Percussionaire TXP-2D User manual

1
TXP®-2D
NEONATAL
HF-TRANSPORT
VENTILATOR
Percussionaire® Corporation
1655 Glengary Bay Rd. / PO Box 817
Sandpoint, ID 83864
Tel: [phone] Fax: [phone]
Web Site: www.percussionaire.com

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TABLE OF CONTENTS
GENERAL DESCRIPTION
TXP®-2D_______________________3
FACE PANEL
Control knobs _____4
PHASITRON® _____7
VENTILATION MODES
High-frequency _____8
SET-UP
High-frequency _____9
PARAMETER CHANGES
High-frequency _____10
NO SET-UP _____11
CLEANING PROCEDURE______________12
MAINTENANCE AND REPAIR _____13
SPECIFICATIONS _____14
CALIBRATION _____15
FUNCTIONAL CHECK _____16
DRAWINGS
Circuit _____17
Phasitron® _____18
NO kit _____19
COMPETENCY
Simulations _____20
Test _____21
Test key _____23
BIBLIOGRAPHY _____25

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General Description
TXP®-2D
The TXP®-2D® is a high-frequency ventilator intended for the transport of neonatal
patients. It is classified as a Pressure limited; Time cycled, High frequency, Flow
interrupter.
The ventilator consists of three main components:
•Front panel.
•Phasitron® patient interface with one-way failsafe and adjustable PEEP/Paw
valve.
•Vent selection switch
The front panel and the Phasitron® are connected with a 2 meter (approx. 6 ft.) long red
and white breathing harness.
Front panel
The front panel contains the pneumatic circuitry necessary for control of ventilation.
Settings are made using various control knobs on the front panel. Feedbacks from the
settings are displayed on the frequency counter and manometer.
Phasitron®
The Phasitron® is the Mechanical/Physiological interface. Essentially the Phasitron® is
a sliding venturi that acts as both the inhalation and exhalation valve.
Ventilator switch
A switch located on the side of the transporter selects the ventilator which will be
supplied blended gas.

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Airway Pressure Manometer
Gives a visual indication of airway pressure in cmH
2
O or kPa
Mean Button Control
When not depressed, Airway Pressure Manometer gives indication of Mean Airway
Pressure.
When button is depressed and held, Airway Pressure Manometer gives indication of
Amplitude.
NOTE: Mean Button does not alter ventilation.

5
Frequency Counter
When button is depressed, screen displays the high frequency rate in bpm.

6
Frequency Control Knob
By rotating knob the high-frequency rate during ventilation is set.
Range: 200-700 bpm
Amplitude Control Knob
By rotating knob the pressure or chest wiggle during high frequency ventilation is set.

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PHASITRON®
General
The Phasitron® is the Mechanical/Physiological interface. Essentially the Phasitron® is
a sliding venturi that acts as both the inhalation and exhalation valve (see below).
Programmed gas from the face plate is introduced through the delivery port from the
white line. As targeted pressure is reached the venturi automatically decreases flow. This
protects the lungs from dissecting pressures and allows the inspiratory and expiratory
volumes to equalize; further enhancing diffusion and the mixing of gases.
Schematic

High-frequency details
High-frequency
The TXP®-2D delivers high
-
(Approx. 3-10 Hz.)
Goals of High-Frequency
The aim of High-
frequency is:
•
Limit pressure exposure
•
Optimize lung volumes where atelectasis is a major issue.
Applicable patients
This mode can be suitable for:
•
Neonates with air leak syndromes
•
Respiratory Distress Syndrome
•
Persistent Pulmonary Hypertension o
•
Meconium Aspiration Syndrome
Important considerations
•
Carefully monitor PaO
in the patient’s lung/thorax compliance/resistance. These changes can at times be
considerable.
•Careful mon
itoring is necessary for tracheal or ETT obstruction.
Settings
The following control knobs will be used:
•
High Frequency (rate)
•Amplitude
•
Mean Airway Pressure (external valve)
•O
2
conc. %
-
frequency, flow interrupted breaths at 200-
700 bpm.
frequency is:
Limit pressure exposure
Optimize lung volumes where atelectasis is a major issue.
This mode can be suitable for:
Neonates with air leak syndromes
Respiratory Distress Syndrome
Persistent Pulmonary Hypertension o
f the Newborn
Meconium Aspiration Syndrome
Carefully monitor PaO
2
and PCO
2
as these parameters vary according to changes
in the patient’s lung/thorax compliance/resistance. These changes can at times be
itoring is necessary for tracheal or ETT obstruction.
The following control knobs will be used:
High Frequency (rate)
Mean Airway Pressure (external valve)
8
700 bpm.
as these parameters vary according to changes
in the patient’s lung/thorax compliance/resistance. These changes can at times be

