ResMed Astral Series User manual

User guide
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User guide

User guide
English

Contents
Introduction..........................................................................................................................1
Indications for use............................................................................................................ 1
Clinical benefits ................................................................................................................1
Intended patient population/medical conditions................................................................ 2
Contraindications.............................................................................................................. 2
Adverse effects................................................................................................................2
General warnings and cautions......................................................................................... 3
The Astral device ................................................................................................................. 5
The Astral device interface ............................................................................................... 6
Touch screen....................................................................................................................7
Information bar.................................................................................................................8
Menu bar..........................................................................................................................9
Bottom bar .......................................................................................................................9
Main screen .....................................................................................................................9
Pressure bar ................................................................................................................... 10
Using the Astral device...................................................................................................... 11
Using the Astral device for the first time ........................................................................ 11
Powering on the device.................................................................................................. 12
Powering off the device ................................................................................................. 12
Enhanced access feature ............................................................................................... 13
Starting and stopping ventilation .................................................................................... 15
Locking and unlocking the touch screen......................................................................... 15
Navigating the menus..................................................................................................... 16
Monitors menu..................................................................................................................................16
Setup menu.......................................................................................................................................18
Alarms menu .....................................................................................................................................18
Information menu..............................................................................................................................19
Device settings............................................................................................................... 19
Adjusting device settings ..................................................................................................................20
Programs........................................................................................................................ 20
Manual Breath feature.................................................................................................... 21
Sigh Breath feature ........................................................................................................ 21
Travelling with the Astral device..................................................................................... 22
Assembling patient circuits............................................................................................... 22
Circuit options ................................................................................................................ 22
Fitting the circuit adapter................................................................................................ 24
Connecting a single limb circuit with intentional leak...................................................... 24
Connecting a single limb circuit for invasive use...............................................................................25
Connecting a single limb circuit with expiratory valve..................................................... 26
Connecting a double limb circuit (Astral 150 only) .......................................................... 28
Connecting a mouthpiece circuit .................................................................................... 29
Learn Circuit ................................................................................................................... 30

Accessories .........................................................................................................................33
Power accessories..........................................................................................................33
Optional accessories.......................................................................................................33
Attaching patient circuit accessories...............................................................................33
Attaching a humidifier....................................................................................................................... 34
Attaching a Heat Moisture Exchange (HME).................................................................................... 35
Attaching a bacterial/viral filter.......................................................................................................... 35
Adding supplemental oxygen ........................................................................................................... 36
Monitoring delivered oxygen............................................................................................................ 38
Attaching a nebuliser........................................................................................................................ 38
Attaching other accessories............................................................................................39
Attaching a pulse oximeter............................................................................................................... 39
Attaching a remote alarm ................................................................................................................. 41
Power management........................................................................................................42
Connecting to mains power ............................................................................................................. 43
Connecting the Astral External Battery ............................................................................................ 44
Connecting to a ResMed Power Station (RPSII) .............................................................................. 45
Connecting to an external DC power source.................................................................................... 45
Using the internal battery ................................................................................................................. 46
Device power source indicators ....................................................................................................... 48
Astral Carry Bag ..............................................................................................................49
Alarms.................................................................................................................................50
Alarm priority ..................................................................................................................51
Viewing the active alarms ...............................................................................................53
Muting alarms.................................................................................................................53
Resetting alarms.............................................................................................................54
Adjusting the alarm volume.............................................................................................
54
Testing the alarm sounders and indicators......................................................................55
Testing the Remote Alarm ..............................................................................................56
Testing the alarms..............................................................................................................56
Power alarms..................................................................................................................57
Detecting circuit disconnection and de-cannulation ........................................................58
Astral Disconnection Alarm.............................................................................................59
Adjusting the Disconnection Alarm .................................................................................59
Data management process ................................................................................................60
Cleaning and maintenance ................................................................................................61
Single patient use ...........................................................................................................61
Weekly.............................................................................................................................................. 61
Monthly ............................................................................................................................................ 62
Multi-patient use.............................................................................................................62
Replacing the air filter .....................................................................................................62
Replacing the double limb adapter (expiratory valve).......................................................63
Servicing .........................................................................................................................63
Maintenance Timetable.................................................................................................................... 63
Internal Battery................................................................................................................................. 64
Device information ........................................................................................................................... 64
Troubleshooting .................................................................................................................65
Alarm troubleshooting.....................................................................................................65

