Usermanual and setting of Fabian Theraphy nCpap ventilator

1. fabian Therapy
evolution
Preparation and Start-Up

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

3. FRONT CONNECTIONS
INITIAL SET-UP

4. NIV with fabian
Non Invasive Ventilation (NIV)
in Open Valveless System :
• nCPAP
• duoPAP
• nAPRV
• HHFNC

5. Infant Flow® variable flow
Clinical performance
Reduction in imposed work of breathing
Moa G, Nilsson K. Crit Care Med. 1988;16:1238–1242

6. 38/51
PATIENT CIRCUIT SET-UP
Patient circuit for NIV (i.e. Infant Flow)
• nasal CPAP
• nasal DuoPAP
Patient circuit for HFNC – High Flow Nasal Cannula

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

8. Neonatal patient circuit for NIV
i.e. by using Inspire/Infant Flow Generator and Circuit
Generator and nasal prongs (P/N 7186)

9. Neonatal patient circuit for NIV
i.e. by using Inspire/Infant Flow Generator and Circuit*
* P/N 5292, NIV breathing circuit, compatible with F&PMR850 humidifier
* P/N 5291 same as 5292 but includes also humidity chamber

10. Neonatal patient circuit for NIV
i.e. by using Inspire/Infant Flow Generator and Circuit*
* P/N 5292, NIV breathing circuit, compatible with F&PMR850 humidifier
* P/N 5291 same as 5292 but includes also humidity chamber

11. Neonatal patient circuit for NIV
i.e. by using Inspire/Infant Flow Generator and Circuit*
* P/N 5291 or P/N 5292, NIV breathing circuit, compatible with F&PMR850 humidifier

12. ASSEMBLY of NIV DISPOSABLE CIRCUIT*
connect Infant Flow connecting tube:
from NIV port to the humidifier chamber inlet
* P/N 5291 or P/N 5292, NIV breathing circuit, compatible with F&PMR850 humidifier

13. connect inspiratory heated tube
onto the humidifier chamber outlet
ASSEMBLY of NIV DISPOSABLE CIRCUIT*
* P/N 5291 or P/N 5292, NIV breathing circuit, compatible with F&PMR850 humidifier

14. connect the other end of
proximal pressure line to the
Prox connector on fabian
ASSEMBLY of NIV DISPOSABLE CIRCUIT*
* P/N 5291 or P/N 5292, NIV breathing circuit, compatible with F&PMR850 humidifier
connect a green connector
to one end of proximal
pressure line

15. connect the HEATER WIRE cable
for the HEATING of the RESISTANCE inside the breathing circuit
ASSEMBLY of NIV DISPOSABLE CIRCUIT*
* P/N 5291 or P/N 5292, NIV breathing circuit, compatible with F&PMR850 humidifier

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

17. INSERT the TEMPERATURE SENSORS onto the breathing circuit
Push the airway probe into the breathing circuit.
Make sure the airway probe is correctly located in its hole and that it’s pushed
home.
ASSEMBLY of NIV DISPOSABLE CIRCUIT*
* P/N 5291 or P/N 5292, NIV breathing circuit, compatible with F&PMR850 humidifier

18. ASSEMBLY of NIV DISPOSABLE CIRCUIT*
* P/N 5291 or P/N 5292, NIV breathing circuit, compatible with F&PMR850 humidifier
If needed, CONNECT the EXTENSION tube onto the breathing circuit
The extension tube is prepared also for inhaled NO (Nitric Oxide) with Luer-lock connection for sampling line)

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

20. INSERT the nCPAP GENERATOR onto the connectors of breathing
circuit
ASSEMBLY of NIV DISPOSABLE CIRCUIT*

21. ASSEMBLY of NIV DISPOSABLE
CIRCUIT
i.e. Infant Flow generator
INSERT the sized nasal prongs or nasal mask to the nCPAP
GENERATOR
Follow the Instruction for Use

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

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

24. 41/51
Neonatal patient circuit for NIV
i.e. by using Inspire/Infant Flow Generator and Circuit
Generator and nasal prongs

25. Sized bonnets color coded by Inspiration Healthcare

27. “Colored sizing guide” for Bonnets by Carefusion Healthcare

53. Every hour…
Perform a “final check” as before in order to
ensure a correct and stable positioning of the
Generator.
The baby is receiving the appropriate level of
comfort during nCPAP.
Advantages: fabian NIV stabilizes the prescribed
pressure of nCPAP.

54. Every 3 – 4 hours…
Perform a comprehensive inspection of the baby
and their interfaces: ties, bonnet, prongs or mask.
Massage the nares and re-evaluate for correct
sizing of the interface and change if necessary.

55. Feeding during nCPAP…
Orogastric tube free to potentially minimise gastric
distension
In “gavage” incentive pacifier

60. NIV with Infant Flow /
Inspire

61. SWITHING ON FABIAN
The FABIAN is switched on with the ON / OFF green button.

62. START UP SCREEN
The START SCREEN appears when you turn on the FABIAN.
The device SELF TEST is carried out.
All acoustic alarms are suppressed automatically for two minutes.

63. START UP SCREEN
The CALIBRATION Menu appears after the system Self Test.
The automatic O2 calibration begins after leaving the calibration menu and
automatically every 24h.
However if desired, O2 sensor calibration ca be carried out at any time from this
Menu,

64. nasalCPAP mode provides an automatic leak compensation in case of
leaks around mask or prongs; the leak flow is compensated up to +25%
!
Unique feature !
Easy control
Selectable generators like
Medijet,
InfantFlow/Inspire,
InfantFlow LP
nCPAP
without Exp. Valve !!

