Cosmed Quark PFT User manual

Manuale Utente
User Manual
Manuel d’utilisation
Benutzerhandbuch
Manual del Usuario
Quark PFT
Quark CPET
Quark SPIRO

COSMED does not assume any liability for end user interpretation of this user manual or for casual or consequential damages in connection with the
provision, representation or use of this documentation.
No parts of this manual may be reproduced or transmitted in any form without the expressed written permission of COSMED Srl.
Each copy of the COSMED Software can only be installed on one computer.
Excel is a registered trademark of Microsoft Corporation.
DBIII is a registered trademark of Bordland International Inc.
Lotus 123 is a registered trademark of Lotus Development Corporation.
Quark User manual, XIII Edition
01/2018
Copyright © 2012 COSMED
COSMED Srl - Italy
http://www.cosmed.com
Part N. C03262-02-91

2
Table of Contents
Table of Contents ................................................................................................................................................................... 2
Getting Started ...................................................................................................................................................................... 7
 Important Notices ................................................................................................................................................................................................8
 Intended Use.................................................................................................................................................................................................8
Specific Indications for Use ............................................................................................................................................................................8
Measured Parameter Table............................................................................................................................................................................9
 Warnings.......................................................................................................................................................................................................9
 Contraindications...............................................................................................................................................................................................11
 Contraindications for the Spirometry...........................................................................................................................................................11
Absolute Contraindications..........................................................................................................................................................................11
Relative Contraindications...........................................................................................................................................................................11
 Contraindications for Bronchial Provocation Testing....................................................................................................................................11
Absolute Contraindications..........................................................................................................................................................................11
Relative Contraindications...........................................................................................................................................................................11
 Contraindications for Exercise Testing..........................................................................................................................................................12
Absolute Contraindications..........................................................................................................................................................................12
Relative Contraindications...........................................................................................................................................................................12
 Environmental Conditions for Operation ............................................................................................................................................................13
 Overview............................................................................................................................................................................................................14
 Introduction.......................................................................................................................................................................................................15
 System Overview ...............................................................................................................................................................................................16
 Quark Unit...................................................................................................................................................................................................16
Powering on the device ...............................................................................................................................................................................16
Powering off the device...............................................................................................................................................................................16
 Flowmeter(s)...............................................................................................................................................................................................16
Turbine Flowmeter......................................................................................................................................................................................16
Pneumotach X9 (PNT)..................................................................................................................................................................................17
 The Breathing Valve ....................................................................................................................................................................................17
 Hans Rudolph V2 Exercise Testing Mask.......................................................................................................................................................18
 Paper mouthpieces......................................................................................................................................................................................19
 Soft PTE Mouthpieces ..................................................................................................................................................................................19
 Antibacterial filters......................................................................................................................................................................................19
 Nose Clips....................................................................................................................................................................................................20
 HR Monitor..................................................................................................................................................................................................20
 Oximeter .....................................................................................................................................................................................................20
 ROCC PNT.......................................................................................................................................................................................................20
 Mixing Chamber..........................................................................................................................................................................................21
 Dosimeter....................................................................................................................................................................................................21
 System Warm-Up...............................................................................................................................................................................................22
Installation.......................................................................................................................................................................... 23

