Message Cause Remedy

!!! Device failure XX.YYYY Device faulty. If the alarm message disappears on
pressing the »Alarm Reset« key,
ventilation with Savina can be continued.
If the alarm message does not disappear
on pressing the »Alarm Reset« key,
disconnect the patient from Savina and
continue ventilation without delay, using
another independent ventilator. Use
PEEP and/or an increased O2
concentration if necessary.
Call DrägerService.

!! Device over temperature Temperature inside the device is too high. Check condition of the dust filter and
replace if necessary, page 76.

!!! Exp. valve inop. Expiration valve not properly connected to Fit expiration valve correctly.
socket.

Flow sensor defective. Replace flow sensor.

Expiration valve faulty. Replace expiration valve.

!!! Ext. DC ? External battery defective or not Disconnect Savina from the external
sufficiently charged. battery and connect to another charged
battery.

! Ext. DC supply active Device operating with external battery. Note capacity of external power source.

!!! Ext. DC high External battery voltage is too high. Disconnect Savina from the external
battery and connect to a battery with the
permissible voltage.

!!! FiO2 high Due to a low minute volume MV, the mixer Message disappears after a short time.
is not yet completely steady.

O2 sensor not calibrated. Calibrate O2 sensor manually, page 49.


O2 sensor(s) faulty. Replace O2 sensor(s), page 77,
Calibrate O2 sensor(s), page 49.

Faulty mixer function. In order to continue ventilating with


Savina:
Use external O2 monitoring and switch off
the built-in O2 monitoring, page 50.
Call DrägerService

!!! FiO2 low Due to a low minute volume MV, the mixer Message disappears after a short time.
is not yet completely steady.

O2 sensor not calibrated. Calibrate O2 sensor manually, page 49.


O2 sensor(s) faulty. Replace O2 sensor(s), page 77,
Calibrate O2 sensor(s), page 49.

Faulty mixer function. In order to continue ventilating with


Savina:
Use external O2 monitoring and switch off
the built-in O2 monitoring, page 50.
Call DrägerService

58
Fault – Cause – Remedy

Message Cause Remedy

!!! Flow measurement inop. Water in flow sensor. Dry flow sensor.

Flow sensor faulty. Replace flow sensor.

Flow measurement malfunction. In order to continue ventilating with


Savina:
Use alternative external flow monitoring
and switch off the built-in flow monitoring,
page 50.
Call DrägerService.

! Flow monitoring off Flow monitoring is switched off. Switch flow monitoring on again, see
page 50, or immediately provide
adequate external monitoring.

!!! Flow sensor? Flow sensor not fully inserted in Insert flow sensor correctly.
rubber lip of expiration valve.

!!! High frequency Patient is breathing at a high Check condition of patient.


spontaneous frequency, therefore the Check pattern of ventilation.
monitored overall frequency is too high. Correct alarm limit if necessary.

!!! Insp / Exp cycle failure The device does not deliver any gas. Set an IPPV frequency of at least 4/min.

Apnoea alarm time TApnoea is set Extend apnoea alarm time TApnoea .
less than time for one respiration phase
(TApnoea < 60/f).

Disconnection. Reconnect.

! Insp. hold interrupted The »Insp. hold« key was held down Release »Insp. hold« key.
longer than 15 seconds.

!!! Int. batt. almost discharged Working time when running on the Immediately connect supply via mains,
internal battery has almost expired, external battery or a vehicle DC
mains power or external DC power supply on-board network.
not connected.

! Int. batt. almost discharged Mains power connected; internal Do not switch over Savina to operation via
battery almost discharged. internal battery.

!! Int. battery activated Savina is being supplied via the internal Restore mains power or supply from
battery as there is no mains supply or charged external battery or DC on-board
external battery and no DC on-board network within 60 minutes.
voltage. This alarm can be acknowledged by
The typical working time using a supply pressing »Alarm Reset«. It will then
from the internal battery (new and fully appear as an advisory message (!).
charged) is 60 minutes.

! Int. battery activated Savina is being supplied via the internal Restore mains power or supply from
battery as there is no mains supply or charged external battery or DC on-board
external battery and no DC on-board network within 60 minutes.
voltage.
The typical working time using a supply
from the internal battery (new and fully
charged) is 60 minutes.

59
Fault – Cause – Remedy

Message Cause Remedy

!!! Int. battery failed Internal battery has failed. If there is a reliable mains or external
DC supply, ventilation with Savina can
be continued. This alarm can be
acknowledged by pressing the »Alarm
Reset« key; it will then appear as an
advisory message (!).
Call DrägerService.

! Int. battery failed Internal battery has failed. If there is a reliable mains or external
DC supply, ventilation with Savina can
be continued.
Call DrägerService.

!! Int. battery low Savina is being supplied via the internal Restore mains power or supply from
battery as there is no mains supply or charged external battery or DC on-board
external battery and no DC on-board network immediately.
voltage. There are only a few minutes’
working time left.

! Int. battery low Mains power connected. The remaining Do not switch over Savina to operation via
operating time is only a few minutes. internal battery.

!! Key xx failed xx key (e.g. » 2 min«) can no longer Disconnect patient from Savina and
be pressed. continue ventilation without delay, using
another independent ventilator. Use
PEEP and/or an increased O2
concentration if necessary.
Call DrägerService.

!! Key xx overused Keys pressed very frequently within Acknowledge message by pressing
a short time (e.g. » 2 min« key). »Alarm Reset«.
If this message appears again:
Disconnect patient from Savina and
continue ventilation without delay, using
another independent ventilator. Use
PEEP and/or an increased O2
concentration if necessary.
Call DrägerService.

! Leakage Leaking cuff. Inflate cuff and perform leak test.


Not displayed in »Mask/NIV« mode.
Leak in breathing system. The calculated Check hose connection is tight. Check
leak minute volume MVleak is greater than that the water trap collecting jar is
the measured expiratory minute volume. connected to the expiration valve.

60
Fault – Cause – Remedy

Message Cause Remedy

!! Main switch overused Savina has detected very frequent Acknowledge message by pressing
operation of the switch within a short time. »Alarm Reset«.
If message appears again:
Ventilation with Savina can be continued.
If Savina cannot be switched off after
ventilation:
Turn the power switch to » « and press
the » Standby« key to switch Savina
off.
Call DrägerService.

!!! Malfunction fan Fan failure. Savina uses the fan to cool the interior of
the device and to avoid increased fire risk
in the event of an O2 leak.
If the »!!! Malfunction fan« alarm message
occurs:
Disconnect patient from Savina and
continue ventilation without delay, using
another independent ventilator. Use
PEEP and/or an increased O2
concentration if necessary.
Call DrägerService.

! MEDIBUS COM. inop. The connector of the MEDIBUS cable has Reconnect the connector and secure
been unplugged during operation. against disconnection with the two screws.

MEDIBUS cable defective. Use a new MEDIBUS cable.

Interface defective. Ventilation with Savina can be continued.


Call DrägerService.

!! Microfilter blocked Microfilter clogged. Change microfilter, see page 75.

!!! Microfilter missing Microfilter is missing or is not Fit microfilter, see page 75.
correctly fitted.

!!! MV high The minute volume has exceeded the Check condition of patient.
upper alarm limit. Check pattern of ventilation.
Correct alarm limit if necessary.

Flow sensor faulty. Replace flow sensor.

Water in flow sensor. Drain water trap,


dry flow sensor.

Machine malfunction. Disconnect patient from Savina and


continue ventilation without delay, using
another independent ventilator. Use
PEEP and/or an increased O2
concentration if necessary.
Call DrägerService.

61
Fault – Cause – Remedy

Message Cause Remedy

!!! MV low The minute volume has fallen below Check condition of patient.
the lower alarm limit. Check pattern of ventilation.
Correct alarm limit if necessary.

Leak in breathing system. Ensure that the breathing system is


leakproof.
Check that the water trap collecting jar is
connected to the expiration valve.

Flow sensor faulty. Replace flow sensor.

Machine malfunction. Disconnect patient from Savina and


continue ventilation without delay, using
another independent ventilator. Use
PEEP and/or an increased O2
concentration if necessary.
Call DrägerService.

! MV low Alarm off The minute volume lower alarm limit Reset MV alarm limit to the desired
Only in »Mask/NIV« mode (optional) MV has been switched off. monitoring value if necessary.

! Nebulizer on The medicament nebulizer is


switched on.

!!! No battery charging Battery not charging. If there is a reliable mains supply,
ventilation with Savina can be continued.
Call DrägerService.

!!! No int. battery Internal battery is missing, defective or not Call DrägerService.
connected or fuse has failed. This alarm can be acknowledged by the
»Alarm reset« key. Then it appears as
advisory message (!).

! No int. battery Internal battery is missing, defective or not If there is a reliable mains supply,
connected or fuse has failed. ventilation with Savina can be continued.
Call DrägerService.

!!! O2 measurement inop. O2 sensor provides invalid measured Calibrate O2 sensor, see page 49.
values. Replace if necessary, page 77.

O2 sensor consumed or not fitted. Fit new O2 sensor, see page 77.
Calibrate, see page 49.

O2 measurement malfunction. In order to continue ventilating with


Savina:
Use external O2 monitoring and switch off
the built-in O2 monitoring, page 50.
Call DrägerService.

!! O2 monitoring off On switching on, Savina notifies that O2 Reactivate O2 monitoring, see
monitoring is switched off. page 50 or immediately connect
adequate external monitor function.
This alarm can be acknowledged by
pressing »Alarm Reset«. It will then
appear as an advisory message (!).

62
Fault – Cause – Remedy

Message Cause Remedy

! O2 monitoring off O2 monitoring is switched off. Switch O2 monitoring on again, see


Switched-off state has been confirmed. page 50 or immediately ensure
adequate external monitoring.

!!! O2 supply down O2 supply pressure too low. Ensure pressure is greater than 2.7 bar.

! O2 supply down O2 supply pressure too low. Ensure pressure is greater than 2.7 bar.
O2 supply pressure is not required
when FiO2 = 21 Vol.%.

!! O2 supply pressure high O2 supply pressure too high. Make sure pressure is less than 6 bar.

! O2 supply pressure high O2 supply pressure too high. Make sure pressure is less than 6 bar.
O2 supply pressure is not required
when FiO2 = 21 Vol.%.

!!! PEEP high Expiration tract incorrectly positioned. Check hose system and expiration valve.

Increased expiratory resistance. Check bacterial filter.


Replace if necessary.

!!! PEEP inop. PEEP set not reached. Check system for leaks.

Ventilation with Savina can be continued,


though the PEEP set will not be reached.
Observe the patient closely.
Call DrägerService.

!!! Pressure meas. inop. Fluid in expiration valve. Replace expiration valve,
then disinfect/clean and dry,
see page 71.

Pressure measurement malfunction. Disconnect patient from Savina and


continue ventilation without delay, using
another independent ventilator. Use
PEEP and/or an increased O2
concentration if necessary.
Call DrägerService.

!! Rotary knob failed Rotary knob cannot be turned or pressed. Disconnect patient from Savina and
continue ventilation without delay, using
another independent ventilator. Use
PEEP and/or an increased O2
concentration if necessary.
Call DrägerService.

!! Rotary knob overused Rotary knob has been pressed very Press »Alarm Reset« to acknowledge
frequently within a short time. message.
If this message appears again:
Disconnect patient from Savina and
continue ventilation without delay, using
another independent ventilator. Use
PEEP and/or an increased O2
concentration if necessary.
Call DrägerService.

