Datex-Ohmeda Avance - User Reference Manual PDF

Avance
Users Reference Manual

Software Revision 6.X
Datex-Ohmeda, Inc., a General Electric Company, doing business as GE Healthcare.
User Responsibility
This Product will perform in conformity with the description thereof
contained in this Users Reference manual and accompanying labels
and/or inserts, when assembled, operated, maintained, and repaired
in accordance with the instructions provided. This Product must be
checked periodically. A defective Product should not be used. Parts
that are broken, missing, plainly worn, distorted, or contaminated
should be replaced immediately. Should repair or replacement
become necessary, Datex-Ohmeda recommends that a telephonic or
written request for service advice be made to the nearest
Datex-Ohmeda Customer Service Center. This Product or any of its
parts should not be repaired other than in accordance with written
instructions provided by Datex-Ohmeda and by Datex-Ohmeda
trained personnel. The Product must not be altered without the prior
written approval of Datex-Ohmeda. The user of this Product shall
have the sole responsibility for any malfunction which results from
improper use, faulty maintenance, improper repair, damage, or
alteration by anyone other than Datex-Ohmeda.
CAUTION
U.S. Federal law restricts this device to sale by or on the

order of a licensed medical practitioner. Outside the
U.S.A., check local laws for any restriction that may apply.
Datex-Ohmeda products have unit serial numbers with coded logic
which indicates a product group code, the year of manufacture, and a
sequential unit number for identification. The serial number can be in
one of two formats.
AAAX11111
The X represents an alpha
character indicating the year
the product was manufactured;
H = 2004, J = 2005, etc. I and
O are not used.
AAAXX111111AA
The XX represents a number
indicating the year the product
was manufactured; 04 = 2004,
05 = 2005, etc.
Avance, Advanced Breathing System, ComWheel, D-fend,

EZchange, Disposable Multi Absorber, Reusable Multi Absorber,
PSVPro, SmartVent, Tec 6 Plus, and Tec 7 are registered
trademarks of Datex-Ohmeda, Inc.
Other brand names or product names used in this manual are
trademarks or registered trademarks of their respective holders.
Table of Contents
1 Introduction
Intended use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-2
Symbols used in the manual or on the equipment . . . . . . . . 1-4
Typeface conventions used . . . . . . . . . . . . . . . . . . . . . . . . . 1-7
Abbreviations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-7
2 System Controls and Menus

System overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-2
Advanced breathing system (ABS) components . . . . . . . . . 2-5
Optional ABS components . . . . . . . . . . . . . . . . . . . . . . . 2-7
Non-circle circuit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-8
ACGO (optional) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-9
Scavenging the ACGO sample flow . . . . . . . . . . . . . . . . 2-9
Scavenging from an auxiliary manual breathing circuit 2-10
Scavenging a gas monitor sample flow . . . . . . . . . . . . 2-10
Vaporizer controls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-11
Display controls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-13
Anesthesia system display . . . . . . . . . . . . . . . . . . . . . . . . . 2-14
Waveform fields . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-16
Digit field . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-16
Using menus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-17
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3 Operation
Turning on the system . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-2
Start case (start gas flow) . . . . . . . . . . . . . . . . . . . . . . . . . . 3-3
Using default settings . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-4
Using customized settings . . . . . . . . . . . . . . . . . . . . . . . 3-4
Minimum Alveolar Concentration (MAC) . . . . . . . . . . . . 3-5
End case . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-6
Ventilator setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-7
Using quick keys . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-7
Using Vent Setup menu . . . . . . . . . . . . . . . . . . . . . . . . . 3-8
Changing ventilator modes and settings . . . . . . . . . . . . 3-8
Gas setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-9
Using quick keys . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-9
Using Gas Setup menu . . . . . . . . . . . . . . . . . . . . . . . . . 3-9
Changing gas and settings . . . . . . . . . . . . . . . . . . . . . . 3-9
Changing circuit type . . . . . . . . . . . . . . . . . . . . . . . . . . 3-10
Spirometry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-11
Setting loop type . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-12
Scaling . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-13
Spirometry setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-14
Setting patient and sensor type . . . . . . . . . . . . . . . . . . 3-14
Selecting a data source . . . . . . . . . . . . . . . . . . . . . . . . 3-15
Setting spirometry split screen . . . . . . . . . . . . . . . . . . . 3-15
Main Menu . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-16
Trends . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-17
Cardiac bypass . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-18
Fresh gas usage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-19
Screen configuration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-20
Select page . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-20
Screen setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-21
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Alarm setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-23
Setting alarm limits . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-23
Volume apnea . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-24
MV/TV alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-24
CO2 alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-24
Auto MV limit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-25
Alternate O2 control . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-26
EZchange canister (optional) . . . . . . . . . . . . . . . . . . . . . . . 3-27
Condenser (optional) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-28
Passive AGSS (optional) . . . . . . . . . . . . . . . . . . . . . . . . . . 3-29
Active AGSS (optional) . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-30
Connecting active AGSS with a flow indicator . . . . . . . 3-31
Connecting active adjustable AGSS . . . . . . . . . . . . . . 3-31
4 Preoperative Checkout
Every day before your first patient . . . . . . . . . . . . . . . . . . . . 4-2
Before every patient . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-3
5 Preoperative Tests
Inspect the system . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-2
Vaporizer installation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-3
Flow and pressure calibration . . . . . . . . . . . . . . . . . . . . . . . 5-4
Circuit compliance compensation . . . . . . . . . . . . . . . . . . . . 5-4
Checkout menu . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-5
Leak < 250 ml . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-5
No . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-5
Yes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-5
Machine check . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-6
Machine check - system . . . . . . . . . . . . . . . . . . . . . . . . 5-6
Machine check - circuit . . . . . . . . . . . . . . . . . . . . . . . . . 5-7
Machine check -circuit O2 . . . . . . . . . . . . . . . . . . . . . . . 5-7
Machine check - monitor . . . . . . . . . . . . . . . . . . . . . . . . 5-7
Individual checks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-8
System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-8
Circuit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-8
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Circuit O2 cell . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-9
Low P leak . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-9
Low P leak (machines with ACGO) . . . . . . . . . . . . . . . . 5-9
Positive low pressure leak test (ACGO systems only) . . . . 5-10
Vaporizer back pressure test . . . . . . . . . . . . . . . . . . . . . . . 5-11
6 Airway Modules
Airway modules . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-2
Connection to a patient . . . . . . . . . . . . . . . . . . . . . . . . . 6-4
Parameters setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-5
Data source . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-5
CO2 setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-5
O2 setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-5
Agent setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-5
Spirometry setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-5
Automatic agent identification . . . . . . . . . . . . . . . . . . . . . . . 6-6
Calibration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-6
7 Alarms and Troubleshooting

Alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-2
Alarm priorities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-2
Silencing alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-2
Display changes during alarms . . . . . . . . . . . . . . . . . . . 7-2
De-escalating alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-3
Battery indicator . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-3
Internal failure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-3
List of alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-4
Alarm ranges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-12
Alarm tests . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-14
Breathing system problems . . . . . . . . . . . . . . . . . . . . . . . . 7-16
Electrical problems . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-17
Pneumatic problems . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-18
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8 Setup and Connections
Setup warnings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-2
Canister setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-4
When to change the absorbent . . . . . . . . . . . . . . . . . . . 8-5
Removing a canister . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-6
Removing an EZchange canister . . . . . . . . . . . . . . . . . . 8-6
Reusable Multi Absorber canister filling . . . . . . . . . . . . . 8-7
Electrical connections . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-9
Mains inlet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-9
Outlets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-9
Serial port . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-10
Pneumatic connections . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-11
Pipeline inlets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-11
Scavenging . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-11
Sample gas return port . . . . . . . . . . . . . . . . . . . . . . . . 8-12
Vacuum suction regulator (optional) . . . . . . . . . . . . . . 8-12
Venturi suction regulator (optional) . . . . . . . . . . . . . . . 8-13
Auxiliary O2 flowmeter (optional) . . . . . . . . . . . . . . . . . 8-13
How to install gas cylinders . . . . . . . . . . . . . . . . . . . . . . . . 8-14
Pin indexed cylinder yokes . . . . . . . . . . . . . . . . . . . . . 8-14
DIN cylinder connections . . . . . . . . . . . . . . . . . . . . . . . 8-14
High-pressure leak test . . . . . . . . . . . . . . . . . . . . . . . . 8-15
How to attach equipment to the top of the machine . . . . . . 8-16
9 User Maintenance
Repair policy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-2
Maintenance summary and schedule . . . . . . . . . . . . . . . . . 9-2
Datex-Ohmeda approved service . . . . . . . . . . . . . . . . . 9-3
Circuit O2 cell replacement . . . . . . . . . . . . . . . . . . . . . . . . . 9-4
Calibration menu . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-5
Flow and pressure calibration . . . . . . . . . . . . . . . . . . . . . . . 9-5
Circuit O2 cell calibration . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-6
21% O2 calibration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-6
Airway gas calibration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-6
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Backlight test . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-7
How to help prevent water buildup . . . . . . . . . . . . . . . . . . . . 9-7
10 Parts
Flow sensor module . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-2
Breathing circuit module . . . . . . . . . . . . . . . . . . . . . . . . . . 10-3
Bellows . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-4
Complete Advanced Breathing System . . . . . . . . . . . . . . . 10-5
Absorber canister . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-6
Exhalation valve assembly . . . . . . . . . . . . . . . . . . . . . . . . . 10-7
AGSS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-8
EZchange canister system . . . . . . . . . . . . . . . . . . . . . . . . . 10-9
Condenser . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-10
Test tools and system parts . . . . . . . . . . . . . . . . . . . . . . . 10-11
11 Specifications and Theory of Operation

System pneumatic circuits . . . . . . . . . . . . . . . . . . . . . . . . . 11-2
Gas supplies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-4
O2 flow . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-4
Air and N2O . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-4
Mixed gas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-4
EZchange canister . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-4
Condenser . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-5
Pneumatic specifications . . . . . . . . . . . . . . . . . . . . . . . . . . 11-5
Gas supplies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-5
ACGO Port relief . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-5
Non-circle circuit relief . . . . . . . . . . . . . . . . . . . . . . . . . 11-5
Electrical block diagram . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-6
Electrical power . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-8
Power cord . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-8
Battery information . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-9
Flow specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-9
Breathing system specifications . . . . . . . . . . . . . . . . . . . . 11-10
Gas scavenging . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-11
Physical specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-12
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Environmental requirements . . . . . . . . . . . . . . . . . . . . . . 11-12
Airway module specifications . . . . . . . . . . . . . . . . . . . . . . 11-13
Gas specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-13
Typical performance . . . . . . . . . . . . . . . . . . . . . . . . . 11-14
Suction regulators (optional) . . . . . . . . . . . . . . . . . . . . . . 11-15
Ventilator theory . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-16
O2 monitoring theory of operation . . . . . . . . . . . . . . . 11-17
Ventilation modes . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-17
Ventilator operating specifications . . . . . . . . . . . . . . . . . . 11-25
Pneumatics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-25
Fresh gas compensation . . . . . . . . . . . . . . . . . . . . . . 11-25
Pressure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-25
Volume . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-25
Oxygen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-25
Ventilator accuracy data . . . . . . . . . . . . . . . . . . . . . . . . . 11-26
Electromagnetic compatibility (EMC) . . . . . . . . . . . . . . . . 11-27
Guidance and manufacturers declaration electromagnetic emissions . . . . . . . . . . . . . . . . . . . . . 11-27
Guidance and manufacturers declaration electromagnetic immunity . . . . . . . . . . . . . . . . . . . . . 11-28
Power immunity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-28
Radiated immunity . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-29
Recommended separation distances . . . . . . . . . . . . . 11-30
Electrical safety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-31
IEC 60601-1 Classification . . . . . . . . . . . . . . . . . . . . . . . . 11-32
Standards . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-32
System components . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-33
Integral . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-33
Not integral . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-33
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12 Super User Mode
Install/Service menu . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-2
Using super user mode . . . . . . . . . . . . . . . . . . . . . . . . 12-3
Menus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-4
Cumulative gas usage . . . . . . . . . . . . . . . . . . . . . . . . . 12-4
Volume apnea setup . . . . . . . . . . . . . . . . . . . . . . . . . . 12-5
Setting time and date . . . . . . . . . . . . . . . . . . . . . . . . . . 12-6
Trends setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-7
Setting colors and units . . . . . . . . . . . . . . . . . . . . . . . . 12-9
Parameter settings . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-10
Page Setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-10
Configuring case defaults . . . . . . . . . . . . . . . . . . . . . 12-12
Index
Warranty
viii
M1145956
1 Introduction
WARNING
In this section
Read each components Users Reference manual and

understand the following before using this system:
All system connections.
All warnings and cautions.
How to use each system component.
How to test each system component.
Before using the system:
Complete all of the tests in the Preoperative Tests

section.
Test all other system components.
If a test fails, do not use the equipment. Have a

Datex-Ohmeda trained service representative repair the
equipment.
Intended use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-2
Symbols used in the manual or on the equipment . . . . . . . . 1-4
Typeface conventions used . . . . . . . . . . . . . . . . . . . . . . . . . 1-7
Abbreviations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-7
M1145956
1-1
Avance
Intended use
The Avance anesthesia system combines our highly advanced
anesthesia delivery, the very best in patient monitoring, and care
information management. The contemporary, compact design
addresses many ergonomic considerations including an efficient
cable management solution and storage system and an extra large
work surface area. Optional, integrated features include auxiliary O2
and suction control. The Avance system offers improved usability
through integration of ventilation, gas delivery and gas monitoring (E
and M-Series respiratory gas module capable) on a full-color 12-inch
display. This system also features electronic gas mixing of up to three
gases.
The Avance 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), and VCV cardiac bypass. These advanced features allow
for the ventilation of a broad patient range: from neonates and
compromised patients to routine cases.
The Avance system uses the Advanced Breathing System (ABS).
This integrated breathing system is easy to remove and disassemble,
is made of highly durable polymers, and is fully autoclavable. Its fully
integrated design enhances the systems elegance while minimizing
tube connections, minimizing circuit volume, and increasing the work
surface area.
The anesthesia system is designed for expansion and upgrades, so it
is easy to add new technologies and ventilation capabilities without
investing in a new system.
This anesthesia system is not suitable for use in an MRI environment.
This system must only be operated by authorized medical personnel
well trained in the use of this product. It must be operated according
to the instructions in this Users Reference manual.
1-2
WARNING
Explosion Hazard. Do not use this system with flammable

anesthetic agents.
Note
Configurations available for this product depend on local market and

standards requirements. Illustrations in this manual may not
represent all configurations of the product. This manual does not
cover the operation of every accessory. Refer to the accessory
documentation for further information.
M1145956
AB.91.108
1 Introduction
Figure 1-1 Front view
M1145956
1-3
Avance
Symbols used in the manual or on the equipment

Symbols replace words on the equipment, on the display, or in
Datex-Ohmeda manuals.
Warnings and Cautions tell you about dangerous conditions that can
occur if you do not follow all instructions in this manual.
Warnings tell about a condition that can cause injury to the operator
or the patient.
Cautions tell about a condition that can cause damage to the
equipment. Read and follow all warnings and cautions.
On (power)
Standby
1-4
Off (power)
O2 +
O2 Flush button
Type BF equipment
Type B equipment
Airway module indicator
ACGO active
Dangerous voltage
Frame or chassis ground
Protective earth ground
Earth ground
Direct current
Alternating current
Caution/Warning
Attention, refer to product instructions
Refer to product instructions
Pinch hazard
Electrical input
Electrical output
Electrical input/output
Sample gas inlet to scavenging
M1145956
1 Introduction
Pneumatic inlet
SN
134C
Serial number
REF
Stock number
Equipotential
Lamp, lighting, illumination
Variability
Variability in steps
Suction bottle outlet
Vacuum inlet
Maximum
Vacuum
Exhaust
Bellows volumes are approximate
Plus, positive polarity
Minus, negative polarity
Bag position/manual ventilation
Mechanical ventilation
Inspiratory flow
Expiratory flow
Movement in one direction
Movement in two directions
Lock
Unlock
Isolation transformer
Low pressure leak test
Autoclavable
Not autoclavable
This way up
APL settings are approximate
M1145956
Pneumatic outlet
O2%
O2 cell connection
Anesthetic Gas Scavenging System
1-5
Avance
Caution: federal law prohibits
dispensing without prescription.
Alarm silence touch key (Tec 6 Plus)
O2% indicator on left and balance gas

indictor on right. Colors associated
with gas settings.
Gas indicator. Color associated with gas

settings.
Alarm silence
Submenu
No battery/battery failure
Battery in use. Bar indicates amount of

battery power remaining.
Read to center of float
EZchange canister (CO2 bypass)
Open drain (remove liquid)
Close drain
Pipeline
Cylinder
Systems with this mark agree with the

European Council Directive (93/42/
EEC) for Medical Devices when they
are used as specified in their Users
Reference manuals. The xxxx is the
certification number of the Notified
Body used by Datex-Ohmedas
Quality Systems.
Authorized representative in the

European Community
Date of manufacture
Manufacturer
Indicates that the waste of electrical

and electronic equipment must not be
disposed as unsorted municipal waste
and must be collected separately.
Please contact an authorized
representative of the manufacturer for
information concerning the
decommissioning of equipment.
GOST R Russian certification
This product consists of devices that

may contain mercury, which must be
recycled or disposed of in accordance
with local, state, or country laws.
(Within this system, the backlight
lamps in the monitor display contain
mercury.
1-6
M1145956
1 Introduction
Typeface conventions used

Names of hard keys on the display and modules are written in bold
typeface; for example, Normal Screen.
Menu items are written in bold italic typeface; for example, Vent
Setup.
Messages that are displayed on the screen are enclosed in single
quotes; for example, Check sample gas out.
When referring to different sections and other documents, the names
are written in italic typeface and enclosed in double quotes; for
example, System Controls and Menus.
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
C
CGO
Common Gas Outlet
CO2
Carbon dioxide
Compl
Compliance
E
ET
End-tidal concentration
EtCO2
End-tidal carbon dioxide
EtO2
End-tidal oxygen
Exp
Expiratory
M1145956
FI
Fraction of inspired gas
FiCO2
Fraction of inspired carbon dioxide
FI-ET
Difference between inspiratory and expiratory

concentrations
FiO2
Fraction of inspired oxygen
F-V
Flow-volume loop
1-7
Avance
Abbreviation
Definition
I
I:E
Inspiratory-expiratory ratio
Insp
Inspiratory
Insp Pause
Inspriatory pause time
M
MAC
Minimum Alveolar Concentration
MV
Minute volume
MVexp
Expired minute volume
MVinsp
Inspired minute volume
N
N2O
Nitrous oxide
O
O2
Oxygen
P
Pair
Air supply pressure
Paux
Auxiliary pressure
Paw
Airway pressure
PCV
Pressure controlled ventilation
PCV-VG
Pressure controlled ventilation - volume guaranteed
PEEP
Positive end expiratory pressure
PEEPe
Extrinsic positive end expiratory pressure
Pexp
Expiratory pressure
P-F
Pressure-flow loop
Pinsp
Inspiratory pressure
Plimit
High pressure limit
Pmax
Maximum pressure
Pmean
Mean pressure
PO2
Oxygen supply pressure
Ppeak
Peak pressure
Pplat
Plateau pressure
Psupp
Support pressure
PSV
Pressure supported ventilation
PSVPro
Pressure supported ventilation with apnea backup
P-V
Pressure-volume loop
R
Rate
1-8
Respiratory rate
Raw
Airway resistance
RR
Respiratory rate
M1145956
1 Introduction
Abbreviation
Definition
S
SIMV/PSV
Synchronized intermittent mandatory ventilation with

pressure supported ventilation
SIMV-PC
Synchronized intermittent mandatory ventilation pressure controlled
T
TV
Tidal volume
TVexp
Expired tidal volume
TVinsp
Inspired tidal volume
M1145956
VCO2
Carbon dioxide production
VCV
Volume controlled ventilation
Vol
Volume
1-9
Avance
1-10
M1145956
WARNING
Do not use antistatic or electrically-conductive breathing

tubes or masks. They can cause burns if used near highfrequency surgical equipment.
Explosion Hazard. Do not use this system with flammable

anesthetic agents.
In this section
System overview. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-2

Advanced breathing system (ABS) components . . . . . . . . . 2-5
Vaporizer controls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-11
Display controls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-13
Anesthesia system display . . . . . . . . . . . . . . . . . . . . . . . . . 2-14
Using menus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-17
M1145956
2-1
Avance
System overview
12
11
1
2
3
4
5
10
6
7
1.
2.
3.
4.
5.
6.
Light switch
Dovetail
Vaporizer
Alternate O2 control
System switch
Mains indicator
AB.91.111
7. Integrated suction (optional)

8. Brake
9. O2 flush button
10. Advanced breathing system
11. Auxiliary O2 flow control (optional)
12. Anesthesia display
Figure 2-1 Front view
2-2
M1145956
Item, Figure 2-1
Description
Alternate O2 control Alternate O2 control activates automatically in the case of certain failures or errors. It
can also be activated manually by pushing the Alternate O2 control button if the display
fails. Turn the knob counterclockwise to increase the flow. Turn the knob clockwise to
decrease the flow. See Alternate O2 control in the Operation section.
System switch
Set the switch to the On (|) position to permit gas flow and to turn on the system.
6
7
Mains indicator
Integrated suction
(optional)
The mains indicator will come on when AC power is connected.