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Troubleshooting
Symptom
Cause Solution
Volume too low. Check working pressure on
cylinders or wall.
Decreased compliance or
increased resistance.
Adjust working pressure to
50 psi
Increase pressure and treat
problem according to
findings.
Volume too high. Increase compliance or
decreased resistance.
Decrease inspiratory
pressure.

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Parameter Changes
High-frequency
If:
•CO
2
is HIGH
oMaximize Amplitude
oDecrease Rate
Amplitude and Rate are interconnected; changing one parameter
will affect other.
•CO
2
is LOW
oDecrease Amplitude
•PO
2
is HIGH
oDecrease FIO
2
oDecrease MAP (By use of PEEP valve)
•PO
2
is LOW
oIncrease FIO
2
oIncrease MAP (By use of PEEP valve)
Any Increase in MAP will increase PO
2
MAP= 1/2 (PIP-EEP) + (It/TCT + EEP)
•Any increase in Amplitude, PEEP or rate will increase
MAP

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NO Set-up instructions
•Replace standard Phasitron® swivel tee with NO swivel tee (if applicable)
•Connect Aeronox® Injection port to Phasitron® NO Injection port.
•Connect Aeronox® Monitoring port to Phasitron® NO monitoring port.
•Connect red proximal airway port from TXP®-2D unit to proximal airway
monitoring port.
•Connect to test lung with the approximate same resistance as patient.
•Set desired TXP®-2D settings.
•Set desired Aeronox® settings.
•Attach to patient.
•Adjust all settings as necessary.
Note: If patient is breathing spontaneously a change in NO PPM may be noted.

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Cleaning Procedures
These cleaning procedures supersede all others prior to January 29, 2007.
PERCUSSIONAIRE® EQUIPMENT
All new Percussionaire® products are packaged clean. They should not be considered
sterile or decontaminated. Prior to use it is recommended that breathing circuit
components be disassembled and sterilized/decontaminated.
STERRAD® 100S
Percussionaire ® Corporation recommends the Sterrad® 100S sterilization system.
Follow instructions below for how to disassemble Percussionaire® breathing circuits.
Was and dry all parts completely
Breat ing arness s ould be wiped down between patients
Process through Sterrad® Sterilizer at a standard cycle with a 35% (2.080 Mg H
2
O/Liter)
concentration.
Reassemble circuit.
Other Techniques
The decision to use other decontamination techniques should be based on the following
parameters: < 280 Fahrenheit (137.8 Celsius)
Standard Phasitron® part # A50007-12
The above components can withstand temperatures < 280 Fahrenheit (137.8 Celsius).
These parts can withstand temperatures < 140 Fahrenheit (60 Celsius)
Interface tubing assembly part # A50034

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MAINTENANCE
Warranty
All devices are sold with a (1) one-year warranty on parts and labor from date of set-up.
Overhaul
Devices should be checked by an authorized maintenance center anytime clinical efficacy
is not as expected.
Annually each unit should have a PM performed to insure proper function.
If units are kept clean and water free, a three (3)-year life span between mandatory
overhauls is a reasonable expectation.
Units returned for maintenance and repair must be handled by a Percussionaire
distributor. A return goods authorization number (RGA) can be obtained by contacting
International Biomedical (512-873-0033).
Periodic maintenance
•Lubricate red and white o-rings on the breathing harness periodically or when
resistance is felt during connections with approved lubricant (A50060).
•Lubricate Phasitron® diaphragm and o-rings after cleaning /sterilization process.