63
Fault – Cause – Remedy

Message Cause Remedy

!!! Standby activated Savina has been switched to standby. Confirm standby by pressing
»Alarm Reset«.

!!! Temperature high Breathing gas temperature in Savina Reduce ambient temperature. Switch off
higher than 40 oC. humidifier to protect the patient and use
longer inspiration hoses.

! Temperature high Due to high ambient temperatures Lower the ambient temperature.
(35 to 40 oC), the device has reached its
peak pressure, but not its peak flow.

!!! Temperature meas. inop. Temperature sensor faulty. Fit new temperature sensor.

!!! Temperature sensor ? Temperature sensor probe has been Reconnect probe.
disconnected during operation.

Sensor cable broken. Fit new temperature sensor.

!!! Tidal volume high After third breathing stroke: Check the condition of the patient.
The upper alarm limit of the applied Check the ventilation pattern.
inspiratory tidal volume V T has been If necessary, correct the alarm limit.
exceeded during three consecutive
ventilation strokes.

Leak or disconnection. Check that the connections of the hose


system are leakproof.

! Tidal volume high After first breathing stroke: Check the condition of the patient.
The upper alarm limit of the applied Check the ventilation pattern.
inspiratory tidal volume V T has been If necessary, correct the alarm limit.
exceeded during three consecutive
ventilation strokes.

Leak or disconnection. Check that the connections of the hose


system are leakproof.

!! Tidal volume low After fourth breathing stroke: Extend inspiration time »Tinsp«,
Because of pressure and time limitations raise »FlowAcc«,
the set tidal volume V T will not be raise pressure limitation using »Pinsp«
applied. key.
This alarm can be acknowledged by the
»Alarm reset« key. Then it appears as
advisory message (!).

After fourth breathing stroke in Extend inspiration time »Tinsp«,


AutoFlow: raise »FlowAcc«,
Because of pressure and time limitations raise upper alarm limit for airway pressure
the set tidal volume V T will not be Paw .
applied. This alarm can be acknowledged by the
»Alarm reset« key. Then it appears as
advisory message (!).

64
Fault – Cause – Remedy

Message Cause Remedy

! Tidal volume low After second breathing stroke: Extend inspiration time »Tinsp«,
Because of pressure and time limitations raise »FlowAcc«,
the set tidal volume V T will not be raise pressure limitation using »Pinsp«
applied. key.

After second breathing stroke in Extend inspiration time »Tinsp«,


AutoFlow: raise »FlowAcc«,
Because of pressure and time limitations raise upper alarm limit for airway pressure
the set tidal volume V T will not be Paw .
applied.

! VTi high Alarm off The inspiratory tidal volume Reset alarm limit V Ti to desired
Only in »Mask/NIV« mode (optional) upper alarm limit V Ti has been monitoring value if necessary.
switched off.

65
66
Care
Dismantling . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68
Removing parts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68
Disinfecting/Cleaning/Sterilising . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71
Disinfecting/cleaning/sterilising schedule for Savina Intensive Care Ventilator . . 73
Maintenance Intervals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74
Replacing the microfilter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75
Replacing the dust filter set . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76
Replacing the O2 sensors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77
Using an external battery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77
Correct disposal of batteries and O2 sensors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 78
Correct disposal of internal battery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 78
Important when storing Savina . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 78
Correct disposal of apparatus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 78

67
Care

Care
● Observe the hospital hygiene regulations.
● Clean and prepare the machine after each patient.

Recommendation:
● Change the hose system and expiration valve every week.
Keep the replacement systems ready.

Dismantling
Removing parts
● Switch off the ventilator and breathing gas humidifier,
and remove their power plugs.
1 Drain condensate from water traps and ventilation hoses.
Drain the water trap on the expiration valve.
2 Drain the water container of the humidifier.
1

1
2
1

109 29 170
Ventilation hoses
● Remove ventilation hoses from the device ports.
● Remove the water traps from the ventilation hoses. 3
Remove the water containers from the water traps and
the expiration valve.
● Prepare the ventilation hoses, water traps and associated
water jars, and the Y-piece for disinfection and cleaning
by autoclaving.
3 Remove the bacterial filter and treat it in accordance with
the accompanying instructions for use.
110 29 170

68
Care

● When removing the ventilation hoses, always grasp


them by the sleeve, never by the hose itself, to avoid
possibly tearing the hose at the sleeve or ripping it out
of the sleeve.

093 29 170
Medicament nebulizer (optional)
1 Remove nebulizer hose from the medicament nebulizer and
from the spigot on the device.
2 Pull medicament nebulizer out of the adult hose set, or

2 1

016 29 170
2 dismantle medicament nebulizer from the paediatric hose
set.
3 Pull catheter connector (ISO cone ø15/ø11) out of the 5 4 3
input.
4 Pull spigot (ISO cone ø22/ø11) out of the output.
5 Pull corrugated hose out of the spigot. 2 1
● Dismantle and prepare medicament nebulizer in
accordance with the accompanying instructions for use.
021 29 170

69
Care

Flow sensor
1 Push the flow sensor to the left as far as it will go and
2 pull out.
D Savina

● The flow sensor cannot be autoclaved or


steam-sterilised. It is not temperature-stable
and would be destroyed.

● Disinfect flow sensor for about 1 hour in 70 % ethanol


solution.
● Leave sensor to dry in air for at least 30 minutes.
Residual alcohol could otherwise cause the sensor to fail
during calibration.
● The flow sensor may be re-used as long as automatic 1
calibration can be carried out successfully.

058 29 170
Expiration valve
3 Remove collecting jar from water trap.
4 Turn knurled sleeve to the left and 4
5 remove expiration valve.

059 29 170
3

6 Remove diaphragm.
7 Remove rubber bushing.
● Do not disassemble the expiration valve any further.
● The expiration valve together with the diaphragm, rubber
bushing and dismantled water trap collecting jar are
suitable for disinfection and cleaning by autoclaving or
sterilising.

6
048 29 170

Breathing gas humidifier


● Dismantle according to the relevant Instructions for Use
and prepare for disinfection/sterilisation.

70
Care

Disinfecting/Cleaning/Sterilising
Use surface disinfectants. For surface compatibility, use
disinfectants based on:
— aldehydes,
— quaternary ammonium compounds.

Due to possible damage to the materials, do not use any


preparations based on:
— Compounds containing alkylamine
— Compounds containing phenol
— Halogen-releasing compounds
— Strong organic acids
— Oxygen-releasing compounds

For users in the Federal Republic of Germany, we recommend


that only disinfectants on the current DGHM list are used
(DGHM: German Society for Hygiene and Microbiology).
The DGHM list (published by mhp-Verlag, Wiesbaden) also
classifies each disinfectant by its active agents. For countries
where the DGHM list is not available, we recommend the types
of disinfectant given above.

Disinfectants often contain – besides their main active agents


– additives that can also damage materials.
● If in doubt, ask the supplier/manufacturer of the
disinfectant/cleaning agent.

● Do not sterilise parts in ethylene oxide!


Ethylene oxide can diffuse into the parts.
Danger to health!

— Savina basic device with trolley


— Hinged arm
— Medical gas hose
● Wipe disinfect.

— Ventilation hoses
— Y-piece
— Water traps and collecting jars
— Expiration valve casing
— Expiration valve diaphragm
— Containers for water traps
● Hot-steam disinfect in the autoclave (93 oC/10 minutes)
using detergent only.

71
Care

— Ventilation hoses
— Y-piece
— Water traps and collecting jars
— Expiration valve casing
— Expiration valve diaphragm
— Containers for water traps
— Temperature sensor
● are thermo-stable and can be steam-sterilised at 134 oC.

— Prepare medicament nebulizer


● in accordance with the accompanying instructions for use.

— Handle bacterial filter


● in accordance with the accompanying instructions for use.

72
Care

Disinfecting/cleaning/sterilising schedule for


Savina Intensive Care Ventilator
Applicable for use with non-infectious patients.
For infectious patients, all parts that conduct breathing gas
must be additionally sterilised after disinfecting and
cleaning.
The parts that conduct breathing gas listed here can be
steam-sterilised at 134 oC. See "Sterilising" column.
This schedule contains guideline values only. The protocols
of the responsible hospital hygiene official remain
unaffected!

Part How often How


Reusable Recommended Disinfecting and cleaning Sterilising
components cleaning Autoclaving at Wiping Bath Steam
intervals 93 oC 10 minutes immersion 134 oC
10 minutes
Savina per patient no outside no no
basic device
Trolley per patient no outside no no
Hinged arm
Medical gas hose
Ventilation hoses, per patient/ yes no possible yes
Y-piece, weekly
Water traps and
Collecting jars
Expiration valve per patient/ yes no possible yes
weekly
Flow sensor daily no* outside possible* no

Temperature sensor daily no yes no yes


* Special treatment, bath disinfect in 70 % ethanol, see page 70

73
Care

Maintenance Intervals
Clean and disinfect equipment and/or components
before any maintenance procedures – and before returning
for repair!

O2 sensors replace when the following message is displayed:


!!! O2 measurement inop.
in case of calibration is no longer possible.
Used O2 sensors can be returned to
Dräger Medical AG & Co. KGaA for disposal.

Microfilter Replace after 1 year, see page 75.


Dispose of with normal domestic waste.

Dust filter set Replace after 1 year, see page 76.


Dispose of with normal domestic waste.

Blower unit To be replaced by trained service personnel after


20.000 hours’ operation or after 8 years – whichever is earlier.

Lead-gel battery To be replaced by trained service personnel after 2 years.


Lead-gel batteries should be disposed of as special waste,
see page 78.

Filter in O2 inlet To be replaced by trained service personnel every 6 years.

Real-time clock To be replaced by trained service personnel every 6 years.

Pressure reducer To be replaced by trained service personnel every 6 years.

Equipment inspection Should be carried out for the first time after 2 years or
and service 6,000 hours’ operation, whichever is earlier.
Thereafter annually or after 6,000 hours’ operation, whichever
is earlier.
For other servicing (e.g. six-monthly inspection, etc.), contact
DrägerService.
Only original Dräger parts should be used.

74
Care

Replacing the microfilter


— This should be replaced once a year.

1 Hold down both latches,


2 lift filter cover and remove.

1 1

097 29 170
3 Remove used microfilter from its housing.
● Slide new microfilter into housing as far as it will go.

● Dispose of used microfilter with domestic waste.

● Do not operate Savina without a microfilter, as the


inspiration side will get dirty.

099 29 170
4 Insert filter cover with two lugs into rear panel.
5 Position power cable under filter cover. 4 4
6 Push latches into housing until they engage.

6 6
114 29 170

75
Care

Replacing the dust filter set


— Inspect after 4 weeks for soiling, clean or replace as
necessary.

1 Hold down both latches,


2 lift filter cover and remove.

1 1

097 29 170
3 Remove used dust filter from filter cover.
● Fit new dust filter.

● Dispose of used dust filter with domestic waste.


3 3

098 29 170

4 Insert filter cover with two lugs into rear panel.


5 Position power cable under filter cover. 4 4
6 Push latches into housing until they engage.

5
Breathing air and cooling air are drawn in through the
filter cover.
● Do not cover, do not place up against a wall –
risk of device overheating.
6 6
114 29 170

76
Care

Replacing the O2 sensors


— If the following message appears:
!!! O2 measurement inop.
Exchange O2 sensor 1
or
!!! O2 measurement inop.
Exchange O2 sensor 2
or
— if calibration is no longer possible.