Turn the switch to MAX for full vacuum. Turn the switch to Off (0) for no vacuum. Turn
the switch to On (|) for adjustable vacuum. When in adjustable vacuum, turn the knob
clockwise to increase the vacuum and counterclockwise to decrease the vacuum.
Brake
Push down to lock. Lift to release.
O2 flush button
Push the O2 flush button to supply high flows of O2 to the breathing system.
11
Auxiliary O2 flow
control (optional)
Turn the knob counterclockwise to increase the flow. Turn the knob clockwise to
decrease the flow.
M1145956
2-3
Avance
1
2
3
4
5
6
11
9
8
1.
2.
3.
4.
5.
6.
Outlet circuit breaker

Isolated electrical outlet (optional)
Cable access door
Vacuum connection
Collection bottle connection
Cylinder yoke
AB.91.029
10
7. AGSS (Anesthesia Gas Scavenging System)

8. Equipotential stud
9. Mains inlet
10. System circuit breaker
11. Pipeline connections
Figure 2-2 Rear view
2-4
M1145956
Advanced breathing system (ABS) components
15
14
13
12
11
10
1
2
3
4
6
1.
2.
3.
4.
5.
6.
7.
8.
Expiratory check valve

Inspiratory check valve
Inspiratory flow sensor
Expiratory flow sensor
Absorber canister
Absorber canister release
Leak test plug
Breathing system release
AB.91.110
9. Manual bag port

10. Adjustable pressure-limiting (APL) valve
11. Bag/Vent switch
12. Bellows assembly
13. Sample gas return port
14. AGSS indicator (only on some AGSS versions)
15. Airway module (optional)
Figure 2-3 Advanced breathing system
M1145956
2-5
Avance
Item, Figure 2-3
Description
3, 4
Inspiratory flow sensor

Expiratory flow sensor
Absorber canister release
Flow sensors provide volume measurements for some monitoring

functions and tidal volume delivery.
Push to remove the canister. This causes the breathing system to vent to
the room (unless the EZchange canister option is installed). Be sure to hold
the canister by the handle before releasing the canister.
Adjustable pressure-limiting
(APL) valve
Adjusts breathing system pressure limit during manual ventilation. The

scale shows approximate pressures. Above 30 cmH2O, the knob will click
as it turns.
10
N
MI
30
70
20
11
2-6
Bag/Vent switch
Selects between manual ventilation (bag) or mechanical ventilation

(ventilator).
M1145956
Optional ABS
components
7
5
6
1.
2.
3.
4.
5.
6.
7.
AB.82.043
AB.91.109
Bag support arm

Auxiliary Common Gas Outlet (ACGO) switch
ACGO port
EZchange canister module (CO2 bypass)
EZchange canister release
Condenser drain button
Condenser
Figure 2-4 Breathing system options

Item, Figure 2-4
Description
Bag support arm
Squeeze the button to raise or lower the arm.
Auxiliary Common Gas

Outlet (ACGO) switch
EZchange canister
release
Set switch to ACGO position for fresh gas to flow through the ACGO port. The
ACGO may be used to provide fresh gas to an auxiliary manual breathing circuit.
Push to drop the canister to EZchange position. This seals the breathing circuit,
permitting continued ventilation and rebreathing of exhaled gases. Be sure to
hold the canister by the handle before releasing the canister.
Push to drain water out of the condenser.
Condenser drain button
M1145956
2-7
Avance
Non-circle circuit
Fresh gas flow is diverted around the inspiratory check valve and out
through the inspiratory port when non-circle ventilation is selected.
This fresh gas source may be used with circuits without CO2
absorbent capability (for example, Mapleson variants). Mechanical
ventilation is not available when using the non-circle circuit. Tidal
volume monitoring is not available.
O2 monitoring of fresh gas is available automatically when using the
non-circle circuit if the system has the airway module option or the O2
cell monitoring option.
Fresh gas oxygen concentration is displayed on the screen. Set the
alarm limits appropriately. Note that fresh gas oxygen concentration
may not reflect FiO2 when using these types of circuits. Use an
external O2 monitor when using a rebreathing circuit with the noncircle circuit.
Systems with both an airway module and an O2 cell will display the
circuit O2 value obtained from the airway module.
Do not use an external ventilator when using the non-circle circuit. Do
not use the non-circle circuit to drive external ventilators or for jet
ventilation.
WARNING
2-8
The maximum pressure at the non-circle circuit can be up

to 27 kPa (4 psi). Use a breathing circuit with pressure
relief.
M1145956
ACGO (optional)
Fresh gas flow is directed through the Auxiliary Common Gas Outlet
(ACGO) on the front of the machine when the ACGO switch is in the
ACGO position. Mechanical ventilation is not available when
operating an auxiliary manual breathing circuit with fresh gas from the
ACGO. The Bag/Vent switch, APL valve, and bag arm are not part of
the external circuit. Volume and pressure monitoring are not
available.
O2 monitoring of fresh gas is available automatically when the ACGO
is selected if the system has the airway module option or the O2 cell
monitoring option. 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.
Fresh gas oxygen concentration is displayed on the screen. Set the
alarm limits appropriately. Note that fresh gas oxygen concentration
may not reflect FiO2 during spontaneous breathing or in rebreathing
circuits. Use an external O2 monitor if using a rebreathing circuit on
ACGO.
circuit O2 value obtained from the airway module.
Do not use an external ventilator on the ACGO. Do not use the ACGO
to drive external ventilators or for jet ventilation.
WARNING
The maximum pressure at the ACGO can be up to 55 kPa

(8 psi). Use a breathing circuit with pressure relief.
Scavenging the
ACGO sample flow
A sample of the fresh gas is diverted to the airway module or the O2

cell in the breathing system to show the O2 numerics on the screen.
This sample flow should be scavenged when an auxiliary manual
breathing circuit is used with N2O or volatile anesthetics. If
scavenging is not connected, the sample flow is emptied into the
room. To connect the scavenging:
1. Attach a circle breathing circuit to the inspiratory and expiratory
ports.
2. Occlude the breathing circuit by connecting the Y-piece to the
leak test plug located behind the expiratory port.
3. Check for clinically correct settings.
4. Check the position of the Bag/Vent switch.
If the Bag/Vent switch is set to mechanical ventilation mode,
the bellows fills slowly with the sample flow. When the
bellows is full, the sample flow goes to the AGSS.
(Mechanical ventilation does not start when the ACGO switch
is set to ACGO.)
If the Bag/Vent switch is set to the bag mode, set the APL
valve to MIN, and attach a bag. The bag fills slowly with the
sample flow. When the bag is full, the sample flow goes to the
AGSS.
M1145956
2-9
Avance
Scavenging from an
auxiliary manual
breathing circuit
Scavenge the exhaust if an auxiliary manual breathing circuit is used

with N2O or volatile anesthetics.
An auxiliary inlet is available for active and passive AGSS units. It
provides a female connection with 30 mm - 30 mm male connector
(or a 30 mm -19 mm male connector) into the auxiliary port under the
breathing system. Do not use these connectors as an outlet for
exhaust flow.
The auxiliary inlet is a convenience inlet to the air brake of active
AGSS units. There is a reservoir to capture exhaust flows higher than
the extract flow.
A separate exhaust hose is needed from the auxiliary manual
breathing circuit to the disposal point for all AGSS units.
Scavenging a gas
monitor sample flow
2-10
Sample gas from a gas monitor can be scavenged using the sample
gas return port or the AGSS.
To scavenge from a gas monitor using the sample gas return
port, connect the tubing from the monitor to the sample gas return
port.
To scavenge from a gas monitor using the AGSS, connect tubing
from the monitor to the male luer inlet on the bottom of the AGSS
underneath the breathing system.
M1145956
Vaporizer controls
Refer to the vaporizer Users Reference manual for more detailed
information on the vaporizer.
1.
2.
3.
4.
5.
6.
AA.43.051
AB.80.009
Tec 6 Plus
Tec 7
Lock lever
Concentration control and release
Indicators (Tec 6 Plus)
Silence alarm touch key (Tec 6 Plus)
Figure 2-5 Vaporizer controls
M1145956
2-11
Avance
Item, Figure 2-5
Description
Lock lever
Turn the lever fully clockwise to lock the vaporizer in position.
Concentration control and

release
Push the release and turn the concentration control to set the agent
concentration. The Tec 6 Plus concentration control does not turn as long
as the warm-up indicator is on.
n
be
Indicators (Tec 6 Plus)
Silence alarm touch key

(Tec 6 Plus)
2-12
All indictors come on briefly at the start. The warm-up indicator goes off
after approximately 10 minutes and the operational indicator comes on.
Other indicators come on to advise the user of required action.
Push to silence alarms. Hold for 4 seconds to sound the speaker and light
all indicators (alarm test).
M1145956
Display controls
8
1.
Silence Alarms key
2.
3.
Menu keys
ComWheel
4.
5.
Normal Screen key

Quick keys
6.
7.
8.
Timer keys
MV/TV Alarms key
Alarm LEDs
AB.91.107
Push to silence any active, silenceable high and medium priority alarms or to
suspend/acknowledge any non-active medium or high priority alarms. Alarm is
silenced for 120 seconds or alarm is suspended for 90 seconds.
Push to show corresponding menu.
Push to select a menu item or confirm a setting. Turn clockwise or counterclockwise
to scroll menu items or change settings.
Push to remove all menus from the screen.
Push to change corresponding gas setting or ventilator setting. Turn the ComWheel
to make a change. Push the ComWheel to activate the change.
Push to start or stop the timer. Push to reset the timer back to zero.
Push to turn off the MV and TV alarms. Push again to turn the MV and TV alarms on.
Turn on solid or flash to indicate alarm priority.
Figure 2-6 Display controls
M1145956
2-13
Avance
Anesthesia system display

2
4 5
3
Plug in power
cable. On
battery.
Paw
Timer:
7
cmH2O
Measured
l/min
Agent
Ppeak
Pmean
PEEP
RR /min
Et %
Fi %
8
MAC 40
CO2
Air
EtCO2 %s
O2
EtO2 %
Fresh Gas: O2+Air

O2
%
FiCO2 %s
PCV-VG: Ventilator On
Total Flow
l/min
TV
ml
FiO2 %
Exp Flow
RR
/min
I:E
PEEP
cmH2O
MV l/min
TVexp ml
12
11
10
AB.91.125
Off
1. Split screen area showing electronic gas flow indicators

2. Alarm silence symbol and countdown
3. Alarm message fields
4. Waveform fields
5. General message field or timer field
6. Clock
7. Battery indicator field
8. Measured values field
9. Pipeline and cylinder supply or respiratory data or digit field
10. Ventilator settings
11. Ventilation mode
12. Gas settings
Figure 2-7 Normal view
2-14
M1145956

When a menu key is selected, the menu field overlays the gas flow
indicators and the waveform fields start at the right edge of the menu.
2
cmH2O
Main Menu
Ppeak
Pmean
PEEP
RR /min
Et %
Fi %
Trends
System Status
Cardiac Bypass Off
Fresh Gas Usage
Screen Setup
Parameters Setup
Calibration
Normal Screen
MAC 40
EtCO2 %s
Show trends.
EtO2 %
Fresh Gas: O2+Air

O2
%
PCV-VG: Ventilator On
Total Flow
l/min
TV
ml
FiCO2 %s
FiO2 %
Exp Flow
RR
/min
I:E
PEEP
cmH2O
MV l/min
TVexp ml
AB.91.124
Off
1. Menu
2. Waveform fields
Figure 2-8 Menu view
M1145956
2-15
Avance
Waveform fields
Up to three waveforms can be shown on the normal screen view.

Each waveform can be set to show specific information such as Paw,
agent, flow, or CO2 data. The corresponding numeric information
shows in the measured values field to the right of the waveform. If the
waveform is set to show the agent and no airway module is inserted,
that waveform and numeric areas are blank.
When one waveform is turned off, that waveform and the
corresponding numerics information are removed from the normal
screen view. The remaining waveforms and numerics increase in size
to fill the waveform area. When two waveforms are turned off, those
waveforms and the corresponding numerics information are removed
from the normal screen view. The remaining waveform increases in
size and is centered in the waveform area.
See Screen configuration in the Operation section for more
information.
Digit field
The digit field can be set to show specific information such as gas
supply, flow, or agent. 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 is not selected to show on the
display, the digit field information is replaced with the missing
parameter.
See Screen configuration in the Operation section for more
information.
2-16
M1145956
Using menus
Push a menu key to display the corresponding menu. Use the
ComWheel to navigate the menu.
1
Main Menu
3
Trends
On
System Status
Cardiac Bypass
On
Off
Fresh Gas Usage
Screen Setup
Parameters Setup
Calibration
Normal Screen
1.
2.
3.
4.
5.
6.
5
AB.91.126
On suspends the volume, apnea, low

agent, and low CO2 alarms.
Menu title
Current selection
Adjustment window
Submenu
Instructions or help information
Menu items
Figure 2-9 Menu example

1. Push the menu key to display the corresponding menu.
2. Turn the ComWheel counterclockwise to highlight the next menu
item. Turn the ComWheel clockwise to highlight the previous
menu item.
3. Push the ComWheel to enter the adjustment window or a
submenu.
4. Turn the ComWheel clockwise or counterclockwise to highlight
the desired selection.
5. Push the ComWheel to confirm the selection.
6. Select Normal Screen or push the Normal Screen key to exit
the menu and return to the normal monitoring display. (Select
Previous Menu to return to the last displayed menu, if available.)
M1145956
2-17
Avance
2-18
M1145956
3 Operation
WARNING
Ventilator alarms indicate potential hazard conditions. All

alarms that occur should be investigated to help ensure
adequate patient safety.
Maintain sufficient fresh gas flow when using sevoflurane.
Desiccated (dehydrated) absorbent material may produce

dangerous chemical reactions when exposed to inhalation
anesthetics. Adequate precautions should be taken to
ensure that absorbent does not dry out. Turn off all gases
when finished using the system.
In this section
Turning on the system . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-2

Start case (start gas flow) . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-3
End case . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-6
Ventilator setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-7
Gas setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-9
Spirometry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-11
Spirometry setup. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-14
Main Menu . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-16
Screen configuration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-20
Alarm setup. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-23
Alternate O2 control . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-26
EZchange canister (optional) . . . . . . . . . . . . . . . . . . . . . . . 3-27
Condenser (optional) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-28
Passive AGSS (optional) . . . . . . . . . . . . . . . . . . . . . . . . . . 3-29
Active AGSS (optional) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-30
M1145956
3-1
Avance
Turning on the system

1. Plug the power cord into an electrical outlet. Make sure the
system circuit breaker is on.
The mains indicator is lit when AC power is connected.
Battery is charging if it is not already fully charged.
AB.91.044
1. System switch
2. Mains indicator
Figure 3-1 Mains indicator and system switch

2. Check that the breathing system is properly connected.
CAUTION
Do not turn on the system with the right-hand (inspiratory)

port plugged.
3. Turn the System switch to On.
The display shows the power-up screen.
The system does a series of automated self tests.
4. Perform a Machine Check before the first case of the day.
5. Perform a preoperative checkout before each case. See the
Preoperative Checkout section.
Note
3-2
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.
M1145956
3 Operation
Start case (start gas flow)

Access the Start Case menu by pushing the Start/End Case key or
by selecting Start Case from the Checkout menu. Use the Start
Case menu to set the case data and to start the gas flow.
Start Case
Default Settings
Patient Weight
Set Vent By Weight
Patient Age
Other Gas
CO2 Alarms
Volume Apnea
Start Case Now
The Default Settings has five selections. The first four selections are
case types. The fifth selection is Last Case. The case type in the first
slot shows as the default when the Start Case menu is opened.
Case types are configured in the Install/Service - Case Defaults
menu. The Install/Service menu is only accessible by a Super User
or a service person. See the Super User Mode section for more
information on the Start Case menu defaults.
The values of Patient Weight, Patient Age, Other Gas, and Volume
Apnea are configured to the default case type by the Super User.
CO2 Alarms setting is set to On when the Start Case menu is
opened.
Note
Volume Apnea is not shown on the Start Case menu when the
Volume Apnea Selection is set to Disable in the Install/Service
menu.
The Set Vent By Weight menu item is accessible when the
ventilation mode is set to VCV or PCV-VG. Use this setting for breath
rate and tidal volume calculations based on the set patient weight.
The Default Settings selection shows Weight when Set Vent By
Weight is selected.
M1145956
3-3
Avance
Using default
settings
1. Set the Bag/Vent switch to Bag.

2. Push the Start/End Case key.
The case defaults are shown on the menu.
The Default Settings selection shows the preset case type.
3. Verify or change the settings on the Start Case menu.
4. Select Start Case Now. Gas flow starts.
Using customized
settings
The case type, ventilator settings, ventilation mode, alarm settings,

and gas settings can be changed before starting a case. Use the
Vent Setup menu, Alarm Setup menu, or Gas Setup menu to
change settings not shown on the Start Case menu before starting a
case. Return to the Start Case menu from these menus to make
additional adjustments or to start a case.
3. Verify or change the settings on the Start Case menu.
Select a case type or Last Case from the Default Settings.
Make adjustments to the other settings as appropriate for the
case.
The Default Settings selection changes to show Preset if
any changes to the settings are made.
4. To change the alarm settings:
Push the Alarm Setup key.
Select Adjust Settings.
Change the settings.
Select Back.
Make any other changes to the alarm setup.
Select Previous Menu to return to the Start Case menu to
make additional adjustments.
5. To change ventilator settings:
Push the Vent Setup key.
Select Exit to return to the Start Case menu.
6. To change the ventilation mode:
Push the Vent Setup key.
Select the desired mode.
Select Confirm or adjust the settings and select Confirm to
return to the Start Case menu.
3-4
M1145956
3 Operation
7. To change the gas settings:
Push the Gas Setup key.
Select Exit to return to the Start Case menu.
8. To change the balance gas:
Select the balance gas to use with O2.
Select Exit or adjust the settings and select Exit to return to
the Start Case menu.
9. To change the circuit type:
Select the circuit type.
Select Confirm or adjust the settings and select Confirm to
return to the Start Case menu.
10. From the Start Case menu, select Start Case Now. Gas flow
starts.
Minimum Alveolar
Concentration (MAC)
The adjusted Minimum Alveolar Concentration (MAC) is calculated

based on the patient age entered in the Start Case menu. The
default patient age of selected case type is used if no patient age is
entered.
The MAC value is calculated from the exhaled gas concentration and
the related affects based on the age of the patient. Typically, younger
patients have better liver function and can clear a drug faster,
resulting in a higher MAC value. The MAC calculation used is based
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 mini-trend, agent waveform numeric information,
gases digit field, and graphical trends page. MAC data shows as
dashes if there is not an airway module installed in the module bay.
M1145956
3-5
Avance
End case
Use the End Case menu to stop gas flow and end the patient alarms.
End Case
End Case Now
Normal Screen

3. Select End Case Now to put the system in standby (stops gas
flow and patient alarms).
3-6
M1145956
3 Operation
Ventilator setup
Access the Vent Setup menu by pushing the Vent Setup key. The
system has up to six modes of mechanical ventilation:
Volume Control Ventilation (VCV).
Pressure Control Ventilation (PCV) (optional).
Synchronized Intermittent Mandatory Ventilation/Pressure
Support (SIMV/PSV) (optional).
Pressure Support Ventilation (PSVPro) (optional).
Synchronized Intermittent Mandatory Ventilation-Pressure
Control (SIMV-PC) (optional).
Pressure Control Ventilation-Volume Guarantee (PCV-VG)
(optional).
Vent Setup
Adjust Settings
Mode:
VCV
PCV
Spirometry
Normal Screen
WARNING
Most anesthetic agents will cause patients to have

reduced ventilatory responses to carbon dioxide and to
hypoxemia. Therefore, triggered modes of ventilation may
not produce adequate ventilation.
The use of neuromuscular blocking agents will reduce the

patients breathing response, which will interfere with
triggering.
Important
Using quick keys
Refer to the Specifications and Theory of Operation section for

more information on ventilation modes.
The four main ventilator settings for each mode can easily be
changed using the ventilator quick keys.
1. Push a ventilator quick key to select the corresponding ventilator
setting.
2. Turn the ComWheel to make a change.
3. Push the ComWheel to activate (confirm) the change.
M1145956
3-7
Avance
Using Vent Setup

menu
1. Push the Vent Setup key.

Adjust Settings is selected by default.
An arrow to the right of the mode indicates the current mode.
2. Push the ComWheel to enter the adjustment window for the
selected mode.
3. Use the ComWheel to navigate the adjustment window and to
change a value.
4. Push the ComWheel to activate the change.
5. Push the Normal Screen key or select Exit.
Changing ventilator
modes and settings

2. Select the mode and push the ComWheel to enter the adjustment
window.
3. Use the ComWheel to navigate the adjustment window and to
change a value.
4. Select Confirm to activate the mode.
3-8
M1145956
3 Operation
Gas setup
Access the Gas Setup menu by pushing the Gas Setup key. Use
the Gas Setup menu to adjust the O2% and total flow, to change the
balance gas, and to change the circuit type.
Gas Setup
Adjust Settings
Gas:
N2O
Air
Circuit:
Circle
Non-Circle
Normal Screen
Using quick keys
The O2% and total flow can easily be changed using the gas quick
keys.
1. Push a gas quick key to select the corresponding gas setting.
2. Turn the ComWheel to make a change.
3. Push the ComWheel to activate (confirm) the change.
Using Gas Setup

menu
1. Push the Gas Setup key.

An arrow to the right of the balance gas indicates the gas
currently being used with O2.
2. Push the ComWheel to enter the adjustment window.
3. Use the ComWheel to navigate the adjustment window and
change a value.
Changing gas and

settings

2. Select the balance gas to use with O2 and push the ComWheel
to enter the adjustment window.
3. Use the ComWheel to navigate the adjustment window and
change a value.
M1145956
3-9
Avance
Changing circuit type

An arrow to the right of the circuit type indicates the circuit
currently in use.
2. Use the ComWheel to select Circle or Non-Circle and enter the
adjustment window.
3. Confirm or change and confirm the settings.
3-10
M1145956
3 Operation
Spirometry
There are three types of spirometry loops: Pressure-Volume (P-V),
Flow-Volume (F-V) and Pressure-Flow (P-F). View, save, and erase
spirometry loops and set the loop scaling in the Spirometry menu.
Access the Spirometry menu by pushing the Vent Setup key and
selecting Spirometry.
Use the Spirometry menu to:
View a specific loop type; select Loop Type and set the loop
type.
Adjust the loop scaling; select Scaling and set the scale type.
Access the Spirometry Setup menu; select Spiro Setup.
Store a loop to memory; select Save Loop. Up to six loops can
be saved.
View a saved loop; select Reference Loop and the time at which
the loop was saved.
Erase a saved loop; select Erase Loop and the time at which the
loop was saved.
Spirometry
Loop Type
Scaling
Spiro Setup
Save Loop
Reference Loop
Erase Loop
Previous Menu
M1145956
P-V
None
None
3-11
Avance
The spirometry loops show in the spirometry window and can be set
to show alongside the waveforms as the split screen.
AB.98.039
Setting loop type
1.
2.
3.
4.
Volume axis
Pressure axis
Real-time loop
Reference loop (appears on display in white)
Figure 3-2 Example of a P-V loop

To set the loop type:
2. Select Spirometry - Loop Type and set the loop type.
Set to P-F for Paw-Flow.
Set to F-V for Flow-Volume.
Set to P-V for Paw-Volume.
Note
3-12
The loop type can also be set in the Spirometry Setup menu. Push
the Main Menu key, and select Parameters Setup - Spirometry
Setup - Loop Type.
M1145956
3 Operation
Scaling
The scales shown in the spirometry loop graph are set in the Scaling
menu. The available settings for the volume, Paw, and flow graph
axes are dependent on the set patient type of adult or pediatric.
The AUTO selection automatically adjusts the volume, Paw, and flow
axes of the loop graph based on the minimum and maximum breath
reading shown in the waveform.
The Linked selection links the adjustment of the volume, Paw, and
flow axes of the loop graph together. Change one of the scales and
the remaining two scales automatically change based on the one set
scale.
The Indep selection allows the axes of the loop graph to be changed
separately for the volume, Paw, and flow axes.
Scaling
Scaling AUTO
Vol Scale
Paw Scale
Flow Scale
Previous Menu

2. Select Spirometry - Scaling.
3. Set the scale type to AUTO, Linked, or Indep.
If AUTO is selected, the scales are automatically set.
If Linked is selected, set one of the scales volume, Paw, or
flow. The other two scales adjust based on the set scale.
If Indep is selected, set the volume scale, set the Paw scale,
and set the flow scale.
M1145956
3-13
Avance
Spirometry setup
Push the Vent Setup key and select Spirometry - Spiro Setup to
access the Spirometry Setup menu. Use the Spirometry Setup
menu to:
Set the patient and sensor type.
Select a data source.
Set the loop type.
Change the volume shown on the spirometry split screen to
MVexp or TVexp.
Set split-screen view.
Access the Paw and MVexp alarm limits.
Note
The Spirometry Setup menu is also accessible through Main Menu

- Parameters Setup - Spirometry Setup.
Spirometry Setup
Patient and Sensor Type
Data Source
Loop Type
TV or MV
Split Screen
Paw Alarm
MVexp Alarm
Previous Menu
Setting patient and

sensor type
Adult
Vent
P-V
TV
None
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, ensure that the sensor type matches the airway adapter
used.
If the sensor type is not set correctly, the information displayed may
not be accurate.
2. Select Spirometry.
3. Select Spiro Setup - Patient and Sensor Type.
4. Select Adult or Pedi depending on the sensor used.
Adult refers to the D-lite sensor.
Pedi refers to the Pedi-lite sensor.
3-14
M1145956
3 Operation
Selecting a data
source
Several monitoring parameters can be obtained from the ventilator or

the airway module.
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. If the internal ventilator
sensor readings disagree with the airway module sensor readings,
the associated alarm occurs.
Information that is retrieved from the airway module is identified with
the module data indicator. See the Airway Modules section for more
information.
Figure 3-3 Airway module data indicator

3. Select Spiro Setup - Data Source.
4. Select Patient or Vent as 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.
5. Push the Normal Screen key or select Previous Menu.
Setting spirometry
split screen
Spirometry loops can be viewed alongside the waveforms on the

normal screen. To set up the spirometry split screen:
3. Select Spiro Setup.
4. Select Split Screen - Spiro.
5. Push the Normal Screen key.
M1145956
3-15
Avance
Main Menu
Menus and settings available through the Main Menu include
Trends, System Status, Cardiac Bypass, Fresh Gas Usage,
Screen Setup, Parameters Setup, and Calibration.
System Status shows the status of gas supplies, electrical supplies,
and software settings.
See Screen configuration for information on the Screen Setup
menu item.
See Parameters setup in the Airway Modules section for more
information on the Parameters Setup menu item.
See the User Maintenance section for more information on
calibrations.
Main Menu
Trends
System Status
Cardiac Bypass Off
Fresh Gas Usage
Screen Setup
Parameters Setup
Calibration
Normal Screen
3-16
M1145956
3 Operation
Trends
There are three views for patient trends: measured (numerical),

settings, and graphical. Trend information is saved every 1 minute for
the most recent 24 hours.
Trends
Cursor
Next Page
View
Measured
Settings
Graphical
Time Scale
Previous Menu
1. Push the Main Menu key.

