Dräger PulmoVista 500 User manual

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Mini-Manual
Electrical Impedance Tomography (EIT)
Device handling, application tips and examples
D-30766-2017
Christian Bozsak
Eckhard Teschner

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© 2018 Drägerwerk AG & Co. KGaA
Moislinger Allee 53–55 · 23558 Lübeck
All rights, in particular the right of
reproduction, distribution and translation, reserved.
Printed in Germany
This manual is intended to provide additional guidance for the use of PulmoVista® 500.
The information and data provided in this manual are subject to technical changes.
For the use of the Dräger products, the instructions for use enclosed with the products
always apply and are not in any way replaced or otherwise superseded by this manual.
Medical knowledge is subject to constant change due to research and clinical experience.
The authors of this publication have taken utmost care to ensure that all information
provided, in particular concerning applications and effects, is current at the time of
publication. This does not, however, absolve readers of the obligation to take clinical
measures on their own responsibility.
The use of registered names, trademarks, etc. in this publication does not imply, even
in the absence of a specific statement, that such names are exempt from the relevant
protective laws and regulations.

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Table of Contents
Page
INTRODUCTION 6
1. PREPARE THE DEVICE FOR THE CLINICAL USE 7
1.1. Start and Device Check
1.2. Selection and application of the electrode belt
1.2.1. Choosing the right belt size
1.2.2. Attach patient cable to electrode belt
1.2.3. Prepare the patient
1.2.4. Prepare the electrode belt
1.2.5. Positioning of the electrode belt on the thorax
1.2.6. General procedure when attaching the belt
1.3. Signal Check
1.4. Settings before starting an EIT measurement
1.5. Start the EIT session
1.6. Check the correct electrode belt position
1.7. Special Case: 15-electrode mode
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8
8
10
11
12
12
12
16
17
17
18
20
2. DIFFERENT VIEWS AND THEIR SPECIAL PROPERTIES 21
2.1. Main and Fullscreen view
2.1.1. Referencing
2.1.2. Regions of Interest (ROIs)
2.2. Trend views – End-inspiratory and End-expiratory
2.3. Diagnostic View
2.3.1. Conduct analysis dialogue window
2.3.2. Results of the analysis
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Table of Contents
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Page
3. USEFUL TOOLS AND TIPS 32
3.1. Contour of ventilated area
3.2. Negative impedance changes
3.3. Filtration
3.4. Save screenshot and record EIT data
3.5. Coupling of a Dräger ventilator with Pulmovista® 500
3.6. Frame rate
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Table of Contents
Page
INTRODUCTION 6
1. PREPARE THE DEVICE FOR THE CLINICAL USE 7
1.1. Start and Device Check
1.2. Selection and application of the electrode belt
1.2.1. Choosing the right belt size
1.2.2. Attach patient cable to electrode belt
1.2.3. Prepare the patient
1.2.4. Prepare the electrode belt
1.2.5. Positioning of the electrode belt on the thorax
1.2.6. General procedure when attaching the belt
1.3. Signal Check
1.4. Settings before starting an EIT measurement
1.5. Start the EIT session
1.6. Check the correct electrode belt position
1.7. Special Case: 15-electrode mode
7
8
8
10
11
12
12
12
16
17
17
18
20
2. DIFFERENT VIEWS AND THEIR SPECIAL PROPERTIES 21
2.1. Main and Fullscreen view
2.1.1. Referencing
2.1.2. Regions of Interest (ROIs)
2.2. Trend views – End-inspiratory and End-expiratory
2.3. Diagnostic View
2.3.1. Conduct analysis dialogue window
2.3.2. Results of the analysis
21
23
24
26
28
28
30
4. CLINICAL APPLICATION
4.1. Identify responder or non-responder to a recruitment-maneuver (RM)
4.2. Identify possible de-recruitment and overdistension
4.3. Influence of positioning on the distribution of ventilation
4.4. Patient proning
4.5. Intubation Check
4.6. Patient with pleural effusion
4.7. ΔEELI-trend after suction
5. EIT-TERMINOLOGY
6. CONTRAINDICATIONS
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Introduction
Welcome to the world of Electrical Impedance Tomography (EIT).
PulmoVista® 500 is the first clinical EIT device which up to date has been used
in several thousand patients. EIT is a non-invasive imaging technique that gives
you a special view inside the lungs. In a cross-sectional projection, the distribution
of the tidal volume in the thorax is shown. This illustration shows ventilated and
non-ventilated areas of the lungs as well as their changes as a function of time.
The device can be used in various situations in everyday clinical practice. You
have the ability to examine at the bedside the status of your patients' lung, track
and assess therapeutic measures in real time.
This manual is intended to assist you in the use of this device and to provide
tips and special features in order to implement the presented information in a
practical way.
D-4671-2017
Trunk cable port
Test connector
Cockpit
EIT-Module
PulmoVista® 500

