Air Liquide MONNAL T60 User manual

User manual
Software version V2.7.x
www.airliquidehealthcare.ca
MONNAL T60
YL180117 - Rev 9D - 2020-03
YL180117
V2.7.xI9D
EN

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YL180117 - Rev. 9D - 2020-03
Contents
1. Before use ...............................................................................................................7
1.1. Denitionsofuserwarnings ..........................................................................................................7
1.2. Intended use .................................................................................................................................7
1.3. Training.........................................................................................................................................7
1.4. Briefdescriptionofthedevice .......................................................................................................8
1.5. Symbolsandmarkingsonthedevice.............................................................................................9
1.6. Generalsafetyinstructions..........................................................................................................11
2. Descriptionofthedevice .......................................................................................14
2.1. TerminologyUsed .......................................................................................................................14
2.2. Frontview....................................................................................................................................14
2.3. Right-handside:Patientcircuitconnectionpanel ........................................................................15
2.4. Left-handside:Turbineairinletpanel..........................................................................................15
2.5. Rearpanel ...................................................................................................................................15
3. Installationandcommissioning.............................................................................16
3.1. Unpacking ...................................................................................................................................16
3.2. Connectionsandcommissioning.................................................................................................16
3.2.1. Electrical power supply ...................................................................................................................................................16
3.2.2. Oxygen supply....................................................................................................................................................................16
3.2.3. Assembly of patient circuit and accessories...............................................................................................................17
3.2.4. CO2Measurement Probe (IRMA™).................................................................................................................................18
3.2.5. Humidier ...........................................................................................................................................................................19
3.2.6. Nebulizer.............................................................................................................................................................................19
3.2.7. Interchangeable battery...................................................................................................................................................19
3.2.8. Applying power..................................................................................................................................................................20
3.2.9. Automatic tests ................................................................................................................................................................21
4. Use ........................................................................................................................22
4.1. Start-upscreen ...........................................................................................................................22
4.2. Ventilationscreen .......................................................................................................................25
4.3. Homescreen(currentventilation) ...............................................................................................26
4.4. Ventilatorcontrols.......................................................................................................................27
4.5. Newpatient .................................................................................................................................29
4.5.1. Selecting the patient category........................................................................................................................................29
4.5.2. Selecting the patient height and gender.......................................................................................................................30
4.6. Emergencyventilationstart-up....................................................................................................31
4.7. Start/stopventilation.................................................................................................................32
4.8. Shuttingdowntheunit.................................................................................................................33
4.9. Ventilationmodes .......................................................................................................................34
4.9.1. Mode selection ..................................................................................................................................................................34
4.9.2. Ventilation settings ...........................................................................................................................................................34
4.9.3. Apnea ventilation adjustment.........................................................................................................................................35
4.9.4. VCV (controlled ventilation or assisted volume-controlled ventilation).................................................................. 36
4.9.5. PCV (controlled ventilation or assisted pressure-controlled ventilation)............................................................... 37
4.9.6. PSV (spontaneous ventilation with inspiratory assistance and PEEP) ................................................................. 38
4.9.7. SIMV ....................................................................................................................................................................................39
4.9.8. PSV / NIV (non-invasive ventilation)..............................................................................................................................40
4.9.9. CPAP (Continuous Positive Airway Pressure) .............................................................................................................41
4.9.10. Duo-Levels (Alternation of two CPAP levels) ...............................................................................................................42