65. nasalCPAP mode provides an automatic leak compensation in case of
leaks around mask or prongs; the leak flow is compensated up to +25%
! Unique feature !
nCPAP
without Exp. Valve !!
Easy control
Selectable generators like
Medijet,
InfantFlow/Inspire,
InfantFlow LP

66. nasalCPAP mode has an automatic leak compensation in case of leaks
around mask or prongs; the leak flow is compensated up to +25% !
Unique feature !
nCPAP
In nCPAP Mode the patient
breaths spontaneously
through a nasal mask or
nasal prongs/cannula.
If an apnea occurs it is
necessary and strongly
recommended an additional
patient monitoring, i.e.
Impedance measurement
ECG, SpO2 and PCO2

67. nasalCPAP mode
Digital flowmeter
on screen for
better evaluation
of delivered flow
nCPAP

68. * Unique feature *

69. * Unique feature *
nCPAP

70. * Unique feature *
nCPAP

71. * Unique feature *

72. Nasal duoPAP mode has an automatic leak compensation in case of
leaks around mask or prongs; the leak flow is compensated up to +25%
!
Unique feature !
duoPAP
Like in nCPAP Mode the
patient breaths spontaneously
through a nasal mask or nasal
prongs/cannula. But there is
the possibility to increase
additional positive pressure
(PDUO) at a certain frequency
and Inspiration time.
If an apnea occurs it is necessary and
strongly recommended an additional
patient monitoring, i.e. Impedance
measurement ECG, SpO2 and PCO2

73. Nasal duoPAP mode has an automatic leak compensation in case of
leaks around mask or prongs; the leak flow is compensated up to +25%
!
Unique feature !
duoPAP
Easy control
Selectable InfantFlow
generator like InfantFlow
or Inspire, InfantFlow LP
or MediJet

74. duoPAP
Nasal duoPAP mode
Digital flowmeters
on screen for
better adjustment
of CPAP level

75. Nasal APRV
Nasal Airway Pressure Release Ventilation
Nasal APRV is
possible in duoPAP
mode by selecting
appropriate timing
(Thigh up to 15
seconds) and inverse
I:E ratio. In APRV
mode there are very
short period of
exhalation in order to
improve CO2 washout.

76. PATIENT CIRCUIT SET-UP
Patient circuit for NIV (i.e. Infant Flow)
• nasal CPAP
• nasal DuoPAP
Patient circuit for HFNC – High Flow Nasal Cannula

77. HIGH FLOW THERAPY
POSITIONING

79. Neonatal patient circuit for HFNC
i.e. by using nasal Cannula and Circuit*
* P/N 5292, NIV breathing circuit, compatible with F&PMR850 humidifier

80. * P/N 5292, NIV breathing circuit, compatible with F&PMR850 humidifier
* P/N 5291 same as 5292 but includes also humidity chamber
Neonatal patient circuit for HFNC
i.e. by using nasal Cannula and Circuit*

81. * P/N 5291 or P/N 5292, NIV breathing circuit, compatible with F&PMR850 humidifier
Neonatal patient circuit for HFNC
i.e. by using nasal Cannula and Circuit*

82. ASSEMBLY of NIV DISPOSABLE CIRCUIT for HFNC*
connect Infant Flow connecting tube:
from NIV port to the humidifier chamber inlet
* P/N 5291 or P/N 5292, NIV breathing circuit, compatible with F&PMR850 humidifier

83. connect inspiratory heated tube
onto the humidifier chamber outlet
* P/N 5291 or P/N 5292, NIV breathing circuit, compatible with F&PMR850 humidifier
ASSEMBLY of NIV DISPOSABLE CIRCUIT for HFNC*

84. connect the HEATER WIRE cable
for the HEATING of the RESISTANCE inside the breathing circuit
* P/N 5291 or P/N 5292, NIV breathing circuit, compatible with F&PMR850 humidifier
ASSEMBLY of NIV DISPOSABLE CIRCUIT for HFNC*

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

86. INSERT the TEMPERATURE SENSORS onto the breathing circuit
Push the airway probe into the breathing circuit.
Make sure the airway probe is correctly located in its hole and that it’s pushed
home.
* P/N 5291 or P/N 5292, NIV breathing circuit, compatible with F&PMR850 humidifier
ASSEMBLY of NIV DISPOSABLE CIRCUIT for HFNC*

87. * P/N 5291 or P/N 5292, NIV breathing circuit, compatible with F&PMR850 humidifier
CONNECT the special adaptor (included in the blister) for nasal cannula
onto the breathing circuit.
If necessary, even the extension tube (prepared also for inhaled NO) can be added.
ASSEMBLY of NIV DISPOSABLE CIRCUIT for HFNC*

88. * Nasal cannulas are available in different sizes, S, M, L:
P/N 5303 for preemies (S)
P/N 5304 for neonates (M)
P/N 5305 for infants (L)
ASSEMBLY of NIV DISPOSABLE CIRCUIT for HFNC*

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

90. O2 Therapy as HHFNC
O2 Therapy with
fabian can be
achieved also as
HHFNC.
Exceeding 5 L/min the
therapist must
confirm for higher
values of Flow
(maximal 19 L/min).

91. READY FOR USE
Fabian is ready for use.
Before patient application, perform the device check.
Refer to the fabian Therapy evolution User Manual.

92. fabian Therapy
evolution