Savina uses one O2 sensor for O2 control and display


(sensor 1) and a separate O2 sensor for O2 monitoring
(sensor 2).

1 Swivel inspiration port downwards


2 Unscrew screw, using a coin or similar object, and remove
cover plate.
3/4 Remove used O2 sensor from housing
3/4 Slide new O2 sensor into respective housing for
"Sensor 1" or "Sensor 2". Turn using light pressure
until the O2 sensor slides further into the housing.
2 Screw cover plate into place. 3 4

Sensor 1
is automatically calibrated after fitting.
1
Sensor 2:
● Allow not more than 20 minutes warm-up time to elapse,
then
● calibrate manually, see page 49.

The internal battery supplies the two O2 sensors with current


even when Savina is switched off. This enables Savina to
2

054 29 170
supply valid O2 measured values as soon as it is switched on.
If the internal battery is discharged, Savina does not supply any
O2 measured values for the first 20 minutes after switching on.
The O2 dosage operates at reduced accuracy during this time.

Using an external battery


Either 12 V batteries or 24 V batteries can be connected as
the external battery.
The use of 24 V batteries (two 12 V batteries arranged in
series) with a minimum capacity of 15 Ah each is
recommended.
With batteries of this type, the efficiency of the DC power
supply and the associated operating time is considerably
greater than with 12 V batteries of comparable capacity.

77
Care

Correct disposal of batteries and O2 sensors


Batteries and O2 sensors:
● Do not incinerate or throw in fire; risk of explosion.
● Do not open using force; risk of caustic burns.

Batteries must be disposed of as special waste:


● Information may be obtained from the local environmental
and public health authorities or from approved waste
disposal companies.

O2 sensors:
● can be returned to Dräger Medical AG & Co. KGaA.

Correct disposal of internal battery


Savina contains permanent batteries that contain harmful
substances.
● The permanent batteries containing harmful substances
that are fitted in Savina should be removed and disposed of
by Dräger Service.

Important when storing Savina


If Savina is stored for longer than 1 month without power:
● Remove fuse for internal battery. This avoids undesirable
total discharge of the internal battery, which would
otherwise constantly supply the O2 sensors with current.
006 29 170

Correct disposal of apparatus


— at the end of its useful life.

● After contacting the competent waste disposal company,


hand over Savina for appropriate disposal. The applicable
legal regulations must be observed.

78
Preparation
Assembling . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80
Mounting the expiration valve . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80
Inserting the expiration valve . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80
Fitting the flow sensor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81
Fitting the bacterial filter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81
Note on the use of expiratory bacterial filters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 82
Note on the use of heat and moisture exchangers . . . . . . . . . . . . . . . . . . . . . . . . . . . 82
Positioning the humidifier . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83
For ventilating infants . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83
Fitting the Aquapor humidifier . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83
Fitting the Fisher & Paykel humidifier . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 84
Electrical power supply . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85
O2 supply . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91
Expected operating time when using an O2 cylinder supply . . . . . . . . . . . . . . . . . . 91
Nurse call system . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 92
Checking readiness for operation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 93
Checklist . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 96

79
Preparation

Preparation
Assembling
Only use the duly prepared components!

Mounting the expiration valve


1 Attach diaphragm to expiration valve.
2 Attach rubber bushing to port.

052 37261
Inserting the expiration valve
3 Turn knurled sleeve to left as far as it will go.
4 Insert expiration valve. 3
3 Turn knurled sleeve to right.
5 Fit container for water trap.
4

5
028 37261

80
Preparation

Fitting the flow sensor


1 Push the socket to the left as far as it will go.

2 Insert the flow sensor, with the probe facing towards the 2
ventilator, into the mounting and push it into the socket
as far as it will go.

Then:

3 Push flow sensor to the right as far as it will go into the


rubber lip of the expiration valve.

029 37261
Fitting the bacterial filter
An inspiratory bacterial filter is necessary to protect the patient
from contamination from the ambient air drawn in.
● Push bacterial filter on to inspiration port.

034 37261

81
Preparation

Note on the use of expiratory bacterial filters


The use of expiratory bacterial filters on the ventilator is not
recommended.
However, if a bacterial filter is used on the expiration side, an
undesirable increase in breathing resistance may occur.
Especially during medicament nebulisation and humidifying,
the resistance of the bacterial filter may increase gradually. For
the patient, the effect may be increased breathing effort and
intrinsic PEEP.

1 An intrinsic PEEP can be recognised by the fact that the f


expiratory flow does not return to "0" before the end of Flow
expiration.
1
If PEEP is unacceptably high, the unit signals the t
»!!! PEEP high« alarm.

04037388
The current PEEP is then approximately 8 mbar higher than
the PEEP set.

● Check the bacterial filter and replace it if it is the cause


of the PEEP alarm.

Note on the use of heat and moisture


exchangers
The use of a heat and moisture exchanger (HME) in the patient
connection of the Y-piece can considerably increase breathing
resistance.
An increase in breathing resistance will in turn lead to greater
effort in spontaneous breathing and/or greater trigger effort
during assisted ventilation. Under unfavourable conditions, an
increase in breathing resistance can lead to an unwanted
intrinsic PEEP.
This breathing resistance in the patient connection cannot be
directly monitored by the ventilator.
Therefore:
● The condition of the patient and the ventilator's measured
values for air volume must be checked more frequently.
● Follow the Instructions for Use of the heat and moisture
exchanger (HME).
● Do not use the heat and moisture exchanger (HME)
together with a medicament nebulizer or humidifier!
This can increase the breathing resistance.

● The inspiratory breathing gas warmed by the built-in


blower is appropriately cooled when using the
ventilation hoses indicated. If shorter hoses are used,
the breathing gas temperature at the Y-piece may
exceed the permissible limit, thus putting the patient at
risk.

82
Preparation

Positioning the humidifier


Depending on the desired position of the ventilator in relation
to the bed, the hinged arm can be fitted to either side of the
machine.

Attachment on right-hand side:


● Turn both ports to the left.
● Turn Aquapor to the left.

The following description applies when the ventilation hoses


have been attached to the left-hand side.

For ventilating infants


● Use a suitable humidifier, e.g. Fisher & Paykel MR 730 with
humidifier chamber MR 340
and
● use suitable ventilation hoses, see Order List on page 126.

If using heated paediatric hoses with internal hot wires,


please note:
In the event of Savina failure, high breathing resistance is
to be expected in spontaneous breathing.

Fitting the Aquapor humidifier


● Aquapor should only be used at ambient temperatures
below 30 oC, to avoid the risk of overheating of the
breathing gas in the event of Aquapor failure.

● Prepare Aquapor in accordance with the separate


instructions for use.
● Monitor the breathing gas temperature.
1 Hang the Aquapor with a bracket to the mounting and
tighten the screws.
2 Insert elbow connector into Aquapor.
3 Insert double nozzle into elbow connector.
● Fill Aquapor tank with sterile distilled water to the upper
level. 3
● Do not use an additional heat and moisture exchanger 2
(HME) at the same time as a humidifier.
Risk of increased breathing resistance because of
condensation.
1
030 37261

83
Preparation

Connecting the ventilating hoses


Do not use anti-static or conductive hoses*.

1 Hang the hinged arm from the rail on the left-hand side
and tighten screws.
● Connect ventilation hoses, and note length of hoses
(in metres).
● The total length of the inspiratory hoses between
Aquapor and the Y-piece must be not less than 1.1 m,
to avoid the risk of overheating the breathing gas.

2 Turn ports in direction of hoses.


3 Install water traps in vertical position at the lowest point
of their hose lines. 1
● Connect the Y-piece, with the rubber sleeve of the Y-piece
on the inspiratory side. 2 2
● Insert Y-piece into bracket of hinged arm.
0,6m
0,4m

0,6m 3

0,6m 0,6m

113 37261
Fitting the Fisher & Paykel humidifier
● Prepare the humidifier in accordance with the separate
instructions for use.
1 Hang the humidifier with bracket to the humidifier holder
rail and tighten the screws.

● Do not use an additional heat and moisture exchanger


(HME) at the same time as a humidifier.
Risk of increased breathing resistance because of
condensation.

1
111 37261

* DIN VDE 0750 Part 215:


The use of anti-static or electrically conductive material in the
breathing system of the lung ventilator is not considered to
contribute any improvement in safety. On the contrary, the use
of these materials increases the danger of electric shock to the
patient and of fire due to the presence of oxygen.

84
Preparation

Fitting ventilation hoses


1 Hang the hinged arm with a bracket to the rail on the
left-hand side, and tighten the screws.
● Connect the ventilation hoses as described in the
Instructions for Use of the humidifier, and note their
length (in metres).

● Do not use shorter ventilation hoses than specified,


to avoid the risk of overheating the breathing gas.
1

0,4m

1,1m

1,2m

036 37261
Electrical power supply
The ventilator is designed for a mains voltage of:
100 V to 240 V, 50/60 Hz

The built-in power adapter of the Savina automatically adapts


to the mains supply.
● Insert the plug into the mains socket.

102 37261

85
Preparation

Connecting to DC on-board network or external battery


Note requirements for external battery, see "Technical Data",
page 118 onwards.
● Only rechargeable batteries should be used.
The charging function of the DC power supply may cause
non-rechargeable batteries to explode during mains use.

● Connect external battery to device via DC battery cable S


(84 14 092) or connect DC on-board network to device via
DC on-board network cable S (84 14 048).
The plug on the connecting cable that plugs into the Savina
is coded. This enables Savina to detect whether an external
battery or a DC on-board network is connected.

● Ensure polarity is correct.


black = –
red = +
If an external battery or DC on-board network is wrongly
connected, the device will ignore it!
● Insert plug into DC socket on rear of device.

025 37261
● Do not connect DC power supplies to the DC socket.

86
Preparation

Internal batteries
In the event of a mains power failure and if the external battery
is discharged or not connected or in the event of failure of the
DC on-board network, Savina automatically switches over to
power from its own internal batteries.

Active power supply display


The status of the power supply is indicated by three lamps
at the right of the rotary knob.
1 Lamp for mains supply »N«
2 Lamp for DC on-board network »ext. J«, e.g. in an
ambulance or helicopter, or external battery, e.g. on
a trolley.
N 1
3 Lamp for internal battery »int. J« ext. J 2
int. J 3

Significance of lamp colours

094 37261
green: power source is available

yellow: battery is charging

lamp out: power source not available

Use of power sources


Savina automatically prioritises the use of the power sources.

Mains supply:
If a mains supply is available, Savina automatically switches to
mains voltage and charges the internal and external batteries.

● The device should only be left connected to the power


supply in well-ventilated rooms.
Electrolytic gas is produced when the battery is charging,
and in the right concentration this can cause an explosion.

External battery or DC on-board network:


In case of mains power failure, if direct-current voltage is
connected Savina automatically switches to the external battery
or DC on-board network.

Internal battery:
If neither a mains power supply, an external battery nor
the DC on-board network is available.

87
Preparation

Operating with mains power supply


Display (example):

1 Savina running on mains supply: lamp »N« shows green.


2 External battery not yet fully charged: middle lamp N 1
»ext. J« shows yellow.
3 Internal battery charged: bottom lamp »int. J« shows ext. J 2
green. int. J 3

When operating with a mains power supply, the internal battery

055 37261
is automatically charged first. Once this has been charged
(lamp shows green), the external battery is automatically
charged.

