ESPRIT Ventilator

OPERATOR’S MANUAL

REF 580-1000-01P
For Technical Support, contact:
Respironics. Inc. Customer Service
Within the U.S.A. 1-800-345-6443
Outside the U.S.A. 724-387-4000
Facsimile 724-387-5012
[email protected]

United States of America

Respironics California, Inc.
2271 Cosmos Court
Carlsbad, CA 92009
USA
1-800-345-6443
or 724-387-4000

Authorized Representative
Respironics Deutschland, Inc.
Gewerbestrasse 17
D-82211 Herrsching Deutschland
+49-8-15-29-30-60

Copyright © 2004. Respironics, Inc.

All rights reserved.

This work is protected under Title 17 of the United States copyright code and is the sole property of Respironics.
No part of this document may be copied or otherwise reproduced, or stored in any electronic information
retrieval system, except as specifically permitted under United States copyright law, without the prior written
consent of Respironics.

ii Esprit® Ventilator Operator’s Manual © Respironics, Inc. REF 580-1000-01P

Revision History

Revision Description
G Update to include Esprit 4.10 software enhancements
H Update to include Esprit 4.10 software enhancements
J Update to include Esprit 5.0 software enhancements
K Update to include EST procedure change and CE mark change
L Update to include 7.0 software enhancements and format
change
M Update to include 7.10 software enhancements
N Update to include 8.10 software enhancements
P Addition of EMC Declaration

What’s New

NICO®-Esprit Interface
The NICO-Esprit Interface software allows the Esprit Ventilator and the NICO Monitor to exchange information
via a bidirectional RS-232 serial link. Through this link, the Esprit ventilator supplies the NICO monitor with
breath type and FIO2 information. In turn, the NICO monitor provides the Esprit ventilator with data for trending
including: Cardiac Output Average, O2 Saturation, End Tidal CO2, Volume CO2, Alveolar Tidal Volume, and
Alveolar Minute Volume. See the NICO-Esprit Interface option insert for complete details.

Increased High Priority Alarm Volume

The High Priority Alarm pitch and volume have been heightened to produce a more distinct sound. This is
standard on Esprit Ventilators with 8.10 software or later.

E-Cycle Range
The E-cycle maximum setting has been increased from 45% to 80%. The new range is 10-80%. E-Cycle
defines the percent of peak inspiratory flow that end inspiratory flow needs to drop to in order for inspiration to
end.

Pplat
Plateau Pressure (Pplat) has been added to the Static C & R display and Patient Status windows. Pplat is a
measured value collected during the last saved Static C and R maneuver.

REF 580-1000-01P Esprit® Ventilator Operator’s Manual © Respironics, Inc. iii

Backup Battery Not Connected Message
The operator can now have the Esprit confirm the backup battery is connected each time that the machine
powers on. Pressing the BKUP BATTERY button, in Diagnostics mode, enables this confirmation feature,
identified by an active button with a white background.

Static C & R Measurements

The Static C & R value displayed is now the last accepted value replacing the method where the average of the
last 3 accepted values was displayed.

iv Esprit® Ventilator Operator’s Manual © Respironics, Inc. REF 580-1000-01P

 Contents

Esprit Ventilator Operator’s Manual

What’s New. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . iii

1. Introduction and Intended Use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-1

2. Warnings, Cautions and Notes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-1

Summary of Warnings, Cautions, and Notes . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-1

3. Symbols . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-1

4. Getting Started . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-1

Unpacking . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-1
Inspection. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-2
List of Parts and Accessories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-2
Repacking. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-4
Inspiratory Bacteria Filter Installation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-5
Heated Expiratory Bacteria Filter Installation . . . . . . . . . . . . . . . . . . . . . . . . . . 4-6
Oxygen Source Connection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-8
Patient Circuit Flex Arm Installation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-10
Ventilator Positioning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-11

5. Setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-1
Back Panel Connections & Controls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-1
Connecting AC Power Cord . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-3
Power On/Off. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-5
Entering Diagnostic Mode. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-6
User Configuration Screen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-7
Backup Battery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-12
Extended Self Test (EST) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-13

6. Connecting Additional Equipment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6-1

Communication Interface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . 6-1
Connecting Serial Communications Devices . . . . . . . . . . . . . . . . . . . . . . . .. . . 6-2
Connecting Remote Alarm Port . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . 6-2
Connecting Humidifier . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . 6-3
Connecting the Patient Circuit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . 6-5
Connecting the Analog Port . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . 6-7

7. Operating Theory . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-1

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . .. . . . .. . . . .. . . 7-1
System Overview . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . .. . . . .. . . . .. . . 7-1
Ventilator Breath Types . . . . . . . . . . . . . . . . . . . . . .. . . . . .. . . . .. . . . .. . . 7-1
Ventilation Modes Common to VCV and PCV. . . . . . . .. . . . . .. . . . .. . . . .. . . 7-2

REF 580-1000-01P Esprit® Ventilator Operator’s Manual © Respironics, Inc. v

 Contents

Ventilation Modes Common to NPPV . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-6

Emergency Modes of Ventilation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7-7

8. Operating Instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-1

Esprit Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-1
The Front Panel. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-2
Ventilator Screens . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-7
Settings Screens . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-11
Selecting a New Ventilation Breath Type (VCV, PCV, or NPPV) . . . . . . . . . . . . . . 8-20
Selecting the Mode (A/C-SIMV-CPAP or Spont-Spont/T) . . . . . . . . . . . . . . . . . . 8-23
Apnea Ventilation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-24
Patient Data Screen. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-25
Monitor Screen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-26
Special Procedures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-28
Preoperational Procedure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-29
Alarm Testing Procedure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-31
Where To Go For Help . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8-31

9. Alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-1
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-1
Visual Alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-1
Audible Alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-2
Alarm Reset . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-3
Alert Messages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-4
Alarm Indicators . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9-8

10. Care and Maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-1

General Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-1
Cleaning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-1
Sterilization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-2
Bacteria Filters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-4
Periodic Maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-6
Storage. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-10
Repairs. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10-10

11. Diagnostics. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-1

Entering Diagnostic Mode. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-2
Diagnostic Functions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-2
Extended Self Test (EST) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-3
Self Test. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11-8

12. Technical Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-1

Breath Types. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-1
Modes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-1
Volume Ventilation Settings, Ranges & Resolution . . . . . . . . . . . . . . . . . . . . . . 12-1
Pressure Control Ventilation Settings, Ranges & Resolution . . . . . . . . . . . . . . . . 12-2

vi Esprit® Ventilator Operator’s Manual © Respironics, Inc. REF 580-1000-01P

 Contents

Non-Invasive Positive Pressure Ventilation Settings, Ranges & Resolution . . . . . 12-3

Apnea Ventilation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-3
Value Entry Message . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-4
Patient Data Screen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-5
Front Panel Keys . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-6
Level Controls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-7
Calculated Values from Expiratory Hold Maneuver. . . . . . . . . . . . . . . . . . . . . . 12-7
Interface Ports . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-7
Environmental Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-7
Environmental Protection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-8
Alarms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-8
Connectors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-9
Filters. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-9
Measuring and Display Devices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-10
AC Power & Battery Indicators . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-10
Leakage Current . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-10
Compliance and Approvals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-11
Power Requirements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-11
Dimensions and Weights . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-11
Electromagnetic Compatibility Declaration . . . . . . . . . . . . . . . . . . . . . . . . . . 12-12
Pneumatic System. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-17
Labels . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12-18

13. Options and Accessories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13-1

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13-1

13A. Oxygen Sensor Option . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13A-1

Assemble O2 sensor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13A-1
Attaching the sensor to the ventilator. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13A-2
Warranty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13A-3

A. RS-232 Communications Protocol . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-1

RS-232 Configuration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-1
Commands Transmitted to the Ventilator . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-1
Transmission of Data from the Ventilator . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-1
Ventilator Report Command and Response (VRPT) . . . . . . . . . . . . . . . . . . . . . . A-1
Volume Control Ventilation Settings Report (VCVS) . . . . . . . . . . . . . . . . . . . . . A-11
Pressure Control Ventilation Settings Report (PCVS) . . . . . . . . . . . . . . . . . . . . A-14
Non-Invasive Positive Pressure Ventilation Settings Report (NPVS) . . . . . . . . . . A-16
Patient Data Report (PTDT) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-18
Alarm Status Report (ALRM). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-21
Unrecognized Commands . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-24

B. Customer Service & Warranty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B-1

Customer Service. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B-1
Warranty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B-1

REF 580-1000-01P Esprit® Ventilator Operator’s Manual © Respironics, Inc. vii

 Contents

Options and Accessories. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B-2

C. Alarm Testing Procedure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . C-1

G. Glossary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . G-1
Abbreviations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . G-1
Definitions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . G-4

1. Index. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-1

viii Esprit® Ventilator Operator’s Manual © Respironics, Inc. REF 580-1000-01P

 Chapter 1. Introduction and Intended Use

The Esprit Ventilator is a microprocessor-controlled, electrically powered

mechanical ventilator. It is intended for use by qualified medical personnel to
provide continuous or intermittent ventilatory support for adult and pediatric
patients as prescribed by a physician. The Esprit Ventilator is intended for use
in either invasive or non-invasive applications in institutional environments.

The Esprit Ventilator meets applicable safety requirements, consensus

guidelines, U.S.A. regulatory statutes, and international regulatory standards
for life support mechanical ventilation devices.

Please read this manual thoroughly and become familiar with the ventilator's
operation before using it on a patient. For additional information about
accessories or related equipment, such as humidifiers and remote alarm
systems, refer to the appropriate instruction manual prior to operating with the
Esprit Ventilator.

Advanced troubleshooting, calibration, and maintenance instructions are

included in the Esprit Ventilator Service Manual, P/N 580-1000-02. All
maintenance and repair work should be performed by qualified biomedical
technicians who have received appropriate training and authorization to
provide maintenance, repair, and service for the Esprit Ventilator.

WARNING: Patients on life-support equipment should be visually monitored by

competent medical personnel, since life-threatening circumstances may
arise that may not activate alarms. The operator should heed all appropriate
alarms and follow the instructions and warnings in this operator’s manual.
Always check life-support equipment for proper operation before use..

WARNING: Do not use in the presence of flammable anesthetics. Possible explosion

hazard.

CAUTION: Federal law (USA) restricts this device to sale by or on the order of a
physician.

NOTE: Follow the setup instructions in this manual before placing the Esprit
Ventilator into service. If you have questions, contact Respironics
Customer Service at 1-800-345-6443.

REF 580-1000-01P Esprit® Ventilator Operator’s Manual © Respironics, Inc. 1-1

Chapter 1

Introduction and Intended Use

(This page is intentionally blank.)

1-2 Esprit® Ventilator Operator’s Manual © Respironics, Inc. REF 580-1000-01P

 Chapter 2. Warnings, Cautions and Notes

Throughout this manual the following definitions apply:

WARNING: A condition that could cause injury to a patient or operator if the operating
instructions in this manual are not followed correctly.

CAUTION: A condition that could cause damage to, or shorten the service life of,
the Esprit Ventilator.

NOTE: Important information concerning the construction or operation of the

Esprit Ventilator.

Additional Warnings, Cautions and Notes pertaining to options and accessories

are included in the documentation for each option or accessory. Refer to
Chapter 13, “Options and Accessories”.

Summary of Warnings
Warnings, Cautions, • Patients on life-support equipment should be visually monitored
and Notes by competent medical personnel, since life-threatening
circumstances may arise that may not activate alarms. The
operator should heed all appropriate alarms and follow the
instructions and warnings in this operator’s manual. Always check
life-support equipment for proper operation before use.
• Do not use in the presence of flammable anesthetics. Possible
explosion hazard.
• One person alone should not attempt to lift the ventilator or
remove it from the shipping carton. At least two people are
required in order to avoid possible personal injury or damage to
the equipment.
• To reduce the chance of contamination or infection, always use an
inspiratory bacteria filter when the Esprit is in operation. Refer to
manufacturer’s instructions and follow institutional infection
control guidelines when replacing the inspiratory filter.
• Do not use anti-static or conductive hoses or conductive patient
tubing.
• The expiratory filter housing may be hot if removed from the
ventilator immediately after use. Wait 15 minutes after turning off

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Chapter 2

Warnings, Cautions and Notes

ventilator power before removing the heated expiratory bacteria

filter. Exercise caution when handling the filter housing.
• All oxygen connections should be carefully inspected to ensure
that leaks are not present. Excessive leaks can result in higher
than normal ambient oxygen concentrations and create a
potentially hazardous oxygen-enriched environment.
• Worn/frayed oxygen hoses or oxygen hoses contaminated by
hydrocarbon greases or oils should not be used since an oxygen
leak or intense fire could result.
• Care in the routing of the oxygen inlet hose should be exercised to
ensure it is not exposed to mechanisms that could cause damage
by cutting or heating/melting.
• The cover plate for the PCMCIA slot at the back of the ventilator
must be replaced after the adaptor and card are installed. This is
to protect the ventilator.
• AC power is applied to the humidifier from the Esprit humidifier
outlet (only available on 100-120 VAC ventilators). Under no
circumstances does the Esprit Ventilator provide control for the
humidifier. To ensure patient safety, it is important that any
humidifier used with the Esprit Ventilator include an acceptable
temperature control and monitoring mechanism, as well as a
temperature display and appropriate alarm capabilities (refer to
ISO 8185).
• To avoid electrical shock hazard, connect the ventilator to a
properly grounded AC power outlet.
• The Esprit front panel LEDs will indicate the power source that is
being used. If the ventilator is plugged in and the MAINS LED is
not lit, either the circuit breaker is off or the wall power outlet is
not functioning.
• The two circuit breakers (MAINS/Humidifier) located on the back
of the ventilator are covered to prevent unintentional ventilator
power-off. Do not use the circuit breaker to power the ventilator
on/off. The power switch is located on the front of the ventilator
below the front panel.
• Always turn the ventilator power OFF before connecting additional
equipment.
• Use only Respironics approved cables when connecting to the
remote alarm port. Be sure to fully insert the cable into the remote
alarm port and into the remote alarm.
• When using the Remote Alarm Port be sure to fully test the
Remote Alarm Port and cable by:
• Verifying that annunciated alarms on the Esprit are also
annunciated on the remote alarm.
• Verifying that disconnecting the cable from the Remote Alarm
port results in an alarm notification at the Remote Alarm.

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• Verifying that disconnecting the cable from the remote alarm

results in an alarm notification at the Remote Alarm.
• Ensure that an alternative means of ventilation (i.e., a resuscitator
or similar device) is available while the Esprit Ventilator is in use
on a patient.
• The Esprit Ventilator complies with the requirements of IEC 601-
1-2 (EMC collateral standard), including the E-field susceptibility
requirements at a level of 10 volts per meter. However, even at
this level of immunity, certain transmitting devices (cellular
phones, walkie-talkies, etc.) emit radio frequencies that could
disrupt ventilator operation if operated in a range too close to the
ventilator.
• DO NOT operate the Esprit ventilator in a Magnetic Resonance
Imaging (MRI) environment.
• Vent Inop is a serious condition, which is indicated by both visual
and audible alarms. If the ventilator is attached to a patient when
Vent Inop occurs, the patient must be supported with another
means of life support ventilation.
• When the battery low indicator is flashing red, operation of the
ventilator from battery power should be discontinued.
• For patient safety the HIP Limit Setting should be set as close to
the peak inspiratory pressure as patient conditions allow.
• DO NOT perform the preoperational procedure when the ventilator
is on a patient.
• The operator will be warned if the compliance is 9.0 ml/cmH2O
(hPa) or larger. Patients should not be put on a patient circuit that
does not meet this requirement.
• A high priority, visual and audible alarm indicates a potentially
life-threatening condition and immediate response is required.
• When the safety valve open indicator is lit, the ventilator does not
provide any ventilatory support to the patient. Immediately use a
backup means of ventilatory support.
• Visually monitor the patient and ventilator during the Alarm
Silence period to ensure that alarms do not go undetected.
Allowing alarm conditions to continue without intervention may
result in harm to the patient and/or ventilator.
• Do not expose expiratory and inspiratory bacteria filters or
reusable patient tubing to ETO gas.
• Disposable or single-patient filters must be discarded between
patients. Do not chemically disinfect or expose single patient use
bacteria filters to ETO gas.

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Warnings, Cautions and Notes

• The patient must be disconnected from the ventilator before

entering the Diagnostic Mode since normal ventilation is
suspended.
• Do not use a ventilator that has failed SST without verifying
operational readiness by other means. Doing so may place a
patient at risk.
• Never initiate SST while the patient is connected to the ventilator.
The high airway pressures generated during SST can injure a
patient.
• Never initiate EST while the patient is connected to the ventilator.
The high airway pressures and gas flows generated during EST can
injure a patient.
• Do not use a ventilator that has failed EST without verifying
operational readiness by other means. Doing so may place a
patient at risk.
• If any of the diagnostic codes, other than diagnostic code 1, 3,
2000, 3000, 5000, 5001, 5002, 8003 , or 8004 occur, remove
the ventilator from service and contact trained service personnel.
• Use of an Esprit ventilator that has not passed SST or EST is
against the strongest recommendation of Respironics.
• Please contact Respironics Customer Service at 1-800-345-6443
or consult your service manual if any diagnostic codes are
encountered.
• When connecting a humidifier to the humidifier outlet (available
only on 100-120 VAC ventilators) allowable leakage current values
may be exceeded.
• The use of accessories, cables and transducers other than those
specified may result in increased EM emissions or decreased
immunity of the system.
• Respironics recommends using an oxygen monitor that complies
with ISO-7767; Oxygen Monitors or Monitoring Patient Breathing
Mixtures - Safety Requirements. This requirement ensures that
the desired fraction of inspired oxygen (FiO2) is delivered to the
patient.

Cautions
• Federal law (USA) restricts this device to sale by or on the order of
a physician.
• Be sure to check all exterior parts of the ventilator. Problems
found during inspection should be corrected and/or reported to
Respironics before using the ventilator.

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• Always ship the Esprit Ventilator using the original packing

material. If the original material is not available, contact your
Respironics representative to order replacements.
• Do not operate the Esprit Ventilator without a properly functioning
expiratory filter and heater. Humidity from the patient circuit may
damage delicate components, such as the expiratory flow sensor.
• The Esprit Ventilator oxygen filter should be replaced annually as
a part of preventive maintenance.
• Table top must be capable of bearing 66 pounds (30 kg) of weight
– 86 pounds (39 kg) with Backup Battery – and must be at least
24 inches (60 cm) deep by 14 inches (35 cm) wide in dimension
in order to accommodate the ventilator.
• To prevent damage to ventilator, ensure that the table top surface
is completely flat, dry, and free of dust, dirt, and debris before
positioning the ventilator.
• The PCMCIA card should only be removed by trained service
personnel once power to the ventilator is off.
• To avoid the possibility of damage to the Esprit Ventilator, do not
connect a humidifier whose maximum rating exceeds 3 amps.
Ensure that the humidifier power cord is free from defects and any
obvious wear, and is properly grounded. A humidifier connection is
only available on 100-120VAC ventilators.
• Before connecting the Esprit Ventilator to the AC power source,
ensure that the total electrical load does not exceed the ampere
rating of the AC branch circuit, especially when using the
ventilator with other electrical equipment. An AC branch circuit
includes all outlets serviced by a single circuit breaker. If the
maximum current drain through a branch circuit exceeds the
circuit breaker’s rating, the branch circuit will open, causing the
ventilator to lose power. For further information, consult a service
technician or a trained biomedical technician.
• The Esprit Ventilator is shipped with a power cord that complies
with electrical safety standards. Do not use substitute power cords
unless specifically instructed to do so by an authorized distributor
or qualified personnel. Do not modify the power cord or connect it
with electrical extension cords or outlet adapters.
• To prevent the risk of excessive leakage due to external equipment
being connected to Esprit via the communication ports, a means
for external separation of the conductive earth paths must be
provided.
• All equipment used and connected to the Esprit communications
ports (analog, parallel and serial) must comply with the medical
electrical equipment (IEC601-1) or other applicable standards.

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Warnings, Cautions and Notes

• To prevent damage to the remote alarm, relay contacts should not

exceed the maximum rating of 125VAC, 0.5 amp or 24VDC, 1
amp.
• If clinical conditions do not require setting the HIP Limit above
60 cmH2O, it is recommended the setting normally be adjusted to
60 cmH2O or less in order to prolong the operating life of the
blower and to maximize backup battery run time.
• The Esprit alarm indicators and the Alerts insert should be
monitored closely during the Alarm Silence period to ensure that
unexpected alarms are noticed.
• If an alarm persists for no apparent reason, contact Respironics
Customer Service at 1-800-345-6443.
• Care should be taken when cleaning the Touch Display. (Refer to
Figure 8-2 on page 8-3.). A soft moist cloth should be used that
does not drip water and/or soap solution when in contact with the
display. After cleaning and rinsing with a damp cloth, remove all
moisture with a dry, soft cloth. Never allow solutions of any kind to
collect on the bottom bezel of the display. Never use a brush or
device that can cause abrasion to clean the touch display or its
bezel, they will cause irreparable damage.
• Do not remove any screws from the cooling fan area. Removing
screws from this area will result in damage to internal
components.
• Follow the detergent manufacturer’s instructions. Exposure to
detergent solution stronger than necessary can shorten the useful
life of the product. Rinse parts thoroughly to remove all detergent
residues. Wipe parts dry. Detergent residue can cause blemishes
or fine cracks, especially on parts exposed to elevated
temperatures during sterilization.
• Autoclavable parts will withstand repeated steam autoclaving at
temperatures not to exceed 135 C (275ºF).
• DO NOT autoclave the Esprit Ventilator.
• Formaldehyde, phenol-based, and quaternary ammonium
compound (QUATS) disinfectants are not recommended because
these agents can cause cracking and crazing of plastic parts.
Exposure of components to disinfectant concentrations stronger
than required or for excessive time may shorten product life. Parts
should be thoroughly rinsed and dried to prevent spotting and
blemishes when exposed to elevated temperatures.
• DO NOT allow liquid to penetrate the ventilator rear or front panel.
DO NOT attempt to sterilize the ventilator by exposing to ETO gas.
DO NOT steam-autoclave.
• Troubleshooting and repair should be performed only by a
qualified service technician.

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• If the optional external O2 sensor is in-line then it must be

calibrated during EST.
• Diagnostic codes should only be cleared by qualified personnel.
• To prevent contamination of the O2 sensor, always locate it
between the ventilator gas output port and the inspiratory bacteria
filter.

Notes
• Follow the setup instructions in this manual before placing the
Esprit Ventilator into service. If you have questions, contact
Respironics Customer Service at 1-800-345-6443.
• Respironics recommends that, before using the ventilator for the
first time, the user should wipe the exterior clean and disinfect or
sterilize its components according to the instructions in Chapter
10, “Care and Maintenance” or the component manufacturer’s
instructions.
• Follow institutional infection control guidelines when replacing
inspiratory bacteria filter.
• When adding attachments or other components or subassemblies
to the breathing system, i.e., HME or Humidifier, the user should
ensure that the inspiratory and expiratory resistances (measured at
the patient connection port) do not exceed 6 cmH2O (hPa) at a
flow of 60L/min for adults, 30L/min for pediatrics.
• Follow institutional infection control guidelines when replacing
heated expiratory bacteria filter.
• The Esprit Ventilator should only be connected to an appropriate
medical grade 100% O2 gas source capable of delivering a
regulated 40 to 90 PSIG (276-620 kPa).
• The Esprit Ventilator is shipped with the appropriate gas fittings
and hoses for the intended environment, i.e. DISS (U.S.A. and
Canada), Ohmeda (Germany), NIST (UK), Air Liquide (France),
SIS (Australia).
• All volumes entered into Esprit are assumed to be BTPS (Body
Temperature atmospheric Pressure Saturated (with H2O)) volumes
unless otherwise noted. All volumes reported by Esprit are
reported as BTPS volumes. All pressures are assumed to be
relative to atmospheric pressure unless otherwise noted.
• The Air Inlet Filter houses a reusable foam filter which should be
periodically cleaned by the user. Refer to Chapter 10, “Care and
Maintenance”, for more information on filter changes.
• Unless the Mains Circuit Breaker is turned OFF, electrical power is
applied to the ventilator even though the front panel switch is in

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the OFF position. With the Mains Circuit Breaker ON, if the
optional Backup Battery is connected, Esprit will charge the
battery if it requires a charge.
• To disconnect the ventilator from MAINS power, remove the AC
plug from the wall power receptacle. The MAIN switch/circuit
breaker is covered to prevent unintentional ventilator turn off.
• If the operator sets the %O2 setting to 100%, the 100% O2
indicator does not light. The 100% O2 indicator only lights when
the 100% O2 front panel key has been pressed.
• The Esprit Ventilator selects its power source based on the
following prioritization: AC power (if present), external battery,
then backup battery.
• The ventilator may automatically reset certain types of alarm
conditions once the causes of the alarms are corrected. After an
automatic reset, the ventilator will clear the audible alarm, and
will display a Low Urgency Alarm alert in the Alert Message Insert
to inform the operator that an alarm condition existed. When this
situation occurs, use ALARM RESET to clear the visual alarm
indicator.
• If the 100% O2 key is pressed and a 100% O2 gas source is not
available, the Low O2 alarm will be active for the two-minute
100% O2 delivery period.
• Manual breaths are not permitted during the inspiratory phase of a
breath (whether manual or spontaneous). Pressing the MANUAL
BREATH key during these times will not result in the delivery of a
manual breath.
• Some settings buttons appear active despite the fact they are not
being used in the ACTIVE MODE. This is because the setting is
used in Apnea Ventilation or when manual inspiration is pressed.
The operator should always choose a value for an active button
that is appropriate for the patient being ventilated.
• When the active mode is set to NPPV, the HIP Limit Setting will
automatically be adjusted to 10 cmH2O above the current IPAP
setting.
• Pt. Leak only appears on Patient Data block on Settings screen.
• Esprit keeps a distinct set of alarm limits for each ventilation
breath type (VCV, PCV and NPPV).
• Any of the changes made in the screen shown in Figure 8-14, do
not take effect until the operator switches to the new ventilation
breath type (in this case Pressure Control).
• If the EXP HOLD key is held continuously and the exhalation hold
period exceeds 5 seconds, Esprit automatically terminates the
exhalation hold period and begins a new inspiratory period.

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• If Auto PEEP as calculated in Equation 1: Auto-PEEP =

Exhalation Pause Pressure – End Exhalation Pressure, is negative,
Auto-PEEP will be displayed as “—.”
• All components of the patient circuit must not have leaks in order
to pass SST.
• If time is found to be incorrect more than once in the
preoperational procedure, an internal battery may have to be
replaced. Contact qualified service personnel or call Respironics
Customer Service at 1-800-345-6443.
• Because conditions and practices in health care institutions vary,
this manual can only describe general guidelines. It is the user’s
responsibility to ensure the validity and effectiveness of the
methods used.
• Because some environments cause a quicker collection of lint and
dust than others, inspect and clean the fan filters more often than
every 250 hours if necessary.
• The “Hardware” function and EST in the Diagnostics Mode should
only be run by qualified personnel.
• A “restart” is an infrequent event.
• The gas return port on the ventilator is a cylindrical port which
requires mating to a specified expiratory filter to seal the
expiratory limb.
• Humidifier connection available only on 100-120VAC ventilators.
• Record O2 sensor manufacturing or warranty numbers and
installation date for future reference. Save manufacturers
instruction about end of life replacement.
• To ensure accurate O2 monitoring, check O2 sensors periodically
and replace as per manufacturer specification.
• Sensor performance and expected operating life information is
outlined in the sensor manufacturer’s instructions for use.
Thoroughly review all O2 sensor instructions prior to installation
and use with the Esprit Ventilator.
• O2 sensor calibration is performed during EST. If recalibration of
the O2 sensor is required, follow the instructions in “Extended
Self Test (EST)” on page 11-3 for running EST.
• Medical electrical equipment needs special precautions regarding
EMC and needs to be installed and put into service according to
the EMC information provided in Chapter 12, “Technical
Specifications”, of this manual.

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 Chapter 3. Symbols

The following symbols appear on the Esprit Ventilator. Additional symbols

pertaining to options and accessories are included in the documentation for
each option or accessory. Refer to Chapter 13, “Options and Accessories”.

Symbols

Symbol Reference Meaning

IEC 878 This symbol indicates ATTENTION, consult the ACCOMPANYING
Symbol 03-02 DOCUMENTS.

IEC 417 This symbol indicates the ON condition for part of the
Symbol 5264 equipment. When pressed, the ventilator will operate from the
MAINS voltage if connected or from the Backup Battery if the
battery charge is within operating specifications.
IEC 417 This symbol indicates the OFF condition for part of the
Symbol 5265 equipment.

IEC 417 This symbol indicates protective EARTH (ground).

Symbol 5019

IEC 417 This symbol indicates the POTENTIAL EQUALIZATION

Symbol 5021 CONNECTOR used to connect the equipment to an electrical
installation earth busbar.

IEC 878-02 This symbol indicates TYPE B applied part, which indicates
Symbol 02 equipment that provides a particular degree of protection against
electric shock, particularly with regards to allowable leakage
current and of the protective earth connection.
IEC 417 This symbol is located on the rating plate. It indicates the
Symbol 5032 equipment is SUITABLE FOR ALTERNATING CURRENT.
IEC 529 Drip proof.

IEC 417 Chart recorder ANALOG OUTPUT. Pin 12 signals an unsilenced

Symbol 5192 high or medium urgency alarm: 0 VDC= active alarm, 1.5 VDC =
no alarm or silenced alarm. Voltage signal for flow and pressure
reserved for future use.
IEC 5001 This symbol indicates DC BATTERY CONNECTION.

ISO 7000 This symbol indicates HOT SURFACE warning. It appears next to
Symbol 0535 the heated expiratory filter.

Table 3-1: Symbols (Sheet 1 of 2)

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Chapter 3

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Symbols (Continued)

Symbol Reference Meaning

93/42/EEC This symbol indicates EUROPEAN CONFORMITY.

This symbol indicates REMOTE ALARM connection.

IEC 5035 This symbol indicates RS-232 serial output.

This symbol indicates PARALLEL PORT printer connection. (For

future use.)

IEC 5436 This symbol indicates the ALARM SILENCE key (Silences alarm
for two minutes.)

IEC 5056 This symbol indicates BRIGHTNESS ADJUST.

This symbol indicates the AUDIO ALARM VOLUME CONTROL.

This symbol indicates ACCEPT parameter key.

IEC 878 This symbol indicates DANGEROUS VOLTAGE—electrical shock

Symbol 03-01 hazard.

IEC 417 This symbol indicates the portion of the circuit breaker that must
Symbol 5008 be pushed in to turn the CIRCUIT BREAKER OFF.

IEC 417 This symbol indicates the portion of the circuit breaker that must
Symbol 5007 be pushed in to turn the CIRCUIT BREAKER ON.

This symbol indicates CANADIAN STANDARDS ASSOCIATION

approval.

EN 980 This symbol indicates DATE OF MANUFACTURE.

Table 3-1: Symbols (Sheet 2 of 2)

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 Chapter 4. Getting Started

Unpacking The Esprit Ventilator has been carefully packaged to assure safe shipping. In
addition, the packing container has been designed for easy unpacking. Do not
discard packing materials until ventilator installation is complete and proper
machine function has been verified.

Before unpacking Esprit Ventilator, examine the shipping carton(s) for visible
damage. If the shipping carton(s) arrives damaged or if you suspect the
contents are damaged, contact the carrier for an inspection report. If any
damage is evident, Respironics recommends that you photograph the carton(s)
before the shipment is unpacked. Report any damage to the shipping container
or Esprit Ventilator to your local authorized Respironics distributor and to the
carrier.

Save all packing material after removing the ventilator. In the event that the
Esprit Ventilator needs to be repacked and reshipped, use the original packing
material or order replacement material from a Respironics representative.

Top Foam Insert

Esprit Ventilator

Center Foam Insert

Backup Battery

Bottom Foam Insert

Figure 4-1: Unpacking/Repacking the Esprit Ventilator

WARNING: One person alone should not attempt to lift the ventilator or remove it from
the shipping carton. At least two people are required in order to avoid
possible personal injury or damage to the equipment.

