Guide
10 Pages
Preview
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Introduction
Innocor can be used to measure Vo2 in CathLab using model 10, 400 and 500. However, the standard breathing valves doesn’t interface to standard tubings in CathLab, instead standard flowmeters from Hans Rudolph can be used. This document describes typical questions to the CathLab setup.
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Setup
The standard breathing valve is replaced with a flowmeter and a bacterial filter. The Nafion tube is connected to the port in the bacterial filter with a CathLab inlet tip, which allows the gas to be sampled in the middle of the flow stream.
Nafion gas dryer CathLab inlet tip
OD = 15 mm (ISO)
ID = 15 mm (ISO)
Subject bacterial filter
Mini guide for Innocor in Cathlab.docx
Flowmeter
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The interface is ISO 15 mm ID to the subject and ISO 15 mm OD at the other end. The flowmeter and bacterial filter can therefore be inserted in a standard CathLab setup with 15 mm tubing. The flowmeter shall be inserted as close as possible to the Y-tube in a ventilator setup – see below.
To subject: facemask or tracheal tubes
From ventilator Back to ventilator
Note: the flowmeter above is not a standard 15 / 22 mm
Mini guide for Innocor in Cathlab.docx
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CathLab deadspace Alternative a facemask or a mouth piece can be used:
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Configurations
Innocor has the following types of configurations depending on the subject, but more can be added. Configuration CathLab (neonates, -5 kg) CathLab (infants, 5-10 kg) CathLab (pediatric, 10-30 kg) CathLab (pediatric, 10-30 kg)
Flow range [l/min] 0 – 10 0 – 35 0 – 160 0 – 160
VT range [ml] 30 – 100 30 – 100 75 – 300 150 - 1200
The configurations exist for both spontaneous breathing and ventilated. The flow range and dead spaces are the same for spontaneous and ventilated, but calculations setup is a little different. HR 8311 with Barrier Baby filter:
HR 4500 with Barrier Baby filter:
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CathLab deadspace HR 4700 with Hygro Boy filter:
HR 4700 with Barrier Bac filter:
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Gas sample flow
The gas sample flow is 120 ml/min. I.e. 120 ml/min is removed from the ventilator circuit.
Gas sample flow = 120 ml/min
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Dead Space and Interface Dead space 2
Dead space 1
*Dead space 1: Dead space from mouth piece to inlet *Dead space 2: Dead space from inlet to ambient air
Dead space and interface of Hans Rudolph flowmeters: Flowmeter HR 8311B HR 4500B HR 4700B
Dead space [ml] 5.1 8.7 13.9
Flow range [l/min] 0 – 10 0 – 35 0 – 160
IF Y-tube
IF filter
15 mm OD 15 mm OD 15 mm OD
15 mm ID & 22 mm OD 15 mm ID & 22 mm OD 15 mm ID & 22 mm OD
Dead space and interface of filters: Filter Barrier Baby Hygro Boy Barrier Bac S
Dead space [ml] 11 ml 25 ml 36 ml
VT range [ml] 30 – 100 75 – 300 150 - 1200
IF patient
IF flowmeter
15 mm ID 15 mm ID & 22 mm OD 15 mm ID & 22 mm OD
15 mm OD 15 mm OD & 22 mm ID 15 mm OD & 22 mm ID
Dead space of configurations: Configuration
Filter
flowmeter
CathLab_Vent (neonates, -5 kg) Baby HR 8311 CathLab (infants, 5-10 kg) Baby HR 4500 CathLab (pediatric, 10-30 kg) Boy HR 4700 CathLab (pediatric, 10-30 kg) Barrier Bac S HR 4700 Reduced dead space when connecting flowmeter and filter: 1.8 ml
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Dead space 1 9 9 23 34
Dead space 2 6 10 15 15
Total dead space 15 19 38 49
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Step by step guide •
Power Innocor on.
•
Press Measurement on Screen.
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Select appropriate configuration.
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Press Prepare.
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Press change on Ambient data and enter actual data.