3
 Before Starting.................................................................................................................................................................................................. 24
 Checking the Packing contents.................................................................................................................................................................... 24
 Optional Modules........................................................................................................................................................................................ 24
 Options / Accessories .................................................................................................................................................................................. 25
 System Description............................................................................................................................................................................................ 26
 Quark Installation.............................................................................................................................................................................................. 27
 Quark front panel........................................................................................................................................................................................ 27
 Quark Unit Rear Panel................................................................................................................................................................................. 28
 Gas Cylinders (Calibration and Testing) ....................................................................................................................................................... 29
Install the gas regulators on the cylinder .................................................................................................................................................... 29
Connect the hoses to the regulators............................................................................................................................................................ 30
Connect the hoses to the Quark................................................................................................................................................................... 30
 Assemble the Breathing Valve and flowmeter ............................................................................................................................................ 30
Turbine ....................................................................................................................................................................................................... 31
PNT X9 ........................................................................................................................................................................................................ 31
 Attach the flowmeter to the handle............................................................................................................................................................ 31
 Connect the breathing valve and/or the flowmeter to the Quark................................................................................................................. 32
 Assemble the VO2max mask and the turbine flowmeter.............................................................................................................................. 32
 Assemble the ROCC PNT................................................................................................................................................................................. 33
 Connect the Quark to the computer (PC) ..................................................................................................................................................... 33
 Power the Quark Unit when installed on the Optional Trolley ..................................................................................................................... 33
 Prepare the Quark Unit and Subject for Exercise Testing .................................................................................................................................... 34
 Prepare the Quark....................................................................................................................................................................................... 34
 Subject Preparation .................................................................................................................................................................................... 34
 Select the correct mask size for the subject ................................................................................................................................................. 34
 Assemble the Flowmeter and Mask............................................................................................................................................................. 35
The Mask .................................................................................................................................................................................................... 36
 Secure the mask.......................................................................................................................................................................................... 36
 Mask Leak Test............................................................................................................................................................................................ 36
The HR Monitor........................................................................................................................................................................................... 37
ECG Electrodes ............................................................................................................................................................................................ 38
Testing with a Mouthpiece.......................................................................................................................................................................... 39
 Contact COSMED................................................................................................................................................................................................ 40
Comments, Feedback and Suggestions ....................................................................................................................................................... 40
System Cleaning & Maintenance ............................................................................................................................................41
 System Maintenance......................................................................................................................................................................................... 42
 Cleaning & Disinfection ..................................................................................................................................................................................... 43
 Introduction................................................................................................................................................................................................ 43
 Prevention of infection transmission........................................................................................................................................................... 43
Transmission to technicians ........................................................................................................................................................................ 43
Cross-contamination................................................................................................................................................................................... 43
Tuberculosis................................................................................................................................................................................................ 43
Haemoptysis and oral lesions...................................................................................................................................................................... 43
Other known transmissible infectious diseases ........................................................................................................................................... 43
Disposable in-line filters ............................................................................................................................................................................. 43

4
 Other precautions and warnings..................................................................................................................................................................43
 Decontamination.........................................................................................................................................................................................45
 Pretreatment...............................................................................................................................................................................................45
 Water ..........................................................................................................................................................................................................45
 Maintenance ...............................................................................................................................................................................................45
 Procedure For Third-Party Products .............................................................................................................................................................45
 Symbols ......................................................................................................................................................................................................45
 Spirometry Tests ................................................................................................................................................................................................46
 Cleaning and Disinfection Methods ........................................................................................................................................................47
 Disposable items .......................................................................................................................................................................................53
 CPET & RMR Tests...............................................................................................................................................................................................54
 Cleaning and Disinfection Mmethods .....................................................................................................................................................55
 Disposable Items .........................................................................................................................................................................................60
 Mixing Chamber Test .........................................................................................................................................................................................61
 Cleaning and Disinfection Methods ........................................................................................................................................................67
 Disposable items........................................................................................................................................................................................74
 Rocc test ............................................................................................................................................................................................................75
75
 Cleaning and Disinfection Methods ........................................................................................................................................................76
 Disposable Items........................................................................................................................................................................................77
 Sampling line maintenance (Permapure)...........................................................................................................................................................78
 Equipment Inspection........................................................................................................................................................................................79
 Fuse Replacement..............................................................................................................................................................................................80
Appendix............................................................................................................................................................................. 81
 EMC ...................................................................................................................................................................................................................82
 Declaration of Conformity ..................................................................................................................................................................................86
 Service - Warranty..............................................................................................................................................................................................87
 Warranty and limitation of liability..............................................................................................................................................................87
 Return goods policy for warranty or non-warranty repair ............................................................................................................................87
 Repair Service Policy....................................................................................................................................................................................87
 Privacy Information............................................................................................................................................................................................89
 Personal data treatment and propose..........................................................................................................................................................89
 How your personal data is treated ...............................................................................................................................................................89
 Consent .......................................................................................................................................................................................................89
 Responsible party........................................................................................................................................................................................89
 Customer rights...........................................................................................................................................................................................89
 Disposing of electrical equipment ......................................................................................................................................................................90
 Safety and conformity........................................................................................................................................................................................91
Safety..........................................................................................................................................................................................................91
EMC.............................................................................................................................................................................................................91
Paramagnetic O2analyzer............................................................................................................................................................................91
Quality Assurance........................................................................................................................................................................................91
Medical Device Directive (CE mark)..............................................................................................................................................................91
 Technical Specifications .....................................................................................................................................................................................92
Flowmeter...................................................................................................................................................................................................92