Prepare the device for the clinical use
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1. Prepare the device for the clinical use
1.1. START AND DEVICE CHECK
Press the green power button in the lower left corner of the screen to turn on
the device. The device check ensures that all components of the device and the
trunk cable (cable from the device to the patient) function properly.
1. Make sure the device is in standby mode (Start / Standby).
2. Plug-in the trunk cable into the trunk cable port and insert the patient
cable plugs into their respective test connectors → match label and color.
D-2280-2010 | D-2281-2010
D-11961-2017
D-11960-2017
D-15487-2017

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Size table
Size in cm Size in inch
XXL 124 – 150 49 – 59
XL 106 – 127 42 – 50
L92 – 110 36 – 43
M80 – 96 31 – 38
S70 – 85 28 – 33
3. Select ›Device Check‹.
4. Select ›Start‹ and confirm with the
Rotary Knob .
5. The device check is running automatically. Wait for the test phase to finish.
The device will announce the test result.
D-6061-2014
1.2. SELECTION AND APPLICATION OF THE ELECTRODE BELT
If the device check fails, check the message and, if necessary, the
connectors. If the problem persists, stop using the device and contact
customer service.
1.2.1. Choose the right belt size
The application requires an EIT patient interface. This consists of an elastic
electrode belt (16 electrodes) and an attachable patient cable. In order to cover
a wide patient spectrum, there are five belt sizes, from 70 cm to 150 cm chest
circumference. Electrode belt and patient cable are marked in size and color.
Both the electrode belt and the patient cable are reusable and can be disinfected
with wipes.

Prepare the device for the clinical use
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a. Determine the proper belt size with the help of the measurement tape
–Measure about 5 cm (two inches) below the armpit from axilla to axilla
(4th to 6th ICS).
–If the area is in the transition zone between two sizes, the next larger belt
is recommended.
Start here to measure from the left to
the right mid axilla to estimate belt size
Making ventilation visible™
www.draeger.com
measurement range 4th–6th ICS
Right Axilla Left Axilla
1 Mid position marker
2 Closure holes
D-11923-2017 D-11924-2017
Applying an EIT electrode belt to estimate the right fit.
This EIT electrode belt has the correct size.
How to find the right belt size
b. Determine the size with the electrode belt
–Choose the electrode belt which you think might possibly fit
–The electrode belt has a
mid position marker 1. Hold it approx.
5 cm below the right or left axilla and place the end with the belt closure
2 over the thorax to the opposite side.
–The belt should fit when the closure holes, preferably the one in the
middle, are below the opposite axilla.
–Otherwise, choose the next smaller or larger belt.

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1.2.2. Attach patient cable to electrode belt
Take the electrode belt and the corresponding patient cable and attach the
patient cable to the electrodes in a zigzag pattern. Attach snap 1 of the patient
cable to stud 1 of the electrode belt.
Pay attention to the correct orientation of the patient cable. At the electrodes 1
and 16 there are lines that serve as a guide. Ensure the orientation of the cable
over the stud is maintained as illustrated and as marked on the electrode belt.
Electrode belt too short Electrode belt too long
D-11922-2017
D-11925-2017
Orientation of the patient cable and electrode belt
D-1254-2010
›correct‹
›wrong‹