Learn Circuit troubleshooting.......................................................................................... 69
General troubleshooting ................................................................................................. 72
Technical specifications..................................................................................................... 73
Symbols ......................................................................................................................... 78
Standards compliance .................................................................................................... 79
Training and support....................................................................................................... 79
Limited warranty................................................................................................................ 80
Appendix A: Definitions..................................................................................................... 81
Ventilation settings definitions........................................................................................ 81
Measured and calculated parameter definitions ............................................................. 83

Introduction
English 1
Introduction
The Astral device provides mechanical ventilation to both ventilation dependent and non-dependent
patients. It delivers pressure and volume ventilation through either a valve or leak circuit, and is
compatible with a range of accessories to support specific use cases.
The information in this guide applies to both the Astral 100 and the Astral 150 devices. Where
information applies to only one of these devices, that device will be specified.
Note: Some features may not be available on your device.
The User Guide is for patient or carer users, and also provides introductory content for clinical users.
The User Guide does not contain all the information provided in the Clinical Guide.
WARNING
•
Read the entire manual before using the Astral device.
•Use the Astral device only as directed by a physician or healthcare provider.
•Use the Astral device only for the intended use as described in this manual. Advice contained
in this manual does not supersede instructions given by the prescribing physician.
•Install and configure the Astral device in accordance with the instructions provided in this
guide.
Indications for use
The Astral 100/150 provides continuous or intermittent ventilatory support for patients weighing more
than 5 kg who require mechanical ventilation. The Astral device is intended to be used in home,
institution/hospital and portable applications for both invasive and non-invasive ventilation.
CAUTION
The Astral device is not intended for use as an emergency transport ventilator.
Clinical benefits
The clinical benefits of non-invasive mechanical ventilation in the acute environment may include;
reductions in hospital mortality, endotracheal intubation, intensive care unit (ICU) length of stay, weaning
failure and ventilator-associated pneumonia, and improvement in physiologic parameters (eg, blood
gases and work of breathing).
The clinical benefits of non-invasive mechanical ventilation in the chronic environment may include;
improvements in overall survival, daytime symptoms (eg, somnolence and fatigue), physiologic
parameters (eg, blood gases and lung function), health-related quality of life and sleep quality, and
decrease in hospitalisations and dyspnoea.
The clinical benefit of invasive mechanical ventilation is sustaining life, or as an alternative to non-invasive
mechanical ventilation where non-invasive mechanical ventilation is contraindicated.

Introduction
2
Intended patient population/medical conditions
The intended patient population using the Astral devices are patients requiring mechanical ventilation.
Mechanical ventilation is indicated when a patient cannot achieve an appropriate level of ventilation to
maintain adequate gas exchange and acid-base balance. It can be delivered in the acute or chronic
environment, and may be delivered invasively or non-invasively to patients who may be non-dependent
or dependent on ventilation.
Patient populations who require acute mechanical ventilation may include:
•Acute respiratory failure
•Exacerbation of chronic respiratory conditions
•Coma
•Neuromuscular disease
Patient populations who require chronic mechanical ventilation may include:
•Chronic respiratory failure
•Patients recovering from acute illnesses and acute respiratory failure who do not respond to repeated
attempts at weaning from a ventilator.
•Patients with chronic disorders who only require mechanical ventilation for a portion of the day but
can maintain spontaneous ventilation on their own for several hours each day.
•Patients requiring continuous ventilator support to survive.
Contraindications
The Astral device is contraindicated in patients with the following pre-existing conditions:
•pneumothorax or pneumomediastinum
•pathologically low blood pressure, particularly if associated with intravascular volume depletion
•cerebrospinal fluid leak, recent cranial surgery or trauma
•severe bullous lung disease
•dehydration.
WARNING
AutoEPAP is contraindicated when using an invasive interface.
Adverse effects
Report unusual chest pain, severe headache or increased breathlessness to your physician. The following
side effects may arise during use of the device:
•drying of the nose, mouth or throat
•nosebleed
•bloating
•ear or sinus discomfort
•eye irritations
•skin rashes.