5
O2analyzer.................................................................................................................................................................................................. 92
CO2analyzer................................................................................................................................................................................................ 92
CO analyzer................................................................................................................................................................................................. 92
CH4analyser................................................................................................................................................................................................ 92
Humidity absorber...................................................................................................................................................................................... 92
Power Supply.............................................................................................................................................................................................. 92
Environmental Sensors ............................................................................................................................................................................... 92
Dimension and Weight ............................................................................................................................................................................... 92
Oximeter..................................................................................................................................................................................................... 92
Accuracy specifications................................................................................................................................................................................ 92
 Refernces - Calculations..................................................................................................................................................................................... 93
 VO2and VCO2............................................................................................................................................................................................... 93
 Anaerobic Threshold (modified V-Slope)..................................................................................................................................................... 93
References .................................................................................................................................................................................................. 93
 Oxygen Kinetics .......................................................................................................................................................................................... 93
 Predicted Sets.................................................................................................................................................................................................... 94
 Automatic Diagnosis (algorithm) ................................................................................................................................................................ 95
 Quality Control Messages............................................................................................................................................................................ 96
 References......................................................................................................................................................................................................... 97
Spirometry.................................................................................................................................................................................................. 97
Dosimeter................................................................................................................................................................................................... 97
Lung Volumes............................................................................................................................................................................................. 97
Single-Breath with Apnoea......................................................................................................................................................................... 97
Single-Breath without Apnoea.................................................................................................................................................................... 97
MIP/MEP..................................................................................................................................................................................................... 97
P0.1 ............................................................................................................................................................................................................ 97
Resistance................................................................................................................................................................................................... 97
Gas Exchange.............................................................................................................................................................................................. 97
Indirect Calorimetry .................................................................................................................................................................................... 98
Sub-maximal exercise testing ..................................................................................................................................................................... 98
Oximeter..................................................................................................................................................................................................... 98
Canopy........................................................................................................................................................................................................ 98
General....................................................................................................................................................................................................... 98

Getting Started

8 - Getting Started - Important Notices
 Important Notices
 Intended Use
The COSMED Quark Series is a modular system with multiple configurations which can perform the following tests: Spirometry, Lung Function,
Cardiopulmonary Exercise, and Resting Metabolic Testing.
The system and its accessories are indicated for the acquisition, analysis, formatting, display, printing and storage of certain physiologic parameters.
The main measurements which are displayed by this product line are Oxygen Uptake, Carbon Dioxide Production, Air Flow, Ventilation, Heart Rate
and Energy Expenditure. It is intended to assist a clinician in the diagnosis of cardiac and pulmonary diseases.
Caution: Federal law restricts the sale of this device by or on the order of a licensed healthcare practitioner to be sold to the order of a physician.
The Quark Series devices must not be used as monitoring device, nor as a sole means for determining a patient’s diagnosis, but for the purpose of
assisting the clinician in the cardiac and pulmonary cardio-pulmonary diseases.
This equipment is intended to be used for the following applications:
• Understanding and Formulating lung pathology diagnosis
• Assisting with human physiology studies
• Contributing to sports medicine applications
COSMED Srl is not responsible for incidents which occur due to improper use of this device. Examples include:
• Operation of the device by unqualified individuals
• Use of the device not indicated by this manual
• Not complying with the precautions and instructions described in this manual
Specific Indications for Use
Model Indication for Use Major Clinical Applications Measured Parameters
Quark
SPIRO
Pulmonary Function testing (Age 6 to adult) Spontaneously breathing
patients, healthy or individuals
affected by respiratory disease
(asthma or COPD, etc.)
FVC, FEV1, FEF25-75%, PEF,
MVV, SpO2
Quark PFT Pulmonary Function testing
(Age 6 to adult)
Cardiopulmonary Exercise Testing (Age 6 to adult)
Spontaneously breathing
patients, healthy or individuals
affected by respiratory disease
(asthma or COPD, etc.)
FVC, FEV1, FEF25-75%, PEF,
MVV, FRC, DLCO, MIP/MEP,
P0.1, SpO2, Ve, RF, HR, VO2,
VCO2, TGV
Quark CPET Pulmonary Function testing (Age 6 to adult)
Cardiopulmonary Exercise testing (Age 6 to adult)
Spontaneously breathing
patients, healthy or individuals
affected by diseases which limit
exercise tolerance
FVC, FEV1, FEF25-75%, PEF,
MVV, VO2, VCO2, Ve, RF, HR,
SpO2
Quark SPIRO and Quark PFT can also measure Airways Resistance Test using the interrupter technique (ROCC test) for pediatric patients (3 to 6 years
old). ROCC technique was specifically developed for pediatric population and uncooperative children unable to perform spirometric maneuvers (FVC,
SVC, etc.). The interrupter technique is possible to perform with preschool children, with repeatable results that correlate well with “gold
standard” techniques.