2. Select Trends.
3. Select the desired view.
An arrow indicates the current trend view.
4. Select Cursor to scroll through the current trend view.
5. Push the ComWheel to return the highlight to Cursor.
6. Select Next Page to view additional parameters.
M1145956
3-17
Avance
Cardiac bypass
There are two types of cardiac bypass. Manual ventilation cardiac

bypass is standard. VCV cardiac bypass is optional.
Manual ventilation
cardiac bypass
Manual ventilation cardiac bypass suspends alarms for patients on

cardiac bypass when the ventilator is not mechanically ventilating.
The volume, apnea, low agent, CO2, and respiratory rate alarms are
suspended. The alarms are enabled when cardiac bypass is turned
off or mechanical ventilation is started.
WARNING
Manual ventilation cardiac bypass and VCV cardiac

bypass modes should only be used when the patient is
receiving extra-corporeal oxygenation by means of a
heart-lung machine. These modes of ventilation are not
intended to provide metabolic levels of ventilation to the
patient.
3. Set Cardiac Bypass to On.
The general message Cardiac Bypass shows in the
waveforms and in the general message field when manual
ventilation cardiac bypass is active.
VCV cardiac bypass

(optional)
WARNING
Systems with VCV cardiac bypass enabled can mechanically

ventilate while in VCV mode. The VCV mode is the only ventilation
mode available while using VCV cardiac bypass. The volume, apnea,
low agent, CO2, low Paw, and respiratory rate alarms are suspended.
The alarms are enabled when VCV cardiac bypass is turned off or
mechanical ventilation is stopped.
Manual ventilation cardiac bypass and VCV cardiac

bypass modes should only be used when the patient is
receiving extra-corporeal oxygenation by means of a
heart-lung machine. These modes of ventilation are not
intended to provide metabolic levels of ventilation to the
patient.
1. Start mechanical ventilation in VCV mode.
3. Set Cardiac Bypass to On.
The PEEP is set to 5 cmH2O.
TV settings of less than 170 ml prior to starting cardiac
bypass remain at the set TV.
TV settings of more than 170 ml prior to starting cardiac
bypass change to 170 ml.
PEEP and TV settings can be changed after entering cardiac
bypass mode.
4. The general message VCV Cardiac Bypass shows in the
waveforms and in the general message field when VCV cardiac
bypass is active.
3-18
M1145956
3 Operation
Fresh gas usage
Use the Fresh Gas Usage selection 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.
2. Select Fresh Gas Usage.
3. Select the patient case to view.
M1145956
3-19
Avance
Screen configuration
Each case type selected on the Start Case menu has a
corresponding screen configuration for the normal screen. Four
additional normal screen views are available through the Select Page
menu. The case type screen configurations and the normal screen
views are set by the Super User in the Install/Service menu.
Areas of the normal screen can be customized to show specific
information. Use the Screen Setup menu to customize the normal
screen view.
Select page
Use the Select Page menu to quickly change or return the normal
screen view to a case type view.
Select Page
Page:
Default Screen
PAW TUBES
LOOPS
BIG WAVE
LOCAL
Normal Screen
1. From the normal screen with no menus showing, push the

ComWheel.
An arrow to the right of the menu item indicates the page
view that is in use.
A corresponding message shows in the general message
area.
If no arrow shows on the Select Page menu, a customized
normal screen view is in use.
2. Select a view or select Normal Screen to leave the selections
unchanged.
3-20
M1145956
3 Operation
Screen setup
Waveform, digit field, fresh gas control style, split screen, sweep
speed, and brightness are adjusted in the Screen Setup menu.
Changes made to all settings (except Brightness) during a case are
not saved when the case is ended. The set Brightness remains until
it is changed again or until the system power is turned off.
Screen Setup
Waveform Field 1
Waveform Field 2
Waveform Field 3
Digit Field
Fresh Gas Controls
Split Screen
Sweep Speed
Brightness
Install/Service
Previous Menu
Waveform fields
Paw
Flow
CO2
AA
O2%
None
Fast
4
The waveforms can be set to show agent, CO2, flow, Paw, or can be
set to off. Waveforms cannot be set to the same value (except for off).
If waveform is set to the same value as another waveform, the
previously set waveform changes to off and is removed from the
normal screen
2. Select Screen Setup.
3. Select the waveform field and make the change.
Digit field
The digit field can be set to show gas supply, flow, or agent.
2. Select Screen Setup - Digit Field.
3. Select the Supply, Flow, or AA.
If AA is selected, an airway module must be inserted or the
digit field will be blank.
M1145956
3-21
Avance
Setting gas controls and
screen configuration
There are two ways to configure gas controls: O2% with total flow or
individual gas flow. The Super User can set the gas control for the
facility. Or the Super User can set the gas control to allow the user to
select the setting.
Selecting O2% shows O2% as the first quick key and total flow l/min
as the second quick key. This gas control configuration adjusts the
balance automatically when either the O2% or the total flow is
changed.
Selecting Flow shows balance gas l/min as the one quick key and O2
l/min as the other quick key. This gas control/screen configuration
allows individual control of the gasses.
2. Select Screen Setup - Fresh Gas Controls.
Split screen
Gas and agent delivery, trends, spirometry loops, or a Paw gauge

can be shown as a split screen alongside the waveforms on the
normal screen. To change the normal screen to show a split screen:
2. Select Screen Setup - Split Screen.
Sweep speed
The waveform draw rate can be set to fast (6.25 mm/s) or slow
(0.625 mm/s). When the sweep speed is changed, the waveforms are
redrawn at the new rate.
2. Select Screen Setup - Sweep Speed.
3. Set the speed.
3-22
M1145956
3 Operation
Alarm setup
Alarm limits, alarm volume, and other alarm settings are adjusted in
the Alarm Setup menu. Alarm history is also accessed through this
menu. Selecting Default Limits loads the default settings as set by
the Super User or the factory defaults if no Super User settings have
been entered.
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.
The apnea time delay is the amount of time that can pass without the
system detecting a measured breath before the apnea alarm occurs.
The apnea time delay range is 10 to 30 seconds. Set the Apnea
Time in 1 second increments.
Alarm Setup
Adjust Settings
Volume Apnea
MV/TV Alarms
Leak Audio
CO2 Alarms
Auto MV Limit
Default Limits
Alarm Volume
Apnea Time
Alarm History
Previous Menu
Setting alarm limits
Off
On
On
On
Off
3
30
1. Push the Alarms Setup key.

2. Select Adjust Settings.
3. Scroll to the desired alarm.
4. Select alarm limit and set the limit.
5. Push the Normal Screen key or select Back.
M1145956
3-23
Avance
Volume apnea
Volume Apnea is not shown on the Alarm Setup menu when the
Volume Apnea Selection is set to Disable in the Install/Service
menu.
Set Volume Apnea to Off to disable the volume apnea alarm during
manual ventilation. Volume Apnea Off shows in the general
message field. The volume apnea alarm remains disabled until the
Bag/Vent switch is set to ventilator or Volume Apnea is set to On.
1. Push the Alarm Setup key.
2. Select Volume Apnea and set to On or Off.
Note
MV/TV alarms
When Volume Apnea is set to Off during manual ventilation and then
mechanical ventilation is started, the volume apnea alarms are active.
Volume Apnea - Off requires confirmation through a pop-up window
when manual ventilation is resumed.
The MV and TV alarms can be turned off. When the volume alarms
are disabled, MV/TV Alarms Off appears in the general message
field. The volume alarm limits waveform numerics show as dashes
during a case.
If the MV and TV alarms are set to Off during manual ventilation, the
alarms remain off until the Bag/Vent switch is set to ventilator or the
MV/TV Alarms is set to On.
The MV and TV alarms retain the last value set during mechanical
ventilation. If MV/TV Alarms is set to On during mechanical
ventilation, it remains on when manual ventilation starts. If MV/TV
Alarms is set to Off during mechanical ventilation it remains off when
manual ventilation starts.
2. Select MV/TV Alarms and set to On or Off.
CO2 alarms
CO2 information is obtained from the airway module installed in the

anesthesia system module bay. The CO2 alarms setting has no affect
if there is no airway module in the anesthesia system.
Set CO2 Alarms to Off during manual ventilation to disable the CO2
Apnea alarm, EtCO2 low, EtCO2 high, and FiCO2 high.
Absorbent OK? alarms. The CO2 Alarms Off message shows in the
general message field. The CO2 and O2 alarm limits waveform
numerics show as dashes during a case.
If CO2 Alarms is set to Off, the alarms remain disabled until the Bag/
Vent switch is set to ventilator, the case is ended, or the CO2 Alarms
is set to On.
2. Select CO2 Alarms and set to On or Off.
3-24
M1145956
3 Operation
Auto MV limit
MV alarm limits can be calculated automatically for mechanical

ventilation when in VCV or PCV-VG modes and volume
compensation is enabled. Set Auto MV Limit to On for automatic
calculations of the MV alarm limits. The MV alarm limits continue to
be automatically calculated until Auto MV Limit is set to Off or until
an MV alarm limit is manually adjusted during mechanical ventilation.
If the automatic calculation of the low or high minute volume alarm
limit exceeds the allowable limit, the minimum or maximum alarm limit
is used.
2. Select Auto MV Limit and set to On.
M1145956
3-25
Avance
Alternate O2 control
WARNING
The Alternate O2 control is not an auxiliary source of O2.

Alternate O2 control delivers agent and O2 through an independent
pneumatic path to the selected patient circuit and is connected to the
system O2 supply. Alternate O2 control activates automatically in the
case of certain failures or errors. It can also be activated manually.
O2 flow is 0.5 l/min to 10 l/min as indicated on the flow tube.
WARNING
When Alternate O2 control is enabled, flow from the

electronic mixer is stopped. O2 is flowing through the
Alternate O2 control to the breathing system. To activate
anesthetic agent flow to the breathing system, set the
agent to the desired concentration.
The Alternate O2 control is available approximately 20 seconds after
the system is turned on. The minimum flow can be preset to 0.5 to 10
l/min.
1. Push the Alternate O2 ON/OFF button.
2. The O2 flow is indicated on the flow tube.
3. Use the flow control to adjust the O2 flow.
4. Set the agent to the desired concentration.
5. To end Alternate O2 control, push the Alternate O2 ON/OFF
button.
1
2
AB.91.077
1. ON/OFF button
2. Flow tube
3. Flow control
Figure 3-4 Alternate O2 control
3-26
M1145956
3 Operation
EZchange canister (optional)

Push the absorber canister release to activate the EZchange canister
mode. The canister will swing down to the EZchange position. The
EZchange canister mode seals the breathing circuit when the canister
holder is down. This permits continued ventilation and rebreathing of
exhaled gases while easily replacing the absorber canister.
AB.82.042
Systems with EZchange canister have the following label on the

canister holder. When the system is in EZchange position, the
message CO2 Absorber Out of Circuit shows in the waveform area
on the anesthesia display.
To return to absorber mode, reinsert the canister into the holder and
push the canister back up and snap it into absorber position. When
the canister is in the absorber position, the exhaled gas flows through
the absorber, removing CO2.
Note
Check the absorber canister to ensure it has side rails. If the canister
does not have side rails, it will not work in the EZchange canister
holder.
AB.74p.043
1. Side rails
M1145956
3-27
Avance
Condenser (optional)
The condenser removes water in the system that is produced from
the reaction of CO2 gas with the absorbent. When fresh gas flow
settings of less than the patient minute volume are used during
ventilation, the amount of re-breathed gas increases. More CO2 flows
through the breathing system increasing the absorbent consumption.
The moisture buildup in the breathing system is also increased.
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 condensers
reservoir.
Visually check the condenser reservoir daily. Drain the reservoir daily.
1. Place a container under the reservoir.
2. Push the drain button to empty any water in the condenser.
AB.75p080
1. Drain button
2. Reservoir
3. Condenser
Figure 3-5 Condenser
3-28
M1145956
3 Operation
Passive AGSS (optional)

WARNING
Always verify the proper operation of any gas scavenging

system; ensure the scavenging system is not occluded.
The passive AGSS (Anesthesia Gas Scavenging System) contains
both positive and negative pressure relief valves to protect the
breathing system and the patient. The outlet is a 30-mm tapered
connector on the bottom of the receiver.
There is also a connector that may be used for scavenging the
sample from a gas monitor. The male luer inlet connection is located
near the 30 mm connector.
Passive AGSS is intended primarily for use in operating room
environments which have no active gas extraction system for waste
gas disposal. The disposal system generally consists of large
diameter tubing directly linking the passive AGSS with the building
exterior. The tubing should be as large in diameter and as short as
possible for the particular application.
Passive AGSS may also be used with a non-recirculating ventilation
system for waste gas disposal. The tubing connection from passive
AGSS to the non-recirculating ventilation system should be an open
connection, essentially at atmospheric pressure. For example, to an
exhaust grill.
M1145956
3-29
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Active AGSS (optional)

WARNING
Always verify the proper operation of any gas scavenging

system; ensure the scavenging system is not occluded.
There are several versions of the optional active AGSS (Anesthesia
Gas Scavenging System) available depending on the hospitals type
of waste gas disposal system.
Each version has a two-liter reservoir to capture peak exhaust flows
that briefly exceed the extract flow. The disposal system normally
entrains room air through an air brake (located in a receiver
underneath the breathing system), but will spill from this port during
extended periods of high exhaust flow. Its effectiveness is limited by
the extract flow of the particular active AGSS device.
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.
Another version is the active adjustable flow. It provides the
capability 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 36 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 system. It requires an
external venturi system with flowmeter and 36 l/min extract flow.
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 36 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 36 l/min extract flow. A flow indicator on the
system indicates when the unit is in operation.
3-30
M1145956
3 Operation
Connecting active
AGSS with a flow
indicator
To use the optional active AGSS on a system that has a flow

indicator, connect it as follows.
1. Connect the proper hose to the AGSS outlet connector on the
bottom of the AGSS underneath the breathing system. Attach the
other end to the hospital disposal system.
AB.91p093
2. With the AGSS operating, verify that the flow indicator ball on the
flow indicator rises to the green zone, indicating adequate flow.
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.
3. Complete the tests in the Preoperative Tests section of this
manual.
Connecting active
adjustable AGSS
The active adjustable AGSS option 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:
1. Connect a disposal hose to the DISS connector on the needle
valve on the bottom of the AGSS (underneath). The hose should
be flexible and reinforced to help prevent kinking and crushing.
2. Attach the other end of the hose to the hospital disposal system.
3. Attach the three-liter bag to the 30 mm auxiliary 1 port on the
bottom of the AGSS.
M1145956
3-31
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AB.75p.110
4. Use the needle valve to adjust the flow rate to match the amount
of gas being scavenged. Use the visual indicator bag when
adjusting the flow rate. The bag should remain partially inflated
when the flow rate is adequate.
5. Complete the tests in the Preoperative Tests section of this

manual.
3-32
M1145956
WARNING
In this section
Read each components Users Reference manual and

understand the following before using this system:
All system connections.
All warnings and cautions.
How to use each system component.
How to test each system component.
Before using the system:
Complete all of the tests in the Preoperative Tests

section.
Test all other system components.
If a test fails, do not use the equipment. Have a

Datex-Ohmeda trained service representative repair the
equipment.
Every day before your first patient . . . . . . . . . . . . . . . . . . . . 4-2
Before every patient . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-3
M1145956
4-1
Avance
Every day before your first patient
4-2
Check that necessary emergency equipment is available and in good

condition.
Check that the equipment is not damaged and that components are
correctly attached.
Check that pipeline gas supplies are connected and cylinders are
installed.
Check vaporizer installation:

Make sure that the top of each vaporizer is horizontal (not on
crooked).
Make sure each vaporizer is locked and cannot be removed.
Make sure the alarms and indicators operate correctly (Tec 6
series vaporizer).
Make sure more than one vaporizer cannot be turned on at
the same time.
Make sure that the vaporizers are adequately filled.
Check that the breathing circuit is correctly connected, not damaged,

and the breathing system contains sufficient absorbent.
Turn the System switch to On.
Connect scavenging and verify operation.
Calibrate the flow sensors. Do a Flow and Pressure calibration in the

Calibration menu.
Do a Machine Check in the Checkout menu.
To check the vaporizers, do a Low P Leak check in the Checkout

menu.
Check that an adequate reserve O2 supply is available.
Check that the ventilator functions correctly:

Connect a test lung to the patient Y.
Set the ventilator to VCV mode and the settings to TV at 400
ml, RR at 12, I:E at 1:2, Tpause at Off, PEEP at Off, and
Pmax at 40.
Set the gas flow to the minimum settings.
Start a case.
Set the Bag/Vent switch to ventilator.
Fill the bellows using O2 flush.
Check that mechanical ventilation starts. Check that the
bellows inflate and deflate. Check that the display shows the
correct ventilator data. Check that there are no inappropriate
alarms.
Set the appropriate controls and alarm limits for the case.
M1145956
Before every patient
M1145956
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.
Check that necessary emergency equipment is available and in good

condition.
Check vaporizer installation:

Make sure that the top of each vaporizer is horizontal (not on
crooked).
Make sure each vaporizer is locked and cannot be removed.
Make sure the alarms and indicators operate correctly (Tec 6
series vaporizer).
Make sure more than one vaporizer cannot be turned on at
the same time.
Make sure that the vaporizers are adequately filled.
Do a Low P Leak check in the Checkout menu.
Check that the breathing circuit is correctly connected, not damaged,

and the breathing system contains sufficient absorbent.
Leak check the breathing system:

Set the Bag/Vent switch to Bag, close the APL valve (set to
70), and occlude the patient Y.
Pressurize the breathing system to approximately 30 cmH2O
using the O2 flush button.
Ensure that the pressure remains fixed for at least 10
seconds.
Check that the ventilator functions correctly:

Connect a test lung to the patient Y.
Set the ventilator to VCV mode and the settings to TV at
400 ml, RR at 12, I:E at 1:2, Tpause at Off, PEEP at Off, and
Pmax at 40.
Set the gas flow to the minimum settings.
Start a case.
Set the Bag/Vent switch to ventilator.
Fill the bellows using O2 flush.
Check that mechanical ventilation starts. Check that the
bellows inflate and deflate. Check that the display shows the
correct ventilator data. Check that there are no inappropriate
alarms. Make sure that the alarms function. See the Alarm
tests.
Set the appropriate controls and alarm limits for the case.
4-3
Avance
4-4
M1145956
In this section
Inspect the system . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-2

Vaporizer installation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-3
Flow and pressure calibration . . . . . . . . . . . . . . . . . . . . . . . . 5-4
Circuit compliance compensation . . . . . . . . . . . . . . . . . . . . . 5-4
Checkout menu. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-5
Leak < 250 ml . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-5
Machine check . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-6
Individual checks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-8
Positive low pressure leak test (ACGO systems only) . . . . 5-10
Vaporizer back pressure test . . . . . . . . . . . . . . . . . . . . . . . 5-11
M1145956
5-1
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Inspect the system

WARNING
The top shelf weight limit is 34 kg (75 lb).
Make sure that the breathing circuit is correctly connected

and not damaged. Replace the breathing circuit if it is
damaged.
Do not leave gas cylinder valves open if the pipeline

supply is in use. Cylinder supplies could be depleted,
leaving an insufficient reserve supply in case of pipeline
failure.
Before using the system, ensure that:
The equipment is not damaged.
Components are correctly attached.
The breathing circuit is correctly connected, not damaged, and
the breathing system contains sufficient absorbent.
The vaporizers are locked in position and contain sufficient agent.
Pipeline gas supplies are connected and the pressures are
correct.
Cylinder valves are closed.
Models with cylinder supplies have a cylinder wrench attached to
the system.
Models with cylinder supplies have a reserve supply of O2
connected to the machine during system checkout.
The necessary emergency equipment is available and in good
condition.
Equipment for airway maintenance, manual ventilation, tracheal
intubation, and IV administration is available and in good
condition.
Applicable anesthetic and emergency drugs are available.
If an optional O2 flowmeter is present, ensure there is adequate
flow.
If an optional suction regulator is present, ensure there is
adequate suction.
The casters are not loose and the brakes are set and prevent
movement.
The power cord is connected to an electrical outlet. The mains
indicator comes on when AC Power is connected. If the indicator
is not on, the system does not have mains (electrical) power. Use
a different outlet, close the circuit breaker, or replace or connect
the power cable.
5-2
M1145956
Vaporizer installation
WARNING
Use only the Datex-Ohmeda Selectatec series vaporizers

Tec 4 or greater.
Do not use a vaporizer that lifts off of the manifold when

the lock lever is in the locked position.
Do not use this anesthesia system if more than one

vaporizer can be turned on at the same time.
Tec 6 Plus vaporizers will not align correctly unless the

power cable goes through the channel on the bottom of
the vaporizer.
1. Make sure the top of the vaporizer is horizontal. If not, remove the
vaporizer and reinstall it.
2. Set each vaporizer lock lever to the locked position.
3. Try to lift each vaporizer straight up off the manifold rather than
pulling forward. Do not rotate the vaporizer on the manifold.
4. If a vaporizer lifts off of the manifold, install it again and repeat
steps 1, 2, and 3. If the vaporizer lifts off a second time, do not
use the system.
5. With a Tec 6 Plus vaporizer:
Make sure that the vaporizer is connected to an electrical
outlet.
Hold down the Auditory Alarm Mute button for a minimum of
4 seconds.
Make sure all indicators turn on and the alarm speaker starts.
Release the Auditory Alarm Mute button.
Do not continue until the operational indicator turns on. The
concentration control will not turn if the operational indicator
is off.
6. Try to turn on more than one vaporizer at the same time:
Test each possible combination.
If more than one vaporizer turns on at the same time, remove the
vaporizers, install them again, and repeat the test.
M1145956
5-3
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Flow and pressure calibration

Calibrate the flow sensors by removing them from the system. Onscreen instructions are available through Main Menu - Calibration Flow and Pressure.
Important
Room temperature fluctuations of more than 5C may affect sensor

measurements. Recalibrate the flow sensors if the room temperature
changes by more than 5C.
2. Remove the flow sensor module.
3. Wait for No insp flow sensor and No exp flow sensor alarms to
occur.
4. Reinsert the flow sensor module. Wait for alarms to clear.
5. Start mechanical ventilation when ready.
Circuit compliance compensation

Circuit compliance is determined during the Machine Check-System
check or when the System check is done as an individual check.
The ventilator adjusts gas delivery and monitoring to compensate for
the compliance of the patient circuit if:
The system has a gas analyzer installed.
The Machine Check is completed after the system is turned on.
In volume modes, circuit compliance compensation increases the
volume delivered at the inspiratory port by taking into consideration
the circuit compliance value. In all modes, circuit compliance
compensation adjusts the exhaled volume measurements. Circuit
compliance compensation provides consistent ventilator accuracy at
the patient circuit.
WARNING
5-4
Perform a Machine Check after changing the patient tube

type. Changing the patient breathing circuit after
completing a Machine Check affects the volume delivery
in volume ventilation modes and affects the exhaled
volume measurements in all modes.
M1145956
Checkout menu
The Checkout menu shows on the display after turning on the
system. To access the Checkout menu between cases, push the
Checkout key. Step-by-step instructions show in the right window
next to the Checkout menu during the checks. Use the Checkout
menu to:
Perform a Machine Check.
Perform any of the individual checks.
Set the Leak < 250 ml setting.
View the Check Log.
Start a case.
Checkout
Machine Check
Leak < 250 ml No
Individual Checks
System
Circuit
Circuit O2 Cell
Low P Leak
Check Log
Start Case
Leak < 250 ml

The Leak < 250 ml setting is used during the circuit leak check
portion of the checkout procedures. This check tests for leaks in the
machine, breathing circuit, patient circuit, and manual bag. The
default setting is No.
Note
M1145956
Extraction of gas by external gas monitors may cause failure of the

leak checks during tests.
No
When No is selected, the leak test will pass for leaks below 250 ml at
3 kPa (30 cmH2O) pressure with no user interaction required. For
leaks between 250 ml and 750 ml, the user can fix the leak and rerun
the test or accept the leak and continue. For leaks above 750 ml, the
test will fail and the user must fix the leak and rerun the test.
Yes
Set to Yes to measure small leaks above 100 ml during the checkout
procedures. Selecting Yes will display the measured leak at 3 kPa
(30 cmH2O) pressure and result in the test taking somewhat longer.
5-5
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Machine check
The Machine Check or the individual checks must be performed at
least once within every 24-hour period.
Perform the Machine Check at the start of each day. The machine
check runs automatically and beeps to indicate when it is finished or if
interaction is required.
The Machine Check does a Machine Check-System check,
Machine Check-Circuit check, and a Machine Check-Circuit O2
cell check (if circuit O2 cell is present). When one of the checks is
completed, the next check begins.
1. Turn the System switch to On.
2. Select Machine Check and follow the instructions.
3. If a check fails, follow the instructions to perform a recheck or
accept the results.
4. When the Machine Check is completed, start a case.
Note
Machine check system
In case of a patient emergency, the Machine Check may be

bypassed by selecting Start Case from the Checkout menu. The
general message Please Do Checkout is displayed if a Machine
Check is not completed with passing results within 24 hours.
The Machine Check-System checks the Bag/Vent switch, proper
gas supply pressures, ventilator operation and leak, battery and
electrical power, circuit compliance, and flow control operation. This
is a two-step check.
1. Set the Bag/Vent switch to Vent.
2. Open the patient Y.
3. (ACGO option only.) Set the ACGO switch to Circle.
4. Select Start. The display shows the checks being run.
The system beeps when this portion of the check is done.
The results are shown on the display.
5. Make sure the bellows is fully collapsed.
6. Occlude the patient Y.
7. Select Continue. The display shows the checks being run.
8. When the check passes, the next check starts.
5-6
M1145956
Machine check circuit
The Machine Check-Circuit checks the Bag/Vent switch, proper gas

supply pressures, airway pressure measurement transducer, APL
valve, and manual circuit leak.
2. Set Bag/Vent switch to Bag.
3. Set the APL valve halfway between 30 and 70.
The system beeps when the check is done.
6. When the check passes, the next check starts.
Machine check circuit O2
The Machine Check-Circuit O2 check measures the O2%.