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YL180117 - Rev. 9D - 2020-03
4.9.11. PRVC (Pressure-Regulated Volume Controlled) .........................................................................................................43
4.9.12. PS-Pro (Pressure Support - Pro).....................................................................................................................................44
4.9.13. PSIMV (Synchronized Intermittent Mandatory Pressure Monitored Ventilation)................................................. 45
4.10.CPV:Cardio-PulmonaryVentilation .............................................................................................46
4.11.Oxygentherapy ...........................................................................................................................48
4.12.CO2option ...................................................................................................................................49
4.13.Keepingalarmsettingsandthresholds........................................................................................50
4.14.Displayingthecurves..................................................................................................................52
4.14.1. Adjustment of scales .......................................................................................................................................................52
4.14.2. Freezing the curves...........................................................................................................................................................52
4.15.Monitoring...................................................................................................................................53
4.15.1. Adjustment of alarm thresholds ....................................................................................................................................54
4.15.2. Automatic thresholds.......................................................................................................................................................55
4.15.3. Display of measurements ...............................................................................................................................................56
4.15.4. Trends..................................................................................................................................................................................57
4.15.5. Monitoring screen.............................................................................................................................................................58
4.16.Menu...........................................................................................................................................60
4.16.1. Description .........................................................................................................................................................................60
4.16.2. Menu structure ..................................................................................................................................................................61
4.16.3. Sensors ...............................................................................................................................................................................62
4.16.4. Low-pressure O2...............................................................................................................................................................63
4.16.5. Patient monitoring ............................................................................................................................................................64
4.16.6. Data transfer ......................................................................................................................................................................64
4.16.7. Congurationoftheventilator........................................................................................................................................65
4.17.Otherfunctions ...........................................................................................................................67
4.17.1. 100% O2.............................................................................................................................................................................. 67
4.17.2. Screen lock key (Lock) ....................................................................................................................................................67
4.17.3. Day/Night key.....................................................................................................................................................................67
4.17.4. 180° Key..............................................................................................................................................................................67
4.18.Personalizingthedevice..............................................................................................................68
4.18.1. Default patient ...................................................................................................................................................................69
4.18.2. Gender/Heightconguration.........................................................................................................................................69
4.18.3. VT/PBWcoecient ..........................................................................................................................................................69
4.18.4. SI Unit ..................................................................................................................................................................................69
4.18.5. Keycongurationonthehomescreen.........................................................................................................................70
4.18.6. Selecting the height display unit ....................................................................................................................................70
4.18.7. Choice of communication protocol...............................................................................................................................70
4.18.8. Display of the ventilation timer.......................................................................................................................................70
4.18.9. Mains disconnection alarm.............................................................................................................................................70
4.18.10. Saving the ventilation settings and alarm thresholds................................................................................................ 71
4.18.11. Set-point selection ............................................................................................................................................................71
4.18.12. Display of the monitoring blocks ...................................................................................................................................71
4.18.13. Display modes in the ‘other modes’ window ...............................................................................................................71
5. Alarmsandothermessages...................................................................................72
5.1. Display ........................................................................................................................................72
5.2. AlarmAcknowledgement............................................................................................................74
5.3. Alarminhibition...........................................................................................................................74
5.4. Preventivealarminhibition .........................................................................................................75
5.5. Reset...........................................................................................................................................75
5.6. History ........................................................................................................................................75

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YL180117 - Rev. 9D - 2020-03
5.7. Table of alarms............................................................................................................................76
6. Maintenance..........................................................................................................87
6.1. Denitions...................................................................................................................................87
6.2. RoutineMaintenance...................................................................................................................87
6.3. Bacteriologicallter ....................................................................................................................87
6.4. Airinletlter(MonnalClean’In) ..................................................................................................88
6.5. Expiratoryassembly:Flowsensor+expiratoryvalve....................................................................89
7. Accessories...........................................................................................................91
7.1. Regulatoryrequirements .............................................................................................................91
7.2. Itemsincludedinthepackage .....................................................................................................92
7.3. Listofoptionsandaccessories ..................................................................................................93
8. Maintenance..........................................................................................................96
8.1. Bytheuser ..................................................................................................................................96
8.2. Bythetechnician.........................................................................................................................96
8.3. O2Cell .........................................................................................................................................97
9. Technicaldescription.............................................................................................98
9.1. Operation ....................................................................................................................................98
9.1.1. Pneumatic system............................................................................................................................................................98
9.1.2. Ventilation function...........................................................................................................................................................99
9.1.3. Air/O2mixture ...................................................................................................................................................................99
9.1.4. CO2monitoring ................................................................................................................................................................100
9.2. Electricalpowersources............................................................................................................100
9.2.1. Managing the power supply..........................................................................................................................................100
9.2.2. AC power supply ............................................................................................................................................................101
9.2.3. Interchangeable battery and internal battery ............................................................................................................101
9.2.4. Battery status indicator LED .........................................................................................................................................102
9.3. Inputsandoutputs.....................................................................................................................103
9.3.1. Video output.....................................................................................................................................................................103
9.3.2. USB Connections ...........................................................................................................................................................103
9.3.3. Connectivity to hospital networks ...............................................................................................................................104
9.4. Performanceandcharacteristics...............................................................................................106
9.4.1. Regulatory requirements ...............................................................................................................................................106
9.4.2. Recovery of the components of the medical device................................................................................................106
9.4.3. Technical Characteristics ..............................................................................................................................................107
9.4.4. Settings tables.................................................................................................................................................................122
9.4.5. Settings table (CPV) .......................................................................................................................................................126
9.4.6. Calculation of predicted body weight..........................................................................................................................127
9.4.7. Interdependency of settings .........................................................................................................................................128
9.4.8. Alarm thresholds.............................................................................................................................................................129
9.4.9. Alarm thresholds – CPV ................................................................................................................................................133
9.5. Bibliography ..............................................................................................................................134
10. Appendix .............................................................................................................135
10.1.Checklist ...................................................................................................................................135
10.2.Maintenancedatasheet ............................................................................................................136
10.3.Troubleshooting ........................................................................................................................137
10.3.1. Introduction......................................................................................................................................................................137
10.3.2. Autotests failure: “Circuit resistance could not be calculated................................................................................137
10.3.3. Alarm N°003: “Expiratory Branch may be obstructed!!!” / Alarm N°130: “Obstructed expiratory branch!!! Safety