Introduction
English 3
General warnings and cautions
The following are general warnings and cautions. Further specific warnings, cautions and notes appear
next to the relevant instruction in the manual.
A warning alerts you to possible injury.
WARNING
•
If you notice any unexplained changes in the performance of the device, if it is making unusual
or harsh sounds, if the device or the power supply are dropped or mishandled discontinue use
and contact your healthcare provider.
•For ventilator-dependent patients, always have alternate ventilation equipment available, such
as a back-up ventilator, manual resuscitator or similar device. Failure to do so may result in
patient injury or death.
•The Astral device is a restricted medical device intended for use by qualified, trained personnel
under the direction of a physician. Clinical supervision is required in critical care/intensive care
unit environments.
•Ventilator-dependent patients should be continuously monitored by qualified personnel or
adequately trained carers. These personnel and carers must be capable of taking the necessary
corrective action in the event of a ventilator alarm or malfunction.
•The internal battery is not intended to serve as a primary power source. It should only be used
when other sources are not available or briefly when necessary; for example, when changing
power sources.
•The Astral device is not intended to be operated by persons (including children) with reduced
physical, sensory or mental capabilities without adequate supervision by a person responsible
for the patient's safety.
•
The Astral device is not intended to be operated by patients unless they have been given
adequate instruction concerning the operation of the device by a person responsible for the
patient's safety.
•The Astral device must not be used in the vicinity of an MRI or diathermy device.
•The effectiveness of ventilation and alarms should be verified including after any ventilation or
alarm setting change, any change in circuit configuration, or after a change to co-therapy (eg,
nebulisation, oxygen flow).
•The Astral device and AC Power Supply can get hot during operation. To prevent possible skin
damage do not leave the Astral device or AC Power Supply in direct contact with the patient for
extended periods of time.
•The device can provide therapies typically associated with both ventilator-dependent and
non-dependent patients. The mode of ventilation, circuit type, and alarm strategies should be
chosen after a clinical evaluation of each patient’s needs.
•The device must not be used at an altitude above 3000m or outside the temperature range of
0–40°C. Using the device outside these conditions can affect device performance which can
result in patient injury or death.
•The device should not be used adjacent to or stacked with other equipment. If adjacent or
stacked use is necessary, the device should be observed to verify normal operation in the
configuration in which it will be used.
•The use of accessories other than those specified for the device is not recommended. They
may result in increased emissions or decreased immunity of the device.
•Additional equipment connected to medical electrical equipment must comply with the
respective IEC or ISO standards. Furthermore, all configurations shall comply with the
requirements for medical electrical systems (see IEC 60601-1). Anybody connecting additional
equipment to medical electrical equipment configures a medical system and is therefore
responsible that the system complies with the requirements for medical electrical systems.

Introduction
4
Attention is drawn to the fact that local laws take priority over the above mentioned
requirements. If in doubt, consult your local representative or the technical service department.
•Portable RF communications equipment (including peripherals such as antenna cables and
external antennas) should be used no closer than 30 cm to any part of the device, including
cables specified by the manufacturer. Otherwise, degradation of the performance of this
equipment could result.
Note: Any serious incident that has occurred in relation to this device should be reported to ResMed and
to the competent authority in your country.
A caution explains special measures for the safe and effective use of the device.
CAUTION
•Repairs and servicing of the device should only be performed by an authorised ResMed service
representative.
•The temperature of the airflow for breathing produced by the device can be as much as 6ºC
higher than the temperature of the room. Caution should be exercised if the room temperature
is warmer than 35ºC.
•Do not expose the device to excessive force, dropping or shaking.
•Dusty environments may affect device performance.
•The Astral device may experience interference in the vicinity of electronic article surveillance
(EAS). Keep the Astral device at least 20 cm away from the EAS.
A note advises of special product features.
Notes:
•For assistance and reporting of issues associated with the Astral device, contact your Health Care Provider or
authorised ResMed representative.

The Astral device
English 5
The Astral device
The following images describe the components of the Astral device.
Description
1Adapter port
Can be fitted with single limb adapter, single limb leak adapter or double limb adapter (Astral 150 only).
2Handle
3Inspiratory port (to patient)
Provides an outlet for pressurised air to be delivered to the patient via the patient circuit. Includes FiO2sensor on the
Astral 150. The FiO2sensor is an optional accessory on the Astral 100.
4Ethernet connector (service use only)
5USB connector (for download to ResScan and connection of approved accessories)
6Mini USB connector (for connection to RCM or RCMH)

The Astral device
6
Description
7DC power inlet
8Device on/off push button
9SpO2Sensor connector
10 Remote alarm five pin connector
11 Low flow oxygen input (up to 30 L/min)
12 Air inlet (complete with hypoallergenic filter)
The Astral device interface
The interface of the Astral device comprises several different features described in the following image.
Description
1Touch screen
2Power source indicators
AC (mains power supply)
DC (external battery or car accessory adapter or RPSII)
Internal battery
3Therapy on/off indicator
Device ready
Constant green display when the device is turned on but not ventilating.