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NOTE: Medical electrical equipment needs special precautions regarding EMC

and needs to be installed and put into service according to the EMC
information provided in Chapter 12, “Technical Specifications”, of this
manual.

Unpacking Instructions
Refer to Figure 4-1.
• Tools Required: Box knife
1. Using box knife, cut slit in packaging tape on top of shipping carton.
2. Remove accessories box and optional flex arm box (not shown).
3. Remove top foam insert from inside carton.
4. Roll the plastic shipping bag (not shown) off the ventilator.
5. Gently lift ventilator from the bag and carton.
6. Remove patient circuit package (not shown).
7. Store carton, foam insert, and plastic bag in safe place for possible
future use.

Inspection After unpacking the ventilator, inspect its cabinet exterior for damage,
including cracks and scratches or blemishes. Inspect the front panel for
scratches, chips, abrasions or other deformities.

CAUTION: Be sure to check all exterior parts of the ventilator. Problems found
during inspection should be corrected and/or reported to Respironics
before using the ventilator.

List of Parts and Using the Packing List that accompanies the ventilator, take an inventory of
Accessories the entire shipment before assembling the ventilator. In case of discrepancies,
immediately contact Respironics Customer Service at 1-800-345-6443.

The Esprit Service Manual (P/N 580-1000-02) is available for qualified

personnel. It includes block diagrams, components parts lists, descriptions,
calibration instructions, and other information which will assist the user’s
appropriately qualified personnel to repair those parts of the equipment which
are designated by the manufacturer as repairable. For more information
contact Respironics Customer Service at 1-800-345-6443

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NOTE: Respironics recommends that, before using the ventilator for the first
time, the user should wipe the exterior clean and disinfect or sterilize
its components according to the instructions in Chapter 10, “Care and
Maintenance” or the component manufacturer’s instructions.

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Repacking Should the Esprit Ventilator need to be returned to Respironics for servicing, or
shipped elsewhere for any reason, instructions for repacking are listed below.
The following instructions should be followed closely to avoid damage to the
ventilator.

WARNING: One person alone should not attempt to lift the ventilator or remove it from
the shipping carton. At least two people are required in order to avoid
possible personal injury or damage to the equipment.

CAUTION: Always ship the Esprit Ventilator using the original packing material. If
the original material is not available, contact your Respironics
representative to order replacements.

Repacking Instructions
Refer to Figure 4-1.
• Tools Required: Heavy duty packaging tape
1. Open carton so that bottom foam insert is facing up.
2. Place backup battery in the bottom foam insert if it is being shipped.
3. Place center foam insert into box on top of the bottom foam insert.
4. If you are also shipping the flex arm, place it in its box (not shown)
and place the box in the bottom of the center foam insert.
5. Remove all power cords and accessory items from the Esprit
Ventilator.
6. Set the open ventilator shipping bag (not shown) in the box on the
middle foam insert.
7. Gently place Esprit Ventilator into the open bag. Check to ensure that
the ventilator is firmly positioned into bottom foam insert. Close
plastic bag over the ventilator.
8. Replace accessories box (not shown) in the center foam insert beside
the ventilator (if also being shipped).
9. Place top foam insert onto ventilator. Ensure snug fit.
10. Close top flaps of carton and seal with heavy-duty packaging tape.

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Inspiratory Bacteria The inspiratory bacteria filter (4) in Figure 4-2, mounts on the gas outlet port
Filter Installation (1) located in the lower right corner on the front of the Esprit Ventilator. If the
optional O2 sensor (2) will be used then it will be connected to the gas outlet
port (1) before the inspiratory bacteria filter is connected. For more
information regarding the optional O2 sensor refer to Chapter 13, “Options and
Accessories”.

5
4
3
2
1

5 4 3 2 1

Flow

Figure 4-2: Inserting Disposable Inspiratory Bacteria Filter

WARNING: To reduce the chance of contamination or infection, always use an

inspiratory bacteria filter when the Esprit is in operation. Refer to
manufacturer’s instructions and follow institutional infection control
guidelines when replacing the inspiratory filter.

WARNING: Do not use anti-static or conductive hoses or conductive patient tubing.

NOTE: Follow institutional infection control guidelines when replacing

inspiratory bacteria filter.

NOTE: When adding attachments or other components or subassemblies to the

breathing system, i.e., HME or Humidifier, the user should ensure that
the inspiratory and expiratory resistances (measured at the patient
connection port) do not exceed 6 cmH2O (hPa) at a flow of 60L/min for
adults, 30L/min for pediatrics.

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Inspiratory Bacteria Filter Installation Instructions

Refer to Figure 4-2.
1. Locate the gas outlet port (1) on the Esprit Ventilator front panel.
2. If the optional O2 sensor (2) will be used then connect it to the gas
outlet port (1).
3. Remove the inspiratory bacteria filter from the filter package and
inspect for cracks or potential leaks. Discard the filter if it is cracked,
has moisture inside, or is otherwise unserviceable.
4. Some bacteria filters provide an arrow or other mark to indicate the
direction of flow. The flow indicator should be pointed away from the
ventilator, toward the patient circuit connection
Insert inspiratory filter inlet (4) into either:
• the optional O2 sensor (2) using the 22mm connector (3)
or
• the gas outlet port (1) if the optional O2 sensor (2) is not used.
5. Connect inspiratory limb of patient circuit (5) to bacteria filter (4).

Heated Expiratory
Bacteria Filter
Installation

Figure 4-3: Installing Expiratory Bacteria Filter

WARNING: The expiratory filter housing may be hot if removed from the ventilator
immediately after use. Wait 15 minutes after turning off ventilator power
before removing the heated expiratory bacteria filter. Exercise caution when
handling the filter housing.

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CAUTION: Do not operate the Esprit Ventilator without a properly functioning

expiratory filter and heater. Humidity from the patient circuit may
damage delicate components, such as the expiratory flow sensor.

NOTE: Follow institutional infection control guidelines when replacing heated

expiratory bacteria filter.

NOTE: When adding attachments or other components or subassemblies to the

breathing system, i.e., HME or Humidifier, the user should ensure that
the inspiratory and expiratory resistances (measured at the patient
connection port) do not exceed 6 cmH2O (hPa) at a flow of 60L/min for
adults, 30L/min for pediatrics.

Heated Expiratory Bacteria Filter Installation Instructions

Refer to Figure 4-3.
1. Locate the heated expiratory bacteria filter (1) and receiving
compartment (6) in the lower center of the Esprit Ventilator front
panel.
2. Turn knob (2) counterclockwise to unlatch retaining bracket (3).
3. Open retaining bracket (3) by pulling it out and away from the
ventilator.
4. Use tabs (4) to gently pull the heater housing (5) away from the
ventilator.
5. Ensure that ventilator has been turned off for 15 minutes. If not, allow
the heater housing (5) to cool before touching it with fingers.
6. Gently remove the heater housing (5). Tap filter input port (7) if the
filter does not come out easily.
7. Insert the new expiratory bacteria filter (1) into the heater housing (5).
8. Reinstall housing (5) and filter (1) into receiving compartment (6),
then close retaining bracket (3).
9. Ensure that the retaining bracket (3) is securely closed and turn knob
(2) clockwise to secure latch.
10. Connect the exhalation limb and water trap of the patient circuit (not
shown) to the inlet port of the exhalation filter (7).

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Chapter 4

Getting Started

Oxygen Source
Connection

Figure 4-4: O2 Gas Connections and Filter

WARNING: All oxygen connections should be carefully inspected to ensure that leaks
are not present. Excessive leaks can result in higher than normal ambient
oxygen concentrations and create a potentially hazardous oxygen-enriched
environment.

WARNING: Worn/frayed oxygen hoses or oxygen hoses contaminated by hydrocarbon

greases or oils should not be used since an oxygen leak or intense fire
could result.

WARNING: Care in the routing of the oxygen inlet hose should be exercised to ensure it
is not exposed to mechanisms that could cause damage by cutting or
heating/melting.

CAUTION: The Esprit Ventilator oxygen filter should be replaced annually as a part
of preventive maintenance.

NOTE: The Esprit Ventilator should only be connected to an appropriate

medical grade 100% O2 gas source capable of delivering a regulated 40
to 90 PSIG (276-620 kPa).

NOTE: The Esprit Ventilator is shipped with the appropriate gas fittings and
hoses for the intended environment, i.e. DISS (U.S.A. and Canada),
Ohmeda (Germany), NIST (UK), Air Liquide (France), SIS (Australia).

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Oxygen Source Connection Instructions

Refer to Figure 4-4.
1. Locate the O2 filter with water trap (1) located in the lower left corner
of the Esprit rear panel.
2. Ensure that the O2 filter and water trap (1) are properly attached to
the Esprit Ventilator. Inspect the bowl (1) for cracks or potential leaks.
Ensure all connections are tight.
3. Inspect the O2 hose (2), hose connector (3) and the hose connector
mate (4) on the Esprit Ventilator.
4. Check the oxygen gas supply. Clean, adjust pressure, and drain
condensate from any water traps, filters, or regulators in the O2 supply
lines.
5. Connect O2 gas connector (3) to the Esprit Ventilator O2 filter with
DISS hose connector (4).
6. If gas source is not already turned on, turn it on and verify that no O2
gas is leaking.

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Patient Circuit Flex A patient circuit flex arm is provided for use on the Esprit Ventilator. The
Arm Installation patient circuit flex arm may be installed on either the left or right side rail on
the Esprit Ventilator.

Figure 4-5: Connection of Adapter for Patient Circuit Support

Patient Circuit Flex Arm Installation Instructions

Refer to Figure 4-5.
1. Slide flex arm bracket (1) on to Esprit side rail (2) (one per side).
2. Tighten black screw knob (3) on flex arm bracket (1).
3. Insert base of flex arm (4) into flex arm bracket and tighten.
4. Place patient circuit hose clamp (5) into the flex arm clamp (6) and
tighten.

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Ventilator Positioning The Esprit Ventilator may be mounted on a table top or on an optional
Respironics approved cart.

CAUTION: Table top must be capable of bearing 66 pounds (30 kg) of weight – 86
pounds (39 kg) with Backup Battery – and must be at least 24 inches
(60 cm) deep by 14 inches (35 cm) wide in dimension in order to
accommodate the ventilator.

CAUTION: To prevent damage to ventilator, ensure that the table top surface is
completely flat, dry, and free of dust, dirt, and debris before positioning
the ventilator.

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 Chapter 5. Setup

Back Panel
Connections &
Controls
Remote Alarm Parallel PCMCIA
Serial Port Nurse Call Printer Port Card Slot Analog Port

DC Battery
Connector

AC Inlet
Cooling
Fan Humidifier AC
Inlet Circuit Breaker

Circuit Breaker
Potential Cover
Equalization (not shown)
Connection
O2 Inlet Mains Circuit
Filter & Breaker
Water
Trap Humidifier
AC Outlet

O2 Inlet
Connector
Air Inlet Duct
Elapsed & Filter
Time
Meter:

Figure 5-1: Esprit Back Panel

RS-232 Serial Port: Connection source for devices capable of serial

communication. Refer to Chapter 6, “Connecting Additional Equipment”.

Remote Alarm Nurse Call: Connection source for remote alarm devices.

Parallel Printer Port: For use with the Communications Option. Refer to
Chapter 13, “Options and Accessories”.

PCMCIA Card Slot: (PC Card) For use with the Trending Option. Refer to
Chapter 13, “Options and Accessories”.

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WARNING: The cover plate for the PCMCIA slot at the back of the ventilator must be
replaced after the adaptor and card are installed. This is to protect the
ventilator.

CAUTION: The PCMCIA card should only be removed by trained service personnel
once power to the ventilator is off.

Analog Port: Pin 12 signals an unsilenced high or medium urgency alarm.

Other pins are used by the Communications Option. Refer to Chapter 13,
“Options and Accessories”.

DC Battery Connector: Connection source for battery power cord.

AC Inlet: Connection for AC power cord.

Humidifier AC Circuit Breaker: Circuit breaker for AC power applied to a

humidifier.

WARNING: AC power is applied to the humidifier from the Esprit humidifier outlet (only
available on 100-120 VAC ventilators). Under no circumstances does the
Esprit Ventilator provide control for the humidifier. To ensure patient safety,
it is important that any humidifier used with the Esprit Ventilator include an
acceptable temperature control and monitoring mechanism, as well as a
temperature display and appropriate alarm capabilities (refer to ISO 8185).

CAUTION: To avoid the possibility of damage to the Esprit Ventilator, do not

connect a humidifier whose maximum rating exceeds 3 amps. Ensure
that the humidifier power cord is free from defects and any obvious
wear, and is properly grounded. A humidifier connection is only
available on 100-120VAC ventilators.

Circuit Breaker Cover: Circuit breaker cover (not shown) protects the
Humidifier AC Circuit Breaker and Mains Circuit Breaker switches.

Mains Circuit Breaker: Circuit breaker for main AC circuit.

Humidifier AC Outlet: Connection for Humidifier AC power cord.

Air Inlet Duct and Filter: Filters room air drawn into the ventilator internal air
source.

Elapsed Time Meter: Records time when the Power On/Off Switch is on ( ).

O2 Inlet Connector: Connection for oxygen hoses.

O2 Inlet Filter and Water Trap: Filters oxygen entering the ventilator.

Potential Equalization Connection: Common grounding point.

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Cooling Fan Inlet: Allows cooling air to enter the ventilator.

NOTE: All volumes entered into Esprit are assumed to be BTPS (Body
Temperature atmospheric Pressure Saturated (with H2O)) volumes
unless otherwise noted. All volumes reported by Esprit are reported as
BTPS volumes. All pressures are assumed to be relative to atmospheric
pressure unless otherwise noted.

NOTE: The Air Inlet Filter houses a reusable foam filter which should be
periodically cleaned by the user. Refer to Chapter 10, “Care and
Maintenance”, for more information on filter changes.

Connecting AC Power
Cord
2
3

Circuit Breaker
Cover not shown.

Figure 5-2: AC Power Cord Retaining Bracket

WARNING: To avoid electrical shock hazard, connect the ventilator to a properly

grounded AC power outlet.

CAUTION: Before connecting the Esprit Ventilator to the AC power source, ensure
that the total electrical load does not exceed the ampere rating of the
AC branch circuit, especially when using the ventilator with other
electrical equipment. An AC branch circuit includes all outlets serviced
by a single circuit breaker. If the maximum current drain through a
branch circuit exceeds the circuit breaker’s rating, the branch circuit
will open, causing the ventilator to lose power. For further information,
consult a service technician or a trained biomedical technician.

CAUTION: The Esprit Ventilator is shipped with a power cord that complies with
electrical safety standards. Do not use substitute power cords unless
specifically instructed to do so by an authorized distributor or qualified
personnel. Do not modify the power cord or connect it with electrical
extension cords or outlet adapters.

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Connecting AC Power Cord Instructions

Refer to Figure 5-2.
• Tools Required: Small phillips screwdriver
1. Ensure that the Esprit Ventilator is properly positioned on a secure
table top, wall mount, or pedestal.
2. Connect the AC Power Cord (1) to the AC inlet (3) located on the
Esprit rear panel. (Refer to Figure 5-1.)
3. After cord is fully inserted, tighten the retaining bracket screw (2) so
that the power cord cannot be inadvertently disconnected from the
ventilator.

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Power On/Off The Esprit Ventilator ON/OFF ( / ) switch is located in the lower portion of
the front panel, and is recessed to avoid inadvertent access.

When the switch is in OFF ( ) position, the ventilator does not provide
mechanical ventilation. If the AC plug is connected and the Mains circuit
breaker (refer to Figure 5-1) is ON ( ) AC power is active and the green Mains
circuit indicator on the front panel, is illuminated.

Power On/
Off Switch

Figure 5-3: On/Off Switch

Turning the Ventilator On

1. Ensure that the Mains Circuit Breaker (refer to Figure 5-1), located on
the ventilator back panel, is in the ON ( ) position.
2. For 120V applications, if a humidifier is attached to the ventilator,
ensure that the Humidifier AC Circuit Breaker (refer to Figure 5-1),
located on the ventilator back panel, is in the ON ( ) position. A
humidifier connection is only available on 100-120VAC ventilators.
3. Press the Power ON/OFF Switch to the ON ( ) position (left side up).

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WARNING: The Esprit front panel LEDs will indicate the power source that is being
used. If the ventilator is plugged in and the MAINS LED is not lit, either the
circuit breaker is off or the wall power outlet is not functioning.

Turning the Ventilator Off

1. Press the Power ON/OFF Switch to the OFF ( ) position (right side
up).

WARNING: The two circuit breakers (MAINS/Humidifier) located on the back of the
ventilator are covered to prevent unintentional ventilator power-off. Do not
use the circuit breaker to power the ventilator on/off. The power switch is
located on the front of the ventilator below the front panel.

NOTE: Unless the Mains Circuit Breaker is turned OFF, electrical power is
applied to the ventilator even though the front panel switch is in the
OFF position. With the Mains Circuit Breaker ON, if the optional Backup
Battery is connected, Esprit will charge the battery if it requires a
charge.

NOTE: To disconnect the ventilator from MAINS power, remove the AC plug
from the wall power receptacle. The MAIN switch/circuit breaker is
covered to prevent unintentional ventilator turn off.

Entering Diagnostic The Diagnostic Mode is used for:

Mode 1. Running tests of the operation of the ventilator that can only be run
when a patient is not attached to the machine.
2. Setting altitude, time and date, and circuit compliance.
3. Other more detailed service/maintenance functions.
4. Calibration of inline Oxygen Sensor, during EST only.

Some of these functions are discussed in detail in Chapter 12, “Technical

Specifications”. Explained here, are the functions of the Diagnostic Mode that
are used to make the machine ready for use as a ventilator when it is first put
into service.

Entering Diagnostic Mode

1. To access the Diagnostic Mode, simultaneously press the ALARM
RESET and 100% O2 Keys on the console for approximately five
seconds while turning the ventilator power on. The following message
will appear on the screen:

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Figure 5-4: Warning in Diagnostic Mode

2. Press the OK button to enter the Diagnostic Mode. The following

screen appears:

Figure 5-5: Main Screen in Diagnostic Mode

User Configuration The buttons across the top and bottom bars are used to select the Diagnostic
Screen Mode functions. To set up the machine for the first time for operation as a
ventilator, USER CONFIG should be selected. When this button is pressed the
following screen appears.

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Chapter 5

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Figure 5-6: User Configuration Screen

The User Configuration screen allows the operator to:

• Set the date and time
• Activate or deactivate the automatic patient circuit compliance
compensation feature
• Set the proper altitude
• Set 24 Hrs/AM PM time display
• Activate or deactivate Backup Battery check at startup

Date and Time

The real time clock and calendar of Esprit will last for approximately 2.5 years.
When the Esprit is received, the clocks time will have to be changed to that of
the existing time zone. The date should be checked and changed if necessary.

Setting Date and Time Format

To set time (Figure 5-8) or date (Figure 5-7):
1. Press the desired date or time button (month, day, year, hour, minute,
second).
2. When the window insert appears, press the INCREASE or DECREASE
button, or rotate the control knob, to change the value of the selected
parameter.
3. Press the ACCEPT button to confirm the change and return to the User
Config screen. Press the CANCEL button to leave the value
unchanged.

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Window insert
to change the
value of Month

Figure 5-7: Setting the Date

Window insert
to change the
value of Hour

Figure 5-8: Setting the Time

4. After the date and time values have been set, the changes will be
shown on the screen.
5. Press the APPLY DATE and APPLY TIME buttons to activate the
change.

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Chapter 5

Setup

Apply Date
button

Apply Time
button

Figure 5-9: User Configuration Screen After Date and Time are Set

6. The 24 HR CLOCK button allows the operator or technician to set the

displayed time in an AM/PM (e.g., 1:15 PM) or 24 Hr. (e.g., 13:15)
format. When the 24 HR CLOCK button has a white background, time
is displayed in the 24 Hr. format; when it has a gray background, time
is displayed in the AM/PM format.
7. Press the 24 HR CLOCK button to toggle between AM/PM and 24 Hr.
formats. Observe the time display in the lower right hand corner of the
diagnostic screen to confirm the format.

Altitude
The User Configuration screen in the Diagnostic Mode is used to input the
altitude of the location of the ventilator. To enter Diagnostic Mode, follow the
instructions “Entering Diagnostic Mode” on page 5-6. At Figure 5-5 select
USER CONFIG and the screen in Figure 5-10 appears. Pressing the ALTITUDE
button allows the operator or technician to set the altitude to that of the
present geographical location of the ventilator. This factor ensures a more
accurate tidal volume delivery.

Setting Altitude
To adjust the altitude:
1. Verify the altitude using an altimeter, if available, or estimate the
altitude in feet (or meters) above sea level.
2. Press the ALTITUDE button.
3. When the window insert appears, select either feet or meters. Press
the INCREASE or DECREASE button, or rotate the control knob, to
change the value. The longer the increase and decrease are touched,
the faster the value will change.

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4. Press ACCEPT to accept the changed value. Press the CANCEL button
to leave the value unchanged.

Window insert
to change the
value of Altitude.

Figure 5-10: Setting Altitude

Enabling/Disabling Tubing Compliance

The operator can activate or deactivate “tubing compliance compensation” in
the User Configuration screen. To enter Diagnostic Mode, follow the
instructions for “Entering Diagnostic Mode” on page 5-6. At Figure 5-5, select
USER CONFIG and the screen in Figure 5-6 appears.

Figure 5-11: Compliance Activated

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Setup

The operator can have Esprit compensate the volumes delivered in volume
controlled, mandatory breaths, with the tubing compliance volume, by
activating the COMPLIANCE button (Figure 5-11). Circuit compliance is
activated when this button has a white background. When the function is
activated the exhaled volumes reported by Esprit, will also be tubing
compliance compensated.

Backup Battery If the backup battery is installed, the operator can have the Esprit confirm the
backup battery is connected each time that the machine powers on. Pressing
the BKUP BATTERY button (Figure 5-12) allows this confirmation feature,
identified by an active button with a white background.

Backup Battery
(confirm at
startup)
button active

Figure 5-12: Backup Battery Activated

From then on when the machine powers on it searches for a backup battery. If
the backup battery is connected to the ventilator the startup is normal. If the
backup battery is not connected then the ventilator displays a message at
startup and a 5002 Diagnostic Code will be logged.

Figure 5-13: No Backup Battery Connected message

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Press the OK button to clear the message from the screen. You may continue
to use the ventilator without the backup battery or power off the ventilator and
reconnect the backup battery.

WARNING: Always turn the ventilator power OFF before connecting additional
equipment.

To turn this feature off, enter Diagnostic Mode and deactivate the messaging
feature by pressing the Bkup Battery button.
1. Power off the ventilator.
2. Power on the ventilator while holding down the ALARM RESET and
100% O2 keys for approximately 5 seconds.
3. A message appears on the ventilator screen asking the user to ‘Verify
that the patient is disconnected prior to proceeding.’ Press OK to enter
Diagnostic Mode.
4. Once you’ve entered Diagnostic Mode, select USER CONFIG button
which takes you to the User Config screen.
5. Press the BKUP BATTERY button. The background color should return
to blue signifying that this feature has been deactivated.

Extended Self Test Respironics recommends that the user runs Extended Self Test (EST) upon
receipt of the ventilator to ensure that there has been no shipping damage to
(EST)
the system. Respironics also recommends that the user run EST between
patients to verify the overall functional integrity of the ventilator. Refer to
chapter 11 for instructions on running EST.

If EST was run successfully and all configuration information has been
entered, Esprit is ready to be used. Follow the recommended “Preoperational
Procedure” on page 8-29 once a patient has been selected.

To exit the Diagnostics Mode you must turn the Power On/Off switch OFF ( )
then ON ( ).

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 Chapter 6. Connecting Additional Equipment

WARNING: Always turn the ventilator power OFF before connecting additional
equipment.

Communication
Interface CAUTION: To prevent the risk of excessive leakage due to external equipment being
connected to Esprit via the communication ports, a means for external
separation of the conductive earth paths must be provided.

CAUTION: All equipment used and connected to the Esprit communications ports
(analog, parallel and serial) must comply with the medical electrical
equipment (IEC601-1) or other applicable standards.

The Esprit Ventilator provides three communications interfaces: one serial RS-
232 port, an analog output port, and a parallel port. (The Parallel port is
reserved for use by the Communications Option.)

Parallel Analog

Remote Alarm

AC Power Cord
Serial

Circuit Breaker
(cover not shown)

Humidifier AC
Outlet

Figure 6-1: Ports and outlets on the Rear Panel

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Chapter 6

Connecting Additional Equipment

Connecting Serial The serial port on Esprit is designed to transmit data on a one device to one
Communications device serial communications channel. In the connection between the two
devices, Esprit assumes the “slave” role and responds to commands
Devices transmitted to it via the serial port by the external “master”. The serial
communications port uses a standard RS-232, null modem, pin configuration.
Esprit assumes the serial communications is set-up for:
• 19,200 bits/second baud rate
• 8 data bits
• no parity bit
• 1 stop bit

Esprit is sent commands that are 4 ASCII characters from the external device
and responds with a fixed format message. The commands and the responses
are specified in A, “RS-232 Communications Protocol”.

Connecting Remote The Esprit Ventilator is equipped with a remote alarm port allowing ventilator
alarm conditions to be sounded at remote locations away from the ventilator.
Alarm Port
Pressing ALARM SILENCE deactivates the remote alarm. The ventilator signals
an alarm using a normally open or normally closed relay contact. The de-
energized state of the relay represents an alarm state (any Medium or High
Priority alarm) and the energized state represents no alarms.

The remote alarm port is a standard ¼ inch, female, phono jack (ring, tip,
sleeve) connector.

Remote alarm
connector & cable
NO Ring

NC Tip
Common Sleeve

Figure 6-2: Remote Alarm Port

The port is configured to work with the Normally Open (NO), Normally Closed
(NC), and Respironics (LifeCare) systems. Each requires specific cabling
identified in Table 6-1:.

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Connecting Additional Equipment

Remote Alarm Cable Kits

System Part Number

Remote Alarm Cable Kit (Normally Open Protocol) 1003741
Remote Alarm Cable Kit (Normally Closed Protocol) 1003742
Remote Alarm Cable Kit — Respironics (LifeCare) 1003743
Table 6-1: Remote Alarm Cable Kits

WARNING: Use only Respironics approved cables when connecting to the remote alarm
port. Be sure to fully insert the cable into the remote alarm port and into the
remote alarm.

WARNING: When using the Remote Alarm Port be sure to fully test the Remote Alarm
Port and cable by:
• Verifying that annunciated alarms on the Esprit are also
annunciated on the remote alarm.
• Verifying that disconnecting the cable from the Remote Alarm port
results in an alarm notification at the Remote Alarm.
• Verifying that disconnecting the cable from the remote alarm
results in an alarm notification at the Remote Alarm.

CAUTION: To prevent damage to the remote alarm, relay contacts should not
exceed the maximum rating of 125VAC, 0.5 amp or 24VDC, 1 amp.

Connecting Respironics recommends only those humidifiers that comply with ISO 8185,
for use on Esprit.
Humidifier
When connecting a humidifier to the patient circuit, the operator should follow
the set-up procedure supplied by the humidifier manufacturer. The following
steps should be followed to electrically connect the humidifier to Esprit (for
100-120 VAC ventilators). For ventilators using voltage other than 100-120
VAC, the humidifier must be connected to another AC outlet.
1. Ensure that the Esprit Ventilator is properly positioned on a secure
table top, wall mount, or pedestal.
2. Remove the cover of the humidifier AC power outlet on the back of
Esprit (Figure 6-3).
3. Connect the humidifier AC plug to the humidifier AC power outlet
(Figure 6-4).

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Connecting Additional Equipment

(Circuit Breaker
Cover not shown)

Humidifier AC
Outlet Cover

Figure 6-3: Humidifier AC Outlet Cover

(Circuit Breaker
Cover not shown)

Humidifier AC
Plug

Figure 6-4: Humidifier AC Plug

4. Run any test procedures recommended by the humidifier

manufacturer before the ventilator and humidifier are used on a
patient.

WARNING: AC power is applied to the humidifier from the Esprit humidifier outlet (only
available on 100-120 VAC ventilators). Under no circumstances does the
Esprit Ventilator provide control for the humidifier. To ensure patient safety,
it is important that any humidifier used with the Esprit Ventilator include an
acceptable temperature control and monitoring mechanism, as well as a
temperature display and appropriate alarm capabilities (refer to ISO 8185).

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Connecting the 1. The humidifier should be connected between the Esprit inspiratory
Patient Circuit bacteria filter (Figure 6-5) and the inspiratory limb of the patient
circuit which leads to the patient wye (Figure 6-6).
2. Follow steps illustrated by Figure 6-5, Figure 6-6 and Figure 6-7.

Figure 6-5: Ventilator Gas Outlet Port to Humidifier Patient Circuit Connection

Figure 6-6: Humidifier Outlet to Patient Wye Connection

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Connecting Additional Equipment

Figure 6-7: Expiratory Limb of Patient Circuit to Water Trap Connection

When connecting a patient circuit without a humidifier refer to Figure 6-8.

Figure 6-8: Patient Circuit without Humidifier

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Connecting the The analog output port adds a second remote alarm output. Pin 12 (fourth pin
Analog Port from the top left is pin 12) signals an unsilenced high or medium urgency
alarm:
• 0 VDC = active alarm
• 1.5 VDC = no alarm or silenced alarm

The Communications option provides additional signals on this port. Refer to

Chapter 13, “Options and Accessories”.

Analog
Port

(Circuit
breaker cover
not shown)

Figure 6-9: Analog Port

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 Chapter 7. Operating Theory

Introduction This chapter describes the Esprit Ventilator’s breath delivery capabilities. It
includes a system overview and descriptions of the ventilation modes and
available breath types. For descriptions of button settings and general
operating instructions, refer to Chapter 8, “Operating Instructions”.

System Overview The Esprit Ventilator is a microprocessor controlled ventilator capable of

delivering a mixture of air and oxygen to a patient’s lungs in a predetermined
manner to augment or replace the work normally performed by the patient’s
respiratory system. The ventilator performs breath delivery via two different
patient interfaces:
• endotracheal tube or tracheostomy tube (invasive ventilation)
• face mask, nasal mask, nasal pillows, or mouthpiece with a seal (non-
invasive ventilation)

Ventilator Breath The Esprit Ventilator provides the following ventilation breath types:
Types • Volume Control Ventilation (VCV) – invasive ventilation
• Pressure Control Ventilation (PCV) – invasive ventilation
• Non-Invasive Ventilation (NPPV) – non-invasive ventilation

During mechanical ventilation, the operator selects one of the ventilation

modes. The selected ventilation breath type, along with the selected mode, the
patient breathing effort and the ventilator settings, determine the type of
breath delivered. Each ventilation breath type has it’s own settings, alarms and
monitor screens. (Refer to Chapter 8, “Operating Instructions”.)

Volume Control Ventilation (VCV)

In Volume Control Ventilation, breaths may be controlled by the ventilator
(mandatory) or triggered by the patient (spontaneous). When controlled by the
ventilator, breaths will be flow controlled and time cycled, thus delivering an
operator (TIDAL VOLUME) set volume. In Volume Control Ventilation, the flow
pattern can be selected between square and descending ramp waveforms.
Refer to Figure 7-1.

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Figure 7-1: Volume Control Ventilation (VCV) Waveform

Pressure Control Ventilation (PCV)

In Pressure Control Ventilation, breaths may be controlled by the ventilator
(mandatory) or by the patient (spontaneous). When controlled by the ventilator,
breaths are pressure limited and time cycled, resulting in an operator set
(PRESSURE) pressure being delivered for an operator set (I-TIME) period of
time. Refer to Figure 7-2.

Figure 7-2: Pressure Control Ventilation (PCV) Waveform

Ventilation Modes In Volume Control Ventilation and Pressure Control Ventilation, the operator
Common to VCV and can select between ventilation modes of Assist/Control, SIMV and CPAP.

PCV

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Assist Control Ventilation (A/C)

With the Assist/Control mode (refer to Figure 7-1 or Figure 7-2), a minimal rate
and tidal volume (or inspiratory pressure) are set by the operator. The patient
can trigger the ventilator at a more rapid rate, but the operator set tidal volume
(or inspiratory pressure) is delivered during each breath. Esprit delivers only
mandatory breaths. Assisted breaths may be either pressure or flow triggered.
If the trigger setting is adjusted so that the patient can not trigger the
ventilator, all breaths will be delivered by the ventilator at the operator set rate
and tidal volume (or pressure).