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Monnal T60
YL180117 - Rev. 9D - 2020-03
ventilation”.........................................................................................................................................................................................138
10.3.4. Alarm N°006: “Ventilation Interrupted!!! Use an alternative ventilator” .................................................................139
10.3.5. Alarm N°021: “PEEP greater than PEEP set-point + 5 cmH2O!!!”...........................................................................140
10.3.6. Alarm N°008: “Patient disconnection!!!”......................................................................................................................141
10.3.7. AlarmN°044:“Expiratoryflowmeasurementinoperative!!!”...................................................................................142
10.3.8. Alarm N°113: “Slight leak detected during automatic tests!” .................................................................................143
10.3.9. External power supply failure........................................................................................................................................144
10.3.10. Difference between the set and the monitored volumes in non-invasive ventilation ........................................145
10.3.11. Difference between the FiO2 set value and the FiO2 monitored value 1. ........ Alarm N°097: “O2 mixer defect!!!
Ventilation Effective to 21%”..........................................................................................................................................................146
10.3.12. Alarms N°089, 092 or 093: “O2 mixer defect!!! Ventilation Effective to 21%” ......................................................147
10.4.Expiratoryassemblycleaningprotocol.......................................................................................148
10.4.1. Monnal EVA autoclavable expiratory assembly........................................................................................................149
10.4.2. Monnal EVA single-use expiratory assembly.............................................................................................................149

Before use
YL180117 - Rev. 9D - 2020-03 7
1. Before use
1.1. Denitionsofuserwarnings
Warning
Warns the user of the risks associated with the use or
misuse of the device:
- occurrence of a technical problem or device mal-
function,
- slight or serious injury to the patient.
If the risk to the patient is very high, the warning will
appear in bold lettering.
Information
Highlights a particular item of information.
1.2. Intended use
MonnalT60 is a standalone ventilator using air (pro-
pelled by a blower) used to treat infants (3 kg and
above), children, and adults. It is not intended for neo-
natal ventilation.
It is used for patient ventilation to compensate for or
mitigate respiratory failure. Contact with the patient is
made via an adequate patient interface (e.g., mask or
endotrachealtube),whichallowsairtoflowfromthe
ventilator into the lungs.
It is for use by hospital personnel (doctors, nurses,
etc.) and is used:
• for pre-admission transportation,*
• for transportation within a hospital,
• for transportation between hospitals,*
• for intra-hospital emergencies,
• in post-operative recovery rooms,
• in intensive care.
*Land transportation and air ambulances.
Medicalelectricalsystem
MonnalT60 is part of the medical electrical system
consisting of the following components:
• a CO2measurement probe (IRMA™)
• aMonnalClean’In(HEPA)lter
• ahumidier
• a nebulizer
• an interchangeable battery
• an external power supply
• oxygen from a supply network, cylinder, or concen-
trator.
MonnalT60 provides monitoring for the following re-
spiratory gases: oxygen and carbon dioxide (using the
optional IRMA probe).
Requisiteknowledge
Persons intending to operate this ventilator must be
trained in its use.
Only persons who have fully read and understood this
manual are authorized to handle and use this ventila-
tor. The present manual is intended to give all informa-
tion necessary for the correct utilisation of this venti-
lator, but is in no way intended to replace the medical
prescription that is essential for adjusting the appara-
tus according to patient needs.
1.3. Training
There are two main types of training:
• training in the use of the ventilator,
• training in the routine maintenance of the ventilator.
Trainingintheuseoftheventilator
Training in the use of the ventilator takes around thir-
ty minutes. It is carried out during installation in the
hospital department by Air Liquide Medical Systems
staff or by an authorized Air Liquide Medical Systems
distributor.
This training includes:
• validation of the intended use and description of
the ventilator,
• installation and commissioning,
• comprehensive presentation of the operating func-
tions of the ventilator,
• practice on a test lung, adapted to the type of hos-
pital service.
This training can be repeated or covered in more depth
at the request of the users, by contacting the usual Air
Liquide Medical Systems representative.
Traininginroutinemaintenance
Training in the routine maintenance of the ventilator
takes around thirty minutes. It is carried out during de-
livery to the biomedical department, or during installa-
tion in the hospital department by Air Liquide Medical
Systems staff or by an authorized Air Liquide Medi-
cal Systems distributor. It is intended for biomedical
teams and equipment supervisors in the department.
The training includes:
• consumables management
• daily recommended maintenance practices
• monitoring minor alarms

