Aisys CS : User's Reference Manual
Aisys CS : User's Reference Manual
Aisys CS : User's Reference Manual
1 Introduction
5824841 i
Aisys CS²
3 Operation
ii 5824841
Table of Contents
5824841 iii
Aisys CS²
4 Preoperative checkout
5 Preoperative tests
iv 5824841
Table of Contents
6 Airway modules
Alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-2
Alarm priorities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7-2
Pausing alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-2
Cancelling audio pause . . . . . . . . . . . . . . . . . . . . . . . . . . 7-3
Display changes during alarms . . . . . . . . . . . . . . . . . . . . 7-3
De-escalating alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . .7-3
Battery indicator . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7-3
Internal failure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-4
Informational tones . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-4
List of alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-5
Sustained pressure threshold . . . . . . . . . . . . . . . . . . . . 7-12
Alarm ranges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-14
Alarm tests . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7-16
Breathing system problems . . . . . . . . . . . . . . . . . . . . . . . . .7-18
Electrical problems . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-19
Pneumatic problems . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-20
5824841 v
Aisys CS²
9 User maintenance
vi 5824841
Table of Contents
10 Parts
5824841 vii
Aisys CS²
viii 5824841
Table of Contents
5824841 ix
Aisys CS²
13 Vaporizer cassettes
Vaporizer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13-2
Aladin2 cassette variants . . . . . . . . . . . . . . . . . . . . . . . 13-2
Changing a cassette during a case . . . . . . . . . . . . . . . . . . .13-5
Removing a cassette . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13-6
Installing a cassette . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13-7
Cassette maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13-8
Cleaning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13-8
Draining cassettes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13-8
Draining halothane cassettes . . . . . . . . . . . . . . . . . . . . 13-9
Filling Aladin2 cassettes . . . . . . . . . . . . . . . . . . . . . . . . . . 13-10
Filling with Easy-Fil system or SAFE-T-SEAL adapter
system . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13-10
Filling with Quik-Fil, SAFE-T-SEAL, or Piramal Fill
system . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13-12
Filling with SAFE-FIL bottle . . . . . . . . . . . . . . . . . . . . .13-13
Index
x 5824841
1 Introduction
Introduction
5824841 1-1
Aisys CS²
Intended use
The Aisys CS2 is scalable, flexible, and functionally integrated,
featuring the most advanced design, ventilation, respiratory
monitoring, and breathing system. Module bays allow for the physical
integration of legacy Datex-Ohmeda patient monitors and supports
mounting of other GE Healthcare monitors. Optionally, the open
architecture design supports mounting of non-Datex-Ohmeda patient
monitors, record keeping, and connections to the hospital information
system. The INview movable display arm helps keep the
anesthetist’s focus on the patient by offering control of all
hemodynamic, gas delivery, anesthetic agent, and ventilation
parameters.
This anesthesia system is designed for mixing and delivering
inhalation anesthetics, Air, O2, and N2O.
The anesthesia system’s small breathing system volume allows an
anesthetic agent delivery response time of less than 7 seconds.
(Agent response time defined as achieving 90% of the setting
change measured while in non-circle circuit with a 2 l/min fresh gas
flow.)
This anesthesia system uses SmartVent ventilation technology
offering Volume Control Ventilation with tidal volume compensation
and electronic PEEP. The proven SmartVent technology also
features optional Pressure Control Ventilation, Pressure Support
Ventilation with an Apnea Backup (PSVPro™) that is used for
spontaneously breathing patients, Synchronized Intermittent
Mandatory Ventilation (SIMV) modes, Pressure Control Ventilation-
Volume Guarantee (PCV-VG), Continuous Positive Airway Pressure
+ Pressure Support Ventilation (CPAP + PSV), and VCV Cardiac
Bypass. In Volume Control Ventilation, a patient can be ventilated
using a minimal tidal volume of 20 ml. In Pressure Control
Ventilation, volumes as low as 5 ml can be measured. These
advanced features allow for the ventilation of a broad patient range.
General information
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1 Introduction
5824841 1-3
Aisys CS²
AB.75.253
Serial numbers
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1 Introduction
AAAX11111 AAAXX111111AA
The X represents an alpha character The XX represents a number
indicating the year the product was indicating the year the product was
manufactured; H = 2004, J = 2005, manufactured; 04 = 2004, 05 = 2005,
etc. I and O are not used. etc.
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Aisys CS²
Trademarks
Aisys, Carestation, CARESCAPE, D-fend, D-lite, PSVPro,
SmartVent, Easy-Fil, Aladin
These terms are trademarks of General Electric Company and its
subsidiaries.
All other brand names or product names used in this manual are
trademarks or registered trademarks of their respective holders.
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1 Introduction
Air Air
Maximum Vacuum
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Aisys CS²
Lock Unlock
Systems with this mark agree with the Authorized representative in the
European Council Directive (93/42/ European Community
EEC) for Medical Devices when they
are used as specified in their User’s
Reference manuals. The xxxx is the
certification number of the Notified
Body used by Datex-Ohmeda’s Quality
Systems.
Date of manufacture Manufacturer
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1 Introduction
5824841 1-9
Aisys CS²
Pediatric Adult
Pipeline Cylinder
Test indicator: red for failure, yellow for Alarm low and alarm high limit indicator
conditional outcome, and green for
pass.
Network device okay Network device error
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1 Introduction
5824841 1-11
Aisys CS²
Abbreviations
Abbreviation Definition
A
AA Anesthetic agent
ABS Advanced breathing system
ACGO Auxiliary common gas outlet
AGSS Anesthesia gas scavenging system
Alt O2 Alternate O2
APL Adjustable pressure-limiting
APN Apnea
ATPD Ambient temperature and pressure, dry humidity
conditions
B
BTPS Body temperature, ambient pressure, saturated humidity
conditions
C
CGO Common gas outlet
CO Carbon monoxide
CO2 Carbon dioxide
Compl Compliance
CPAP + PSV Continuous positive airway pressure + pressure support
ventilation
E
EMC Electromagnetic Compatibility
ET End-tidal concentration
EtCO2 End-tidal carbon dioxide
EtO2 End-tidal oxygen
Exp Expiratory
F
FI Fraction of inspired gas
FiCO2 Fraction of inspired carbon dioxide
FiO2 Fraction of inspired oxygen
Flow-Vol Flow-volume loop
I
I:E Inspiratory-expiratory ratio
Insp Inspiratory
Insp Pause Inspiratory pause time
K
kg Kilogram
M
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1 Introduction
Abbreviation Definition
MAC Minimum alveolar concentration
MV Minute volume
MVexp Expired minute volume
MVinsp Inspired minute volume
N
N2 Nitrogen
N2O Nitrous oxide
O
O2 Oxygen
P
Paw Airway pressure
PCV Pressure control ventilation
PCV-VG Pressure control ventilation - volume guaranteed
PEEP Positive end expiratory pressure
Paw-Flow Pressure-flow loop
Pinsp Inspiratory pressure
Pmax Maximum pressure
Pmean Mean pressure
Ppeak Peak pressure
Pplat Plateau pressure
Psupport Support pressure
PSV Pressure support ventilation
PSVPro Pressure support ventilation with apnea backup
Paw-Vol Pressure-volume loop
R
Raw Airway resistance
RF Radio frequency
RR Respiratory rate
S
SIMV PCV Synchronized intermittent mandatory ventilation -
pressure control ventilation
SIMV PCV-VG Synchronized intermittent mandatory ventilation -
pressure control ventilation - volume guaranteed
SIMV VCV Synchronized intermittent mandatory ventilation - volume
control ventilation
T
Texp Expiratory time
Tinsp Inspiratory time
Tpause Time where breath is paused with no flow
TV Tidal volume
TVexp Expired tidal volume
TVinsp Inspired tidal volume
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Aisys CS²
Abbreviation Definition
V
VCV Volume control ventilation
Vol Volume
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1 Introduction
System information
System classification
• Class I Equipment.
• Type B Equipment.
• Type BF Equipment (airway modules).
• Ordinary Equipment.
• Not for use with flammable anesthetics.
• Continuous operation.
Devices used with this anesthesia system shall comply with the
following standards where applicable:
Devices used with this anesthesia system shall comply with the
following standards where applicable:
5824841 1-15
Aisys CS²
• CO2 monitor.
• Anesthetic agent monitor.
• O2 monitor (when O2 cell is not installed).
• Suction regulator.
• EZchange canister system.
• Condenser.
System accessories
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1 Introduction
System safety
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Aisys CS²
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1 Introduction
Electrical safety
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Aisys CS²
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2 System controls and menus
5824841 2-1
Aisys CS²
System overview
15
14
13
2
3
12 4
5
6
7
8
11
10
AB.75.251
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2 System controls and menus
1
2
6
7
AB.75.255
12 8
10 9
11
1. Network connections 7. Pipeline connections
2. Serial port 8. Mains inlet
3. Collection bottle connection 9. System circuit breaker
4. Cylinder wrench (key) storage 10. Equipotential stud
5. Cylinder yoke 11. Outlet circuit breaker
6. Anesthesia Gas Scavenging System 12. Isolated electrical outlet
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Aisys CS²
AC.22.009
1. Push down on the brake pedal to lock the system in place.
2. Lift up on the brake pedal to release the brake.
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2 System controls and menus
6. Tilt the display left or right to adjust the horizontal angle of the
display.
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Aisys CS²
13
12
11
10
1
2
9
8
7
6 3
4
AB.75.252
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2 System controls and menus
2
3
AB.75.254
7
Use the optional bag support arm to hold the breathing circuit bag.
AB.82.023
1. To raise the bag support arm, squeeze the button and rotate the
arm up to the top position.
2. To lower the bag support arm, squeeze the button and rotate the
arm down to the lower position.
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Aisys CS²
AB.60.038
4 3
2-8 5824841
2 System controls and menus
Display controls
The system uses touchscreen technology, hard keys, and a
ComWheel to access system functions, menus, and settings.
AC.22.001
6 5 4 3 2 1
1. ComWheel Selects a menu item or confirms a setting. Turn clockwise or counterclockwise
to scroll through menu items or change settings.
2. Home key Removes all menus from the screen.
3. Screen Lock/Unlock key Locks the touchscreen. Toggles between lock and unlock functions.
4. Start/End Case key Initiates Start or End Case function.
5. Touchscreen Activates functions when touch areas on the screen are selected.
6. Audio Pause key Stops audio for 120 seconds for any active, eligible high and medium priority
alarms. Prevents audio (audio off) for 90 seconds when no medium or high
priority alarms are active. Allows the operator to acknowledge any non-active
medium or high priority latched alarms.
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Aisys CS²
Touch points
The touchscreen has touch point areas for quick access to menus
and settings. The function keys on the right side of the screen
provide direct access to commonly used menus and settings. The
ventilator quick keys provide access to the ventilation modes and
settings. The gas quick keys provide access to the gas settings used
during a case.
Touch only one touch point at a time to make sure the correct
selection is made.
1 2
3
7
4
AB.75.256
6 5
1. Wave fields 5. Ventilator quick keys
2. Measured values 6. Gas quick keys
3. Function keys 7. Split screen values
4. Digit fields
Figure 2-7 • Normal/Full screen view with shaded touch point areas
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2 System controls and menus
5824841 2-11
Aisys CS²
1 2 3 4 5 6
12 7
8
9
AB.75.258
11 10
1. Audio pause symbol and Indicates when alarm audio is paused and the countdown clock until audio is
countdown clock on.