Savina automatically detects the voltage of the external


battery (12 V or 24 V).

Once the respective battery is fully charged, trickle charging


takes place:
Savina charges the battery to counteract running-down.

Operation with an external battery or DC on-board network


In the event of a mains power failure, Savina seamlessly
switches over to the external DC power supply connected.
This may take either of two forms:

— Supply from external battery


or
— Supply from DC on-board network

Savina detects whether an external battery or the DC on-board


network is connected. This prevents Savina from charging the
DC on-board network.

4 When an external battery or DC on-board network is


connected, the »ext. J« lamp shows green.

Display (example):
N
No mains voltage:
top lamp »N« out. ext. J 4
int. J
Supply from external battery:
middle lamp »ext. J« shows green.

Internal battery fully charged:


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bottom lamp »int. J« shows green.

88
Preparation

If the external battery is discharged or if no DC on-board


voltage is available, the device switches over to the internal
battery and displays the message:
!! Int. battery activated

● Acknowledge message = press »Alarm Reset« key.


The following advisory message is displayed:
! Int. battery activated

The operating time with an external battery depends on the


state of charge and type of battery connected:
With a fully charged 24 V battery with 17 Ah, the operating
time is about 7 hours.
Savina detects when the external battery is discharged and
switches over to the internal battery.
When a mains voltage becomes available again, Savina
automatically switches over to mains power supply, charging
the internal battery first and then the external battery.

When the power source is an external battery, the internal


battery is not charged. Only trickle charging takes place.

● Immediately reconnect Savina to mains power supply to


fully recharge the internal and external battery again.

Operation with the internal battery


In the event of a mains power failure, if no external battery is
connected or if the external battery is discharged, Savina
seamlessly switches over to the internal battery.

Display:

1 No mains supply: top lamp »N« out.


2 No external battery or no DC on-board network: middle N 1
lamp »ext. J« out
3 Supply from internal battery: bottom lamp »int. J« ext. J 2
shows green. int. J 3
When the device automatically switches over to the internal
battery, the following advisory message is displayed:
057 37261

!! Int. battery activated

● Acknowledge message = press »Alarm Reset« key.


The following advisory message is displayed:
! Int. battery activated

89
Preparation

The operating time with the internal battery depends on the


state of charge:
With a new, fully charged battery the operating time for typical
ventilation is about 60 minutes.

After about 25 minutes’ operating time, a caution message


is displayed:
!! Int. battery low

● Immediately reconnect to mains power supply


or
● connect to a charged external battery or the DC on-board
network.

At the end of the operating time, a warning message is


displayed:
!!! Int. batt. almost discharged

● Immediately reconnect to a power supply from the mains or


a charged external battery or from the DC on-board network
to prevent any interruption to ventilation.

After operating the Savina with an internal battery:


● Reconnect Savina to the mains voltage in order to charge
the internal battery and, if applicable, the external battery
again immediately.

When the power source is an external battery, the internal


battery is not charged. Only trickle charging takes place.

When the power source is the DC on-board network,


the internal battery is charged.
The charging time is around 5 hours.

● Always ensure the internal battery is charged from the


mains or from the DC on-board network. The internal
battery supplies the two O2 sensors with current even when
Savina is switched off. This enables Savina to supply valid
O2 measured values as soon as it is switched on. If the
internal battery is discharged, Savina does not supply any
O2 measured values for the first 20 minutes after switching
on, and the O2 mix operates at reduced accuracy during
this time.

90
Preparation

O2 supply
Compressed O2 must be free of dust and oil and must
be dry. Gas pressure must be 2.7 to 6 bar.

● Screw the O2 hose on to the side of Savina. Connect up O2


from the medical gas pipeline system or an O2 cylinder.
In the case of a supply from an O2 cylinder, the reserve gas
should be calculated. See "Expected operating time when
using an O2 cylinder supply".
A 90o connector is available for the O2 threaded
connection on the device; see order list.
After an O2 concentration is set, it takes 3 minutes for this
concentration to be reached, due to the mixing process.
The mixing process may take longer with minute volumes
less than 2 L/min.
The "O2 high" or "O2 low" alarm indicates that the

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O2 concentration set has not been reached within
this time.

Expected operating time when using an O2


cylinder supply
When using an increased O2 concentration (greater than
21 % by vol.) Savina ventilates with a mixture of air (delivered by
a blower) and O2.
When using an O2 cylinder supply, the maximum possible
operating time depends on the O2 reserve (as well as on the O2
concentration and the ventilation parameters).

For example:
Cylinder pressure measured at the pressure regulator on the
O2 cylinder: 200 bar
O2 cylinder capacity: 3 L
O2 reserve: 200 bar x 3 L = 600 L

Expected operating time with the following parameters:


— Ventilation mode : »IPPV«
— Frequency »f « : 10 bpm
— Tidal volume »V T« : 600 mL
— Minute volume »MV« : 10 bpm x 0.6 L = 6 L/min
— Selected O2 concentration
»O2« : 50 % by vol = O2 fraction: 0.5
The device allows for the O2 concentration of 21 % by vol. in
the air.

91
Preparation

Gas reserve [L]


Expected operating time =
(O2 fraction – 0.21) x MV [L/min]
600 L
=
(0.5 – 0.21) x 6 L/min
600
=
0.29 x 6
= approx. 340 min
= approx. 5.6 h

With a higher O2 concentration, the operating time is reduced


accordingly.
Once the reserve O2 from the cylinder has been used up, the
O2 concentration is reduced to 21 % by vol. Otherwise, the
ventilation parameters are unchanged.

● Do not place any liquid container (e.g. infusion


container) above or on top of Savina.
Any leak, spill or seepage could prevent it working
properly, and endanger the patient.

Nurse call system


Optional
Connection for redirecting alarm signals to a clinic-internal
central alarm system can be found on the rear side of Savina.

● Installation of the supplementary equipment should be


carried out by experts.
● The 6-pin round plug (female) should be connected to the 5
clinic-internal central alarm by experts.

When Savina displays an alarm message, the connection 3-5 is 3


closed and the nurse call system is active.
1
022 37261

92
Preparation

● Push the plug into the » « socket at the back and screw
in tightly.
Only alarm signals will be transferred through the nurse
call system.
1 5

Warning messages appear with 3 exclamation marks in the 3


upper line on screen; see page 31. Caution and advisory
messages will not be transferred. The nurse call system will
also be activated when the original alarm tone device is
defective, or the power supply to the device being used is cut
off.

● Test the connected nurse call system for proper


functioning.
The installation of the nurse call system does not replace
the regular Savina screen surveillance.
● Regularly check on-screen messages.

023 37261
Technical data
Potential-free DC contact
Input voltage max. 40 V =
Input current max. 500 mA
Switching power max. 15 W

Checking readiness for operation


● to be carried out after preparation.

The following functions are tested during this check:


— Operation of lamps/LEDs, displays and the audible alarm
— Ventilation function
— PEEP function
— Expiratory volume measurement MV
— Measurement of inspiratory O2 concentration FiO2
— Lower alarm limit MV
— Lower alarm limit Paw
— Mains power failure alarm
— O2 alarm

93
Preparation

Connecting test lung


The test lung consists of a mask elbow for connection to the
Y-piece, a 7 mm diameter catheter connector to simulate the
resistance of the airway, and a 2-litre breathing bag 84 03 201
to simulate lung compliance.
● Attach mask elbow to patient connection of Y-piece.

Switching on
● To switch on = power switch on the back panel of the
device to » «.
Savina runs through its self-test procedure.

035 37261
● Wait until the 12-second test phase has been completed.

Savina automatically matches the speed of its blower to the


patient’s gas requirement. A slight whine may be heard
temporarily at the start of ventilation or when setting the
ventilation parameters.

Checking the lamps and audible alarm


At the end of the 12-second test phase, the device activates all
the LEDs, all the lamps in the keys, and the trigger and power
supply lamps. The audible alarm is tested briefly.

The lamp indicating the power source in use at any given time
is lit continuously.

Testing the ventilation function


1 Ventilation mode »IPPV«
2 »V T« 800 mL
D Savina
3 »Tinsp« 2 s
4 »f« 10 bpm 2
5 »O2« 60 vol.% 7 3
6 »PEEP« 10 mbar 4 6
7 »Trigger« 5 L/min on screen under 5
»Settings 1/1«
8
● »FlowAcc« 35 mbar/s (in screen »Settings 1/1«)
● »Pmax« in screen »Configuration 2/4«) 1
● »Plateau« (in screen »Configuration 2/4«)

Savina ventilates the test lung using the ventilation pattern set.

8 Press »Values ∆∆« key to select »Values 1/2«


The bar display on the screen shows the inspiratory
pressure and the end-expiratory pressure, alternating
037 37261

between inspiration and expiration.

94
Preparation

PEEP display:
PEEP 10 mbar
± 2 mbar tolerance

Minute volume display:


MV 7.8 L/min
± 1.0 L/min tolerance

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O2 concentration display:
FiO2 60 %
± 3 vol.% tolerance

● Detach test lung from Y-piece


The following message is displayed:
»!!! Airway pressure low«.
Display after about 45 seconds:
MV 0 L/min
+ 0.5 L/min tolerance

● Reconnect test lung to the Y-piece.

Checking mains power failure


● Disconnect mains plug, or disconnect DC supply plug.
The device switches over to the internal battery and
continues ventilating.
Display:
!! Int. battery activated
● Reconnect mains plug or DC supply plug.

Checking the O2 alarm


● Disconnect O2 compressed gas hose connector:
Intermittent audible alarm and display:
!!! O2 supply down
Savina ventilates with air.

● Reconnect O2 compressed gas hose connector.


A warning !!! FiO2 low may appear briefly.
● Press »Alarm Reset«.

After successful testing of readiness for operation, Savina is


ready to use.

● Do not use device unless all the test steps have been
completed.

95
Preparation

Checklist
● To be carried out every time before using the device.
Device is complete and ready for operation.
The test lung is connected.

What How What should happen


Operation of lamps/ Switch device on: All lamps (except the lamps for power supply)
LEDs and audible alarm and LEDs light up, audible alarm sounds.
Operation of audible Hold down »Alarm Reset« for about Audible alarm sounds.
alarm for mains power 3 seconds:
failure
Apnoea alarm Set ventilation mode CPAP, At the end of the apnoea alarm time TApnoea,
set PEEP 10 mbar, audible alarm sounds, the warning !!! Apnoea
steadily inflate and deflate the test lung to appears on the screen.
simulate spontaneous breathing, then stop
simulation:
Press »Alarm Reset«.
"PEEP high" alarm Set ventilation mode IPPV, Audible alarm sounds, red lamp flashes,
set Paw to 100 mbar, the warning !!! PEEP high appears on the
keep flow sensor tight: screen.
Press »Alarm Reset«.
"Airway pressure high" Set pressure limit Pmax to OFF, set Paw Audible alarm sounds. The warning
alarm below the current max. airway pressure: !!! Airway pressure high appears on
the screen.
Set Paw to 100 mbar.
Press »Alarm Reset«.
If necessary, set pressure limit Pmax to ON.
"MV low" alarm Set MV higher than the current MV Audible alarm sounds, the red alarm lamp
measured value: flashes, the warning !!! MV low appears on
the screen.
Set MV lower than the current MV
measured value again.
Press »Alarm Reset«:
Tightness of breathing Set high flow acceleration FlowAcc, press and Plateau pressure remains constant.
system hold down the »Insp. hold« key and observe
pressure curve:

When the check has been completed successfully, Savina is


ready for use.