The Astral device
English 7
Description
Device ventilating
Flashes blue when the device is ventilating and the Ventilation LED setting is 'ON'.
Otherwise is 'OFF'.
4Alarm mute/reset button
Illuminates when an alarm is triggered and flashes when the sound is muted.
5Alarm bar
Flashing red High priority alarm
Flashing yellow Medium priority alarm
Constant yellow Low priority alarm
Touch screen
The main method of interacting with the Astral device is via the touch screen. The display on the touch
screen changes according to the function being performed.
Description
1Clinical mode access button
Locked Unlocked
2Manual breath button
only shown if enabled
3Information bar
4Internal battery indicator

The Astral device
8
Description
5Lock touch screen button
6Menu bar
7Bottom bar
8Start/Stop ventilation button
9Main screen
10 Sub-menus
11 Pressure bar
Note: Do not access Clinical mode unless directed by a clinician.
Information bar
The Information bar is displayed at the top of the touch screen. The Information bar displays the
operating status of the device, including patient type, current circuit configuration, programs, information
messages, ventilation status, alarms and power status.
Description
Patient type – Adult
Patient type – Paediatric
Circuit type – Single limb with intentional leak
Circuit type – Single limb with expiratory valve
Circuit type – Double limb
Circuit type – Mouthpiece
P1:DAY
(A)CV
Program number and program name
Ventilation mode
Multiple alarms are active simultaneously. The highest priority active alarm is displayed first.
Message
window
Will display alarms or information. Image above shows device in Standby. (Displayed when the device is powered
on but not ventilating). Date and time will be displayed when the device is ventilating and there are no active
alarms.
Information messages are displayed in blue text. If the device Alert tone setting is 'On', you will be alerted to new
information messages by a single beep.

The Astral device
English 9
Menu bar
The Menu bar provides access to the four main menus in the Astral device.
Monitors menu
View real-time patient data in either waveform or monitoring formats including pressure, flow, leak, tidal
volume, synchronisation and oximetry.
Setup menu
Configure and view ventilation therapy or device settings; and import/export data.
Alarms menu
Configure and view alarms including alarm volume.
Information summary menu
View therapy statistics, used hours, events, reminder and device information.
Bottom bar
The Bottom bar changes with the function of the device.
It can display buttons to Stop or Start ventilation and Apply or Cancel functions.
Main screen
The Main screen displays the monitoring data, ventilation and device controls. Each function is accessed
through the various menus and tabs.

The Astral device
10
Pressure bar
The Pressure bar displays real-time therapy data while the Astral device is ventilating.
Patient pressure is shown as a bar graph. Peak inspiratory pressure is shown as a numerical value and
watermark. Spontaneously triggering and cycling is indicated by and .
The example below displays the pressure bar when a patient is spontaneously breathing.
Description
1Peak inspiratory pressure (PIP) value
2Spontaneous cycled breath marker—indicates patient-cycled breath
3Peak inspiratory pressure marker
4Current pressure
5Positive end expiratory pressure (PEEP) setting
6Spontaneous triggered breath marker—indicates patient-triggered breath