4. The display will show the O2%. Do not select Done when 21 is
first displayed. Allow the reading to stabilize, then select Done.
Calibrate the O2 cell if necessary.
Machine check monitor
M1145956
When External Gas Monitor is set to Yes by the Super User, the
Machine Check-Monitor check occurs. This check is not a test. This
check is a reminder to connect a respiratory gas monitor.
5-7
Avance
Individual checks
The Machine Check or the individual checks must be performed at
least once within every 24-hour period.
Individual checks allow the user to perform any combination of single
checks. These checks are helpful if there is a specific problem/alarm
and the user wishes to test only that portion of the system.
The checks do not automatically move on to the next check. After
completing a check, do another check or start a case. If a check fails,
follow the instructions to perform a recheck or accept the results.
System
The System check checks the Bag/Vent switch, proper gas supply
pressures, ventilator operation and leak, battery and electrical power,
circuit compliance, and flow control operation. This is a two-step
check.
The system beeps when this portion of the check is done.
5. Make sure the bellows is fully collapsed.
7. Select Continue. The display shows the checks being run.
8. When the check passes, select Back.
9. Select another check or select Start Case to go to the Start Case
menu.
Circuit
The Circuit check checks the Bag/Vent switch, proper gas supply
pressures, airway pressure measurement transducer, APL valve, and
manual circuit leak.
2. Set Bag/Vent switch to Bag.
3. Set the APL valve halfway between 30 and 70.
6. When the check passes, select Back.
menu.
5-8
M1145956
Circuit O2 cell
The Circuit O2 Cell check measures the O2%.

4. The display will show the O2%. Do not select Done when 21 is
first displayed. Allow the reading to stabilize, then select Done.
Calibrate the O2 cell if necessary.
menu.
Low P leak
The positive pressure Low P Leak check measures machine leaks

before the breathing system, between the common gas outlet and the
high pressure pneumatics and includes the gas mixer and vaporizer.
It measures low pressure pneumatic leaks with a pass or fail limit of
50 ml.
1. Make sure that the vaporizers to be used during the case are
mounted on the machine and turned off.
2. Occlude the inspiratory (right-hand) port.
3. Select Start.
4. The display shows the checks being run. The system beeps
when the check is done.
5. Repeat the check once for each vaporizer with one vaporizer
turned on at a time.
6. When the checks pass, turn the vaporizer off.
7. Open the inspiratory port and reconnect the breathing circuit.
Select another check or select Start Case to go to the Start Case
menu.
Low P leak
(machines with
ACGO)
The negative Low P Leak check measures machine leaks before the
breathing system, between the common gas outlet and the high
pressure pneumatics and includes the gas mixer and vaporizer. It
measures low pressure pneumatic leaks with a pass/fail limit of 50 ml.
1. Make sure that the vaporizers to be used during the case are
mounted on the machine and turned off.
2. Make sure the ACGO switch is set to ACGO.
3. Attach the squeeze bulb to the ACGO outlet.
4. Squeeze (collapse) the bulb.
5. If the bulb inflates in less than 30 seconds, select Fail.
6. If the bulb remains collapsed, repeat the check once for each
vaporizer with one vaporizer turned on at a time.
7. When the checks pass, turn the vaporizers off and remove the
squeeze bulb from the ACGO outlet.
M1145956
5-9
Avance
Positive low pressure leak test (ACGO systems only)

Note
CAUTION
For ACGO machines, perform either a negative Low P Leak check in

the Checkout menu or positive low-pressure leak check depending
on local requirements.
Do a positive-pressure leak test at the ACGO port only.

1. Connect the leak test device to the ACGO port with the positivepressure 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. Repeat this low-pressure leak test for each vaporizer.
Set the applicable vaporizer to 1%.
Turn the vaporizer off after the test.
WARNING
Agent mixtures from the low-pressure leak test stay in the

system. Always flush the system with O2 after the lowpressure leak test (1 l/min for at least one minute).
Turn all vaporizers off at the end of the low-pressure leak

test.
10. Remove the adapter and leak test device.
11. Set the O2 flow to 1 l/min and continue flow for one minute.
5-10
M1145956
Vaporizer back pressure test

WARNING
Anesthetic agent comes out of the circuit during this test.

Use a safe, approved procedure to collect and remove the
agent.
1. Set the System switch to On.
2. Start a case.
3. Set the O2 flow to 6 l/min.
4. Slowly adjust the vaporizer concentration from 0 to 1%.
Make sure that the O2 flow stays constant.
Verify that the system continues to operate without issuing
any related alarms.
5. Repeat this test for both vaporizer positions.
M1145956
5-11
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5-12
M1145956
6 Airway Modules
In this section
Airway modules . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-2

Parameters setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-5
Automatic agent identification . . . . . . . . . . . . . . . . . . . . . . . . 6-6
Calibration. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-6
M1145956
6-1
Avance
Airway modules
The optional compact airway modules measure and monitor gases
delivered to the patient and exhaled through the breathing circuit. The
modules consist of an infrared sensor for measuring CO2, N2O, and
anesthetic agents; a paramagnetic O2 sensor; and a gas sampling
system with the D-fend water separation system.
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.
WARNING
6-2
Remove the airway sampling line from the patients

airway and seal the sample port while nebulized
medications are being delivered. Nebulized medications
interfere with accurate gas reading.
If the Data Source is set to Patient in the Spirometry
Setup menu, no Paw, Flow, Agent, or CO2 waveforms or
numeric information is displayed during the airway gas
module warm-up period (approximately 2 minutes). Set
the Data Source to Vent to display the waveforms and
numeric information during the airway gas module warmup period.
CAUTION
Use only cables and accessories approved by

Datex-Ohmeda. Other cables and accessories may
damage the system or interfere with measurement.
Single-use accessories are not designed to be reused.
Strong scavenging suction on the monitor exhaust port

may change the operating pressure of the monitor and
cause inaccurate readings or internal damage.
M1145956
6 Airway Modules
Use only airway modules that have anesthetic agent monitoring and
O2 monitoring on this system. The following modules can be used on
this system: E-CAiO, E-CAiOV, E-CAiOVX, M-CAiO, M-CAiOV, and
M-CAiOVX. (E series modules must be software version 4.5 and
above. M series modules must be software version 3.2 and above.)
Letters in the name of the airway modules stand for:
E = plug-in gas module
M = plug-in gas module
C = CO2 and N2O
A = anesthetic agents
i = agent identification
O = patient O2
V = patient spirometry
X = Gas exchange
2
3
4
6
MD.60.008
1.
2.
3.
4.
5.
6.
D-fend water trap

Sampling line connector
Water trap latch
Reference gas inlet
Sample gas outlet
Cooling fan
Figure 6-1 Compact airway module
M1145956
6-3
Avance
Connection to a
patient
1. Check that the airway gas module is installed.

2. Check that the airway adapter connections are tight and that the
adapter is correctly installed.
3. Check that the water trap container is empty and properly
attached.
WARNING
Before connecting the exhaust line to the sample gas

outlet on the compact airway module, ensure the other
end is connected to the sample gas return port on the
anesthesia machine. Incorrect connections may cause
patient injury.
4. Connect the exhaust line from the sample gas return port to the
sample gas outlet if N2O or volatile agents are used. (See the
Parts section.)
5. Attach the gas sampling line to the sampling line connector on
the water trap.
6. Turn the system on. The system does a series of automated self
tests. The automatic agent identification is activated.
7. Connect the sampling line to the airway adapter. Take the gas
sample as close to the patients airway as possible. Position the
adapters sampling port upwards to prevent condensed water
from entering the sampling line.
AB.91.010
1. Airway module
2. Gas sampling line
3. Airway adapter with sampling line connector
Figure 6-2 Airway gases setup with compact airway module
6-4
M1145956
6 Airway Modules
Parameters setup
Use the Parameters Setup menu to change the monitoring settings
of the data source, CO2, O2, agent, and spirometry. Push the Main
Menu key. Select Parameters Setup.
Data source
Several monitoring parameters can be obtained from the ventilator or

the airway module. Information that is retrieved from the airway
module is identified with the module data indicator.
Figure 6-3 Airway 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. If the internal ventilator
sensor readings disagree with the airway module sensor readings,
the associated alarm occurs.
CO2 setup
O2 setup
Change the size of the CO2 waveform by changing the scale height.
The scale units (%, kPa, and mmHg) are set by the Super User.
Select CO2 Alarm or Resp Rate Alarm to access and change the
alarm limits for the corresponding alarm.
Select O2 Alarm to access and change the O2 alarm limits.
Agent setup
Change the size of the agent waveform by changing the scale height.
Select Agent Alarm to access and change the agent alarm limits.
Spirometry setup
Change the size of the Paw and Flow waveforms by changing the
corresponding scale heights. Select Paw Alarm or MVexp Alarm to
access and change the alarm limits for the corresponding alarm.
M1145956
6-5
Avance
Automatic agent identification

Airway modules with agent identification will automatically identify
and select Halothane, Enflurane, Isoflurane, Sevoflurane, and
Desflurane. The inspiratory and expiratory concentrations of the
agent appear in the number field or the agent waveform field if
selected.
Minimum concentration for the identification is 0.15% volume. The
agent selection remains active even if the concentration decreases
below 0.15% volume during the case.
Automatic agent identification operates after the normal warm up of
the gas module (approximately five minutes).
Calibration
Calibrate airway modules once every six months or whenever there
are indications of errors in the gas readings. Use a Datex-Ohmeda
calibration gas and regulator to calibrate the modules. See the
Parts section for the stock numbers of the calibration gas and
regulator.
WARNING
Only use Datex-Ohmeda calibration gas. Do not use any

other calibration gases or the calibration will not succeed.
During gas calibration, % units are used for CO2 regardless of
selected measuring units.
1. Turn on the power. Let the module warm up for 30 minutes before
starting calibration.
2. Attach the regulator to the calibration gas cylinder.
3. Attach a new sampling line to the water trap. Connect the loose
end of the sampling line to the regulator on the calibration gas
cylinder.
5. Select Calibration.
6. Select Airway Gas.
7. Wait until Feed Gas appears after each gas name:
CO2 Feed Gas.
O2 Feed Gas.
N2O Feed Gas.
Agent Feed Gas.
8. Open the regulator until the gauge reads between 5 to 7 psi.
Feed the calibration gas until the message OK or Adjust
appears.
If an error occurs during calibration or if no gas is fed, Calibr
Error appears after the gas name. Push the ComWheel to
perform a new calibration.
6-6
M1145956
6 Airway Modules
9. If adjustments are needed:
Do not close the regulator until all the adjustments have been
made.
Select the gas to be adjusted and press the ComWheel.
Use the ComWheel to change the value until it matches the
calibration gas cylinder value. Push the ComWheel to confirm
the change.
Repeat for each gas requiring adjustment.
M1145956
6-7
Avance
6-8
M1145956
CAUTION
WARNING
In this section
No repair should ever be attempted by anyone not having

experience in the repair of devices of this nature. See the
Repair policy in the User Maintenance section.
If an alarm occurs, safeguard the patient first before
performing troubleshooting or doing repair procedures.
Alarms. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-2
List of alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-4
Alarm ranges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-12
Alarm tests . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-14
Breathing system problems . . . . . . . . . . . . . . . . . . . . . . . . 7-16
Electrical problems . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-17
Pneumatic problems . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-18
M1145956
7-1
Avance
Alarms
Alarms are divided into technical alarms and parameter alarms.
These alarms may be high priority, medium priority, or informational.
When an alarm occurs during a case, an alarm tone sounds and the
alarm message is displayed in the alarm message field.
Technical alarms result from a technical problem and occur whether
or not a patient is connected to the system. Parameter alarms are
calculated limits and limits that are set by the user on the Alarm
Setup menu. Parameter alarms occur only during a case.
Alarm priorities
Alarm priority is indicated by the color of the alarm message and the
alarm LED located next to the alarm silence button.
High-priority alarm messages appear in white text on a red
background. During a high-priority alarm, the red LED flashes.
Medium-priority alarm messages appear in yellow text on a gray
background. During a medium-priority alarm, the yellow LED flashes.
Informational alarms appear in white text on a gray background.
During an informational alarm, the yellow LED is on solid.
When a high-priority alarm is active at the same time as a mediumpriority alarm or an informational alarm, the red and yellow LEDs
flash. When a high-priority alarm is active at the same time as an
informational alarm, the red LED flashes and the yellow LED is on
solid. When a medium-priority alarm is active at the same time as an
informational alarm, the yellow LED flashes. Pushing the Silence
Alarms key changes the LED from flashing to on solid until the end
of the alarm silence.
Silencing alarms
Silencing an alarm stops the audible tone for 120 seconds. The alarm
message shows in the alarm message field. Pushing the Silence
Alarms key when no medium or high priority alarms are active
suspends audible alarm tones for 90 seconds.
Alarms in the apnea alarm family have special silence behavior to
reduce apnea nuisance alarms. Apnea family alarms include Apnea,
TVexp low, EtCO2 low, MVexp low, and RR low.
When silencing an apnea family alarm, the audio tone for the active
alarm is silenced for 120 seconds. The audible tone for any additional
apnea family alarm that occurs during the silence period is silenced
for the remain time shown on the alarm silence countdown. Only the
audible alarm tone is silenced. The alarm messages still show in the
alarm message fields. APN shows above the alarm silence
countdown when the audible tone silence is in affect for the apnea
family alarms.
Display changes
during alarms
7-2
Messages may appear in the waveform field during some alarms. If

more than one alarm has a message, the message for the highest
priority alarm is displayed. The message is removed when the alarm
is resolved.
M1145956

The color of the alarm text shown in the alarm message fields is
dependent on the alarm priority. Messages for high-priority alarms
use red text. Messages for medium-priority alarms use yellow text.
Informational messages use white text.
When the O2 pipeline supply pressure drops to less than 252 kPa (36
psi), the lower-right corner of the display toggles between the O2
supply information and the set digit field.
Some patient parameter alarms, such as Ppeak high and FiO2 low,
will latch when the alarm condition is corrected. When an alarm is
latched, it is displayed in white text on a black background. The
parameter box will stop flashing. All the associated waveform,
numeric, and digit field messages are removed from the display. The
flashing LED associated with that alarm changes from flashing to on
solid. The alarm will remain in this condition until it is acknowledged
by pushing the Silence Alarms key or until the alarm re-occurs.
When the alarm is acknowledged, it is removed from the screen. If an
alarm has latched and the alarm re-occurs before it is acknowledged,
the alarm will revert to an active state.
De-escalating alarms
Battery indicator
Internal failure
M1145956
Some device related alarms, such as Reverse Flow and No insp

flow sensor, will de-escalate priority when the alarm is acknowledged
by pushing the Silence Alarms key. The audible alarm tone is
stopped for that active alarm until the alarm condition is resolved. The
alarm message shows at the informational 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.
The color and fill amount of the battery in use symbol indicates the
amount of battery power remaining. Green indicates greater than 10
minutes of battery power remaining. Yellow indicates less than 5
minutes battery power remaining.
Internal problem prevents normal operation. shows on the display
during a software or hardware failure that requires service. If this
message occurs, contact a Datex-Ohmeda trained service
representative.
7-3
Avance
List of alarms
If the corrective action does not resolve the alarm message, contact a
Datex-Ohmeda trained 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.
Message
Priority
Cause
Action
AA, CO2
monitoring not
connected
Medium
External Gas Monitor setting is

set to No on the Install/Service
menu. External Gas Monitor
setting is No on the Install/
Service menu and the monitor
condition changes to
disconnected.
Set External gas monitor setting to Yes if the

system uses a stand-alone monitor for O2,
AA, and CO2.
Air pressure low. High

Increase O2 %.
O2% is set to Air at 21%. Air

Ensure the air pipeline and cylinder are
pipeline pressure is less than
properly connected. Increase the O2% flow.
252 kPa (36 psi) and the air
cylinder pressure dropped below
2633 kPa (381 psi) for one
second.
Air supply
pressure low
Medium
Air pipeline pressure is less than

252 kPa (36 psi) and the air
second.
Ensure the air pipeline and cylinder are

properly connected.
Contact a Datex-Ohmeda trained service
representative.
Apnea
Medium
Apnea time delay (10-30

seconds) has passed without a
measured breath.
Apnea time delay (20 - 30
seconds) has passed without a
changed in the measured CO2
by at least 1%.
Check for leaks in the patient circuit. Check

for patient disconnection.
Apnea >120 s
High
Apnea time exceeds 120

seconds.
Check for leaks or blockages in the breathing

circuit. Ensure the Bag/Vent switch is in the
Vent position. Check the patient.
Backup Mode
active
Informational
No spontaneous breaths in set

period of time (Backup Time)
and 30 seconds have passed
since starting PSVPro mode.
Select a new ventilation mode.

The number of consecutive patient triggered
breaths reaches the Exit Backup setting.
Breathing
system loose
Informational
The breathing system is not

latched.
Push the breathing system onto the frame

and ensure it latches.
7-4
M1145956
Message
Priority
Cause
Calibrate
(remove) flow
sensors
Informational
Flow calibration failure or more

Calibrate the flow sensors.
than 24 hours have passed since
the last flow sensor calibration.
Calibrate O2
sensor
Informational
Calibration failure or measured

O2 is greater than 110%.
Calibrate the O2 cell. Replace the O2 cell if

necessary.
Calibrate, dry, or Informational

replace flow
sensors
Patient volume mismatch

occurred during the last case.
Calibrate, dry or replace the flow sensors.

Start a new case.
Cannot monitor
Air pipeline
Medium
Air pipeline pressure is invalid.
Check pipeline supply pressure.

representative.
Cannot monitor
gas supplies
Informational
Hardware failure.

representative.
Cannot monitor
O2 pipeline
Medium
O2 pipeline pressure is invalid.
Check pipeline supply pressure.
Cannot read gas Medium

supply
pressures
Transducer failure.

representative.
Check circuit
connections
Medium
Breaths detected in circle circuit

while non-circle circuit is
selected.
Check circle circuit connections and settings.
Check D-Fend
Medium
Water trap not attached.
Check that the water trap is properly attached

to the airway module.
Check flow
sensors
Medium
System has detected an

improper flow pattern in the
breathing circuit.
Ensure the internal flow sensors are

connected correctly.
Check sample
gas out
Medium
Possible blockage in airway

module sample gas outlet.
Check for blockage in the airway module

sample gas outlet. Remove blockage.
Circuit leak
Medium
Vent TVexp is less than half of

vent TVinsp for at least 30
seconds.
Check for leaks in the patient circuit.

Calibrate flow sensors. If problem persists,
replace flow sensors.
Circuit leak
silenced
Informational
Setting on Alarm Setup menu.
Vent TVexp is less than 50% of vent TVinsp

for at least 30 seconds. Message indicates
that the Leak Audio alarm is turned off.
Circuitry >75C
shutdown
possible
Medium
Power supply temperature

exceeds 75C.
Shut down system as soon as possible.

Then, check cooling fans and filters.
Cooling fan
needs service.
System OK.
Medium
Fan reporting error.

Then, check cooling fans and filters.
Cooling fans
failed. May
overheat.
Medium
Fan reporting error.

representative.
M1145956
Action
7-5
Avance
Message
Priority
Cause
Action
Display panel
controls failure
Medium
Communication lost between

panel and key pad.
Turn the system off and back on.
EtCO2 high
High
EtCO2 is greater than high alarm Check the patient and EtCO2 settings. Check
limit.
if absorbent needs to be changed.
EtCO2 low
Informational
Medium after 1
minute
EtCO2 is less than alarm limit.

Priority escalates to Medium if
alarm is not resolved after 1
minute.
Ensure the patient is properly intubated.

Check for leaks or blockages in the patient
circuit.
EtDES high
Medium1
EtDES is greater than alarm

limit.
Set the alarm limits appropriately. Decrease

the agent concentration.
EtDES low
Informational
EtDES is less than alarm limit.
Check the fill level on the vaporizers. Set

alarm limit appropriately. Increase the agent
concentration.
EtENF high
Medium1
EtENF is greater than alarm

limit.

EtENF low
Informational
EtENF is less than alarm limit.

concentration.
EtHAL high
Medium1
EtHAL is greater than alarm limit. Set the alarm limits appropriately. Decrease
EtHAL low
Informational
EtHAL is less than alarm limit.
EtISO high
Medium1
EtISO is greater than alarm limit. Set the alarm limits appropriately. Decrease
EtISO low
Informational
EtISO is less than alarm limit.

concentration.
EtO2 high
Medium
EtO2 is greater than high alarm

limit.

the O2 concentration.
EtO2 low
Medium
EtO2 is less than low alarm limit. Set the alarm limits appropriately. Increase
the O2 concentration.
EtSEV high
Medium
EtSEV is greater than alarm

limit.

EtSEV low
Informational
EtSEV is less than alarm limit.

concentration.
FiCO2 high.
Absorbent OK?
High
FiCO2 is greater than alarm limit. Check if absorbent needs to be changed.

Check the patient.
FiDES high
Medium1
FiDES is greater than alarm limit. Set the alarm limits appropriately. Decrease
7-6

concentration.
M1145956
Message
Priority
Cause
Action
FiDES low
Informational
FiDES is less than alarm limit.

concentration.
FiENF high
Medium1
FiENF is greater than alarm limit. Set the alarm limits appropriately. Decrease
FiENF low
Informational
FiENF is less than alarm limit.
FiHAL high
Medium1
FiHAL is greater than alarm limit. Set the alarm limits appropriately. Decrease
FiHAL low
Informational
FiHAL is less than alarm limit.
FiISO high
Medium1
FiISO is greater than alarm limit. Set the alarm limits appropriately. Decrease
FiISO low
Informational
FiISO is less than alarm limit.

concentration.
FiO2 high
Medium
FiO2 is greater than high alarm

limit.
Check the O2 setting. Recalibrate the O2 cell

and the airway module.
FiO2 low
High
FiO2 is less than low alarm limit. Check O2 setting. Check for leaks or
blockages in the patient circuit.
FiSEV high
Medium
FiSEV is greater than alarm limit. Set the alarm limits appropriately. Decrease
FiSEV low
Informational
FiSEV is less than alarm limit.

concentration.
For mech vent,

set Bag/Vent
switch
Informational
Bag/Vent switch is set to Bag

and the ACGO switch is set to
Circle.
Move switch to the Vent position to start

mechanical ventilation.
Gas monitoring
not available
Medium
Airway module hardware failure. Replace airway module. Then, turn power off
and back on between cases to clear the
alarm and receive module data.

concentration.

concentration.
Increase low MV Medium

limit
Low MV limit is off in SIMV/PSV, Increase Low MV alarm limit to improve

SIMV-PC, or PSVPro modes.
patient disconnection detection.
Inspiration
stopped
Medium
High airway pressure.
Internal failure.
System may
shut down.
High
Power controller software failure. Contact a Datex-Ohmeda trained service

representative.
Internal failure.
System may
shut down.
Medium
Power controller software failure. Contact a Datex-Ohmeda trained service

representative.
M1145956
Check system for blockages.
7-7
Avance
Message
Priority
Cause
Action
Memory
(EEPROM)
failure
Informational
Software error.

representative.
Module fail. No
CO2, AA, O2
data.
Medium
Airway module hardware failure. Replace module.
Module not
compatible
Informational
The monitoring module detected Remove the incompatible module. Use a

is not compatible with system
compatible module.
software.
Move Bag/Vent
Switch to Bag
Medium
Bag/Vent switch is in the wrong

position.
MVexp high
Medium
MVexp is greater than MVexp

Change TV, RR, I:E, or PEEP to reset the
high alarm limit (for nine breaths minute volume to below the MVexp high
alarm limit.
or one minute).
MVexp low
Medium
MVexp is less than MVexp low

alarm limit (for nine breaths or
one minute).
Change TV, RR, I:E, or PEEP to reset the

minute volume to above the MVexp low alarm
limit.
N2O supply
pressure low
Medium
N2O pipeline pressure is less

than 252 kPa (36 psi) and the
N2O cylinder pressure is less
than 2633 kPa (381 psi).
Ensure the N2O pipeline and cylinder are

properly connected.
Negative airway High

pressure
Paw is less than -10 cm H2O.
Check for blockages in the patient circuit.
No battery
backup
Medium
Battery or charging failure.
Between cases turn the system circuit

breaker off, then back on after 15 seconds to
reset the system.
No exp flow
sensor
Medium
Electrical signals show the flow

sensor is not connected.
Connect the flow sensor. Replace the flow

sensor if necessary.
No fresh gas
flow!
High
Possible patient detected while

system is in checkout state.
Disconnect the patient or start a case.
No fresh gas
flow?
High
Possible fresh gas flow occlusion Switch to circle circuit or bag the patient.
or loss of gas pressure.
Check pipeline supply connection.
No insp flow
sensor
Medium
Electrical signals show the flow

sensor is not connected.
Connect the flow sensor. Replace the flow

sensor if necessary.
O2 flush stuck
on?
Informational
Switch is detected on
continuously for more than 30
seconds.
Check flush valve. Ensure flush valve is not

sticking.
O2 monitoring
not connected
Medium
O2 cell not connected.
Install airway gas module or connect the O2

cell.
O2 supply
pressure low
High
O2 pipeline pressure is less than Ensure the O2 pipeline and cylinder are
252 kPa (36 psi) and the O2
properly connected.
second.
7-8
Move switch to the Bag position.
M1145956
Message
Priority
Cause
Action
PEEP high.
Blockage?
High
Paw greater than or equal to

sustained limit for 15 seconds.2
Plug in power
cable. On
battery.
Medium
The mains supply is not

connected or has failed and the
system is using battery power.
Ventilate manually to save power. Make sure

the power cable is plugged in and system
circuit breaker is on.
Ppeak high
High
Paw is greater than Pmax alarm

limit.
Ppeak low.
Leak?
Medium
Peak airway pressure is less

Check for leaks in the patient circuit.
than low Pmin + 4 cmH2O for 20
consecutive seconds if the set
respiratory rate is four or higher
and 35 seconds if the set
respiratory rate is less than four
breaths/min.
Replace D-Fend Medium
Buildup in airway module sample Replace D-Fend.

line.
Replace exp
flow sensor
Informational
EEPROM calibration data read

failure.
Replace the expiratory flow sensor.
Replace insp
flow sensor
Informational
EEPROM calibration data read

failure.
Replace the inspiratory flow sensor.
Replace O2
sensor
Informational
Measured O2 is less than 5%.
Calibrate the O2 cell. Replace the O2 cell if

necessary.
Reverse exp
flow. Check
valves OK?
Medium
Flow toward the patient seen in Check the flow sensor condition. Replace the
the expiratory flow sensor during expiratory check valve between cases. Zero
inspiration for six breaths in a
flow transducers between cases.
row.
Reverse insp
flow. Check
valves OK?
Medium
Flow away from the patient seen Check the flow sensor condition. Replace the
in the inspiratory sensor during
inspiratory check valve between cases. Zero
expiration for six breaths in a
flow transducers between cases.
row.
RR high
Medium
RR is greater than high alarm

limit.
Set the alarm limits appropriately or adjust

the RR setting.
RR low
Medium
RR is less than low alarm limit.
Set the alarm limits appropriately or adjust

the RR setting.
Sample line
blocked
Medium
Airway module sample line is

blocked.
Replace airway module sample line.
Service
calibration
advised
Informational
Calibration data is corrupt.

representative.
Set Alt O2 flow!