● Do not use device unless all the test steps have been
completed.
● Adapt all settings and alarm limits to current patient
situation.

96
Description
Ventilation modes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 98
Volume-controlled ventilation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 98
IPPV . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 98
Flow Acceleration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 98
Pressure limiting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 98
IPPVAssist . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 99
Sigh (intermittent PEEP) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 99
AutoFlow® (optional) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100
SIMV . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 102
ASB . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 103
BIPAP (optional) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 104
Automatic leakage compensation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 105
NIV – Non-invasive ventilation (optional) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 106
Bibliography . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 108

97
Description

Description
Ventilation modes
Volume-controlled ventilation
IPPV
Volume-constant mandatory ventilation stroke
Paw
The ventilation pattern is specified by the settings for tidal with plateau without plateau
volume V T, frequency f, inspiration time Tinsp, PEEP, and Tplat
FlowAcc.
FlowAcc FlowAcc
Pplat
At the end of the flow phase, the expiration valve remains PEEP
closed until the end of the inspiration time Tinsp. This phase,
the inspiratory pause, can be identified as the plateau Pplat t
in the curve Paw (t). The values for plateau pressure Pplat and
Tinsp Te Tinsp
plateau time Tplat are shown on Values screens 1/2 and 2/2.

When the plateau is turned off Savina immediately changes to T= 1


f
expiration as soon as the set tidal volume V T is applied. In this Flow
case the inspiration time is not adjustable, but it is the result of
the compliance and resistance of the patient’s lungs together
with the set values tidal volume V T and flow acceleration. The
value for Tinsp is shown on Values screen 2/2. Savina t
establishes a minimum expiration time of 500 ms and limits the

045 37388
resulting I:E ratio to max. 4:1.

Flow Acceleration
With the parameter »FlowAcc« the pressure and flow increase
can be influenced. A greater Flow acceleration produces a
steeper pressure and flow increase. Flow acceleration (and
the inspiration time) can be used to adapt the pressure and
flow curve to suit the individual patient’s needs.

Pressure limiting
Pressure Limited Ventilation (PLV)
Paw
Savina can limit the peak pressure in IPPV, IPPVAssist and
SIMV and SIMV/ASB modes. The »Pinsp« ventilation
parameter is used to set the limit.
The value of Pinsp remains effective until Savina has applied
Pinsp
the set tidal volume V T or until the inspiration time has elapsed.
If the set tidal volume V T cannot be delivered with the set
values, a »! Tidal volume low« alarm will be displayed.
t
117 37261

Tinsp Te

98
Description

IPPVAssist
Assisted ventilation with continuous positive airway pressure.
The mandatory ventilation stroke begins when the patient
reaches an inspiratory flow corresponding at least to the flow
trigger set.
The current ventilation frequency may be greater than the
set frequency for the same trigger.

Sigh (intermittent PEEP)


"Sigh", in the form of intermittent PEEP, is operative in IPPV
and IPPV Assist modes. Paw
Sigh phase
The purpose of the expiratory sigh during ventilation is to open
collapsed areas of the lung, or to keep open "slow" areas of interm.
the lung. PEEP
Since atelectatic alveoli have a longer time constant – also
caused by obstructed bronchioles – increased airway
PEEP
pressure maintained over a longer period is required to
open them.

038 37388
t
In many cases, the sigh function is achieved by increasing
the ventilation stroke; however, due to the short time available,
this form of sigh only marginally improves the filling of the
"slow" alveoli.
In Savina, the sigh operates during expiration with an
intermittent PEEP. It is set relative to PEEP (∆ sigh).
The average airway pressure is higher, and a longer filling
time is normally available.
When the sigh is activated, the end-expiratory pressure
increases every 3 minutes by the intermittent PEEP set
for 2 ventilation strokes.

99
Description

AutoFlow® (optional)
The AutoFlow function can be activated in the »Settings«
Paw
menu. FlowAcc FlowAcc Paw >
high low Pmax
With AutoFlow, the inspiration flow is automatically adjusted to FlowAcc FlowAcc
PPLAT
changes in lung conditions (C, R) and to the spontaneous
breathing demand of the patient. PEEP
t

Always set the alarm limit »Paw W« as well as V T W in Tinsp Te


order to set off an alarm in the event of an increase in 1
airway pressure or tidal volume V T with change of f
Flow
compliance. VT

t
Typically, the selected inspiration time Tinsp is noticeably
longer than the filling time of the lungs. The inspiration
pressure Pinsp corresponds to the minimum value resulting

024 37388
from both tidal volume V T and compliance C of the lungs. without spontaneous breathing with spontaneous breathing

Savina automatically controls the inspiration flow so that there


is no pressure peak caused by the resistances of the tube and
the airways. The plateau pressure Pplat varies with changes in
compliance C, as is normal in all constant-volume ventilation
strokes. With AutoFlow, these variations occur in maximum
steps of 3 mbar between ventilation strokes. The plateau
pressure Pplat is automatically limited by the pressure
limitation Pmax = Paw W –5 mbar.

If the tidal volume V T is reached (inspiration flow = 0) before


the inspiration time has elapsed, the patient can breathe in and
out during the remaining inspiration time at the level of the
plateau pressure Pplat.

If the patient breathes in or out during mandatory inspiration,


the plateau pressure Pplat is not changed for this ventilation
stroke. Only the inspiration and expiration flow are adapted to
the patient’s demand. The individually applied tidal volume V T
may differ from the set tidal volume V T in specific ventilation
strokes, but on average over time a constant tidal volume V T is
supplied.

The exceeding increase of the tidal volume V T can be


Paw
restricted by the alarm limit »VTi W«. If the set alarm limit is Paw >
exceeded one time, Savina sets of an advisory message (!);
if the alarm limit is exceeded three times, Savina sets of a PPLAT
warning message (!!!). The volume is actively limited to the
alarm limit value »VTi W« by switching over to the PEEP level. PEEP
t

A set inspiration time Tinsp which is shorter than the filling Tinsp Te

time of the lungs can be recognized from the flow curve: the 1
f
flow at the end of the inspiration time has not yet returned to Flow
VT
zero. The »! Tidal volume low« or »!! Tidal volume low« alarms
indicate that the settings selected do not permit full delivery of
t
the tidal volume V T. It must now be decided whether the
current condition of the patient permits prolongation of the
inspiration time Tinsp or an increase of the flow acceleration,
033 37388

in order to apply the set tidal volume V T. without spontaneous breathing with spontaneous breathing

100
Description

A stenosis can also cause the filling time of the lungs to


become longer than the set inspiration time Tinsp.

Starting behavior of AutoFlow


Upon switching on the function AutoFlow Savina applies
the set tidal volume V T using a volume-controlled breathing
stroke.
The plateau pressure Pplat derived from this breathing stroke
serves the function AutoFlow as starting value for the
inspiration pressure.

Settings to suit the patient’s needs


The Start of the mandatory inspiration can be synchronized
with the patient’s inhalation effort with the help of the variable
flow trigger. The flow trigger can only be completely turned off
in IPPV (IPPVAssist –> IPPV).

The steepness of the pressure increase from PEEP level to the


inspiration level can further be adapted with the ventilation
parameter FlowAcc in SIMV and IPPV to suit the patient’s
needs.

101
Description

SIMV
Synchronised Intermittent Mandatory Ventilation
Combination of mandatory ventilation and spontaneous
breathing. unsynchronised synchronised
Paw mandatory mandatory
ventilation stroke ventilation stroke
SIMV enables the patient to breathe spontaneously in regular
prescribed intervals between mandatory ventilation strokes FlowAcc FlowAcc
that ensure a minimum ventilation.
PEEP
This minimum ventilation is defined by two set values, tidal
volume (V T) and ventilation frequency (f). The minimum t
Trigger
ventilation is the product of V T x f. window Tinsp spontaneous
breathing time
spontaneous
breathing time
The ventilation pattern is set by the ventilation parameters + T
tidal volume V T, frequency f, inspiration time Tinsp and flow 1
set IMV time
f
acceleration FlowAcc. set IMV time 1

041 37388
f
To prevent the mandatory ventilation stroke being applied
during spontaneous expiration, the Flowtrigger of the machine
ensures that the ventilation stroke is triggered within a "trigger
window" and synchronised with the patient's spontaneous
inspiration.
The "trigger window" is no longer than 5 seconds. If the
expiration times are less than 5 seconds, the trigger window
covers the entire expiration time, less a minimum expiration
time of 500 ms.

Since the synchronisation of the mandatory ventilation stroke


reduces the effective SIMV time and therefore would normally
result in an undesirable increase in the effective IMV
frequency, Savina adds in the reduced SIMV time by
prolonging the subsequent spontaneous breathing phase by
the SIMV time difference ∆ T – thus preventing an increase in
SIMV frequency. The frequency parameter f remains constant.
This parameter, in combination with the tidal volume V T, sets
the minimum ventilation. If the patient has breathed in a
considerable inspiratory volume at the beginning of the trigger
window, the machine reduces the subsequent mandatory
ventilation stroke by shortening the time for the inspiratory flow
phase and the inspiration time. In this way, the tidal volume V T
remains constant, and over-inflation of the lungs is avoided.

During the spontaneous breathing phases, the patient can be


assisted by ASB pressure support.

In the course of progressively weaning the patient from


artificial ventilation, the ventilation frequency f is further
reduced while the spontaneous breathing time is increased,
so that the required total minute volume is supplied more and
more by spontaneous breathing.
The ventilation frequency can be reduced to 2/min.

102
Description

ASB
Assisted Spontaneous Breathing

Pressure support for insufficient spontaneous breathing.


Paw
The function of the machine in assisting insufficient
spontaneous breathing is similar to that of the anaesthetist Phase
I II
who manually assists and monitors the patient's spontaneous
∆ PASB
breathing by feeling the breathing bag.
above PEEP
FlowAcc
The machine takes over part of the inhalation function, with
the patient maintaining control of spontaneous breathing. CPAP

The CPAP system supplies the spontaneously breathing t


Start of inspiration End of inspiration
patient with breathing gas, even if the inspiration effort is
weak.
Insp.
Flow
The pressure support of the ASB system is started: max. 4 s
— when the spontaneous inspiration flow reaches the set
value of the Flowtrigger,
or at the latest
— when the spontaneous inspired volume exceeds 25 mL.
25% insp. flow

042 37388
The machine then produces an increase in pressure up to t
the preselected ASB pressure ∆ PASB above PEEP, which
is adjustable to the breathing requirement of the patient.
The flow supply can be adjusted using »FlowAcc« to meet the
individual needs of the patient.
— In case of high flow acceleration
Savina supports the insufficient spontaneous breathing
of the patient with a high peak flow.
— In case of low flow acceleration
Savina begins smoothly with even inspiratory flow.

ASB is terminated:
— when the inspiration flow returns to zero during phase I,
i.e. when the patient exhales or fights the ventilator,
or
— when the inspiration flow in phase II falls below 25 % of
the last inspiration flow supplied (∆ PASB above PEEP is
thus reached)
or
— at the latest after 4 seconds if the two other criteria have
not come into operation.
If this time criterion occurs, the advisory message
"! ASB > 4 s" is displayed.
If this time criterion occurs three times in succession,
Savina displays a warning message "!!! ASB > 4 s" and
warns of a possible leak in the ventilation system.
In »Mask/NIV« mode the »Tinsp« key is used to set the
maximum duration of the ABS stroke.

