ResMed Astral Series Astral 150 Mouthpiece Ventilation User Guide
- June 4, 2024
- ResMed
Table of Contents
Astral Series Astral 150 Mouthpiece Ventilation
User Guide
Mouthpiece ventilation
The settings below are suggested for ‘open’ or ‘sip’ mouthpiece ventilation
where the patient exhales to the atmosphere frequently or continuously, eg,
for on-demand daytime ventilation via a 15 mm non-vented mouthpiece. Other
modes and settings are also available if required.
Mouthpiece circuit settings:
| Ventilation Setting | Selection | Detail/explanation |
|---|---|---|
| Patient type | Adult | |
| Circuit | Mouthpiece circuit (tube only) | 15 mm or 22 mm circuit without |
intentional leak or expiratory valve.
Note: Not designed to support continuous exhalation into the circuit.
Ventilation mode| (A)CV| (A)CV mode allows the patient to stack breaths as a
set volume is delivered with each breath.
Tidal volume| As appropriate| Set based on patient comfort and preference.
Resp. rate| As appropriate| Resp. The rate shall be set appropriately for
patients who may rely on the backup rate. Otherwise, it can be turned Off.
PEEP| Off| Not available in this configuration.
Trigger| Touch, High, Medium, Low, Off| The Touch trigger setting will allow a
breath to be delivered upon engagement of the mouthpiece or inspiratory effort
is detected.
High, Medium, and Low settings only deliver a breath when the inspiratory
effort is detected. If the patient experiences false triggering then the
trigger sensitivity should be reduced.
Single limb/Double limb
circuit settings:
| Ventilation Setting | Selection | Detail/explanation |
|---|---|---|
| Patient type | Adult | |
| Circuit | Single limb circuit with valve or Double limb | |
| Interface | Mouthpiece | |
| Ventilation mode | (A)CV | (A)CV mode allows the patient to stack breaths as a |
set volume is delivered with each breath.
Tidal volume| As appropriate| Set based on patient comfort and preference.
Resp. rate| As appropriate| Resp. Rate shall be set appropriately for patients
who may rely on the backup rate. Otherwise, it can be turned Off.
PEEP| Off|
Trigger| Very High, High, Medium, Low, Very Low| If the patient experiences
false triggering then the trigger sensitivity should be reduced.
Note: Vented (intentional leak) modes are not recommended for highly discontinuous ventilation such as ‘sip’ mouthpiece ventilation.
Safety considerations for mouthpiece ventilation
The Disconnect Alarm allows detection of circuit disconnection (for example,
when the mouthpiece has fallen out of reach of the patient), and whether the
patient is able to reliably trigger ventilation or not.
Regardless of whether the Disconnection Alarm is active or not, other
mitigations may need to be put in place to ensure that patient safety is not
compromised, such as the Apnea alarm, external monitoring, a SpO2 alarm, or
full-time supervision.
| Alarm setting | Selection | Detail/explanation |
|---|---|---|
| Disconnection Alarm | On | Enables Disconnection Alarm. |
| Disconnection | As appropriate | Sets a higher or lower tolerance to the degree |
of circuit disconnection required to activate the Disconnection Alarm.
Alarm Activation Time| As appropriate| The time it takes for the alarm to
activate once the disconnection threshold is satisfied. It can be adjusted
from 5 seconds to 15 minutes for mouthpiece interface, as appropriate for the
patient’s ventilator dependency.
Apnoea Response| Off| It may be appropriate to configure Apnoea Response to
OFF if the Disconnection Alarm is appropriately configured.
Low-pressure alarms are sometimes used to imply circuit disconnection and are
quick to activate. Should this be an annoyance, for example when the patient
is receiving a partial breath or missing a breath, or if a false triggered
breath occurs, it is at the discretion of the Clinician to turn OFF? Other
mitigations may need to be put in place to ensure that patient safety is not
compromised. This may include external monitoring, SpO2 alarm, or full-time
supervision.
Mouthpiece Ventilation with Astral 100/150 mouthpiece circuit is not intended
to support continuous exhalation into the circuit. The non-user adjustable NV
Mask/Rebreathing alarm will activate if the device detects continuous
exhalation into the circuit. For patients that may prefer continuous
exhalation into the circuit, a circuit with an expiratory valve should be
considered.
Note: All alarms except for High pressure and Disconnection alarms are
defaulted to Off when the Mouthpiece circuit or Mouthpiece interface is
selected via Setup Assistant in Adult configuration.
Because the quality of life matters
ResMed’s mouthpiece ventilation solution has been thoughtfully designed to
reflect the needs of patients and their carers and support a good quality of
life.
The EasySpeak mouthpiece is the ideal daytime solution for patients using
Astral. It helps to make eating, breathing, and talking more natural and can
also help to reduce the risk of infections and complications¹.
The circuit support arm holds the mouthpiece in a comfortable, accessible
position. Quick to install, set up, and clean, it readily adapts to any care
environment, making it a practical choice in the hospital, at home, and on the
move.
Ordering information
| Product name| Code
---|---|---
1| EasySpeak mouthpiece angled with 17cm Flexi-tube 22F| 21353
2| EasySpeak mouthpiece angled for 15M connection| 21351
3| EasySpeak mouthpiece angled for 22M/15F connection| 21354
4| MPV Circuit Support Arm| 27955
¹ Boitano LJ, Benditt JO. An evaluation of home volume ventilators that support open-circuit mouthpiece ventilation. Respir Care. 2005 Nov ; 50(11):1457-61.
ResMed Pty Ltd
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Astral and EasySpeak are trademarks and/or registered trademarks of the ResMed
family of companies. For patent and other intellectual property information,
see ResMed.com/ip. © 2018 ResMed. 278140/5 2018-08