Monnal T60
YL180117 - Rev. 9D - 2020-038
1.4. Briefdescriptionofthedevice
Monnal T60 can supply tidal volumes from 20 to
2000mLinvolume-controlledmode,andinsuation
pressures from 5 to 60 cmH2O in pressure-controlled
mode.
It can also supply FiO2from 21 to 100%. This is contin-
uously monitored.
It features the following ventilation modes and func-
tions:
VCV (controlled ventilation or assisted volume-con-
trolled ventilation)
PCV(controlled ventilation or assisted pressure-con-
trolled ventilation)
PSV (spontaneous ventilation with inspiratory assis-
tance and PEEP)
PSV / NIV (spontaneous ventilation with inspiratory
assistance/non-invasive ventilation)
CPAP(Continuous Positive Airway Pressure)
SIMV (intermittent assisted controlled ventilation)
PSIMV (intermittent assisted pressure-controlled
ventilation)
Duo-Levels(Alternation of two CPAP levels)
NIV (Non Invasive Ventilation)
PRVC (Pressure-regulated volume controlled ventila-
tion)
PS-Pro(Spontaneous ventilation with inspiratory as-
sistance, PEEP and servomechanism frequency)
Oxygentherapy
CPV (Cardio-Pulmonary Ventilation)
The device is equipped with an 8.4-inch colour touch
screen, an ergonomic control wheel and a functional
interface for adjustment of the various settings and
ventilation parameters.
Patientenvironment
During normal use, the patient is lying on a hospital
bed with the MonnalT60 device placed close by. All
parts of the medical electrical system are suitable for
use in the patient environment.
Userposition
The human machine interface of the device faces the
user so that the user can make the necessary adjust-
ments with the control wheel and read the information
displayed on the screen. The recommended distance
depends on the environment, the ambient lighting and
the user’s visual acuity. The back of the device is ac-
cessible to the user.

9
Before use
YL180117 - Rev. 9D - 2020-03
1.5. Symbolsandmarkingsonthedevice
Weight and rated output of product Expiratory valve eject button
Weight of MonnalT60 device
Weight of complete system (Mon-
nalT60, mobile stand, articulated arm,
interchangeable battery and patient
circuit)
Manufacturer Highpressureoxygeninlettting
Device Catalogue Number Lowpressureoxygeninlettting
Serial Number of the device Patientcircuitinspiratorytting
Date of manufacture: YYYY-MM Patientcircuitexpiratorytting
Class II IRMA™ CO2probe connector
Caution: refer to the user manual
On the device, the symbol is shown
in blue.
Lithium-ion interchangeable battery
Type BF applied part protects
againstdebrillationshocks. Internal battery status indicator
ON button Interchangeable battery status indicator
IP34
ProtectionIndexaccording to the
EN 60529 standard
3:protection from the penetration
ofsolidbodiesofdiameter≥2.5
mm
4: Protection from water splashing
from any direction
USB connector
DC power supply connector
This logo means that the equipment
must not be disposed of via ordinary
waste channels. It must receive appro-
priate end-of-life handling, in accor-
dance with European Directive 2012/19/
EU (WEEE). This device was manufac-
tured after 13.08.05.
Do not let liquid enter this area. Mains power supply or DC voltage
Direct current VGA video output
Alternating current Oxygen cell hatch open
Curtis Straus Bureau Veritas S-Mark

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Monnal T60
YL180117 - Rev. 9D - 2020-03
SpecicsymbolsforIRMA™CO2measurementprobe
IP44
ProtectionIndexaccording to the
EN 60529 standard
4: protection from the penetration
ofsolidbodiesofdiameter≥1mm.
4: protection from water splashing
from any direction
Type BF device