103
Description

BIPAP (optional)
Biphasic Positive Airway Pressure

The BIPAP ventilation mode is a pressure-controlled/time-


cycled ventilation mode in which the patient can always
breathe spontaneously. BIPAP is therefore often described
as a timed alternation between two CPAP levels.*

The time-cycled change of pressure produces controlled


ventilation corresponding to the pressure-controlled ventilation
PCV. However, the constant option of spontaneous breathing
allows the transition from controlled breathing to independent
spontaneous breathing to take place smoothly over the course
of the weaning phase, without requiring any change in the
ventilation mode. To adapt easily to the patient's spontaneous
breathing pattern, the change-over from expiratory pressure
level to inspiratory pressure level, and also the change-over
from inspiratory pressure level to expiratory pressure level, are
synchronised with the patient's spontaneous breathing.

The frequency of the change-over is kept constant, even with


patient synchronisation, by defining a trigger time window with
a fixed time constant.

This smooth adaptation to the patient's spontaneous breathing


requires less sedation, so that the patient returns to
spontaneous breathing more rapidly.

As in all pressure-controlled ventilation modes, the patient is


not prescribed a fixed tidal volume (V T). The tidal volume
results principally from the pressure difference between the
settings for PEEP and Pinsp and also lung compliance.

The display of the tidal volume measured on expiration, V Te, is


used to set the required difference between the two pressure
levels. Any increase in this difference will cause an increased
BIPAP ventilation stroke.

Changes in lung compliance and airways, as well as active


'fighting' by the patient can lead to changes in tidal volume.
This is a desired effect in this ventilation mode.

With the knowledge that the tidal volume, and therefore the
minute volume, are not constant, the alarm limits for minute
volume must be adjusted with care.

* Bibliography (1), (2), (3), page 108.

104
Description

Using BIPAP
As with SIMV, the time pattern is set using the basic setting
mandatory synchronised
parameters of frequency f and inspiration time Tinsp. The Paw BIPAP stroke spontaneous breathing BIPAP stroke
lower pressure level is set with the PEEP parameter, while
the upper level is set with Pinsp.
FlowAcc
When switching over from volume controlled ventilation to
BIPAP mode – while retaining the time pattern – only the Pinsp
PEEP
setting needs to be changed.

The steepness of the pressure increase is controlled by the t


Trigger
»FlowAcc« setting. window Tinsp
During the lower pressure level phase, spontaneous breathing
can be assisted by ASB.

026 37388
1
The steepness of the pressure increase to ASB pressure f
∆ PASB above PEEP is also controlled by the »FlowAcc«
setting.
The transition from controlled ventilation via the weaning
phase to fully spontaneous breathing is achieved by a
gradual reduction of the inspiratory pressure Pinsp and/
or frequency f.

Automatic leakage compensation


Savina determines the difference between the inspiratory
metered flow and the expiratory measured flow. The difference
provides an indication of the extent of leakage and is
designated leak minute volume, MVleak. The leak minute
volume MVleak is taken into account for trigger detection, for
optimum synchronisation of the ventilator with the patient.

Automatic leakage compensation for trigger detection


In order to synchronize with the patient’s efforts to breathe in
and out, Savina detects volume and flow values caused by the
patient. In order to optimize synchronisation, the measured
flow values are automatically corrected to take account of the
leakage flow, up to a maximum of 10 L/min.

Monitoring leakage
In »Tube« mode if Savina detects a major leak in the system,
the message »! Leakage« appears. In this case the tube and
patient hose system connections should be checked for
tightness.

105
Description

NIV – Non-invasive ventilation (optional)


With the NIV option, Savina offers an application mode
optimized for non-invasive ventilation using a nose or face
mask. Greater leakage generally occurs with non-invasive
ventilation than with ventilation via a tube. In »Mask/NIV«
mode, therefore, automatic leakage compensation for trigger
detection, alarms and monitoring are adjusted to these special
conditions. Additionally, in volume-controlled ventilation
modes Savina automatically compensates for volume lost due
to leaks.

Automatic leakage compensation for trigger detection


As with invasive ventilation with Savina, automatic leakage
compensation takes place with respect to the trigger criteria in
»Mask/NIV« mode. Savina takes account of leakage up to
25 L/min for trigger detection purposes.

Alarms
During non-invasive ventilation in »Mask/NIV« mode, some
alarm limits are not needed in certain circumstances or cannot
be monitored due to big artefacts. For example, in the case of
very big leaks it is often not possible to measure any expiratory
minute volume. If this alarm were not switched off, the device
would generate alarms all the time. The following alarms can
therefore be deactivated in »Mask/NIV« mode:
— Minute volume low
— Tidal volume high
— Apnoea detection.
Non-invasive ventilation with the alarms switched off is only
permissible if the patient’s safety is not put at risk.
The »!!! Airway pressure low« alarm can be delayed by up to
60 seconds. This is done by setting a delay time TDisconnect
from 0 to 60 seconds on an additional screen page
»Alarms 2/2«. For example, with a setting of 10 seconds the
patient can remove the mask for up to 10 seconds before
Savina activates an »!!! Airway pressure low« alarm.
Because leaks are normal in non-invasive ventilation, the
messages "! Leakage", "! ASB >4s" and "!!! ASB > 4s" are not
displayed in this mode.

Monitoring
Savina provides an additional Values page in »Mask/NIV«
mode. Among other things, this shows the leak minute volume
MVleak as a percentage of the measured minute volume.
The tidal volume VTpat indicates the volume actually reaching
the patient. VTpat is the delivered tidal volume less the volume
lost due to leakage during inspiration.

106
Description

Automatic volume compensation


If volume-controlled ventilation modes (IPPV, SIMV) are
applied in »Mask/NIV« mode, Savina increases the applied
tidal volume V T by the amount lost due to leakage during
inspiration. If a tidal volume V T of 500 mL has been set and
50 mL are lost during inspiration, Savina will automatically
deliver 550 mL. Because unlimited leakage compensation is
not advisable, Savina compensates for leakage up to 100 % of
the set tidal volume.

107
Description

Bibliography
(1) Baum, M., Benzer, H., Putensen, Ch., Koller, W., Putz,G.:
Biphasic Positive Airway Pressure (BIPAP) – eine neue
Form der augmentierenden Beatmung
Anaesthesist 38 (1989), 452-458

(2) Vincent, J.-L.:


Yearbook of Intensive Care and Emergency Medicine
Springer-Verlag 1993

(3) Sydow, M.:


Biphasic Positive Airway Pressure (BIPAP) und Airway
Pressure Release Ventilation (APRV)
in: Kuhlen, R., Guttmann, J., Rossaint, R. (Hrsg.):
Neue Formen der assistierten Spontanatmung
Urban & Fischer 2000

108
What‘s what
Control unit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 110
Front connection block . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111
Back panel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 112
Abbreviations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113
Symbols . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 115

109
What's what

What's what
Control unit

20 1 2
D Savina
Trigger
3
19 VT Pinsp g
2g
Verneb.
Neb.
mL L mbar min 4
O2 Y
18 Absaug.
Suction Tinsp. ∆PASB Alarm

Insp.
s über PEEP
above PEEP Reset 5
17 hold f PEEP
bpm mbar
Lock 6
O2
Vol.% N
16
Curves
Kurven Settings
Einstell. Alarms
Alarme Values
Werte Config.
Konfig. ext. J 7
int. J

IPPV SIMV
CPAP
ASB
BIPAP O
Standby 8

15 14 13 12 11 10 9

084 37388
1 Screen for displaying application-specific screen pages. 13 »Alarms ∆∆« key for setting and displaying alarm limits.
2 Parameter keys for setting the ventilation parameters and 14 »Settings ∆∆« key for setting other ventilation parameters
displaying the settings. on the screen.
3 Red and yellow lamps for alarms and advisory messages. 15 »Curves « key for changing to the main page
4 » 2 min« key for suppressing the audible alarm tone and for switching the curve displayed (Flow or Paw)
for 2 minutes. 16 » « key for switching the screen brightness between
5 »Alarm Reset« key for acknowledging alarm messages. bright/dark.
6 » Lock« key for protecting against unauthorised 17 »Insp. hold« key for manual inspiration.
modification. 18 »O2 Y Suction« key for bronchial suction.
7 Power supply indicators 19 » Nebul.« key for switching the pneumatic
medicament nebuliser on/off.
N Mains power 20 Trigger indicator.

ext. J External battery or DC on-board network

int. J Internal battery

8 » Standby« key for changing between ventilation


and standby.
9 Central "turn and press" rotary knob for selecting
and confirming settings.
10 Mode keys for IPPV, SIMV, CPAP/ASB, BIPAP
11 »Config. ∆∆« key for system settings.
12 »Values ∆∆« key for displaying measured values.

110
What's what

Front connection block

2
3
1 4
5

088 37261
1 Flow sensor
2 Expiration valve with expiration port
3 Socket for breathing gas temperature sensor plug
4 Inspiration port
5 Gas supply port for the medicament nebuliser
6 Protective cover for O2 sensors

111
What's what

Back panel

6 7

4
8
3

9
10

089 37261
1 RS 232 serial interface
2 Nurse call socket (optional)
3 Power switch
4 Fuse for internal battery
5 Power unit socket
6 DC inlet (external battery or DC on-board network)
7 Potential equilisation connector
8 Filter cover
9 Low pressure O2 inlet
10 In side panel: connection for O2 pressure hose

112
What's what

Abbreviations

Abbreviation Definition

ASB Assisted Spontaneous Breathing


Pressure-supported spontaneous breathing
BIPAP Biphasic Positive Airway Pressure
Ventilation mode for spontaneous breathing at continuous
positive airway pressure with two different pressure levels
bpm breaths per minute
BTPS Body Temperature, Pressure, Saturated
Measured values based on the conditions of the patient’s lungs,
with body temperature 37 oC, atmospheric pressure, steam-
saturated gas
C Compliance
CPAP Continuous Positive Airway Pressure
Breathing with continuous positive pressure in the airways
∆ PASB above Setting for pressure support ASB above PEEP
PEEP
f frequency
fApnoe Frequency setting for apnoea ventilation
fspn spontaneous breathing frequency
ftot total breathing frequency
Fail to cycle Machines detects no inspiration
FiO2 Inspiratory O2 concentration
FlowAcc Flow acceleration
Int. PEEP Intermittent Positive End-Expiratory Pressure = Sigh
IPPV Intermittent Positive Pressure Ventilation
IPPVAssist Assisting Intermittent Positive Pressure Ventilation
IRV Inversed Ratio Ventilation
Ventilation with inversed inspiration/expiration ratio
I:E Ratio of Inspiration time to Expiration time
MV Minute volume
MVleak Leak minute volume
MVspn Spontaneous fraction of minute volume
NIV Non-invasive ventilation
O2 Setting for inspiratory oxygen concentration
Paw Airway pressure
PEEP Positive End-Expiratory Pressure
Pinsp Setting of the upper pressure level in BIPAP
PLV Pressure Limited Ventilation
Pmean Mean airway pressure
Ppeak Peak pressure
Pplat End-inspiratory airway pressure
R Resistance

