Percussionaire Bronchotron Transport System User manual

Bronchotron®Transport System
High-Frequency Percussive Ventilation
User Manual

II
© 2020 Percussionaire® Corporation
ALL RIGHTS RESERVED
1st Edition
First Printing April 2021
Percussionaire® is a registered trademark of Percussionaire Corporation.
This work is the sole property of Percussionaire® Corporation. The information in this
manual is condential and may not be disclosed to third parties without the prior written
consent of Percussionaire®. No part of this document may be copied, reproduced,
transmitted, or stored in any electronic information system without the prior written
consent of Percussionaire® Corporation.
One or more patents may cover the devices and products contained in this manual.
This manual was originally released and supplied in English.
For a list of available translations, contact customerser[email protected]om.
All ventilators should be operated and serviced only by trained professionals.
Percussionaire® Corporation’s sole responsibility with respect to its ventilators, accessories,
components, and software, and their use, are as stated in the warranty provided in the
manuals. The information set forth herein is believed to be accurate; it is not a substitute
for the exercise of professional judgment.

III
Table of Contents
Chapter 1: Introduction ............................................................................................................. 1
Bronchotron® Transport Controller............................................................................ 1
High-Frequency Percussive Ventilation (HFPV)..........................................................2
Percussive Lung Ination .............................................................................................. 2
Phasitron® Breathing Circuit A50605-D ................................................................... 3
Phasitron® Breathing Circuit......................................................................................... 3
HFPV Lung Recruitment Protocol Chart ................................................................. 4
Document Symbols ......................................................................................................... 4
Chapter 2: Intended Use............................................................................................................ 5
Indications for Use............................................................................................................ 5
Patient Population ............................................................................................................ 5
Absolute Contraindications .......................................................................................... 5
Relative Contraindications ............................................................................................ 5
Possible Adverse Reactions........................................................................................... 5
Physiological Benets of TRUE-IPV®........................................................................... 5
Clinical Limitations/Restrictions.................................................................................. 6
Warnings and Cautions................................................................................................... 6
WARNINGS .................................................................................................................. 6
CAUTIONS ................................................................................................................... 7
Chapter 3: System Description............................................................................................... 8
Bronchotron® HFPV Controller Functions............................................................... 9
Monitron® Patient Monitoring System...................................................................10
Digital Multimeter (DM)................................................................................................10
Power-On Self-Test (POST) Mode ....................................................................11
Wake Mode...............................................................................................................12
Active Mode .............................................................................................................12
Report Mode............................................................................................................13
Sleep Mode ..............................................................................................................14
Fault Mode ...............................................................................................................14
Fault Detection .......................................................................................................15
Fault Logging ..........................................................................................................15

IV
Chapter 4: Setup..................................................................................................................... 16
Chapter 5: Pre-Use Check ................................................................................................... 17
Pre-Use Check with Blender................................................................................... 17
Pre-Use Check ............................................................................................................. 17
Alarm Check................................................................................................................. 18
Chapter 6: Basic Ventilation Starting Strategies........................................................ 19
Neonatal Starting Guidelines ................................................................................ 21
Neonatal Strategies.............................................................................................. 21
Pediatric Starting Guidelines................................................................................. 22
Pediatric Strategies............................................................................................... 22
Adult Starting Guidelines ...................................................................................... 23
Adult Strategies ..................................................................................................... 24
Chapter 7: Cleaning and Disinfection............................................................................ 25
Controller...................................................................................................................... 25
Digital Multimeter (DM) .......................................................................................... 25
Phasitron® Kit A50605-D ......................................................................................... 26
Cleaning and Disinfection Solutions .................................................................. 26
Chapter 8: Maintenance...................................................................................................... 27
Changing Digital Multimeter (DM) Batteries ................................................... 27
Chapter 9: Troubleshooting ............................................................................................. 28
Chapter 10: Technical Specications ........................................................................... 29
Bronchotron® Controller ........................................................................................ 29
Digital Multimeter (DM) Specications.............................................................. 30
Phasitron® A50605-D ............................................................................................... 30
Chapter 11: Service and Repair....................................................................................... 31
Preventive Maintenance ......................................................................................... 31
Returns and Shipping ............................................................................................. 31
Disposal of Equipment ........................................................................................... 31
Chapter 12: Limited Warranty.......................................................................................... 31