Getting Started - Important Notices - 9
Measured Parameter Table
 Warnings
The device, program algorithms and presentation of the measured data has been developed in accordance with the specifications outlined by the
ATS (American Thoracic Society) and ERS (European Respiratory Society). Additional international references have also been applied where
applicable. There is a bibliography of all references in the AppendixThis User Manual has been developed in accordance with the Class IIa European
Medical Device Directive requirements
Warning: To avoid risk of electric shocks, this device must be connected to sockets with protective earth
Read and understand these precautions before operating the device to ensure the safety of user and subject
1. This User Manual should always be available as a reference while testing
2. The following standards should be applied to ensure the accuracy of individual test results:
• Accessories should only be used as they are described in this manual. The manufacturer does not warranty the use of any unauthorized
accessories. The manufacturer may offer suggestions while using third-party accessories and the complications which may occur
• Device Service and Repair should ONLY be performed by COSMED authorized and trained personnel
• Environmental and electrical conditions in which the device operates must comply with this manual. Note that the reliability of the device
ground and leakage current suppression is only assured when the three-wire power cord is connected to a grounding point (yellow-green
return connected to earth ground). Any attempt to avoid the proper groung connection is dangerous for both the user and equipment
• Equipment maintenance, inspections, disinfection and cleaning should be as described in this manual.
3. Prior to powering on the system, the power cords and plugs should be fully inspected. Any damaged electrical part(s) must be replaced
immediately by COSMED authorized personnel.
4. Gas cylinders:
a. Large gas cylinders provided by the manufacturer or purchased by the customer must be secured with cylinder safety chains or
safety stands as required by local law
b. After removing the cylinder’s protective cap, the valve should be inspected for damaged threads, dirt, oil and/or grease. Any
dust or dirt should be removed; however, the cylinder should not be used if oil, grease, or damaged threads are present
c. Ensure that the pressure regulator is compatible with the intended gas cylinder (chemically and physically) prior to installation
d. The regulator must be properly connected and working pressure adjusted and displayed on the regulator
e. Close cylinder before disconnecting the cylinder from the
5. Residue and other contaminants in the breathing circuit pose a safety risk to the patient during testing procedures. Aspiration of contaminants
can be potentially life-threatening. Each component in contact with the subject’s breath should be cleaned and disinfected prior to each test
6. The cleaning procedures and inspections in the System Cleaning & Maintenance section should be performed prior to each test
7. This device should not be used in the presence of flammable anaesthetics. This is not an AP or APG device (according to the EN 60 601-1
definitions)
8. The device should not come near any heat or flame sources, flammable or inflammable liquids or gases and explosive properties
9. The device should not be used in conjunction with any other medical device unless that device is recommended by the manufacturer
Parameter Description Parameter Description
FVC Forced Expiratory Vital Capacity P0.1 Respiratory Drive
FEV1Forced Expiratory Volume in 1 sec VEVentilation
FEF25-75% Mid-expiratory flow between 25-75% of the FVC RF Respiratory frequency
PEF Peak Expiratory Flow HR Heart Rate
MVV Maximum Voluntary Ventilation VO2Oxygen uptake
FRC Functional Residual Capacity VCO2Carbon Dioxide production
DLCO CO Diffusion Capacity SpO2Hemoglobin saturation
MIP Maximum inspiratory pressure TGV Thoracic Gas Volume
MEP Maximum expiratory pressure

10 - Getting Started - Important Notices
10. The device should be used with a computer with electromagnetic compatibility, CE marking and low radiation emission displays
11.
The PC connected to the device must be compliant with EN 60601-1 by means of an isolation transformer
12.
Precautions regarding EMC should be taken prior to installation and can be noted in the section EMC
13.
Portable and mobile RF communication equipment may interfere with the performance of the device
14.
Only the cables and accessories supplied with the equipment should be used with the device. The use of any other accessories and/or cables may
result in increased emissions or decreased immunity of the equipment
15.
The device should not be placed adjacent to or stacked either on top or under other equipment. If this is absolutely necessary, the device operation
must be verified to ensure normal operation The graphical symbols used with the device are described below:
Applied part type B (EN60601-1)
Potential equalization node
Applied part type BF (EN60601-1) PC connection
OFF Connector for the RH/TA sensor
ON
TTL auxiliary input/output
Protective earth ground USB connector
Alternating current HR probe connector
Refer to the instructions for use