2. Alarm message fields Displays the active alarms.
3. Waveform fields Displays the waveforms of measured values. For example: Paw, Flow, and
CO2.
4. General message fields or lock Displays general messages and the touchscreen lock indicator.
touchscreen indicator
5. Measured values fields Displays the measured values. For example: Paw, Flow, and CO2.
6. Clock Displays the current time.
7. Function keys Functions available are: Audio Pause, Alarm Setup, Alarms On/Off, Auto
Limits, System Setup, Next Page, Trends, Spirometry, Procedures, Timer,
Start, and End Case.
8. Digit fields Contains information for Loops, Resp, Agent, Gas Supplies, Flow, and Gases.
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2 System controls and menus
9. Ventilation mode Displays the selected ventilation mode. For example: Ventilator On and Volume
Control.
10. Ventilator quick keys Displays set or preset (in brackets) Mode, associated ventilation parameters,
and More Settings. For example: Mode, TV, RR, I:E, PEEP and More Settings.
11. Gas quick keys Displays set or preset (in brackets) O2, Total Flow, Agent, and Gas Setup.
12. Split screen Contains airway pressure, gas flow values, compliance, trends, spirometry and
optional ecoFLOW information.
Digit fields
The digit field can be set to show specific information such as gas
types, gas supply, flow, agent, respiration, and spirometry loops. If
the digit field is set to show agent and no airway module is inserted,
the area is blank.
Paw, O2, and either TVexp or CO2 must show on the display during
a case. If any of these parameters are not selected to show on the
display, the right most digit field information is replaced with the
missing parameter.
Waveform fields
The split screen field can be set to show gas metabolics, trends,
spirometry loops, Paw gauge, airway compliance, and optional
5824841 2-13
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2-14 5824841
2 System controls and menus
Display navigation
Use the touchscreen and ComWheel to navigate the display.
Using menus
5824841 2-15
Aisys CS²
Use the ComWheel to scroll through the quick key settings and
function keys, make selections, change settings, and confirm
settings.
The gas settings and the main ventilator settings for each ventilation
mode can be changed using the quick keys.
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2 System controls and menus
5824841 2-17
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3 Operation
Operation
5824841 3-1
Aisys CS²
3-2 5824841
3 Operation
5824841 3-3
Aisys CS²
3-4 5824841
3 Operation
1. Plug the power cord into an electrical outlet. Make sure the
system circuit breaker is on.
AB.91.044
1. System switch
2. Mains indicator
Note The system must perform a power-up self test after 12 hours of
remaining on. If the system has been on longer than 12 hours
without a power-up self test, the ‘Turn power Off and On for self
tests’ alarm occurs. Turn the power off and then back on between
cases to resolve the alarm.
5824841 3-5
Aisys CS²
Start a case
Use the Start Case menu to access the tabs for Anesthesia,
Patient/ Case ID, and Monitoring Only.
A case can be started using default settings or using custom
settings. The Case Defaults setting is linked on the Anesthesia tab
and the Monitoring Only tab. The default settings are configured by
the Super User. See the "Super user mode" section for information
on the menu defaults.
The CO2 Alarms is On by default.
The Age and Ideal Weight values are exchanged when the system
has a direct network connection to a Sapphire client. The Network
device okay symbol shows when the patient data is received from a
Sapphire client for these values. A message shows when the patient
data is received from the Sapphire client.
The Volume Apnea Alarm, Age, and Ideal Weight values are set to
the pre-selected settings defined by the Super User corresponding to
the case type if the system is not connected to a network.
Note The TV for Ideal Body Weight menu item from the Patient
Demographics menu can only be accessed when the ventilation
mode is set to VCV, PCV-VG, SIMV VCV, and SIMV PCV-VG. Use
this setting for breath rate and tidal volume calculations based on the
set patient weight.
3-6 5824841
3 Operation
on the Eger formula. When two agents are detected, the MAC values
of each agent are added together. The MAC value range is 0.0 to
9.9.
The adjusted MAC value shows on several areas of the screen
including in the agent waveform numeric information, agent digit
field, and graphical trends page. MAC value does not show when
two agents are detected.
Start anesthesia
5824841 3-7
Aisys CS²
See the "Ventilator setup" section for information on the Vent Mode
menu.
See the "Gas setup" section for information on the Gas Setup menu.
See the "Alarm setup" section for information on the Alarm Setup
menu.
Patient/Case ID
Change or view patient data in the Patient/ Case ID tab. The patient
data includes Medical Record Number, Case ID, First Name, Last
Name, and Location. The system assigns a unique Medical Record
Number for each case by default. All the patient data except Case
ID value is exchanged when the system has a direct network
connection to a Sapphire client. Access to this tab is controlled
through the Super User settings.
Note A message shows when patient data is received from the Sapphire
client patient demographics exchange.
3-8 5824841
3 Operation
5824841 3-9
Aisys CS²
End a case
Use the End Case menu to stop gas flow and end the patient
alarms. The amount of gas used and agent used during the case
shows in the menu.
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3 Operation
5824841 3-11
Aisys CS²
Ventilator setup
Use the Vent Mode menu to set the ventilation mode. Use ventilator
quick keys and More Settings to change ventilator settings.
1. Select the Mode quick key. The Vent Mode menu shows.
2. Select the desired ventilation mode.
3. Set and confirm the primary ventilation setting to activate the
ventilation mode.
Controls that are frequently used in the ventilation mode can be
adjusted with the ventilator quick keys and the More Settings
quick key.
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3 Operation
Auto limits
Use the Auto Limits menu to quickly set alarm ranges for ‘MV’, ‘TV’,
and ‘EtCO2’ during mechanical ventilation.
Note The proposed low and high alarm limits are shown in highlighted
text. The alarm limits that are not highlighted do not change.
5824841 3-13
Aisys CS²
Gas setup
Use the Gas Setup menu to adjust the agent, O2% and total flow, to
change the balance gas, and to change the circuit type. If ecoFlow is
enabled, minimum O2 marker can be set.
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3 Operation
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Aisys CS²
3-16 5824841
3 Operation
System setup
Use System Setup to access menus and settings for Patient
Demographics, Screen Setup, Fresh Gas Usage, System Status,
Calibration, and Checkout History.
See the "User maintenance" section for information on the
Calibration menu item.
Patient demographics
5824841 3-17
Aisys CS²
Use the Screen Setup menus to customize the screen view. Areas
of the screen can be customized to show specific information.
Waveform fields and the split screen view cannot be changed while
in Monitoring Only.
Screen Setup contains the Layout, Scales, Time and Date, and
More Settings submenus.
3-18 5824841
3 Operation
Note Resistance (Raw) shows in the airway compliance split screen when
the system detects an airway module with spirometry and the
module has completed a warm-up phase.
Note The Time and Date menu cannot be changed when a case is
running.
4. Select Close.
5824841 3-19
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3-20 5824841
3 Operation
Note Both O2% and Flow are available if User is selected by the Super
User. If User is not selected by the Super User, either O2% or Flow
will be unavailable.
Use Fresh Gas Usage to view the volume of O2, Air, N2O, and
agents used for the three most recent cases.
• Data only shows for gases available on the system.
• Agent data shows the three most recently used agents.
System status
5824841 3-21
Aisys CS²
the airway gas module basis setting, and the airway module
configuration.
• Select Network to see the system network status.
• Select Log Transfer to view the log transfer configuration
information, to see the set log transfer time, or to manually
transfer the service log files. If a case is in progress during the
set transfer time, the transfer occurs when the case ends. If the
transfer is in progress when a case is started, the transfer stops
and does not complete.
• Select Clock Sync. to view the clock synchronization method if
configured. Clock synchronization is disabled during a case and
will occur outside of a case.
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3 Operation
Alarm setup
Use the Alarm Setup menu to set and adjust alarm limits, alarm
volume, and other alarm settings and to view alarm history. The
Alarm Setup menu contains the Primary Limits, More Limits,
Alarm History, and Configure tabs.
Use the CO2 Alarms setting to turn off the CO2 ‘Apnea’ alarm,
‘EtCO2 low’, ‘EtCO2 high’, and ‘FiCO2 high. Absorbent OK?’ alarms
during manual ventilation.
CO2 information is obtained from the airway module installed in the
anesthesia system module bay. The CO2 alarms setting has no
effect if there is no airway module in the anesthesia system.
Use the Vol Apnea Alarm setting to turn off the volume apnea alarm
during manual ventilation. The volume apnea alarm remains off until
the Bag/Vent switch is set to Vent or Vol Apnea Alarm is set to On.
Note Vol Apnea Alarm does not show on the Alarm Setup menu when
the Volume Apnea Selection has been disabled by the Super User.
See the "Super user mode" section for more information.
5824841 3-23
Aisys CS²
3. To turn the volume apnea alarms on, set Vol Apnea Alarm to
On.
4. Select Close.
Use the MV/TV Alarms setting to turn off the MV and TV alarms.
Settings made during manual ventilation are not retained when
mechanical ventilation starts. Settings made during mechanical
ventilation are retained when manual ventilation starts.
For example, if MV/TV Alarms is set to Off during manual
ventilation, the alarms remain off until the Bag/Vent switch is set to
Vent or the MV/TV Alarms is set to On.
For example, if the MV/TV Alarms is set to Off during mechanical
ventilation, the alarms remain off when manual ventilation starts.
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3 Operation
Use the Alarm History tab to view the list of the 12 most recent high
and medium priority alarms that occurred since the start of the case.
The alarm history clears at the start of a new case.
Use the Apnea Delay setting to set the desired apnea time delay.
The apnea time delay is the amount of time that can pass without the
system detecting a measured breath before the apnea alarm occurs.
4. Select Close.
5824841 3-25
Aisys CS²
Use the Leak Audio setting to silence audio alarms of small leaks.
Setting Leak Audio to Off silences audio alarms for small leaks.
Leak Audio is automatically set to On and cannot be changed when
either the Low MV alarm limits are off or the MV/TV Alarms is set to
Off.
Note If the Low MV alarm limits are off or MV/TV Alarms is set to Off,
Leak Audio is automatically set to On and cannot be changed.
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3 Operation
Use Change to Default Limits to set alarm limits to the values set
by the Super User.
Selecting Change to Default Limits loads the default settings as set
by the Super User or the factory defaults if no Super User settings
have been entered.
5824841 3-27
Aisys CS²
Alarms On/Off
Use the Alarms On/Off menu to turn On or turn Off the CO2 Alarms
Limits and MV/TV Alarm Limits during manual ventilation. Alarm
limits are enabled at the start of mechanical ventilation.
Note The CO2 ‘Apnea’ alarm cannot be turned off through the Alarms
On/Off menu. Only the ‘EtCO2’ and ‘FiCO2’ alarms are turned off
using this menu.
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3 Operation
Next page
Select Next Page to change the screen view. A default view and four
configurable screen views are available. A general message displays
identifying the page number of the screen view.
See the "Super user mode" section for information on setting the
preset screen views.
Note Any changes that were made to the screen layout are replaced with
the selected preset screen view.
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Aisys CS²
Trends
Use the Trends menu to view patient trends and set the time scale.
There are three views for patient trends: measured (numerical),
settings, and graphical. Trend information is saved every 15 seconds
for the most recent 24 hours.
Setting trends
1. Select Trends.
2. Select the desired view.
3. Select Scroll to move through the current trend view.
4. Select Time Scale to select the desired scale from the drop-
down menu.