113
What's what

Abbreviation Definition

SIMV Synchronized Intermittent Mandatory Ventilation


TDisconnect Delay time for "Airway pressure lower alarm limit" alarm
(only in »Mask/NIV« mode)
Temp Inspiratory breathing gas temperature
Te Expiration time
Tinsp Setting for the inspiratory time
Tplat Plateau time
VT Setting for tidal volume
V TApnoea Setting for tidal volume of apnoea ventilation
V Te Expiratory tidal volume
V Ti Inspiratory tidal volume
V Tpat Leakage-compensated inspiratory measured tidal volume

114
What's what

Symbols

Symbol Explanation

Neb. Switch medicament nebuliser on / off

O2 Y
Suction Activate/deactivate oxygen enrichment for bronchial suction

Insp.
hold Start manual inspiration and hold
Settings
∆∆ Select settings page
Config.
∆∆ Configure system settings
Alarms
∆∆ Display alarm limits
Values
∆∆ Display measured values
Curves
Switch between flow / pressure curve

Bright/dark screen brightness setting

Mute audible alarm for 2 minutes


Alarm
Reset Acknowledge alarms

Lock Lock ventilation parameters and ventilation mode

Standby

Upper alarm limit

Lower alarm limit

Lower/upper alarm limit

Follow instructions for use!

m Protection class Type B

m Protection class Type BF

º Insert flow sensor

115
116
Technical data
Technical data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 118

117
Technical data

Technical data
Environmental conditions
In operation
Temperature 5 to 40°C
Atmospheric pressure 700 to 1060 hPa
Rel. humidity 5 to 95 %, no dew

In storage and transit


Temperature –20 to 70°C
Atmospheric pressure 600 to 1200 hPa
Rel. humidity 10 to 95 %, no dew

Settings
Ventilation modes IPPV/IPPVAssist,
SIMV, SIMV/ASB
BIPAP, BIPAP/ASB
CPAP/ASB

Ventilation frequency f 2 to 80 bpm

Inspiration time Tinsp 0.2 to 10 s


Tidal volume V T 0.05 to 2.0 L, BTPS*
Accuracy ±10 % of set value or ±25 mL,
whichever is greater.

Inspiratory pressure Pinsp 0 to 99 mbar**


O2 concentration
Accuracy 21 to 100 vol.%
±3 vol.%
The accuracy of the inspiratory O2 concentration is appreciably
reduced when operating Savina without O2 sensors.

Positive end-expiratory pressure PEEP


or interm. PEEP 0 to 35 mbar

Trigger sensitivity 1 to 15 L/min


Can be switched off in IPPV ventilation mode.

Pressure assist ∆ PASB with PEEP 0 to 35 mbar (relative to PEEP)

Flow Acceleration FlowAcc 5 to 200 mbar/s

* BTPS
Body Temperature, Pressure, Saturated.
Measured values with reference to the conditions of the patient’s lung,
body temperature 37 oC, ambient pressure, steam-saturated gas.
** 1 mbar = 100 Pa

118
Technical data

Performance data
Control principle Time-cycled, volume-constant, pressure-controlled
Intermittent PEEP frequency 2 cycles every 3 minutes

Medicament nebulisation For a maximum of 30 minutes, in the inspiratory flow phase,


(with O2 supply only) 2 bar, max. 10 L/min.,
Savina takes the nebulizer flow into account and keeps the
minute-volume constant

Oxygen enrichment for bronchial suction


(with O2 supply only)
disconnection detection automatic
reconnection detection automatic
oxygen enrichment max. 3 minutes with 100 vol.% O2
active suction phase max. 2 minutes
final oxygen enrichment 2 minutes with 100 vol.% O2

Supply system for spontaneous breathing and ASB Blower with quick-action pressure control valve
max. inspiratory flow 180 L/min, BTPS*
Equipment compliance
(with Fisher & Paykel MR 730 humidifier
and adult patient hose system) ≤2 mL/mbar
Inspiration resistance ≤2.3 mbar/60 L/min
Expiratory resistance ≤3.8 mbar/60 L/min

Equipment compliance
(with Fisher & Paykel MR 730 humidifier
and tubing system for paediatric use) ≤1 mL/mbar

Inspiration resistance ≤4.1 mbar/30 L/min


Expiration resistance ≤4.1 mbar/30 L/min
Additional functions
Inspiratory relief valve opens breathing system in case of failure
Safety valve opens the breathing system at 100 mbar.

Measured value displays


Airway pressure measurement
(resistive relative pressure sensor)

Max. airway pressure PPeak


Plateau pressure PPlat
Pos. end-exp. pressure PEEP
Mean airway pressure PMean
Range 0 to 99 mbar
Resolution 1 mbar
Accuracy ±2 mbar

Inspiratory O2 measurement:
(maintenance-free electrochemical sensor)

Inspiratory O2 concentration FiO2


Range 18 to 100 vol.%
Resolution 1 vol.%
Accuracy ±3 vol.%
* BTPS
Body Temperature, Pressure, Saturated.
Measured values with reference to the conditions of the patient’s lung,
body temperature 37 oC, ambient pressure, steam-saturated gas.

119
Technical data

Flow measurement
(hot-wire sensor)

Inspiratory peak flow FlowPeak


Range 0 to 196 L/min
Resolution 1 L/min
Accuracy ±8 % of measured value

Minute volume MV
Spontaneous breathed minute volume MVspon
Range 0 to 99 L/min, BTPS*
Resolution 0.1 L/min
Accuracy ±8 % of measured value
T0...90 approx. 35 s

Leakage minute volume MVleak


based on the inspiratory minute volume
(only in »Mask/NIV« mode)
Range 0 to 100 %
Resolution 1%
Accuracy ±18 % of measured value

Measured expiratory tidal volume V Te


Range 0 to 3999 mL, BTPS*
Resolution 1 mL
Accuracy ±8 % of measured value

Leakage-compensated inspiratory measured tidal


volume VTpat
(only in »Mask/NIV« mode)
Range 0 to 3999 mL, BTPS*
Resolution 1 mL
Accuracy ±18 % of measured value

Frequency Measurement
Spontaneous breathing frequency fspn
Total frequency ftot
Range 0 to 150 /min
Resolution 1 /min
Accuracy ±1 /min
T0...90 approx. 35 s

Inspiration/expiration ratio I:E


Range 0 : 150 to 150 : 1
Resolution 0.1
Accuracy ±6 % of measured value

Inspiration time Tinsp


Range 0 to 15 s
Resolution 0.1 s
Accuracy 0.1 s

* BTPS
Body Temperature, Pressure, Saturated.
Measured values with reference to the conditions of the patient’s lung,
body temperature 37 oC, ambient pressure, steam-saturated gas.

120
Technical data

Plateau time Tplat


Range 0 to 10 s
Resolution 0.1 s
Accuracy 0.1 s

Resistance R
Range 3 to 100 mbar/L/s
Resolution 1mbar/L/s
Accuracy ±2.5 mbar/L/s or 20 %, whichever is greater

Compliance C
Range 3 to 200 mL/mbar
Resolution 1 mL/mbar
Accuracy ±2 mL/mbar or 20 %, whichever is greater

Breathing gas temperature measurement


(NTC sensor)
Range 18 to 51 oC
Resolution 1 oC
Accuracy ±1 oC
Curve displays
Airway pressure Paw (t) –5 to 100 mbar
Flow (t) –200 to 200 L/min

Monitoring
Expiratory minute volume MV
Upper alarm limit alarm when MV exceeds the upper alarm limit.
Setting range 41 to 2 L/min, in 0.1 L/min steps

Lower alarm limit alarm when MV falls below the lower alarm limit.
Setting range 0.5 to 40 L/min, in 0.1 L/min steps

Airway pressure Paw


Upper alarm limit alarm when the "Paw high" value is exceeded.
Setting range 10 to 100 mbar
Lower alarm limit alarm when the value "PEEP +5 mbar" (coupled with the PEEP set value)
is not exceeded for at least 0.1 s in two successive ventilation
strokes

Delay time TDisconnect for 0 to 60 s


"Airway pressure lower alarm limit" alarm
(only in »Mask/NIV« mode)

Insp. O2 concentration FiO2


Upper alarm limit alarm if FiO2 exceeds the upper alarm limit for at least 20 seconds.

Lower alarm limit alarm if FiO2 falls below the lower alarm limit for at least 20 seconds.
Range both alarm limits are automatically allocated to the set value:
below 60 vol. % with ± 4 vol. %
above 60 vol. % with ± 6 vol. %

121
Technical data

Tachypnoea monitoring
Alarm if the total frequency is exceeded during spontaneous breathing.
Adjustment range 10 to 120/min

Apnoea alarm time


Alarm if no breathing activity is detected.
Adjustment range 15 to 60 s, adjustable in 1 second steps.

Insp. tidalvolume
Alarm if the delivered tidal volume V T exceeds the alarm limit
Setting range 0.06 to 4 L

Operating data

Mains power connection 100 V to 240 V, 50/60 Hz


Current input
at 230 V max. 1.3 A
at 100 V max. 3.4 A
Power consumption in typical ventilation typically approx. 100 W
Machine fuses
Range 100 V to 240 V F 5 H 250 V IEC 127-2 (2x)
Protection class I, Type B
DC fuse for internal battery Plug-in fuse 1 SA/32 V

Supply from DC on-board network 12 to 36 V DC

Supply from external batteries 12 or 24 V


Input current (DC)
12 V battery typically 10 A, max. 20 A
24 V battery typically 5 A, max. 10 A

Bridging time if mains supply is down, with charged


external battery and typical ventilation

examples
12 V battery 36 Ah approx. 4 hours (e.g. with 1 lead-gel battery 12V/36 Ah)
24 V battery 17 Ah approx. 7 hours (e.g. with 2 lead-gel batteries 12V/17 Ah)

Bridging time if mains supply is down and no approx. 60 minutes with typical ventilation
external DC supply is available (new, charged
batteries)

External battery
Sourcing information:
Standard rechargeable lead or lead-gel batteries
can be used, e.g.
Sonnenschein A212/36 A (1 or 2 batteries)
Panasonic LCL 12 V 17P (2 batteries)
LCL 12 V 33AP (1 or 2 batteries)
LCL 12 V 38P (1 or 2 batteries)

122
Technical data

Battery charging
Savina automatically detects the voltage of the
external battery connected.
Charge current: 12 V battery approx. 4 A
24 V battery approx. 2 A

When the battery is fully charged, the charging


system switches to trickle charging.
Trickle charging is effected by short current pulses.

Charging times
The charging times indicated refer to immediate
charging of the battery after discharge.

Several successive partial discharges or


intermediate mains charging can extend the
charging time.

Type: lead-gel batteries, maintenance-free, sealed


Minimum capacity
12 V battery 30 Ah
24 V battery 15 Ah
Charging time
12 V battery < 10 hours (about 5 hours at 80 % charge)
24 V battery < 10 hours (about 5 hours at 80 % charge)
Charge current
12 V battery 4A
24 V battery 2A

Internal battery
Type Lead-gel battery, maintenance-free, sealed.
Charging time < 5 hours, including from external DC on-board
network
(about 1.5 hours at 80 % charge)
Protection class
Machine Class I

Temperature sensor AWT01 (sensor fitted) Type BF


Gas supply
O2 gauge pressure 3 bar –10 % to 6 bar
O2 connection thread NIST
The gas must be dry and free from oil and dust.