Synchronized Intermittent Mandatory Ventilation (SIMV)

SIMV is a ventilation mode where the patient is allowed to breath
spontaneously and the machine attempts to deliver volume (VCV) or pressure
(PCV) mandatory breaths in synchrony with the patient’s effort at the operator
set rate and volume (or pressure). This is accomplished by a combination of
spontaneous and mandatory windows that open and close. The type of breath
delivered depends upon whether the event during the window is patient
initiated, operator initiated or time initiated. This logic is illustrated in Table 7-
1: “SIMV Logic”.

SIMV Logic

Current Next
SIMV State Inputs Ventilator Response SIMV State
Mand Time Trigger Deliver mandatory breath using operator Mand
Window (breath period settings for mandatory breath type; Restart Window
timer expires) breath period
Mand Patient Trigger; Deliver mandatory breath using operator Spont
Window Operator Trigger settings for mandatory breath type Window
Spont Patient Trigger Deliver a spontaneous breath using Spont
Window operator settings for spontaneous breath Window
type
Spont Operator Trigger Deliver a mandatory breath using operator Spont
Window settings for mandatory breath type Window
Spont Time Trigger Restart breath period timer Mand
Window (breath period Window
elapses)

Table 7-1: SIMV Logic

Continuous Positive Airway Pressure (CPAP)

CPAP is a spontaneous mode of ventilation. No mandatory breaths are
delivered. Throughout the breath cycle, an operator set pressure is provided.
The level of pressure delivered during CPAP is the baseline pressure, or PEEP
(Positive end Expiratory Pressure). Refer to Figure 7-3.

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Figure 7-3: Continuous Positive Airway Pressure (CPAP)

Pressure Support Ventilation (PSV)

In Pressure Support Ventilation, the patient’s spontaneous efforts are assisted
by the ventilator at an operator set level of inspiratory pressure. Inspiration is
initiated by the patient and terminated when the inspiratory flow falls below an
operator set percentage of the peak flow during this breath. During Pressure
Support, the patient determines the respiratory rate, and the patient and
ventilator determine the inspiratory time and tidal volume. Refer to Figure 7-4.

Figure 7-4: Pressure Support Ventilation (PSV)

Positive End Expiratory Pressure (PEEP)

The PEEP pressure is the operator set baseline pressure maintained during
exhalation. All breaths are referenced to this baseline pressure and the
resulting pressure is in addition to the baseline pressure. Refer to Figure 7-5.

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Figure 7-5: Positive End Expiratory Pressure (PEEP)

Rise Time Setting

Rise Time applies to all pressure targeted breaths - PSV, PCV and IPAP in
NPPV. The operator can adjust the velocity of pressurization to better match
the patients demand for flow. Refer to Figure 7-6.

Figure 7-6: Rise Time

Patient Initiated Breath Triggering

Patient initiated breaths can be flow or pressure triggered in A/C, SIMV, CPAP
for Pressure or Volume breath types, or flow triggered in NPPV. The pressure
trigger level determines the amount of pressure below the baseline pressure
that the patient must create in order for the ventilator to deliver a breath. The
Flow Trigger level is the amount of flow that the patient must inspire from the
base flow in order for the ventilator to deliver a breath.

Patient Leak Display

Estimated patient leak (Pt Leak) is displayed in LPM and updated at each
breath. Pt Leak is the average leak rate during a breath (delivered volume
minus exhaled volume divided by the breath time).

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Pt Leak is estimated breath by breath. If the physical characteristics of the

leak change, there will be a corresponding change in the actual leak flow,
which will be detected and leak estimation will be updated in subsequent
breaths. Physical characteristics of leaks are determined by a number of
factors, for example, the size and shape of the leak (such as a gap in the seal
between the mask and face). Leaks that may occur during invasive ventilation
are usually undesirable and are not compensated to allow easier leak
detection.

Ventilation Modes Non-Invasive Positive Pressure Ventilation (NPPV)

Common to NPPV In Non-Invasive Ventilation, gas is delivered to the patient via a nasal mask,
full face mask, nasal pillows, or mouthpiece with a lip seal. The operator
determines whether the mode is totally spontaneous (Spont Ventilation Mode)
or spontaneous with a back up rate (Spont/T Ventilation Mode).

Spontaneous Ventilation Mode (Spont)

In Spontaneous Ventilation Mode, the operator sets the pressure during
exhalation (EPAP) and the target pressure during inspiration (IPAP). The
patient triggers the breath based on the Flow Trigger setting. Exhalation is
determined by the setting E-Trigger, which is a percentage of peak flow during
the breath. Refer to Figure 7-7.

Spontaneous/Timed Ventilation Mode (Spont/T)

In the Spontaneous/Timed Ventilation Mode, the patient can breathe
spontaneously, or receive machined controlled breaths. The machine
controlled breaths are delivered for a set inspiratory time at a set breath rate.
In Spont/T mode, every patient initiated breath is spontaneous and restarts the
breath period timer. If the patient triggers a breath before the breath period
elapses, the ventilator delivers a spontaneous supported breath (based upon
the settings). If the breath period elapses without a patient trigger, the
ventilator delivers a ventilator initiated mandatory breath at the set IPAP level.
Patient initiated, time cycled breaths are not delivered in Spont/T mode. Refer
to Figure 7-7.

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Figure 7-7: Spont/T Mode

Emergency Modes of The Esprit ventilator has two emergency modes of ventilation that are entered
in response to certain alarm conditions. They are:
Ventilation
• Apnea Ventilation
• Safety Valve Open

Apnea Ventilation
Apnea ventilation provides an emergency mode of ventilation if the ventilator
does not deliver a breath for an operator set interval of time. The apnea time
can be set between 10 and 60 seconds. Upon entering this mode of
ventilation, Esprit will alarm and immediately start using the Apnea Rate
setting specified by the operator. In PCV and VCV, Esprit will begin delivering
breaths in Assist/Control (A/C), but with the operator set Apnea Rate. In NPPV,
Esprit will deliver only machine controlled breaths either at the operator set
Apnea Rate or in response to patient effort. In Apnea ventilation, the alarms
used are the ones used for machine controlled breaths for the ventilation
breath type (VCV, PCV and NPPV) Esprit was using when Apnea occurred.

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Parameters Used in Apnea Ventilation, Settings and Alarm Limits

VCV PCV NPPV

Settings Tidal Volume Inhalation Pressure Inhalation Time
Peak Flow Inhalation Time IPAP
Flow pattern Rise Time EPAP
I-Trigger (pressure/flow) I-Trigger (pressure/flow) Rise Time
E-Trigger sensitivity E-Trigger sensitivity I-Trigger (flow)
Apnea Rate Apnea Rate E-Trigger sensitivity
Insp Hold PEEP Apnea Rate
PEEP O2 % O2%
O2 %
Alarm High Pressure High Pressure Low Pressure
Limits Low Insp Pressure Low Insp Pressure Low EPAP
Low PEEP Low PEEP Low Tidal Volume
Low Mandatory Tidal Volume Low Mandatory Tidal Volume High Rate
High Rate High Rate Low Exhaled Minute
Low Exhaled Minute Volume Low Exhaled Minute Volume Volume
High Exhaled Minute Volume High Leak

Table 7-2: Parameters Used in Apnea Ventilation, Settings and Alarm Limits

The ventilator will reset out of Apnea Ventilation if the operator presses the
Alarm Reset button, or if the patient triggers two successive breaths.

Safety Valve Open (SVO)

Safety valve open is an emergency mode of ventilation that allows the patient
to breathe through the system whenever any of the following occur:
1. An occlusion is detected.
(The ventilator resumes normal breathe delivery if the occlusion is
removed.)
2. Loss of both the air supply and the oxygen supply occurs.
(The ventilator resumes normal breath delivery if the gas supply is made
available.)
3. The Ventilator Inoperative state (Vent InOp) is entered due to a hardware
malfunction that prevents breath delivery.
(The ventilator will not resume normal breath delivery in this case. Call for
service.)

During SVO:
1. The safety valve is opened,
2. The exhalation valve is opened,
3. The air and oxygen valves remain closed,
4. A high priority alarm is activated,
5. The Safety Valve Open indicator is illuminated,
6. The Normal indicator is turned off.

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Esprit Overview
WARNING: Ensure that an alternative means of ventilation (i.e., a resuscitator or similar
device) is available while the Esprit Ventilator is in use on a patient.

WARNING: The Esprit Ventilator complies with the requirements of IEC 601-1-2 (EMC
collateral standard), including the E-field susceptibility requirements at a
level of 10 volts per meter. However, even at this level of immunity, certain
transmitting devices (cellular phones, walkie-talkies, etc.) emit radio
frequencies that could disrupt ventilator operation if operated in a range too
close to the ventilator.

WARNING: DO NOT operate the Esprit ventilator in a Magnetic Resonance Imaging

(MRI) environment.

There are three ventilation breath types:

• Volume Control Ventilation VCV
• Pressure Control Ventilation PCV
• Non-Invasive Ventilation NPPV

Each has mandatory or machine controlled breaths and each has patient
controlled or spontaneous breaths.

Each ventilation breath type has its own settings that are mutually exclusive
from the other ventilation modes.1
• In VCV, the operator can select either A/C, SIMV, or CPAP mode
• In PCV, the operator can select either A/C, SIMV, or CPAP mode
• In NPPV, the operator can select Spont/T or Spont mode

Alarms are specific to the ventilation breath type. Alarm limits in one
ventilation breath type are mutually exclusive from the alarm limits of the
other ventilation breath types.

Esprit is easy to use because all mode settings and alarm limits are selected
using the same three step process:
1. Select the parameter to be changed by pressing the associated button.
The screen insert shown in Figure 8-1 appears.

1. Set O2 is an exception that can be changed only in the active mode and applies to all
modes.

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Increase bar, the

farther from the middle
the bar is pushed the
faster the value
Digital value of changes. Similarly for
setting to be the decrease bar.
changed

Figure 8-1: Entering Settings and Alarm Parameters

2. Press the INCREASE bar or DECREASE bar, until desired value

appears in the digital window or use the front panel control knob to
increase or decrease the displayed value.
3. Press the ACCEPT button (or FRONT PANEL ACCEPT key) to enter the
value and return to the previous display. Press the CANCEL button to
leave the value unchanged.

NOTE: All volumes entered into Esprit are assumed to be BTPS (Body
Temperature atmospheric Pressure Saturated (with H2O)) volumes
unless otherwise noted. All volumes reported by Esprit are reported as
BTPS volumes. All pressures are assumed to be relative to atmospheric
pressure unless otherwise noted.

The Front Panel The Esprit Ventilator’s front panel includes the indicators and controls shown
in Figure 8-2.

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Indicators

Touch
Display

Controls

Figure 8-2: Esprit Front Panel

Front Panel Indicators

The front panel indicators (above the screen) alert the operator to the
ventilators operational status and alarm conditions. (Refer to Chapter 9,
“Alarms” for more detailed descriptions.)

Figure 8-3: Front Panel Indicators

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Normal: illuminated green; indicates that no active or auto reset alarm

conditions exist.

Alarm High: flashes red to indicate that a high priority alarm condition exists.

Alarm Med/Low: flashes yellow to indicate medium priority alarm condition.

Continuous yellow illumination indicates low priority alarm conditions exist. In
addition, auto reset conditions are indicated by continuous yellow
illuminations.

Vent Inop: illuminated red when active. Indicates that the Esprit Ventilator is
not capable of supporting mechanical ventilation and requires service. During
Vent Inop, the ventilator opens the safety valve to allow the patient to breathe
room air spontaneously. The ventilator also discontinues detection of new
alarm conditions during Vent Inop.

WARNING: Vent Inop is a serious condition, which is indicated by both visual and
audible alarms. If the ventilator is attached to a patient when Vent Inop
occurs, the patient must be supported with another means of life support
ventilation.

Safety Valve: illuminated red when active; indicates that the safety valve is
open and the ventilator is not in operation. This is a high priority alarm
condition. When the Safety Valve indicator is illuminated, the ventilator is not
providing ventilatory support to the patient. The safety valve opens to allow the
patient to breathe spontaneously through the ventilator circuit. The patient
must be capable of creating a spontaneous breath in order to breathe through
the safety valve.

Alarm Silence: illuminated yellow when the audible alarm has been
disabled; is active and stays on for 120 seconds when the ALARM
SILENCE button is pressed. If Alarm Silence is active, and a new alarm
condition occurs, which involves exceeding an active alarm limit, the visual
alarm functions will be active. (Refer to “Alarm Silence” on page 9-2.) ALARM
RESET clears ALARM SILENCE. If a medium or high priority alarm exists after
ALARM RESET clears ALARM SILENCE the audible alarm will begin.

100%O2: illuminated green, and is active only when the 100% O2 front panel
button has been pressed and the ventilator is delivering 100% O2 to the
patient; remains on for the duration of 100% O2 delivery (two minutes).

NOTE: If the operator sets the %O2 setting to 100%, the 100% O2 indicator
does not light. The 100% O2 indicator only lights when the 100% O2
front panel key has been pressed.

Screen Lock: illuminated green when active; prevents inadvertent changes to

the buttons on the graphic user interface display. All on-screen buttons are

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disabled until the touch screen is unlocked. MANUAL BREATH, 100% O2,
EXP. HOLD, ALARM RESET, and ALARM SILENCE keys are still active keys.

External Battery: Optional accessory. Refer to Chapter 13, “Options and

Accessories”.

Battery In Use: illuminated yellow when active; indicates that the ventilator is
running on Backup Battery power. The Backup Battery is used when there is no
AC power and no other battery is available.

Battery Charging: illuminated yellow when active; indicates that the optional
backup battery is charging. The battery should not be considered a fully
charged power source when this indicator is illuminated. The Battery Charging
indicator will stay on for the duration of the charging cycle, which can last for
up to ten hours. Once the battery has fully charged, the Battery Charging
indicator will go off.

Battery Low: illuminated flashing red when the backup battery has
approximately 5 minutes power remaining.

WARNING: When the battery low indicator is flashing red, operation of the ventilator
from battery power should be discontinued.

Mains: illuminated green whenever the ventilator is connected to AC power

source and the rear panel Mains circuit breaker is on ( I ).

NOTE: The Esprit Ventilator selects its power source based on the following
prioritization: AC power (if present), external battery, then backup
battery.

Front Panel Keys

The FRONT PANEL keys (the bar and knob below screen) allow the operator to
initiate special ventilator and machine functions (Refer to Chapter 9, “Alarms”
for more detailed information on the alarm keys and buttons).

Figure 8-4: Front Panel keys

ALARM SILENCE: disables the audio alarm for 120 seconds. The alarm silence
period ends after the 120 seconds has elapsed. If Alarm Silence is active and
an alarm takes place that involves an operator alarm limit being exceeded, the

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alarm indicator is illuminated, but Alarm Silence will continue to be active and
the Alarm Silence timer will continue to time out. Alarms that can not be
silenced are listed in Table 9-1: “Alarm Alert Messages” on page 9-4. When
the ALARM SILENCE button is pressed, the Alarm Silence indicator is
illuminated for the duration of the 120 second alarm silence period.

ALARM RESET: Used to clear the visual indicator for auto reset alarms, certain
active alarms (Refer to Chapter 9, “Alarm Reset”.) and reset out of apnea
ventilation back to the active mode of ventilation (Refer to “Apnea Ventilation”
on page 8-24.) Alarm reset also terminates ALARM SILENCE.

NOTE: The ventilator may automatically reset certain types of alarm conditions
once the causes of the alarms are corrected. After an automatic reset,
the ventilator will clear the audible alarm, and will display a Low
Urgency Alarm alert in the Alert Message Insert to inform the operator
that an alarm condition existed. When this situation occurs, use ALARM
RESET to clear the visual alarm indicator.

100%O2: Delivers 100% O2 to the patient for two minutes. Subsequent button
presses will reset the timer to two minutes. The delivery of 100% O2 cannot be
cancelled during the two minute delivery period.

NOTE: If the 100% O2 key is pressed and a 100% O2 gas source is not
available, the Low O2 alarm will be active for the two-minute 100% O2
delivery period.

MANUAL BREATH: causes the ventilator to deliver an operator-initiated,

mandatory (OIM) breath. Delivery of the breath is based on the current
ventilation breath type settings.

NOTE: Manual breaths are not permitted during the inspiratory phase of a
breath (whether manual or spontaneous). Pressing the MANUAL
BREATH key during these times will not result in the delivery of a
manual breath.

SCREEN LOCK: used to lock and unlock the graphic display (touch screen).
When the screen lock is activated, all on-screen buttons are disabled. This
function is available to prevent inadvertent setting and display changes via the
touch screen.

EXP. HOLD: allows calculations of Auto-PEEP from an expiratory hold maneuver.

(Refer to “Special Procedures” on page 8-28.)

ACCEPT: allows operator to accept selected settings on the front panel

graphical display.

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ADJUST CONTROL KNOB: used in conjunction with the front panel graphical
display and touch screen, to enter operator-selected values for ventilator
settings and alarms.

AUDIBLE ALARM VOLUME: A recessed alarm volume control knob is

located in the lower left corner of the front panel. It is used to
increase or decrease the audible alarm volume. The minimum
audible alarm volume is dictated by international standards. The
audible alarm volume control will not turn the audible alarm volume lower than
the minimum decibel level dictated by these standards. It is not possible to
turn the audible alarm volume off.

DISPLAY BRIGHTNESS: A recessed brightness control knob is located

in the lower left corner of the front panel. It is used to increase or
decrease the brightness of the touch screen display.

ON/OFF SWITCH: is located in the lower portion of the front panel, and is
recessed to avoid inadvertent or accidental access. When the switch is in off
( ) position, the ventilator does not provide mechanical ventilation, although
AC power is active and the green Mains indicator is illuminated.

OPTIONS: Reserved for future use.

Ventilator Screens Front Panel Touch Display

The front panel display allows the operator to select ventilation modes, breath
types, settings, alarms, and access patient data. The front panel display is a
touch screen that lets you select settings and data so you can monitor the
status of the patient, ventilator and control ventilator operation.

There are two different categories of screens:

• Ventilator Screens that appear when the machine is functioning as a
ventilator
• Diagnostic Screens that appear when the machine is not functioning
as a ventilator and is running internal tests.

(Refer to Chapter 11, “Diagnostics”, for more information about displaying

ventilator diagnostic information.)

Common Ventilator Screen Components

Except for the patient data screen, screen configurations are determined by
the selected ventilation breath type. Figure 8-5 shows the elements that are
common to all ventilator (that is, non-diagnostic) screens: the top bar, bottom
bar, and manometer.

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Top Bar

Manometer

Bottom Bar

Figure 8-5: Elements common to all operational screens (VCV settings shown)

Figure 8-6 shows the top bar and describes its buttons.

Active Mode: push to display the Active Alarms: push to show current alarm
settings for the active ventilation mode settings for the active ventilation mode and
and breath type. breath type.

Patient Data: push to show Monitor: push to display the monitor

the Patient Data screen screen (ventilator settings and
patient data)

Figure 8-6: Top Bar (common to all operational screens)

Figure 8-7 shows the bottom bar and describes its buttons.

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VCV Settings: push to display VCV NPPV Settings: push to display NPPV Respiratory Graphics
settings screen, which allows you to settings screen, which allows you to Mechanics button: selects
view and change settings for volume view and change settings for button: selects option if
controlled ventilation noninvasive positive pressure option if installed.
ventilation installed.

PCV Settings: push to display PCV settings Option: for use in the Printer: Available if
screen, which allows you to view and future Communications
change settings for pressure controlled option is installed
ventilation

Figure 8-7: Bottom Bar (common to all operational screens)

Buttons in the bottom bar have two states, “selected” and “not selected”. In
the “selected” state, the button has a white background and black letters (see
VCV SETTINGS in Figure 8-7). In the “not-selected” state the button has a
gray background and black letters (see PCV SETTINGS, and NPPV SETTINGS
in Figure 8-7). In the upper bar the buttons MONITOR, ALARM SETTINGS and
PATIENT DATA are also the “selected/not-selected” type.

When one of these “selected/not-selected” buttons is selected, it indicates

that the screen is being used to display the information described by the name
of the button on the screen. Making a setting screen “selected” (for a breath
type that is not active), is the first step to activate that ventilation breath type
(Refer to “Selecting a New Ventilation Breath Type (VCV, PCV, or NPPV)” on
page 8-20.)

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Figure 8-8 shows the real time manometer displays.

Waveform: airway pressure

Indicator
versus time

Upper limit of
real time display High pressure
determined by alarm setting -
High Pressure press this button
alarm setting to modify HIP.

Zero pressure
line

Breath
Indicator

Manometer with Waveform Manometer only

(for mode setting screens)

Figure 8-8: Manometer (common to operational screens)

Table 8-1: “Breath Indicator” describes the breath indicator.

Breath Indicator
Breath Symbol Description
Mand Operator or ventilator triggered mandatory breath.

Assist Patient triggered mandatory breath.

Plateau Inspiratory hold, can be set at the end of the inspiratory phase of a VCV
breath type.
Support Patient triggered spontaneous breath with PSV>0 or IPAP>EPAP.

Spont Patient triggered spontaneous breath, PSV=0 or IPAP = EPAP.

Exhale Indicates exhalation phase of any breath.

Table 8-1: Breath Indicator

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Pressing the HIP indicator on the screen (Figure 8-8) will immediately
HIP allow the operator to modify the high pressure limit for VCV or PCV. In
NPPV, the high pressure limit is automatically set to 10 cmH2O (hPa)
above IPAP. The HIP indicator does not appear near the manometer in NPPV.

Settings Screens The buttons in the middle of the settings and alarm limit screens all have two
states, active and inactive. Active settings have a gray background with black
letters (Figure 8-9). An active setting is currently being used by Esprit to
control ventilation or as an alarm limit. Inactive settings buttons have a gray
background with gray letters. Inactive settings are not currently being used by
Esprit to control ventilation or as an alarm limit. In both states the button can
be pressed and an insert window will appear that will allow the operator to
change the value of the setting (Figure 8-1).

NOTE: Some settings buttons appear active despite the fact they are not being
used in the ACTIVE MODE. This is because the setting is used in Apnea
Ventilation or when manual inspiration is pressed. The operator should
always choose a value for an active button that is appropriate for the
patient being ventilated.

Pressing the ACTIVE MODE button displays the settings screen for the
currently selected ventilation breath type and mode (Chapter 7, “Operating
Theory”, for more information on ventilation modes, breath types, and
controls).

For example, in Figure 8-9 the current breath type is VCV and the mode is A/C.
Because A/C does not allow the ventilator to deliver any spontaneous breaths,
any settings that apply to spontaneous breaths are not active and are grayed
out. In Figure 8-9, PSV is grayed out, indicating that it isn’t active, but you
can still push this button and change the PSV value. The PSV value will
become active only if the SIMV or CPAP mode is selected.

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Ventilation mode: A/C, SIMV, or CPAP. Spont

or Spont/T are available during NPPV

Ventilation control settings: VCV, PCV, or NPPV

Figure 8-9: VCV Settings Screen (VCV active)

Selecting Settings
Follow these steps to adjust ventilator control settings:
1. Push VCV SETTINGS, PCV SETTINGS, or NPPV SETTINGS.
2. Push the button for the control settings you want to select. The
ventilator displays the current value for that parameter in an insert
that allows the operator to adjust the settings value. (Figure 8-10).
3. Press the bar to increase or decrease the setting to the value you want
or use the front panel knob to adjust the value of the setting.
4. Press the screen ACCEPT button or the front panel ACCEPT button to
activate the new setting or CANCEL to leave the setting unchanged.

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Push this bar to

increase the value

Current or new value

displayed digitally and
graphically

Push this bar to

decrease the value

Press ACCEPT to
activate the new
setting
Press CANCEL to
leave the setting
unchanged

Figure 8-10: Changing a setting

When a value is entered, as shown in Figure 8-10, Esprit checks to assure that
the value has been accepted by the operator, is within limits and will not cause
other settings to be out of limits. If the new value causes these limits to be
exceeded a diagnostic message will be displayed. (Refer to “Value Entry
Message” on page 12-4 for more details about the diagnostic messages).

Selecting Alarm Limits

Follow these steps to adjust currently active alarm limits:
1. Push ALARM SETTINGS. The ventilator displays the alarm limits for
the currently active ventilation mode (Figure 8-11).
2. Push the button for the alarm limit you want to adjust. The ventilator
displays the current value for that alarm limit in a display insert,
similar to Figure 8-10.
3. Press the bar or use the front panel knob to adjust the value.
4. Press ACCEPT to activate the new alarm limit or CANCEL to leave it
unchanged.

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Active
ventilation
mode and
breath type
button
displayed

Indicates this
screen is for
VCV alarms

Push
button of
alarm you
want to
adjust

Figure 8-11: Setting alarm limits that are currently active

The High Pressure Alarm Setting may be accessed through the Alarms Settings
Screen or through the HIP Indicator adjacent to the manometer in the PCV and
VCV Settings, Alarm Settings, Patient Data and Monitor Screens.

WARNING: For patient safety the HIP Limit Setting should be set as close to the peak
inspiratory pressure as patient conditions allow.

CAUTION: If clinical conditions do not require setting the HIP Limit above 60
cmH2O, it is recommended the setting normally be adjusted to 60
cmH2O or less in order to prolong the operating life of the blower and to
maximize backup battery run time.

NOTE: When the active mode is set to NPPV, the HIP Limit Setting will
automatically be adjusted to 10 cmH2O above the current IPAP setting.

Follow these steps to adjust alarm limits that are not currently active:
1. Depending on the alarm limits you wish to review, push VCV
SETTINGS, PCV SETTINGS, or NPPV SETTINGS button that has a
gray background and black letters (not active).

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ACTIVATE
button

Figure 8-12: PCV Setting while NPPV is the active breath type

2. From the control settings screen, push ACTIVATE button. Refer to

Figure 8-12. The ventilator displays a prompt insert (Figure 8-13).

Figure 8-13: Change breath type insert window for PCV

3. Select the REVIEW ALARMS button and Esprit will display the alarm
settings for PCV (Figure 8-14).
4. Notice that all the alarm buttons (Figure 8-14) are grayed out,
indicating that the alarm limits are not currently active. The ventilator
displays the current value for that set of alarm limits. Push the button
for the alarm limit you want to adjust.

NOTE: Esprit keeps a distinct set of alarm limits for each ventilation breath
type (VCV, PCV and NPPV).

5. Press the bar or use the front panel knob to adjust the value (as shown
in Figure 8-10).
6. Press ACCEPT to activate the new alarm limit or CANCEL to leave it
unchanged.

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Grayed out buttons indicate that the alarm limits are not active

Push button of
alarm setting to
adjust

Press this ACTIVATE

button to switch to the
ventilation breath type
indicated. The
ventilation breath type
on this button
indicates which alarm
set is shown on this

Figure 8-14: Setting alarm limits that are not currently active

NOTE: Any of the changes made in the screen shown in Figure 8-14, do not
take effect until the operator switches to the new ventilation breath type
(in this case Pressure Control).

Selecting Waveforms (VCV only)

Esprit offers a choice of two inspiratory flow waveforms for mandatory VCV
breaths: descending ramp and square wave (Figure 8-15). The selected
waveform is highlighted and defines the inspiratory flow for all mandatory VCV
breaths, whether they are initiated by the patient, the ventilator, or the
operator. The waveform selection is not applicable to PCV or NPPV.

Descending ramp and square wave act as

mutually exclusive select/non-select buttons.

Push this button Push this button to

to select select square
descending ramp waveform
waveform

Figure 8-15: Selecting Waveforms (descending ramp selected)

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Selecting Adult/Pediatric Buttons

You can configure Esprit to ventilate adult or pediatric patients (Figure 8-16).
Selecting adult or pediatric, tailors the ventilator’s breath delivery algorithms
to the selected adult/pediatric patient type. Selecting adult or pediatric does
not change how the screens work, and does not change ventilator or alarm
settings. The patient type selection determines flow output at various rise time
settings for PCV, PSV and IPAP. In addition, the “I-Time too long” alarms and
time out for spontaneous breaths are set to 3.5 seconds for the adult setting
and 2.5 seconds for the pediatric setting. Peak flow is limited to 100 LPM in
all pressure-based breaths when using the pediatric setting.

Push this Push this button

button to to select
select adult pediatric
controls controls

Figure 8-16: Selecting Adult/Pediatric Controls (adult selected)

Selecting the Inspiratory Trigger (I-Trigger)

The I-Trigger setting determines how inspiratory effort is detected (by
measuring a drop in airway pressure or an increase in patient inspiratory flow)
and when inspiration begins.
• In VCV and PCV, you can select a pressure or flow I-Trigger.
• In NPPV, the I-Trigger is always Flow.

Follow these steps to set the I-Trigger:

1. Push the VCV SETTINGS, PCV SETTINGS, or NPPV SETTINGS button.
2. Push the I-TRIGGER button. The inspiratory trigger window insert
(Figure 8-17) appears.
3. In VCV and PCV: select Pressure or Flow. (Because only flow trigger is
available in NPPV, the Pressure and Flow buttons do not appear in this
insert in NPPV.)
4. Adjust and change the value as described above.

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You can select Pressure or

Flow in VCV or PCV. In
NPPV, only Flow I- Trigger
is available (these buttons
do not appear).

Figure 8-17: Inspiratory Trigger Window

Settings with Calculated Values

Certain window inserts that are used to modify values of settings, can also have
calculated results in them (Figure 8-18).

When the settings window insert being displayed is VCV Rate, the calculated
minute volume that results from the rate and tidal volume settings, is
displayed along with the rate value. This is also the case when the tidal volume
setting window insert is displayed. When the setting window insert for PCV
Rate is displayed, the calculated value for the I:E ratio that will result from the
PCV rate value is also displayed.

When the setting window insert for VCV Apnea Rate is displayed, the
calculated minute ventilation that will exist if the ventilator goes into Apnea
Ventilation in VCV is shown. When the setting window insert for PCV Apnea
Rate is displayed, the I:E Ratio shown is the I:E Ratio that will exist if the
ventilator goes into Apnea Ventilation in PCV.

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PCV Settings Window Insert VCV Settings Window Insert

Setting to be
changed on the
top.

Setting that is
calculated as
the setting
above changes,
below.

I:E Ratio is the parameter that is VE is the parameter that is calculated

calculated and displayed in certain PCV and displayed in certain VCV setting
setting window inserts. These are PCV window inserts. These are VCV Rate, VCV
Rate, PCV I-Time, and PCV Apnea Rate. Tidal Volume, and VCV Apnea Rate.

Figure 8-18: Settings window inserts with calculated results

Rate and Apnea Rate Settings Relationship

For all breath types, VCV, PCV and NPPV, the Esprit ventilator will ensure the
Apnea Rate setting is equal to or greater than the set Rate. If the set Rate is
changed, and the current Apnea Rate is less than the Set Rate, the Apnea
Rate will be automatically changed to be equal to the set Rate. However, the
set Rate can be adjusted to be less than the Apnea Rate without effecting the
Apnea Rate.

Changing IPAP or EPAP in NPPV

When changing the IPAP or EPAP settings in NPPV, the difference between
IPAP and EPAP is displayed in the window insert as PSV.

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Figure 8-19: Changing IPAP or EPAP in NPPV

Selecting a New Follow these steps to select the ventilation breath type:
Ventilation Breath 1. Press the button for the new breath type you want to select from the
bottom bar (Figure 8-20) [PCV in our example].
Type (VCV, PCV, or
NPPV)

Figure 8-20: Ventilation Control buttons (PCV settings selected)

2. The setting screen for the selected breath type appears. All of the
settings are grayed out, indicating that they are not currently active.
However, you can use the grayed out buttons to change the settings as
necessary, (with the exception of Set O2, which can be changed only
in the active mode).
For example, if you press PCV SETTINGS when the current breath type
is NPPV, all the PCV settings are grayed out (Figure 8-21) because
NPPV is currently active.

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ACTIVATE
button

Figure 8-21: Settings Screen (PCV settings, PCV not currently active)

3. Press the ACTIVATE button. The prompt in Figure 8-22 is displayed on

the screen.