5. Select Next Page to view additional parameters.
6. Select Close.
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3 Operation
Spirometry
Use the Spirometry menu to:
AB.98.039
1. Volume axis
2. Pressure axis
3. Real-time loop
4. Reference loop (appears on display in gray)
1. Select Spirometry.
2. Select Loop Type and select the loop from the drop-down list.
3. Select Close.
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Aisys CS²
Patient and sensor type refer to the style of airway adapter used with
the airway module. If spirometry data is obtained from the airway
module, make sure that the sensor type matches the type of airway
adapter used. Adult or pediatric patient types are available.
WARNING Make sure that the set sensor type corresponds to the
type of airway adapter in use. If the sensor type is not set
correctly, the information displayed may not be accurate.
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3 Operation
1. Select Spirometry.
2. To store a loop to memory, select Save Loop. Up to six loops
can be saved.
3. To view a saved loop, set Show Ref. Loop to the time at which
it was saved.
4. To delete a saved loop, set Delete Ref. Loop to the time at
which it was saved.
5. Select Close.
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Procedures
Use the Procedures menu to pause the gas flow, start cardiac
bypass, perform or change settings for a vital capacity procedure,
perform or change the settings for a cycling procedure, or to start
Monitoring Only.
Note Vital Capacity shows in the menu if it is set to Yes by the Super
User. Vital Capacity is only selectable during mechanical ventilation.
Note Cycling shows in the menu if it is set to Yes by the Super User.
Cycling is only selectable during mechanical ventilation.
Use Pause Gas Flow to temporarily suspend the flow of gas during
a case. Using Pause Gas Flow while the breathing circuit is
disconnected prevents the flow of gas into the room. Pause Gas
Flow is available during both mechanical ventilation and manual
ventilation.
1. Select Procedures.
2. Select Pause Gas Flow.
The amount of time remaining in the gas flow pause shows in
the window.
Gas flow stops for 1 minute and automatically resumes after 1
minute.
If mechanical ventilation is on, mechanical ventilation stops for 1
minute and then automatically resumes after 1 minute.
3. Resume the flow of gas at any time during the pause by
selecting Restart Gas Flow.
Cardiac bypass
3-34 5824841
3 Operation
Note PEEP and TV settings can be changed after entering cardiac bypass
mode.
4. Select Close.
Vital capacity
5824841 3-35
Aisys CS²
The Pressure Hold, Hold Time, and PEEP on Exit settings can be
preset by the Super User. These settings can be changed by the
user before starting the procedure.
Note There is a limited amount of gas in the bellows. Patients with a high
compliance may need an increase of fresh gas flow during the
procedure. When adjusting the fresh gas flow, O2 and agent
concentration changes could be needed in order to deliver the
desired concentrations to the patient.
Cycling
3-36 5824841
3 Operation
Note There is a limited amount of gas in the bellows. Patients with a high
compliance may need an increase of fresh gas flow during the
procedure. When adjusting the fresh gas flow, O2 and agent
concentration changes could be needed in order to deliver the
desired concentrations to the patient.
Using cycling
1. Select Procedures.
2. Select Cycling.
3. Select a Procedure to perform.
4. Select Start Cycling.
The procedure begins.
Procedure progress shows in the procedure window.
5. Stop the procedure anytime by selecting Stop Cycling.
6. Select Close.
Monitoring only
1. Select Procedures.
2. Select Monitoring Only.
3. Set the Bag/Vent switch to Bag.
4. Connect the patient to the auxiliary O2 outlet.
5. Connect the gas monitor sample line to the patient connection.
6. Select Confirm.
Fresh gas, agent delivery, and ventilation are not available.
5824841 3-37
Aisys CS²
3-38 5824841
3 Operation
Timer function
Use Start as a timer function. When selected a clock will display
counting up from zero.
5824841 3-39
Aisys CS²
ecoFLOW
The ecoFLOW split screen view shows the approximate minimum
O2 flow needed to maintain a preset inspired O2 concentration. The
flow scale changes based on the flow value. The approximate
amount of agent used per hour and the cost also shows.
The ecoFLOW is available when an airway module is installed and
the system is delivering mechanical ventilation.
40
20 60
0 80
-20 100
15 21.91 2
9
3
100
9 2
8
10
1
7
O2 Total Iso
6 3
1.30 4
AC.22.041
Fi25 O2 flow
5 0.60
4
1. Agent Shows Agent cost and flow information.
2. Agent cost The cost per hour of the current agent flow. This value is determined by the agent flow
multiplied by the agent cost set in Super user mode.
3. Agent flow The measured value of the liquid agent flow from the vaporizer. The agent flow may have
a delayed response. For example: Iso.
4. Minimum O2 marker The graphical representation on the flow tube of the FiO2 flow required to maintain the
minimum O2%. This marker can be removed by disabling it in Super user mode.
5. FiO2 flow The minimum O2 flow needed to maintain the set inspired O2 flow. This item can be
disabled in Super user mode. For example: Fi25 O2 flow.
6. O2 total (numeric) The numeric representation of the total O2 flow. If N2O is the balance gas, this equals the
set O2 flow. If Air is the balance gas, this is the set O2 flow plus 21% of the Air flow. For
example: O2 Total.
7. O2 total (graphical) The graphical representation of the total O2 flow. If N2O is the balance gas, this equals
the set O2 flow. If Air is the balance gas, this is the set O2 flow plus 21% of the Air flow.
8. Remaining gas flow If N2O is the balance gas, this equals the set N2O flow. If Air is the balance gas, N2 is
79% of the Air flow.
9. Flow bobbin The height of this represents the total fresh gas flow delivered to the breathing system.
3-40 5824841
3 Operation
Using ecoFLOW
5824841 3-41
Aisys CS²
Alternate O2 control
2
AB.91.077
1. ON/OFF button
2. Flow control
3. Flow tube
3-42 5824841
3 Operation
5824841 3-43
Aisys CS²
AB.82.042
Figure 3-5 • EZchange canister holder label
1
AC.22p.010
1. Side rails
3-44 5824841
3 Operation
Note Make sure that the absorber canister has side rails. If the canister
does not have side rails, it will not work in the EZchange canister
holder.
5824841 3-45
Aisys CS²
Condenser
Use the optional condenser to remove water in the system that is
produced from the reaction of CO2 gas with the absorbent. The
condenser is connected between the outlet of the absorber canister
and the inlet of the circuit module. Moisture in the gas is condensed
into water droplets, which run into the condenser’s reservoir.
AB.82.043
2 1
1. Drain button
2. Reservoir
3. Condenser
3-46 5824841
3 Operation
5824841 3-47
Aisys CS²
AC.20.027
Figure 3-8 • ACGO switch position
WARNING The Bag/Vent switch and the APL valve do not control
the ACGO or any breathing circuit connected to the
AGCO. Do not use these controls when using a breathing
circuit with fresh gas from the ACGO. Patient injury may
occur.
• Volume and pressure monitoring are not available
through the system when using the ACGO port. Monitor
the patient using other methods.
• Do not use an external ventilator on the ACGO. Do not
use the ACGO to drive external ventilators or for jet
ventilation.
• The maximum pressure at the ACGO can be up to 55
kPa (8 psi). Use a breathing circuit with a pressure
limiting device to limit the pressure at the patient
connection port, during normal and single-fault
3-48 5824841
3 Operation
Note A sample of the fresh gas is diverted to the O2 cell in the breathing
system. The sample flow to the O2 cell is dependent on the pressure
in the external circuit. The sample flow reduces the fresh gas flow
rate to the auxiliary breathing circuit equal to the amount diverted to
the O2 cell.
5824841 3-49
3-50 5824841
4 Preoperative checkout
Preoperative checkout
5824841 4-1
Aisys CS²
□ Turn the system circuit breaker off and check that mechanical
ventilation continues while the system is running on battery
power. After completing the check, turn the system circuit
breaker on. The mains indicator is lit when AC power is
connected.
□ Set the appropriate controls and alarm limits for the case.
4-2 5824841
4 Preoperative checkout
Note This check does not need to be done before the first case of the day
if the "Every day before your first patient" checklist was done.
□ Set the appropriate controls and alarm limits for the case.
5824841 4-3
4-4 5824841
5 Preoperative tests
Preoperative tests
5824841 5-1
Aisys CS²
1. Using the liquid level indicator, check that the cassette is filled to
the appropriate level.
2. If using Aladin2, unlock the cassette handle before installing it
into the active bay.
3. Insert the cassette into the active bay until a click is heard. An
audible click indicates that the cassette is in position.
4. Turn the lock on the handle to the horizontal position (Aladin2
cassettes only).
5. The cassette is properly inserted when the agent is identified on
the display. Make sure that the displayed agent matches the
cassette.
Note Store the cassettes in the cassette storage bay when they are not in
use. See the "Vaporizer cassettes" section for additional cassette
information.
5-2 5824841
5 Preoperative tests
Important Room temperature fluctuations of more than 5°C may affect sensor
measurements. Recalibrate the flow sensors if the room temperature
changes by more than 5°C.
Calibrate the flow sensors by removing the flow sensor module from
the system. On-screen instructions are available through System
Setup - Calibration - Flow and Pressure.
5824841 5-3
Aisys CS²
WARNING Perform a Vent and Gas test after changing the patient
tube type. Changing the patient breathing circuit after
completing a Vent and Gas test affects the volume
measurements in all modes.
5-4 5824841
5 Preoperative tests
Checkout menu
The Checkout menu shows on the display after turning on the
system. To access the Checkout menu between cases, select
Checkout. Step-by-step instructions show in the Checkout menu
during the tests. Use the Checkout menu to:
• Perform a Full Test.
• Perform any of the individual tests.
• View the Test Log.
• Start a case.
5824841 5-5
Aisys CS²
Full test
The Full Test or the individual tests must be performed at least once
within every 24-hour period.
Perform the Full Test at the start of each day. The full test runs
automatically and beeps to indicate when it is finished or if
interaction is required.
Perform a Full Test when any component of the system is changed
(breathing system, vaporizers, pipeline inlets).
The Full Test does the following tests: Vent and Gas, Circuit Leak,
and Circuit O2 Cell (if circuit O2 cell is present). When one of the
tests is completed, the next test begins.
1. From the Checkout menu, select Full Test and follow the
instructions.
2. If a test fails, follow the instructions to perform a retest or accept
the results.
3. When the Full Test is completed, start a case.
Note Any cassette may be used during the test. Use a non-desflurane
cassette during the test to check the full functionality of the internal
electronic control unit.
Circuit leak
The Circuit Leak test checks the Bag/Vent switch, proper gas supply
pressures, airway pressure measurement transducer, APL valve,
and manual circuit leak.
To run this test, follow the on-screen instructions. When the test
passes, the next test starts.
5-6 5824841
5 Preoperative tests
Circuit O2 cell
When External Gas Monitor is set to Yes by the Super User, the
External Gas Monitor reminder occurs. This is not a test. This is a
reminder to connect a respiratory gas monitor.
5824841 5-7
Aisys CS²
Individual tests
The Full Test or all of the individual tests must be completed with
passing results at least once within every 24-hour period.
Individual tests allow the user to perform any combination of single
tests. These tests are helpful if there is a specific problem/alarm and
the user wishes to test only that portion of the system.
The tests do not automatically move on to the next test. After
completing a test, do another or start a case. If a test fails, follow the
instructions to perform a recheck or accept the results.
Note Any cassette may be used during the test. Use a non-desflurane
cassette during the test to check the full functionality of the internal
electronic control unit.
Circuit leak
The Circuit Leak test checks the Bag/Vent switch, proper gas supply
pressures, airway pressure measurement transducer, APL valve,
and manual circuit leak.
To run this test, follow the on-screen instructions.