Before use
YL180117 - Rev. 9D - 2020-03 11
1.6. Generalsafetyinstructions
Useofoxygen
• Precautions in case of oxygen leak:
• No smoking
• Avoidanyflameorsourceofsparks
• Disconnect the oxygen source
• Ventilateroomduringleakageandatleast20minutesafterleakage.
• Air one‘s own clothing.
• The device must not be in operation near any incandescent source.
• Thisventilatormustnotbeusedwithinflammableanestheticagentsorexplosiveproducts.
• Do not use the equipment with helium or helium mixed with another gas.
• The ventilator does not directly administer nitric oxide but can be used concomitantly with a Nitric Oxide
administration system, provided that the manufacturer of the nitric oxide delivery system has validated its
use.
• Do not use the device with components that have been contaminated by inflammable substances (e.g.
grease, oil, etc.).
• The internal components of the device were degreased before delivery or use a type of grease which is
compatible with oxygen. Do not grease or lubricate any part of the device.
• Medical grade oxygen must be used (i.e. dust-free and dry, H2O < 20 mg/m3).
• Thesupplypressuremustbebetween280kPa(2.8bars)and600kPa(6bars).
• When the device is not in use, it is recommended that you disconnect all oxygen sources from it.
Usewithadebrillator
• When using the Monnal T60 andadebrillatorsimultaneously,thedebrillationshockinthepresenceof
enrichedoxygenandcombustibles(suchastextiles)cancauseanexplosionorrewhichcouldinjurethe
patient and bystanders.
• It is recommended to use adhesive electrodes.
• Duringthedebrillation:
• remove the oxygen mask or the nasal cannula and keep it at least 1 m from the patient’s torso;
• if the patient is intubated, leave the ventilator connected;
• ensure that the oxygen-enriched air at the outlet of the expiratory valve is not facing the patient’s torso.
Electricalpowersupply
• Check that the voltage in the mains socket used matches the electrical characteristics of the ventilator (indicated on
the rear panel of the power supply adapter).
• Use only the mains cable and mains power supply box supplied with the device.
• If an external power supply is used, check that the voltage and current used match the electrical characteristics
of the ventilator (indicated on the side of the ventilator).
• The mains power supply adapter is not protected from splashes of water (IPX0), unlike the device itself,
which complies with IPX4 during battery-powered operation.
• This ventilator has an internal battery and an interchangeable battery. The device must be connected to the mains
regularly to maintain the battery charge at a suitable level.
• In the event of any doubt about the condition of the mains power supply cable, use the device on its internal
battery only.
• In case of long battery-powered operation, we recommend keeping a spare interchangeable battery on hand.
• Do not use antistatic or electrically conductive pipes.
• The user must not touch the patient and the equipment enclosures at the same time.

Monnal T60
YL180117 - Rev. 9D - 2020-0312
Internalbatteryelectricalpowersupply
• The internal battery is a backup power source only. If connection to the mains power supply (primary power
source) is impossible, an interchangeable battery (secondary power source) must be used. Using the internal
battery as the main power source can cause ventilation to stop unexpectedly.
IPProtection
• To ensure the IP protection level of the device is maintained during normal use, it is essential that all removable
components(airlter,expiratoryassembly,O2sensorcoverandtherearplasticpanel)arettedinplace
Electromagneticcompatibility
• Thepresenceofequipmentasdiathermyunits,highfrequencyelectro-surgicalequipment,debrillatorsand
cellular telephones or of electromagnetic interferences exceeding EN 60601-1-2 levels in its vicinity may
interfere with the normal operation of the ventilator.
• The MonnalT60 should not be placed next to or on top of this equipment. If such use is necessary, the
MonnalT60 should be observed together with the other ventilators to ensure that they are operating normally.
• Donotusethisventilatorinaspecicallymagneticenvironment(MRI,NMR,etc.).
• Monnal T60 is compliant with the requirements dened in standard EN 60601-1-2 relating to the
electromagnetic compatibility of medical devices. Precautionary measures are required with this device
in terms of EMC and the devices must be installed and put into operation in accordance with the EMC
information provided in this user manual.
• The replacing of cables or internal components with cables or components that are not supplied by Air
Liquide Medical Systems may result in an increase in emissions or a decrease in the immunity of the device.
Connectiontootherelectricaldevices
• Donotconnect thedevice toother electricalappliancesnot mentionedin thisuser manualwithout rst
consulting the manufacturers concerned or a specialist.
• Devices connected to the inputs and signal outputs must comply with the 60601-1 Standard.
Set-up
• The device must not be put into service immediately after storage or transportation where the temperature
and humidity were different from the recommended operating conditions.
• Before each use, check that the audible and visual alarms are working correctly and carry out the checks
listed in the appendix (see section ““10.1 Checklist”).
• The ventilator should not be covered or positioned in such a way that its functioning or performance are
affected. Always leave some space around the device: for example, never place the ventilator close to a
curtainwhichcouldimpedethefreshairflowandcauseoverheating.
• If the MonnalT60 is installed on the universal support (KA010400), follow the instructions in the assembly
manual. Ensure that the structure or unit (bed rail, for example) onto which the universal support is mounted
can support the weight of the MonnalT60.
Use
• The manufacturer has tried to anticipate most of the possible malfunction scenarios of this ventilator, and
these are normally monitored by the internal monitoring system. It is nevertheless recommended, in cases of
complete patient dependence, that you provide an additional, fully autonomous system which can be used to
checktheeffectivenessoftheventilation,aswellasaback-updevice,suchasasuitablemanualinsuator.
• Lack of an alternative means of ventilation may result in patient death should the ventilator fail.
• If the accessories used are not compliant with the manufacturer‘s recommendations, the manufacturer
accepts no responsibility in the event of an incident.
• Do not expose the device to direct sunlight.
• Do not use MonnalT60 in a hyperbaric chamber.
• The device and its accessories (masks, circuits, etc.) are Latex-free.
• The air inlets located at the back and side of the device must be completely unobstructed.
• Tooperatethedevicefromambientair,aMonnalClean-In(HEPA)ltermustbeusedattheventilatorinlet.
ThislterisrecommendedbyAir Liquide Medical Systems.
• Donotusetheventilatorinanexplosiveornicotine-ladenatmosphere(cigarettesmoke,re,etc.).
• In order to prevent dust from entering:
• between ventilator uses in the bag, close the inspiratory limb cap;