Figure 8-22: Prompt when Activate is pressed and PCV settings selected

4. At this prompt the operator can:

• Move directly into PCV by pressing the OK button, or
• Review the PCV alarm settings, or
• Change nothing and return to the PCV settings screen by pressing
the CANCEL button.
If the OK button is pressed, Esprit immediately begins operations in
PCV, the PCV settings become active and screen in Figure 8-23(a)
appears.

(a) Press the OK button and go

to this screen.

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Press the Review Alarms button

(b) to go to this screen.

Press the Cancel button and

(c)
return to this screen.

Figure 8-23: Destination Screens after Activate Prompt

If the REVIEW ALARMS button is pressed Esprit immediately displays

the screen shown in Figure 8-23(b) appears. If the CANCEL button is
pressed, Esprit returns to the settings screen for the selected breath
type as shown in Figure 8-23(c).
5. If the operator elects to review alarm settings, the alarm settings
screen for the destination mode is shown (Figure 8-24). All the alarm
limits are grayed out in this screen, because the selected breath type
(PCV), is not yet active. However the grayed out buttons can be used
to adjust values as seems appropriate for the patient.

Press to activate
new breath type.

Figure 8-24: Alarm Limits Screen (PCV active)

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6. If the operator reviews alarm settings and then activates the new
breath type, Esprit uses the new breath type and displays the alarm
settings of the new breath type (Figure 8-25).

Active mode and

breath type

ALARM
Indicates the active SETTINGS
breath type alarms button is
selected
indicating the
alarm settings
shown are for
Alarm limits no the active breath
longer grayed out, type
indicating that the
selected breath type
is active

Figure 8-25: Alarm Limits Screen (PCV inactive)

Selecting the Mode

(A/C-SIMV-CPAP or Summary—Ventilation Modes and Availability
Spont-Spont/T) Ventilation Available
Mode during… Description
A/C VCV or PCV Assist/control: all breaths are mandatory, and are triggered by
operator, patient, or ventilator.
SIMV VCV or PCV Synchronous intermittent mandatory ventilation: breaths can
be mandatory or spontaneous. Mandatory breaths are triggered
by operator, patient, or ventilator. PSV is available.
CPAP VCV or PCV Continuous positive airway pressure: all patient triggered
breaths are spontaneous, and can be pressure supported. PSV
is available. The MANUAL BREATH key can be used to initiate
a mandatory breath.
Spont NPPV Spontaneous ventilation: all breaths are spontaneous and
patient triggered. The MANUAL BREATH key can be used to
initiate a mandatory breath.
Spont/T NPPV Spontaneous Timed ventilation: breaths can be spontaneous or
mandatory. The MANUAL BREATH key can be used to initiate
a mandatory breath.

Table 8-2: Summary—Ventilation Modes and Availability

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The ventilation mode buttons are the selected/not-selected type.

Follow these steps to select the mode:

1. Press the button for the mode you want to select (the active mode is
highlighted) from the top bar:
• If VCV or PCV breath types are active, you can select A/C, SIMV, or
CPAP mode (Figure 8-26).
• If NPPV is active, you can select Spont/T or Spont.

Figure 8-26: Ventilation Mode buttons (A/C and Spont/T active as shown)

2. The ventilator asks you to confirm the mode change (Figure 8-27).
Press YES to confirm, or press NO to leave the mode as is.

Figure 8-27: Mode Change Confirmation Message

3. Once you confirm a mode change, the ventilator changes the mode
selected to active (Figure 8-28).

Figure 8-28: Ventilation Mode buttons (SIMV and Spont shown as active)

Apnea Ventilation Apnea ventilation provides an emergency mode of ventilation if the ventilator
does not deliver a breath for an operator set interval of time. The apnea time
can be set between 10 and 60 seconds. Upon entering this mode of
ventilation, Esprit will immediately start using the Apnea Rate setting
specified by the operator. In PCV and VCV, Esprit will begin delivering breaths
in Assist/Control (A/C), but with the operator set Apnea Rate. In NPPV, Esprit
will deliver only machine controlled breaths either at the operator set Apnea
Rate or in response to patient effort. In Apnea ventilation, the alarms used are
the ones used for machine controlled breaths in the active breath type (VCV,
PCV and NPPV) Esprit was in, when Apnea occurred.

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Patient Data Screen You can view the patient data screen (Figure 8-29) by pressing the PATIENT
DATA button in the top bar. The format of this screen is the same in VCV, PCV,
and NPPV. Table 8-3: “Patient Data Definitions: Range, Units & Resolution”
summarizes the definitions, display ranges, and resolution for patient data
parameters.

Figure 8-29: Patient Data Screen

Patient Data Definitions: Range, Units & Resolution

Parameter Description Display Range Resolution

PIP Peak Inspiratory Pressure -20.0 to 130 0.1 for -20.0 to 99.9
The maximum airway pressure cmH2O (hPa) 1 for 100 to 130
during inspiration.
MAP Mean Airway Pressure -20.0 to 120 0.1 for -20.0 to 99.9
The average of airway pressure cmH2O (hPa) 1 for 100 to 130
during one full breath cycle.
Pe End Pressure at End Expiration -20.0 to 99.9 0.1
The pressure measured at the end cmH2O (hPa)
of expiration.
Pi End Pressure at End Inspiration -20.0 to 130 0.1 for -20.0 to 99.9
The pressure measured at the end cmH2O (hPa) 1 for 100 to 130
of inspiration (or at the end of Insp
Hold if it is >0).
Tidal Vol. Exhaled Tidal Volume 0 to 9999 ml 1
The volume exhaled at each breath. (BTPS)
Compliance compensated (if
enabled).
Spont VE Spontaneous Minute Volume 0.00 to 99.9 L 0.01 for 0.00 to 9.99
The spontaneous ventilation (BTPS) 0.1 for 10.0 to 99.9
normalized to one minute.
Compliance compensated (if
enabled).

Table 8-3: Patient Data Definitions: Range, Units & Resolution (Sheet 1 of 2)

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Patient Data Definitions: Range, Units & Resolution (Continued)

Parameter Description Display Range Resolution

Total VE Exhaled Minute Volume 0.00 to 99.9 L 0.01 for 0.00 to 9.99
The total volume exhaled by the (BTPS) 0.1 for 10.0 to 99.9
patient in one minute. Compliance
compensated (if enabled.)
% O2 Delivered O2 0.0 to 110% 0.01 for 0.00 to 9.99
One second average of O2 sensor 1 for 100 to 110
reading (if O2 sensor is installed).
Spont Rate Spontaneous Respiratory Rate 0.0 to 150 Bpm 0.1 for 0.0 to 9.9
The respiratory rate of spontaneous 1 for 10 to 150
breaths.
Total Rate Total Respiratory Rate 0.0 to 150 Bpm 0.1 for 0.0 to 9.9
The respiratory rate for all breaths. 1 for 10 to 150
F/Vt Rapid Shallow Breathing Index 0 to 150 Bpm/L 1
The ratio of the respiratory rate to
exhaled tidal volume for
spontaneous breaths.
I:E Ratio I:E Ratio 9.9:1 to 1:99 0.1 for 9.9:1 to 1:9.9
The ratio of inspiratory time to one (1) for 1:10 to
expiratory time. 1:99

Table 8-3: Patient Data Definitions: Range, Units & Resolution (Sheet 2 of 2)

NOTE: Pt. Leak only appears on Patient Data block on Settings screen.

Monitor Screen The monitor screen (Figure 8-30) is the default screen, and is automatically
displayed if the screen has not been touched for 15 minutes. The screen can
also be viewed by pressing the MONITOR button. The screen is shown in
Figure 8-30. The patient data and settings displayed on this screen depend on
the active breath type (Refer to Table 8-4: “Monitor Screen Settings
Displayed” and Figure 8-30.)

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This screen is displayed

in VCV

This screen is displayed

in PCV

This screen is displayed

in NPPV

Figure 8-30: Monitor Screen

Monitor Screen Settings Displayed

Ventilation
Breath Type Monitor Screen Settings Displayed
VCV Rate, Peak Flow, Tidal Volume, PEEP, %O2, Pressure Support
PCV Rate, Inspiration Time, Pressure, PEEP, %O2, Pressure Support
NPPV Rate, IPAP, EPAP, %O2

Table 8-4: Monitor Screen Settings Displayed

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Special Procedures Auto-PEEP Calculation

Esprit allows the operator to calculate Auto-PEEP from an expiratory hold
procedure. This function is active only at the end of a mandatory breath and is
not available in the emergency ventilation mode. Expiratory hold is initiated by
pressing the EXP HOLD button on the front panel. When exhalation ends in the
breath during which the EXP HOLD button is being pressed an exhalation hold
function will begin and will continue only as long as the button is pressed.
During the exhalation hold period the screen shown in Figure 8-31 below will
appear.

Pressure
versus time
waveform.

Figure 8-31: Expiratory Hold Maneuver

While the EXP HOLD button is held, the exhalation valve and the air and O2
valves will be closed. During this period there is no flow of gas into or out of
the patient circuit from Esprit. The operator can monitor the airway pressure by
watching the EXHALATION PAUSE PRESSURE digital display and by watching
the pressure versus time waveform. When the operator determines the airway
pressure has stabilized, the EXP HOLD button should be released. If the
button is held for 5 seconds, Esprit will automatically terminate the maneuver
and perform the calculation if stability was achieved. Esprit then calculates
Auto-PEEP as shown in the equation below:
• Auto-PEEP = Exhalation Pause Pressure - End Exhalation Pressure

NOTE: If the EXP HOLD key is held continuously and the exhalation hold
period exceeds 5 seconds, Esprit automatically terminates the
exhalation hold period and begins a new inspiratory period.

NOTE: If Auto PEEP as calculated in Equation 1: Auto-PEEP = Exhalation

Pause Pressure – End Exhalation Pressure, is negative, Auto-PEEP will
be displayed as “—.”

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Preoperational The preoperational procedure verifies that the ventilator is ready for use on a
Procedure patient.

WARNING: Ensure that an alternative means of ventilation (i.e., a resuscitator or similar

device) is available while the Esprit Ventilator is in use on a patient.

WARNING: DO NOT perform the preoperational procedure when the ventilator is on a

patient.

Follow these steps:

1. Follow the setup procedures in Chapter 5, “Setup”, to prepare Esprit
for use.
2. Connect the patient circuit to be used on the next patient.
3. Install any components that are to be used in line with the patient
circuit (for example, humidifier, O2 monitor, or airway temperature
monitors).

NOTE: All components of the patient circuit must not have leaks in order to
pass SST.

4. Ensure that the ventilator is not on a patient!

5. Hold down the ALARM RESET and 100% O2 keys while the ventilator
is powered up. The operator must confirm that the machine should be
in Diagnostic Mode (Figure 8-32).

Figure 8-32: Entering Diagnostic Mode

6. Press OK to clear the Warning message and enter Diagnostic Mode.

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7. Push USER CONFIG to check time, time format, date and altitude and
set compliance compensation as required (Figure 8-33).

NOTE: If time is found to be incorrect more than once in the preoperational

procedure, an internal battery may have to be replaced. Contact
qualified service personnel or call Respironics Customer Service at
1-800-345-6443.

8. Press START SST to begin Short Self Test, and follow the screen
prompts. Use a cap to plug the patient port of the patient circuit wye
at the prompt.
9. During SST, as each test is performed, the ventilator displays test
results (Figure 8-33). Do not proceed until the ventilator completes
SST without failures.

Push USER
CONFIG to set
time, date,
altitude,
compliance
compensation
enable, and time
format

Any failures
detected during
SST are listed
here

Figure 8-33: SST Results

WARNING: The operator will be warned if the compliance is 9.0 ml/cmH2O (hPa) or
larger. Patients should not be put on a patient circuit that does not meet this
requirement.

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Altitude set

Date set Compliance

compensation
enable/disable

Time format (12 or

Time set 24_hour) set

Backup Battery
(confirm at startup)
enable/disable

Figure 8-34: User Config Screen

10. Once you have reviewed all the parameters on the User Config screen,
the ventilator is ready for patient use. Turn the ventilator off, then on,
without holding down any front panel keys.
11. Ventilator settings from the previous use are in effect at power up.
Select appropriate settings for the next patient as described in this
chapter.

Alarm Testing A procedure is available if the operator wants to test the operation of alarms.
Respironics recommends following the preoperational procedure. (Refer to C,
Procedure
“Alarm Testing Procedure”.)

Where To Go For Help For clinical or technical support, contact Respironics Customer Service at
1-800-345-6443.

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 Chapter 9. Alarms

Introduction The Esprit ventilator provides an easy-to-use hierarchical alarm system that
includes both visual and audible alarms. When the Esprit ventilator detects an
operating condition that requires attention, it generates an alarm. The alarm
system communicates three levels of urgency and priority:
• High Urgency: Alerts the operator that immediate response is
required. (red flashing indicator)
• Medium Urgency: Alerts the operator that prompt response is
required. (yellow flashing indicator)
• Low Urgency: Alerts the operator to a change in the ventilator status.
(yellow continuous indicator)

In most cases, the alarm will have the following audible and visual
components:
• an indicator is illuminated
• a sequence of tones sounds
• a screen alert window appears with a message in it

Visual Alarms The Esprit ventilator includes alarm and status indicators located above the
front panel to provide a visual summary of active alarm conditions. Each of
these indicators is illuminated by either a red, green or yellow light, which will
flash or remain lit, depending on the alarm condition.

Figure 9-1: Alarm Indicators

Pressing the ALARM RESET button in the lower left corner of the front panel
clears the visual indicators for active or auto-reset alarms. If the alarm
condition reoccurs, the visual indicator turns on again.

Alarm messages also appear in an alarm alert insert that appears in any screen
whenever there is a low, medium or high urgency alarm active (Figure 9-2).

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Figure 9-2: Alarm Alerts

Audible Alarms When an alarm condition exists, the Esprit Ventilator will generate a sequence
of audible tones to alert the operator. The sequence varies according to the
urgency and priority level of the alarm:
• High Urgency: The ventilator emits a repeating sequence of five tones.
• Medium Urgency: The ventilator emits a repeating sequence of three
tones.
• Low Urgency: No audible tone emitted. (Med/Low indicator
illuminates and alarm messages appear in the front panel Alerts
window)

When more than one alarm is active, only the highest urgency level alarm is
audibly enunciated. Procedures for silencing audible alarms are described
below.

Alarm Silence
To silence alarms, perform the following:
• Press the ALARM SILENCE button at the bottom left corner of the
Esprit front panel. The audible tone will cease and the alarm silence
indicator will light and remain lit for two minutes. Specific alarms that
cannot be silenced are listed in Table 9-1: “Alarm Alert Messages”.

When ALARM SILENCE is pressed before the end of the two-minute period,
the two-minute timer is reset, and alarm silence begins anew. Pressing ALARM
SILENCE multiple times does not give multiple two-minute silence periods.

If new alarms occur during alarm silence, all visual alarm enunciation
continues. If the Alerts insert is not present, it will appear. The message for
any alarms that occur during the alarm silence period will appear in the Alerts
insert if there are fewer than three messages currently displayed or the new
message is higher priority than one of the currently displayed messages. The
highest three priority messages will be displayed.

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ALARM SILENCE is immediately terminated if ALARM RESET is hit. Any

medium or high priority alarm that is active will immediately begin audible
annunciation.

CAUTION: The Esprit alarm indicators and the Alerts insert should be monitored
closely during the Alarm Silence period to ensure that unexpected
alarms are noticed.

Alarm Reset Automatic Alarm Reset (Auto-Reset)

When the alarm conditions that have caused a medium or high level alarm,
clear, the audible alarm will terminate automatically (auto-reset). However,
after an alarm condition has been corrected, the operator must press the Alarm
Reset button to clear all visual alarm indicators.

Operator-Initiated Alarm Reset

The operator can clear active and auto-reset alarms by pressing the ALARM
RESET button. This clears the alarm messages in the Alerts insert for active
and auto-reset alarms. If the alarm condition reoccurs, the alarm restarts at its
initial level of urgency and elevates as described in Table 9-1: “Alarm Alert
Messages” on page 9-4.

For the operator to clear an apnea alarm, the ALARM RESET button may be
pressed. Once it has been pressed, the ALARM RESET will cancel an existing
apnea alarm and return ventilation to the active mode. If the condition that
triggered the apnea alarm persists after the ALARM RESET button has been
pressed, the apnea alarm will re-trigger. If the patient triggers two successive
breaths in apnea ventilation, Esprit will automatically reset out of apnea
ventilation.

CAUTION: If an alarm persists for no apparent reason, contact Respironics

Customer Service at 1-800-345-6443.

Alarm Reset Terminates Alarm Silence

If ALARM SILENCE is active when ALARM RESET is pressed, the ALARM
SILENCE period will terminate and any active medium or high priority alarms
will become audible.

Alarm Enunciation Volume Control

Under the left hand bottom edge of the front panel is a partially exposed round
control that allows the operator to control the volume of audible alarms (Figure
9-3).

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Alarm Enuciation
Volume Control Knob

Figure 9-3: Alarm Enunciation Volume Control

The volume control can be adjusted between a minimum and maximum to suit
the particular clinical situation.

Alert Messages When the ventilator detects an alarm condition, it presents an Alert insert
below the Patient Data box in the middle of the screen.

While the alarm is active (i.e. visual and audible alarms are still present), the
message in the alert insert appears in bold-faced type. Once the alarm
condition has been corrected, the message automatically switches to regular
face type. Pressing ALARM RESET clears alarm messages.

When the operator presses the ALARM RESET button (described above), the
alarm messages disappear from the alert window.

When the ventilator detects more than three alarm conditions, the three
highest priority alert messages will be displayed.

Alert messages, along with the corresponding alarm descriptions, are listed in
Table 9-1: “Alarm Alert Messages”.

Alarm Alert Messages

Alert Message Description

Air Source Fault A high urgency alarm indicates the internal air source is not
functioning properly, patient ventilation continues using the 100%
O2 gas source if available. Call for service. Cannot be silenced or
manually reset.
Apnea The ventilator triggers a medium urgency alarm condition and
enters Apnea Ventilation mode if no inspiration is started within the
operator set apnea interval while in a non-emergency breathing
mode. It is elevated to high urgency after one minute of Apnea
Ventilation.

Table 9-1: Alarm Alert Messages (Sheet 1 of 4)

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Alarm Alert Messages (Continued)

Alert Message Description

Audible Alarm Failed Primary audible alarm is defective. Alarm cannot be manually reset.
Bad ADC Wrap Sensor Alarm cannot be silenced or manually reset. Call for service.
Bad Bat Volt Sensor Alarm cannot be silenced or manually reset. Call for service.
Bad Int O2 Sensor Alarm cannot be silenced or manually reset. Call for service.
Bad Int Temp Sensor Alarm cannot be silenced or manually reset. Call for service.
Battery Backup On Indicates the Backup Battery is the power source for ventilator
operation. Alarm cannot be silenced.
Exp Valve Stuck Open Alarm cannot be silenced or manually reset. Call for service.
Gas Supplies Lost - SVO A high urgency alarm indicates the oxygen and air source are no
longer operable. Safety valve opens. Check O2 source and internal
air source. Call for service. Cannot be silenced or manually reset.
High Inspiratory Pressure Indicates that circuit pressure exceeds the high pressure limit.
When High Inspiratory Pressure condition occurs, the ventilator
immediately cycles into the exhalation phase and illuminates the
low priority indicator. Then on the second consecutive breath with a
pressure violation, sounds the audible alarm, lights the Alarm High
indicator, and displays High Inspiratory Pressure message.
High Internal O2 Oxygen concentration internal to the enclosure is beyond allowable
levels. Indicative of an internal O2 leak. Alarm cannot be silenced
or manually reset.
High Leak Rate The average estimated leak from the previous breath has exceeded
the set High Leak alarm limit (alarm applies to NPPV mode only).
Medium urgency, escalates to high urgency after 60 seconds. The
alarm cancels when the estimated leak from the previous breath
equals or falls below the alarm setting, if the ventilation type
changes from NPPV to another ventilation mode or if the alarm is
reset by the clinician.
High Minute Volume Indicates total minute ventilation (VE) measured in exhalation is
higher than the set limit. This alarm is available in Volume Control
and Pressure Control modes. It is elevated to high urgency after one
minute.

Note: For Esprit Ventilators with software earlier than version 7.10,
the High Minute Volume alarm is available in Pressure Control only.
High O2 A high urgency alarm indicates that the monitored O2 concentration
is at least 6% above the set value (%O2) for 30 seconds. Verify
operation of the O2 sensor. Alarm cannot be manually reset.
High Respiratory Rate The ventilator triggers a medium urgency alarm if the total
respiratory rate is greater than the operator-set High Respiratory
Rate limit. The ventilator evaluates this alarm condition at the start
of inspiration, after calculating the total respiratory rate including
the just completed breath. It is elevated to high urgency after one
minute.
High Temperature Internal temperature monitor detects higher than allowed
temperatures inside the enclosure. Alarm cannot be silenced or
manually reset.

Table 9-1: Alarm Alert Messages (Sheet 2 of 4)

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Alarm Alert Messages (Continued)

Alert Message Description

I-Time Too Long The ventilator triggers a medium urgency alarm to indicate that a
spontaneous breath has exceeded the maximum allowed inspiratory
time of 3.5 seconds (2.5 seconds in Pediatric mode). The alarm is
elevated to high urgency after two consecutive breaths that meet
the alarm criteria.

Note: For Esprit Ventilators with software earlier than version 7.10,
the alarm is elevated to high urgency after one minute, if still
active. In CPAP it elevates after two consecutive breaths.
Low Backup Battery If the Backup Battery is low, a high priority alarm will be triggered.
Immediately connect an AC power source to avoid a loss of power.
Provide AC power and/or replace the Backup Battery. Alarm cannot
be silenced or manually reset. 5 minutes or less of battery run time
remains.
Low EPAP If the Exhalation Positive Airway Pressure is less than the operator
set Low EPAP Pressure limit for one second, the ventilator signals a
medium urgency condition. If the Low EPAP alarm remains active
for one minute, the ventilator elevates the alarm to high urgency.

Note: A Low EPAP setting of zero (0) will disable this alarm.

Note: If an inspiration is triggered immediately after the mandatory

minimum exhalation time of 200 msec., this alarm will not be
activated unless this condition occurs for three consecutive
breaths.
Low Insp Pressure If the peak airway pressure during any mandatory inhalation is less
than the Low Insp Pressure limit, Esprit will immediately signal a
high priority alarm.

Note: If an inspiration is triggered immediately after the mandatory

minimum exhalation time of 200 msec., this alarm will not be
activated unless this condition occurs for three consecutive
breaths.
Low Minute Volume Indicates the measured patient minute ventilation (VE) is below the
set limit. It is elevated to high urgency after one minute.

Note: A Low Minute Volume setting of zero (0) will disable this
alarm.
Low O2 A high urgency alarm indicates that the monitored O2 concentration
is 18% or at least 6% below set value for 30 seconds. Verify
operation of the O2 sensor. Alarm cannot be manually reset.
Low O2 Supply A high urgency alarm indicates that O2 gas supply is below
acceptable levels and the %O2 setting is above 21%. Check O2 gas
connections and inlet filter. Alarm cannot be manually reset.

Table 9-1: Alarm Alert Messages (Sheet 3 of 4)

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Alarm Alert Messages (Continued)

Alert Message Description

Low PEEP If PEEP is less than the operator set Low PEEP limit for one second
during exhalation, triggers a medium priority alarm. If the Low
PEEP alarm remains active for one minute, the alarm moves to high
priority.

Note: A Low PEEP setting of zero (0) will disable this alarm.

Note: If an inspiration is triggered immediately after the mandatory

minimum exhalation time of 200 msec., this alarm will not be
activated unless this condition occurs for three consecutive
breaths.
Low Tidal Volume The ventilator triggers a medium urgency alarm to indicate that the
NPPV (mandatory or spontaneous breath) tidal volume is less than
the set limit. It is elevated to a high urgency alarm after one
minute.

Note: A Low Tidal Volume setting of zero (0) will disable this alarm.
Low Vt Mandatory The ventilator triggers a medium urgency alarm to indicate that the
VCV or PCV mandatory tidal volume is less than the set limit. It is
elevated to high urgency after one minute.

Note: A Low Vt setting of zero (0) will disable this alarm.

Note: If an inspiration is triggered immediately after the mandatory

minimum exhalation time of 200 msec., this alarm will not be
activated unless this condition occurs for three consecutive
breaths.
Low Vt Spontaneous The ventilator triggers a medium urgency alarm to indicate that the
VCV or PCV spontaneous tidal volume is below the set alarm limit.
It is elevated to high urgency after one minute.

Note: A Low Vt setting of zero (0) will disable this alarm.

O2 Valve Stuck Closed Alarm cannot be silenced or manually reset. Call for service.
Occlusion - SVO Safety Valve opens. The ventilator triggers a high urgency alarm to
indicate that an occlusion has been detected in the patient circuit.
Check circuit tubing for crimped hoses or blockage. Check filters
and humidification devices to ensure they are functioning properly.
Alarm cannot be manually reset.
Restart The ventilator has restarted. If the ventilator repeatedly restarts on
its own, call for service.
Using Default Altitude Ventilator is using default altitude.
Using Default Compliance Ventilator is using default compliance.
Using Default Settings Ventilator is using default settings.

Table 9-1: Alarm Alert Messages (Sheet 4 of 4)

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Alarm Indicators

Figure 9-4: Alarm and Status Indicators

Normal
The Normal indicator, located in the upper left-hand corner above the front
panel, remains lit with a steady green light as long as there are no active or
auto reset alarm conditions present.

Alarm High
The Alarm High indicator, to the right of the Normal indicator, visually
indicates a high priority alarm. When a high priority alarm condition exists, this
indicator flashes red and an audible five tone sequence sounds until the
condition is corrected or reset.

WARNING: A high priority, visual and audible alarm indicates a potentially life-
threatening condition and immediate response is required.

Alarm Med/Low
The Alarm Med/Low indicator, to the right of the Alarm High indicator, visually
indicates a medium or low priority alarm. When a medium priority alarm
condition exists, this indicator will flash yellow and an audible three tone
sequence will be heard until the condition is corrected. When a low priority
alarm condition exists, this indicator remains lit with a steady yellow light,
until the alarm is reset.

Vent Inop
The Vent Inop indicator signals the operator that the ventilator is not capable
of supporting ventilation and requires service. During a ventilator inoperative
condition, the ventilator enters a safe state, where the safety valve is opened
and new alarm condition detection is discontinued. If the ventilator is attached
to a patient when this condition is detected, the ventilator must be replaced
immediately.

WARNING: Vent Inop is a serious condition, which is indicated by both visual and
audible alarms. If the ventilator is attached to a patient when Vent Inop
occurs, the patient must be supported with another means of life support
ventilation.

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When a ventilator inoperative condition is detected, the Vent Inop indicator

will display a steady red light, and the ventilator will sound a five-tone audible
alarm sequence.

The Vent Inop alarm cannot be reset by an operator. It cannot be auto-reset or

silenced. The ventilator must be serviced by a qualified service representative,
in order for the Vent Inop audible and visual alarms to be cleared.

Safety Valve
This indicator signals that the Safety Valve is open and the ventilator is not
providing breath support to the patient. It is accompanied by a five-tone
audible alarm sequence and a Safety Valve Open message in the touch screen
display.

The Safety Valve opens automatically whenever the ventilator is not able to
provide breath support to the patient. It allows the patient to spontaneously
breathe room air through the ventilator system.

The Safety Valve Open condition is normal during start-up and restart, and it
automatically turns off when the start-up sequence is complete. If this
condition occurs at any other time, it cannot be reset. Immediately use an
alternative ventilation source and call for service.

WARNING: When the safety valve open indicator is lit, the ventilator does not provide
any ventilatory support to the patient. Immediately use a backup means of
ventilatory support.

Alarm Silence
The indicator , located in the center of the indicators at the top of the front
panel, will illuminate with a steady yellow light whenever the operator presses
the alarm silence control (located at the bottom left of the front panel). The
indicator remains lit for two minutes (120 seconds) after the Alarm Silence
control is pressed. If Alarm Silence is active and an alarm takes place that
involves an operator alarm limit being exceeded, the alarm will be enunciated
visually, but Alarm Silence will continue to be active and the Alarm Silence
timer will continue to time out. Alarms that can not be silenced are listed in
Table 9-1: “Alarm Alert Messages” on page 9-4. If Alarm Reset is hit at any
time during the Alarm Silence period, the Alarm Silence period is terminated.
If any high or medium priority alarm condition exists after pressing Alarm
Reset, an audible alarm sounds.

WARNING: Visually monitor the patient and ventilator during the Alarm Silence period
to ensure that alarms do not go undetected. Allowing alarm conditions to
continue without intervention may result in harm to the patient and/or
ventilator.

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 Chapter 10. Care and Maintenance

General Information Procedures for Esprit Ventilator cleaning, sterilizing and periodic maintenance
must be performed to ensure consistent ventilator operation. Institutional
policies may also provide guidelines, procedures, and schedules for cleaning
and sterilizing equipment before, during and after patient use.

In addition, recommended methods and time frames for performing all

necessary care and maintenance procedures for the Esprit Ventilator are
presented in this section.

Respironics recognizes that cleaning, sterilization, sanitation and disinfecting

practices vary widely among health care institutions. It is not possible for
Respironics to specify or require specific practices that will meet all needs, or
to be responsible for the effectiveness of cleaning, sterilization, and other
practices carried out in the patient care setting.

General procedures for cleaning and sterilizing the Esprit Ventilator are
described in the following sections. Some ventilator parts must be
disassembled before cleaning and sterilizing. (Refer to “Removing and
Replacing Internal Air Source Inlet Filter” on page 10-9.)

Cleaning When cleaning parts, avoid the use of hard brushes or other instruments likely
to cause surface damage.

CAUTION: Care should be taken when cleaning the Touch Display. (Refer to Figure
8-2 on page 8-3.). A soft moist cloth should be used that does not drip
water and/or soap solution when in contact with the display. After
cleaning and rinsing with a damp cloth, remove all moisture with a dry,
soft cloth. Never allow solutions of any kind to collect on the bottom
bezel of the display. Never use a brush or device that can cause
abrasion to clean the touch display or its bezel, they will cause
irreparable damage.

CAUTION: Follow the detergent manufacturer’s instructions. Exposure to detergent

solution stronger than necessary can shorten the useful life of the
product. Rinse parts thoroughly to remove all detergent residues. Wipe
parts dry. Detergent residue can cause blemishes or fine cracks,
especially on parts exposed to elevated temperatures during
sterilization.

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Care and Maintenance

Sterilization
WARNING: Do not expose expiratory and inspiratory bacteria filters or reusable patient
tubing to ETO gas.

NOTE: Because conditions and practices in health care institutions vary, this
manual can only describe general guidelines. It is the user’s
responsibility to ensure the validity and effectiveness of the methods
used.

Do not clean, disinfect, sterilize or reuse disposable products.

Steam Autoclaving
The O2 Sensor Tee (P/N 1001736) and the O2 Sensor coupling (P/N
1002505) may be steam autoclaved.

CAUTION: Autoclavable parts will withstand repeated steam autoclaving at

temperatures not to exceed 135 C (275ºF).

1. Ensure that the part has been disassembled, cleaned, and partially
reassembled, as applicable.
2. Separately wrap the part in muslin or equivalent paper wrapper.
3. Steam autoclave according to the autoclave manufacturers
instructions. In many institutions it may be routine to place a
biological indicator in the autoclave load as a subsequent test for
sterility.
4. Aseptically store parts until used.

CAUTION: DO NOT autoclave the Esprit Ventilator.

Chemical Disinfecting
The O2 Sensor Tee (P/N 1001736) and the O2 Sensor coupling (P/N
1002505) may be chemically disinfected.

For chemically disinfected parts, reassemble after disinfecting.

CAUTION: Formaldehyde, phenol-based, and quaternary ammonium compound

(QUATS) disinfectants are not recommended because these agents can
cause cracking and crazing of plastic parts. Exposure of components to
disinfectant concentrations stronger than required or for excessive time
may shorten product life. Parts should be thoroughly rinsed and dried to
prevent spotting and blemishes when exposed to elevated temperatures.

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1. Separately immerse each part in the chemical disinfectant, i.e.

ammonia (15% solution), bleach (10% solution) or commercial,
hospital grade disinfectant, etc. Follow the disinfectant manufacturers
directions for the solution concentration, immersion times, and other
conditions for disinfecting. The use of a laminar air flow hood during
the chemical disinfecting process is recommended.
2. Thoroughly rinse and dry each part.
3. Aseptically reassemble (as required) and store the part until use.