1
Chapter 1: Introduction
Bronchotron® Transport Controller
This chapter provides an overview of the Bronchotron® Transport device and
High-Frequency Percussive Ventilation (HFPV).
The Bronchotron® Transport is a pneumatically powered, ow-regulated, time-cycled
ventilator that provides high-frequency percussive ventilation (HFPV), between 200-
800 cycles per minute. These high-frequency pulses ramify throughout the airways
and alveolar ducts, augmenting diusive ventilation in the gas exchange regions of the
lungs, allowing improved ventilation and FRC, CO₂ removal, airway clearance, and lung
recruitment.
The Bronchotron® Transport gives clinicians a rugged and portable option for
High Frequency Percussive Ventilation, specially designed for transport.
Powered directly by wall
gas source or through
oxygen blender
Operates from a single
oxygen cylinder or from a
standard high-ow blender.
It does not depend on
electrical power.
Invasive or Non-Invasive
Mechanical Ventilation
Patients can breathe
spontaneously at any point
in the breath cycle.
Selectable Inspiratory
and Expiratory Time

2
High-Frequency Percussive Ventilation (HFPV)
Percussive Lung Ination
This HFPV system supports both diusive and convective ow by stacking breaths in
cumulative subtidal volumes, allowing for air exchange, airway clearance, and lung
recruitment for most patient populations, neonatal to adult.
The following chart displays a typical multistage Bronchotron® percussive lung ination.
10 mm/second
Spontaneous Oscillatory Demand CPAP
Basic Oscillatory Equilibrium
OD-CPAP
cmH2O
cmH
2
O
40
35
30
25
20
15
10
5
0
120
105
90
75
60
45
30
15
0
VDR®-4 Waveform viewed on Monitron II
AIP/CPR
AIP during
Convective
Pressure
Rise Use
AIP during
Pulsatile
Flow
AIP/PF
AEP
Mean Airway
Pressure

3
Phasitron® Breathing Circuit A50605-D
The patented Phasitron® uses a unique sliding venturi mechanism to protect the
lung from overpressure. By automatically adjusting to the resistance of the lung, the
Phasitron® precisely and safely delivers the optimal amount and pressure of air required
by the alveolar space. When lung resistance is low, as in a compliant lung, all the pulsed
air from the device enters the mouth of the venturi tube inside the Phasitron® and is
delivered instantly to the patient. If needed, each pulse of the Phasitron® is capable of
entraining up to four times as much additional air into the venturi, which is delivered
directly to the patient.
Phasitron® Breathing Circuit
Air/Oxygen
inlet
Entrainment Port Exhalation Port Monitoring
Sample Port
Patient Airway
Connector
Accessory
Proximal
Airway
Monitoring
Ports
NOTE: The Phasitron®breathing circuit is part of the system and can not be used
independently or with any other manufacturer's products.

4
The chart below illustrates the typical high-frequency percussive ventilation algorithm:
This is a method of preventing recruited bronchial airways and alveoli from deating to
a collapsed end resting position during each expiratory lung deation.
HFPV Lung Recruitment Protocol Chart
Subtidal
lung volume increasing
Adjustable CPAP
Document Symbols
NON
STERILE
LATEX
PHT DEHP
DIBP
DBP
BBP
i
C
M
N
D
h
g
y
WARNING
CAUTION
Read the manual
before use
CE marking
Manufacturer
Manufacture Date
Non-Sterile
Does Not Contain
the Phthalate
Plasticizers DEHP,
DIBP, DBP, or BBP
Type BF Applied Part
Single Patient Use
Prescription Only
Catalog Number
Lot Number
European
Representative
Not Made with
Natural Rubber Latex
Disposal

5
Chapter 2: Intended Use
The Bronchotron® Transport is indicated for transport of patients that require
high-frequency percussive ventilation. The device is intended for hospital or pre-hospital
use, emergency care, intra-hospital, and external hospital transport.
Patient Population
Indications for Use
Absolute Contraindications
Relative Contraindications
Possible Adverse Reactions
Physiological Benets of TRUE-IPV®
The Bronchotron® Transport is for use on neonatal, pediatric, and adult patient populations.
• Untreated tension pneumothorax • Untrained or unskilled operator
• History of pneumothorax • Myocardial infarction
• Recent pneumonectomy • Vomiting
• Pulmonary hemorrhage • Pulmonary air leak
(without functioning chest tube)
• Decreased cardiac output • Increased intracranial pressure
• Pneumothorax • Increased air trapping
• Hyper-oxygenation • Pulmonary air leak
• Pulmonary hemorrhage • Hyperventilation
• Gastric distension • Apnea
• Recruitment of atelectatic lung • Mechanical bronchodilation
• Improved FRC • Improved breathing pattern
• Decreased work of breathing • Increased secretion mobilization