Before use
YL180117 - Rev. 9D - 2020-03 13
• betweenventilatorusesinthebag,leaveabacteriologicallterorpatientcircuitontheinspiratoryoutlet
of the ventilator;
• duringcleaning,leaveabacteriologicallterorapatientcircuitontheinspiratoryoutletoftheventilator;
• clean the inside of the bag regularly.
Transportation
• During transportation, we recommend that you use the device in its protective carry bag. The case must be
securely fastened in the vehicle using the strap loops provided for the purpose.
• The device must not be subjected to violent impact.
• Use the carry bag recommended by Air Liquide Medical Systems only.
• During transport, the use of Monnal T60 outside of its bag does not ensure compliance with EN 13718-1, EN
1789 and EN 794-3 standards.
Riskofcross-contamination
• Reusing single-use accessories or consumables carries the risk of patient cross-contamination. This risk
also arises if reusable accessories or consumables are not sterilized between each use.
• The breathing tube, mask, patient circuit, bacteriological lters, expiratory valve, humidication chamber,
CO2probe or nebulizer adapters are part of the air path and can be contaminated under normal operating
conditions, and in the event of a single fault condition by bodily fluids, secretions or gas exhaled by the
patient.
Maintenance
• This ventilator must be checked regularly. To plan and keep a record of all maintenance, operations, refer to
the maintenance sheet in the appendix.
• In accordance with the EN 60601-1 Standard (Appendix A, Para. 6.8.2.b), the manufacturer, the assembler,
the installer or the importer shall only consider itself responsible for the effects on the safety, reliability and
characteristics of a device if:
• “Assembly,extensions,adjustments,modicationsorrepairshavebeencarriedoutbypersonswhomit
has authorized;
• The electrical installation in the corresponding area is compliant with IEC recommendations.
• The device is used in conformity with the instructions for use.”
• The approved technician must use only Air Liquide Medical Systems spare parts when carrying out routine
maintenance of the device.
• Donotuseabrasivepowders,alcohol,acetoneorothereasilyflammablesolvents.
• The device must be disconnected from the mains during any procedure such as maintenance or cleaning.
Recommendationsforaspiration
• Aspiration may be carried out according to different methods: fully unplugging the circuit, opening a
respiratory circuit connection, or closed system.
• When using a breathing tube in a closed system, it is advised to use the PAC mode with the parameters
adjusted to the patient and, if tolerated, a PEEP of at least 3 cmH2O.
Medicalcontraindications
• Certain conditions require appropriate treatment before ventilator use. The absence of such treatment may
have negative effects on the patient‘s health.
• Monnal T60 is not suitable for very low-weight patients (premature infants, and infants under 3 kg).
• Monnal T60cannotbeusedinmagneticresonanceimaging(MRI)roomsunlessasucientlylongcircuit
is added.
• Monnal T60 is not designed for hyperbaric ventilation.
• The CPV ventilation function (cardiopulmonary ventilation, optional) is not suitable for children and infants.
RecommendationsforusingtheMASIMOIRMA™CO2measurementprobe
See “4.12. CO2 option”, page 49.