•
Press calibrate on Flowmeter and follow calibration guide using a syringe.
•
Press calibrate on Flow-gas delay and follow calibration guide using a subject who performs fast inspirations/slow expirations.
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Press calibrate on Oxygen, expose tip of inlet to air and wait for “Current signal” to become stable. Press Start. Wait approximately 30 seconds. Press Save and Exit.
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Press OK.
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Press OK.
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Press New Pt. and enter patient data.
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Move cursor to the patient you want to study and press Select.
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Press Test.
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Connect patient to breathing assembly.
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Press OK when patient ready.
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You are now measuring. If scaling is not optimal then press Graph Setup and optimize axis settings.
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A measurement can be stopped manually by pressing Stop test.
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Go to Results, Details or Graph to evaluate data.
•
Go to Print Prev. to print data.
Note: avoid saturation of the flowmeters when calibrating, i.e. don’t empty/fill the syringe faster than specified in the table below: Flowmeter HR 8311B HR 4500B HR 4700B
1 litre syringe 6 sec 1.7 sec 0.4 sec
3 litre syringe 18 sec 5.2 sec 1.1 sec
It can be difficult to perform the flow-gas delay calibration on the smallest flowmeter HR 8311. If so, use a bigger flowmeter: •
Select configuration with the bigger flowmeter
•
Connect the bigger flowmeter, but with the Nafion tube associated to the flowmeter HR 8311
•
Perform the flow-gas delay calibration, and note down the results
•
Select configuration with the HR 8311 flowmeter
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Connect the HR 8311 flowmeter with associated Nafion tube
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Do all calibrations, except the flow-gas delay, which is entered from the calibration above
Mini guide for Innocor in Cathlab.docx
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Ordering
One-time purchase: Part no. Part description TUB00101 Nafion Dryer Gas Tube 70’’ Recommended use: change every 500 test - at least once a year (part of recommended yearly calibration)
TIP00001 FLO00102
Cathlab inlet tip Hans Rudolph Pneumotach (HR 8311) 0-10 LPM 22/15mm Recommended use: < 5 kg
FLO00101
Hans Rudolph Pneumotach (HR 4500) 0-35 LPM 22/15mm Recommended use: 5 – 10 kg
FLO00103
Hans Rudolph Pneumotach (HR 4700) 0-160 LPM 22/15mm Recommended use: > 10 kg
RVU00004
Stand-alone flowmeter tubing
Consumables: Part no. FIL00104
Part description FILTER: HYGROBABY ISO 22M/15F-22F/15M Recommended use: new per each patient / < 5 kg
FIL00103
FILTER: HYGROBOY ISO 22M/15F-22F/15M Recommended use: new per each patient / 5 – 10 kg
FIL00105
FILTER: BARRIERBAC Barrierbac S - Electros. Filt Recommended use: new per each patient / > 10 kg
FIL00001
Bacterial Filters for Gas Analyser Sold in multiples of 10 pieces only, the price is per item Recommended use: change every 500 test - at least once a year (part of recommended yearly calibration)
The Nafion dryer gas tube and flowmeter tubing can be shared between the setups, but it is recommended to have one for each setup. A recommended setup consists of: TIP00001 FLO0010x
TUB00101
RVU00004
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CathLab deadspace If all 3 configurations are wanted the following are recommended: Part no. Part description TUB00101 Nafion Dryer Gas Tube 70’’
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Pcs. 3
Recommended use: change every 500 test - at least once a year (part of recommended yearly calibration)
TIP00001 FLO00102
Cathlab inlet tip Hans Rudolph Pneumotach (HR 8311) 0-10 LPM 22/15mm
3 1
Recommended use: < 5 kg
FLO00101
Hans Rudolph Pneumotach (HR 4500) 0-35 LPM 22/15mm
1
Recommended use: 5 – 10 kg
FLO00103
Hans Rudolph Pneumotach (HR 4700) 0-160 LPM 22/15mm
1
Recommended use: > 10 kg
RVU00004
Stand-alone flowmeter tubing
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