 Contraindications
Performing forced expiratory maneuvers in spirometry testing may be contraindicated as outlined below.
 Contraindications for the Spirometry
Absolute Contraindications
FVC, VC and MVV tests:
 Post-operative thoracic surgery patients
FVC tests:
• Severe instability of the airways (patients with severe Emphysema)
• Bronchial non-specific marked hypersensitivity
• Severe gas exchange impairment (total or partial respiratory insufficiency)
Relative Contraindications
FVC tests:
• Spontaneous post-pneumothorax
• Arterial-venous aneurysm
• Severe arterial hypertension
• Pregnant with complications in the 3rd month (12 weeks)
MVV tests:
 Hyperventilation syndrome
 Contraindications for Bronchial Provocation Testing
Bronchial Provocation testing must be executed under the direction of a physician. Testing is considered safe when executed properly in a clinical
setting, however the following contraindications should be acknowledged prior to testing:
Absolute Contraindications
• Severe bronchial obstruction (decreased FEV1in adults)
• Recent myocardium infarction
• Recent cerebral vascular accident
• Known arterial aneurysm
• Inability to understand the provocation testing procedures implications
Relative Contraindications
• Bronchial obstruction caused by performing respiratory maneuvers
• Moderate or serious bronchial obstruction (FEV1< 1.51 in men and FEV1< 1.21 in women)
• Recent respiratory infection
• Recent Asthma exacerbation
• Hypertension
• Pregnancy
• Epilepsy

12 - Getting Started - Contraindications
 Contraindications for Exercise Testing
Absolute Contraindications
• Acute MI (within the past 2 days)
• High-risk/unstable angina
• Uncontrolled cardiac dysrhythmias causing symptoms of hemodynamic compromise
• Active endocarditis
• Symptomatic severe aortic stenosis
• Decompensated symptomatic heart failure
• Acute pulmonary embolus or pulmonary infarction
• Acute non-cardiac disorder that may affect exercise performance or be aggravated by exercise (e.g., infection, renal failure, thyrotoxicosis)
• Acute myocarditis or pericarditis
• Physical disability that would preclude safe and adequate test performance
• Inability to obtain consent
Relative Contraindications
• Left main coronary stenosis or its equivalent
• Moderate stenotic valvular heart disease
• Electrolyte abnormalities
• Tachyarrhythmias or bradyarrhythmias
• Atrial fibrillation with uncontrolled ventricular rate
• Hypertrophic cardiomyopathy
• Mental impairment leading to inability to cooperate
• High-degree AV block
Note: Relative contraindications can be superseded if benefits outweigh risks of exercise.
Review the section, Prepare the Quark Unit and Subject for Exercise Testing

Getting Started - Environmental Conditions for Operation - 13
 Environmental Conditions for Operation
1. COSMED devices should not be operated near explosive substances
2. COSMED devices should not be installed near electrical or magnetic devices such as x-ray equipment, transformers or power lines. These devices
could create electrical interference when performing testing procedures.
3. COSMED devices are not AP or APG units (according to EN 60601-1) and should never be operated in the presence of flammable anaesthetic
mixtures
4. COSMED devices should be operated under normal environmental temperatures and conditions [IEC 60601-1/EN 60601-1]:
• Temperature: 10°C (50°F) and 40°C (104°F)
• Relative humidity: 30% to 90% (not condensing)
• Atmospheric Pressure: 600 mBar (450 mmHg) to 1060 mBar (795 mmHg)
• Avoid operating equipment in the presence of noxious fumes or in a dusty environment
• Do not place units near heating sources
• Cardiopulmonary resuscitation equipment should be accessible in the case of an emergency
• Adequate floor space and easy access to the subject during exercise testing is necessary
• Adequate ventilation should be maintained in the room the testing is to be performed
• No other testing should be performed in the room simultaneously

14 - Getting Started - Overview
 Overview
This manual is organized in the following chapters:
1. Getting Started –Describes the intended use of the device, how to properly use it and features of the unit and accessories
2. Installation – Lists the steps required to properly install the device
3. System Cleaning & Maintenance –Describes system cleaning, disinfection and routine maintenance procedures
4. Appendix – Contains information regarding the warranty, treatment of personal data, reference standards, technical features, predicted
values and bibliographic references
Software and test execution are described in the Software Manual. We recommend reading both manuals before using this device.