Ventilator Exterior
Wipe clean with a damp cloth and mild detergent. Do not use liquid or aerosol
bactericide. Do not allow moisture to come in contact with the touch panel
screen or to collect between the keypad and front bezel assembly.

CAUTION: DO NOT allow liquid to penetrate the ventilator rear or front panel. DO
NOT attempt to sterilize the ventilator by exposing to ETO gas. DO NOT
steam-autoclave.

CAUTION: Care should be taken when cleaning the Touch Display. (Refer to Figure
8-2 on page 8-3.). A soft moist cloth should be used that does not drip
water and/or soap solution when in contact with the display. After
cleaning and rinsing with a damp cloth, remove all moisture with a dry,
soft cloth. Never allow solutions of any kind to collect on the bottom
bezel of the display. Never use a brush or device that can cause
abrasion to clean the touch display or its bezel, they will cause
irreparable damage.

Patient Circuit Support Arm

Wipe the Patient Circuit Support Arm clean with alcohol or bactericide.

O2 Gas Supply Filter/Water Trap

Wipe exterior of the O2 Gas Supply Filter/Water Trap with a mild solution of
soap and water. Rinse and dry parts. Do not steam-autoclave, chemically
disinfect, or expose to ETO gas. Do not allow liquid to migrate into the inlet
port.

Reusable Patient Circuit Tubing, Couplings and Connectors

Disassemble and clean manually followed by steam-autoclave. Follow all
institutional guidelines for autoclaving.

Visually inspect tubing for nicks, cuts and holes prior to use with the Esprit
Ventilator.

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Care and Maintenance

Reusable In-line Water Traps

Disassemble and clean water traps as per the manufacturers instructions.
Inspect for cracks or leaks prior to use with the Esprit Ventilator. Replace if
cracked or leaking.

Bacteria Filters Bacteria filters are typically used on the inspiratory and expiratory port
connections on the front of the Esprit Ventilator. Filter locations are illustrated
below.

Expiratory Filter Inspiratory Filter

Figure 10-1: Inspiratory and Expiratory Bacteria Filter Locations

The inspiratory filter port is a 22mm standard connector. Use the filter
supplied with the ventilator.

The expiratory port includes a heated exhalation compartment. Use the filter
supplied with the ventilator.

WARNING: Disposable or single-patient filters must be discarded between patients. Do

not chemically disinfect or expose single patient use bacteria filters to ETO
gas.

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Removing and Replacing Inspiratory Bacteria Filter

Follow the steps outlined below to remove and replace the inspiratory bacteria
filter.

Figure 10-2: Removing and Replacing Inspiratory Bacteria Filter

1. Disconnect circuit tubing (1) from inspiratory bacteria filter outlet (2).
2. Disconnect filter (3) from Esprit gas outlet (4). If optional O2 sensor is
installed, ensure it is not dislodged. When used, O2 sensor is located
between gas outlet (4) and filter (3).
3. Insert new filter onto Esprit gas outlet (4) with flow direction indicator
(on the filter) pointing away from the ventilator.
4. Reconnect circuit tubing (1) to new filter outlet (2).

Removing and Replacing Expiratory Bacteria Filter

Refer to the illustration below and follow the steps outlined below to remove
and replace the expiratory bacteria filter.

WARNING: The expiratory filter housing may be hot if removed from the ventilator
immediately after use. Wait 15 minutes after turning off ventilator power
before removing the heated expiratory bacteria filter. Exercise caution when
handling the filter housing.

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Figure 10-3: Removing and Replacing Expiratory Bacteria Filter

1. Disconnect circuit tubing from filter inlet (not shown).

2. Unscrew knob (1) to unlatch retaining bracket (2).
3. Open retaining bracket (2).
4. Use tabs (3) to gently remove heater housing (5) and filter (4) from
the ventilator.
5. Do not touch heater housing. If ventilator has not been turned off and
heater housing has not been allowed to cool, it may be hot to the
touch.
6. Carefully remove filter (4) from heater housing (5).
7. Tap filter input port (6) if filter (4) cannot be easily removed from
housing (5).
8. Insert new filter into housing (5).
9. Reinstall housing (5) and new filter and close retaining bracket (2).
10. Connect circuit.

Periodic This section includes detailed operator maintenance.

Maintenance

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Schedule for Periodic Maintenance

Frequency Component Maintenance

Required daily Inspiratory bacteria filter Check filters daily for occlusions, cracks, and
Expiratory bacteria filter tears.
Ensure that the ventilator functions normally with
both filters in place.
Monitor performance of disposable filters and
replace as needed.
Oxygen supply water trap Check and empty as required every shift.
and filter
250 Hours Air Inlet & Fan Filters Inspect and clean.
12,500 Hours 12,500 hour preventive 12,500 hour preventive maintenance kit, includes
maintenance kit, test and installation instructions as well as
P/N 1001733 replacement parts.
N/A Backup Battery If you have the backup battery option, refer to
section 13-B for charging and maintenance
instructions.

Table 10-1: Schedule For Periodic Maintenance

NOTE: Because some environments cause a quicker collection of lint and dust
than others, inspect and clean the fan filters more often than every 250
hours if necessary.

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Removing Cooling Filter

2 1

Figure 10-4: Removing Cooling Filter

Refer to Figure 10-4.

1. Remove black filter retaining bracket (1). (Pry off if necessary.)
2. Wash filter (2) in soapy water.
3. Dry thoroughly before reinstalling.

CAUTION: Do not remove any screws from the cooling fan area. Removing screws
from this area will result in damage to internal components.

Removing and Replacing O2 Input Filter Element

5
4

3 2

Figure 10-5: Removing & Replacing O2 Input Filter Element

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Refer to Figure 10-5.

1. Disconnect O2 Hose (1).
2. Unscrew filter housing (3).
3. Unscrew filter element retaining screw (4).
4. Remove and replace filter element (5).
5. Reconnect filter element retaining screw (4).
6. Reinstall filter housing (3).
7. Reconnect O2 hose (1).
8. Check system for leaks prior to patient use.

Removing and Replacing Internal Air Source Inlet Filter

1 2

Pull filter out from

underside of duct.

Figure 10-6: Removing & Replacing Internal Air Source Inlet Filter

Refer to Figure 10-6. Figure 10-6 shows exploded view of the duct (2) and
filter (1), but it does not have to be disassembled.
1. Move the ventilator so that there is easy access to the underside of the
internal air source duct (2).
2. The internal air source filter (1) can be removed manually. The filter
can be reached from under the internal air source duct (2) as
indicated by the arrow.
3. Wash internal air source filter (1) with mild soap and water.
4. Rinse thoroughly then pat dry.
5. Reinstall internal air source filter (1) from underneath the duct (2) in
the same fashion it was removed.

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Storage If you need to store the ventilator for fifteen days or more, ensure that the
altitude, temperature and humidity of the storage site fall within the following
ranges:
• Environmental Temperature: -20 to 60°C (-4 to 140° F)
• Relative Humidity: 10 to 100% noncondensing
• Maximum Altitude: 6,560 m (20,000 ft.)

Repairs For technical service or repairs not included in this chapter, refer to the Esprit
Ventilator Service Manual, P/N 580-1000-02 (English language), or contact
Respironics Customer Service at 1-800-345-6443.

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 Chapter 11. Diagnostics

Esprits Diagnostic Mode allows you to:

• Run short self test (SST)
• Run extended self test (EST)
• Run hardware diagnostics to help you troubleshoot SST or EST failures
• Check the software revision of the ventilator
• Set user configuration, including:
• time and date
• compliance compensation enable/disable
• local altitude and time format
• backup battery (confirm at startup) enable/disable
• Check diagnostic codes.

WARNING: The patient must be disconnected from the ventilator before entering the
Diagnostic Mode since normal ventilation is suspended.

CAUTION: Troubleshooting and repair should be performed only by a qualified

service technician.

NOTE: The “Hardware” function and EST in the Diagnostics Mode should only
be run by qualified personnel.

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Diagnostics

Entering Diagnostic To enter Esprit’s Diagnostic Mode, hold down the ALARM RESET and 100%
Mode O2 keys for approximately 5 seconds while you turn on the ventilator. A
message appears on the ventilator asking the user to confirm that the patient
is disconnected before entering Diagnostic Mode (Figure 11-1). Press OK to
enter Diagnostic Mode.

Figure 11-1: Entering Diagnostic Mode

Once you’ve entered Diagnostic Mode, you can select any of diagnostic
functions by pressing its button. Change values in Diagnostic Mode the same
way you change ventilator settings.

Diagnostic Functions Short Self Test (SST)

SST verifies the integrity of the patient circuit tubing by measuring its leak
rate and compliance. SST also tests critical hardware components, including
the safety valve, flow sensors and autozero solenoids. Perform SST before
every patient circuit change. If SST passes, the ventilator and all attached
components are ready for use.

WARNING: Do not use a ventilator that has failed SST without verifying operational
readiness by other means. Doing so may place a patient at risk.

WARNING: Never initiate SST while the patient is connected to the ventilator. The high
airway pressures generated during SST can injure a patient.

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Equipment required to run SST:

• Patient circuit to be used on the next patient including any devices
installed in line with the circuit (such as a humidifier, O2 sensors,
and/or temperature sensor).
• Plug or cap for the patient wye

Follow these steps to run SST:

1. Connect the circuit to be used on the next patient, to the ventilator.
2. Press the SST button (Figure 11-1) on the diagnostic screen.
3. Press the Start SST button to begin the test.
4. When prompted, unplug the patient wye and press the OK button.
5. When prompted, plug the patient wye and press the OK button.
6. When SST completes successfully, press the OK button.

When SST is completed the calculated circuit compliance is displayed on the

screen.

Extended Self Test EST verifies the overall functional integrity of the ventilator by testing all
critical hardware subsystems and components. Perform EST between patients
(EST)
as part of preventive maintenance, a performance verification, or if the
operational integrity of the ventilator is in question. EST is typically run by
qualified trained personnel.

WARNING: Never initiate EST while the patient is connected to the ventilator. The high
airway pressures and gas flows generated during EST can injure a patient..

WARNING: Do not use a ventilator that has failed EST without verifying operational
readiness by other means. Doing so may place a patient at risk.

CAUTION: If the optional external O2 sensor is in-line then it must be calibrated

during EST.

Equipment required to run EST:

• Patient circuit
• Plug for the patient wye
• High pressure O2 source

Follow these steps to run EST:

1. Enter Diagnostic Mode as described “Entering Diagnostic Mode” on
page 11-2.
2. Connect a patient circuit to the ventilator.
3. Press the EST button on the diagnostic screen (Figure 11-1).

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4. Press START EST to begin EST.

5. Follow the prompts.
6. When EST completes successfully, press the OK button.

Hardware
The Hardware function allows a trained service technician to operate critical
components separately to help identify a faulty component in the event that
the ventilator fails SST, EST, or performance verification testing. For more
information on the Hardware function, see the Esprit Ventilator Service Manual
(P/N 580-1000-02).

Software
The Software function displays the ventilators serial number, software part
numbers and version numbers and the part numbers of other critical
components.

User Config
The User Config function allows you to:
• Set the date and time when first setting up the ventilator.
• Set the altitude for the location of the ventilator. This setting allows
for more accurate tidal volume delivery.
• Enable or disable the automatic patient circuit compliance
compensation feature. Compliance compensation corrects the
delivered volumes of VCV mandatory breaths for patient circuit
compliance. It also corrects all exhaled volume for patient circuit
compliance volume. The COMPLIANCE button is grey when
compliance compensation is disabled and white when compliance
compensation is enabled.
• Set the time format (AM/PM or 24 hour).
• Enable or disable the confirmation that the backup battery is
connected each time that the machine powers on.

Diagnostic Codes
The Diagnostic Codes function allows you to review the diagnostic log in
ventilator memory.

To view the diagnostic codes, press the DIAGNOSTIC CODE button on the
diagnostic screen. The ventilator displays the following information:
• Number: Diagnostic codes are numbered in reverse order of
occurrence (most recent first).

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• Code: The number assigned to a specific diagnostic code, used in

determining the cause of a possible failure.
• Repeat: If the same code occurs consecutively, this parameter will be
incremented rather than creating a new entry in the log. For example,
if the diagnostic code 1002 occurs three consecutive times, it is
logged as diagnostic code 1002 and the repeat column is 2. The
repeat column increments until a different diagnostic code occurs.
• Time: Diagnostic codes are time stamped in hour:minute:second
format (for example: 09:15:23). When the same diagnostic code
repeats, the time stamp represents the most recent occurrence of the
diagnostic code.
• Date: Diagnostic codes are date stamped in month/day/year format (for
example: 03/12/98). When the same diagnostic code repeats, the date
stamp represents the most recent occurrence of the diagnostic code.
• Corrupted: The microprocessor cross checks the data in memory prior
to display. If it determines that the memory contents have been
corrupted it logs a YES indicating that the memory contents validity is
suspect.

Diagnostic codes, associated with EST and SST are only recorded the first time
the failure is encountered.

The log holds the last 20 diagnostic codes. The screen can only display 10
codes at a time. Press NEXT PAGE button to see the next group of codes or
PREV PAGE to view the previous group.

The CLEAR CODES button allows a qualified service technician to delete

codes from the log. Because diagnostic codes provide the primary means of
fault diagnosis, they should only be cleared by or under the advice of qualified
personnel.

CAUTION: Diagnostic codes should only be cleared by qualified personnel.

Table 11-1: “Diagnostic Codes and Descriptions”, summarizes some

diagnostic codes and their descriptions. The codes and descriptions for SST
and EST are identical except that SST codes are preceded by a 2 and EST
codes are preceded by a 3. For example, if code 106 occurred during a SST it
would be logged as 2106. If it occurred during an EST, it would be logged as
3106.

WARNING: If any of the diagnostic codes, other than diagnostic code 1, 3, 2000, 3000,
5000, 5001, 5002, 8003 , or 8004 occur, remove the ventilator from
service and contact trained service personnel.

WARNING: Use of an Esprit ventilator that has not passed SST or EST is against the
strongest recommendation of Respironics.

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Diagnostic Codes and Descriptions

Code Description
1 Normal mode startup
3 Diagnostic Startup

2XXX Short Self Test

2000 SST Passed
2106 Patient Circuit Leak
2107 Inh Pressure Too Low
2110 Check Valve 3 Leak
2125 Inhalation Pressure/Exhalation Pressure Disagreement
2128 Circuit Compliance Out of Range
2129 Pressure Leak Out of Range
2130 Safety Valve Cannot Open
2131 Patient Wye Not Blocked
2134 Cannot Calibrate Air Flow Sensor
2135 Cannot Calibrate O2 Flow Sensor
2136 Cannot Calibrate Exh Flow Sensor
2137 Verify Failure—Air Flow Sensor Cal
2138 Verify Failure—O2 Flow Sensor Cal
2139 Verify Failure—Exh Flow Sensor Cal
2140 Cannot Erase Flow Sensor Tables
2141 Cannot Open Inh Autozero Solenoid
2142 Cannot Open Exh Autozero Solenoid
2152 Patient Wye Not Unblocked

3XXX Extended Self Test

3000 EST Passed
3100 Canceled By User
3101 Air Stepper Motor Outside Range
3102 O2 Stepper Motor Outside Range
3103 Air Flow Outside Range
3104 O2 Flow Outside Range
3105 Exh Flow Outside Range
3106 Patient Circuit Leak
3107 Inh Pressure Too Low
3108 Exh Pressure Outside Range
3109 Check Valve 2 Leak

Table 11-1: Diagnostic Codes and Descriptions (Sheet 1 of 3)

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Diagnostic Codes and Descriptions (Continued)

Code Description
3110 Check Valve 3 Leak
3111 O2 Not Connected
3112 O2 Not Disconnected
3113 FiO2 Sensor Sample Out of Range
3114 FiO2 Sensor Average Out of Range
3115 Primary Audio Not Sounding
3116 Backup Audio Not Sounding
3117 Crossover Circuit Fault
3118 Blower Off Switch Failure
3119 Blower DAC Failure
3120 Pressure Relief Valve Cracking Pressure Too High
3121 Pressure Relief Valve Cracking Flow Not Stable
3122 Pressure Relief Valve Cracking Pressure Too Low
3123 O2 Valve Cracking Flow Outside Range
3124 O2 Valve Full Flow Outside Range
3125 Air Flow Sensor/Exh Flow Sensor Disagreement or Inhalation Pressure/Exhalation
Pressure Disagreement
3126 O2 Flow Sensor/Exh Flow Sensor Disagreement
3127 Heated Filter Backpressure Out of Range
3128 Circuit Compliance Out of Range
3129 Pressure Leak Out of Range
3130 Safety Valve Cannot Open
3131 Patient Wye Not Blocked
3132 keyboard Failure
3133 Rotary Knob Failure
3134 Cannot Calibrate Air Flow Sensor
3135 Cannot Calibrate O2 Flow Sensor
3136 Cannot Calibrate Exh Flow Sensor
3137 Verify Failure—Air Flow Sensor Cal
3138 Verify Failure—O2 Flow Sensor Cal
3139 Verify Failure—Exh Flow Sensor Cal
3140 Cannot Erase Flow Sensor Tables
3141 Cannot Open Inh Autozero Solenoid
3142 Cannot Open Exh Autozero Solenoid
3143 Air Step Position for Open—Outside Range
3144 Air Step Position for Midpoint—Outside Range

Table 11-1: Diagnostic Codes and Descriptions (Sheet 2 of 3)

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Diagnostic Codes and Descriptions (Continued)

Code Description
3145 Air Step Position for Close—Outside Range
3146 O2 Step Position for Open—Outside Range
3147 O2 Step Position for Midpoint—Outside Range
3148 O2 Step Position for Close—Outside Range
3149 Exh Step Position for Open—Outside Range
3150 Exh Step Position for Midpoint—Outside Range
3151 Exh Step Position for Close—Outside Range
3152 Patient Wye Not Unblocked
3153 Touchscreen Failure
3154 LED Indicator Failure
3155 Remote Alarm Not Sounding

5XXX Safety Valve Open or Backup Battery Not connected

5000 Occlusion - Safety Valve Open Alarm
5001 Gas Supplies Lost - Safety Valve Open Alarm
5002 Backup Battery Not Connected

8XXX Software Diagnostic information

8003 Software Option Button Failure
8004 Insufficient Blower Current

Table 11-1: Diagnostic Codes and Descriptions (Sheet 3 of 3)

WARNING: Please contact Respironics Customer Service at 1-800-345-6443 or

consult your service manual if any diagnostic codes are encountered.

Information
The Information function is reserved for future expansion.

Option
The Option function is reserved for future expansion.

Self Test Introduction

Esprit has an extensive system of checks designed into the system to ensure
that it operates safely and detects fault conditions that can compromise the
performance of the system as a ventilator. These checks include hardware that
checks the integrity of the software and software that checks the hardware to

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ensure that it is operating within normal ranges. These checks are described
below.

Self-Test Hardware
The self-test hardware involves hardware components that check the integrity
of the software. The hardware components that perform these checks are the
watchdog timer and the bus activity monitor.
• Watchdog Timer: The watchdog timer is a timer that the software must
reset. If the timer times out it causes a reset that restarts Esprit as if
the power switch had been turned on. Normally the software resets the
watchdog timer and it never times out.
• Bus Activity Monitor: The bus activity monitor is a timer similar to the
watchdog timer. The bus activity monitor timer is a timer that only
times out if there has been no activity on the microprocessor bus. If
there is no activity on the bus, it would indicate there is a malfunction
of some kind and the Esprit microprocessor is restarted in the same
way that the watchdog timer does.

Power On Self Test (POST)

POST is the test that Esprit does when the machine power is turned on or if
there has been a potential fault detected by the watchdog timer or the bus
activity monitor. POST has the constraint that it must be able to run safely
when Esprit has a patient attached. POST checks the integrity of critical
system electronics such as the self test hardware and microprocessor
electronics. POST also tests other critical ventilator components that can be
tested.

A primary objective of POST is to ensure that the watchdog timer and the bus
activity monitor hardware are working and will catch software malfunctions.
These are critical components of the Esprit safety system and therefore POST
tests these components every time it runs.

POST also checks all critical digital hardware, including the processor,
program memory, data memory, and functions of various measurement
systems.

POST also checks pneumatic components that can be safely tested with the
safety valve open.

If all these tests pass, Esprit will operate as a ventilator.

Built-In Test
When Esprit is operating as a ventilator it is constantly making reasonableness
checks on the operation of the hardware to ensure that failures have not
occurred and that the hardware appears to be operating normally. Also while

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the microprocessor is operating there is execution time available that is not

required for ventilator operation. When execution time is available, the Esprit
microprocessor runs many of the hardware tests that are run during POST.
These include Program memory, RAM memory, and other measurements that
can be tested without interfering with the operations of the ventilator.

Esprit’s safety system of hardware checking software and software checking

hardware means that Esprit only operates as a ventilator if the extensive
constraints of the safety system are met.

Restart
During normal operation, the ventilator performs background checks to ensure
the integrity of the system. If a problem is detected, the ventilator enters the
“restart” sequence, in which it opens the safety valve while it performs
additional integrity checks. Restart is 10 to 20 seconds, depending upon the
reason for the restart. The ventilator sounds an alarm and displays a visual
message indicating the unit is in a restart sequence. In some cases, a
countdown timer will display the number of seconds remaining until the
ventilator completes the restart cycle. If, during the restart sequence, an
actual problem is confirmed, the ventilator enters the “Vent Inop” state, in
which it activates audible and visual alarms while the safety valve remains
open. Alternatively, if at the end of the restart sequence the ventilator
determines it is safe to continue operation, the unit will return to normal
ventilation.

NOTE: A “restart” is an infrequent event.

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 Chapter 12. Technical Specifications

Breath Types
Breath Types
Volume Controlled Ventilation VCV
Pressure Controlled Ventilation PCV
Non-Invasive Positive Pressure Ventilation NPPV
Apnea Ventilation

Table 12-1: Breath Types

Modes
Modes
Assist/Control (A/C) VCV, PCV
SIMV VCV,PCV
CPAP VCV, PCV
Spont/T NPPV
Spont NPPV

Table 12-2: Modes

Volume Ventilation Resolution is one unit unless otherwise noted (cmH2O is considered
Settings, Ranges & numerically equivalent to hPa).

Resolution Volume Ventilation Settings, Ranges & Resolution

Setting Range
Respiratory Rate 1 to 80 Bpm
Tidal Volume 50 to 2500 mL
Peak Inspiratory Flow 3 to 140 Lpm (Compliance compensated, actual to 200 Lpm)
PEEP 0 to 35 cmH2O (hPa)
PSV Pressure 0 to 100 cmH2O (hPa)

Table 12-3: Volume Ventilation Settings, Ranges & Resolution (Sheet 1 of 2)

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Volume Ventilation Settings, Ranges & Resolution (Continued)

Setting Range
Inspiratory Trigger
(I-trigger)

Pressure Sensitivity -20 to -0.1 cmH2O (hPa) (Resolution is .1 cmH2O (hPa))

Flow Sensitivity 0.5 to 20 LPM (Resolution is .1 LPM)

Expiratory Trigger
(E-Cycle)

% Peak Flow 10 to 80% of inspiratory peak flow

Rise Time 0.1 to 0.9 seconds (Resolution is 0.1 second)
%O2 21% to 100%
Insp. Hold 0 to 2.0 seconds (Resolution is 0.1 second)
Flow Waveform Descending ramp, square
Patient Type Adult/Pediatric

Table 12-3: Volume Ventilation Settings, Ranges & Resolution (Sheet 2 of 2)

Pressure Control Resolution is one unit unless otherwise noted (cmH2O is considered
Ventilation Settings, numerically equivalent to hPa).

Ranges & Resolution

Pressure Control Ventilation Settings, Ranges & Resolution

Setting Range
Apnea Rate 1-80 Bpm
Respiratory Rate 1 to 80 Bpm
PCV Pressure 5 to 100 cmH2O (hPa) (Relative to PEEP)
Inspiratory Time 0.1 to 9.9 seconds (Resolution is 1 second)
PEEP 0 to 35 cmH2O (hPa)
PSV Pressure 0 to 100 cmH2O (hPa) (Relative to PEEP)
Inspiratory Trigger
(I-trigger)

Pressure Sensitivity -20 to -0.1 cmH2O (hPa) (Resolution is .1 cmH2O (hPa))

Flow Sensitivity 0.5 to 20 LPM from base flow of 3 LPM above sensitivity (Resolution is
.1 LPM)
Expiratory Trigger
(E-Cycle)

% Peak Flow 10 to 80% of inspiratory peak flow

Table 12-4: Pressure Control Ventilation Settings, Ranges & Resolution (Sheet 1 of 2)

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Pressure Control Ventilation Settings, Ranges & Resolution (Continued)

Setting Range
Rise Time 0.1 to 0.9 seconds
%O2 21% to 100%
Patient Type Adult/Pediatric

Table 12-4: Pressure Control Ventilation Settings, Ranges & Resolution (Sheet 2 of 2)

Non-Invasive Positive Resolution is one unit unless otherwise noted (cmH2O is considered
numerically equivalent to hPa).
Pressure Ventilation
Settings, Ranges &
Resolution Non-Invasive Positive Pressure Ventilation Settings, Ranges & Resolution

Setting Range
Respiratory Rate 1 to 80 Bpm
EPAP 2 to 25 cmH2O (hPa)
IPAP 2 to 35 cmH2O (hPa)
Inspiratory Time 0.1 to 9.9 seconds (Resolution is .1 second)
Rise Time 0.1 to 0.9 seconds
Inspiratory Trigger
(I-tigger)

Flow Sensitivity 0.5 to 20 LPM from base flow of 3 LPM above sensitivity (Resolution is .1
LPM)
Expiratory Trigger
(E-Cycle)

% Peak Flow 10 to 80% of inspiratory peak flow

%O2 21% to 100%
Apnea Rate 1-80 Bpm
Patient Type Adult/Pediatric

Table 12-5: Non-Invasive Positive Pressure Ventilation Settings, Ranges & Resolution

Maximum delivered flow during pressure controlled breaths in NPPV is limited

to 100 LPM for the pediatric patient type.

Apnea Ventilation Considered equivalent to Assist Control with Apnea Rate in VCV and PCV. In
NPPV only mandatory breaths are delivered, triggered either at the Apnea Rate
or by the patient.

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Value Entry Message If the operator enters a value that is outside the operational limits of the Esprit
Ventilator, the operator will be shown a message window on the screen. Once
the operator acknowledges the message, the Esprit Ventilator returns to the
value modification display without changing the value.

Assist/Control Ventilation
Value Entry Reasonability Checks

Item Limit Exceeded Message

Apnea Rate I:E Ratio>3:1 I:E Ratio must be less than or equal to 3:1.
Check Vt, Peak Flow, or Insp. Hold
Peak Flow I:E Ratio>3:1 I:E Ratio must be less than or equal to 3:1.
Check Vt, Apnea Rate, or Insp. Hold.
Tidal Volume I:E Ratio>3:1 I:E Ratio must be less than or equal to 3:1.
Check Flow, Apnea Rate, or Insp. Hold.
Insp. Hold I:E Ratio>3:1 I:E Ratio must be less than or equal to 3:1.
Check Vt, Apnea Rate or Peak Flow.
Waveform I:E Ratio>3:1 I:E Ratio must be less than or equal to 3:1.
Check Vt, Peak Flow or Apnea Rate.
I-Time I-Time>9 sec. I-Time must be less than or equal to 9 sec.
Check Vt, Peak Flow, Insp. Hold or Waveform.

Table 12-6: Assist/Control Ventilation Value Entry Reasonability Checks

Pressure Control Ventilation

Value Entry Reasonability Checks

Item Limit Exceeded Message Changed

Apnea Rate I:E Ratio>4:1 I:E Ratio must be less than Readjust the Apnea Rate or
or equal to 4:1.Check I- adjust I-Time or Rate.
Time.
I-Time I:E Ratio>4:1 I:E Ratio must be less than Readjust the I-Time or
or equal to 4:1.Check adjust Apnea Rate or Rate.
Apnea Rate.
I-Time I-Time<Rise Time I-Time must greater than or Increase the Rise Time or
equal to Rise Time. increase the I-Time.
Rise Time Rise Time>I Time Rise Time must be less Decrease the Rise Time or
than I-Time. increase the I-Time.

Table 12-7: Pressure Control Ventilation Value Entry Reasonability Checks

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Non-Invasive Ventilation
Value Entry Reasonability Checks

Item Limit Exceeded Message Changed

Apnea Rate I:E Ratio>4:1 I:E Ratio must be less than Readjust the Apnea Rate or
or equal to 4:1. Check I- adjust I-Time or Rate.
Time.
I-Time I:E Ratio>4:1 I:E Ratio must be less than Readjust the I-Time or
or equal to 4:1. Check adjust Apnea Rate or Rate.
Apnea Rate.
IPAP IPAP<EPAP IPAP must be greater than Readjust IPAP higher or
or equal to EPAP. adjust EPAP lower.
EPAP EPAP>IPAP EPAP must be less than or Readjust EPAP lower or
equal to IPAP. adjust IPAP higher.
Rise Time Rise Time>I Time Rise Time must be less Decrease the Rise Time or
than I-Time. increase the I-Time.

Table 12-8: Non-Invasive Ventilation Value Entry Reasonability Checks

General Value Entry Reasonability Checks

Item Limit Exceeded Message Changed

Apnea Apnea Rate<Set Rate Apnea Rate must be Increase the Apnea Rate or
greater than or equal to the decrease the Rate.
Set Rate.

Table 12-9: General Value Entry Reasonability Checks

Patient Data Screen Monitored patient data is displayed when Patient Data is pressed. Patient data
ranges, resolution, units, and accuracy specifications are provided in the table
below. Minute volume data is based on an eight breath average.

Patient Data Range, Resolution, Units & Accuracy

Patient Data Display Range Units Resolution Accuracy

Exhaled Minute 0.00 to 99.9 L 0.01 for 0.00-9.99; ±10%
Volume 0.1 for 10.0-99.9
Exhaled Tidal Volume 0 to 9999 mL 1 ±10%
Spontaneous Minute 0.00 to 99.9 L 0.01 for 0.00-9.99; ±10%
Volume 0.1 for 10.0-99.9
Rapid Shallow Breathing 0 to 500 Bpm/L 1 ±10%
Index

Table 12-10: Patient Data Range, Resolution, Units & Accuracy (Sheet 1 of 2)

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Patient Data Range, Resolution, Units & Accuracy (Continued)

Patient Data Display Range Units Resolution Accuracy

I:E 9.9:1 to 1:99 none 0.1 for 9.9:1-1:9.9; ±10%
1 for 1:10-1:99
Peak Inspiration -20.0 to 130 cmH2O 1 for 100-130; ±10%
Pressure (hPa) 0.1 for -20.0 to 99.9
End Inspiration -20.0 to 130 cmH2O 1 for 100-130; ±10%
Pressure (Pi End) (hPa) 0.1 for -20.0 to 99.9
Mean Airway -20.0 to 120 cmH2O 1 for 100-120; ±10%
Pressure (hPa) 0.1 for -20.0 to 99.9
Delivered O2% 0.0 to 110 -- 1 for 100-110; ±3 vol%
0.1 for -20.0 to 99.9
Total Respiratory Rate 0.0 to 150 Bpm 1 for 10-150; ±10%
0.1 for 0.0 to 9.9
Spontaneous 0.0 to 150 Bpm 1 for 10-150; ±10%
Respiratory Rate 0.1 for 0.0 to 9.9
End Exhalation -20.0 to 99.9 cmH2O 0.1 ±10%
Pressure (Pe End) (hPa)
Patient Leak (Pt Leak) 0.0 to 140 LPM 0.1 for 0.0-99.9 Not
1 for 100-140 specifieda
Percent Patient Trigger 0.0 to 99.9 % 0.1 for 0.0-99.9 ±10%
(%Pt Trigger) 1 for 100

Table 12-10: Patient Data Range, Resolution, Units & Accuracy (Sheet 2 of 2)
a. Due to the variable nature of patient leaks, this parameter is an estimate only.