Check agent
setting!
Medium
Software or hardware failure

prevents mixed gas delivery.

representative.
System leak?
Informational
Leak detected between

ventilator and patient circuit.
Check for leaks in the breathing system.
M1145956
7-9
Avance
Message
Priority
Cause
Action
System
shutdown in <5
min
High
Remaining battery power is

between zero and five minutes.
Plug in the power cable. Check that the

system circuit breaker is on.
Turn power Off

and On for self
tests
Informational
System has been operating for

longer than 12 hours without a
power-up self test.
Turn power off and back on between cases to

perform a self test.
Turn switch on
to continue use
High
System is in therapy when

System switch is turned to
Standby.
Turn the System switch to On to continue

therapy. The system will return to normal
function. If System switch is not turned to On
within 8 seconds, the system will shut down.
TV not achieved Informational
Measured tidal volume is less

than set tidal volume.
Check for leaks in the patient circuit. Check

for leaks in the breathing system.
TVexp high
Medium
TVexp is greater than TVexp

high alarm limit (for nine
breaths).
Change TV, RR, I:E, or PEEP or change the

tidal volume to reset TVexp high alarm limit.
TVexp low
Medium
TVexp is less than TVexp low

alarm limit (for nine breaths).
Change TV, RR, I:E, or PEEP or change the

tidal volume to reset TVexp low alarm limit.
Unable to drive
bellows
Informational
Bellows is collapsed.
Check the drive gas. Increase fresh gas flow

(or push the O2 flush button) to fill the
bellows.
Using battery.
Power
Controller fail.
Medium
Mains supply is OK, but the

Shut down the system as soon as possible.
system is running on the battery. Contact a Datex-Ohmeda trained service
representative.
Ventilate
manually!
High

prevents mechanical ventilation.
No pressure, no flow, and no
volume monitoring from
ventilator.
Use a manual bag to ventilate the patient or

use an alternate machine. Shutdown the
system as soon as possible and contact a
Datex-Ohmeda trained service
representative.
Ventilate
manually!
Medium

prevents mechanical ventilation.
Pressure, flow, and volume
monitoring from ventilator still
available.
Use a manual bag to ventilate the patient or

use an alternate machine. Shutdown the
system as soon as possible and contact a
representative.
Ventilator has
no drive gas
High
Drive gas supply is not sufficient Check drive gas supply. Use a manual bag to
to mechanically ventilate.
ventilate the patient until the drive gas supply
is restored.
Vol and Apnea

monitoring off
Informational
Non circle circuit is selected.
Message will clear when circle circuit is

selected.
Vol vent only.

No PEEP or
PSV.
Medium
Manifold pressure error.

Pressure control unavailable.
Medium priority alarm when Bag/
Vent switch is in Vent and
running PCV, PSVPro, or SIMVPC mode.
Use volume control ventilation mode. Shut

down system as soon as possible. Contact a
representative.
7-10
M1145956
Message
Priority
Cause
Action
Vol vent only.

No PEEP or
PSV.
Informational
Manifold pressure error.

Pressure control unavailable.
Informational priority alarm when
Bag/Vent switch is in Vent and
not running PCV, PSVPro, or
SIMV-PC mode; Bag/Vent switch
is in Bag; or Non-circle circuit or
ACGO is selected.
Continue to use volume control ventilation

mode or ventilate manually. Shut down
system as soon as possible. Contact a
representative.
Volume sensors Informational

disagree
TVexp is greater than TVinsp for Calibrate the flow sensors. Replace the flow
six breaths.
sensors if the message does not clear.
The alarm priority escalates to High if the alarm is not resolved after 2 minutes.
2The
sustained pressure threshold is calculated from the pressure limit setting. The sustained limit is calculated as
follows:
Mechanical
Ventilation with
PEEP Off:
For Pmax less than 30 cmH2O, the sustained pressure limit is 6 cmH2O.
For Pmax between 30 and 60 cmH2O, the sustained pressure limit is 20% of Pmax.
For Pmax greater than to 60 cmH2O, the sustained pressure limit is 12 cmH2O.
Mechanical
Ventilation with
PEEP On:
For Pmax less than 30 cmH2O, the sustained pressure limit is 6 cmH2O plus set 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.
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.
M1145956
7-11
Avance
Alarm ranges
The alarms names are listed in order they appear on the Alarm
Limits page accessible from the Alarm Setup menu. The alarms
setting ranges show in the order they appear in the setting selections
in the Alarm Settings menu. See the Super User Mode section for
more information on the alarm default settings.
7-12
Alarm
Range
Increment
Pmax (only high)
12 -100 cmH2O
1.2 - 9.8 kPa
12 - 98 mbar, hPa
9 - 73 mmHg
1 cmH2O
0.1 kPa
1 mbar, 1hPa
1 mmHg
MV High
0.5 - 30.0, Off l/min
0.5 l/min
MV Low
Off, 0.1 - 10.0 l/min
0.1 l/min
TV High
20 - 1600, Off ml
20 ml
TV Low
Off, 5 - 20 ml
20 - 1500 ml
5 ml
20 ml
RR High
2 - 100, Off bpm
1 bpm
RR Low
Off, 1 - 99 bpm
1 bpm
EtCO2 High
0.1 -15%, Off

0.1 - 15, Off kPa
1 -115, Off mmHg
0.1%
0.1 kPa
1 mmHg
EtCO2 Low
Off, 0.1 - 14.9%

Off, 0.1 - 14.9 kPa
Off, 1 - 114 mmHg
0.1%
0.1 kPa
1 mmHg
FiCO2 High
0.1 - 15%, Off

0.1 - 15, Off kPa
1 - 115, Off mmHg
0.1%
0.1 kPa
1 mmHg
FiO2 High
19 - 100%, Off
1%
FiO2 Low
18 - 99%
1%
EtO2 High
19 - 100%, Off
1%
EtO2 Low
Off, 1 - 99%
1%
FiISO High
0.1 - 7.0%
0.1%
FiISO Low
Off, 0.1 - 6.9%
0.1%
FiSEV High
0.1 - 10.0%
0.1%
FiSEV Low
Off, 0.1 - 9.9%
0.1%
FiDES High
0.1 - 20.0%
0.1%
FiDES Low
Off, 0.1 - 19.9%
0.1%
FiENF High
0.1 - 7.0%
0.1%
FiENF Low
Off, 0.1 - 6.9%
0.1%
FiHAL High
0.1 - 7.0%
0.1%
FiHAL Low
Off, 0.1 - 6.9%
0.1%
EtISO High
0.1 - 7.0%, Off
0.1%
EtISO Low
Off, 0.1 - 6.9%
0.1%
M1145956
M1145956
Alarm
Range
Increment
EtSEV High
0.1 - 10.0%, Off
0.1%
EtSEV Low
Off, 0.1 - 9.9%
0.1%
EtDES High
0.1 - 20%, Off
0.1%
EtDES Low
Off, 0.1 - 19.9%
0.1%
EtENF High
0.1 - 7.0%, Off
0.1%
EtENF Low
Off, 0.1 - 6.9%
0.1%
EtHAL High
0.1 - 7.0%, Off
0.1%
EtHAL Low
Off, 0.1 - 6.9%
0.1%
7-13
Avance
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 in order to test the O2
alarms.
1. Connect a test lung to the patient connection.
2. Start a case.
4. Set the O2 concentration to 30%, and allow the O2 reading to
stabilize.
For machines configured to individual gas control, set the O2
flow to approximately 500 ml/min and Air flow to
approximately 5 l/min.
5. 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 button.
Make sure the FiO2 high alarm occurs.
Set the FiO2 High alarm limit back to 100%. Make sure that
the FiO2 high alarm cancels.
6. Test the MVexp low alarm:
Go to the Alarm Setup menu.
Set the MV Low alarm limit to greater than the measured
minute volume.
Make sure that a MVexp low alarm occurs.
Set the MV Low alarm limit to off.
7. Test the Ppeak high alarm:
Set the Pmax to less than the peak airway pressure.
Make sure that the Ppeak high alarm occurs.
Set the Pmax to the desired level.
8. Test the PEEP high. Blockage? alarm:
Close the APL valve.
Set the Bag/Vent switch to Bag. Mechanical ventilation stops.
Block the patient connection and push the O2 flush button.
Make sure that the PEEP high. Blockage? alarm occurs
after approximately 15 seconds.
7-14
M1145956

9. Test the Ppeak low. Leak? alarm:
Unblock the patient connection.
Set the Bag/Vent switch to Vent.
Set the tidal volume and total flow to minimum.
Other alarms such as MVexp low can occur.
Make sure that the Ppeak low. Leak? alarm occurs.
10. Set all alarm limits to approved clinical values.
M1145956
7-15
Avance
Breathing system problems

Symptom
Problem
Gas scavenging flow is too low or Scavenging extract flow problem.

too high.
Filter blockage. Active systems
have a flow indicator.
The bellows fills when the Bag/

Leak through Bag/Vent switch.
Vent switch is set to Bag or the
bag fills when the switch is set to
Vent.
Solution
Use a different scavenging extraction
system. Verify flow is within specification.
Replace the filter. Refer to Remove the
AGSS receiver filter in the Advanced
Breathing System Cleaning and Sterilization
Users Reference manual.
representative to repair the system.
The ventilator does not read the

position of the Bag/Vent switch.
Ventilator or absorber malfunction. Ventilate manually.

representative to repair the system.
APL valve does not operate

correctly.
APL valve problem.
Replace APL valve seal and diaphragm.
Large breathing system leak not

quickly located (in bag mode).
Bag hose not connected properly.
Ensure that the bag hose is connected to the

bag port (below the APL valve).
Absorber canister not installed

correctly.
Reinstall the absorber canister, ensure both

pins are engaged.
Leak in the breathing system.
Check, clean, or reposition the pressure

relief valve. If the problem persists, replace
the pressure relief valve, bellows base, or
bellows assembly.
Bellows falls below top of

indicator during Bellows
assembly test.
7-16
M1145956
Electrical problems
WARNING
If a circuit breaker opens frequently, do not use the

system. Have a Datex-Ohmeda trained service
representative repair the system.
Symptom
Problem
Solution
Mains indicator is not on.
The electrical power cable is not

connected.
Connect the power cable.
The system circuit breaker (switch) Turn the circuit breaker on.
is off.
M1145956
The power cable is damaged.
Replace the power cable.
The electrical socket the power

cable connects to has no power.
Use a different electrical socket.
An internal fuse is open.
Contact a Datex-Ohmeda trained

service representative to repair the
system.
One electrical outlet does not have The outlet circuit breaker is off.
power.
Turn the circuit breaker on.
A circuit breaker opens frequently. Equipment connected to the

outlet(s) uses more current than
the circuit breaker rating.
Use a different power supply for

some of the equipment.
The equipment connected to the

outlet has a short.

system.
Tec 6 Series vaporizer has no

power.
Not plugged into outlet.
Connect power cable.
The outlet circuit breaker is off.
Turn the circuit breaker on.
The real time clock on the

anesthesia display does not
maintain accurate time and date.
The battery in the anesthesia

display needs to be replaced.

system.
Audible alarm. System function

stops. Screen is blank.
Internal power converter failure.
Turn the system off.

system.
7-17
Avance
Pneumatic problems
Symptom
Problem
Solution
High-pressure leak test fails.
Controls are not set correctly.
Ensure no gas is flowing, turn off

the auxiliary flowmeter, and repeat
the test.
Incorrect cylinder connection.
Make sure that there is only one

cylinder gasket, the gasket is in
good condition, and the
connection is tight.
The vaporizer is not correctly

installed.
Correctly install the vaporizer.
Low-pressure leak test fails with a

vaporizer on.
The vaporizer filler is loose (fill port Tighten the filler.

type vaporizer).
Vaporizer port o-rings (external)
are damaged or not installed.
Install new o-rings.
A vaporizer malfunction (the leak

stops if you use a different
vaporizer in the same position).
Send the vaporizer to a

Datex-Ohmeda Service Center for
repair.
A port valve malfunction (the leak

continues if you use a different
vaporizer in the same manifold
position).

vaporizer manifold.
Low-pressure leak with a vaporizer Anesthesia machine problem.

OFF.
7-18

service representative.
M1145956
In this section
Setup warnings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-2

Canister setup. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-4
Electrical connections . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-9
Pneumatic connections. . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-11
How to install gas cylinders. . . . . . . . . . . . . . . . . . . . . . . . . 8-14
How to attach equipment to the top of the machine . . . . . . 8-16
M1145956
8-1
Avance
Setup warnings
See Standards and System components in the
Specifications and Theory of Operation section for
information on specific monitoring requirements.
WARNING
8-2
Datex-Ohmeda strongly recommends the use of O2

monitoring and anesthetic agent monitoring with this
equipment. Refer to local standards for mandatory
monitoring.
European, international, and national standards require
the following monitoring be used with this system:
Exhaled volume monitoring.
O2 monitoring.
CO2 monitoring.
Anesthetic agent monitoring be used when anesthetic

vaporizers are in use.
Always make sure that the pipeline supply hoses and the
breathing circuit components are not toxic and will not:
Cause an allergic reaction in the patient.
React with the anesthetic gases or agent to produce

dangerous by-products.
To prevent incorrect values or equipment malfunction,

use only Datex-Ohmeda cables, hoses and tubing.
This system operates correctly at the electrical

interference levels of IEC 60601-1-2. Higher levels can
cause nuisance alarms that may stop mechanical
ventilation.
M1145956
M1145956
To help prevent false alarms from devices with highintensity electrical fields:
Keep the electrosurgical leads away from the

breathing system, the flow sensors, and the oxygen
cell.
Do not allow the electrosurgical leads to contact any

part of the anesthesia system.
Do not use cell phones near the anesthesia system.
To protect the patient when electrosurgical equipment is

used:
Monitor the correct operation of all life support and

monitoring equipment.
Keep backup manual ventilation available in case the

electrosurgical equipment prevents safe use of the
ventilator.
Do not use antistatic or electrically-conductive breathing

tubes or masks. They can cause burns if used near highfrequency surgical equipment.
Use only reservoir bags that comply with EN1820 on this

system.
Use only breathing tubes that comply with EN12342 on

this system.
A malfunction of the medical gas central supply system

may cause all connected devices to stop.
8-3
Avance
Canister setup
The absorber canister is available in two versions: Disposable Multi
Absorber and Reusable Multi Absorber. Both are removed and
installed on the breathing system in the same way.
Each canister holds 800 grams of loose absorbent. The manufacturer
recommends MedisorbTM absorbent.
Both absorber versions should only be used with mixtures of air,
oxygen, nitrous oxide, halothane, enflurane, isoflurane, desflurane
and sevoflurane.
4
3
AB.74p042
AB.74p043
1.
2.
3.
4.
5.
6.
7.
Canister support pin

Canister handle
Disposable Multi Absorber canister
Absorbent
Expiratory water reservoir
Canister release latch
Reusable Multi Absorber canister
Figure 8-1 Canister
8-4
M1145956

WARNING
When to change the

absorbent
Obey applicable safety precautions:
Do not use the absorber with chloroform or

trichloroethylene.
The Disposable Multi Absorber is a sealed unit which

should not be opened or refilled.
Avoid skin or eye contact with the contents of the

absorber. In the event of skin or eye contact,
immediately rinse the affected area with water and
seek medical assistance.
Do not remove the absorber canister to change the

canister or to change the absorbent while ventilating a
patient unless the system is equipped with the
EZchange canister module.
Change absorbent often to prevent the buildup of

non-metabolic gases when the system is not in use.
Inspect absorbent color at the end of a case. During

non-use, absorbent can go back to the original color.
Refer to the absorbent labeling for more information
about color changes.
If the absorbent completely dries out, it may give off

carbon monoxide (CO) when exposed to anesthetic
agents. For safety, replace the absorbent.
Desiccated (dehydrated) absorbent material may

produce dangerous chemical reactions when exposed
to inhalation anesthetics. Adequate precautions
should be taken to ensure that absorbent does not dry
out. Turn off all gases when finished using the system.
A gradual color change of the absorbent in the canister indicates

absorption of carbon dioxide. The color change of the absorbent is
only a rough indicator. Use carbon dioxide monitoring to determine
when to change the canister.
Discard the absorbent when it has changed color. If left standing for
several hours, absorbent may regain its original color giving a
misleading indication of activity.
Read the absorbent manufacturers instructions completely before
using the product.
M1145956
8-5
Avance
1. Hold the canister by the handle and push on the release latch to
unlock the canister.
AB.74p058
Removing a canister
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
Removing an
EZchange canister
AB.75p089
2. Slide the canister up and out of the cradle.
8-6
M1145956

1. Turn the canister upside down and, using your thumbs, turn the
cover locking ring counterclockwise to unlock it.
AB.74p044
Reusable Multi
Absorber canister
filling
2. Push up to release the seal.
AB.74p046
3. Lift off the cover to remove it.
4. Remove and properly discard the foam filters, the absorbent, and
any water in the reservoir.
Be careful when draining condensate from the absorber.

The liquid is caustic and may burn skin.
AB.74p047
WARNING
5. To clean and disinfect the canister, refer to the Absorber canister

cleaning in the Advanced Breathing System Cleaning and
Sterilization manual.
M1145956
8-7
Avance
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 cover is properly sealed to
prevent leaks and spillage. Alignment of the arrows helps to
indicate correct assembly.
WARNING
The filters must be in place to help prevent dust and

particles from entering the breathing circuit.
8. When replacing the canister, make sure that it is seated properly
on the support pins or in the EZchange canister module before
latching it into place.
8-8
M1145956
Electrical connections
Arrow shows the mains power inlet and cord.
AB.74p048
Mains inlet
Labels show outlet voltage ratings and circuit breaker amp ratings.
These are isolated outlets. Regularly test the leakage current.
AB.91p048
Outlets
M1145956
8-9
Avance
Serial port
The system has an RS-232C electrical interface. The RS-232C

connector allows serial input/output of commands and data. The 15pin connector is located on the back of the display unit.
8-10
AB.91p085
AB.91p050
The 15-pin female D connector - Data Communications Equipment

configuration (DCE):
Pin 1 - Monitor On/Standby
Pin 5 - Signal ground
Pin 6 - Receive data
Pin 9 - Monitor On/Standby Return
Pin 13 - Transmit data
M1145956
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:
venturi suction regulator (optional).
auxiliary O2 flowmeter (optional).
AB.91p040
Pipeline inlets
Scavenging
The scavenging assembly is located below the bellows on the

breathing system. Adapters may be necessary to interface to the
scavenging connector.
AB.91p045
See Passive AGSS (optional) and Active AGSS (optional) in the

Operation section for more scavenging information.
M1145956
8-11
Avance
Connect the Datex-Ohmeda sample gas exhaust tube to the gas
return port. Exhaust gas will be directed to the scavenging system.
AB.91p093
Sample gas return

port
Vacuum suction
regulator (optional)
The vacuum suction regulator uses an external vacuum supply.

Connect the vacuum connection to the source vacuum supply.
Connect the collection bottle connection to the collection bottle.
4
2
AB.74p032
1.
2.
3.
4.
External vacuum connection

Overflow safety trap
Splash guard
Figure 8-2 External vacuum suction
8-12
M1145956
Venturi suction
regulator (optional)
The venturi suction regulator uses the system air or O2 supply

source. Connect the collection bottle connection to the collection
bottle.
4
3
AB.74p189
1.
2.
3.
4.
Venturi muffler
Overflow safety trap
Splash guard
Figure 8-3 Venturi suction
Auxiliary O2
flowmeter (optional)
1
AB.91p039
1. Auxiliary O2 outlet
2. Auxiliary O2 flow control
Figure 8-4 Auxiliary O2 flowmeter
M1145956
8-13
Avance
How to install gas cylinders

CAUTION
Pin indexed cylinder

yokes

failure.
1. Locate the cylinder wrench.
2. Close the cylinder valve on the cylinder to be replaced.
3. Loosen the tee handle.
4. Open the cylinder yoke.
5. Remove the used cylinder and the used gasket.
6. Remove the cap (if equipped) from the cylinder valve on the new
cylinder.
WARNING
Make sure there is only one gasket on the cylinder

connection. No gasket or more than one gasket can
cause a leak.
7. Install a new gasket.
8. Align the cylinder post with the index pins.
9. Close the yoke gate and tighten the tee handle.
10. Make sure there is a cylinder plug and gasket in any empty
cylinder yokes.
11. Perform a High-pressure leak test.
DIN cylinder
connections
1. Close the cylinder valve on the cylinder to be replaced.

2. Loosen the adapter and remove the cylinder.
3. Remove the cap from the cylinder valve on the new cylinder.
4. Install the cylinder.
5. Perform a High-pressure leak test.
8-14
M1145956
High-pressure leak
test
1. Turn on the system.

2. Disconnect pipeline supplies.
3. Turn off the auxiliary O2 flowmeter and the venturi suction.
4. Open the cylinder.
5. Record the cylinder pressure.
6. Close the cylinder.
If the cylinder pressure decreases more than 690 kPa
(100 psi) in one minute there is a significant leak.
7. To repair a leak, install a new cylinder gasket and tighten the
adapter.
8. Repeat the leak test. If the leak continues, do not use the system.
M1145956
8-15
Avance
How to attach equipment to the top of the machine

WARNING
The top of the machine has a weight limit of 34 kg (75 lb).

Check the stability of the system in its final configuration.
Make sure that weight is evenly distributed throughout the
system.
1. Locate the clips or slots.
2. Install the straps. See the Parts section for more information.
3. Fully tighten the straps.
4. Make sure the straps hold the equipment in position.
WARNING
8-16
Fully tighten the straps. If straps are not fully tightened,

equipment can fall off the top of the machine.
M1145956
9 User Maintenance
WARNING
To help prevent fires:
Do not use lubricants that contain oil or grease. They

may burn or explode in high O2 concentrations.
All covers used on the system must be made from

antistatic (conductive) materials. Static electricity can
cause fires.
Desiccated (dehydrated) absorbent material may

produce dangerous chemical reactions when exposed
to inhalation anesthetics. Adequate precautions
should be taken to ensure that absorbent does not dry
out. Turn off all gases when finished using the system.
Obey infection control and safety procedures. Used

equipment may contain blood and body fluids.
Moveable parts and removable components may present

a pinch or a crush hazard. Use care when moving or
replacing system parts and components.
In this section
Repair policy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-2

Maintenance summary and schedule . . . . . . . . . . . . . . . . . . 9-2
Circuit O2 cell replacement. . . . . . . . . . . . . . . . . . . . . . . . . . 9-4
Calibration menu. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-5
Flow and pressure calibration . . . . . . . . . . . . . . . . . . . . . . . . 9-5
Circuit O2 cell calibration. . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-6
Airway gas calibration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-6
Backlight test . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-7
How to help prevent water buildup . . . . . . . . . . . . . . . . . . . . 9-7
M1145956
9-1
Avance
Repair policy
Do not use malfunctioning equipment. Make all necessary repairs or
have the equipment serviced by a Datex-Ohmeda trained service
representative. After repair, test the equipment to ensure that it is
functioning properly, in accordance with the manufacturers published
specifications.
To ensure full reliability, have all repairs and service done by a
Datex-Ohmeda trained 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.
CAUTION
No repair should ever be attempted by anyone not having

experience in the repair of devices of this nature.
Replace damaged parts with components manufactured or sold by
Datex-Ohmeda. Then test the unit to ascertain that it complies with
the manufacturers published specifications.
Contact the local Datex-Ohmeda Field Service Representative for
service assistance.
Maintenance summary and schedule

These schedules indicate the minimum frequency of maintenance
based on typical usage of 2000 hours per year. Service the
equipment more frequently if it is used more than the typical yearly
usage.
Note
Local policies or regulations may require that maintenance be

performed more frequently than stated here.
Minimum Frequency
Maintenance
Daily
Two weeks
Monthly
During cleaning and

setup
9-2
Clean the external surfaces.