Circuit O2 cell
Low P leak
5-8 5824841
5 Preoperative tests
Note Any cassette may be used during the check. Using a desflurane
cassette only checks for leaks between the vaporizer and common
gas outlet.
Agent delivery
The agent delivery test checks the agent delivery systems and the
cassette. This check releases agent to the circuit.
Note Any cassette may be used during the test. Use a non-desflurane
cassette during the test to check the full functionality of the internal
electronic control unit.
5824841 5-9
Aisys CS²
Note For ACGO machines, perform either a negative Low P Leak test or
a positive low-pressure leak test depending on local requirements.
1. Connect the leak test device to the ACGO port with the positive-
pressure leak test adapter. Push the adapter into the ACGO port
throughout the test to get a good seal.
2. Fully open the needle valve on the test device. Keep the test
device flow tube vertical for accurate results.
CAUTION If the needle valve is not fully open, this test can damage
the pressure gauge on the test device.
3. Turn the ACGO switch to the ACGO position.
4. Set the O2 flow to 500 ml.
5. Make sure that the total flow through the flowmeter on the test
device is 0.5 l/min.
6. Make sure that the pressure gauge on the test device reads
zero.
7. Close the needle valve on the test device until the test gauge
reads 20 kPa (3 psi) (BSI) or 3 kPa (0.4 psi) (ISO).
8. If the flow through the test device is less than 0.45 l/min (ISO) or
0.4 l/min (BSI), there is a low pressure leak in the anesthesia
machine. See the "Alarms and troubleshooting" section for more
information.
9. Remove the adapter and leak test device.
10. Set the O2 flow to 1 l/min and continue flow for one minute to
flush out any residual agent.
WARNING Agent mixtures from the low-pressure leak test stay in the
system. Always flush the system with O2 after the low-
pressure leak test (1 l/min for at least one minute).
5-10 5824841
6 Airway modules
Airway modules
5824841 6-1
Aisys CS²
Airway modules
The optional airway modules measure and monitor gases delivered
to the patient and exhaled through the breathing circuit. The modules
consist of:
Systems with both an airway module and an O2 cell will display the
patient inspired O2 value obtained from the airway module.
Respiratory rate is the frequency of peak (end tidal) CO2
measurements per minute. A breath is defined as a change in the
CO2 signal that exceeds 1% (8 mmHg). All concentrations are
measured and displayed breath by breath.
Use only airway modules that have anesthetic agent monitoring and
O2 monitoring on this system. The following modules can be used on
this system:
Note The ventilator can be set to automatically compensate for the gas
module sample flow. See section "Ventilator settings" in "Super user
mode" for more information.
Note The gas module sample flow can be configured to return to the
breathing system or to go to scavenging. Check the configuration of
the airway module through the System Status menu. Contact an
authorized service representative to change the configuration.
6-2 5824841
6 Airway modules
1
2
3
4
MD.60.013
5824841 6-3
Aisys CS²
3
AC.22.010
1. Airway module
2. Gas sampling line
3. Airway adapter with sampling line connector
6-4 5824841
6 Airway modules
Data source
Several monitoring parameters can be obtained from the ventilator or
the airway module. Information retrieved from the airway module is
identified with the module data indicator.
Set the Data Source to Patient or Vent to select the primary source
for information. If Patient is selected, the airway module will be the
first source for information. If Vent is selected, the internal sensors of
the ventilator will be the first source for information.
When setting the airway module as the data source, make sure that
a D-lite™ or Pedi-lite sensor is properly connected on the airway
module. If the sensor is not properly connected, but the airway
module is installed, the waveform shows no flow. The gas monitor
samples and displays room air.
If information is not available through the airway module, information
comes from the internal ventilator sensors.
5824841 6-5
Aisys CS²
6-6 5824841
6 Airway modules
5824841 6-7
Aisys CS²
6-8 5824841
7 Alarms and troubleshooting
5824841 7-1
Aisys CS²
Alarms
Alarms may be high priority, medium priority, or low priority. When an
alarm occurs during a case, an alarm tone sounds and the alarm
message is displayed in the alarm message field. The system
checks for alarm conditions at 1 second intervals. The alarm tone is
from 47 to 78 db(A) depending on the alarm volume setting.
Alarm priorities
Alarm priority is indicated by the color of the alarm message and the
audio sequence.
Pausing alarms
Selecting Audio Pause for an active alarm stops the audible tone for
120 seconds. The alarm message shows in the alarm message field.
Selecting Audio Pause when no medium or high priority alarms are
active prevents the audible alarm tones (audio off) for 90 seconds.
Alarms in the apnea alarm family have special silence behavior to
reduce apnea nuisance alarms. Apnea family alarms include
‘Apnea’, ‘EtCO2 low’, ‘MVexp low’, ‘RR low’, and ‘TVexp low’.
When pausing an apnea family alarm, the audio tone for the active
alarm is paused for 120 seconds. The audible tone for any additional
apnea family alarm that occurs during the audio paused period is
silenced for the remaining time shown on the audio pause
countdown. Only the audible alarm tone is silenced. The alarm
messages still show in the alarm message fields. ‘APN’ shows above
the audio pause countdown when the audible tone silence is in effect
for the apnea family alarms.
7-2 5824841
7 Alarms and troubleshooting
Selecting and holding Audio Pause for 2 seconds will cancel the
audio pause function.
De-escalating alarms
Some device related alarms, such as ‘No insp flow sensor’ will de-
escalate priority when the alarm is acknowledged by selecting Audio
Pause. The alarm message shows at the low-priority alarm level until
the alarm condition is resolved and the alarm is cleared. If that alarm
reoccurs after it has been resolved, the alarm occurs at its standard
priority level.
Battery indicator
The color and fill amount of the battery in use symbol indicates the
amount of battery power remaining.
5824841 7-3
Aisys CS²
Internal failure
Informational tones
7-4 5824841
7 Alarms and troubleshooting
List of alarms
If corrective action does not resolve the alarm message, contact an
authorized service representative.
Circuit pressures and volumetric flows are measured by the
ventilator and airway gas module. If the Data Source is set to
Patient the displayed waveforms and numeric information are
measured by the airway gas module. Although not displayed, the
ventilator measurements continue and if a measured value violates
an alarm setting, the appropriate alarm occurs. The value highlighted
in the parameter numeric box may not appear to have violated the
alarm setting. Changing the Data Source to Vent will display the
circuit pressures and volumetric flows measured by the ventilator.
.
5824841 7-5
Aisys CS²
7-6 5824841
7 Alarms and troubleshooting
5824841 7-7
Aisys CS²
7-8 5824841
7 Alarms and troubleshooting
5824841 7-9
Aisys CS²
7-10 5824841
7 Alarms and troubleshooting
5824841 7-11
Aisys CS²
Mechanical Ventilation with For Pmax less than 30 cmH2O, the sustained pressure limit is 6 cmH2O.
PEEP Off: For Pmax between 30 and 60 cmH2O, the sustained pressure limit is 20% of
Pmax.
For Pmax greater than 60 cmH2O, the sustained pressure limit is 12 cmH2O.
Mechanical Ventilation with For Pmax less than 30 cmH2O, the sustained pressure limit is 6 cmH2O plus “set
PEEP On: PEEP” minus 2 cmH2O.
For Pmax between 30 and 60 cmH2O, the sustained pressure limit is 20% of
Pmax plus “set PEEP” minus 2 cmH2O.
For Pmax greater than 60 cmH2O, the sustained pressure limit is 12 cmH2O plus
“set PEEP” minus 2 cmH2O.
7-12 5824841
7 Alarms and troubleshooting
Mechanical Ventilation Off: For Pmax between 12 and 60 cmH2O, the sustained pressure limit is 50% of
Pmax.
For Pmax greater than 60 cmH2O, the sustained pressure limit is 30 cmH2O.
5824841 7-13
Aisys CS²
Alarm ranges
The alarm names are listed in the Primary Limits and More Limits
tabs on the Alarm Setup menu. See the "Super user mode" section
for more information on the alarm default settings.
7-14 5824841
7 Alarms and troubleshooting
5824841 7-15
Aisys CS²
Alarm tests
Test the system to verify that alarms are functioning.
Note If an airway module is installed, the FiO2 readings are taken from the
module instead of from the O2 cell. A sample line must be connected
from the airway module to the breathing circuit to test the O2 alarms.
• Set the FiO2 Low alarm limit to 50%. Make sure an FiO2
low alarm occurs.
• Set the FiO2 Low alarm limit back to 21% and make sure
that the FiO2 low alarm cancels.
• Set the FiO2 High alarm limit to 50%.
• Push the O2 flush.
• Make sure the FiO2 high alarm occurs.
• Set the FiO2 High alarm limit back to 100%. Make sure that
the FiO2 high alarm cancels.
7-16 5824841
7 Alarms and troubleshooting
5824841 7-17
Aisys CS²
7-18 5824841
7 Alarms and troubleshooting
Electrical problems
5824841 7-19
Aisys CS²
Pneumatic problems
.
7-20 5824841
8 Setup and connections
5824841 8-1
Aisys CS²
Setup safety
8-2 5824841
8 Setup and connections
5824841 8-3
Aisys CS²
8-4 5824841
8 Setup and connections
6 1
5
2
AB.74p042
4
3
7
AB.74p.043
5824841 8-5
Aisys CS²
8-6 5824841
8 Setup and connections
Removing a canister
1. Hold the canister by the handle and push on the release latch to
unlock the canister.
AB.74p058
2. Remove the canister by tilting it downward and off the two
support pins.
1. Hold the canister by the handle and push the canister cradle
release latch to unlock the canister cradle.
AB.75p088
5824841 8-7
Aisys CS²
AB.75p089
Filling the Reusable Multi Absorber canister
1. Turn the canister upside down and, using your thumbs, turn the
cover locking ring counterclockwise to unlock it.
AB.74p044
8-8 5824841
8 Setup and connections
AB.74p047
5. To clean and disinfect the canister, refer to the "Cleaning and
Sterilization" manual.
6. Place a new filter in the bottom of the canister, pour absorbent
into the canister and place a new filter over the absorbent before
closing and locking the cover. Wipe off any absorbent dust.
7. Align the cover slots with the canister locking tabs and press the
cover down into place. Turn the cover locking ring clockwise to
lock the cover in place. Ensure the cover is properly sealed to
prevent leaks and spillage. Alignment of the arrows helps to
indicate correct assembly.
AB.82p001
5824841 8-9
Aisys CS²
Electrical connections
Mains inlet
The arrow shows the mains power inlet and cord.
AB.75p008
Equipotential stud
Outlets
Labels show outlet voltage ratings and circuit breaker amp ratings.
These are isolated outlets. Regularly test the leakage current.
8-10 5824841
8 Setup and connections
AB.75p134
Serial port
The system has a Universal Serial Bus (USB) port on the back of the
display unit. This port is for use by authorized service personnel to
load software and access log files. It should not be used for other
purposes.
AB.75p133
5824841 8-11
Aisys CS²
Pneumatic connections
CAUTION Use only medical grade gas supplies. Other types of gas
supplies may contain water, oil, or other contaminants
which could affect the operation of the pneumatic system.
The gas supplies provide gas to these devices through internal
connections:
Pipeline inlets
AB.75p010
Scavenging
1
2
3
AC.22p011
8-12 5824841
8 Setup and connections
1. Auxiliary inlet
2. Sample gas scavenging port
3. Outlet connection
5824841 8-13
Aisys CS²
Connect the sample gas exhaust tube to the gas return port. Exhaust
gas will be directed to the scavenging system if the system is
configured for scavenging the sample flow.