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SPECIFICATIONS
Size
4.25” W X 8.5” H X 3.475” D
Weight
5lbs.
Gas consumption
10-15 plum
1800 psi. X .28 (E cylinder factor) = (33 minutes) Approx. time E cylinder will last.
15 L
Batteries
Frequency Counter-4 AA batteries
Frequencies/Rates
High Frequency-200-700*bpm
I:E Ratios in high frequency mode are as follows:
Rate I:E
450+ 1:1
350- 450 1:1.5
250- 350 1:2
185-250 1:2.5
*This can be programmed to the individual needs of the hospital.

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Calibration
Valve Identification
H.F.-TB-20
Amplitude-FA-1
Set-up Procedures
Set-up using standard Percussionaire® HF transport breathing circuit A50605 connected
to a Percussionaire® test lung A50123.
Open PEEP valve to full counterclockwise position.
Connect TXP®-2D to 50 psi. gas source and set ventilator switch to HF.
Remove knobs by loosening set screw.
Insure manometer needle is zeroed. Adjust as necessary by removing cover and adjusting
calibration screw.
Calibration
1. Insure Amplitude valve stop is at 6:00 position.
2. Rotate Amplitude full clockwise to “off” position. Install control knob with
spring.
3. Rotate Amplitude to 12:00 position, set HF working pressure between 30-42 psi.
4. Insure HF valve control knob stop is at 6:00 position.
5. Rotate Amplitude control knob full counterclockwise.
6. Push button to turn frequency counter “ON”.
7. Adjust H.F. control knob for frequency of 185-210 breaths per minute.
8. Install H.F. control knob with arrow full clockwise against stop.
9. Rotate H.F. control knob full counterclockwise observe frequency > 700 breaths
per minute.

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TXP®-2D Functional Check
Set-up Procedure
Set up using standard Percussionaire® HF transport-breathing circuit (A50605) using test
lung A50123.
Open PEEP valve to full counterclockwise position.
Insure Manometer needle is zero. If required remove cover of manometer and adjust
calibration screw.
Functional Check
Connect to appropriate gas source(s)
Turn (rotate) ventilator switch to “HF” position.
Turn on frequency counter
Rotate High Frequency control knob to full clockwise position.
Rotate Amplitude control knob full counterclockwise.
Observe a frequency of 185-210 bpm. Actual____
Rotate Amplitude control knob clockwise.
Observe a gentle decrease in amplitude until “off” at the full clockwise position.
Rotate Amplitude control knob to full counterclockwise position.
Rotate Frequency control knob slowly to full counterclockwise position.
Observe a smooth increase in frequency.
Max frequency should be >700bpm. Actual____
Rotate Amplitude control knob to the full “off” clockwise position.
NOTE: Biomed
HF regulator should be set at 30-42 psi.
Re-index knobs as necessary by loosening allen head screw on knob rotating metering valve stem to
desired setting then re-attaching knob.

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Circuit A50605
Included accessories (not s own)
•Lube tube A50060
•NO kit A50610
•Neo test lung B12305
A50302 PEEP
Adapter
A50304
PEEP
Valve
A50007-12
Phasitron
B11060 Sleeve
A50034

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Phasitron® A50007-12
Accessories (not shown)
PEEP valve A50304
PEEP valve adapter A50302
Failsafe one-way valve A50324
Combination kit of A50302/A50304/A50324-A50326
NO kit A50610

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NO Kit A50610
B110015-1
A99535

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Competency
Simulations
Sim 1
Set-up a standard TXP®-2D transport circuit.
PASS FAIL
Sim 2
Set-up a TXP®-2D transport circuit with provisions for NO.
PASS FAIL
Sim 3
Set-up a neonatal lung model with the following settings:
•Frequency-9Hz. /450bpm.
•Amplitude-As needed for effective chest wiggle. Approx.10-15 cmH
2
O
•Mean Airway Pressure-10 CmH
2
O.
•FIO
2
-100%
From the above lung model if an ABG of
PH-7.19
CO
2
-60mmHg
HCO
3
-25meq/L
PO
2
-120mmHg
was recorded, what would be the ventilator change(s) needed?
Perform change on lung model.
PASS FAIL
Name________________________________________________
Date_____________
PASS FAIL Signature____________________________