6
Clinical Limitations/Restrictions
Warnings and Cautions
Use of the Bronchotron® Transport is limited to individuals who have received proper
training.
Read all safety instructions and the entire Bronchotron® Transport User Manual before
using the device.
NOTE: A WARNING icon indicates a risk of injury to patient or operator.
A CAUTION icon indicates a risk of equipment damage.
WARNINGS
Use only Percussionaire® accessories explicitly designed for
use with the Bronchotron®. Using accessories not specically
designed for use with the Bronchotron® may cause harm to the
patient.
Because pulmonary alveoli cannot be ventilated when their
transmitting airways are obstructed, suctioning should be
performed as necessary.
For ventilator-dependent patients, do not rely on any single
alarm to detect a circuit disconnect condition.
Test the operation of the Phasitron® breathing circuit disconnect
function daily and whenever a change is made to the Phasitron®
circuit. An increase in circuit resistance can prevent the proper
operation of some alarms.
Speaking valves, Heat Moisture Exchangers (HMEs), and
lters create additional circuit resistance and may aect the
performance of alarms chosen for circuit disconnect protection.
Always check the drive pressure settings on the Bronchotron®
before starting ventilation.
A clinician must be available at all times when the HFPV®
device is used on a patient with an indwelling airway
(endotracheal or tracheostomy tube). HFPV® devices
enhance secretion clearance. Patients must be assessed for
a reduced vital capacity/FRC or the need for assistance in
clearing airway secretions.
If the Bronchotron® malfunctions, do not utilize it any further.
Report any malfunctions immediately.
Accessories
Airway
Obstruction
and Suctioning
Disconnect
Protection
Drive Pressures
Clinical Support
Malfunction

7
Before placing a patient on the Bronchotron® ventilator,
complete a clinical assessment to determine:
• The device alarm settings.
• If alternative ventilation equipment is needed.
• If an alternative monitor is required.
Clinicians should evaluate how their patients tolerate treatment.
Auscultation and observation of the mechanical vibrations
of the chest and abdomen are primary indicators of eective
treatment.
Monitor the patient while using the Bronchotron®.
The Bronchotron® Transport is a restricted medical device
designed for medical transport under the supervision of
physicians and respiratory clinicians.
Change the device settings only on the order of the supervising
physician or respiratory clinician.
Read and understand the user manual before operating the
Bronchotron®.
Operators must receive training in the use of the Bronchotron®
and each therapeutic procedure before providing HFPV on a
patient.
Always conduct a pre-use check before use of the Bronchotron®.
It is the responsibility of the clinician to read and understand
the user manual and be fully trained before using the
Bronchotron®.
Maintain close supervision of the patient.
Caution: Federal law restricts this device to sale by or on the order
of a physician.
Do not connect the device to equipment that does not comply
with the applicable safety regulations for the intended use.
All guidelines in this manual are only suggested; always
follow hospital or institutional protocols.
Patient Monitoring
Personnel
Qualications
Pre-Use Check
Responsibility of
the Clinician
Safety Regulations
Guidelines
CAUTIONS
Accessories
Modications
Qualied Service
Personnel
User Manual
Use only Percussionaire® accessories designed specically for
use with the Bronchotron®. Using accessories not intended for
use with the Bronchotron® may cause equipment damage.
Never attempt to modify the Bronchotron®, as this may cause
equipment damage.
Only Percussionaire®-authorized service personnel may open
the Bronchotron® for any device servicing or repair.
Follow the instructions in the user manual when using the
Bronchotron®.

8
Chapter 3: System Description
Powered by any
remote source
of 50-80 psi
respiratory gas Portable,
high-impact,
closable
carrying case
Battery-operated
patient monitoring
system
Bronchotron® HFPV®Controller Functions
PSI Pressure Gauge
• Powered by any remote source of
50-80 psi medical grade oxygen or blended gas.
Pulse Frequency
• Controls the high-frequency rate from
200-800 bpm with an automatic i:e ratio.
Oscillatory CPAP
• Determines the pulse amplitude delivered to
the patient during the expiratory phase.
The Oscillatory CPAP is limited to approximately
20% below the high-amplitude setting, which is
selected by pulsatile ow.
This prevents the selection of an incompatible
oscillatory CPAP during the adjusted
expiratory interval.