Note The gas module sample flow can be configured to return to the
breathing system or to go to scavenging. Check the configuration of
the airway module through the System Status menu. Contact an
authorized service representative to change the configuration.
AB.75p127
8-14 5824841
8 Setup and connections
AB.75p007
Vacuum suction regulator (optional)
5824841 8-15
Aisys CS²
1. Venturi muffler
2. Overflow safety trap
3. Splash guard
4. Collection bottle connection
8-16 5824841
8 Setup and connections
1. Auxiliary O2 outlet
2. Auxiliary O2 flow control
5824841 8-17
Aisys CS²
8-18 5824841
8 Setup and connections
5824841 8-19
Aisys CS²
WARNING Fully tighten the straps. If straps are not fully tightened,
equipment can fall off the top of the machine.
8-20 5824841
8 Setup and connections
Passive AGSS
5824841 8-21
Aisys CS²
Active AGSS
• The active low flow system is for use with high vacuum disposal
systems. It requires a vacuum system capable of a continuous
nominal flow of 36 l/min and 300 mmHg (12 inHg) or greater
vacuum pressure. A flow indicator on the system indicates when
the unit is in operation.
• The active high flow system is for use with low vacuum (blower
type) disposal systems. This requires a system capable of
providing a continuous nominal flow of 50 l/min. A flow indicator
on the system indicates when the unit is in operation.
• The active adjustable flow system provides the ability to adjust
the flow with a needle valve (located in a receiver underneath
the breathing system) and a visual indicator bag which should
be properly inflated. It requires a vacuum system capable of a
continuous nominal flow of 30 l/min and 300 mmHg (12 inHg) or
greater vacuum pressure.
• The active low flow system with a 12.7 mm hose barb connector
is for use with low vacuum disposal systems. It requires an
external system with flowmeter.
• The active low flow system with a 25 mm barb connector is for
use with low vacuum disposal systems. It requires an external
venturi/ejector system with 40 to 50 l/min extract flow. A flow
indicator on the system indicates when the unit is in operation.
• The active low flow system with 30 mm ISO taper is for use with
low vacuum disposal systems. It requires an external venturi/
ejector system with 40 to 50 l/min extract flow. A flow indicator
on the system indicates when the unit is in operation.
8-22 5824841
8 Setup and connections
AC.22p002
Note The ball in the upper red zone indicates excessively high extraction
flow. The ball in the lower red zone indicates extraction flow rate is
too low or a blocked filter.
4. Complete the tests in the "Preoperative tests" section of this
manual.
The active adjustable AGSS flow rate is limited to 30 l/min with this
option.
To use the optional active AGSS installed on the system which uses
the three-liter bag as a visual indicator, connect it as follows:
5824841 8-23
Aisys CS²
AB.75p.110
5. Complete the tests in the "Preoperative tests" section.
8-24 5824841
9 User maintenance
User maintenance
5824841 9-1
Aisys CS²
Maintenance safety
9-2 5824841
9 User maintenance
Repair policy
Do not use malfunctioning equipment. Make all necessary repairs or
have the equipment serviced by an authorized service
representative. After repair, test the equipment to ensure that it is
functioning properly, in accordance with the manufacturer’s
published specifications.
To ensure full reliability, have all repairs and service done by an
authorized service representative. If this cannot be done,
replacement and maintenance of those parts listed in this manual
may be undertaken by a competent, trained individual having
experience in the repair of devices of this nature.
5824841 9-3
Aisys CS²
Monthly
• Perform 21% and 100% O2 cell calibrations.
9-4 5824841
9 User maintenance
5824841 9-5
Aisys CS²
1. Pull the latch to unlock the flow sensor module from the
breathing system.
AB.74p052
2. Pull the flow sensor module from the breathing system.
3. Remove the O2 cell cable connector from the O2 cell and
unscrew the cell counterclockwise.
AB.74p065
5. Replace the flow sensor module on the system and push the
latch closed to secure the module.
6. Calibrate the new O2 cell according to the "Circuit O2 cell"
procedure.
9-6 5824841
9 User maintenance
Calibration menu
Access the Calibration menu by selecting the System Setup
button. Follow the instructions on the screen.
Important Room temperature fluctuations of more than 5°C may affect sensor
measurements. Recalibrate the flow sensors if the room temperature
changes by more than 5°C.
Calibrate the flow sensors by removing the flow sensor module from
the system. On-screen instructions are available through System
Setup - Calibration - Flow and Pressure.
Circuit O2 cell
21% O2 calibration
1. Select System Setup.
2. Select Calibration on the System Setup menu.
3. Select Circuit O2 Cell 21%.
4. Follow the instructions on the screen.
100% O2 calibration
1. Ensure the wye-piece, or patient connection, is not plugged or
there is no patient tubing connected to the system.
2. (ACGO option only.) Set the ACGO switch to Circle.
3. Set the Bag/Vent switch to Vent.
4. Select Circuit O2 Cell 100%.
5824841 9-7
Aisys CS²
Water buildup
9-8 5824841
10 Parts
Parts
5824841 10-1
Aisys CS²
AB.82.019
2
10-2 5824841
10 Parts
AB.82.021
5
5824841 10-3
Aisys CS²
Bellows
3
12
4
11 5
6
10
9
8
AB.82.018
7
10-4 5824841
10 Parts
AB.82.001
5824841 10-5
Aisys CS²
Absorber canister
3
1
AB.82.017
Item Description Stock number
1 Multi absorber, reusable (includes 40 pack of 1407-7004-000
foam; does not include absorbent)
2 Cover assembly, CO2 canister 1009-8240-000
3 Foam, CO2 canister (pack of 40) 1407-3201-000
4 O-ring 1407-3204-000
5 Canister, CO2 with handle 1407-3200-000
- Multi absorber, disposable, white to violet (pack 8003138
of six)
- Multi absorber, disposable, pink to white (pack 8003963
of six)
- Medisorb twin pack, 4.5 kg canister, pink to 8570042
white (pack of 2)
- Medisorb twin pack, 4.5 kg canister, white to 8570043
violet (pack of 2)
- Multi absorber original, disposable, white to M1173310
violet (pack of 6)
- Multi absorber EF, low alkaline disposable, M1173311
white to violet (pack of 6)
- Medisorb quick fill multi, 0.8 kg bag, white to M1017604
violet change (pack of 20)
10-6 5824841
10 Parts
AB.82.035
Description Stock number
Exhalation valve assembly 1407-7005-000
5824841 10-7
Aisys CS²
AGSS
10-8 5824841
10 Parts
5824841 10-9
Aisys CS²
1
3
2 4
AB.82.131
Item Description Stock number
1 EZchange canister module, includes valve and 1407-7021-000
cap
2 Valve 1407-7023-000
3 Cap 1407-3130-000
4 Condenser 1407-7024-000
- EZchange canister module with condenser 1407-7027-000
10-10 5824841
10 Parts
Condenser
AB.82.045
Item Description Stock number
- Condenser assembly (includes module and 1407-7026-000
condenser)
1 Condenser module 1407-7025-000
2 Condenser 1407-7024-000
5824841 10-11
Aisys CS²
10-12 5824841
11 Specifications and theory of
operation
5824841 11-1
Aisys CS²
AB.75.285
11-2 5824841
11 Specifications and theory of operation
5824841 11-3
Aisys CS²
Gas supplies
O2 flow
11-4 5824841
11 Specifications and theory of operation
Mixed gas
Either Air or N2O can be selected as the balance gas. The balance
gas flow is controlled by the mixer. When Alternate O2 control is in
use, only O2 is flowing and balance gas is disabled.
The mixed gas goes from the mixer outlet through the vaporizer to
the fresh gas outlet and into the breathing system. A pressure-relief
valve sets the maximum outlet pressure.
Note When the total is adjusted toward the lower flow limit and the
calculated O2 flow is required to go below 100 ml, a message shows
in the gas settings area of the screen. The anesthesia system
calculates the required O2% to maintain the user-set total flow.
EZchange canister
Condenser
5824841 11-5
Aisys CS²
Pneumatic specifications
Gas supplies
A relief valve on the vaporizer manifold limits the fresh gas pressure
at the ACGO port to 55 kPa (8 psi) at 45 l/min.
A relief valve limits the fresh gas pressure at the inspiratory port to
27 kPa (4 psi) at 55 l/min when non-circle circuit is selected.
The pneumatic outlet is supplied with the same gas supply pressure
as the attached oxygen medical gas pipeline supply. The anesthesia
11-6 5824841
11 Specifications and theory of operation
system is rated for supply pressures between 280 kPa - 600 kPa.
The anesthesia system is designed to function normally with a
maximum flow of 8 l/min from the pneumatic outlet. Higher flows
from this connection are possible and may result in decreased
anesthesia system performance.
5824841 11-7
Aisys CS²
5
9 10
1 2 3 4 6 7 8
20 22
25
19 21 23 24
26
18 27
17 14 28
16
15 29
56
11 12
13
55 57
58
40
41 42 45 49
50 51
52
30
53
31 54
46 47 48
32
33
34 37
35 38 43 44
36 39 63
59 60
69
70
71
62 72
61
73
74 AB.75.265
64 65 66 67 68
11-8 5824841
11 Specifications and theory of operation
5824841 11-9
Aisys CS²
Electrical power
Power cord
Length 5 meters
Voltage rating 100 to 240 Vac
Current capacity 10 A for 220-240 Vac
15 A for 100-120 Vac
10 A for 120/220-240 Vac
Type Three conductor power supply cord (medical
grade where required).
Battery information
The system is not a portable unit. A sealed lead acid battery supplies
backup power in the event of a power failure.
11-10 5824841
11 Specifications and theory of operation
5824841 11-11
Aisys CS²
Flow specifications
Alternate O2
Minimum flow 500 ml/min to 700 ml/min
Maximum flow 10 l/min to 13 l/min
Indicator Flow tube
Indicator accuracy +/- 5% full scale
Fresh gas
Flow range 0 and 200 ml/min to 15 l/min
Minimum total flow O2 and balance gas is
200 ml/min
Total flow accuracy +/- 10% or +/- 40 ml/min of setting
(whichever is larger)
O2 flow accuracy +/- 5% or +/- 20 ml/min of setting (whichever
is larger)
Balance gas flow accuracy +/- 5% or +/- 20 ml/min of setting (whichever
is larger) Air/N2O
O2 concentration range 21%, 25% to 100%
O2 concentration accuracy +/- 2.5% of setting for total flow of greater
than or equal to 1 l/min and less than or
equal to 15 l/min
+/- 5% of setting for total flow of greater than
or equal to 0.4 l/min and less than 1 l/min
+/- 6.5% of setting for total flow of greater
than or equal to 0.2 l/min and less than 0.4
l/min
Electronic mixer response 500 ms (10% to 90% flow step)
time
Compensation Temperature and atmospheric pressure
compensated to standard conditions of 20°C
and 101.3 kPa (14.7 psi)
Hypoxic guard Electronic
Note: Leakage from one gas inlet to another gas inlet is less than 10 ml per
hour.
Note: The stated flow accuracy may not be met for total flows between 200
and 400 ml/min. The total flow will maintain a minimum of 21% O2.