Monnal T60
14 YL180117 - Rev. 9D - 2020-03
2. Descriptionofthedevice
2.1. TerminologyUsed
Theexpiratoryassembly denotes the expiratoryow
sensor and the expiratoryvalve.
Theexpiratoryvalvedesignates the valvebody, the
membrane and the siliconediscs.
2.2. Frontview
1. Handle
• To carry the machine easily.
2.Touchscreen(8.4inches)
Interface between the user and the device
• Permits adjustment of all ventilation settings.
3.Alarmindicators
Illuminates to inform the user that an alarm has been
activated.
• Redfastflashing(2Hz)=highpriority
• Yellowslowflashing(0.5Hz)=mediumpriority
• Steadyyellow=lowpriority
4.Controlwheel
• Thisisusedtoadjustandconrmtheparameters.
5.ACpowersupplyindicatorlight
6.Internalbatterystatusindicator
7.Interchangeablebatterystatusindicator
HandleSide
8.Secondaryairinlet
9.Speaker
BaseSide
10.Electricalconnectionwiththehotwireexpirato-
ryowsensor(expiratoryassemblywithdrawn) 8 9
10
5
1
6 7
4
3
2

Descriptionofthedevice
15YL180117 - Rev. 9D - 2020-03
2.3. Right-handside:Patientcircuit
connectionpanel
11. Cooling vent
12. IRMA™ CO2probe connector socket
13. Inspiratory circuit connection
14. Expiratory valve eject button
15. Expiratory circuit connection
16.Hotwireexpiratoryflowsensor
2.4. Left-handside:Turbineairinlet
panel
16
11
17 18 19 20 21
24
25
26
23 22
12
15 14 13
17. ON/OFF button
18. Electrical power supply connector
19. Anti-pull cable protection clip
20. High-pressure oxygen inlet
21. Cooling vent
22. Interchangeable battery housing
23. Low-pressure oxygen inlet
24. Air inlet
2.5. Rearpanel
25. FiO2cell
26. Electrical connections for a wall-mounted
charging station

Monnal T60
16 YL180117 - Rev. 9D - 2020-03
3. Installationandcommissioning
3.1. Unpacking
Remove the ventilator from the packaging and place it
horizontally on a table.
Unwrap the accessories supplied with the ventilator.
Before using on a new patient, and before the rst
use of this device, you must clean and disinfect the
accessories (see section “6 Maintenance”).
3.2. Connectionsandcommissioning
3.2.1. Electricalpowersupply
Connect the electrical power supply cable to the venti-
lator (see opposite), and then connect it to an AC pow-
er supply socket.
Always check that the electrical network is com-
patible with the specications in this manual.
Check that the power cable is not damaged.
 Leave enough space behind the device for re-
moving the cord from the power outlet when stopping
the machine.
 The power cord enables Monnal T60 to be dis-
connected from the power supply on all poles simul-
taneously.
3.2.2. Oxygensupply
To use a mixture with more than 21% oxygen, connect the
ventilator’s high- or low-pressure O2inlet to a valid source
via an appropriate connector.
If this oxygen source is a high pressure transport cylinder,
it must be equipped with a pressure reducer to suit the
allowable pressure range (2.8 to 6 bar).
Start by connecting the O2connection hose to the
ventilator before connecting it to the oxygen network.
Check the capacity of the oxygen cylinder before
using the ventilator.
Left-hand side:
Location of power cable with
Anti-pull cable protection clip

Installationandcommissioning
17YL180117 - Rev. 9D - 2020-03
3.2.3. Assemblyofpatientcircuitandaccessories
Make sure that the use of accessories does not affect the safety and the expected performance of the
device.
Only use the accessories described below with the MonnalT60.
MonnalT60 is compatible with double-branch, adult and pediatric circuits.
Y-piece
Double-branch patient circuit
It is necessary to use a hydrophobic bacteriological lter (1) on the ventilator’s inspiratory outlet (2).
1
2
An HME (3) (heat and moisture exchanger) lter can be used in addition to the hydrophobic bacteriological
lter (1). It must be placed on the Y-shaped part(4).
34
Air Liquide Medical Systems recommends using the patient circuits listed in Chapter “7.3 List of options
and accessories”. If not, the use of patient circuits containing phthalates or bisphenol A poses risks for pregnant
women, lactating women and children.
Inacasewheretheexpiratoryvalveisnottted,assembletheexpiratoryvalveasshownin“10.4 Expiratory
assembly cleaning protocol” then insert it into the housing until you here it click into place.
Double-branchpatientcircuit
Connectthepatientcircuittotheventilatorandthehumidier(ifused):
27 28
• Connect the expiratory branch to the expiratory valve of the ventilator: (27).
• Connect the inspiratory branch to the inspiratory outlet cone of the ventilator: (28).
Make sure to limit dead space when installing the patient circuit and accessories.