Perform a flow and pressure calibration.
Empty the water reservoir and replace the
absorbent in the canister.
Drain the vaporizers and discard the agent.
(This is not necessary for the Tec 6 series
vaporizers.)
Perform a Backlight test.
Perform 21% and 100% O2 cell calibrations.
Inspect the parts for damage. Replace or
repair as necessary.
M1145956
9 User Maintenance
Minimum Frequency
Maintenance
As necessary
Datex-Ohmeda
approved service
Install new cylinder gaskets on cylinder

yokes.
Empty the water reservoir and replace the
absorbent in the canister.
Empty the overflow trap on the optional
suction regulator.
Replace the circuit O2 cell. (Under typical
use the cell meets specifications for 1 year.)
Replace the disposable flow sensor (plastic).
(Under typical use the sensor meets
specifications for a minimum of 3 months.)
Replace the autoclavable flow sensors
(metal). (Under typical use the sensor meets
specifications for a minimum of 1 year.)
Replace the receiver filter (active gas
scavenging only.)
Calibrate the airway modules every 6 months
or when there are indications of errors in the
gas readings. Calibrate airway modules that
get extensive usage every 2 months.
Inspect and clean the fan filters (display,
power supply, and airway module).
This is the minimum level of maintenance recommended by

Datex-Ohmeda. Local regulations may contain additional
maintenance requirements. Datex-Ohmeda advocates compliance
with local regulations which meet or exceed this minimum level of
maintenance.
Minimum Frequency Maintenance

12 months
M1145956
Have a Datex-Ohmeda trained service

representative complete the scheduled service
maintenance checks, test, calibrations, and parts
replacements as defined in the Technical Reference
manual.
9-3
Avance
Circuit O2 cell replacement

WARNING
Note
Handle and dispose of O2 cells according to site

biohazard policies. Do not incinerate.
It may take a new O2 cell 90 minutes to stabilize. If the O2 cell
calibration fails after a new O2 cell had been installed, wait 90
minutes and repeat the calibration.
AB.74p052
1. Pull the latch to unlock the flow sensor module from the breathing
system.
2. Pull the flow sensor module from the breathing system.
AB.74p065
3. Remove the O2 cell cable connector from the O2 cell and

unscrew the cell counterclockwise.
AB.74p083
4. Make sure the o-ring is on the cell. Install the replacement O2

cell. Reconnect the O2 cell cable.
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
calibration procedure.
9-4
M1145956
9 User Maintenance
Calibration menu
Access the Calibration menu by pushing the Main Menu key and
selection Calibration from the Main Menu. Select the calibration
procedure and follow the instructions shown.
See Calibration in the Airway Modules section for information on
calibrating the airway modules.
See Backlight test for information on testing the backlights.
Calibration
Flow and Pressure
Circuit O2 Cell
Airway Gas
Backlight Test
Previous Menu
Flow and pressure calibration

Calibrate the flow sensors by removing them from the system. Onscreen instructions are available through Main Menu - Calibration Flow and Pressure.
Important
Room temperature fluctuations of more than 5C may affect sensor

measurements. Recalibrate the flow sensors if the room temperature
changes by more than 5C.
2. Remove the flow sensor module.
3. Wait for No insp flow sensor and No exp flow sensor alarms to
occur.
4. Reinsert the flow sensor module. Wait for alarms to clear.
5. Start mechanical ventilation when ready.
M1145956
9-5
Avance
Circuit O2 cell calibration

21% O2 calibration

3. Select Circuit O2 Cell.
4. Remove the flow sensor module. Unscrew the O2 cell to expose
it to room air.
5. Select 21% O2 and push the ComWheel to start calibration.
6. Put the O2 cell back in and reconnect the flow sensor module
when the calibration passes.
100% O2 calibration
1. Ensure patient Y-piece is not plugged or there is no patient tubing

connected to the system.
4. Select 100% O2 and push the ComWheel to start the calibration.
5. System will flow O2 to calibrate.
Airway gas calibration

The airway gas selection is only available on the Calibration menu
when the system detects an airway module and the module has
completed the warm up phase. See the Airway Modules section for
calibration instructions.
9-6
M1145956
9 User Maintenance
Backlight test
3. Select Backlight Test.
4. Select Start Test.
5. The display will show the test running on light 1 and then on light
2. If the display goes completely blank or flickers during the test,
one of the lights has failed. Contact a Datex-Ohmeda trained
service representative to replace the backlights.
How to help prevent water buildup

Pooled water in the flow sensors or water in the sensing lines may
cause false alarms. Small beads of water or a foggy appearance in
the flow sensors is okay.
Water results from exhaled gas and the chemical reaction between
CO2 and the absorbent that takes place within the absorber canister.
At lower fresh gas flows more water builds up because less gas is
scavenged and:
More CO2 stays in the absorber to react and produce water.
More moist, exhaled gas stays in the patient circuit and the
absorber.
Solutions:
Equip systems with the optional condenser. See the Parts
section for information.
Empty the water reservoir in the canister when changing the
absorbent.
Ensure that water condensing in the breathing circuit tubes is
kept lower than the flow sensors and is not allowed to drain back
into the flow sensors.
Water condensation in the breathing circuit tubing might be
lessened by using a Heat and Moisture Exchange (HME) filter at
the airway connection.
M1145956
9-7
Avance
9-8
M1145956
10 Parts
Note
In this section
This section lists user-replaceable parts only. For other components,

refer to the Technical Reference manual.
Flow sensor module . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-2

Breathing circuit module . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-3
Bellows . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-4
Absorber canister . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-6
Exhalation valve assembly . . . . . . . . . . . . . . . . . . . . . . . . . 10-7
AGSS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-8
EZchange canister system . . . . . . . . . . . . . . . . . . . . . . . . . 10-9
Condenser . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-10
Test tools and system parts . . . . . . . . . . . . . . . . . . . . . . . 10-11
M1145956
10-1
Avance
Flow sensor module

1
AB.82.019
3
2
Item
1
2
3
10-2
Description
Stock number
Flow sensor module (does not include flow

sensors)
Flow sensor cover
Flow sensor cuff
Flow sensor, disposable (plastic)
Flow sensor, autoclavable (metal)
1407-7001-000
1407-3000-000
1407-3004-000
1503-3858-000
1503-3244-000
M1145956
10 Parts
Breathing circuit module

1
AB.82.021
5
Item
1
2
3
4
5
-
M1145956
Description
Stock number
Breathing circuit module (does not include O2

cell, o-ring, or cable)
Check valves circuit lens
Check valve assembly
O-ring for O2 cell or plug
O2 cell (includes o-ring)
Cable, O2 cell
Plug (includes o-ring; for systems without O2
sensing)
1407-7002-000
1407-3101-000
1406-8219-000
1406-3466-000
6050-0004-110
1009-5570-000
1503-3857-000
10-3
Avance
Bellows
2
8
3
7
10-4
AB.82.018
4
5
Item
Description
Stock number
1
2
3
4
5
6
7
8
-
Bellows housing
Bellows
Rim
Pressure relief valve assembly
Latch, rim
Manifold, bellows base
Bellows base with latch
Seal, base
Diaphragm, APL
Poppet, APL valve
Cage, APL
1500-3117-000
1500-3378-000
1500-3351-000
1500-3377-000
1500-3352-000
1407-3702-000
1407-7006-000
1500-3359-000
1406-3331-000
1406-3332-000
1406-3333-000
M1145956
10 Parts
AB.82.001
Complete Advanced Breathing System
Item
Description
Stock number
Complete breathing system assembly includes:
Flow sensor module (does not include flow sensors)
Breathing circuit module (does not include APL valve,O2 cell, o-ring,
or cable)
Complete bellows base
Canister not included

Autoclavable breathing assembly
1407-7008-000
Autoclavable breathing assembly, Australia
1407-7016-000
M1145956
10-5
Avance
Absorber canister
2
3
1
AB.82.017
Item
Description
Stock number
Multi absorber, reusable (includes 40 pack of

foam) (does not include absorbent)
Cover assembly, CO2 canister
Foam, CO2 canister (pack of 40)
O-ring
Canister, CO2 with handle
Multi absorber, disposable, white to violet, (pack
of 6)
Multi absorber, disposable, pink to white (pack
of 6)
1407-7004-000
2
3
4
5
-
10-6
1009-8240-000
1407-3201-000
1407-3204-000
1407-3200-000
8003138
8003963
M1145956
10 Parts
Exhalation valve assembly
M1145956
Description
Stock number
1407-7005-000
10-7
Avance
AGSS
Description
Stock number
Common
Cap 3.18 barb silicone
Connector, inlet 30 mm male to 9 mm male
Connector, inlet 30 mm male to 30 mm male
O-ring for connector, 21.95 ID
O-ring for receiver, 22 ID
O-ring for thumbscrews, 4.47 ID
Reservoir scavenger
Seal, down tube scavenger
Seal, receiver scavenger
Thumbscrew M6 X 28.5
Thumbscrew, M6 X 43
Valve, unidirectional (complete assembly)
1406-3524-000
M1003134
M1003947
1406-3558-000
1407-3104-000
1407-3923-000
1407-3903-000
1407-3904-000
1407-3901-000
1406-3305-000
1406-3304-000
1406-8219-000
Passive AGSS
Adapter, outlet 30 mm female to 19 mm male (pack
of 5)
Exhaust hose
Plug assembly 30 mm ISO
Screw, shoulder 4 diameter X 4 L M3 X 0.5 sst
1500-3376-000
8004461
1407-3909-000
1407-3915-000
Active AGSS, adjustable flow

Bag with 30 mm male connector
Plug assembly 30 mm ISO
8004460
1407-3909-000
Active AGSS, high flow

Filter, 225 micrometer nylon screen AGSS
Seal, filter scavenger
1406-3521-000
1407-3902-000
Active AGSS, low flow

Filter, 225 micrometer nylon screen AGSS
Seal, filter scavenger
10-8
1406-3521-000
1407-3902-000
M1145956
10 Parts
EZchange canister system
AB.82.044
AB.82.057
Item
Description
Stock number
EZchange canister module, includes valve and

cap
Valve
Cap
Condenser
EZchange canister module with condenser
1407-7021-000
2
3
4
-
M1145956
1407-3126-000
1407-3130-000
1407-7024-000
1407-7027-000
10-9
Avance
Condenser
AB.82.045
Item
Description
Stock number
Condenser assembly (includes module and condenser) 1407-7026-000

1
Condenser module
1407-7025-000
2
Condenser
1407-7024-000
10-10
M1145956
10 Parts
Test tools and system parts
M1145956
Description
Stock number
Airway module calibration gas

Airway module calibration gas (U.S. variant only)
Airway module exhaust line
Calibration gas regulator
Calibration gas regulator (U.S. variant only)
Cylinder gasket (pin indexed cylinders only)
Cylinder wrench (DIN 477 and high-pressure hose)
Cylinder wrench for pin-indexed cylinder
DIN O2 plug (cylinder connection)
Handle for yoke tee
Negative low pressure leak test device
Positive low pressure leak test device (BSI)
Positive low pressure leak test device (ISO)
Positive pressure leak test adapter
Ring, sealing gasket (for DIN 477 and O2 high-pressure
hose)
Ring, sealing gasket (for N2O high-pressure hose)
Test lung
Test plug
Touch-up paint, Neutral Gray N7 (Medium Dark), 18 ml
Touch-up paint, Neutral Gray N8 (Medium), 18 ml
Touch-up paint, Neutral Gray N9 (Light), 18 ml
Vaporizer port o-rings, external (6 pack)
Yoke plug
Kit, monitor to shelf mounting straps
755583
755571
8004463
755534
M1006864
0210-5022-300
1202-3651-000
0219-3415-800
1202-7146-000
0219-3372-600
0309-1319-800
1001-8975-000
1001-8976-000
1009-3119-000
1009-3356-000
1202-3641-000
0219-7210-300
2900-0001-000
1006-4198-000
1006-4199-000
1006-4200-000
1102-3016-000
0206-3040-542
0236-0039-870
10-11
Avance
10-12
M1145956
11 Specifications and Theory of

Operation
Note
All specifications are nominal and subject to change without notice.
Note
All displayed values are shown at ambient temperature and pressure

dry.
In this section
System pneumatic circuits . . . . . . . . . . . . . . . . . . . . . . . . . 11-2

Pneumatic specifications . . . . . . . . . . . . . . . . . . . . . . . . . . 11-5
Electrical block diagram . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-6
Electrical power . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-8
Flow specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-9
Breathing system specifications . . . . . . . . . . . . . . . . . . . . 11-10
Physical specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-12
Environmental requirements . . . . . . . . . . . . . . . . . . . . . . . 11-12
Airway module specifications . . . . . . . . . . . . . . . . . . . . . . 11-13
Suction regulators (optional) . . . . . . . . . . . . . . . . . . . . . . . 11-15
Ventilator theory . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-16
Ventilator operating specifications . . . . . . . . . . . . . . . . . . 11-25
Ventilator accuracy data . . . . . . . . . . . . . . . . . . . . . . . . . . 11-26
Electromagnetic compatibility (EMC) . . . . . . . . . . . . . . . . 11-27
Electrical safety. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-31
IEC 60601-1 Classification . . . . . . . . . . . . . . . . . . . . . . . . 11-32
Standards . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-32
System components . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-33
M1145956
11-1
Avance
AB.91.103
System pneumatic circuits
11-2
M1145956
1. Auxiliary O2, 0-10 l/min (optional)

2. 241 kPa (35 psi) secondary O2 regulator
3. Pipeline: O2, Air, N2O
4. Cylinder: O2, Air, N2O
5. 758 kPa (110 psi) relief
6. Venturi drive gas connection
7. Selector valve, O2, Air, N2O
8. O2 flush
9. 0-120 l/min flow
10. Alternate O2, 0.5-10 l/min
11. System switch
12. Alternate O2 disable valve
13. ACGO/non-circle pilot
14. Vent drive gas select
15. O2 flow controller
16. Balance flow controller
17. Gas inlet valve
18. Vent drive gas regulator 172 kPa (25 psi) at 15 l/min
19. Inspiratory flow control valve
20. Drive gas check valve (3.5 cmH2O bias)
21. Mechanical over pressure valve (110 cmH2O)
22. Free breathing check valve
23. Atmosphere
24. Pressure relief valve
25. Exhalation valve (2 cmH2O bias)
26. Relief valve 10 cmH2o
27. 0-10 l/min drive gas, 0-10 l/min patient and fresh gas,
0-20 l/min total typical flow
28. 200 ml reservoir
29. Control bleed to ambient approximately 1 l/min at
3 cmH2O if continuous (rate dependent)
30. Vent to ambient
31. Flush switch 37.2 kPa (5.4 psi)
32. Selectatec manifold
33. 37.9 kPa (5.5 psi) pressure relief valve
34. Vaporizer
35. Bag/Vent switch
M1145956
36. Bag
37. APL valve 0-70 cmH2O
38. Optional factory connection
39. Default factory connection
40. Gas monitor
41. Negative pressure relief valve
42. Absorber
43. Drain
44. Expiratory flow sensor
45. Inspriatory flow sensor
46. Patient Y
47. Airway transducer
48. Inspiratory flow transducer
49. Expiratory flow transducer
50. Manifold pressure transducer
51. Passive gas scavenging interface
52. 30-mm male, to disposal system
53. 0.3 cmH2O entrainment
54. Reservoir
55. Adjustable gas scavenging interface
56. DISS EVAC connector
57. Active gas scavenging interface
58. Room air
59. Filter
60. High or low flow restrictor
61. Flow indicator
62. To disposal system
63. ACGO variant
64. Circle or ACGO mode switch
65. 22 mm ACGO port
66. O2 cell
67. Non-circle variant
68. Circle or non-circle mode switch
69. 150 cmH2O fresh gas pressure limiting valve
70. EZchange canister
71. Condenser
11-3
Avance
Gas supplies
Pressurized gas supplies enter the system through a pipeline or

cylinder connection. All connections have indexed fittings, filters, and
check valves.
A regulator decreases the cylinder pressures to the appropriate
system pressure. A pressure relief valve helps protect the system
from high pressures.
To help prevent problems with the gas supplies:
Install yoke plugs on all empty cylinder connections.
When a pipeline supply is connected, keep the cylinder valve
closed.
Disconnect the pipeline supplies when the system is not in use.
WARNING
O2 flow

failure.
Pipeline or regulated cylinder pressure supplies O2 directly to the O2
channel of the gas mixer and to the ventilator if O2 is configured as
drive gas. If the pressure is too low, an alarm appears on the display.
A second regulator decreases the pressure for the flush valve and the
auxiliary O2 flowmeter.
The flush valve supplies high flows (between 35 and 50 l/min) of O2
to the fresh gas outlet when the O2 flush button is pushed. The flush
switch uses pressure changes to monitor the position of the flush
valve.
Air and N2O
Pipeline or regulated cylinder pressure supplies Air directly to the air

channel of the gas mixer and to the ventilator if Air is configured as
drive gas. If the pressure is too low, an alarm appears on the display.
Pipeline or regulated cylinder pressure supplies N2O directly to the
N2O channel of the gas mixer. If the pressure is too low, an alarm
appears on the display.
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.
EZchange canister
11-4
When activated, this mode permits continued ventilation and

rebreathing of exhaled gases without any gas passing through the
absorbent.
M1145956
Condenser
The condenser removes water in the system that is produced from

the reaction of CO2 gas with the absorbent. When fresh gas flow
settings of less than the patient minute volume are used during
ventilation, the amount of re-breathed gas increases. More CO2 flows
through the breathing system increasing the absorbent consumption.
The moisture buildup in the breathing system is also increased.
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 condensers
reservoir.
Pneumatic specifications
CAUTION
All gases supplied to the system must be medical grade.
Gas supplies
Pipeline gases
Cylinder gases
Cylinder connections
O2, Air, N2O

O2, Air, N2O (2 cylinder maximum)
Pin indexed
Nut and gland DIN-477
Large cylinder kit available for O2 and N2O
Primary regulator output
Pin indexed: The primary regulator is set to
pressure
pressure less than 345 kPa (50 psi).
DIN-477: The primary regulator is set to
pressure less than 414 kPa (60 psi).
Pressure-relief valve
Approximately 758 kPa (110 psi)
Pipeline connections
DISS - Male; DISS-Female; DIN 13252; AS
(filtered)
4059 (Australian); S90-116 (French Air
Liquide); BSPP 3/8 (Scandinavian) or NIST
(ISO 5359). All fittings available for O2, Air,
and N2O.
Pressure displays
On system display.
Pipeline inlet pressure
280-600 kPa (41-87 psi)
Flush flow
35 l/min to 50 l/min
O2 supply pressure at which O2 pipeline less than 252 kPa (36 psi).
N2O shutoff
O2 cylinder less than 2633 kPa (381 psi).
ACGO Port relief

Non-circle circuit
relief
M1145956
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.
11-5
Avance
AB.91.114
Electrical block diagram
11-6
M1145956
1. Power cord
2. AC inlet and breaker
3. Inrush board
4. Transformer
5. Fuse block
6. Outlet box with breakers
7. Line filter
8. Power controller board
9. Power supply fan with cable
10. Power supply with batteries
11. Display connector board
12. Anesthesia control board
13. Airway module power supply board
14. Airway module
15. Display unit CPU board
16. Display unit system interface board
17. Display unit user interface board
18. Display unit fan with cable
19. LCD backlight 1
20. Compact flash I/O port
21. USB I/O port
22. USB I/O port
23. Network I/O port (Ethernet)
24. Patient monitoring on/standby
25. Serial I/O port
26. LCD backlight 2
27. Electronic gas mixer board
28. Pan connector board
29. Ventilator interface board
30. I/O port
31. Pan fan with cable
32. ABS filter board
33. Air cylinder pressure transducer
34. N2O cylinder pressure transducer
35. O2 cylinder pressure transducer
M1145956
36. Air pipeline pressure transducer

37. N2O pipeline pressure transducer
38. O2 pipeline pressure transducer
39. Second O2 cylinder pressure transducer
40. Alternate O2 switch
41. On/Standby switch and LED
42. Vent engine board
43. Flow control valve with cable
44. Gas inlet valve with cable
45. Expiratory and inspiratory flow sensors
46. O2 cell
47. Light strip boards
48. Light strip switch
49. CGO valve
50. ACGO/non-circle circuit switch
51. CGO switch
52. Bag/vent switch
53. ABS connected switch
54. EZchange canister switch
55. LCD
56. Display unit speaker with cable
57. O2 flush switch
58. DC power in
59. Communication to system
60. ComWheel encoder
61. Lower membrane switch
62. Right membrane switch
63. Left membrane switch
11-7
Avance
Electrical power
Supply voltage
Inlet circuit breakers
100-120 or 220-240 Vac +/-10% at 50 or 60 Hz

100-120 Vac
220-240 Vac
15 A
8A
Outlet circuit
110-120 Vac
Japan
220-240 Vac
breakers
(3) 2 A
2) 2 A
(3) 2 A
(1) 3 A
(1) 4 A
(1) 3 A
System leakage
UL and CSA rated systems (U.S.A. and Canada):
current limit - do not less than 300 amps for the system and all systems
exceed:
connected to electrical outlets.
IEC rated systems (Not U.S.A. and Canada): less
than 500 amps for the system and all systems
connected to electrical outlets.
Note: Products connected to electrical outlets may
increase the leakage current above these limits
Resistance to ground less than 0.2
Power cord
Length
Voltage rating
Current capacity
Type
WARNING
11-8
5 meters
100 to 240 Vac
10 A for 220-240 Vac
15 A for 100-120 Vac
Three conductor power supply cord (medical grade
where required).
Unplug the system power cord to run the system on the

battery power if the integrity of the protective earth
conductor is in doubt.
M1145956
Battery information
The system is not a portable unit; a sealed lead acid battery supplies
backup power in the event of a power failure.
Capacity to operate for 90 minutes under typical operating
conditions; 30 minutes under extreme conditions.
The system functions to specifications through the transition to
battery power.
Only trained service representatives are to replace the battery.
Batteries must be disposed of in accordance with applicable
regulatory requirements in effect at the time and place of disposal.
Contact a trained service representative to disconnect the battery if
the equipment is not likely to be used for an extended time.
Flow specifications
Alternate O2
Flow range
Indicator
Indicator accuracy
500 ml/min to 10 l/min

Flow tube
+/- 5% full scale
Fresh gas
Flow range
0 and 150 ml/min to 15 l/min

Minimum total flow O2 and balance gas
is 150 ml/min
Minimum single gas flow 100 ml/min
(maintaining the total flow of 150 ml/
min)
Total flow accuracy
+/- 10% or +/- 40 ml/min of setting
(larger of)
O2 flow accuracy
+/- 5% or +/- 20 ml/min of setting (larger
of)
Balance gas flow accuracy
+/- 5% or +/- 20 ml/min of setting (larger
of) Air/N2O
O2 concentration range
21%, 25% to 100%
O2 concentration accuracy
+/- 5% of setting
Electronic mixer response time
500 ms (10% to 90% flow step)
Compensation
Temperature and atmospheric pressure
compensated to standard conditions of
20C 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.
M1145956
11-9
Avance
Breathing system specifications

Volume
Absorbent
Connections
System leakage
System compliance
Pressure required to
open Inspiratory or
expiratory valves
Pressure generated by
a wet unidirectional
valve
APL valve
Ventilator side 2730 ml; bag side 1215 ml

With EZchange canister system and condenser:
ventilator side 3445 ml; bag side 1930 ml
950 ml canister
Auxiliary Common Gas Outlet: ISO 5356 type
connector on the front of the system (standard 22
mm OD or 15 mm ID conical friction fit
connectors).
Less than or equal to 150 ml/min total at 3 kPa (30
cmH2O) with EZchange canister system and
condenser (both in absorber mode and with
canister removed).
Volume of gas lost due to internal compliance (bag
mode only)
1.82 ml/0.098 kPa (1 cmH2O)
55 ml/3 kPa (30 cmH2O)
With EZchange canister system and condenser:
2.67 ml/0.98 kPa (1 cmH2O)
80 ml/3 kPa (30 cmH2O)
Dry: 0.49 cmH2O
Wet: 0.91 cmH2O
0.81 cmH2O
Approximately 0 to 70 cmH2O
Breathing system resistance in bag mode*

l/min
kPa
cmH2O
5
0.06
0.6
30
0.22
2.2
60
0.52
5.3
Ezchange canister system and condenser, absorber mode
5
0.06
0.6
30
0.24
2.4
60
0.57
5.8
EZchange canister system and condenser, canister removed
5
0.06
0.6
30
0.24
2.4
60
0.49
5.0
*Values include patient circuit tubing and Y-piece 4.9 kPa (0.5 cmH2O)
at 1 l/s. Patient circuit tubing and breathing system configurations may
affect resistance.
11-10
M1145956
Pressure flow data (APL valve completely open)