11-12 5824841
11 Specifications and theory of operation
5824841 11-13
Aisys CS²
11-14 5824841
11 Specifications and theory of operation
Gas scavenging
All scavenging
Positive pressure relief 10 cmH2O
Passive scavenging
Negative pressure relief 0.3 cmH2O
Outlet connector 30 mm male taper ISO
Active scavenging
Disposal system Outlet Flow range Pressure
type connector*
Adjustable DISS EVAC Up to 30 l/min not applicable
High flow, low BSI 30 mm 50 to 80 l/min not applicable
vacuum threaded
Low flow, high DISS EVAC 36 +/- 4 l/min 305 mmHg (12
vacuum inHg) minimum
vacuum
Low flow, low 12.7 mm hose 36 +/- 4 l/min not applicable
vacuum barb
Low flow, low 25 mm hose barb 40 to 50 l/min not applicable
vacuum
Low flow, low 30 mm ISO taper 40 to 50 l/min not applicable
vacuum
*Other market-specific connectors may be available.
Particle filter at the outlet has a pore size of 225 microns. All flow data uses
a new filter.
5824841 11-15
Aisys CS²
Physical specifications
All specifications are approximate values and can change without
notice.
11-16 5824841
11 Specifications and theory of operation
25
20
15
10
AC.22.039
0
0 10 20 30 40 50 60 70 80
12
11
10
6 AC.22.020
5
40 45 50 55 60 65 70 75
5824841 11-17
Aisys CS²
Environmental requirements
.
11-18 5824841
11 Specifications and theory of operation
CARESCAPE
Airway humidity 10 to 100% condensing
Sampling delay 3.0 seconds typical with a 3 m sampling line
Total system response time Less than 3.8 seconds with a 3 m sampling line
Warm-up time 1 minute for operation with CO2, O2, and N2O
5 minutes for operation of anesthetic agents
20 minutes for full specifications
Respiration rate 4 to 100 breaths/min
Diversion flow 120 +/- 20 ml/min
Airway pressure -20 cmH2O to 100 cmH2O
5824841 11-19
Aisys CS²
Typical performance
.
CARESCAPE*
CO2 Measurement range 0 to 15 vol% (0 to 15 kPa, 0 to 113 mmHg).
Measurement rise time less than 260 ms typical.
Accuracy +/- (0.2 vol% + 2% of reading).
6 hour drift less than 0.1 vol%
Gas cross effects less than 0.2 vol% (O2, N2O, anesthetic agents).
O2 Measurement range 0 to 100 vol%.
Measurement rise time less than 260 ms typical.
Accuracy +/- (1 vol% + 2% of reading).
6 hour drift less than 0.3 vol%
Gas cross effects less than 1 vol% anesthetic agents, less than 2 vol% N2O.
N2O Measurement range 0 to 100 vol%.
Measurement rise time less than 320 ms typical.
Accuracy +/- (2 vol% + 2% of reading).
6 hour drift less than 0.3 vol%
Gas cross effects less than 2 vol% anesthetic agents.
Anesthetic agents Measurement range Hal, Enf, Iso 0 to 6% vol%.
Measurement range Sev 0 to 8 vol%.
Measurement range Des 0 to 20 vol%.
Measurement rise time Des, Enf, Iso, Sev less than 420 ms typical.
Measurement rise time Hal less than 800 ms typical.
Accuracy +/- (0.15 vol% + 5% of reading).
6 hour drift for Hal, Enf, Iso, Sev less than 0.1 vol%
6 hour drift for Des less than 0.3 vol%
Gas cross effects less than 0.15 vol% N2O.
*The effects caused by N2O to the measurement of CO2, O2, and anesthetic agents are
automatically compensated for. The effects caused by anesthetic agents to the
measurement of CO2 and N2O are automatically compensated for.
11-20 5824841
11 Specifications and theory of operation
5824841 11-21
Aisys CS²
Ventilator theory
The ventilator pneumatics are at the rear of the breathing system. A
precision valve controls gas flow to the patient. During inspiration,
this gas flow closes the exhalation valve and pushes the bellows
down. During expiration, a small flow pressurizes the exhalation
diaphragm to supply PEEP pressure. If the maximum pressure
(Pmax) is reached during inspiration, the ventilator will cycle to
expiration.
Volume and flow measurements come from flow sensors in the flow
sensor module. Two tubes from each sensor connect to a transducer
that measures the pressure change across the sensor, which
changes with the flow. A third transducer measures airway pressures
at the inspiratory flow sensor.
The ventilator uses the data from the flow sensors for volume-related
numerics and alarms. The ventilator also uses the flow sensors to
adjust its output for changes in fresh gas flow, small leaks, and gas
compression upstream of the breathing circuit. There is adjustment
for compression in the patient circuit.
In volume ventilation modes, certain alarm conditions prevent the
automatic adjustment of ventilator delivery based on measured flow
values. In these cases, ‘TV accuracy decreased. Adjust manually.’
displays above the ventilator setting area of the screen. When this
message shows, the ventilator may not be able to deliver within the
accuracy range specified. When this occurs, the tidal volume must
be manually adjusted until the volume delivered reaches the desired
level. If compensation stops for a number of breaths, the condition
causing the hold shows as an alarm. Automatic volume
compensation resumes when the alarm conditions are resolved.
For better precision a small quantity of gas bleeds through a resistor
to keep pressure on the exhalation valve constant. At high airway
pressures, this can cause a slight hiss during inspiration.
11-22 5824841
11 Specifications and theory of operation
The ecoFLOW option provides a split screen view that shows the
approximate minimum O2 flow to maintain a preset FiO2 value. It
also shows the approximate agent used per hour and the cost. Some
information associated with the ecoFLOW option is not provided
when the airway module is warming up, not present, or non-
functional.
The split screen shows the Paw gauge in the upper area and the
ecoFLOW gauge in the lower portion of the screen. The ecoFLOW
gauge consists of a fresh gas flow tube, an agent flow indicator, and
related parameters.
The fresh gas flow tube is a stacked flow tube showing the total O2
flow on the bottom and the remaining gas (N2 or N2O) on top. These
gases determine the total fresh gas flow setting. Below the fresh gas
flow tube is the measured total O2 flow to the patient and the
calculated FiO2 flow value. The minimum O2 marker is based on the
value set in the Gas Setup menu. This is the minimum O2 flow
needed to deliver a preset inspired O2 concentration. The minimum
O2 marker is specific to each patient and case. It is calculated using
the fresh gas settings, the patient O2 uptake, the dilution effect of
agent being delivered, and the effects of the circle breathing system.
The agent flow indicator shows the amount of liquid agent flow as
related to the fresh gas setting. The calculated cost of the agent
shows above this indicator. This cost is based on agent flow and the
values entered in the Agent Costs menu set in Super User mode.
Ventilation modes
5824841 11-23
Aisys CS²
• TV
• RR
• I:E
• Tpause
• PEEP
• Pmax
2
3 4
1
5
7
6
AB.98.036
1. Paw waveform
2. Tinsp
3. Insp Pause
11-24 5824841
11 Specifications and theory of operation
4. Texp
5. PEEP
6. Flow waveform
7. TV
• Pinsp
• RR
• I:E
• PEEP
• Pmax
• Rise Rate
2 3
4
1
5
6
AB.98.037
1. Paw waveform
2. Tinsp
3. Texp
4. Pinsp
5. PEEP
5824841 11-25
Aisys CS²
6. Flow waveform
PCV-VG mode
In PCV-VG, a tidal volume is set and the ventilator delivers that
volume using a decelerating flow and a constant pressure. The
ventilator will adjust the inspiratory pressure needed to deliver the
set tidal volume breath-by-breath so that the lowest pressure is used.
The pressure range that the ventilator will use is between the PEEP
+ 2 cmH2O level on the low end and 5 cmH2O below Pmax on the
high end. The inspiratory pressure change between breaths is a
maximum of +/- 3 cmH2O. If a high airway pressure alarm is active
due to the current breath, the next breath’s target will be 0.5 cmH2O
less than the current breath’s pressure target.
This mode will deliver breaths with the efficiency of pressure
controlled ventilation, yet still compensate for changes in the
patient’s lung characteristics. PCV-VG begins by first delivering a
volume breath at the set tidal volume. The patient’s compliance is
determined from this volume breath and the inspiratory pressure
level is then established for the next PCV-VG breath.
PCV-VG mode setting:
• TV
• RR
• I:E
• PEEP
• Pmax
• Rise Rate
2 3
1
5
7
6
AB.98.034
1. Paw waveform
2. Tinsp
11-26 5824841
11 Specifications and theory of operation
3. Texp
4. Variable pressure to deliver desired TV
5. PEEP
6. Flow waveform
7. TV
• TV
• RR
• Tinsp
• Tpause
• Psupport
• PEEP
• Pmax
• Trig Window
• Flow Trigger
• End of Breath
• Rise Rate
5824841 11-27
Aisys CS²
1
4
5 2
AB.91.040
TI
6
• Pinsp
• RR
• Tinsp
• Psupport
• PEEP
• Pmax
• Trig Window
• Flow Trigger
• End of Breath
• Rise Rate
• Exit Backup
11-28 5824841
11 Specifications and theory of operation
2 3 4
6
1 5
AB.98.038
1. Paw waveform
2. Tinsp
3. Spontaneous breathing period
4. Trigger window
5. Pressure supported breath
6. Pinsp
7. Flow waveform
5824841 11-29
Aisys CS²
• TV
• RR
• Flow Trigger
• Psupport
• PEEP
• Tinsp
• Pmax
• Trig Window
• End of Breath
• Rise Rate
• PSV Rise Rate
2 3 4
1 6
8
7
AB.98.153
1. Paw waveform
2. Tinsp
3. Spontaneous breathing period
4. Trig Window
5. Variable pressure to deliver desired TV
11-30 5824841
11 Specifications and theory of operation
6. PEEP
7. Flow waveform
8. TV
PSVPro mode
PSVPro is pressure supported ventilation with apnea backup.
PSVPro is a spontaneous mode of ventilation that provides a
constant support pressure once the ventilator senses that the patient
has made an inspiratory effort. In this mode, the clinician sets the
Pressure Support (Psupport) and PEEP levels. The patient
establishes the rate, inspiratory flow, and inspiratory time. The tidal
volume is determined by the pressure, lung characteristics, and
patient effort.
PSVPro uses an inspiration termination level that establishes when
the ventilator will stop the pressure-supported breath and cycle to the
expiratory phase. The inspiration termination level is user adjustable
from 5 to 75%. This parameter sets the percent of peak inspiratory
flow that the ventilator uses to end the inspiratory phase of the
breath and to cycle into the expiratory phase. If the inspiration
termination is set to 30% then the ventilator will stop inspiration when
the flow decelerates to a level equal to 30% of the measured peak
inspiratory flow. The lower the setting the longer the inspiratory time
and conversely, the higher the setting the shorter the inspiratory
phase.
An apnea backup mode is provided if the patient stops breathing.
When setting this mode the clinician adjusts the inspiratory pressure
(Pinsp), respiratory rate (RR), and the inspiratory time (Tinsp). As
long as the patient is triggering the ventilator and the apnea alarm
does not activate, the patient will get pressure-supported breaths
and the ventilator will not deliver machine breaths.
If the patient stops triggering the ventilator for the set apnea delay
time, the apnea alarm will activate and the ventilator will
automatically switch to the backup mode that is SIMV PCV. Once in
this mode the ventilator will begin delivering machine pressure
controlled breaths at the inspiratory pressure level, inspiratory time,
and rate that the user has set. If, during this time, the patient takes
spontaneous breaths in between the machine breaths, the patient
will receive pressure supported breaths.