Getting Started - Introduction - 15
 Introduction
The Quark is the designed for evaluation of the cardiorespiratory system
The system can perform spirometry, lung volumes, diffusion or exercise testing
The Quark can be configured with the following modules according to the specific application:
Quark Spiro Quark PFT Quark CPET
Spirometry 
Lung Volumes - -
Diffusing Capacity (DLCO) - -
Respiratory Mechanics - -
CPET - 
Dosimeter -
Oximeter 
Airway Resistance -
Mixing Chamber - 
Standard
Optional
The Quark Spiro and Quark PFT must be configured with either the turbine flowmeter or X-9 PNT
Each module will allow the following tests to be performed:
Module Tests Available
Spirometry FVC, VC, MVV
Lung Volumes FRC (via Nitorgen Wash-out), Closing Volume
Diffusing Capacity (DLCO) Diffusing Capacity (with or without apnea, or intra-breath method)
Respiratory Mechanics MIP/MEP, P0.1
CPET Breath-by-breath exercise testing
Dosimeter Allows measurements to be obtained after the delivery of broncho-provocators according to
standardized protocols
Oximeter Oximetry Tests
Airway Resistance Airways Resistance using the interrupter technique (Rocc)
Mixing Chamber Exercise testing using the mixing chamber technique (ideal for sports medicine)

16 - Getting Started - System Overview
 System Overview
The Quark Series consists of the following main parts:
• Quark unit
• Flowmeter
• Breathing valve (if required)
• Additional external sensors and devices (temperature-humidity, HR, oximeter)
 Quark Unit
The Quark unit contains the following elements:
• Power switch (located on the front panel)
• Connectors and ports (located on the rear panel)
Powering on the device
When the unit is plugged in, press the power switch on the front panel. The green led above the switch will turn on, indicating that the Quark is on
Powering off the device
Press the power switch on the front panel. The green led above the switch will turn off, indicating that the Quark is no longer powered on
 Flowmeter(s)
Turbine Flowmeter
The turbine flowmeter assembly consists of a bidirectional turbine and an optoelectronic reader. The reader measures infrared light interruptions
caused by the spinning blade inside the turbine. The device may be used to measure a wide flow range and is not affected by ambient conditions
(pressure, humidity, room temperature, exhaled gas concentration). Daily calibration of the turbine is not necessary, however calibrations should be
performed regularly to ensure accurate measurements.
There are three turbine flowmeters: ID28, ID28 Spiro and ID18.
VO2max

Getting Started - System Overview - 17
The ID28 flowmeter can be used for all tests except for RMR testing and is provided with the Quark PFT and Quark CPET units and CPET module
The ID28 Spiro flowmeter is identical to the ID28 with the absence of a sampling line. This flowmeter should only be used for spirometry testing when
exhaled gas analysis is not necessary. This flowmeter is provided with the Quark Spiro unit.
The ID18 flowmeter is used for RMR testing and it is provided with the Nutritional assessment module
Pneumotach X9 (PNT)
The X9 calculates the flow by measuring differential pressure between the two sides of a polyester mesh net.
The X9 can be reused, after proper disinfection and must be calibrated using the same procedure asthe turbine flowmeter, however it is required to
calibrate prior to each test. It can be used for all spirometry tests
Each X9 is shipped with an individualized linearization table. It is necessary to load the table from the paired USB drive (same serial number) into
OMNIA, see the Calibration chapter for more information.
NOTE: The PNT X9 can ONLY be used with the COSMED antibacterial filter
 The Breathing Valve
This breathing valve allows the breathing circuit to automatically switch between the demand valve (connected to the gas cylinder) and ambient air.
This valve closes during DLCO testing to block the air going to the patient during the required apnea time. The body of the valve is made of ABS plastic
with a silicone membrane used to open and close the breathing circuit. The valve is easily connected to the flowmeter and easily disassembled for
disinfection. Either the patient should hold the valve, or an articulated arm should can be used to support it
There are 2 versions of the breathing valve depending on which flowmeter is used (PNT X9 or Turbine)
VO2max
RMR

18 - Getting Started - System Overview
 Hans Rudolph V2 Exercise Testing Mask
The exercise test masks are made of silicone and may be reused after proper disinfection (see the chapter System Cleaning & Maintenance).
These blue masks are available in different sizes and should be assembled the included head cap as shown in the chapter Exercise testing.
Mask without Inspiratory Valves
(Required for Exercise Flow Volume Loops)
Mask with Inspiratory Valves
Turbine Assembly with Mask
 The canopy hood