SLE2000, SLE2000HFO, SLE2000HFO+
1. The characteristic (Figure ; Appearance photograph of SLE2000HFO) (Figure ; Outward appearance photograph of SLE200)
Because the resuscitator of the SLE Inc. is composed of valve less circuit, breathing circuit becomes a release type fully. Therefore, there is a characteristic not to be closed down with the side of intake and the side of the expiration, too, even if it is an inspiratory-phase and an expiratory-phase. Therefore, there are few breathing work volumes. In SLE2000 of the sale in 1990, PTV by the pressure trigger formula is possible. The object patient is to the 8-Kg weight. SLE-2000 of the sale in 1995 HFO became able to add HFO of the method to turn the nozzle of jet gas in the "WO" exhalation-valve block. In 1999, it powered up in SLE2000+HFO and the 20-Kg (HFO is 8 Kg) weight became an object.
2. The performance
1) The mode that it is possible to use
2) This proximal dater
The sampling time 10ms
The maximum intake gas flow rate
The active-ventilation ? LPM
The number of the maximum active-ventilations 250 BPM
The maximum SIMV number of times 250 BPM
The maximum expired volume per minute 5 The degree, HFO + are a degree as 15LPM as LPM.
3. The explanation of the control circuit, the controlling mechanism
1) The outline of the controlling mechanism
80C31(11MHz,8bit) is used for MPU. This is used for a timing-control and an alarm. An ironhand mechanism is accomplished with the new Mattick circuit.
2) The characteristic of the mechanical mechanism (Figure ; Mechanism outline figure of SLE2000)
SLE 2000 breathing circuits make a Jackson lease circuit basic. Fresh gas is fixed on 5LPM. The pressure in the expiration block rises, and gas in the tube of the side of the expiration flows backward and becomes the intake gas of the patient when drive gas flows into the expiration block in quantities. In other words, the expiration block is equivalent to the bag of the Jackson lease circuit. Therefore, it isn't limited to intake gas flow rate. "HA" 5LPM. Theoretically, there is not limitation in the demand flow rate.
3) The gas flow rate measurement
Gas flow rate. "HA" can not be measured. The air quantity of ventilation, too, can not be measured.
4) The intake valve
There is not an intake valve.
5) The expiration valve
It doesn't exist. It is in the expiration block that it is equivalent to this.
4. The new Mattick circuit (Figure ; New Mattick circuit of SLE2000HFO)
SLE 2000 pieces of composition consist of the fresh gas circuit and the expiration block drive circuit. An oxygen concentration is adjusted by the blender about the oxygen, the compressed air which was supplied from the central plumbing. The dense fog which was adjusted to the gas of 7LPM in NV-2 to maintain precision is abandoned as the blender bleed. This gas is secondarily supplied to the Ž_‘f sensor. It adjusts fresh gas to 0.7 bar with regulator Reg.3, it adjusts decompressed gas to 5LPM with neelde valve NV-1 and it is made. SV2 is an atmosphere relief valve at the system malfunction time and RV2 is a pressure relief valve at the time of the abnormal fluid pressure. Fresh gas is a pressure transducer and the pressure is watched over. Fresh dense fog is inputted to the ET connector via list Richter. As for expiration block drive gas, of PEEP/CPAP —p and a thing for inspiratory-pressure (INSP.PRESS) are independently prepared. Regulator Reg.2 adjusts the gas stream which makes PEEP/CPAP and this gas is jetted out by the expiration block through the nozzle. Because there is a limit in the exhaust from the expiration block, the block internal pressure rises by the jet and the PEEP/CPAP pressure occurs. Regulator Reg.1 adjusts the gas stream which makes inspiratory-pressure (PIP) but station on the way SMALL VOLUME CHAMBER and LARGE VOLUME CHAMBER is provided by the nozzle. There is latter in the former to make an intake corrugation Žb‘ corrugation, delaying the standing-up of the inspiratory-pressure to prevent the overshoot of the inspiratory-pressure. SV-1 opens and makes an inspiratory-pressure with inspiratory-phase but when choosing Žb‘ corrugation, SV-3, too, operates at the same time. In the expiratory-phase, SV-1 and SV-3 (Discharge) each CHAMBER in •úˆ³. The attachment and removal and the sterilization of the expiration block are possible. Also, the maintenance is simple because there is not a movable part. The proximal pressure is monitored with the pressure transducer and detects a trigger signal.
SLE-2000 In HFO, the nozzle to change the direction into the expiration block by the motor is provided. If the direction of the gas stream from the nozzle is expiration gas and the direction, as for the airway pressure, the positive pressure can shake "AREBA" in the opposite direction which it is possible to attach to the negative pressure. It becomes the amplitude of vibration that the blow-of-gas quantity from the nozzle is HFO. The number of rotations of the motor becomes U” of HFO. (Figure ; HFO mechanism explanatory figure)
5. The control software
The explanation of the each function
1) The trigger formula
It is a pressure trigger formula. If saying whether or not PTV is possible why in spite of not being conventional one and a specially changing mechanism, the reason can be looked for at breathing circuit of the valve less. By the change of the secondary pressure which accompanies the operation of the valve because there is not a valve It becomes for the intake effort of the patient to have been able to be purely taken as the change of the pressure without inducing an auto cycle even if it made rarely sensitive setting for its purpose.