Output for pneumatic medicament nebuliser O2, max. 2 bar, max. 10 L/min

Sound pressure level 45 dB (A) for typical ventilation at 1 m distance


(for free-field measurement over
a reflecting surface)
Dimensions (W x H x D)
Basic machine 380 x 383 x 358 mm
Machine with trolley 580 x 1335 x 560 mm

123
Technical data

Weight
Basic machine approx. 22 kg

Machine outputs
Digital output Output and reception via an RS 232 C interface
for MEDIBUS protocol

Classification Class IIb


as per EC Directive 93/42/EEC
Annex IX

UMDNS-Code 17 – 429
Universal Medical Device
Nomenclature System –
nomenclature for medical products

Relevant standards
EN 794-1, Lung ventilators –
Part 1: Special requirements for intensive care
ventilators

EN 60601-1, Medical electrical appliances –


Part 1: General safety rules (IEC 601-1, 1996)
EN 60601-1-2, Medical electrical appliances –
Part 1: General safety rules –
Second supplementary standard: Electromagnetic
compatibility – Requirements and testing
(IEC 601-1-2 1993)
RTC/DO-160D, Environmental Conditions and Test
Procedures for Airborne Equipment, Section 21:
Emissions of radio frequency energy, 29.7.1997
MIL-STD-461, Requirements for the control of
electromagnetic interference emissions and
suspectability, RE 101, CS 114, RS 101

124
Order List
Order List . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 126

125
Order List

Order List
Designation/Description Part No. Designation/Description Part No.
Basic machine Special accessories
Savina 84 13 600 Pneumatic medicament nebulizer 84 12 935
Articulated bracket 84 09 609
Accessories required for operation or
Quick-fit articulated bracket 2 2M 85 706
O2 connecting hose 3 m (NIST) M 34 402
SavinaMobil trolley 84 14 335
non-colour coded or
O2 connecting hose 5 m (NIST) M 34 403
For manual ventilation:
non-colour coded
Resutator 2000 21 20 046
Paediatric Resutator 2000 21 20 984
For adult ventilation
Resutator hook M 26 349
Temperature sensor 84 05 371
Aquapor humidifier 84 05 020
Adult test lung 84 03 201
Bracket set 84 03 345
Hose set adult 84 13 146
comprising: MEDIBUS cable 83 06 488
Patient hoses, water traps, Y-piece, DC battery cable (ext. battery) 84 14 092
catheter connector Ext. lead-gel battery 12 V/17 Ah 18 43 303
HME hose set (adult) 84 12 860 (2 batteries needed)
Humidifier basic unit MR 730 84 11 046 DC on-board network cable S 84 14 048
(Fisher & Paykel) o
90 O2 connector 84 13 641
Fastening set (rail bracket) 84 11 074 Set of side rails 84 14 358
Humidifier chamber MR 370 (adult) 84 12 217
Hose set (adult), Fisher & Paykel 84 12 108 Options
Bacterial filter SecuRed Big, Stl. MX 02 650 AutoFlow kit 84 14 069
BIPAP kit 84 14 060
For paediatric ventilation with MR 730 NIV kit 84 14 115
Humidifier chamber MR 340 (paediatric) 84 11 047 Nurse call kit 84 14 476
including humidifier chamber filter paper
(set of 100) Plug to connect nurse call system to 18 46 248
ventilator
Double temperature sensor 84 11 048
Single-strand wire 1.5 m 84 11 050
For adult ventilation:
Bacterial filter SecuRed L, Stl. MX 02 652
Aquapor patient connection 84 05 029
Hose set paediatric (Fisher & Paykel) 84 12 081
comprising:
Hose heater 23 47 020, Replacement parts
patient hoses, water traps, Y-piece,
For Savina:
catheter connector
O2 sensor (Oxytrace VE) MX 01 049
Bacterial filter (disposable) 84 09 716
Expiration valve 84 13 660

For articulated bracket:


Holder 84 09 746
Hose clamp 84 09 841

126
Order List

Designation/Description Part No. Designation/Description Part No.


For adult ventilation: Consumables
Aquapor E-set cover 84 06 135 Spirolog flow sensor (set of 5) 84 03 735
Aquapor tank 84 04 739 Microfilter 67 37 545
Aquapor float 84 04 738 Set of dust filters S 84 14 057
Adult spiral hose, Filter paper for humidifier chamber F&P 84 11 073
Silicone rubber 0.6 m 21 65 627 (100 pieces)
Adult spiral hose, Hose set for humidifier F&P (disposable) MX 22 780
Silicone rubber 0.35 m 21 65 619 HME hose set (disposable) MX 22 750
Water trap 84 04 985
Pot 84 03 976 Hose set Aquapor (disposable) MX 22 777
Hose clamp 84 03 566 Bacterial filter SecuRed Big, Stl.* MX 02 650
Nozzle M 25 647 Bacterial filter SecuRed L, Stl.* MX 02 652
Y-piece (with thermometer sleeve) 84 05 435
Catheter connector, straight, size 12.5 M 23 841 Mask size 1, disposable* MX 22901
(set of 10)
Mask size 2, disposable* MX 22902
Corrugated hose 84 02 041
Mask size 3, disposable* MX 22903
Adult adapter 84 03 076
Mask size 4, disposable* MX 22904
Catheter connector set, adult 84 03 685
Mask size 5, disposable* MX 22905
Humidifier chamber MR 370 (adult) 84 12 217
(Fisher & Paykel) Mask size 6, disposable* MX 22906
Cap set (set of 5) 84 02 918 Mask, round, disposable* MX 22907
Elbow connector ISO M 25 649

For paediatric ventilation:


Paediatric spiral hose, 21 65 651
silicone rubber 22/10, 1.10 m
Paediatric spiral hose, 21 65 821
silicone rubber 22/10, 0.60 m
Paediatric spiral hose, 21 65 848
silicone rubber 10/10, 0.60 m
Paediatric spiral hose, 21 65 856
silicone rubber 22/10, 0.40 m
Corrugated hose flex., 0.13 m 84 09 634
Catheter connector size 11 (set of 10) M 19 490
Cap 84 01 645
Paediatric adapter 90o 84 03 075
Double cone 84 09 897
Temperature sensor inputs 84 11 044
Expiratory condensate trap 84 09 627
Hose heater 1.10 m 84 11 045
Hose heater adapter 84 11 097
Technical Documents on request
* Not available in all countries. Contact your local distributor for
information.

127
Index

Index

Abbreviations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113 Electrical power supply . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85


Accessories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Event of an alarm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31
Advisory . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32 Event of gas failure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44
Alarm limits Expiration valve . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 70, 80
Factory settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30 External battery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77
Alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14, 15, 31 Extreme settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
Ambient temperature . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44
Apnoea alarm time . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
Apnoea ventilation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28 Fault – Cause – Remedy . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56
Appropriate Monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 FiO2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50
ASB . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 103 Flow Acceleration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 98
Assembling . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80 Flow Acceleration FlowAcc . . . . . . . . . . . . . . . . . . . . . . . . . . 22
Audible alarm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32 Flow monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50
AutoFlow . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24, 100 Flow sensor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 70, 81
Front connection block . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111

Back panel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 112


Bacterial filters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 82 Heat and moisture exchanger . . . . . . . . . . . . . . . . . . . . . . . . 82
Battery status display . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 87 HME . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 82
Battery, external . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 86 Hose set, adult . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81
Bibliography . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 108 Hose set, paediatric . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85
BIPAP . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26, 104 Humidifier
BIPAP/ASB . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26 Aquapor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83
Bronchial suction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40 Fisher & Paykel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 84

Calibrating . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42 Information window . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12


Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68 Inspiration time . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 120
Caution . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31 Intended Use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Checklist . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 96 Intermittent PEEP . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23, 99
Cleaning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71 Internal battery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 78
Configuration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15, 48 IPPV . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21, 98
Configuring the measured values line . . . . . . . . . . . . . . . . . 49 IPPVAssist . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21, 99
Connection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Contrast . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48
Control unit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 110 Keys for routine and additional functions . . . . . . . . . . . . . . 12
Controls
Screen operating . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Ventilation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 Language . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52
CPAP . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27 Leakage compensation . . . . . . . . . . . . . . . . . . . . . . . 35, 105
CPAP/ASB . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27 Locking the keys . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
CPPV . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
Curves . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
Main page . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Mains power failure . . . . . . . . . . . . . . . . . . . . . . . . . . . 44, 95
Date . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52 Maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Description . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 98 Maintenance Intervals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74
Device values . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53 Manual inspiration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37
Device-ID . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53 Manual ventilation device . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
Disinfecting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71 Mask ventilation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34, 106
Disinfecting/cleaning/sterilising schedule . . . . . . . . . . . . . 73 Measured values . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14, 33
Dismantling . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68 MEDIBUS protocol . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53
Disposal . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 78 Medicament nebulization . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38
Dust filter set . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76 Medicament nebulizer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69
Microfilter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75

128
Index

Nebulization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38 TDisconnect . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36
Nebulizer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38 Technical data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 118
NIV – Non-invasive ventilation . . . . . . . . . . . . . . . . . . . . . . . . 34 Time . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52
Nurse calling system . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 92 Trigger . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22, 23

O2 monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50 Values . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
O2 reserve . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91 Ventilating infants . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83
O2 sensor Ventilation hoses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68
Calibrating . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43 Ventilation Modes . . . . . . . . . . . . . . . . . . . . . . . . 19, 21, 98
Disposal . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 78 Volume . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48
Fitting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77 Volume-controlled ventilation . . . . . . . . . . . . . . . . . . . . . . . . . 98
O2 sensor 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49
O2 supply . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91
Operating concept . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 What's what . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 110
Operating time . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91 Working hours . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50, 53
Operation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
Order List . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 126
Oxygen enrichment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40

Patient hose set, adult . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81


Patient hose set, paediatric . . . . . . . . . . . . . . . . . . . . . . . . . . 85
Plateau . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24, 52
Plateau pressure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 98
Plateau time . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 98, 121
PLV . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 98
Pmax ON/OFF . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51
Power supply . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85
Power supply failure . . . . . . . . . . . . . . . . . . . . . . . . . . . 44, 95
Power switch . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
Preparation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80
Pressure limiting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 98

Readiness for operation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 93


Release code . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53

Screen pages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Structure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Selecting the ventilation mode . . . . . . . . . . . . . . . . . . . . . . . 10
Setting new parameters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
Setting ventilation parameters . . . . . . . . . . . . . . . . . . . . . . . . 10
Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
Sigh . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23, 24, 99
SIMV . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25, 102
SIMV/ASB . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
Special functions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37
Standby . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Sterilising . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71
Storing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 78
Suction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40
Supply . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85
SW . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53
Switching on . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
Symbols . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 115

129
130
131
These Instructions for Use apply only to
Savina
with Serial No.:
If no Serial No. has been filled in by
Dräger, these Instructions for Use are
provided for general information only
and are not intended for use with any
specific machine or device.

ç
Directive 93/42/EEC
concerning Medical Devices

Dräger Medical AG & Co. KGaA


Germany
z Moislinger Allee 53 – 55
D- 23542 Lübeck
y +49 451 8 82-0
x 26 80 70
FAX+49 451 8 82-20 80
! http://www.draeger.com

90 37 388 - GA 5664.915 en
© Dräger Medical AG & Co. KGaA
1st edition – March 2001
Subject to alteration

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