9
Inspiratory Time
• Selects the time interval (adjustable from
<0.8 seconds to 6 seconds) in which the
inspiratory amplitude (set with the pulsatile
owrate) is delivered.
Expiratory Time
• Selects the time interval (adjustable from
<0.8 seconds to 6 seconds) that the expiratory
amplitude is being delivered.
Operational Pressure
• Controls the operating pressure of the
entire unit.
• Device on/o switch
Pulsatile Flowrate
• Determines the pulse amplitude delivered
to the patient during inspiratory time.
Manual Inspiration
• Delivers a regulated source of gas through the
Phasitron® venturi.
WARNING: The longer the Manual Inspiration
button is pressed, the greater the potential for
large volumes to be delivered.
Tubing Connectors
• Red – pressure monitoring
• White – breathing circuit
• Yellow – not used
Nebulization
Controls the ow of gas to the aerosol circuit.
Nebulizer toggle valve provides for a constant ow
for nebulization and/or humidication. This is part
of the fresh gas supplied to the patient.

10
Monitron® Patient Monitoring System
Digital
Multimeter (DM)
On/O switch
activates the
audible disconnect
alarm
• An instantaneous digital readout of eective cycling frequency.
• Audible alarming for failure to maintain a proximal airway pressure.
• A digital presentation of proximal airway pressure rise and mean.
The patient monitoring system provides:
On/O Disconnect Alarm
The on/o power switch activates the disconnect alarm.
Failure to turn the switch o upon purposeful
disconnect will result in an audible alarm.
Alarm Delay
The alarm delay sets the auditory alarming
parameters for failure to maintain a proximal airway
pressure rise. 12:00 is a delay of approximately 2.0
seconds.
Digital Multimeter (DM)
The Digital Multimeter (DM) has six
dierent operating modes: POST, Wake,
Active, Report, Sleep, and Fault.
Alarm Delay

11
NOTE: Do not install DM until the POST check is complete, and the screen is blank,
indicating Sleep mode.
Power-On Self-Test (POST) Mode
When batteries are installed in the Digital Multimeter (DM), the software displays the
software revision, battery voltage, total usage time, and serial number for 15 seconds.
This start-up mode allows the software to perform additional tests on the hardware that
are part of the Power-On Self-Test. If any errors are detected, the DM enters the Fault mode.
The POST checks require that the measurement port be left disconnected and exposed to
the atmosphere for the entire duration.
Measuring port
connection
Reset button
(only used
for rmware
upgrades)
Rear view of DM
System Information Page
CAUTION: Do not insert any object
into the measuring port.
Pull up to remove both tabs
NOTE: To access battery pull tabs, turn the DM counterclockwise and remove from device.
NOTE: To ensure correct atmospheric pressure calibration at startup, remove batteries,
wait 30 seconds, and reinstall. Allow 15 seconds for Power-On Self-Test. When screen goes
blank, the multimeter can be installed into the device.

12
Model: SBRO
Device: Bronchotron® Transport
Display Metrics: Pulse Frequency Rate, Mean Airway Pressure, Dynamic Pressure (AIP
and AEP), Usage Timer and Pulse Amplitude Bar Graph
At 16 seconds, the DM enters Active mode. The timer bar will change to a numeric
display, showing the current usage Session Timer. The screen (right side) displays the
currently measured pulse frequency rate.
Mean Airway Pressure (MAP) averages pulse amplitude over 5 seconds. At 100 samples per
second, this is an average of 500 measurements. Above the MAP is a Dynamic Pressure,
which changes between average inspiratory pressure (AIP) (higher reading) and average
expiratory pressure (AEP) (lower reading) as the Bronchotron® cycles.
DM Range: 0-99 cmH₂O/hPa.
To wake up the DM, ensure the ventilator pressure is greater than 2.5 cmH₂O/hPa at the
Phasitron® patient delivery port for more than 1 second. The DM remains on for the rst
15 seconds, showing the bar-graph timer. Stopping usage within 12 seconds causes the
DM to enter Report mode. After 15 seconds, the current session continues counting from
16 seconds, which turns into Active mode.
Wake Mode
Active Mode
NOTE: The DM Display represents an estimate of pressure in the lung (after resistance
of ET tube, etc.). 100 measurements per second are taken at the Phasitron®. The time
duration of the average depends on the time duration of pulsatile ow or O/CPAP.
Bronchotron® Transport
DM Screen in Wake Mode