Front Panel Keys

Front Panel Keys
Alarm Silence Screen Lock
Alarm Reset Exp. Hold
100% O2 Options
Manual breath Accept

Table 12-11: Front Panel Keys

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Level Controls
Level Controls

Control Adjustment
Display Brightness Continuous (min to max)
(underneath front panel Keys)

Alarm Volume Continuous (54 to 77 db)

(underneath front panel Keys)
Adjust Control Knob Continuous—to change values on screen

Table 12-12: Level Controls

Calculated Values
from Expiratory Hold Calculated Values from Expiratory Hold Maneuver
Maneuver Value Range
End Expiratory Pressure -20 to 120 cmH2O (hPa)
Expiratory Pause Pressure -20 to 120 cmH2O (hPa)
Auto PEEP (calculated range) 0 to 120 cmH2O (hPa)

Table 12-13: Calculated Values from Expiratory Hold Maneuver

Interface Ports
Interface Ports
Parallel Printer Port future
RS-232 output and input
Analog Output 0 to 5 VDC full-scale future
Remote Alarm Nurse Call and Remote Alarm Annunciation

Table 12-14: Interface Ports

Environmental
Specifications Environmental Specifications
Temperature/Humidity Operating 10º to 40ºC (50º to 104ºF)
10 to 95% R.H. (non-condensing)
Storage -20º to 60ºC (-4º to 140ºF)
10 to 100% R.H. (non-condensing)
Atmospheric Pressure Operating 700 to 1060 cmH2O (hPa)
Storage 500 to 1060 cmH2O (hPa)

Table 12-15: Environmental Specifications (Sheet 1 of 2)

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Environmental Specifications (Continued)

Altitude Operating 0 to 3280m (0 to 10,000 ft.)
Storage up to 6560m (20,000 ft.)
Oxygen Inlet Supply Pressure 276 to 620 kPa (40-90 psig)
Flow 200 L/min. minimum

Table 12-15: Environmental Specifications (Sheet 2 of 2)

Environmental
Protection Environmental Protection
Batteries Do not dispose of in fire, possible explosion hazard. Do not dispose of in
garbage, recycle lead batteries.
Ventilator Enclosure The system plastic enclosure should not be disposed of in fire, possible
toxic fumes may be generated.
General The system and accessories (bacteria filters, patient tubing, etc.) may be
subject to medical hazardous waste regulations. Consult with local
authorities for proper disposition of the system and accessories at the end
of their useful life.

Table 12-16: Environmental Protection

Alarms
Alarms
Alarm Audible Alarm Volume adjustable, 45 dB(A) to 85 dB(A)
Controls
Alarm Silence 120 seconds
Alarm Reset
Alarm High Inspiratory Pressure 10 to 105 cmH2O (hPa)
Settings
Low Inspiratory Pressure 3 to 105 cmH2O (hPa)
Low PEEP Pressure 0 to 35 cmH2O (hPa)
High Respiratory Rate 0 to 150 Bpm
Low Exhaled Mandatory Tidal Volume 0 mL to 2500 mL
Low Exhaled Spontaneous Tidal Volume 0 mL to 2500 mL
Low Exhaled Minute Volume 0 to 60 Lpm
High Exhaled Minute Volume 0 to 60 Lpm
High Leak (NPPV mode only) 0 to 60 Lpm

Table 12-17: Alarms (Sheet 1 of 2)

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Alarms (Continued)
Alarm Normal Indicator
Status
High Urgency Alarm (flashing red)
Indicators
Medium/Low Urgency Alarm (flashing yellow/steady yellow)
Alarm Silence
Safety Valve Open
Ventilator Inoperative (steady red)
Screen Locked

Table 12-17: Alarms (Sheet 2 of 2)

Connectors
Connectors
Inspiratory Limb Connector Gas outlet port: 22 mm conical male
Expiratory Limb Connector Gas return port (on expiratory filter):
Proprietary barb fitting

NOTE: The gas return port on the ventilator is a

cylindrical port which requires mating to a
specified expiratory filter to seal the expiratory
limb.
Oxygen Inlet DISS male, DISS female, NIST, Air Liquide, or SIS Fitting
(depending on country and configuration).

Table 12-18: Connectors

Filters
Filters
Inspiratory See filter instruction sheets for complete specification.
Bacterial Filter Efficiency: 99.999+%
Viral Filtration Efficiency: 99.99+%
Expiratory See filter instruction sheets for complete specification.
Typical efficiency: 99.97% for nominal particle size of 0.3 micro meter (micron)
at 100L/min flow.

Table 12-19: Filters

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Measuring and
Display Devices Measuring and Display Devices
Pressure Measurements Type Solid State
Sensing Position Inhalation output port
Exhalation input port
Measurements Patient airway pressure
Volume Measurements Type Hot Film Anemometer flow integrated
Sensing Position O2, air and exhalation
Measurements O2 flow, air flow and exhalation flow
Oxygen Measurements Type Zirconia solid electrolyte
Sensing Position Internal enclosure
Measurements Oxygen concentration (range 0 to 95%)
Type Galvanic cell
Sensing Position Inspiratory limb of VBS
Measurements Delivered O2% (range 0 to 110%)
Settings, Alarms and Type TFT liquid crystal touch screen
Data Display

Table 12-20: Measuring and Display Devices

AC Power & Battery

Indicators AC Power & Battery Indicators
Loss of Power (audible only) Battery Low
External Battery In Use Battery In Use
Battery Charging Mains

Table 12-21: AC Power & Battery Indicators

Leakage Current
Leakage Current
Ventilator Earth Leakage Current 100 to 240VAC; 300µA maximum
Enclosure/Patient Leakage Current 100 to 240VAC; 100µA maximum

Table 12-22: Leakage Current

WARNING: When connecting a humidifier to the humidifier outlet (available only on

100-120 VAC ventilators) allowable leakage current values may be
exceeded.

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Compliance and
Approvals Compliance and Approvals
The Esprit Ventilator system complies with the requirements
of the European Directive 93/42/EEC concerning medical
devices and the requirements of Directive 89/336/EEC
relating to electromagnetic compatibility.

IEC 601-1 Classification Protection class 1, type B applied part, drip proof, continuous
operation.
The Esprit Ventilator system IEC 601-1/EN60601-1
complies with these IEC 601-1-2/EN60601-1-2
international and European EN 794-1
Standards.
The Esprit Ventilator system has CSA/NRTL: CSA C22.2 No. 601-1, CSA C22.2 No. 601-2-
been certified by the following. 12, UL2601-1

Table 12-23: Compliance and Approvals

Power Requirements
Power Requirements

Configuration Voltages & Frequencies

Ventilator Only 100 to 240VAC, 50/60Hz, 6 amp max. or
100 to 120VAC, 50/60Hz, 6 amp max. depending on
configuration
Ventilator Only 24VDC, 8AH, Backup Battery pack (operating time
approximately 30 minutes)
Ventilator with Humidifier 100 to 120VAC, 50/60Hz, 9 amp max.

Table 12-24: Power Requirements

NOTE: Humidifier connection available only on 100-120VAC ventilators.

Dimensions and
Weights Dimensions and Weights

Ventilator and Backup

Ventilator Battery Cart, LX200
Height 16 inches (40 cm) 21 inches (53 cm) 32 inches (81 cm)
Width 14 inches (36 cm) 14 inches (36 cmH) 20 inches (51 cm)

Table 12-25: Dimensions and Weights (Sheet 1 of 2)

REF 580-1000-01P Esprit® Ventilator Operator’s Manual © Respironics, Inc. 12-11

Chapter 12

Technical Specifications

Dimensions and Weights (Continued)

Ventilator and Backup

Ventilator Battery Cart, LX200
Depth 24 inches (61 cm) 24 inches (61 cm) 26 inches (66 cm)
27.5 inches with water trap 27.5 inches with water trap
filter (70 cm) filter (70 cm)
Weight 66 pounds (30 kg) 86 pounds (39 kg) 62 pounds (28 kg)

Table 12-25: Dimensions and Weights (Sheet 2 of 2)

Electromagnetic
Compatibility
Guidance and Manufacturer's Declaration - Electromagnetic Emissions
Declaration
The Esprit Ventilator is intended for use in the electromagnetic environment specified below.
The user of the Esprit Ventilator should assure that it is used in such an environment.

Emissions Test Compliance Electromagnetic Enforcement - Guidance

The Esprit ventilator uses RF energy only for its
internal function. Therefore, its RF emissions are
RF Emissions CISPR 11 Group 1
very low and are not likely to cause interference
in nearby electronic equipment.
RF Emissions CISPR 11 Class A The Esprit ventilator is suitable for use in all
establishments, including domestic
Harmonic emissions
Class A establishments and those directly connected to
IEC 61000-3-2
the public low voltage power supply network that
Voltage fluctuations/flicker supplies buildings used for domestic purposes.
Complies
emissions IEC 61000-3-3

Table 12-26: EMC Declaration - Emissions

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 Chapter 12

Technical Specifications

Guidance and Manufacturer's Declaration - Electromagnetic Immunity

The Esprit ventilator is intended for use in the electromagnetic environment specified below. The
user of the Esprit ventilator should assure that it is used in such an environment.

IEC 60601 Test Compliance Electromagnetic Environment -

Immunity Test Level Level Guidance
Electrostatic Floors should be wood, concrete
Discharge (ESD) ±6kV contact ±6kV contac or ceramic tile. If floors are
covered with synthetic material,
IEC 61000-4-2 ±8kV air t±8kV air the relative humidity should be
at least 30%.
Electrical Fast ±2kV for power ±2kV for power Mains power quality should be
Transient/burst supply lines. supply lines. that of a typical hospital
environment
IEC 61000-4-4 ±1kV for input/ ±1kV for input/
output lines output lines
Surge ±1kV differential ±1kV differential Mains power quality should be
mode mode that of a typical hospital
IEC 61000-4-5 environment
±2kV common ±2kV common
mode mode
Voltage dips, short <5% UT <5% UT Mains power quality should be
interruptions and (>95% dip in UT) (>95% dip in UT) that of a typical hospital
voltage variations on for 0.5 cycle for 0.5 cycle environment. If the user of the
power supply input Esprit ventilator requires
lines 40% UT 40% UT continued operation during
(60% dip in UT) (60% dip in UT) power mains interruptions, it is
IEC 61000-4-11 for 5 cycles for 5 cycles recommended that the Esprit
ventilator be powered from an
70% UT 70% UT external battery.
(30% dip in UT) (30% dip in UT)
for 25 cycles for 25 cycles

5% UT 5% UT
(>95% dip in UT) (>95% dip in UT)
for 5 sec for 5 sec
Power Frequency Power frequency magnetic fields
(50/60Hz) magnetic should be at levels characteristic
field 3 A/m 3 A/m of a typical location in a typical
hospital environment.
IEC 61000-4-8
NOTE: UT is the a.c. mains voltage prior to application of the test level.

Table 12-27: EMC Declaration - Immunity

REF 580-1000-01P Esprit® Ventilator Operator’s Manual © Respironics, Inc. 12-13

Chapter 12

Technical Specifications

Guidance and Manufacturer's Declaration - Electromagnetic Immunity

The Esprit ventilator is intended for use in the electromagnetic environment specified below. The
user of the Esprit ventilator should assure that it is used in such an electromagnetic environment.

Immunity IEC 60601 Compliance

Test Test Level Level Electromagnetic Environment - Guidance
Portable and mobile RF communications
equipment should be used no closer to any part of
the Esprit ventilator, including cables, than the
recommended separation distance calculated from
Conducted the equation applicable to the frequency of the
RF transmitter.Recommended separation distance
Table 12-29: “EMC Declaration - Recommended
IEC Distances”.
61000-4-6
3 Vrms150
3.5
kHz to 80
3Vrms d = ------- P
MHz outside V1
ISM bandsa

10 Vrms
12
10 Vrms d = ------ P
150kHz to V2
Radiated 80 MHz in
RF

IEC 12
61000-4-3 d = ------ P 80Mhz to 800Mhz
10 V/m
E1
10 V/m
80Mhz to
23
2.5GHz
d = ------ P 800Mhz to 2.5GHz
E1

where P is the maximum output power rating of

the transmitter in watts (W) according to the
transmitter manufacturer and d is the
recommended separation distance in meters (m).b

Field strengths from fixed RF transmitters, as

determined by an electromagnetic site survey,c
should be less than the compliance level in each
frequency range.d

Interference may occur in the vicinity of equipment

marked with the
following symbol:

Table 12-28: EMC Declaration - Immunity

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 Chapter 12

Technical Specifications

Guidance and Manufacturer's Declaration - Electromagnetic Immunity

NOTE 1 At 80 MHz and 800 MHz, the higher frequency range applies.

NOTE 2 These guidelines may not apply in all situations. Electromagnetic propagation is affected
by absorption and reflection from structures, objects and people.
a The ISM (industrial, scientific and medical) bands between 150 kHz and 80 MHz are
6.765 MHz to 6.795 MHz; 13.553 MHz to 13.567 MHz; 26.957 MHz to 27.283 MHz; and
40.66 MHz to 40.70 MHz.

b The compliance levels in the ISM frequency bands between 150 kHz and 80 MHz and in
the frequency range 80 MHz to 2.5 GHz are intended to decrease the likelihood that mobile/
portable communications equipment could cause interference if it is inadvertently brought into
patient areas. For this reason, an additional factor of 10/3 is used in calculating the
recommended separation distance for transmitters in these frequency ranges.

c Field strengths from fixed transmitters, such as base stations for radio (cellular/cordless)
telephones and land mobile radios, amateur radio, AM and FM radio broadcast and TV broadcast
cannot be predicted theoretically with accuracy. To assess the electromagnetic environment due to
fixed RF transmitters, an electromagnetic site survey should be considered. If the measured field
strength in the location in which the Esprit ventilator is used exceeds the applicable RF
compliance level above, the Esprit ventilator should be observed to verify normal operation. If
abnormal performance is observed, additional measures may be necessary, such as re-orienting or
relocating the Esprit ventilator.

d Over the frequency range 150 kHz to 80 MHz, field strengths should be less than 1 V/m.

Table 12-28: EMC Declaration - Immunity

REF 580-1000-01P Esprit® Ventilator Operator’s Manual © Respironics, Inc. 12-15

Chapter 12

Technical Specifications

Recommended Separation Distances Between

Portable and Mobile RF Communications Equipment and the Esprit Ventilator
The Esprit ventilator is intended for use in an electromagnetic environment in which radiated RF
disturbances are controlled. The user of the Esprit ventilator can help prevent electromagnetic
interference by maintaining a minimum distance between portable and mobile RF communications
equipment (transmitters) and the Esprit ventilator as recommended below, according to the maximum
output power of the communications equipment

Separation Distance According to Frequency of Transmitter

(Meters)
Rated 150 kHz to 80 150 kHz to 80 MHz 80 MHz to 800 MHz 800 MHz to 2.5 GHz
Maximum MHz Outside ISM in ISM Bands
Output Bands
Power of 12 12 23
Transmitter d = ------ P d = ------ P d = ------ P
(Watts) V2 E1 E1

0.01 0.12 0.12 0.12 0.23

0.1 0.38 0.38 0.38 0.74
1 1.20 1.20 1.20 2.30
10 3.80 3.80 3.79 7.40
100 12.00 12.00 12.00 23.00
For transmitters rated at a maximum output power not listed above, the recommended separation
distance d in meters (m) can be determined using the equation applicable to the frequency of the
transmitter, where P is the maximum output power rating of the transmitter in watts (W) according to the
transmitter manufacturer.
NOTE 1 At 80 MHz and 800 MHz, the separation distance for the higher frequency range applies.

NOTE 2 The ISM (industrial, scientific and medical) bands between 150 kHz and 80 MHz are 6.765
MHz to 6.795 MHz;13.553 MHz to 13.567 MHz; 26.957 MHz to 27.283 MHz; and 40.66
MHz to 40.70 MHz.

NOTE 3 An additional factor of 10/3 is used in calculating the recommended separation distance for
transmitters in the ISM frequency bands between 150 kHz and 80 MHz and in the frequency
range 80 MHz to 2.5 GHz to decrease the likelihood that mobile/portable communications
equipment could cause interference if it is inadvertently brought into patient areas.

NOTE 4 These guidelines may not apply in all situations. Electromagnetic propagation is affected by
absorption and reflection from structures, objects and people.

Table 12-29: EMC Declaration - Recommended Distances

12-16 Esprit® Ventilator Operator’s Manual © Respironics, Inc. REF 580-1000-01P

 Chapter 12

Technical Specifications

Pneumatic System

Internal Blower

Inspiratory
Module
To Patient
w/SV and PRV

O2 Inlet Oxygen Assembly

Exhalation Heated
Valve Exhalation
Expiratory Gas Assembly
From Patient
Filter Assy
to Atmosphere

System
Electromechanical
Controls

User Interface

Figure 12-1: Pneumatic System

REF 580-1000-01P Esprit® Ventilator Operator’s Manual © Respironics, Inc. 12-17

Chapter 12

Technical Specifications

Labels
Ventilator Labels

Label Description
On/Off Switch Label

Heated Expiratory Filter Label

Gas Return Label

Gas Outlet Label

Serial Port, Remote Alarm Nurse

Call, parallel printer port Label

Keep Covered Label

Analog port

Potential Equalization Connector

DC Battery Connection Label

AC Power Labels

OR

Humidifier Outlet Label

Power Switch on Front Label

12-18 Esprit® Ventilator Operator’s Manual © Respironics, Inc. REF 580-1000-01P

 Chapter 12

Technical Specifications

Ventilator Labels (Continued)

Mains Circuit Breaker Label

Humidifier Circuit Breaker Label

Oxygen Inlet Label

Emergency Air Intake Label

Cooling Inlet Label

Date of Manufacture Label

Manufacturer’s Label

Warning Label

REF 580-1000-01P Esprit® Ventilator Operator’s Manual © Respironics, Inc. 12-19

Chapter 12

Technical Specifications

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12-20 Esprit® Ventilator Operator’s Manual © Respironics, Inc. REF 580-1000-01P

 Chapter 13. Options and Accessories

Introduction This section of the manual is for inserting information associated with
operating and assembly instructions for Esprit options and accessories. When
you order an option or accessory, the instructions for that item are shipped
with the item. Insert those instructions into this section of the manual.

Options and Accessories

Software Options
Color 1004956
Communications 1010525
Flow-Trak 1019026
Graphics 1003772a
NICO-Esprit Interface 1022488
Respiratory Mechanics 1006600
RS-232 Communications 2 1015725
Trending 1013446

Hardware Accessories
AC Power Cord 1001832a
Backup Battery 1001470a
Battery, external 1001455a
Cable, Vuelink 1006912
Cart, LX200 1001453
Flex Arm Assembly 1003781
Flex Arm Bracket 1002497
Humidifier Bracket, F&P (cart mount) 1002226
Humidifier Bracket, F&P (ventilator mount) 1002901
Humidifier Bracket, Hudson, Concha III (cart mount) 1002227
Humidifier Bracket, Hudson, Concha IV (cart mount) 1002228
O2 Cylinder Brackets 1002241
O2 High Pressure Hose 1001664a
O2 Manifold 1004415
O2 Sensor Kit 1002541
NICO Bracket 1013499
NICO-Esprit, RS-232 serial communications 3’ cable 1018292
Remote Alarm Cable Kit (Normally Open Protocol) 1003741

Table 13-1: Options and Accessories (Sheet 1 of 2)

REF 580-1000-01P Esprit® Ventilator Operator’s Manual © Respironics, Inc. 13-1

Chapter 13

Options and Accessories

Options and Accessories (Continued)

Remote Alarm Cable Kit (Normally Closed Protocol) 1003742
Remote Alarm Cable Kit — Respironics (LifeCare) 1003743
Test Lung 1001737

Reusable Items
Reusable Exhalation Bacteria Filter Omni (Single) 1002970
Reusable Inspiratory Bacteria Filter (Single) 1003847
Reusable Patient Circuit Kit, Adult 1003058
Kit includes:
1 - Reusable Inspiratory Bacteria Filter 1003847
1 - Reusable Exhalation Bacteria Filter 1002970
2 - Water Traps 1003648
2 - Coupling, Straight Silicone 500-1000-43
Reusable Patient Circuit Kit, Pediatric 1003059
Kit includes:
1 - Reusable Inspiratory Bacteria Filter 1003847
1 - Reusable Exhalation Bacteria Filter 1002970
2 - Water Traps 1003648
2 - Coupling, Straight Silicone 500-1000-43
Reusable Vial System, Water Collection Esprit 1021884

Disposable Items
Disposable Exhalation Bacteria Filter (pkg of 12) 1002240
Disposable Inspiratory Bacteria Filter (Single) 1014047
Disposable Inspiratory Bacteria Filter (pkg of 10) 0342077
Disposable Patient Circuit, Adult 1003698a
Kit includes:
1 - Disposable Inspiratory Bacteria Filter 1014047
1 - Disposable Exhalation Bacteria Filter 1002240
2 - Coupling, Straight Silicone 500-1000-43
Disposable Patient Circuit, Pediatric 1003699a
Kit includes:
1 - Disposable Inspiratory Bacteria Filter 1014047
1 - Disposable Exhalation Bacteria Filter 1002240
2 - Water Traps 1003648
2 - Coupling, Straight Silicone 500-1000-43
Disposable Vial System, Water Collection Esprit 1006241

Documentation
Operator’s Manual 580-1000-01a
Quick Reference Guide 1002780a
Service Manual 580-1000-02a

Table 13-1: Options and Accessories (Sheet 2 of 2)

a. The Part delivered varies with the country to which the ventilator is delivered. Call
Respironics Customer Service (1-800-345-6443) for the part number for your
country.

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 Chapter 13

Options and Accessories

WARNING: The use of accessories, cables and transducers other than those specified
may result in increased EM emissions or decreased immunity of the system.

REF 580-1000-01P Esprit® Ventilator Operator’s Manual © Respironics, Inc. 13-3

Chapter 13

Options and Accessories

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13-4 Esprit® Ventilator Operator’s Manual © Respironics, Inc. REF 580-1000-01P

 Chapter 13A: Oxygen Sensor Option

The optional Oxygen sensor (O2 sensor) may be installed to allow monitoring of
delivered O2 to the inspiratory limb of the patient circuit. The Esprit Ventilator
will accept the MSA MiniOX® O2 sensors, P/N 1001454.

Figure 13A-1: O2 Sensor exploded view

Assemble O2 sensor Refer to Figure 13A-1 for the following instructions.

1. Remove the O2 sensor (1) from the package. Discard the o-ring and
adapter (not shown) provided with the sensor.
2. Place flat O-ring (2) into the threaded hole of the O2 Sensor Tee (3).
3. Screw the O2 sensor (2) into the O2 sensor tee (3).
4. Insert one end of the O2 sensor cord (4) into ventilator. Insert other
end of O2 sensor cord (4) into the sensor. Fasten each end with
knurled collars.

REF 580-1000-01P Esprit® Ventilator Operator’s Manual © Respironics, Inc. 1

Chapter 13A

Oxygen Sensor Option

Attaching the sensor The O2 sensor attaches to the gas outlet port located below the front panel on
to the ventilator the ventilator’s lower right corner.

Figure 13A-2: O2 Sensor orientation

1. Rotate the sensor assembly so that the sensor is pointing up.

5
4
3
2
1

5 4 3 2 1

Flow

Figure 13A-3: Connecting O2 sensor and patient circuit

2. Connect the T-fitting (2) to the gas outlet port (1).

3. Insert the inspiratory bacteria filter (4) into the T-fitting (2) using the
22mm connector (3) if necessary. Some bacteria filters provide an
arrow or other mark to indicate the direction of flow. The flow indicator
should be pointed away from the ventilator, toward the patient circuit
connection.

CAUTION: To prevent contamination of the O2 sensor, always locate it between the

ventilator gas output port and the inspiratory bacteria filter.

2 Esprit® Ventilator Operator’s Manual © Respironics, Inc. REF 580-1000-01P

 Chapter 13A

Oxygen Sensor Option

4. Connect inspiratory limb of patient circuit (5) to bacteria filter (4).

5. Ensure that all connections are tight.

NOTE: Record O2 sensor manufacturing or warranty numbers and installation

date for future reference. Save manufacturers instruction about end of
life replacement.
NOTE: To ensure accurate O2 monitoring, check O2 sensors periodically and
replace as per manufacturer specification.
NOTE: Sensor performance and expected operating life information is outlined
in the sensor manufacturer’s instructions for use. Thoroughly review all
O2 sensor instructions prior to installation and use with the Esprit
Ventilator.
NOTE: O2 sensor calibration is performed during EST. If recalibration of the O2
sensor is required, follow the instructions for “Extended Self Test
(EST)” in Chapter 11.

Warranty Respironics warrants the O2 sensor to be free from defects in material and
workmanship for a period of one year from the date of purchase, provided that
the unit is operated under conditions of normal use as described in this
operator’s manual.

At its discretion, Respironics will make replacements, repairs or issue credits

for equipment or parts that are found to be defective.

REF 580-1000-01P Esprit® Ventilator Operator’s Manual © Respironics, Inc. 3

Chapter 13A

Oxygen Sensor Option

(This page is intentionally blank.)

4 Esprit® Ventilator Operator’s Manual © Respironics, Inc. REF 580-1000-01P

 Appendix A. RS-232 Communications Protocol

The Esprit ventilator will allow for the transmission of data from Esprit via the
RS-232 communications interface. The ventilator receives commands from
the remote device and responds with fixed format records.

RS-232 Configuration The RS-232 communications port will be configured in the following manner
for all communications functions:
• Baud Rate 19,200
• Data Bits 8
• Parity None
• Stop Bits 1

Commands Commands are transmitted as a series of four ASCII characters followed by a

Transmitted to the carriage return. Valid commands will be stored and response transmissions will
be sent in the order the corresponding commands were received. Invalid
Ventilator commands will be returned in an error message (Table A-7: “Unrecognized
Commands” on page A-24), in sequence with all other commands.

Transmission of Data Unless stated otherwise, all fields will be left justified and six (6) characters in
length. A comma will separate each field. Each data transmission shall be
from the Ventilator
terminated with a carriage return.

In the following subparagraphs, a space is designated as “◆”. When data is

unavailable, the output field shall contain “----◆◆” (i.e. four dash characters
followed by two spaces).

Ventilator Report When the ventilator receives VRPT followed by a carriage return, it will respond
by transmitting the information shown in Table A-1: “Ventilation Report”. The
Command and
ventilator responds to the VRPT command by returning a string with a variable
Response (VRPT) length. Fields 2 through 4 define the length of the message. The last character
transmitted is a stop code indicating the end of the message. The second field
indicates the number of characters between the start and stop codes. The third
field indicates the number of fields between the start and stop codes. The
fourth field is the start code, 0x02. The last field in the string is the stop code,
0x03.

REF 580-1000-01P Esprit® Ventilator Operator’s Manual © Respironics, Inc. Appendix A-1
Appendix A

RS-232 Communications Protocol

Ventilation Report

Description Example Resolution Range Units Comments

Command Name VRPT N/A N/A N/A
Number of characters 990 N/A N/A N/A 3 character field
between the start and
stop codes
Number of fields 134 N/A N/A N/A 3 character field
between the start and
stop codes
Start Code 0x02 N/A N/A N/A ASCII Start
Transmission
Character (STX)
Time of request 13:45◆ N/A N/A N/A 24 hour clock,
hh:mm◆
Date FEB◆23◆1997◆ N/A N/A N/A 12 character field,
MMM◆DD◆YYYY◆
Current Ventilation VCV◆◆◆ N/A VCV◆◆◆ N/A The ventilation
Type PCV◆◆◆ type currently
NPPV◆◆ being used by the
ventilator.
VCV Mode Setting A/C◆◆◆ N/A A/C◆◆◆ N/A
SIMV◆◆
CPAP◆◆
VCV Waveform Setting RAMP◆◆ N/A RAMP◆◆ N/A
SQUARE
VCV Patient Type ADULT◆ N/A ADULT◆
PED◆◆◆
VCV Respiratory Rate 12◆◆◆◆ 1 1 - 80 BPM
Setting
VCV Tidal Volume 500◆◆◆ 1 50 - 2500 mL
Setting
VCV Peak Flow Setting 30◆◆◆◆ 1 3 - 140 LPM
VCV PEEP Setting 0◆◆◆◆◆ 1 0 - 35 cmH2O
(hPa)
VCV Pressure Support 0◆◆◆◆◆ 1 0 - 100 cmH2O
Setting (hPa)
VCV I-Trigger Type PRESS◆ N/A PRESS◆ N/A
FLOW◆◆
AUTO◆◆
VCV Pressure I-Trigger 2.0◆◆◆ 0.1 0.1 - 20.0 cmH2O
Setting (hPa)
VCV Flow I-Trigger 3.0◆◆◆ 0.1 0.5 - 20.0 LPM
Setting

Table A-1: Ventilation Report (Sheet 1 of 10)

Appendix A-2 Esprit® Ventilator Operator’s Manual © Respironics, Inc. REF 580-1000-01P
 Appendix A

RS-232 Communications Protocol

Ventilation Report (Continued)

Description Example Resolution Range Units Comments

VCV E-Trigger Type %Flow◆ N/A %FLOW◆ N/A
AUTO◆◆
VCV %Flow Expiratory 25◆◆◆◆ 1 10 - 80 %
Trigger Setting
VCV Rise Time 0.1◆◆◆ 0.1 0.1 - 0.9 Sec
VCV Oxygen 21◆◆◆◆ 1 21 - 100 %
Concentration Setting
VCV Plateau Setting 0.0◆◆◆ 0.1 0.0 - 2.0 Sec
VCV Apnea Rate 12◆◆◆◆ 1 1 - 80 BPM
Setting
VCV High Inspiratory 35◆◆◆◆ 1 10 - 105 cmH2O
Pressure Alarm Limit (hPa)
Setting
VCV Low Inspiratory 3◆◆◆◆◆ 1 3 - 105 cmH2O
Pressure Alarm Limit (hPa)
Setting
VCV Low PEEP Alarm 0◆◆◆◆◆ 1 0 - 35 cmH2O
Limit Setting (hPa)
VCV Low Mandatory 0◆◆◆◆◆ 1 0 - 2500 mL
Tidal Volume Alarm
Limit Setting
VCV Low Spontaneous 0◆◆◆◆◆ 1 0 - 2500 mL
Tidal Volume Alarm
Limit Setting
VCV High Respiratory 150◆◆◆ 1 0 - 150 BPM
Rate Alarm Limit
Setting
VCV Low Minute 1.00◆◆ 0.01 for 0.00 - 60.0 L
Volume Alarm Limit 0.00 to 9.99
0.1 for 10.0
Setting to 60.0

VCV Apnea Interval 20◆◆◆◆ 1 10 - 60 sec

Alarm Limit Setting
PCV Mode Setting A/C◆◆◆ N/A A/C◆◆◆ N/A
SIMV◆◆
CPAP◆◆
PCV Patient Type ADULT◆ N/A ADULT◆
PED◆◆◆
PCV Respiratory Rate 12◆◆◆◆ 1 1 - 80 BPM
Setting
PCV Pressure Setting 20◆◆◆◆ 1 5 - 100 cmH2O
(hPa)
PCV Inspiratory Time 1.0◆◆◆ 0.1 0.1 - 9.9 sec
Setting

Table A-1: Ventilation Report (Sheet 2 of 10)

REF 580-1000-01P Esprit® Ventilator Operator’s Manual © Respironics, Inc. Appendix A-3
Appendix A

RS-232 Communications Protocol

Ventilation Report (Continued)

Description Example Resolution Range Units Comments

PCV PEEP Setting 0◆◆◆◆◆ 1 0 - 35 cmH2O
(hPa)
PCV Pressure Support 0◆◆◆◆◆ 1 0 - 100 cmH2O
Setting (hPa)
PCV I-Trigger Type PRESS◆ N/A PRESS◆ N/A
FLOW◆◆
AUTO◆◆
PCV E-Trigger Type %FLOW◆ N/A %FLOW◆ N/A
AUTO◆◆
PCV Pressure I-Trigger 2.0◆◆◆ 0.1 0.1 - 20.0 cmH2O
Setting (hPa)
PCV Flow I-Trigger 3.0◆◆◆ 0.1 0.5 - 20.0 LPM
Setting
PCV %Flow Expiratory 25◆◆◆◆ 1 10 - 80 %
Trigger Setting
PCV Rise Time 0.1◆◆◆ 0.1 0.1 - 0.9 sec
PCV Oxygen 21◆◆◆◆ 1 21 - 100 %
Concentration Setting
PCV Apnea Rate 12◆◆◆◆ 1 1 - 80 BPM
Setting
PCV Apnea Interval 20◆◆◆◆ 1 10 - 60 sec
Alarm Limit Setting
PCV High Inspiratory 35◆◆◆◆ 1 10 - 105 cmH2O
Pressure Alarm Limit (hPa)
Setting
PCV Low Inspiratory 3◆◆◆◆◆ 1 3 - 105 cmH2O
Pressure Alarm Limit (hPa)
Setting
PCV Low PEEP Alarm 0◆◆◆◆◆ 1 0 - 35 cmH2O
Limit Setting (hPa)
PCV Low Mandatory 0◆◆◆◆◆ 1 0 - 2500 mL
Tidal Volume Alarm
Limit Setting
PCV Low Spontaneous 0◆◆◆◆◆ 1 0 - 2500 mL
Tidal Volume Alarm
Limit Setting
PCV High Respiratory 150◆◆◆ 1 0 - 150 BPM
Rate Alarm Limit
Setting
PCV Low Minute 1.00◆◆ 0.01 for 0.00 - 60.0 L
Volume Alarm Limit 0.00 to 9.99
0.1 for 10.0
Setting to 60.0

Table A-1: Ventilation Report (Sheet 3 of 10)

Appendix A-4 Esprit® Ventilator Operator’s Manual © Respironics, Inc. REF 580-1000-01P
 Appendix A

RS-232 Communications Protocol

Ventilation Report (Continued)

Description Example Resolution Range Units Comments

PCV High Minute 60.0◆◆ 0.01 for 0.00 - 60.0 L
Volume Alarm Limit 0.00 to 9.99
0.1 for 10.0
Setting to 60.0

NPPV Mode Setting SPONT/T N/A SPONT/T

SPONT◆◆
NPPV Patient Type ADULT◆ N/A ADULT◆
PED◆◆◆
NPPV Respiratory 12◆◆◆◆ 1 1 - 80 BPM
Rate Setting
NPPV EPAP Setting 5◆◆◆◆◆ 1 2 - 25 cmH2O
(hPa)
NPPV IPAP Setting 5◆◆◆◆◆ 1 2 - 35 cmH2O
(hPa)
NPPV Inspiratory Time 1.0◆◆◆ 0.1 0.1 - 9.9 sec
Setting
NPPV Rise Time 0.1◆◆◆ 0.1 0.1 - 0.9 sec
NPPV I-Trigger Type AUTO◆ N/A FLOW◆◆ N/A
AUTO◆◆
NPPV Flow I-Trigger 3.0◆◆◆ 0.1 0.5 - 20.0 LPM
Setting
NPPV E-Trigger Type AUTO◆◆ N/A FLOW◆◆ N/A
AUTO◆◆
NPPV %Flow 25◆◆◆◆ 1 10 - 80 %
Expiratory Trigger
Setting
NPPV Oxygen 21◆◆◆◆ 1 21 - 100 %
Concentration Setting
NPPV Apnea Rate 12◆◆◆◆ 1 1 - 80 BPM
Setting
NPPV Low Inspiratory 3◆◆◆◆◆ 1 3 - 105 cmH2O
Pressure Alarm Limit (hPa)
Setting
NPPV Low EPAP 0◆◆◆◆◆ 1 0 - 25 cmH2O
Alarm Limit Setting (hPa)
NPPV Low Tidal 0◆◆◆◆◆ 1 0 - 2500 mL
Volume Alarm Limit
Setting
NPPV High 150◆◆◆ 1 0 - 150 BPM
Respiratory Rate
Alarm Limit Setting
NPPV Low Minute 1.00◆◆ 0.01 for 0.00 - 60.0 L
Volume Alarm Limit 0.00 to 9.99
0.1 for 10.0
Setting to 60.0

Table A-1: Ventilation Report (Sheet 4 of 10)

REF 580-1000-01P Esprit® Ventilator Operator’s Manual © Respironics, Inc. Appendix A-5
Appendix A

RS-232 Communications Protocol

Ventilation Report (Continued)

Description Example Resolution Range Units Comments

NPPV Apnea Interval 20◆◆◆◆ 1 10 - 60 sec
Alarm Limit Setting
NPPV High Leak 60◆◆◆◆ 1 10 - 60 sec
Alarm Limit Setting
Measured Peak 24.1◆◆ 0.1 for -20.0 -20.0 - 130 cmH2O The PIP value from
Inspiratory Pressure to 99.9 (hPa) the Patient Data
1 for 100 to
130 screen.