Using the Astral device
English 11
Using the Astral device
WARNING
Make sure the area around the device is dry, clean and clear of bedding or clothes or other objects
that could block the air inlet. Blocking the cooling vents could lead to overheating of the device.
Blocking the air inlet could lead to patient injury.
CAUTION
•
To prevent possible damage to the ventilator, always secure it to its stand or place it on a flat,
stable surface. For mobile situations, ensure the Astral device is contained within its
mobility bag.
•Ensure the device is protected against water if used outdoors.
Using the Astral device for the first time
When using the Astral device for the first time, ResMed recommends you first perform a functional test.
A functional test will ensure the device is in proper working order before starting therapy. Information to
assist you in resolving any issues is available in the Troubleshooting (see page 65) section.
CAUTION
If any of the following checks fail, contact your Healthcare provider or ResMed for assistance.
To perform a functional test:
1. Turn off the device by pressing the power switch at the back of the device.
2. Check the condition of the device and accessories.
Inspect the device and all accessories. Damaged components should not be used.
3. Check the patient circuit setup.
Check the integrity of the patient circuit (device and provided accessories) and that all connections are secure.
4. Turn on the device and test alarms.
WARNING
If no alarm sounds, do not use the ventilator.
Press the power switch at the back of the device to turn on the device. Check that the alarm sounds
two test beeps and the LEDs for the alarm signal and the alarm mute/reset button flash. The device
is ready for use when the Patient Home screen is displayed.
5. Disconnect the device from the mains and external battery (if in use) so that the device is powered
by the internal battery. Check that the Battery Use alarm is displayed and the battery LED is on.
Note: If the charge state of the internal battery is too low an alarm occurs. Refer to Troubleshooting (see page
65).
6. Reconnect the external battery (if in use) and check that the LED for the DC power supply is lit. The
External DC Power Use alarm will be displayed and the Alarm LED will light.
7. Reconnect the device to mains power.
8. Check the pulse oximeter sensor (if in use).
Attach the accessories according to the set up descriptions. From the Monitoring menu, go to the
Monitoring screen. Check that the values for SpO2and pulse are displayed.
9. Check the oxygen connection (if in use). Check for damage to hoses or leaks. Check remaining
capacity of oxygen cylinders.
10. Perform a Learn Circuit.

Using the Astral device
12
Powering on the device
To power on the Astral device, simply press the green power on/off button at the back of the device. The
device will perform a system check as shown on the main screen.
On completion of the system check, the Patient Home screen and active program is displayed.
Note: Settings configured in the active program will be used when ventilation is started.
Helpful hint!
If more than one program displays on the Patient Home screen, the active program will be highlighted
orange. For further information, refer to Programs (see page 20).
For information on powering the Astral device, refer to Power.
Powering off the device
The Astral device can only be powered off when ventilation is stopped.
Removing AC power does not power off the device. The device remains powered on internal battery.
Turning off the device must be done manually and must be performed before leaving the device
disconnected from AC power for any extended period of time. Failure to do so may result in battery
depletion and activation of alarms.
To power off the device, press the green on/off button at the back of the device and follow the on-screen
prompts. To ensure the device is fully powered down, touch the screen.
Note: While the device remains connected to external mains power, the internal battery continues to charge.

Using the Astral device
English 13
Enhanced access feature
The Astral device offers an enhanced access feature ('Big buttons’ mode) to provide you with easier
usability and accessibility. The 'Big buttons' mode can be used to start and stop ventilation, as well as to
mute alarms.
WARNING
To prevent inadvertent alarm mute or reset, do not leave the patient in contact with the device
screen.
To enable the 'Big buttons' mode:
1. From the Main menu press Setup . The Setup menu is displayed.
2. Select the Patient Access tab from the Device Config. menu.
3. Move the Big buttons slider to On.

Using the Astral device
14
Your enhanced access feature is now enabled.
With this feature enabled, it is possible to switch between ‘Big buttons’ mode and standard. Simply
select the Home button from left hand corner of the Bottom bar.
Your screen will return to standard button size and the Home icon will be replaced by the
Big buttons icon .
To return to ‘Big buttons’ mode, simply select the Big buttons icon from the bottom bar.
Note: With the enhanced access feature enabled, your screen will return to ‘Big buttons’ mode once the screen
locks (after two minutes of inactivity).

Using the Astral device
English 15
Starting and stopping ventilation
Your clinician has set up one or more ventilation programs for your therapy. If more than one program
has been set up, follow the directions given by your clinician for when and how each program should be
used.
Note: If using the device for the first time, ResMed recommends performing a functional test before starting
ventilation. Refer to Using the Astral device for the first time (see page 11).
To start ventilation:
1. Press the green on/off button at the back of the device (if power is not already on).
2. Press . Ventilation is started.
3. Add oxygen if required.
To stop ventilation:
Ventilation can be stopped at any time and from any screen.
1. If oxygen is connected, turn off the oxygen.
2. Press and hold .
3. Release when prompted.
4. Press Confirm. Ventilation is stopped.
Locking and unlocking the touch screen
The touch screen can be unlocked at any time.
To manually lock the touch screen, from the Information bar press . When the touch screen is
locked the button is highlighted orange.
Unlocking the touch screen
Touch the screen anywhere and follow the on-screen prompts.