PSVPro mode settings:
• Psupport
• PEEP
• Trig Window
• Flow Trigger
• End of Breath
• Pmax
5824841 11-31
Aisys CS²
• Backup Time
• Pinsp
• RR
• Tinsp
• Rise Rate
• Exit Backup
AB.91.041
TI
3
1. Paw
2. PEEP
3. Time
When the ventilator switches to the backup mode, the ‘Backup Mode
active’ alarm shows until PSVPro is reinstated or until another
ventilation mode is selected. PSVPro mode automatically resumes
when the ventilator registers the number of consecutive patient-
triggered breaths set for the Exit Backup setting. The factory default
setting for Exit Backup is 2. When Exit Backup is set to Off, the user
must reselect the PSVPro mode to reactivate PSVPro. Upon
returning to PSVPro the ventilator immediately begins providing
pressure supported breaths to the patient using the established
settings.
Spontaneous breaths that occur during this mode are indicated by a
color change in the waveform.
11-32 5824841
11 Specifications and theory of operation
phase of the breath and to cycle into the expiratory phase. If the
inspiration termination is set to 30% then the ventilator will stop
inspiration when the flow decelerates to a level equal to 30% of the
measured peak inspiratory flow. The lower the setting the longer the
inspiratory time and conversely, the higher the setting the shorter the
inspiratory phase.
If the spontaneous inspiratory effort does occur within the delay
period, the ventilator delivers pressure controlled breaths with the
preset inspiratory pressure to bring the breath rate up to the
minimum rate. The delay period calculation is 60 s/minimum rate
+ ([60 s/minimum rate] - previous measured breath period).
The inspiratory support pressure and the inspiratory pressure
settings are linked at the start of each case. When the inspiratory
support pressure setting is changed, the inspiratory pressure setting
is automatically adjusted to match the inspiratory pressure setting.
The link can be broken by changing the Pinsp setting through the
Vent Mode menu during the case.
Spontaneous breaths that occur during this mode are indicated by a
color change in the waveform.
CPAP + PSV settings:
• Psupport
• PEEP
• Flow Trigger
• End of Breath
• Pmax
• Pinsp
• Minimum RR
• Tinsp
• Rise Rate
2
AB.91.041
TI
3
1. Paw
2. PEEP
3. Time
5824841 11-33
Aisys CS²
The ventilation mode factory default settings for the ADULT case
default show in the following table. An * indicates the setting is not
used for the ventilation mode. See the "Super user mode" section for
all other case default values.
.
11-34 5824841
11 Specifications and theory of operation
5824841 11-35
Aisys CS²
Pneumatics
Pressure
Volume
11-36 5824841
11 Specifications and theory of operation
Minute volume display range less than 0.1 to 99.9 l/min, 0.1 liter
resolution
Breath rate 4 to 100 bpm (non-spontaneous)
2 to 60 bpm (spontaneous)
1 bpm resolution
Volume sensor type Variable flow orifice
Oxygen
5824841 11-37
Aisys CS²
Delivery accuracy
Volume delivery accuracy Greater than 210 ml tidal volume - accuracy better than 7%.
Less than or equal to 210 ml but greater than or equal to 60 ml tidal
volume - accuracy better than 15 ml.
Less than 60 ml tidal volume - accuracy better than 10 ml.
Volume monitoring accuracy Greater than 210 ml tidal volume - accuracy better than 9%.
Less than or equal to 210 ml but greater than or equal to 60 ml tidal
volume - accuracy better than 18 ml.
Less than 60 ml tidal volume - accuracy better than 10 ml.
Inspiratory pressure delivery accuracy Greater of +/- 10% or +/- 3 cmH2O
PEEP delivery accuracy +/- 1.5 cmH2O
Pressure monitoring accuracy Greater of +/- 5% or +/- 2 cmH2O
Note: Gas composition errors may be in additions to the above normalized accuracy. When adding errors, positive
errors can have the effect of nulling out negative errors.
Note: Use of anesthetic agent could affect the errors by approximately -0.95%/% volume agent in normal mode.
Note: Temperatures greater than or less than 24°C may decrease BTPS accuracy.
AC.22.029
11-38 5824841
11 Specifications and theory of operation
Response time
To 90% of step; measured at fresh gas outlet Less than 7 seconds at fresh gas flow of 2 l/min
AB.60.055
+20%, +1.0% v/v
1000
2000
3000
4000
5000
6000
7000
8000
9000
10000
12000
13000
14000
15000
11000
5824841 11-39
Aisys CS²
3 4 5 6
AB.60.056
+20%, +1.0% v/v
1000
2000
3000
4000
5000
6000
7000
8000
9000
10000
12000
13000
14000
15000
11000
2
AB.60.057
18-25C
10-35C
-20%, -0.4% v/v
0
1000
2000
3000
4000
5000
6000
7000
8000
9000
10000
12000
13000
14000
15000
11000
11-40 5824841
11 Specifications and theory of operation
AB.60.059
+20%, +0.4% v/v
1000
2000
3000
4000
5000
6000
7000
8000
9000
10000
12000
13000
14000
15000
11000
2
5824841 11-41
Aisys CS²
3 4 5
AB.60.060
+20%, +0.4% v/v
1000
2000
3000
4000
5000
6000
7000
8000
9000
10000
12000
13000
14000
15000
11000
2
Note The effect of the fresh gas composition, back pressure (including
ventilation), and ambient pressure on the agent concentration are
included in the accuracy specifications.
Note The system delivers the same output in volumetric percent (% v/v)
within the specified altitude range.
11-42 5824841
11 Specifications and theory of operation
Aladin2 cassettes
.
Filling
Filling system Easy-Fil: Adapter filler system for isoflurane, enflurane, and sevoflurane.
SAFE-FIL: Filler system compatible with Baxter's SAFE-FIL desflurane bottle.
Quik-Fil: Filler system compatible with Abbot’s system for sevoflurane.
Piramal Fill: Filler system compatible with Piramal's Piramal Fill sevoflurane bottle.
SAFE-T-SEAL: Filler system compatible with Baxter's SAFE-T-SEAL sevoflurane bottle
and SAFE-T-SEAL filling adapter.
Filling speed Greater than 2 ml/s
Overfilling protection Overfilling prevention systems built into the cassettes.
Cassette
Empty weight 2.8 kg
Height 7 cm
Depth 24 cm
Width 14 cm
5824841 11-43
Aisys CS²
Essential performance
Cables
11-44 5824841
11 Specifications and theory of operation
5824841 11-45
Aisys CS²
11-46 5824841
11 Specifications and theory of operation
5824841 11-47
11-48 5824841
12 Super user mode
5824841 12-1
Aisys CS²
Note The menu selections shown in the examples are the factory default
values. The available settings are shown to the right of the menu.
12-2 5824841
12 Super user mode
Gas usage
Use the Gas Usage menu to view the total fresh gas usage since the
last reset, to reset the gas usage to zero, and view optional
ecoFLOW and agent cost information.
Setting ecoFLOW
Use the ecoFLOW menu to set the split screen defaults for FiO2
Setting, FiO2 Line, and Agent Cost. This menu item is only
available on systems with the ecoFLOW option installed.
1. From Super User mode, select Gas Usage and then ecoFLOW.
2. Select the item to change. Make the change.
For FiO2 Setting, set the numeric value for FiO2 on the split
screen.
For FiO2 Line, select whether to show or hide the FiO2 line on
the split screen.
For Agent Cost, select whether to show or hide the agent
delivered costs on the split screen.
3. Select Back to return to the Gas Usage menu.
Use the Agent Costs menu to modify the currency and agent cost
defaults used to show the cost of agent delivered on the split screen.
This menu item is only available on systems with the ecoFLOW
option installed.
1. From Super User mode, select Gas Usage and then Agent
Costs.
2. Select the Currency from the drop-down list.
5824841 12-3
Aisys CS²
12-4 5824841
12 Super user mode
System configuration
Use the System Config. menu to set default information for the
system. Use the System Config. menu to access menus and
settings for Colors, Units, Ventilator Settings, Alarm Settings,
Parameter Settings, Trends Setup, and Pages Setup.
Time zone
Use the Time Zone menu to set the time zone and to enable or
disable daylight saving time. Enable daylight saving for automatic
change of local time from daylight saving time to standard and back
at the set time. The system must be on for automatic time change.
Consult the facility network administrator to obtain the local time
zone settings.
4. Select Confirm.
5824841 12-5
Aisys CS²
Note Automatic time switch between standard time and daylight saving
time is disabled during a case. If the system is connected to a time
server and the scheduled time change is during a case, the time
switch occurs at the end of the case. If the system is not connected
to a time server and the scheduled time change is during a case, the
time switch will not occur. Set the time manually.
Note To disable daylight saving automatic time change, enter Super User
mode and select System Config. - Time Zone. Set Daylight
Saving to Disable. Select Confirm
Ventilator settings
Use the Ventilator Settings menu to set the default user settings for
VCV Cardiac Bypass, Circuit Compliance, Sample
Compensation, and TV for Ideal Body Weight.
Alarm settings
Use the Alarm Settings menu to set External Gas Monitor, Apnea
Alarm Filter, and Show Alarm Limits default settings.
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12 Super user mode
Parameter settings
Use the Parameter Settings menu to set the default settings for
Principal Volume, Principal O2, Principal Agent, Vent and
Airway Gas Module TV Basis, CO2 Numbers, Insp Flow, and
Patient ID Data.
Note When set to ATPD, the volume calculation conditions are based on
ambient temperature and pressure, dry humidity conditions. When
set to BTPS, the volume calculation conditions are based on body
temperature, ambient pressure, saturated humidity conditions.
5824841 12-7
Aisys CS²
Note The 47 mmHg is the partial pressure of the saturated water vapor at
37C.
3. Select Back to return to the System Config. menu.
Important Setting the Patient ID data tab to show sends patient information to
configured network clients. This is not encrypted. Consult the facility
information technology administrator before allowing user access to
this tab.
12-8 5824841
12 Super user mode
Trends setup
Use the Trends Setup menu to set the default trend graphical page
layout for the top, middle, and bottom trends for each page shown in
the user’s Trends menu.
1. From the Super User mode, select System Config. and then
Trends Setup.
2. Use the drop-down lists to set Top Trend, Middle Trend, and
Bottom Trend to show the desired parameters.
3. Select Next Page to set up graphical trend defaults for another
page or Back to return to the System Config. menu.
Page setup
Use the Pages Setup menu to set the default screen views for
waveform fields, digit fields, and split screen areas. Four default
screen views can be configured.
5824841 12-9
Aisys CS²
1. From Super User mode, select System Config. and then Pages
Setup.
2. Select the page to set up.
3. Select an item to change. Make the change.
Waveform fields can be set to AA, CO2, Flow, Paw, or Off.
Digit fields can be set to Gases, Respiration, Gas supplies,
Flow, Agent, Loops, or Off.
Split screen can be set to None, Trends, Spirometry, Paw,
Compliance, or optional ecoFLOW.
4. Select another item. Make the change.
5. When done, select Back to select another page to set up.
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12 Super user mode
Case defaults
Use the Case Defaults menu to set the default case types that show
on the Start Case menu and access the Volume Apnea Setup
menu.
Set the case defaults for the case types that are selectable from the
Start Case menu. In each case type, the name, patient defaults, gas
defaults, screen layout defaults, alarm defaults, and ventilator
settings for each available ventilation mode can be preset.
Use the Volume Apnea Setup menu to enable or disable the user’s
ability to turn the volume apnea alarms off during manual ventilation.
5824841 12-11
Aisys CS²
Note When the Volume Apnea Selection is set to Disable, the Volume
Apnea Alarm menu selection does not show on the user’s Start
Case menu and the Vol Apnea Alarm selection does not show on
the Alarm Setup menu.