Flow (l/min)
Flow (l/s)
APL pressure cmH2O
3
10
30
60
70
0.05
0.17
0.51
1.0
1.17
0.78
1.14
1.43
2.61
3.21
Gas scavenging
All scavenging
Positive pressure relief
10 cmH2O
Passive scavenging
Negative pressure relief
Outlet connector
0.3 cmH2O
30 mm male taper ISO
Active scavenging
Disposal system
type
Outlet
connector*
Flow range
Pressure
Adjustable
High flow, low
vacuum
Low flow, high
vacuum
DISS EVAC
BS6834
Up to 30 l/min
50 to 80 l/min
DISS EVAC
36 +/- 4 l/min
not applicable
1.6 kPa
(12 mmHg)
305 mmHg
(12 inHg)
minimum
vacuum
not applicable
Low flow, low

12.7 mm hose
36 +/- 4 l/min
vacuum
barb
Low flow, low
25 mm barb
36 +/- 4 l/min
not applicable
vacuum
Low flow, low
30 mm ISO
36 +/- 4 l/min
not applicable
vacuum
taper
*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.
M1145956
11-11
Avance
Physical specifications
All specifications are approximate values and can change without
notice.
CAUTION
Do not subject the system to excessive shock and

vibration.
Do not place excessive weight on flat surfaces or
drawers.
System
Casters
Drawers
Ventilator display
Height
136 cm
Width
76 cm
Depth
76 cm
Weight
135 kg
Top of machine weight 34 kg
limit
13 cm with brakes on the front casters
23 cm Height x 33 cm Width x 27 cm Depth
146 x 184 mm (31 cm diagonal)
Environmental requirements
Operation
Temperature 10 to 40C
Oxygen cell operates to
specifications at 10 to 40C
Humidity
Altitude
11-12
15 to 95% RH, noncondensing

500 to 800 mmHg
(3565 to -440 meters)
Storage
Compensation range
-25 to 60C
Oxygen cell storage is -15 to
50C, 10 to 95% RH, 500 to 800
mmHg
10 to 95%, non-condensing
Not applicable
375 to 800 mmHg

(5860 to -440 meters)
525 to 795 mmHg

(3000 to -100 meters)
Not applicable
M1145956
Airway module specifications

Use only airway modules that have anesthetic agent monitoring and
O2 monitoring on this system. The following modules can be used on
this system: E-CAiO, E-CAiOV, E-CAiOVX, M-CAiO, M-CAiOV, and
M-AiOVX. (E Series modules must be software version 4.5 and
above. M series modules must be software revision 3.2 and above.)
Gas specifications
Airway humidity
Sampling delay
Total system response time
Warm-up time
Diversion flow
0 to 100% condensing
2.5 seconds typical with a 3 m sampling line
2.5 seconds typical with a 3 m sampling line,
including a sampling delay and rise time
2 minutes for operation with CO2, O2, and
N2O
5 minutes for operation of anesthetic agents
30 minutes for full specifications
200 ml/min
Accuracy under different conditions:

Ambient temperature 10 to
40C.
Ambient pressure 500 to 800
mmHg, +/- 50 mmHg of
calibration
Ambient humidity 10 to 98%
RH, +/- 20% RH of
calibration.
During warm-up 10 to 30
minutes, under normal
conditions.
CO2
+/- (0.3 vol% + 4% of reading)
O2
+/- (2 vol% + 2% of reading)
N2O
Hal, Enf, +/- (0.2 vol% + 10% of reading)
Iso, Sev,
Des
M1145956
During warm-up 2 to 10
minutes (anesthetic agents 5
to 10 minutes), under normal
conditions.
+/- (0.4 vol% + 7% of reading)

+/- (0.3 vol% + 10% of reading)
11-13
Avance
Typical performance
CO2
Measurement range 0 to 15 vol% (0 to 15 kPa, 0 to 113

mmHg).
Measurement rise time less than 400 ms typical.
Accuracy +/- (0.2 vol% + 2% of reading).
Gas cross effects less than 2 vol% (O2, N2O,
anesthetic agents).
O2
Measurement range 0 to 100 vol%.
Accuracy +/- (1 vol% + 2% of reading).
Gas cross effects less than 1 vol% anesthetic agents,
less than 2 vol% N2O.
N2O
Measurement range 0 to 100 vol%.
Accuracy +/- (2 vol% + 2% of reading).
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%.
Accuracy +/- (0.15 vol% + 5% of reading).
Gas cross effects less than 0.15 vol% N2O.
11-14
M1145956
Suction regulators (optional)

Venturi Suction Regulator
Performance Category
Supply
Drive Gas Consumption*
Pharyngeal Suction
Air or O2 from system gas supply
28 l/min with pipeline drive gas at 280 kPa
Maximum Vacuum*
600 mmHg with pipeline drive gas at 280 kPa
550 mmHg with pipeline drive gas at 600 kPa
Maximum Flow*
Vacuum Gauge Accuracy +/- 5% of full scale
*Values are approximate.
Continuous Suction Regulator

Performance Category
Supply
Maximum Vacuum*
Pharyngeal Suction
External vacuum
540 mmHg with external vacuum appplied of
540 mmHg and 40 l/min free flow
Maximum Flow*
39 l/min with external vacuum applied of 540
mmHg and 40 l/min free flow
Vacuum Gauge Accuracy +/- 5% of full scale
*Values are approximate.
M1145956
11-15
Avance
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.
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, Vent mode: TV accuracy decreased. Adj.
manually. shows above the ventilator setting area on the screen.
When this message shows, the ventilator may not be able to deliver
within the accuracy range specified. When this occurs, manually
adjust the tidal volume 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 alarm conditions are resolved.
For better precision a small quantity of gas bleeds through a resistor
to help keep the pressure on the exhalation valve constant. At high
airway pressures, this can cause a slight hiss during inspiration.
WARNING
11-16
Always connect the expiratory flow sensor. If it is not

connected, the patient disconnect alarm can not operate
correctly.
M1145956
O2 monitoring theory
of operation
O2 monitoring measures O2 concentration in the patient circuit. The

O2 concentration measured from the O2 cell is shown on the
ventilator display.
The O2 cell is an electrochemical device (galvanic cell). Oxygen
diffuses through a membrane into the cell and oxidizes a base metal
electrode. This oxidation produces an electrical current proportional
to the partial pressure of the oxygen at the electrodes sensing
surface. The base metal electrode gradually wears out from the
oxidation process.
The voltage from the cell cartridge is affected by the temperature of
the monitored gas mixture. A thermistor in the cells housing
automatically compensates for temperature changes in the cell.
O2 monitoring uses signal processing and analyzing circuitry to
convert the cell signal into a corresponding % oxygen value. The
system displays this value and compares it to saved alarm limits. If
the value falls outside the limits, the monitor produces the appropriate
alarms.
Ventilation modes
M1145956
The system has six modes of mechanical ventilation:

Volume Control Ventilation (VCV).
Pressure Control Ventilation (PCV) (optional).
Synchronized Intermittent Mandatory Ventilation/Pressure
Support (SIMV/PSV) (optional).
Pressure Support Ventilation (PSVPro) (optional).
Synchronized Intermittent Mandatory Ventilation-Pressure
Control (SIMV-PC) (optional).
Pressure Control Ventilation-Volume Guaranteed (PCV-VG)
(optional).
11-17
Avance
Volume control mode
Volume control supplies a set tidal volume. The ventilator calculates a

flow based on the set tidal volume and the length of the inspiratory
time (TI) to deliver that tidal volume. It then adjusts that output by
measuring delivered volumes at the flow sensors. Since the ventilator
adjusts output, it can compensate for breathing system compliance,
fresh gas flow, and moderate breathing system leaks.
A typical volume-controlled pressure waveform increases throughout
the entire inspiratory period, and rapidly decreases at the start of
expiration. An optional inspiratory pause is available to improve gas
distribution.
AB.98.036
Volume control mode settings:

TV
RR
I:E
Tpause
PEEP
Pmax
1.
2.
3.
4.
5.
6.
7.
Paw waveform
Tinsp
Insp Pause
Texp
PEEP
Flow waveform
TV
Figure 11-1 Volume control diagram
11-18
M1145956

Pressure control mode
Pressure control supplies a constant set pressure during inspiration.

The ventilator calculates the inspiratory time from the frequency and
I:E ratio settings. A high initial flow pressurizes the circuit to the set
inspiratory pressure. The flow then decreases to maintain the set
pressure (Pinspired).
Pressure sensors in the ventilator measure patient airway pressure.
The ventilator automatically adjusts the flow to maintain the set
inspiratory pressure.
AB.98.037
Pressure control mode settings:

Pinsp
RR
I:E
PEEP
Pmax
Rise Rate
1.
2.
3.
4.
5.
6.
Paw waveform
Tinsp
Texp
Pinsp
PEEP
Flow waveform
Figure 11-2 Pressure control diagram
M1145956
11-19
Avance
SIMV/PSV mode
Synchronized Intermittent Mandatory Ventilation (SIMV) is a mode in

which periodic volume breaths are delivered to the patient at preset
intervals (time-triggered). Between the machine delivered breaths,
the patient can breathe spontaneously at the rate, tidal volume and
timing that the patient desires.
At the specified time interval, the ventilator will wait for the next
inspiratory effort from the patient. The sensitivity of this effort is
adjusted using the flow trigger level. When the ventilator senses the
beginning of inspiration it synchronously delivers a volume breath
using the set tidal volume, and inspiratory time that is set on the
ventilator. If the patient fails to make an inspiratory effort during the
trigger window time interval, the ventilator will deliver a machine
breath to the patient. The ventilator will always deliver the specific
number of breaths per minute that the clinician has set.
In SIMV, the spontaneous breaths can be pressure supported to
assist the patient in overcoming the resistance of the patient circuit
and the artificial airway. When the Psupport level is set, the ventilator
will deliver the pressure support level to the patient during inspiration.
PEEP can also be used in combination with this mode.
Spontaneous breaths that occur during this mode are indicated by a
color change in the waveform.
SIMV/PSV mode settings:
TV
RR
Tinsp
Tpause
Psupport
PEEP
Pmax
Trig Window
Flow Trigger
End of Breath
Rise Rate
4
5
6
1.
2.
3.
4.
5.
6.
AB.91.040
Mandatory SIMV breath

Spontaneous pressure supported breath
Paw
Psupport
PEEP
Time
Figure 11-3 SIMV/PSV diagram
11-20
M1145956

PSVPro mode
PSVPro is pressure supported ventilation with apnea backup.

PSVPro is a spontaneous mode of ventilation that provides a
constant 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 the 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 in the event 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 pressuresupported 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-PC mode. Once in this mode
the ventilator will begin delivering machine Pressure Control breaths
at the inspiratory pressure level, inspiratory time and rate that the
user has set. If, during this mode, 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
Backup Time
Pinsp
RR
Tinsp
Rise Rate
Exit Backup
M1145956
11-21
Avance
2
3
AB.91.041
1. Paw
2. PEEP
3. Time
Figure 11-4 PSVPro diagram

When the ventilator switches to the backup mode, the alarm text
Backup Mode active shows as an information message 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. 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.
11-22
M1145956

SIMV-PC mode
Synchronized Intermittent Mandatory Ventilation, Pressure Control is

a mode in which a relatively slow mandatory breathing rate is set with
pressure-controlled breathing. This mode combines mandatory
breaths with spontaneous breath support. If a trigger event occurs
within the synchronization window, a new pressure-controlled breath
is initiated. If a trigger event occurs elsewhere during the expiratory
phase, a support for a spontaneous breath is provided with pressure
support added as set by the clinician.
AB.91.038
SIMV-PC mode settings:

Pinsp
RR
Tinsp
Psupport
PEEP
Pmax
Trig Window
Flow Trigger
End of Breath
Rise Rate
Exit Backup
1.
2.
3.
4.
5.
6.
7.
Paw waveform
Tinsp
Spontaneous breathing period
Trigger window
Pressure supported breath
Pinsp
Flow waveform
Figure 11-5 SIMV-PC waveforms
M1145956
11-23
Avance
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.
This mode will deliver breaths with the efficiency of pressure
controlled ventilation, yet still compensate for changes in the patients
lung characteristics. PCV-VG begins by first delivering a volume
breath at the set tidal volume. The patients compliance is determined
from this volume breath and the inspiratory pressure level is then
established for the next PCV-VG breath.
AB.98.034
PCV-VG mode settings:

TV
RR
I:E
PEEP
Pmax
Rise Rate
1.
2.
3.
4.
5.
6.
7.
Paw waveform
Tinsp
Texp
Variable pressure to deliver desired TV
PEEP
Flow waveform
TV
Figure 11-6 PCV-VG waveforms
11-24
M1145956
Ventilator operating specifications

Pneumatics
Gas source
Gas composition
Nominal supply pressure
Pressure range at inlet
Peak gas flow
Fresh gas
compensation
Continuous gas flow

Flow valve range
Anesthesia system
Medical Air or O2
350 kPa (50 psi)
240 to 700 kPa (35 to 102 psi)
120 l/min at 240 kPa (35 psi), 0.75
seconds
80 l/min at 240 kPa (35 psi)
1 to 120 l/min at 240 kPa (35 psi)
Flow compensation range

Gas composition
150 ml/min to 15 l/min

O2, N2O, Air, anesthetic agents
Patient airway pressure range
-20 to +120 cmH2O, +/- 1 cmH2O

resolution
12 to 100 cmH2O, 1 cm increment
6 to 30 cmH2O, 1 cm increment
-20 to 120 cmH2O
Pressure
High pressure alarm set range
Sustained pressure alarm range
Display range
Volume
Tidal volume display range
Setting range
Minute volume
Breath rate
Volume sensor type
0 to 9999 ml, 1 ml resolution

20 to 1500 ml
0.0 to 99.9 liters
4 to 100 bpm (non-spontaneous)
2 to 60 bpm (spontaneous)
1 bpm resolution
Variable flow orifice
Oxygen
Display range
Display resolution
Sensor type
Measurement range
Measurement accuracy
Cell response time
Low O2 alarm range

High O2 alarm setting
Expected cell life
M1145956
0 to 110% O2
1% increments
Galvanic fuel cell
0 to 100% O2
Better than 3% of full scale
35 seconds
Note: Response time of cell and
adapters is measured using the test
method described in ISO 7767 (1997).
18% to 99%
19% to 100% or Off
Note: Low O2 limit may not be set
above high O2 limit. High O2 limit may
not be set below the low O2 limit.
Four months of shelf life (23C room
air) and one year of normal operation.
11-25
Avance
Ventilator accuracy data

The following accuracy data are based on patient conditions and
settings described in ASTM F1101. The ventilator is assumed to be
operating in volume mode. For the following to be true, the ventilator
is operating with 100 percent oxygen in the breathing system; or it is
connected to an anesthesia gas analyzer. If the ventilator is operating
without being connected to an anesthesia gas analyzer, additional
errors may occur as described in the gas composition chart.
The minimum detectable breath size is 5.0 ml.
Delivery accuracy
greater than 210 ml tidal volume accuracy better than 7%
less than 210 ml but greater than 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 210 ml but greater than 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 addition 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.
AB.74.027
Volume delivery accuracy
Figure 11-7 Gas composition related errors
11-26
M1145956
Electromagnetic compatibility (EMC)

WARNING
Changes or modifications to this equipment not expressly

approved by the manufacturer could cause EMC issues
with this or other equipment. Contact the manufacturer for
assistance. This device is designed and tested to comply
with applicable regulations regarding EMC as follows.
Use of portable phones or other radio frequency (RF)

emitting equipment (that exceed electromagnetic
interference levels specified in IEC 60601-1-2) near the
system may cause unexpected or adverse operation.
Monitor operation when RF emitters are in the vicinity.
Use of other electrical equipment on or near this system

may cause interference. Verify normal operation of
equipment in the system before use on patients.
Guidance and
manufacturers
declaration electromagnetic
emissions
The system is suitable for use in the specified electromagnetic

environment. The customer and/or the user of the system should
assure that is used in an electromagnetic environment as described
below.
Emissions test Compliance
Electromagnetic environment guidance
RF emissions
CISPR 11
Group 1
RF emissions
CISPR 11
Class B
The system uses RF energy only for its internal function. Therefore, its RF
emissions are very low and are not likely to cause any interference in nearby
electronic equipment.
The system is suitable for use in all establishments, including domestic
establishments and those directly connected to the public low-voltage power
supply network that supplies buildings used for domestic purposes.
Harmonic
Class A
emissions
IEC 61000-3-2
Voltage
Complies
fluctuations/
flicker emissions
IEC 61000-3-3
M1145956
11-27
Avance
Guidance and
manufacturers
declaration electromagnetic
immunity
The system is suitable for use in the specified electromagnetic

environment. The customer and/or the user of the system should
assure that it is used in an electromagnetic environment as described
below.
Power immunity
Immunity test
Compliance level
Electrostatic discharge 6 kV contact

(ESD) IEC 61000-4-2 8 kV air
6 kV contact
8 kV air
Electrical fast
transient/burst IEC
61000-4-4
2 kV for power supply

lines
1 kV for input/output
lines
1 kV differential mode
2 kV common mode
Floors should be wood, concrete, or

ceramic tile. If floors are covered with
synthetic material, the relative humidity
should be at least 30%.
Mains power quality should be that of a
typical commercial and/or hospital
environment.
Surge IEC 61000-4-5
Voltage dips, short

interruptions and
voltage variations on
power supply input
lines IEC 61000-4-11
Power frequency (50/

60 Hz) magnetic field
IEC 61000-4-8 3
IEC 60601-1-2 test Level
2 kV for power supply

lines
1 kV for input/output
lines
1 kV differential mode
2 kV common mode
<5% UT (>95% dip in
UT) for 0.5 cycle
40% UT (60% dip in UT)
for 5 cycles
for 25 cycles
<5% UT (>95% dip in
UT) for 5 sec.
3 A/m
Mains power quality should be that of a

environment.
<5% UT (>95% dip in UT) Mains power quality should be that of a
for 0.5 cycle)
environment. If the user of the system
requires continued operation during
for 5 cycles
power mains interruptions, it is
recommended that the system be
for 25 cycles
<5% UT (>95% dip in UT) powered from an uninterruptible power
supply or a battery.
for 5 sec.
3 A/m
If display distortion or other abnormalities

occur, it may be necessary to position the
Anesthetic System further from sources
of power frequency magnetic fields or to
install magnetic shielding. The power
frequency magnetic field should be
immersed in the intended installation
location to assure that it is sufficiently low.
Note: UT is the AC mains voltage before application of the test level.
11-28
M1145956
Radiated immunity
Immunity test
Conducted RF
IEC 61000-4-6
Radiated RF
IEC 61000-4-6
IEC 60601-1-2 test Level Compliance level
3 Vrms
150 kHz to 80 MHz
outside ISM bands
10 Vrms
150 kHz to 80 MHz in
ISM bands
10 V/m
80 MHz to 2.5 GHz

Recommended separation distance
3 Vrms (V1)
Portable and mobile RF communications

equipment should be used no closer to
any part of the system, including cables,
than the recommended separation
distance calculated from the equation
appropriate for the frequency of the
transmitter.
D=3.5P
10 Vrms (V2)
D=12P
D=1.2P 80 MHz to 800 MHz

D=3.5P 800 MHz to 2.5 GHz
Where P is the maximum output power
rating of the transmitter in watts (W)
according to the transmitter manufacturer
and D is the recommended separation
distance in meters (m).
Field strengths from fixed RF
transmitters, as determined by an
electromagnetic site survey, should be
less than the compliance level in each
frequency range.
The ISM (industrial, scientific and medical) bands between 150 kHz and 80 MHz are 6.765 MHz to 6.795 MHz; 13.553
MHz to 13.567 MHz; 26.957 MHz to 27.283 MHz; and 40.66 MHz to 40.70 MHz.
The compliance levels in the ISM frequency bands between 150 kHz and 80 MHz and in the frequency range 80 MHz
to 2.5 GHz are intended to decrease the likelihood that a portable communications device could cause interference if
it is inadvertently brought into patient areas. For this reason, an additional factor of 10/3 is used in calculating the
recommended separation distance for transmitters in these frequency ranges.
Field strengths from fixed transmitters, such as base stations for radio (cellular/cordless) telephones and land mobile
radios, amateur radio, AM and FM radio broadcast, and TV broadcast cannot be predicted theoretically with accuracy.
To assess the electromagnetic environment due to fixed RF transmitters, an electromagnetic site survey should be
considered. If the measured field strength in the location in which the system is used exceeds the applicable RF
compliance level above, the system should be observed to verify normal operation. If abnormal performance is
observed, additional measures may be necessary, such as re-orienting or relocating the system.
Over the frequency range 150 kHz to 80 MHz, field strengths should be less than 1 V/m.
Note: These guidelines may not apply in all situations. Electromagnetic propagation is affected by absorption and
reflection from structures, objects, and people.
M1145956
10 V/m (E1)
11-29
Avance
Recommended
separation distances
The system is intended for use in the electromagnetic environment in

which radiated RF disturbances are controlled. The customer or the
user of the system can help prevent electromagnetic interference by
maintaining a minimum distance between portable and mobile RF
communications equipment (transmitters) and the system as
recommended below, according tho the maximum power of the
communications equipment.
Separation distance in meters (m) according to frequency of the transmitter

Rated maximum
output power of
transmitter watts
(W)
150 kHz to 80 MHz

Outside ISM bands
150 kHz to 80 MHz In 80 MHz to 800 MHz

ISM bands
800 MHz to 2.5 GHz
0.01
0.35
1.2
0.12
0.23
0.1
1.1
3.8
0.38
0.73
1
3.5
12
1.2
2.3
10
11
38
3.8
7.3
100
35
120
12
23
For transmitters rated at a maximum output power not listed above, the recommended separation distance D in
meters (m) can be determined using the equation applicable to the frequency of the transmitter, where P is the
maximum output power rating of the transmitter in watts (W) according to the transmitter manufacturer.
Note 1: At 80 MHz to 800 MHz the separation distance for the higher frequency range applies.
Note 2: The ISM (Industrial, Scientific and Medical) bands between 150 kHz and 80 MHz are 6.765 MHz to 6.795
MHz; 13.553 MHz to 13.567 MHz; 26.957 MHz to 27.283 MHz; and 40.66 MHz to 40.70 MHz.
Note 3: An additional factor of 10/3 is used in calculating the recommended separation distance for transmitters in the
ISM frequency bands between 150 kHz and 80 MHz and in the frequency range 80 MHz to 2.5 GHz to decrease the
likelihood that mobile/portable communications equipment could cause interference if it is inadvertently brought into
patient areas.
Note 4: These guidelines may not apply in all situations. Electromagnetic propagation is affected by absorption and
reflection from structures, objects, and people.
11-30
M1145956
Electrical safety
WARNING
The system provides connections for items such as

printers, visual displays and hospital information networks
(only connect items that are intended to be part of the
system). When these items (non-medical equipment) are
combined with the system, these precautions must be
followed:
Do not place items not approved to IEC 60601-1

closer than 1.5 m to the patient.
All items (medical electrical equipment or non-medical

electrical equipment) connected to the system by a
signal input/signal output cable must be supplied from
an AC power source which uses a separating
transformer (in accordance with IEC 60989) or be
provided with an additional protective earth conductor.
If a portable multiple socket outlet assembly is used as

an AC power source, it must comply with IEC 60601-1.
The assembly must not be placed on the floor. Using
more than one portable multiple socket outlet
assembly is not recommended. Using an extension
cord is not recommended.
Do not connect non-medical electrical equipment directly to the AC

outlet at the wall instead of an AC power source which uses a
separating transformer. Doing so may increase enclosure leakage
current above levels allowed by IEC 60601-1 in normal conditions
and under single-fault conditions. This may cause an unsafe electrical
shock to the patient or operator.
After connecting anything to these outlets, conduct a complete
system leakage current test (according to IEC 60601-1).
WARNING
M1145956
An operator of the medical electrical system must not

touch non-medical electrical equipment and the patient
simultaneously. This may cause an unsafe electrical
shock to the patient.
11-31
Avance
IEC 60601-1 Classification

