Care Fusion 3100B User manual

3100B high frequency
oscillatory ventilator
Pocket guide

This clinician’s guide describes equipment set-up and patient management procedures
for the 3100B High Frequency Oscillatory Ventilator (HFOV).
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Warning
Do not use this pocket guide as a substitute for (1) reading and understanding
the operator’s manual, (2) as a substitute for being properly trained or (3) as a
substitute for competency using the 3100B High Frequency Oscillatory Ventilator.
Use this document as a guideline for initiating and managing the patient on
HFOV. Management of a patient on the 3100B HFOV must be altered based on the
patient’s individual clinical needs. This document is not intended to be used as a
substitute for clinical experience or medical guidance.

Contents
Indications and contraindications .......................................................................................1
Things to consider before placing the patient on HFOV ...................................................4
Pre-use checklist ...................................................................................................................6
Patient circuit calibration ....................................................................................................8
Ventilator performance check ...........................................................................................10
Initial settings and management ......................................................................................12
Managing oxygenation and ventilation ...........................................................................16
Assessment of the patient on HFOV .................................................................................18
Documentation of oscillator settings ................................................................................21
Weaning HFOV and transitioning to conventional ventilation ......................................22
Transitioning to conventional ventilation ........................................................................23
Troubleshooting .................................................................................................................24
Recruitment maneuvers for adult patients on HFOV ......................................................34
Cuff leak procedure ...........................................................................................................36
Outcome assessment form .................................................................................................41
Useful information .............................................................................................................42
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1
Indications
The 3100B High Frequency Oscillatory Ventilator is indicated for use in the ventilatory
support and treatment of selected patients weighing 35 kilograms and greater with
acute respiratory failure.
Contraindications
The 3100B High Frequency Oscillatory Ventilator has no specific contraindications.
Indications and contraindications

Identifying patients for high-frequency oscillatory ventilation
Patients with ALI or ARDS, weighing 35 kilograms or greater, who are currently
failing on conventional ventilation with a protective lung strategy, will benefit from
HFOV. The following criteria are generally used for determining the feasibility of
using HFOV.
• FiO2 ≥ 60, PEEP ≥ 10 with a P/F ratio < 200
• Plateau pressure > 30 cmH2O
• Presence of bilateral infiltrates on the chest x-ray consistent with ARDS
• Oxygenation index > 24
Note:
Several clinical papers and randomized control trials have
demonstrated that the earlier application of HFOV on patients with
severe ARDS may be important for successful outcomes.
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3
The Multicenter Oscillatory Ventilation for Acute Respiratory Distress Syndrome Trial1
(MOAT2) excluded severe COPD and asthma patients from the RCT trial of the 3100B
HFOV. High frequency oscillatory ventilation is recognized as less effective in diseases
with increased airway resistance and using it in such cases may potentially result in air
trapping and hyperinflation.

4
Things to consider before placing the patient on HFOV
• Hemodynamic status:
– The patient should be hemodynamically stable with a mean arterial pressure
of at least 75 mmHg
– If mean arterial pressure is less than 75 mmHg, consider fluids and/or
vasopressors to optimize the hemodynamic status before starting
the oscillator
• Obtain ABG
– Ideally, pH should be greater than 7.2
– If pH is less than 7.2, consider correcting with a buffer for the transition
• Patient’s sedation status:
– You may need to consider sedation and neuromuscular blockades for
transition—due to the fixed Bias Flow of the device, patients are unable to
actively breathe and maintain a stable airway pressure and lung volume
– Once transitioned, patients may be able to be maintained on sedation only

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• Ensure the patient has had a recent chest x-ray
• Consider the type of mattress the patient is on—you should have the ability to
firm up the mattress if needed
• Verify whether the patient requires an off-unit procedure such as a CT scan or
MRI; if this is the case, consider doing the off-unit procedure before placing
the patient on HFOV
• If using an in-line suction catheter, ensure the fit to the circuit and suction
patient before placing on HFOV
• Give a brief explanation of HFOV to the family and patient to prepare them
for noise, chest wiggle, etc.
• If lung recruitment maneuvers are not part of your ventilation protocol, speak
with the physician to consider Treatment with Oscillation and Open Lung
Strategy (TOOLS)2

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1. Connect the source gases to system.
2. Connect the power to system.
3. Check that the patient circuit support is installed on the system.
4. Connect the patient circuit and the humidifier to the system.
5. Connect the patient circuit control and pressure sense lines to the system.
6. Turn on the power.
7. Check that the source gas lights are off.
8. Check that the start/stop light is off.
9. Check that the alarm silence light is on.
10. Perform the patient-circuit calibration described in the following section.
11. Perform verification performance.
12. Perform the alarm-check procedure as described in the Operators Manual.
Pre-use checklist

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13. Preset the flow, frequency, % inspiratory time, power and running mean
airway pressure.
14. Set the Max Paw and Min Paw switches.
15. Set the blender and humidifier controls for the desired operation.
16. Remove the stopper from the patient circuit and connect it to the
patient’s ET tube.