CMV is given by the pressure plateau. It becomes IMV if making a breathing rate little.
It does a trigger to the spontaneous-respiration and an active-ventilation is given. When the trigger can not be recognized, the number of times which was set in CMV becomes the back-up number of times. Because the displayed contents of the breathing rate become a trigger air changes per hour, to confirm the back-up number of times, it changes a mode to CMV and it confirms it.
50% of the first halves of the SIMV cycle are a trigger window. In this period, only the taking sends an active-ventilation. It sends an asynchronous active-ventilation if there is not a trigger in the trigger window. A trigger back-up is prepared by the purpose of the time not to put on the intake effort of the patient successfully with the trigger and the back-up number of times is the SIMV number of times. A back-up to the anaerosis isn't prepared.
The inspiratory-phase, the expiratory-phase, the both of CMV and 4 ways of doing continuous HFO to CPAP can be chosen.
6) The output
A pressure corrugation (analog) and digital (RS423) are prepared with the option.
6. The operation system (Figure ; SLE2000 operating panel and figure ; SLE200HFO operating panel)
After setting an oxygen concentration, a breathing rate, intake time, it makes a mode CMV. It calculates I:E ratio automatically and it is displayed. The setting of PEEP/CPAP pressure makes desired value while it changes the display of the pressure monitor to BASE and seeing value. The setting of INSP.PRESSURE (the inspiratory-pressure) changes a display to PEAK and adjusts it to the desired value. Next, it sets an alarm. The setting of Low CPAP is a set value-2cmH.2In the O degree, it adjusts PIP to the value which is the same as the set value of INSP.PRESSURE.
After setting a back-up condition by the CMV mode, it changes a mode to PTV. In the CMV mode, as for the display of the air changes per hour, a set value is displayed but in the PTV mode, the air changes per hour (the actual measurement in 1 minute) that a trigger was done is displayed. In the back-up condition, the LED of "TRIGGER BACK-UP" blinks and the beep sounds. It improves trigger sensitivity gradually from 1 and the time to have become PTV condition from the back-up condition becomes appropriate sensitivity. At this time, the blink of the LED and the beep stop.
After confirming appropriate operating condition by the PTV mode, it enters SIMV mode.
It chooses weighting tense (the inspiratory-phase, the expiratory-phase or the continuation of CMV) in the desired frequency, the amplitude of vibration, HFO. It sets size with amplitude of vibration while seeing a corrugated display with pressure.
5) The inspiratory-pressure corrugation
Of the mode which is being "DURE" except CPAP however, it is possible to set. When setting an air changes per hour to equal to or more than 60 times, it doesn't sometimes function right when choosing Žb Masunami.
7. The monitor, the alarm function
1) Low PEEP/CPAP pressure, PIP pressure are monitored. PIP pressure +/-4cmH2The alarm operates when deviating from the O range.
2) Fresh gas pressure is decompressed by list Richter in the ET connector eve but pressure before decompression is monitored with the sensor. The pressure is 80cmH.2It does "BLOCK" in the caution if becoming above the O and the pressure is 17.5cmH.2It does "LEAK" in the caution if becoming below the O.
3) It is possible to read an expiration block driving-pressure (generating PIP pressure) in DRIVING PRESSURE GAUGE.
4) VENT.INOP. however, at the time with CPU's being mal-function, it warns.
5) The HFO alarm
Show the abnormality of the motor of the oscillator, make the case stop the turn of the motor and the jet style of HFO, too, makes stop.
8. The display feature
A setting breathing rate, the trigger number of times, I:E ratio, a circuit internal pressure, an oxygen concentration are done by the digital display. SLE-2000 An airway pressure graphic display is prepared for the HFO model.
9. The patient circuit composition, the humidifier (Figure ; SLE2000 patient schematic)
10. The daily maintenance
1) Breathing circuit uses a circuit owner-use (there are "DEISUPO", a re-application type).
2) An expiration block is sterilized in the wash. The autoclave of it is possible.
3) As for the re-application type filter, only the autoclave exchanges the filter of "DEISUPO" in possibly, on the side of the expiration.
4) In the moon, in the blender, it resembles 21% each other by 100% and it confirms the display of the oxygen concentration in the taking. It adjusts if there is an error. When it isn't possible to adjust to 100%, it is O.2It exchanges and it readjusts a cell. It is 50cmH in PIP.2It confirms that the error of the airway-pressure-meter when making O is within 3%. The reading of the driving-pressure meter is 40cmH.2The value of PIP is 35-45cmH at the time of the O.2It confirms that it is O.
11. The regular inspection
Always, it does by the service engineer.
1) It is 5,000 hours or 12 months.
The outward appearance and the cleaning, the wiring inside, the check of the plumbing, the check of the inner battery terminal, the battery exchange by it It does an electric circuit, the check of the new Mattick circuit, necessary calibration.
2) It is 10,000 hours or 24 months.
It exchanges the oxygen cell, blender, SV-1 Solenoid-controlled valve, PIP, CPAP regulator. It exchanges if Solenoid-controlled valve SV-2, SV-3, the tube and the connector, the battery folder, the pressure pressure relief valve, the other part are necessary.
12. The fault
1) Comparatively in the air quantity of ventilation, there is much gas consumption.
2) The upper limit of the expired volume per minute of the patient who can be adaptable is low. By HFO +, this was improved.