Measured Mean 5.6◆◆◆ 0.1 for -20.0 -20.0 -120 cmH2O The MAP value
Airway Pressure to 99.9 (hPa) from the Patient
1 for 100 to
120 Data screen.

Measured End 2.0◆◆◆ 0.1 -20.0-99.9 cmH2O The End Exp. value
Expiratory Pressure (hPa) from the Patient
Data screen.
Measured End 24.0◆◆ 0.1 for -20.0 -20.0 - 130 cmH2O The Plateau value
Inhalation Pressure to 99.9 (hPa) from the Patient
1 for 100 to
130 Data screen.

Measured Tidal 468◆◆◆ 1 0 - 2500 mL The Tidal Volume

Volume value from the
Patient Data
screen.
Measured 0.00◆◆ 0.01 for 0.00 - 60.0 L The Spont VE value
Spontaneous Minute 0.00 to 9.99 from the Patient
0.1 for 10.0
Volume to 60.0 Data screen.

Measured Minute 5.83◆◆ 0.01 for 0.00 - 60.0 L The Total VE value
Volume 0.00 to 9.99 from the Patient
0.1 for 10.0
to 60.0 Data screen.

Measured 0.0◆◆◆ 0.1 for 0.0 0.0 - 150 BPM The Spont Rate
Spontaneous Breath to 9.9 value from the
1 for 10 to
Rate 150 Patient Data
screen.
Measured Total Breath 12.0◆◆ 0.1 for 0.0 0 - 150 BPM The Total Rate
Rate to 9.9 value from the
1 for 10 to
150 Patient Data
screen.
Measured Rapid 5◆◆◆◆◆ 1 0 - 500 BPM/L The F/Vt value from
Shallow Breathing the Patient Data
Index screen.
Measured I:E Ratio 1:4.1◆ 0.1 for 9.9:1 4.1:1-1:99 N/A The I:E Ratio
to 1:9.9 display from the
1 for 1:10 to
1:99 Patient Data
screen.
Measured Patient 0.0◆◆◆ 0.1 for 0.0 0.0 - 140 LPM The Pt Leak
Leak to 99.9 display.
1 for 100 to
140

Table A-1: Ventilation Report (Sheet 5 of 10)

Appendix A-6 Esprit® Ventilator Operator’s Manual © Respironics, Inc. REF 580-1000-01P
 Appendix A

RS-232 Communications Protocol

Ventilation Report (Continued)

Description Example Resolution Range Units Comments

Measured Percent of 56.2 0.1 for 0.0 0.0 - 100 % The Pt Trigger
Breaths Triggered by to 99.9 display on the
1 for 100
the Patient (NPPV NPPV Monitor
Spont/T mode only; screen.
otherwise ◆◆◆◆◆◆)
Monitored Oxygen 55.1◆◆ 0,1 for 0.0 0.0 - 100 % The % O2 display
Concentration to 99.9 from the Patient
1 for 100 Data Screen.
Ti/Ttot 0.23◆◆ 0.01 0.00 - 1.00 N/A The Ti/Ttot display
from the
Mechanics Patient
Status Screen
Dynamic Resistance 5.43◆◆ 0.01 for 0.00 - 400 cmH20 The Dynamic
0.00 to /L/Sec Resistance display
9.99 from the
0.1 for Mechanics Patient
10.0 to Status Screen
99.9
1 for 100
to 400
Dynamic Compliance 19.2◆◆ 0.01 for 0.00 - 350 mL/ The Dynamic
0.00 to cmH20 Compliance display
9.99 from the
0.1 for Mechanics Patient
10.0 to Status Screen
99.9
1 for 100
to 350
Peak Lung Flow 35.1◆◆ 0.1 for - -300 - 300 LPM The Peak L-Flow
99.9 to display from the
99.9 Mechanics Patient
1 for -100 Status Screen
to -300
1 for 100
to 300
Vital Capacity 450◆◆ 1 0 - 9999 mL Vital Capacity
display from Vital
Capacity Screen
Vital Capacity Time of 11-14- 1 minute 01-01-70 N/A Time of Last
Last Maneuver 01◆◆13:11 0:00 to Maneuver display
01-19-38 from the Vital
3:14 Capacity
Screen.15
character field, 24
hour clock: MM-
DD-YYuuHH:MM

Table A-1: Ventilation Report (Sheet 6 of 10)

REF 580-1000-01P Esprit® Ventilator Operator’s Manual © Respironics, Inc. Appendix A-7
Appendix A

RS-232 Communications Protocol

Ventilation Report (Continued)

Description Example Resolution Range Units Comments

MIP -54.1◆ 0.1 for -99.9 -100 - 200 cmH20 MIP display from
to 99.9 MIP/P0.1 display
1 for -100
and 100 to Screen
200

MIP Time of Last 11-14-01◆◆13:11 1 minute 01-01-7 N/A MIP Time of Last
Maneuver 0 0:00 to Maneuver display
01-19-38 from MIP/P0.1
3:14 Screen15
character field, 24
hour clock: MM-
DD-YYuuHH:MM
P0.1 -2.3◆◆ 0.1for -99.9 -100 - 200 cmH20 P0.1 display from
to 99.9 MIP/P0.1 display
1 for -100
and 100 to screen
200

P0.1 Time of Last 11-14-01◆◆13:11 1 minute 01-01-70 N/A P0.1 Time of Last
Maneuver 0:00 to Maneuver display
01-1-/38 from MIP/P0.1
3:14 Screen.15
character field, 24
hour clock: MM-
DD-YYwwHH:MM
Static Resistance 5.43◆◆ 0,01 for 0.00 - 400 cmH20 Static Resistance
0.00 to 9.99 /L/Sec display from the
0.1 for 10.0
to 99.9 Static C & R screen
1 for 100 to
400

Static Compliance 19.2◆◆ 0.01 for 0.00 - 350 mL/ Static Compliance
0.00 to 9.99 cmH2O display from the
0.1 for 10.0
to 99.9 Static C & R
1 for 100 to Screen
350

Static C & R Time of 11-14-01◆◆13:11 1 minute 01-01-70 N/A Static C & R Time
Last Maneuver 0:00 to of Last Maneuver
01-19-38 display from Static
3:14 C & R Screen.15
character field, 24
hour clock: MM-
DD-YYwwHH:MM
AutoPeep 1.2◆◆ 0.1 for -9.9 -20 - 120 cmH2O AutoPeep display
to 9.9 from the
1 for -10 to -
20 Mechanics Patient
1 for 10 to Status Screen
120

Table A-1: Ventilation Report (Sheet 7 of 10)

Appendix A-8 Esprit® Ventilator Operator’s Manual © Respironics, Inc. REF 580-1000-01P
 Appendix A

RS-232 Communications Protocol

Ventilation Report (Continued)

Description Example Resolution Range Units Comments

AutoPeep Time of Last 11-14-01◆◆13:11 1 minute 01-01-70 N/A AutoPeep Time of
Maneuver 0:00 to Last Maneuver
01-19-38 display from
3:14 Mechanics Patient
Status Screen.15
character field, 24
hour clock: MM-
DD-YYwwHH:MM
Occlusion Alarm NORMAL N/A NORMAL N/A
Status ALARM◆
RESET◆
Safety Valve Status NORMAL N/A NORMAL N/A
ALARM◆
RESET◆
Low Internal Battery NORMAL N/A NORMAL N/A
Alarm Status ALARM◆
RESET◆
Nonvolatile Memory NORMAL N/A NORMAL N/A
Failure—Using ALARM◆
Default Settings RESET◆
Primary Alarm Failure NORMAL N/A NORMAL N/A
ALARM◆
RESET◆
High Inspiratory NORMAL N/A NORMAL N/A
Pressure Alarm Status ALARM◆
RESET◆
Apnea Alarm Status NORMAL N/A NORMAL N/A
ALARM◆
RESET◆
Low Inspiratory NORMAL N/A NORMAL N/A
Pressure Alarm Status ALARM◆
RESET◆
Air Source Fault NORMAL N/A NORMAL N/A
Alarm Status ALARM◆
RESET◆
O2 Valve Stuck Closed NORMAL N/A NORMAL N/A
Alarm Status ALARM◆
RESET◆
Exhalation Valve NORMAL N/A NORMAL N/A
Stuck Open Alarm ALARM◆
Status RESET◆
Low O2 Supply Alarm NORMAL N/A NORMAL N/A Low supply
Status ALARM◆ pressure
RESET◆

Table A-1: Ventilation Report (Sheet 8 of 10)

REF 580-1000-01P Esprit® Ventilator Operator’s Manual © Respironics, Inc. Appendix A-9
Appendix A

RS-232 Communications Protocol

Ventilation Report (Continued)

Description Example Resolution Range Units Comments

Low O2 Alarm Status NORMAL N/A NORMAL N/A Low O2
ALARM◆ concentration
RESET◆
Low Minute Volume NORMAL N/A NORMAL N/A
Alarm Status ALARM◆
RESET◆
Low Mandatory Tidal NORMAL N/A NORMAL N/A
Volume Alarm Status ALARM◆
RESET◆
High Minute Volume NORMAL N/A NORMAL N/A
Alarm Status ALARM◆
RESET◆
Low Tidal Volume NORMAL N/A NORMAL N/A
Alarm Status ALARM◆
RESET◆
Low Spontaneous NORMAL N/A NORMAL N/A
Tidal Volume Alarm ALARM◆
Status RESET◆
I-Time Too Long Alarm NORMAL N/A NORMAL N/A
Status ALARM◆
RESET◆
High Respiratory Rate NORMAL N/A NORMAL N/A
Alarm Status ALARM◆
RESET◆
High O2 Alarm Status NORMAL N/A NORMAL N/A
ALARM◆
RESET◆
High Enclosure NORMAL N/A NORMAL N/A
Temperature Alarm ALARM◆
Status RESET◆
High Internal Oxygen NORMAL N/A NORMAL N/A
Concentration Alarm ALARM◆
Status RESET◆
Low PEEP Alarm NORMAL N/A NORMAL N/A
Status ALARM◆
RESET◆
Low EPAP Alarm NORMAL N/A NORMAL N/A
Status ALARM◆
RESET◆
High Leak Alarm NORMAL N/A NORMAL N/A
Status ALARM◆
RESET◆

Table A-1: Ventilation Report (Sheet 9 of 10)

Appendix A-10 Esprit® Ventilator Operator’s Manual © Respironics, Inc. REF 580-1000-01P
 Appendix A

RS-232 Communications Protocol

Ventilation Report (Continued)

Description Example Resolution Range Units Comments

100% O2 Function OFF◆◆◆ N/A ON◆◆◆◆ N/A Status of the
Status OFF◆◆◆ 100% O2 LED on
the front panel
Alarm Silence Status OFF◆◆◆ N/A ON◆◆◆◆ N/A Status of the Alarm
OFF◆◆◆ Silence LED on the
front panel
Screen Lock Status OFF◆◆◆ N/A ON◆◆◆◆ N/A Status of the
OFF◆◆◆ Screen Lock LED
on the front panel
Tube Type ET◆◆◆◆ N/A ET◆◆◆◆ N/A Tube type as
TT◆◆◆◆ selected in
NONE◆◆ Respiratory
Mechanics Screens
(Not used)
Tube Size 7.0◆◆◆ 0.1 for 3.5 3.5 - 10 mm Tube size as
to 9.9 selected in
1 for 10
Respiratory
Mechanics Screens
(Not used)
VCV High Minute 60.0◆◆ 0.01 for 0.00 - 60.0 L
Volume Alarm Limit 0.00 to 9.99
0.1 for 10.0
Setting to 60.0

Static C & R Plateau 8.2◆◆◆ 0.1 for -20 -20.0 - 130 cmH2O Pplat display from
End Pressure to 99.9 Static C & R
1 for 100 to
130 Screen

Stop Code 0x03 N/A N/A N/A ASCII End

Transmission
Character (ETX)

Table A-1: Ventilation Report (Sheet 10 of 10)

Volume Control When the ventilator receives VCVS followed by a carriage return, it will respond
Ventilation Settings by transmitting the information shown in Table A-2: “Volume Control
Ventilation Settings Report”. The ventilator responds to the VCVS command by
Report (VCVS) returning a string with a variable length. Fields 2 through 4 define the length
of the message. The last character transmitted is a stop code indicating the
end of the message. The second field indicates the number of characters
between the start and stop codes. The third field indicates the number of
fields between the start and stop codes. The fourth field is the start code,
0x02. The last field in the string is the stop code, 0x03.

REF 580-1000-01P Esprit® Ventilator Operator’s Manual © Respironics, Inc. Appendix A-11
Appendix A

RS-232 Communications Protocol

Volume Control Ventilation Settings Report

Description Example Resolution Range Units Comments

Command Name VCVS N/A N/A N/A
Number of characters 209 N/A N/A N/A 3 character field
between the start and
stop codes
Number of fields 29 N/A N/A N/A 2 character field
between the start and
stop codes
Start Code 0x02 N/A N/A N/A ASCII Start
Transmission
Character (STX)
Time of request 13:45◆ N/A N/A N/A 24 hour clock,
hh:mm◆
Date FEB◆23◆1997◆ N/A N/A N/A 12 character field,
MMM◆DD◆YYYY◆
Current Ventilation VCV◆◆◆ N/A VCV◆◆◆ N/A The ventilation
Type PCV◆◆◆ type currently
NPPV◆◆ being used by the
ventilation.
VCV Mode Setting A/C◆◆◆ N/A A/C◆◆◆ N/A
SIMV◆◆
CPAP◆◆
VCV Waveform RAMP◆◆ N/A RAMP◆◆ N/A
Setting SQUARE
VCV Patient Type ADULT◆ N/A ADULT◆
PED◆◆◆
VCV Respiratory Rate 12◆◆◆◆ 1 1 - 80 BPM
Setting
VCV Tidal Volume 500◆◆◆ 1 50 - 2500 mL
Setting
VCV Peak Flow 30◆◆◆◆ 1 3 - 140 LPM
Setting
VCV PEEP Setting 0◆◆◆◆◆ 1 0 - 35 cmH2O
(hPa)
VCV Pressure Support 0◆◆◆◆◆ 1 0 - 100 cmH2O
Setting (hPa)
VCV I-Trigger Type PRESS◆ N/A PRESS◆ N/A
FLOW◆◆
AUTO◆◆
VCV Pressure I- 2.0◆◆◆ 0.1 0.1 - 20.0 cmH2O
Trigger Setting (hPa)
VCV Flow I-Trigger 3.0◆◆◆ 0.1 0.5 - 20.0 LPM
Setting

Table A-2: Volume Control Ventilation Settings Report (Sheet 1 of 2)

Appendix A-12 Esprit® Ventilator Operator’s Manual © Respironics, Inc. REF 580-1000-01P
 Appendix A

RS-232 Communications Protocol

Volume Control Ventilation Settings Report (Continued)

Description Example Resolution Range Units Comments

VCV E-Cycle Type %Flow◆ N/A %FLOW◆ N/A
AUTO◆◆
VCV %Flow 25◆◆◆◆ 1 10 - 80 %
Expiratory Cycle
Setting
VCV Rise Time 0.1◆◆◆ 0.1 0.1 - 0.9 Sec
VCV Oxygen 21◆◆◆◆ 1 21 - 100 %
Concentration Setting
VCV Plateau Setting 0.0◆◆◆ 0.1 0.0 - 2.0 Sec
VCV Apnea Rate 12◆◆◆◆ 1 1 - 80 BPM
Setting
VCV High Inspiratory 35◆◆◆◆ 1 10 - 105 cmH2O
Pressure Alarm Limit (hPa)
Setting
VCV Low Inspiratory 3◆◆◆◆◆ 1 3 - 105 cmH2O
Pressure Alarm Limit (hPa)
Setting
VCV Low PEEP Alarm 0◆◆◆◆◆ 1 0 - 35 cmH2O
Limit Setting (hPa)
VCV Low Mandatory 0◆◆◆◆◆ 1 0 - 2500 mL
Tidal Volume Alarm
Limit Setting
VCV Low 0◆◆◆◆◆ 1 0 - 2500 mL
Spontaneous Tidal
Volume Alarm Limit
Setting
VCV High Respiratory 150◆◆◆ 1 0 - 150 BPM
Rate Alarm Limit
Setting
VCV Low Minute 1.00◆◆◆ 0.01 for 0.00 - 60.0 L
Volume Alarm Limit 0.00 to 9.99
0.1 for 10.0
Setting to 60.0

VCV Apnea Interval 20◆◆◆◆ 1 10 - 60 sec

Alarm Limit Setting
VCV High Minute 60.0◆◆ 0.01 for 0.00 - 60.0 L
Volume Alarm Limit 0.00 to 9.99
0.1 for 10.0
Setting to 60.0

Stop Code 0x03 N/A N/A N/A ASCII End

Transmission
Character (ETX)

Table A-2: Volume Control Ventilation Settings Report (Sheet 2 of 2)

REF 580-1000-01P Esprit® Ventilator Operator’s Manual © Respironics, Inc. Appendix A-13
Appendix A

RS-232 Communications Protocol

Pressure Control When the ventilator receives PCVS followed by a carriage return, it will respond
Ventilation Settings by transmitting the information shown in Table A-3: “Pressure Control
Ventilation Settings Report”. The ventilator responds to the PCVS command by
Report (PCVS) returning a string with a variable length. Fields 2 through 4 define the length
of the message. The last character transmitted is a stop code indicating the
end of the message. The second field indicates the number of characters
between the start and stop codes. The third field indicates the number of
fields between the start and stop codes. The fourth field is the start code,
0x02. The last field in the string is the stop code, 0x03.

Pressure Control Ventilation Settings Report

Description Example Resolution Range Units Comments

Command Name PCVS N/A N/A N/A
Number of characters 195 N/A N/A N/A 3 character field
between the start and
stop codes
Number of fields 27 N/A N/A N/A 2 character field
between the start and
stop codes
Start Code 0x02 N/A N/A N/A ASCII Start
Transmission
Character (STX)
Time of request 13:45◆ N/A N/A N/A 24 hour clock,
hh:mm◆
Date FEB◆23◆1997◆ N/A N/A N/A 12 character field,
MMM◆DD◆YYYY◆
Current Ventilation VCV◆◆◆ N/A VCV◆◆◆ N/A The ventilation
Type PCV◆◆◆ type currently
NPPV◆◆ being used by the
ventilator.
PCV Mode Setting A/C◆◆◆ N/A A/C◆◆◆ N/A
SIMV◆◆
CPAP◆◆
PCV Patient Type ADULT◆ N/A ADULT◆
PED◆◆◆
PCV Respiratory Rate 12◆◆◆◆ 1 1 - 80 BPM
Setting
PCV Pressure Setting 20◆◆◆◆ 1 5 - 100 cmH2O
(hPa)
PCV Inspiratory Time 1.0◆◆◆ 0.1 0.1 - 9.9 sec
Setting
PCV PEEP Setting 0◆◆◆◆◆ 1 0 - 35 cmH2O
(hPa)
PCV Pressure Support 0◆◆◆◆◆ 1 0 - 100 cmH2O
Setting (hPa)

Table A-3: Pressure Control Ventilation Settings Report (Sheet 1 of 3)

Appendix A-14 Esprit® Ventilator Operator’s Manual © Respironics, Inc. REF 580-1000-01P
 Appendix A

RS-232 Communications Protocol

Pressure Control Ventilation Settings Report (Continued)

Description Example Resolution Range Units Comments

PCV I-Trigger Type PRESS◆ N/A PRESS◆ N/A
FLOW◆◆
AUTO◆◆
PCV Pressure I-Trigger 2.0◆◆◆ 0.1 0.1 - 20.0 cmH2O
Setting (hPa)
PCV Flow I-Trigger 3.0◆◆◆ 0.1 0.5 - 20.0 LPM
Setting
PCV E-Cycle Type %FLOW◆ N/A %FLOW◆ N/A
AUTO◆◆
PCV %Flow Expiratory 25◆◆◆◆ 1 10 - 80 %
Cycle Setting
PCV Rise Time 0.1◆◆◆ 0.1 0.1 - 0.9 sec
PCV Oxygen 21◆◆◆◆ 1 21 - 100 %
Concentration Setting
PCV Apnea Rate 12◆◆◆◆ 1 1 - 80 BPM
Setting
PCV Apnea Interval 20◆◆◆◆ 1 10 - 60 sec
Alarm Limit Setting
PCV High Inspiratory 35◆◆◆◆ 1 10 - 105 cmH2O
Pressure Alarm Limit (hPa)
Setting
PCV Low Inspiratory 3◆◆◆◆◆ 1 3 - 105 cmH2O
Pressure Alarm Limit (hPa)
Setting
PCV Low PEEP Alarm 0◆◆◆◆◆ 1 0 - 35 cmH2O
Limit Setting (hPa)
PCV Low Mandatory 0◆◆◆◆◆ 1 0 - 2500 mL
Tidal Volume Alarm
Limit Setting
PCV Low Spontaneous 0◆◆◆◆◆ 1 0 - 2500 mL
Tidal Volume Alarm
Limit Setting
PCV High Respiratory 150◆◆◆ 1 0 - 150 BPM
Rate Alarm Limit
Setting
PCV Low Minute 1.00◆◆ 0.01 for 0.00 - 60.0 L
Volume Alarm Limit 0.00 to
Setting 9.99
0.1 for
10.0 to
60.0

Table A-3: Pressure Control Ventilation Settings Report (Sheet 2 of 3)

REF 580-1000-01P Esprit® Ventilator Operator’s Manual © Respironics, Inc. Appendix A-15
Appendix A

RS-232 Communications Protocol

Pressure Control Ventilation Settings Report (Continued)

Description Example Resolution Range Units Comments

PCV High Minute 60.0◆◆ 0.01 for 0.00 - 60.0 L
Volume Alarm Limit 0.00 to
Setting 9.99
0.1 for
10.0 to
60.0
Stop Code 0x03 N/A N/A N/A ASCII End
Transmission
Character (ETX)

Table A-3: Pressure Control Ventilation Settings Report (Sheet 3 of 3)

Non-Invasive Positive When the ventilator receives NPVS followed by a carriage return, it will respond
Pressure Ventilation by transmitting the information shown in Table A-4: “Non-Invasive Positive
Pressure Ventilation Settings Report”. The ventilator responds to the NPVS
Settings Report command by returning a string with a variable length. Fields 2 through 4
(NPVS) define the length of the message. The last character transmitted is a stop code
indicating the end of the message. The second field indicates the number of
characters between the start and stop codes. The third field indicates the
number of fields between the start and stop codes. The fourth field is the start
code, 0x02. The last field in the string is the stop code, 0x03.

Non-Invasive Positive Pressure Ventilation Settings Report

Description Example Resolution Range Units Comments

Command Name NPVS N/A N/A N/A
Number of characters 168 N/A N/A N/A 3 character field
between the start and
stop codes
Number of fields 23 N/A N/A N/A 2 character field
between the start and
stop codes
Start Code 0x02 N/A N/A N/A ASCII Start
Transmission
Character (STX)
Time of request 13:45◆ N/A N/A N/A 24 hour clock,
hh:mm◆
Date FEB◆23◆1997◆ N/A N/A N/A 12 character field,
MMM◆DD◆YYYY◆
Current Ventilation VCV◆◆◆ N/A VCV◆◆◆ N/A The ventilation
Type PCV◆◆◆ type currently
NPPV◆◆ being used by the
ventilator.

Table A-4: Non-Invasive Positive Pressure Ventilation Settings Report (Sheet 1 of 3)

Appendix A-16 Esprit® Ventilator Operator’s Manual © Respironics, Inc. REF 580-1000-01P
 Appendix A

RS-232 Communications Protocol

Non-Invasive Positive Pressure Ventilation Settings Report (Continued)

Description Example Resolution Range Units Comments

NPPV Mode Setting SPONT/T N/A SPONT/T
SPONT◆◆
NPPV Patient Type ADULT◆ N/A ADULT◆
PED◆◆◆
NPPV Respiratory 12◆◆◆◆ 1 1 - 80 BPM
Rate Setting
NPPV EPAP Setting 5◆◆◆◆◆ 1 2 - 25 cmH2O
(hPa)
NPPV IPAP Setting 5◆◆◆◆◆ 1 2 - 35 cmH2O
(hPa)
NPPV Inspiratory Time 1.0◆◆◆ 0.1 0.1 - 9.9 sec
Setting
NPPV Rise Time 0.1◆◆◆ 0.1 0.1 - 0.9 sec
NPPV I-Trigger Type FLOW◆◆ N/A FLOW◆◆ N/A
AUTO◆◆
NPPV Flow I-Trigger 3.0◆◆◆ 0.1 0.5 - 20.0 LPM
Setting
NPPV E-Cycle Type %FLOW◆ N/A %FLOW◆ N/A
AUTO◆◆
NPPV %Flow 25◆◆◆◆ 1 10 - 80 %
Expiratory Cycle
Setting
NPPV Oxygen 21◆◆◆◆ 1 21 - 100 %
Concentration Setting
NPPV Apnea Rate 12◆◆◆◆ 1 1 - 80 BPM
Setting
NPPV Low Inspiratory 3◆◆◆◆◆ 1 3 - 105 cmH2O
Pressure Alarm Limit (hPa)
Setting
NPPV Low EPAP 0◆◆◆◆◆ 1 0 - 25 cmH2O
Alarm Limit Setting (hPa)
NPPV Low Tidal 0◆◆◆◆◆ 1 0 - 2500 mL
Volume Alarm Limit
Setting
NPPV High 150◆◆◆ 1 0 - 150 BPM
Respiratory Rate
Alarm Limit Setting
NPPV Low Minute 1.00◆◆ 0.01 for 0.00 - 60.0 L
Volume Alarm Limit 0.00 to 9.99
0.1 for 10.0
Setting to 60.0

NPPV Apnea Interval 20◆◆◆◆ 1 10 - 60 sec

Alarm Limit Setting

Table A-4: Non-Invasive Positive Pressure Ventilation Settings Report (Sheet 2 of 3)

REF 580-1000-01P Esprit® Ventilator Operator’s Manual © Respironics, Inc. Appendix A-17
Appendix A

RS-232 Communications Protocol

Non-Invasive Positive Pressure Ventilation Settings Report (Continued)

Description Example Resolution Range Units Comments

NPPV High Leak 60◆◆◆◆ 1 1 - 60 LPM
Alarm Limit
Stop Code 0x03 N/A N/A N/A ASCII End
Transmission
Character (ETX)

Table A-4: Non-Invasive Positive Pressure Ventilation Settings Report (Sheet 3 of 3)

Patient Data Report When the ventilator receives PTDT followed by a carriage return, it will respond
by transmitting the information shown in Table A-5: “Patient Data Report”.
(PTDT)
The ventilator responds to the PTDT command by returning a string with a
variable length. Fields 2 through 4 define the length of the message. The last
character transmitted is a stop code indicating the end of the message. The
second field indicates the number of characters between the start and stop
codes. The third field indicates the number of fields between the start and
stop codes. The fourth field is the start code, 0x02. The last field in the string
is the stop code, 0x03.

Patient Data Report

Description Example Resolution Range Units Comments

Command Name PTDT N/A N/A N/A
Number of 268 N/A N/A N/A 3 character field
characters between
the start and stop
codes
Number of fields 31 N/A N/A N/A 2 character field
between the start
and stop codes
Start Code 0x02 N/A N/A N/A ASCII Start
Transmission
Character (STX)
Time of request 13:45◆ N/A N/A N/A 24 hour clock,
hh:mm◆
Date FEB◆23◆1997◆ N/A N/A N/A 12 character field,
MMM◆DD◆YYYY◆
Measured Peak 24.1◆◆ 0.1 for -20.0 to 99.9 -20.0 - 130 cmH2O The PIP value from
Inspiratory 1 for 100 to 130 (hPa) the Patient Data
Pressure screen.
Measured Mean 5.6◆◆◆ 0.1 for -20.0 to 99.9 -20.0 -120 cmH2O The MAP value
Airway Pressure 1 for 100 to 120 (hPa) from the Patient
Data screen.