Each case has multiple settings. The default settings for the default
case types are shown in the following table. An * indicates that the
setting is not used for the default ventilation mode in the case type.
Use the empty columns to write in facility changes.
Note VCV ADULT settings are used as the default if the system does not
have an optional ventilation mode shown.
.
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12 Super user mode
5824841 12-13
Aisys CS²
12-14 5824841
12 Super user mode
5824841 12-15
Aisys CS²
Gas controls
Use the Gas Controls menu to set the user’s Agents, Total Flow,
and O2% quick select preset values and the Fresh Gas Controls
setting.
12-16 5824841
12 Super user mode
Procedures setup
Use the Procedures menu to set the procedures available to the
user. From this menu select the default settings for Vital Capacity
and Cycling procedures.
5824841 12-17
Aisys CS²
Network configuration
Use the Network Config. menu to set the client connections for Port
1, Port 2, Clock Sync., Log Transfer, and to test the system
network connectivity. The connectivity test verifies the status of the
device connections.
AB.75p.136
Obtain the system configuration and client configuration information
from the facility information technology administrator before
attempting network configuration activities.
Incorrect client configuration can lead to unintended disclosure of
patient information. Make sure to verify the client configuration.
Important The network traffic from the system is not encrypted. To protect
patient confidentiality, connect the anesthesia system to a secure
network. Do not connect to a public network.
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12 Super user mode
Port 1
Use the Port 1 menu to directly connect to one device. A network
cable must be connected from Port 1 on the back of the display to
the network connection on the device. Obtain the connection
information before attempting connection of Port 1. The static IP
address and subnet mask of the anesthesia system is required. The
direct device client IP address, port number, and type of
communication protocol is required.
5. Select the Speed and Duplex setting. Choose the setting that
communicates with the direct connect device.
• Auto Negotiate.
• 100 MB Full
• 100 MB Half
• 10 MB Full
• 10 MB Half
5824841 12-19
Aisys CS²
Port 2
Use the Port 2 menu to connect up to three devices using a secure
network. A network cable must be connected from Port 2 on the back
of the display to the facility network.
Configure the Port 2 network manually using a static IP address,
subnet mask, default gateway, DNS server. Or use DHCP server to
configure the port dynamically.
External devices 1, 2, and 3 require IP address or DNS, port number,
and type of communication protocol. External devices outside of the
network where the anesthesia system resides require a default
gateway to reach the device.
6. Select the Speed and Duplex setting. Choose the setting that
communicates with the network device.
• Auto Negotiate
• 100 MB Full
• 100 MB Half
• 10 MB Full
• 10 MB Half
12-20 5824841
12 Super user mode
Clock Sync.
Clock synchronization connects the system clock to the same time
as the connected time server device. The system must be set to a
direct device client that has sapphire protocol or a network time
server. Use Port 1 to use the direct connection device time. Use Port
2 for connection to a network time server.
Log Transfer
5824841 12-21
Aisys CS²
Connectivity Test
12-22 5824841
12 Super user mode
5824841 12-23
Aisys CS²
4. Select Confirm.
12-24 5824841
13 Vaporizer cassettes
Vaporizer cassettes
5824841 13-1
Aisys CS²
Vaporizer
The electronically controlled vaporizer consists of the internal
electronic control unit and the agent cassette. The agent cassettes
are color coded, have indexed filling ports, and are magnetically
coded for each agent. The electronic control unit governs the flow
through the agent cassette and the agent concentration in the fresh
gas flow.
The Aladin2 cassette can be used on this system.
Use of an Aladin cassette on this system does not meet the
60601-1-2:2014 standard and may degrade performance of agent
delivery when used in close proximity to high radio-frequency fields.
Remove the cassette from the active bay when not administering
anesthetic agent. Store cassettes in the cassette storage bay when
they are not in use. Store the cassettes and agent at the same
temperature as the system.
13-2 5824841
13 Vaporizer cassettes
AB.60.050
4 3
5824841 13-3
Aisys CS²
AB.60.038
4 3
13-4 5824841
13 Vaporizer cassettes
5824841 13-5
Aisys CS²
Removing a cassette
Use the Changing a cassette during a case procedure when
changing a cassette while a case is in progress.
13-6 5824841
13 Vaporizer cassettes
Installing a cassette
1. Using the liquid level indicator, check that the cassette is filled to
the appropriate level.
2. If using Aladin2, unlock the cassette handle before installing it in
the active bay.
3. Insert the cassette into the active bay until a click is heard,
ensuring the cassette is in the correct position.
4. Turn the lock on the handle to the horizontal position (Aladin2
cassettes only).
5. The cassette is properly inserted when the agent is identified on
the display. Make sure that the displayed agent matches the
cassette.
Note Store the cassettes in the cassette storage bay when they are not in
use.
5824841 13-7
Aisys CS²
Cassette maintenance
Clean and drain the cassettes as recommended.
Cleaning
Draining cassettes
• Make sure that the valve pins do not come in contact with
the system or any other object.
13-8 5824841
13 Vaporizer cassettes
5824841 13-9
Aisys CS²
AB.60.054
Filling with Easy-Fil system or SAFE-T-SEAL adapter system
13-10 5824841
13 Vaporizer cassettes
AB.60.062
2
1. Easy-Fil
2. SAFE-T-SEAL
WARNING Do not open or press the cassette filling port or the gas
connection valves with fingers or any kind of instrument.
Anesthetic agent liquid or gas may squirt into the air.
• When the liquid level indicator reaches the full mark, slowly
remove the bottle from the filling port.
5824841 13-11
Aisys CS²
Note Removing the bottle quickly may cause the agent to splash or
squirt out of the filling port.
AB.60.061
3
1. Quik-Fil
2. SAFE-T-SEAL
3. Piramal Fill
WARNING Do not open or press the cassette filling port or the gas
connection valves with fingers or any kind of instrument.
Anesthetic agent liquid or gas may squirt into the air.
13-12 5824841
13 Vaporizer cassettes
5. Push the agent bottle firmly into the filling port. Let the agent
flow into the cassette.
6. Watch the liquid level indicator.
• When the liquid level indicator reaches the full mark, slowly
remove the bottle from the filling port.
Note Removing the bottle quickly may cause the agent to splash or
squirt out of the filling port.
AB.60.050
AB.60.049
5824841 13-13
Aisys CS²
AA.43.129
1. Bottle cap
2. O-ring
3. Insert the nozzle into the filling port, and push the bottle firmly
against the spring pressure until it stops.
4. Keep the bottle firmly inserted, and lift the bottle upwards.
5. Watch the liquid level indicator. Do not leave the bottle
unattended while it is attached to the cassette.
6. When the liquid level reaches the full mark, lower the bottle to
the lower stop position.
7. Slowly remove the bottle from the filling port. Removing the
bottle quickly may cause the agent to splash or squirt out of the
filling port.
8. Put the cap back on the agent bottle.
13-14 5824841
Index
A Alarm setup
Auto MV limit 3-26
Abbreviations 1-12 CO2 alarms 3-23
Absorbent canister default limits 3-27
canister removal 8-7 leak audio alarms 3-26
EZchange canister removal 8-7 MV/TV alarms 3-24
filling the canister 8-8 setting alarm limits 3-24
Absorbent color change 8-6 setting apnea delay 3-25
Absorber canister volume apnea 3-23
parts 10-6 Alarms
setup 8-5 battery indicator 7-3
when to change the absorbent 8-6 viewing alarm history 3-25
Accessories 1-16 Alarms On/Off 3-28
ACGO Alternate O2 control 3-42
description 3-48 Anesthesia system display 2-12
port relief 11-6 Apnea delay 3-25
Active AGSS 8-22 Auto MV Limit 3-26
Advanced breathing system Automatic agent identification 6-6
parts 10-5 Auxiliary Common Gas Outlet 3-48
Advanced Breathing System Auxiliary O2 flowmeter 8-16
components 2-6
definition 1-2
AGSS
B
active 8-22 Battery indicator 7-3
connecting active adjustable 8-23 Battery information 11-10
connecting active with a flow indicator 8-22 Bellows assembly
parts 10-8 parts 10-4
passive 8-21 Brake 2-4
Airway modules Breathing circuit module
agent identification 6-6 parts 10-3
calibration 6-7 Breathing system
connections to a patient 6-4 gas scavenging 11-15
setting the data source 6-5 problems 7-18
specifications 11-19 specifications 11-13
Alarm
de-escalating 7-3 C
information 7-2
internal failure 7-4 Calibration
list of 7-5 100% O2 9-7
priorities 7-2 21% O2 9-7
ranges 7-14 airway module 6-7
sustained pressure threshold 7-12 circuit O2 cell 9-7
tests 7-16 flow and pressure 5-3, 9-7
volume 3-25 Cancelling audio pause 7-3
Alarm history 3-25 Cardiac bypass
5824841 I-1
Aisys CS²
E H
ecoFLOW 3-40 Hard keys 3-20
ecoFLOW theory of operation 11-23 High-pressure leak test 8-18
Electrical
block diagram 11-8 I
power cord 11-10 Indications for use 1-2
power specifications 11-10 Intended use 1-2
problems 7-19
safety 1-19
I-2 5824841
Index
5824841 I-3
Aisys CS²
I-4 5824841
Index
W
Water buildup 9-8
Waveform
color change 11-31
setup 3-18
Waveform fields 2-13
5824841 I-5
Aisys CS²
I-6 5824841
Warranty
This Product is sold by Datex-Ohmeda under the warranties set forth in the following paragraphs. Such
warranties are extended only with respect to the purchase of this Product directly from Datex-Ohmeda or
Datex-Ohmeda’s Authorized Dealers as new merchandise and are extended to the Buyer thereof, other
than for the purpose of resale.
For a period of twelve (12) months from the date of the original delivery to the Buyer or Buyer’s order, but
in no event for a period of more than two years from the date of original delivery by Datex-Ohmeda to a
Datex-Ohmeda Authorized Dealer, this Product, other than its expendable parts, is warranted against
functional defects in materials and workmanship and to conform to the description of the Product
contained in this User’s Reference manual and accompanying labels and/or inserts, provided that the
same is properly operated under the conditions of normal use, that regular periodic maintenance and
service is performed and that replacements and repairs are made in accordance with the instructions
provided. This same warranty is made for a period of thirty (30) days with respect to expendable parts.
The foregoing warranties shall not apply if the Product has been repaired other than by Datex-Ohmeda,
or altered by anyone other than Datex-Ohmeda, or if the Product has been subject to abuse, misuse,
negligence, or accident.
Datex-Ohmeda’s sole and exclusive obligation and Buyer’s sole and exclusive remedy under the above
warranties is limited to repairing or replacing, free of charge, at Datex-Ohmeda’s option, a Product, which
is telephonically reported to the nearest Datex-Ohmeda Customer Service Center and which, if so
advised by Datex-Ohmeda, is thereafter returned with a statement of the observed deficiency, not later
than seven (7) days after the expiration date of the applicable warranty, to Datex-Ohmeda Customer
Service and Distribution Center during normal business hours, transportation charges prepaid, and which,
upon Datex-Ohmeda’s examination, is found not to conform with above warranties. Datex-Ohmeda shall
not be otherwise liable for any damages including but not limited to incidental damages, consequential
damages, or special damages.
There are no express or implied warranties which extend beyond the warranties hereinabove set forth.
Datex-Ohmeda makes no warranty of merchantability or fitness for a particular purpose with respect to
the product or parts thereof.
Aisys CS²
User's Reference Manual
English
5824841 Rev. 1
05 2019