This system is classified as follows.
Class I Equipment.
Type B Equipment.
Type BF Equipment.
Ordinary Equipment.
Not for use with flammable anesthetics.
Continuous operation.
Standards
Devices used with this anesthesia system shall comply with the
following standards where applicable:
Breathing system and breathing system components ISO 8835-2.
Anesthetic vapor delivery devices ISO 8835-4.
Anesthetic agent monitors ISO 11196.
Oxygen monitors ISO 7767.
Carbon dioxide monitors ISO 9918.
Exhaled volume monitors IEC 60601-2-13.
11-32
M1145956
System components
Integral
Not integral
WARNING
This anesthesia system contains the following integral components,

monitoring devices, alarm systems, and protection devices that
comply with european, international, and national standards:
Breathing system pressure-measuring device.
Airway pressure-limitation device.
Exhaled-volume monitor.
Breathing system integrity alarm.
Breathing system continuing-pressure alarm.
O2 monitor (optional O2 cell).
Anesthesia ventilator.
Breathing system.
These devices are not integral to this anesthesia system:
CO2 monitor.
Anesthetic agent monitor.
O2 monitor.
European, international, and national standards require

the following monitoring be used with this system:
Exhaled volume monitoring.
O2 monitoring.
CO2 monitoring.
Anesthetic agent monitoring be used when anesthetic

vaporizers are in use.
When adding devices to the anesthesia system, follow the installation

instructions provided by the device manufacturer. Whoever adds
individual devices to the anesthesia system shall provide instructions
on how to enable the individual devices. For example, a preoperative
checklist.
M1145956
11-33
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11-34
M1145956
12 Super User Mode
In this section
Install/Service menu . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-2

Menus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-4
M1145956
12-1
Avance
Install/Service menu
WARNING
Important
Do not enter the Install/Service menu when a patient is

connected to the system. Gas flow will cease, and the
system must be powered down in order to restart gas
flow.
Changes made to the super user mode affect the system
configuration. All changes made are permanent and preserved until
changed again.
Several settings can be changed in the super user mode. These
changes should only be made by the person responsible for the
configuration of the system.
The Installation and Service menus are password protected. Go to
Main Menu - Screen Setup - Install/Service. Enter the password
16, 4, 34.
The system must be turned off to exit the Install/Service menu.
Install/Service - Page 1
Cumulative Gas Usage
Show Alarm Limits
Fresh Gas Controls
VCV Cardiac Bypass
External Gas Monitor
Volume Apnea Setup
Time and Date
Factory Defaults
Exit
Yes
O2%
No
No
Yes, No
O2%, Flow, User
Yes, No
Yes, No
Trends Setup
Colors and Units
Parameter Settings
Page Setup
Case Defaults
Installation
Service
Exit
12-2
M1145956
12 Super User Mode
Using super user

mode
Select a menu item showing the submenu symbol to go to the

corresponding submenu. Access the Cumulative Gas Usage,
Volume Apnea Setup, Time and Date, Trends Setup, Colors and
Units, Parameter Settings, Page Setup, and Case Defaults menus
through the Install/Service menu.
Set Show Alarm Limits to Yes to display the alarm limits next to the
measured values on the normal screen.
Set the default style for the fresh gas controls. Set to O2% for O2%
and total flow controls. Set to Flow for individual gas flow controls.
Set to User to allow the user to select the flow control style through
the Screen Setup menu.
Set the VCV Cardiac Bypass to Yes to enable alveolar support
during cardiac bypass. This menu item is only available on systems
with the VCV Cardiac Bypass option installed.
Set the External Gas Monitor to Yes only if the system uses a standalone monitor for O2, agent, and CO2. Selecting Yes disables the O2
limit alarms and the O2 monitoring not connected alarm when there
is not O2 cell or airway module detected in the system. The AA, CO2
monitoring not connected alarm is also disabled.
Factory defaults are the settings installed by the manufacturer. These
cannot be changed. Select Factory Defaults to return the system to
the factory defaults.
Installation is a password-protected menu selection.
Service is a password-protected menu selection.
M1145956
12-3
Avance
Menus
Not all menu items are available depending on the system
configuration. Inactive menu items are grayed out and are not
selectable.
Menu selections shown are the factory default values. The options
are listed to the right of the menu shown.
Cumulative gas
usage
View the total system fresh gas usage since the last reset or reset the
gas usage to 0 through the Cumulative Usage menu.
Cumulative Usage
Reset Usage
Desflurane
Enflurane
Halothane
Isoflurane
Sevoflurane
O2 (*1000 l)
Air (*1000 l)
N2O (*1000 l)
Previous Menu
To reset the gas usage:

1. From Install/Service - Page 1, select Cumulative Gas Usage.
2. Reset Usage is selected by default. Push the ComWheel to
confirm the reset.
Cumulative gas usage totals are set to 0.
Cumulative agent usage totals are set to 0.
The current date and time shows.
3. Select Previous Menu to return to the Install/Service - Page 1.
12-4
M1145956
12 Super User Mode
Volume apnea setup
Use the Volume Apnea Setup menu to enable or disable the users
ability to turn the volume apnea alarms off during manual ventilation.
Set the Volume Apnea Selection to Enable to allow the user to turn
the volume apnea alarm on or off from the Start Case menu and the
Alarm Setup menu. Set the Volume Apnea Selection for each case
type default through this menu.
Set the Volume Apnea Selection to Disable to set the volume
apnea alarms to be always on during manual ventilation. When set to
Disable, the Volume Apnea menu selection is not available from the
Start Case menu and the Alarm Setup menu.
Menu selection names shown in all capital letters are configured from
the Case Defaults menu
Volume Apnea Setup

Volume Apnea Selection
Case Defaults:
ADULT
Volume Apnea
PEDIATRIC
Volume Apnea
LOCAL
Volume Apnea
CUSTOM 1
Volume Apnea
Previous Menu
Enable
Enable, Disable
Off
On, Off
Off
On, Off
Off
On, Off
Off
On, Off
To set the volume apnea for each case default:

1. From Install/Service - Page 1, select Volume Apnea Setup.
2. Set Volume Apnea Selection to Enable.
3. Set the Volume Apnea for each case default.
M1145956
12-5
Avance
Setting time and date
Use the Time and Date menu to set the time and date. The Hour
field is dependent on the Clock Format setting. The Clock Format
can be set to a 12 or 24 hour format.
Time and Date

Hour
Minutes
Zero Seconds
Day
Month
Year
Clock Format 24 h
Previous Menu
To set the time and date or change the clock format:

1. From Install/Service - Page 1, select Time and Date.
2. Select the item to change. Make the change.
The clock format factory default is 24 hours.
When the clock format is set to 12, the hour selections are in
1a format for a.m. and 1p format p.m.
When the clock format is set to 24, the hour selections are 0
to 23 in one hour increments.
3. Select Previous Menu to return to Install/Service - Page 1.
12-6
M1145956
12 Super User Mode
Trends setup
Use the Trends Setup menu to set the default trend that shows in the
right window on the user Trends menu. Access the Graphical
Trends menu from the Trends Setup menu.
Trends Setup
Default Trend Num
Graphical Trends
Previous Menu
Num, Graph, Set
To change the Default Trend setting:

1. From Install/Service - Page 2, select Trends Setup.
2. Select Default Trend.
3. Set the trend type.
Num shows the numerical trends.
Graph shows the graphical trends.
Set shows the trends for the settings.
Setting graphical trends

pages
Use the Graphical Trends menu to configure the graphical trends

pages that show in the right window on the user Trends menu.
Graphical Trends
Page 1
Page 2
Page 3
Page 4
Page 5
Previous Menu
M1145956
12-7
Avance
Page 1
Field 1 Pres
Field 2 TVexp
Field 3 CO2
Previous Menu
The available selections for Field 1, Field 2, and Field 3 are the same
for each field on each page. Selections are Off, rr+co2, Pres, MVexp,
CO2, O2, Bal, AA1, AA2, N2O, MAC, TVexp, Pmean, Spont, Compl,
VO2. The default settings for Field 1, Field 2, and Field 3 of each
page show in the table.
Default settings for Fields on each Page menu

Field 1
Field 2
Field 3
Page 1
Page 2
Page 3
Page 4
Page 5
Pres
TVexp
CO2
O2
N2O
AA1
AA2
N2O
MAC
Bal
MAC
MVexp
rr+co2
Compl
Off
To set the fields for each page view:

1. From Install/Service - Page 2, select Trends Setup - Graphical
Trends.
2. Select the page to set.
3. Select the field to set. Set the value.
4. Select Previous Menu to return the Graphical Trends menu.
5. Repeat for each page.
6. Select Previous Menu to return the Graphical Trends menu.
7. Continue selecting Previous Menu to return to the desired menu.
12-8
M1145956
12 Super User Mode
Setting colors and

units
Set the units of the parameters through the Colors and Units menu.
Access the Colors menu through Colors and Units menu.
Colors and Units

Colors
Patient Weight
CO2
Gas Supply Pressure
Paw
Previous Menu
kg
%
kPa
cmH2O
kg, lb
%, kPa, mmHg
psi, kPa, bar
kPa, hPa, cmH2O, mmHg, mbar
To set the units:

1. From Install/Service - Page 2, select Colors and Units.
Setting colors
Set the colors of the parameter waveform information, digit fields, and
trends through the Colors menu.
Colors
Paw
Flow
Resp
CO2
Previous Menu
Yellow
Green
White
White
Yellow, White, Green, Red, Blue

To set the colors:

1. From Install/Service - Page 2, select Colors and Units Colors.
3. Select Previous Menu to return to the Colors and Units menu.
4. Continue selecting Previous Menu to return to the desired menu.
M1145956
12-9
Avance
Parameter settings
Set the volume conditions and the CO2 humidity compensation

through the Parameter Settings menu. Set the volume calculation
conditions to be based on ATPD (ambient temperature and pressure,
dry humidity conditions) or BTPS (body temperature, ambient
pressure, saturated humidity condition). Set the humidity
compensation type in CO2 partial pressure values to wet or dry.
Parameter Settings
TV Based on ATPD
CO2 Numbers Dry
Previous Menu
Page Setup
Set the preset normal screen layouts through the Page Setup menu.
Menu selection names shown in all capital letters are configured from
the corresponding submenu.
Page Setup
Edit/View Page:
Available Pages
PAW TUBES
LOOPS
BIG WAVE
LOCAL
Previous Menu
12-10
ATPD, BTPS
Dry, Wet
PAW TUBES
Back
Name
Waveform Field 1
Waveform Field 2
Waveform Field 3
Digit Field
Split Screen
PAW TUBES
Paw
Flow
CO2
AA
Paw
M1145956
12 Super User Mode

The default settings for each page type show in the following table.
The fields for each page type have the same selections available:
Waveform Fields are AA, CO2, Flow, Paw, Off.
Digit Field is Supply, Flow, AA.
Split Screen is None, Gas, Trend, Spiro, Metab, Paw.
Default settings for default page views

Name
Waveform Field 1
Waveform Field 2
Waveform Field 3
Digit Field
Split Screen
PAW TUBES
LOOPS
BIG WAVE
LOCAL
PAW TUBES
Paw
Flow
CO2
AA
Paw
LOOPS
Paw
Flow
CO2
AA
Spiro
BIG WAVE
Paw
Off
CO2
Flow
Gas
LOCAL
Off
Off
CO2
Supply
None
To change the normal screen for the preset layout:

1. From Install/Service - Page 2, select Page Setup.
Edit/View Page is selected.
An arrow to the right of the page name indicates the selected
page.
2. Select the page name to enter the adjustment window.
3. To change the name of the page, select Name.
Select Clear to remove the existing name.
Select up to 10 characters from the list.
Select Delete to delete a character.
Select Save to save the name and close the selection
window.
Select Reset to return the name to the factory default name.
When the 10 character maximum is reached, the name is
automatically saved. The selection window closes.
4. Select another item to change. Make the change.
5. When done, select Back to return to the Page Setup menu.
M1145956
12-11
Avance
Configuring case
defaults
Set the user selectable default case types that show in the users
Start Case menu through the Case Defaults menu. The Set to Last
Case selection is only available on submenus if a case has occurred.
Case Defaults
Edit/View Default:
Available Defaults:
ADULT
PEDIATRIC
LOCAL
CUSTOM 1
Previous Menu
ADULT
Back
Set to Last Case
Name ADULT
Patient and Sensor Type Adult
Patient Weight 70 kg
Patient Age 40 y
Other Gas Air
Circuit Circle
Data Source Vent
Vent Mode VCV
-More-
To change the settings for the default case types:

1. From Install/Service - Page 2, select Case Defaults.
Edit/View Default: is selected.
An arrow to the right of the default case name indicates the
selected case name.
2. Select the case name to enter the adjustment window.
3. To change the name of the case, select Name.
Select Clear to remove the existing name.
Select up to 10 characters from the list.
Select Delete to delete a character.
Select Save to save the name and close the selection
window.
Select Reset to return the name to the factory default name.
When the 10 character maximum is reached, the name is
automatically saved. The selection window closes.
4. Select another item to change. Make the change.
5. When finished setting the defaults, select Confirm.
6. Repeat to set the defaults for the other default case types.
12-12
M1145956
12 Super User Mode

Each case type has multiple settings. The default settings for the
default case types show in the following table. Values in bold are
different from the default case type ADULT. A * indicates that the
setting is not available for the default ventilation mode.
Default settings for default case types

Name
Patient and Sensor Type
Patient Weight
Patient Age
Other Gas
Circuit
Data Source
Vent Mode
TV
RR
I:E
Tpause
PEEP
Pmax
Pinsp
RR
I:E
PEEP
Pmax
Rise Rate
O2 %
Total Flow
Sweep Speed
Split Screen
Waveform Field 1
Waveform Field 2
Waveform Field 3
Digit Field
Auto MV Limit
Alarm Volume
MV/TV Alarms
Volume Apnea
MV High
MV Low
TV High
TV Low
RR High
RR Low
EtCO2 High
EtCO2 Low
FiCO2 High
FiO2 High
FiO2 Low
EtO2 High
EtO2 Low
FiISO High
M1145956
ADULT
PEDIATRIC
LOCAL
CUSTOM 1
ADULT
Adult
70 kg
40 y
Air
Circle
Vent
VCV
500
12
1:2
Off
Off
40
*
*
*
*
*
*
100
6.00
Fast
Paw
Paw
Flow
CO2
AA
Off
3
On
On
10.0
2.0
1000
Off
Off
Off
8.0
3.0
Off
Off
21
Off
Off
5
PEDIATRIC
Pedi
18 kg
5y
Air
Circle
Vent
PCV
*
*
*
*
*
*
5
12
1:2
Off
40
Auto
100
6.00
Fast
Gas
Paw
Flow
CO2
AA
Off
3
On
On
10.0
2.0
1000
Off
Off
Off
8.0
3.0
Off
Off
21
Off
Off
5
LOCAL
Adult
70 kg
40 y
Air
Circle
Vent
VCV
500
12
1:2
Off
Off
40
*
*
*
*
*
*
100
0.20
Fast
Gas
Paw
Flow
CO2
AA
Off
1
Off
Off
Off
Off
Off
Off
Off
Off
8.0
3.0
Off
Off
21
Off
Off
5
CUSTOM 1
Adult
70 kg
40 y
Air
Circle
Vent
VCV
500
12
1:2
Off
Off
40
*
*
*
*
*
*
100
6.00
Fast
Gas
Paw
Flow
CO2
AA
Off
3
On
On
10.0
2.0
1000
Off
Off
Off
8.0
3.0
Off
Off
21
Off
Off
5
12-13
Avance
Default settings for default case types
FiISO Low
EtISO High
EtISO Low
FiSEV High
FiSEV Low
EtSEV High
EtSEV Low
FiDES High
FiDES Low
EtDES High
EtDES Low
FiENF High
FiENF Low
EtENF High
EtENF Low
FiHAL High
FiHAL Low
EtHAL High
EtHAL Low
12-14
ADULT
PEDIATRIC
LOCAL
CUSTOM 1
Off
Off
Off
8
Off
Off
Off
15
Off
Off
Off
5
Off
Off
Off
5
Off
Off
Off
Off
Off
Off
8
Off
Off
Off
15
Off
Off
Off
5
Off
Off
Off
5
Off
Off
Off
Off
Off
Off
8
Off
Off
Off
15
Off
Off
Off
5
Off
Off
Off
5
Off
Off
Off
Off
Off
Off
8
Off
Off
Off
15
Off
Off
Off
5
Off
Off
Off
5
Off
Off
Off
M1145956
Index
A
Abbreviations 1-7
Absorber canister
changing absorbent 8-5
filling 8-7
parts 10-6
removing 8-6
setup 8-4
ACGO 2-9
port relief 11-5
positive low-pressure leak test 5-10
scavenging a gas monitor sample flow 2-10
scavenging from an auxiliary manual
breathing circuit 2-10
scavenging the ACGO sample flow 2-9
Active AGSS 3-30
Advanced breathing system 2-5
optional components 2-7
parts 10-5
AGSS
active 3-30
connecting active adjustable 3-31
connecting active with a flow indicator 3-31
parts 10-8
passive 3-29
Air
adjust 3-9
Airway modules 6-2
agent identification 6-6
calibration 6-6
connection to a patient 6-4
parameter setup 6-5
specifications 11-13
Alarm 7-2
battery indicator 7-3
de-escalating 7-3
display changes 7-2
internal failure 7-3
list of 7-4
priorities 7-2
ranges 7-12
silencing 7-2
tests 7-14
Alarm priorities 7-2
M1145956
Alarm ranges 7-12

Alarm setup 3-23
Auto MV limit 3-25
CO2 alarms 3-24
MV/TV alarms 3-24
setting alarm limits 3-23
volume apnea 3-24
Alarm tests 7-14
Alternate O2 control 3-26
Anesthesia system display 2-14
Auto MV limit 3-25
Automatic agent identification 6-6
Auxiliary O2 flowmeter 8-13
B
Backlight test 9-7
Battery
indicator 7-3
information 11-9
Battery indicator 7-3
Bellows assembly
parts 10-4
Breathing circuit module
parts 10-3
Breathing system
problems 7-16
C
Calibration
100% O2 9-6
21% O2 9-6
airway module 6-6
backlight test 9-7
flow sensor 5-4
O2 cell 9-6
Calibration menu 9-5
Canister setup 8-4
Cardiac bypass 3-18
Changing circuit type 3-10
Checkout menu 5-5
I-1
Avance
Circuit
circle 3-10
non-circle 2-8, 3-10
non-circle relief 11-5
Circuit compliance compensation 5-4
CO2 alarms 3-24
Condenser
operation 3-28
parts 10-10
theory 11-5
Configuring case defaults 12-12
Connections
electrical 8-9
pneumatic 8-11
Controls
alternate O2 3-26
on the display 2-13
vaporizer 2-11
Cylinder
installation 8-14
D
De-escalating alarms 7-3
Digit field 2-16
setup 3-21
DIN cylinder connections 8-14
Display changes during alarms 7-2
Display controls 2-13
E
Electrical
power specifications 11-8
problems 7-17
safety 11-31
Electrical block diagram 11-6
Electromagnetic compatibility 11-27
End case 3-6
Environmental requirements 11-12
parts 10-7
EZchange canister 3-27
parts 10-9
removal 8-6
theory 11-4
I-2
F
Flow and pressure calibration 9-5
Flow sensors
parts 10-2
prevent water buildup 9-7
Flow specifications 11-9
Fresh gas usage 3-19
G
Gas scavenging
Gas setup 3-9
Gas supplies 11-4
specifications 11-5
H
High-pressure leak test 8-15
How to attach equipment to the top of the
machine 8-16
How to install gas cylinders 8-14
I
IEC 60601-1 Classification 11-32
Individual checks 5-8
circuit 5-8
circuit O2 cell 5-9
Low P leak 5-9
Low P leak (machines with ACGO) 5-9
system 5-8
Install/Service menu 12-2
Intended use 1-2
Internal failure 7-3
L
Leak 5-5
List of alarms 7-4
Low Pressure Leak test 5-9
M1145956
M
MAC 3-5
Machine check 5-6
circuit 5-7
circuit O2 5-7
monitor 5-7
system 5-6
Main menu 3-16
Mains inlet 8-9
Maintenance schedule 9-2
Minimum Alveolar Concentration 3-5
MV/TV alarms 3-24
Preoperative Tests 5-1

Problems
breathing system 7-16
electrical 7-17
pneumatic 7-18
Q
Quick keys
changing gas settings using 3-9
changing ventilator settings using 3-7
Repair policy 9-2
Negative low pressure leak test 5-9

Non-circle circuit 2-8
O
O2 cell
calibration 9-6
replacement 9-4
theory 11-17
O2 flow
adjust 3-9
start 3-3
Outlets 8-9
Overview
system 2-2
P
Parameters setup 6-5
agent setup 6-5
CO2 setup 6-5
data source 6-5
O2 setup 6-5
spirometry setup 6-5
Passive AGSS 3-29
Pin indexed cylinder yokes 8-14
Pipeline inlets 8-11
Pneumatic
connections 8-11
problems 7-18
specifications 11-5
system pneumatic circuits 11-2
Positive low pressure leak test (ACGO
systems only) 5-10
Preoperative Checkout 4-1
M1145956
Sample gas return port 8-12

Scavenging 8-11
a gas monitor sample flow 2-10
ACGO sample flow 2-9
from an auxiliary manual breathing circuit
2-10
Screen configuration 3-20
Screen setup 3-21
Select page 3-20
Serial port 8-10
Service schedule 9-3
Setting alarm limits 3-23
Setting gas controls 3-22
Setup
changing circuit type 3-10
changing gas and settings 3-9
gas 3-9
vent 3-7
Setup warnings 8-2
Silencing alarms 7-2
Specifications
flow 11-9
gas scavenging 11-11
physical 11-12
pneumatic 11-5
ventilator operating 11-25
Spirometry
menu functions 3-11
scaling 3-13
setting loop type 3-12
I-3
Avance
Spirometry setup 3-14
selecting a data source 3-15
setting patient and sensor type 3-14
setting spirometry split screen 3-15
Split screen 3-22
Standards 11-32
Start case 3-6
Start gas flow 3-3
Suction regulator
vacuum 8-12
Venturi 8-13
Super User menus
case defaults 12-12
colors and units 12-9
cumulative gas usage 12-4
graphical trends 12-7
page setup 12-10
parameter settings 12-10
time and date 12-6
trends setup 12-7
volume apnea setup 12-5
Super User mode 12-1
menus 12-4
using 12-3
Sweep speed 3-22
Symbols 1-4
System
components 11-33
overview 2-2
pneumatic circuits 11-2
turn on 3-2
System inspection 5-2
V
Vacuum suction regulator 8-12
Vaporizer
back pressure test 5-11
controls 2-11
installation 5-3
Vaporizer back pressure test 5-11
Ventilation modes 11-17
PCV-VG 11-24
pressure control 11-19
PSVPro 11-21
SIMV/PSV 11-20
SIMV-PC 11-23
volume control 11-18
Ventilator
accuracy data 11-26
changing modes and settings 3-8
modes 11-17
operating specifications 11-25
setup 3-7
theory 11-16
Venturi suction regulator 8-13
Volume apnea 3-24
W
Water buildup
prevention 9-7
Waveform 2-16
setup 3-21
T
Test tools and system parts 10-11
Trends 3-17
Troubleshooting
electrical 7-17
pneumatic 7-18
Turning system on 3-2
U
Using menus 2-16
I-4
M1145956
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-Ohmedas 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 original delivery to
Buyer or to Buyers 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 Users 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 in accordance with written
instructions provided 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-Ohmedas sole and exclusive obligation and Buyers sole and
exclusive remedy under the above warranties is limited to repairing or
replacing, free of charge, at Datex-Ohmedas 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 the Datex-Ohmeda Customer Service and Distribution
Center during normal business hours, transportation charges prepaid,
and which, upon Datex-Ohmedas 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.
Avance
Users Reference Manual
English
M1145956
05 08 001 18 05 02
Printed in USA

Datex-Ohmeda Avance - User Reference Manual PDF

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Avance

Users Reference Manual

Datex-Ohmeda, Inc., a General Electric Company, doing business as GE Healthcare.

U.S. Federal law restricts this device to sale by or on the

Avance, Advanced Breathing System, ComWheel, D-fend,

2 System Controls and Menus

7 Alarms and Troubleshooting

11 Specifications and Theory of Operation

Read each components Users Reference manual and

All system connections.

All warnings and cautions.

How to use each system component.

How to test each system component.

Before using the system:

Complete all of the tests in the Preoperative Tests

Test all other system components.

If a test fails, do not use the equipment. Have a

Explosion Hazard. Do not use this system with flammable

Configurations available for this product depend on local market and

Figure 1-1 Front view

Symbols used in the manual or on the equipment

Airway module indicator

Frame or chassis ground

Protective earth ground

Attention, refer to product instructions

Refer to product instructions

Sample gas inlet to scavenging

Lamp, lighting, illumination

Suction bottle outlet

Bellows volumes are approximate

Plus, positive polarity

Minus, negative polarity

Bag position/manual ventilation

Movement in one direction

Movement in two directions

Low pressure leak test

APL settings are approximate

Anesthetic Gas Scavenging System

Alarm silence touch key (Tec 6 Plus)

O2% indicator on left and balance gas

Gas indicator. Color associated with gas

Battery in use. Bar indicates amount of

Read to center of float

EZchange canister (CO2 bypass)

Open drain (remove liquid)

Systems with this mark agree with the

Authorized representative in the

Indicates that the waste of electrical

GOST R Russian certification

This product consists of devices that

Typeface conventions used

Advanced breathing system

Auxiliary Common Gas Outlet

Anesthesia Gas Scavenging System

Common Gas Outlet

End-tidal carbon dioxide

Fraction of inspired gas

Fraction of inspired carbon dioxide

Difference between inspiratory and expiratory