Monnal T60
18 YL180117 - Rev. 9D - 2020-03
When using the equipment on a patient for the rst time, make sure that you follow the hospital’s hygiene
protocol for new single-use equipment or adequately sterilized reusable equipment. The accessories and con-
sumables (patient circuit, masks, expiratory valves, adapters, nebulizer, etc.) are generally available in single-use
and autoclavable versions.
Reusing single-use accessories or consumables carries the risk of patient cross-contamination. This risk
also arises if reusable accessories or consumables are not sterilized between each use.
3.2.4. CO2MeasurementProbe(IRMA™)
CO2 monitoring requires a software option that can be enabled using a code. To use this option, contact
your Air Liquide Medical Systems representative
After purchasing this option, Air Liquide Medical Systems provides:
• the activation code for the option,
• the CO2probeformeasuringtheconcentrationofexhaledcarbondioxide(inaccordancewithISO80601-2-
55),
• the necessary adapters.
etCO2connector
1. Connect the IRMA™ probe to the etCO2connection socket (see opposite).
2. Apply power to the ventilator.
3. Connect the probe to its patient adapter (a). The probe is correctly connected to its adapter when you hear
it click into position.
4. Wait at least 10 seconds. If the etCO2monitoring block does not show 0%, or if the error ‘CO2measurement
incorrect’ is displayed, a calibration test should be carried out. See “4.16.3. Sensors”, page 62.
5. TheLEDflashesandthengoesgreen.ThismeansthattheIRMA™probeisreadyforuse(b).
Pre-usechecks(foreachnewpatient)

Installationandcommissioning
19YL180117 - Rev. 9D - 2020-03
1. Connect the sensor to the patient adapter (a). A click should be heard when the sensor is properly connected
to the adapter.
2. Ensure that the etCO2monitoring block is displaying data.
3. Connect the IRMA™ probe, equipped with its adapter, to the Y-piece on the patient circuit (c).
4. Connect the IRMA™ probe to the patient’s endotracheal tube (d).
5. Position the IRMA™ probe (e) (see photo opposite).
The probe sends information and alarms to the MonnalT60. The probe has an LED indicating the following
statuses:
LED status Description
Continuous green OK
Flashing green Calibration in progress
Continuous red Probe error
Flashing red Checking the adapter
3.2.5. Humidier
Ifthisventilatorisusedwithahumidier,ensurethatitisalwaysplacedlowerthantheventilatorandthepatient.
Itisalsorecommendedthatyouusepatientcircuitsequippedwithwatertrapswhenusingahumidier.
Remember to empty the water traps regularly during ventilation.
Ensure that water does not enter the unit during handling of the patient circuit or the humidier (if
used). If this occurs, immediately stop using the device, and contact the Technical Department.
Humidication may increase the resistance of the lters used in the patient circuit. The lters should
be tested frequently to check for an increase in resistance or blockage.
3.2.6. Nebulizer
Y-piece respiratory lters can prevent medication from being effective: their use is therefore not recom-
mended,
The precision of the expired volume can be impaired: a protective lter can then be used at the expiration
end.
Nebulization may increase the resistance of the lters used in the patient circuit. The lters should be test-
ed frequently to check for an increase in resistance or blockage.
3.2.7. Interchangeablebattery
Priortousingtheinterchangeablebatteryforthersttime,pleasecompletetheblankexpirationdatelabelsup-
pliedwiththebattery(2yearsafterdateofrstuse).

Monnal T60
20 YL180117 - Rev. 9D - 2020-03
3.2.8. Applyingpower
Do not obstruct the vents located on the left- and right-hand sides of the device and underneath it, as
this could compromise patient safety.
Apply power to the device using the ON/OFF button located on the left-hand side of the unit (see opposite).
ON/OFF button
The initialization tests start up (duration: up to 5 s). The buzzers sound and the alarm indicators light up.
After the initialization tests, the machine displays the start-up screen.
 When switching the device on using internal/external battery (no mains supply connected), the ON/OFF
button may need to be pressed for an extended period of time than normal to start the device (approximately 3
seconds).
Make sure that you have fully charged both batteries (internal and interchangeable) before using the ven-
tilator.