13
The pulsating bar graph on the left side displays pulse amplitude calculated as average
peak maximum pressure sample in the last 5 seconds minus minimum pressure sample
in the last 5 seconds. The bar graph is a visual representation better reecting AIP values
and represents an estimate of airway pressure. The solid bar at the base of the bar-graph
display represents PEEP, and the pulsating peaks represent AIP.
Pulsating
Bar Graph
Pulsating grey color represents AIP.
Solid black shows PEEP (only when adding PEEP with PEEP valve).
A.
B.
Report Mode
The Session Timer and the Total Usage
Timer (A) are displayed for 2 seconds,
followed by the System Information
page (B) for 2 seconds, alternating. The
alternating page display continues for
5 minutes or until usage resumes and
the DM enters Active mode.
During the 5-minute period, a horizontal
bar graph indicates the time by moving
from left to right at a xed rate. After
5 minutes of no usage, the system
information page is no longer displayed
and the time display ashes (2 seconds
on, 2 seconds o) (C) for an additional
25 minutes.
Dynamic Pressure fluctuates
between (AIP) and (AEP)
Pulse Frequency Rate
Usage Timer
Bar graph measuring
pulse amplitude
(0-50 cmH2O/hPa)
Increments
2.5-3 cmH2O/hPa
Bronchotron® Transport
50
0
30
Mean Airway Pressure

14
C.
D.
The DM enters Sleep mode after
25 minutes.
Measurements drop to zero on the
display screen when the Bronchotron®
Transport ventilator is o.
NOTE: When the Bronchotron® Transport is turned o, the measurements will drop to
zero after a few seconds.
Sleep Mode
Blank screen, indicating
DM Sleep mode
In Sleep mode, the LCD is o, but the
microcontroller continues to sample and
calculate the pressure at the measuring
port ve times a second. If the pressure
is greater than 2.5 cmH₂O/hPa at the
Phasitron® patient delivery port for
1 second over any 3-second period,
the DM enters Wake mode.
Fault Mode
The DM displays an error message
on the LCD stating,“Contact Factory for
Service”and stays in Fault mode until both
batteries are removed.
The displayed information includes the
software revision, DM serial number, the
Total Usage time, and an error code for the
exclusive use of the factory.
In all other modes, the software continuously monitors the hardware for errors as well
as verifying that each data sample is valid. If an error is detected, the software logs the
error and reboots the processor. Rebooting allows the DM to recover from a transient
error. After reboot, the processor returns to the mode it was in before the reboot. If more
than one error is detected in any 10-second period, it is considered a fatal error, and the
software enters Fault mode.

15
NOTE: Pressure faults are triggered by a continuous pressure of more than
150 cmH₂O for more than 5 seconds during Wake and Active modes.
NOTE: If System Failure screen is displayed, remove batteries for 30 seconds. Replace
batteries (note that positive terminals face same direction) and wait 30 seconds until the
screen turns o. If POST check runs correctly, DM may be used. If System Failure screen
recurs, contact an authorized Percussionaire® service center.
The DM has both hardware and software fault detection. This is a dedicated hardware
“watchdog” that runs on an independent clock source and can continue to operate even
if the main microprocessor’s clock fails or the microcontroller pauses in any way. The
independent fault detection is reset each time a valid pressure reading (free of hardware
and software errors) is obtained.
In addition to the hardware fault detection, the software also implements a fault
detection “watchdog”. This “watchdog” detects if a software task fails to complete within
the specied time, logs an error, and resets the processor.
The software keeps track of several types of hardware and data faults. All faults are
logged in the microcontroller’s memory and are retained even if the batteries are
removed. If multiple faults happen within 10 seconds of each other, the DM stops
normal operation and enters Fault mode. In this mode, a subset of the collected fault
information is displayed on the LCD. This data is intended for manufacturing and repair
use only.
The user can exit the Fault mode by removing and replacing the batteries. This resumes
normal operation of the DM but does not erase the faults stored in memory or x the
problem that caused the fault.
Fault Logging
Fault Detection

16
Chapter 4: Setup
Remove chained cap and connect the Bronchotron® to a 50 psi medical gas
source capable of delivering 25 LPM, such as an O₂ supply or a high-ow blender.
One way valve
Connect the paired red and
white/clear hoses to the
connections on the front of
the device.
Phasitron® Breathing Circuit, #A50605-D
1.
Device closed
Device with lid
latched open
Connect oxygen or blended gas
to DISS connection on the
front of the device
2.
Breathing circuit tubing with
connectors and lter
Phasitron® Nitric Oxide
tubing connect
PEEP Valve