Table A-5: Patient Data Report (Sheet 1 of 4)

Appendix A-18 Esprit® Ventilator Operator’s Manual © Respironics, Inc. REF 580-1000-01P
 Appendix A

RS-232 Communications Protocol

Patient Data Report (Continued)

Description Example Resolution Range Units Comments

Measured End 2.0◆◆◆ 0.1 -20.0-99.9 cmH2O The End Exp. value
Expiratory Pressure (hPa) from the Patient
Data Data screen.
Measured End 24.0◆◆ 0.1 for -20.0 to 99.9 -20.0 - 130 cmH2O The Plateau value
Inhalation Pressure 1 for 100 to 130 (hPa) from the Patient
Data screen.
Measured Tidal 468◆◆◆ 1 0 - 2500 mL The Tidal Volume
Volume value from the
Patient Data
screen.
Measured 0.00◆◆ 0.01 for 0.00 to 0.00 - 60.0 L The Spont VE value
Spontaneous 9.99 from the Patient
Minute Volume 0.1 for 10.0 to 60.0 Data screen.

Measured Minute 5.83◆◆ 0.01 for 0.00 to 0.00 - 60.0 L The Total VE value
Volume 9.99 from the Patient
0.1 for 10.0 to 60.0 Data screen.

Measured 0.0◆◆◆ 0.1 for 0.0 to 9.9 0.0 - 150 BPM The Spont Rate
Spontaneous 1 for 10 to 150 value from the
Breath Rate Patient Data
screen.
Measured Total 12.0◆◆ 0.1 for 0.0 to 9.9 0 - 150 BPM The Total Rate
Breath Rate 1 for 10 to 150 value from the
Patient Data
screen.
Measured Rapid 5◆◆◆◆◆ 1 0 - 500 BPM/L The F/Vt value from
Shallow Breathing the Patient Data
Index screen.
Measured I:E Ratio 1:4.1◆ 0.1 for 9.9:1 to 1:9.9 4.1:1-1:99 N/A The I:E Ratio
1 for 1:10 to 1:99 display from the
Patient Data
screen.
Measured Patient 0.0◆◆◆ 0.1 for 0.0 to 99.9 0.0 - 140 LPM The Pt Leak
Leak 1 for 100 to 140 display.
Measured Percent 56.2◆◆ 0.1 for 0.0 to 99.9 0.0 - 100 % The Pt Trigger
of Breaths 1 for 100 display on the
Triggered by the NPPV Monitor
Patient (NPPV screen.
Spont/T mode only;
otherwise
◆◆◆◆◆◆)
Monitored Oxygen 55.1◆◆ 0,1 for 0.0 to 99.91 for 0.0 - 100 % The % O2 display
Concentration 100 from the Patient
Data Screen.
Ti/Ttot 0.23◆◆ 0.01 0.00 - 1.00 N/A The Ti/Ttot display
from the
Mechanics Patient
Status Screen

Table A-5: Patient Data Report (Sheet 2 of 4)

REF 580-1000-01P Esprit® Ventilator Operator’s Manual © Respironics, Inc. Appendix A-19
Appendix A

RS-232 Communications Protocol

Patient Data Report (Continued)

Description Example Resolution Range Units Comments

Dynamic 5.43◆◆ 0.01 for 0.00 to 0.00 - 400 cmH2 The Dynamic
Resistance 9.990.1 for 10.0 to 0/L/ Resistance display
99.91 for 100 to 400
Sec from the
Mechanics Patient
Status Screen
Dynamic 19.2◆◆ 0.01 for 0.00 to 0.00 - 350 mL/cm The Dynamic
Compliance 9.990.1 for 10.0 to H20 Compliance display
99.91 for 100 to 350
from the
Mechanics Patient
Status Screen
Peak Lung Flow 35.1◆◆ 0.1 for -99.9 to 99.91 -300 - 300 LPM The Peak L-Flow
for -100 to -3001 for display from the
100 to 300
Mechanics Patient
Status Screen
Vital Capacity 468◆◆ 1 0 - 9999 mL Vital Capacity
display from Vital
Capacity Screen
Vital Capacity Time 11-14-01◆◆13:11 1 minute 01-01-70 N/A Time of Last
of Last Maneuver 0:00 to Maneuver display
01-19-38 from the Vital
3:14 Capacity
Screen.15
character field, 24
hour clock: MM-
DD-YYuuHH:MM
MIP -54.1◆ 0.1 for -99.9 to -100 - 200 cm MIP display from
99.91 for -100 and H20 MIP/P0.1 display
100 to 200 Screen
MIP Time of Last 11-14-01◆◆13:11 1 minute 01-01-7 N/A MIP Time of Last
Maneuver 0 0:00 to Maneuver display
01-19-38 from MIP/P0.1
3:14 Screen15
character field, 24
hour clock: MM-
DD-YYuuHH:MM
P0.1 -2.3◆◆ 0.1for -99.9 to -100 - 200 cm P0.1 display from
99.91 for -100 and H20 MIP/P0.1 display
100 to 200 screen
P0.1 Time of Last 11-14-01◆◆13:11 1 minute 01-01-70 N/A P0.1 Time of Last
Maneuver 0:00 to Maneuver display
01-1-/38 from MIP/P0.1
3:14 Screen.15
character field, 24
hour clock: MM-
DD-YYwwHH:MM
Static Resistance 5.43◆◆ 0,01 for 0.00 to 0.00 - 400 cmH2 Static Resistance
9.990.1 for 10.0 to 0/L/ display from the
99.91 for 100 to Sec Static C & R screen
400

Table A-5: Patient Data Report (Sheet 3 of 4)

Appendix A-20 Esprit® Ventilator Operator’s Manual © Respironics, Inc. REF 580-1000-01P
 Appendix A

RS-232 Communications Protocol

Patient Data Report (Continued)

Description Example Resolution Range Units Comments

Static Compliance 19.2◆◆ 0.01 for 0.00 to 0.00 - 350 mL/ Static Compliance
9.990.1 for 10.0 to cmH2 display from the
99.91 for 100 to O Static C & R
350 Screen
Static C & R Time 11-14-01◆◆13:11 1 minute 01-01-70 N/A Static C & R Time
of Last Maneuver 0:00 to of Last Maneuver
01-19-38 display from Static
3:14 C & R Screen.15
character field, 24
hour clock: MM-
DD-YYwwHH:MM
AutoPeep 1.2◆◆ 0.1 for -9.9 to 9.91 -20 - 120 cmH2 AutoPeep display
for -10 to -201 for O from the
10 to 120 Mechanics Patient
Status Screen
AutoPeep Time of 11-14-01◆◆13:11 1 minute 01-01-70 N/A AutoPeep Time of
Last Maneuver 0:00 to Last Maneuver
01-19-38 display from
3:14 Mechanics Patient
Status Screen.15
character field, 24
hour clock: MM-
DD-YYwwHH:MM
Static C & R 8.2◆◆◆ 0.2 for -20 to 99.9 -20.0 - 130 cmH2O Pplat display from
Plateau End 1 for 100 to 130 Static C & R
Pressure Screen
Stop Code 0x03 N/A N/A N/A ASCII End
Transmission
Character (ETX)

Table A-5: Patient Data Report (Sheet 4 of 4)

Alarm Status Report When the ventilator receives ALRM followed by a carriage return, it will
(ALRM) respond by transmitting the information shown in Table A-6: “Alarm Status
Report”. The ventilator responds to the ALRM command by returning a string
with a variable length. Fields 2 through 4 define the length of the message.
The last character transmitted is a stop code indicating the end of the
message. The second field indicates the number of characters between the
start and stop codes. The third field indicates the number of fields between
the start and stop codes. The fourth field is the start code, 0x02. The last field
in the string is the stop code, 0x03.

REF 580-1000-01P Esprit® Ventilator Operator’s Manual © Respironics, Inc. Appendix A-21
Appendix A

RS-232 Communications Protocol

Alarm Status Report

Description Example Range Comments

Command Name ALRM N/A
Number of characters between the start 202 N/A 3 character field
and stop codes
Number of fields between the start and 28 N/A 2 character field
stop codes
Start Code 0x02 N/A ASCII Start
Transmission
Character (STX)
Time of request 13:45◆ N/A 24 hour clock,
hh:mm◆
Date FEB◆23◆1997◆ N/A 12 character field,
MMM◆DD◆YYYY◆
Occlusion Alarm Status NORMAL NORMAL
ALARM◆
RESET◆
Safety Valve Status NORMAL NORMAL
ALARM◆
RESET◆
Low Internal Battery Alarm Status NORMAL NORMAL
ALARM◆
RESET◆
Nonvolatile Memory Failure—Using NORMAL NORMAL
Default Settings ALARM◆
RESET◆
Primary Alarm Failure NORMAL NORMAL
ALARM◆
RESET◆
High Inspiratory Pressure Alarm Status NORMAL NORMAL
ALARM◆
RESET◆
Apnea Alarm Status NORMAL NORMAL
ALARM◆
RESET◆
Low Inspiratory Pressure Alarm Status NORMAL NORMAL
ALARM◆
RESET◆
Air Source Fault Alarm Status NORMAL NORMAL
ALARM◆
RESET◆
O2 Valve Stuck Closed Alarm Status NORMAL NORMAL
ALARM◆
RESET◆

Table A-6: Alarm Status Report (Sheet 1 of 3)

Appendix A-22 Esprit® Ventilator Operator’s Manual © Respironics, Inc. REF 580-1000-01P
 Appendix A

RS-232 Communications Protocol

Alarm Status Report (Continued)

Description Example Range Comments

Exhalation Valve Stuck Open Alarm NORMAL NORMAL
Status ALARM◆
RESET◆
Low O2 Supply Alarm Status NORMAL NORMAL Low supply pressure
ALARM◆
RESET◆
Low O2 Alarm Status NORMAL NORMAL Low O2
ALARM◆ concentration
RESET◆
Low Minute Volume Alarm Status NORMAL NORMAL
ALARM◆
RESET◆
Low Mandatory Tidal Volume Alarm NORMAL NORMAL
Status ALARM◆
RESET◆
High Minute Volume Alarm Status NORMAL NORMAL
ALARM◆
RESET◆
Low Tidal Volume Alarm Status NORMAL NORMAL
ALARM◆
RESET◆
Low Spontaneous Tidal Volume Alarm NORMAL NORMAL
Status ALARM◆
RESET◆
I-Time Too Long Alarm Status NORMAL NORMAL
ALARM◆
RESET◆
High Respiratory Rate Alarm Status NORMAL NORMAL
ALARM◆
RESET◆
High O2 Alarm Status NORMAL NORMAL
ALARM◆
RESET◆
High Enclosure Temperature Alarm NORMAL NORMAL
Status ALARM◆
RESET◆
High Internal Oxygen Concentration NORMAL NORMAL
Alarm Status ALARM◆
RESET◆
Low PEEP Alarm Status NORMAL NORMAL
ALARM◆
RESET◆

Table A-6: Alarm Status Report (Sheet 2 of 3)

REF 580-1000-01P Esprit® Ventilator Operator’s Manual © Respironics, Inc. Appendix A-23
Appendix A

RS-232 Communications Protocol

Alarm Status Report (Continued)

Description Example Range Comments

Low EPAP Alarm Status NORMAL NORMAL
ALARM◆
RESET◆
High Leak Alarm Status NORMAL NORMAL
ALARM◆
RESET◆
Stop Code 0x03 N/A ASCII End
Transmission
Character (ETX)

Table A-6: Alarm Status Report (Sheet 3 of 3)

Unrecognized If an unrecognized command is received, the ventilator will respond by

transmitting the information shown in Table A-7: “Unrecognized Commands”.
Commands
Unrecognized Commands

Description Example Comments

The unrecognized command ?ERROR
response: ?ERROR
Time of request 13:45◆ 24 hour clock, hh:mm◆
Up to the first five characters [VRPY] Example for VRPT being sent as VRPY. Non-
received set off in brackets printable characters are returned as ^.

Table A-7: Unrecognized Commands

Appendix A-24 Esprit® Ventilator Operator’s Manual © Respironics, Inc. REF 580-1000-01P
 Appendix B. Customer Service & Warranty

Customer Service For further information or assistance in operating the Esprit Ventilator, contact
Respironics Customer Service:

Within the United States: 800-345-6443

Outside the United States: 724-387-4000

Fax: 724-387-5012

email: [email protected]

Warranty Two Year Warranty

Respironics warrants the Esprit Ventilator to be free from defects in material
and workmanship for a period of two years from the date of purchase, provided
that the unit is operated under conditions of normal use as described in this
Operator’s Manual.

At its discretion, Respironics will make replacements, repairs, or issue credits

for equipment or parts that are found to be defective.

Exclusions
This warranty does not apply to any unit or individual parts which have been
repaired or altered in any way that, in Respironics’ judgement, affect its ability
or reliability, or which has been subjected to misuse, negligence, abuse, or
accident.

Unauthorized service and/or failure to perform periodic maintenance may void

this warranty.

This warranty does not cover damage that may occur in shipment.

Warranty Limits
This warranty takes precedence over all other warranties, expressed or implied.
This warranty also takes precedence over all other obligations or liabilities on
the part of Respironics including, but not limited to, contingent or
consequential damages, such as costs of repairing or replacing other property
which may be damaged as a direct result of Esprit Ventilator operation.

This warranty, and the rights and obligations described herein, is construed
under and governed by the laws of the State of California, U.S.A.

REF 580-1000-01P Esprit® Ventilator Operator’s Manual © Respironics, Inc. Appendix B-1
Appendix B

Customer Service & Warranty

Options and Warranties are available for various options and accessories. See the specific
Accessories option or accessory in Chapter 13 for complete warranty information.

Appendix B-2 Esprit® Ventilator Operator’s Manual © Respironics, Inc. REF 580-1000-01P
 Appendix C. Alarm Testing Procedure

The following procedure is available if the operator wants to test the operation
of the following alarms. Respironics recommends following “Preoperational
Procedure” on page 8-29 before performing the Alarm Testing procedure. It is
assumed that the preoperational procedure has been run before the Alarm
Testing Procedure is followed.

Setup
1. Connect O2 supply to Esprit.
2. Connect optional O2 sensor.
3. Run EST.
4. Attach the test lung to the patient wye. (Use the test lung provided
with your system.)
5. Use the following settings:
• Mode VCV-A/C
• Tidal Vol: 400ml
• High Pressure (HIP): 50cmH20 (hPa)
(or higher if required by the test lung)
• Rate: 10 Bpm
• Low Insp Press: 3 cmH20 (hPa)
• Peak Flow 40 Lpm
• PEEP: 4 cmH20 (hPa)
• Low PEEP: 2 cmH20 (hPa)
• Low Vt Mand: 0 mL
• PSV: 0 cmH20 (hPa)
• Low Vt Spont: 0 Lpm
• I-Trigger: 2 cmH20 (hPa)
• High Rate: 150 Bpm
• O2: 21%
• Low VE: 1 L
• Insp. Hold: 0 sec.
• Apnea: 15 sec.
• Apnea Rate: 20 Bpm

REF 580-1000-01P Esprit® Ventilator Operator’s Manual © Respironics, Inc. Appendix C-1
Appendix C

Alarm Testing Procedure

High Inspiratory Pressure Alarm Test

1. During inhalation squeeze the test lung for at least two breaths until
the High Pressure alarm sounds.
2. Wait for one normal breath, the alarm auto resets.
3. RESET the alarm.

Low Volume Alarm Test

1. Set the Low Vt Mand alarm limit to 500 ml.
2. Wait for one breath and alarm should sound.
3. Set the Low Vt Mand to 0 ml.
4. Wait for one breath and RESET the alarm.

Low O2 Alarm Test

(If optional O2 sensor is installed.)
1. Turn the ventilator OFF.
2. Disconnect the O2 sensor and its Tee from the inhalation limb of the
patient circuit. (Leave the electrical connection.)
3. Connect the inspiratory bacteria filter directly to the gas outlet port
and connect the inhalation limb to the filter.
4. Turn the ventilator ON.
5. Set the O2 setting to 40%.
6. Wait at least 3-5 breaths, the alarm should sound.
7. Set the O2 setting to 21%.
8. Wait for 3 - 5 breaths, the alarm should reset.
9. Press the RESET key to clear the alarm.
10. Turn the ventilator OFF and re-insert the O2 sensor and Tee.
11. Turn the ventilator ON.

Power Fail Alarm Test

1. While the system is ventilating normally, pull the AC plug from the
wall.
2. If the backup battery is attached, Esprit should continue ventilating,
and an alarm should sound every 60 seconds. If no backup battery is
attached, the ventilator will stop operating and sound a continuous
audible alarm.
3. Plug the power cord back in.

Appendix C-2 Esprit® Ventilator Operator’s Manual © Respironics, Inc. REF 580-1000-01P
 Appendix C

Alarm Testing Procedure

4. Alarm should reset. (If the backup battery is attached, Esprit should
return to AC power. If no battery is attached, Esprit will resume
operating.)

Apnea Alarm Test

1. Set the rate to 1 breath per minute.
2. Wait for 20 seconds.
3. Esprit should begin ventilating at a rate of 20 BPM while activating
the Apnea alarm.
4. Reset the rate to 10 BPM.
5. RESET the alarm.
6. Esprit should begin ventilating normally.

REF 580-1000-01P Esprit® Ventilator Operator’s Manual © Respironics, Inc. Appendix C-3
Appendix C

Alarm Testing Procedure

(This page is intentionally blank.)

Appendix C-4 Esprit® Ventilator Operator’s Manual © Respironics, Inc. REF 580-1000-01P
 Glossary

Abbreviations 24 Hrs used to describe format for time-of-day when AM or PM does not appear

AC alternating current (power)

A/C assist/control ventilation

AM/PM used to describe format for time-of-day when AM or PM occurs

ASCII commonly accepted 8-bit binary code for characters

Assist assist/control ventilation

ATPS ambient temperature, ambient pressure, saturated (with water vapor)

Auto-PEEP end-expiratory alveolar pressure above set PEEP level

Aux auxiliary

BTPS Body temperature (98°F, ambient pressure) 100% saturated (with water vapor)

C compliance, ratio of change in volume divided by change in pressure

CL lung compliance

cmH2O unit of pressure measurement centimeters of water

CMV controlled mechanical ventilation (same as A/C)

CPAP continuous positive airway pressure

Crs compliance of respiratory system

Cw chest wall compliance

DISS Diameter Index Safety System

E-Cycle Expiratory Cycle

End Exp end expiratory pressure

EPAP expiratory positive airway pressure

ETO ethylene oxide. Gas used for sterilization.

f respiratory frequency

REF 580-1000-01P Esprit® Ventilator Operator’s Manual © Respironics, Inc. G-1

Glossary

FIO2 fractional inspired oxygen

FRC functional residual capacity

f/VT rate versus tidal volume ratio; rapid shallow breathing index

HIP high inspiratory pressure

HME humidity maintenance equipment

hPa unit of pressure measurement hecto Pascals

I:E ratio inspiration:exhalation ratio

ICU intensive care unit

ISO International Standards Organization

IMV intermittent mandatory ventilation

Inop inoperational

IPAP inspiratory positive airway pressure

I-Time inspiratory time

L Liter

MAP mean airway pressure

mL milliliter, or 1/1000 L

mm millimeters

msec millisecond

M a notation for screw threads: metric

NPPV noninvasive positive pressure ventilation

NO nitric oxide

O2 molecular oxygen

OIM operator initiated mandatory

Paw airway pressure

PCV pressure-controlled ventilation

Pe End airway pressure at end exhalation

G-2 Esprit® Ventilator Operator’s Manual © Respironics, Inc. REF 580-1000-01P

 Glossary

PEEP positive end-expiratory pressure

Pi End airway pressure at the end of inhalation

PIP peak inspiratory pressure

Plateau inspiratory plateau pressure, pressure at end exhalation and no flow from or out of the
ventilator

Pplat end-inspiratory plateau pressure

psi pounds per square inch; Unit of pressure measurement

psig pounds per square inch gauge (above atmospheric pressure)

PSV pressure-support ventilation

SIMV synchronous intermittent mandatory ventilation

Spont Rate spontaneous respiratory rate

Spont T spontaneous timed

Spont VE spontaneous volume exhaled

STPD standard temperature, standard pressure dry

SVO safety valve open

Tidal Vol tidal volume

Total RR total respiratory rate

Total VE total volume exhaled/minute

V volume
•
V flow

VAC volts of alternating current (power)

•
V E expired minute ventilation

Vent ventilator

VT tidal volume

REF 580-1000-01P Esprit® Ventilator Operator’s Manual © Respironics, Inc. G-3

Glossary

Definitions Airway Pressure the pressure in the patient circuit, measured at the distal end
of the exhalation filter.

Baseline as in baseline pressure. The pressure at end exhalation.

Baud serial transmission speed usually bits/second.

Bias flow a continuous flow of gas used during expiratory phase when flow
triggering is active.

Bit binary digit.

Compliance a measure of stiffness for containers that hold gas (i.e. lungs,
patient tubing). The volume required to increase the pressure in the container
by a unit of pressure (i.e., L/cmH2O (hPa)).

Continuous positive airway pressure (CPAP) a mode of ventilator operation that

allows the patient to breath spontaneously from a continuous-flow or demand
valve at an elevated airway pressure. (same as CAP)

E-Cycle The E-Cycle setting on the Esprit determines when the ventilator will
transition from inspiration to expiration in PSV and NPPV modes. E-Cycle
defines the percent of peak inspiratory flow that end inspiratory flow needs to
drop to in order for inspiration to end.

End Expiratory Pressure (End Exp) the airway pressure measured at the end of
exhalation. The display is updated at the end of each exhalation.

Expiratory phase (exhalation) the part of the ventilatory cycle from the
beginning of expiratory flow to the beginning of inspiratory flow.

Flow Trigger initiation of inspiration when the patients inspiratory effort

exceeds the flow sensitivity setting (threshold).

Indicator a light, usually light emitting diode (LED).

Inspiration:Exhalation Ratio (I:E ratio) a standard I:E ratio. It is displayed as

XX:1 when exhalation period is larger than the inhalation period. It is displayed
as 1:XX when inhalation period is larger than the exhalation period.

Inspiratory phase (inspiration) the part of the ventilatory cycle from the
beginning of inspiratory flow to the beginning of expiratory flow. Any inspiratory
pause (plateau) is included in the inspiratory phase.

Inspiratory time inspiratory time (expressed in seconds) is the duration of

inspiration during mechanical ventilation. As inspiratory time increases, mean
airway pressure increases and the I:E ratio becomes lower.

G-4 Esprit® Ventilator Operator’s Manual © Respironics, Inc. REF 580-1000-01P

 Glossary

Inspiratory pause inspiratory pause is a brief pause (0.1 to 2 seconds) at end-

inspiration during which pressure is held constant and flow is zero. The
purpose of the pause is to improve gas distribution throughout the lungs. Same
as Plateau pressure.

Intermittent Mandatory Ventilation (IMV) a mode of ventilatory support that

allows spontaneous breathing in between mandatory breaths from the
ventilator.

Mandatory Breath a breath whose inspiratory flow and or pressure is under the
control of the ventilator.

Manual Breath a breath initiated by the operator.

Mean Airway Pressure (MAP) the average over one inspiration/exhalation cycle.
The value displayed is the average of this calculation over one minute. The
display is updated at the end of each exhalation.

Medical gas a gas that has been refined and purified according to
specifications in the United States Pharmacopoeia (USP) intended for human
use in the diagnosis or treatment of disease.

Millisecond (msec) one thousandth of a second.

•
Minute Ventilation ( V E) the total amount of gas moving out of the lungs during
1 minute.

Noninvasive pertaining to a diagnostic or therapeutic technique that does not

require the skin to be broken or a cavity or organ of the body to be entered.
Mechanical ventilation via mask, nasal prongs, or mouthpiece.

Peak Inhalation Pressure (PIP) the greatest airway pressure during an inspiratory
cycle no matter what the breath type. The pressure is measured at the
exhalation valve and the new data is displayed at the beginning of exhalation.

Plateau Pressure (Plateau) the pressure measured at the end of exhalation on

every breath. The display is updated at the beginning of each exhalation.

PCMCIA Card (PC Card) Acronym for Personal Computer Memory Card
International Association, more commonly referred to as a PC Card. This is a
data storage device with an approximate physical size of a credit card, used in
conjunction with the Trending Option.

Positive End-Expiratory Pressure (PEEP) the application and maintenance of

pressure above atmospheric at the airway throughout the expiratory phase of
positive-pressure mechanical ventilation.

Pressure Support Ventilation (PSV) pressure-limited assisted ventilation

designed to augment a spontaneously generated breath; the patient has

REF 580-1000-01P Esprit® Ventilator Operator’s Manual © Respironics, Inc. G-5

Glossary

primary control over the frequency of breathing, the inspiratory time, and the
inspiratory flow.

Pressure Sensitivity a measure of the amount of negative pressure that must be

generated by a patient to trigger a mechanical ventilator into the inspiratory
phase; alternatively, the mechanism used to set or control this level.

Pressure Trigger initiation of inspiration when the patients inspiratory effort

exceeds the sensitivity threshold.

Rapid Shallow Breathing Index (F/VT) used to evaluate the adequacy of the
patients spontaneous ventilation. It is calculated by as shown below
• f/Vt = (Spont Rate)/(Spont VE)

Resistance The pressure drop across a pneumatic device (i.e. bacteria filter,
patient circuit tubing) for a unit of flow when the volume of the device remains
constant, i.e., (cmH2O (hPa))/mL/sec.

Risetime the time required for a pressure support or pressure controlled breath
to reach its target pressure.

RS-232 ANSI standard for communication.

Spontaneous Respiratory Rate (Spont Rate) the average rate of the spontaneous
breaths in the last eight breaths delivered by the ventilator.
•
Spontaneous Volume Exhaled (Spont V E) the exhaled volume that would come
from spontaneous breaths, projected over one minute. The calculation is done
by averaging the spontaneous exhaled tidal volume from the last eight breaths
and projecting what that volume would be if it continued for one minute.

Tidal Volume (Tidal Vol) the volume of patient gas as measured at the
exhalation flow transducer. The display shows an average unless the current
breath differs substantially from the average. When there is a substantial
change, the current breath is displayed. The average for tidal volume is
restarted when the operator changes the tidal volume setting and the machine
is delivering mandatory breaths.

Time Trigger initiation of inspiration by the ventilator according to the

respiratory frequency (Rate) setting.

Total Respiratory Rate (Total RR) the total breaths taken, spontaneous breath
rate + mandatory breath rate, from the last eight breaths and projecting what
that rate would be if it continued for one minute.
•
Total Volume Exhaled (Total V E) the total exhaled volume that would come from
all the patient’s breaths, projected over one minute. The calculation is done by
averaging the total exhaled tidal volume from the last eight breaths and

G-6 Esprit® Ventilator Operator’s Manual © Respironics, Inc. REF 580-1000-01P

 Glossary

projecting what that volume would be if it continued for one minute. This value
is updated at the end of each exhalation.

Trigger normally a patient effort to begin inhalation.

Volume space occupied by matter measured in milliliters or liters.

Window either a period of time or a portion of a screen depending on the

context.

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Glossary

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G-8 Esprit® Ventilator Operator’s Manual © Respironics, Inc. REF 580-1000-01P

Index

Numerics Altitude, Setting, 5-6, 5-10

100% O2, 8-6 Analog Port, 5-2, 6-7
Apnea Alarm, 9-4
A Apnea Ventilation, 7-7, 8-24
A/C, Assist Control, 7-3 Operation During, 7-7
AC Inlet, 5-2 Respiratory Rate, 8-19
ACCEPT, 8-6 Apply Date, 5-9
ACCEPT key, 5-8, 8-2 Apply Time, 5-9
Accessories, 4-2, 13-1 Assist Control Ventilation, 7-3
Adjust Control Knob, 8-7, 12-7 Assist Control Ventilation (A/C), 7-3
Adult Audible Alarm Failed Alarm, 9-5
Disposable Patient Circuit, 13-2 Auto-PEEP, 8-28
Patient Circuit Kit, 13-2 Calculation, 8-28
Adult/Pediatric Keys, 8-17
Air Inlet Filter, 5-1 B
Air Source Fault Alarm, 9-4 Bad ADC Wrap Sensor Alarm, 9-5
Airway Pressure, 7-3 Bad Bat Volt Sensor Alarm, 9-5
ALARM RESET, 8-6 Bad Int O2 Sensor Alarm, 9-5
Alarm Silence, 12-9 Bad Int Temp Sensor Alarm, 9-5
Alarms, 9-1 Battery Backup On Alarm, 9-5
Audible, 9-2 Baud Rate, RS-232, 6-2, A-1
Auto-Reset of, 9-3 Breath Indicator, 8-10
Descriptions, 9-4–9-7 Breath Type
High Urgency, 9-1, 9-2 Selecting, 8-20
Low Urgency, 9-1, 9-2 Breath Types, 12-1
Medium Urgency, 9-1, 9-2 BTPS, G-1
Operator-Initiated Reset of, 9-3 Built-In Test, 11-9
Remote, 6-2 Bus Activity Monitor, 11-9
Reset, 9-3
Silence, 9-2 C
Visual, 9-1 Cautions, 2-4
Volume Control, 9-3 Circuit Breaker
Alert Messages, 9-4 Humidifier AC, 5-2
Mains, 5-2

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Index

Cleaning, ventilator parts, 10-1 F

clock, 5-8 F/Vt, 8-26
Compliance, G-1, G-4 Flex Arm, 4-10
Circuit, 5-6, 11-4 Front Panel, 8-2
Compensation, 8-30, 11-1 Indicators, 8-3
Tubing, 5-11 Keys, 8-5
Compliance and Approvals, 12-11 Touch Display, 8-7
Continuous Positive Airway Pressure, 7-3
Control Knob, 8-7 G
CPAP, 7-3 Gas Supplies Lost - SVO Alarm, 9-5
Glossary, G-1
D
Date of Manufacture, 3-2 H
Date Setting, 5-8 High Inspiratory Pressure, 9-5, 12-8
Delivered O2, %O2, 8-26 Alarm Test, C-2
Diagnostic High Inspiratory Pressure Alarm, 9-5
Codes, 11-4 High Internal O2 Alarm, 9-5
Codes and Descriptions, 11-6–11-8 High Leak Rate Alarm, 9-5
Mode, 5-6, 11-2 High Minute Volume Alarm, 9-5
Diagnostics, 11-1 High O2 Alarm, 9-5
Display High Respiratory Rate, 9-5, 12-8
Front Touch Panel, 8-7 High Respiratory Rate Alarm, 9-5
Patient Leak, 7-5 High Temperature Alarm, 9-5
High Urgency Alarm, 12-9
E high urgency alarm, 9-1, 9-4
End Exhalation Pressure, 8-28 Humidifier
EPAP, 7-6, 8-19, 12-3, G-1 AC Circuit Breaker, 5-2
EST, 11-3 AC Outlet, 6-1
Exhalation Bacteria Filter, 13-2 Connecting, 6-3
Exp Valve Stuck Open Alarm, 9-5
EXP. HOLD, 8-6 I
Expiratory Bacteria Filter, 4-6, 4-7 I:E Ratio, 8-26
Expiratory Hold Inspiratory Bacteria Filter, 4-6, 13-2
Calculated Values, 12-7 Installation, 4-5
expiratory hold maneuver, 8-6 Removing and Replacing, 10-5
expiratory positive airway pressure, G-1 inspiratory bacteria filter, 13A-2
Extended Self Test (EST), 5-13, 11-3

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 Index

Inspiratory Trigger (I-Trigger), 8-17 table top, 4-11

IPAP, 7-6, 8-19, 12-3 wall, 5-4, 6-3
I-TIME, 7-2
I-Time Too Long Alarm, 9-6 N
Non-Invasive Positive Pressure Ventilation
K (NPPV), 7-6
Knob Non-Invasive Ventilation, 7-6, 8-1
Adjust Control, 8-7 non-invasive ventilation, 7-1
Normal Indicator, 12-9
L Notes, 2-7
Labels, 12-18 NPPV, 7-6, 8-19
lock Nurse Call
screen, 8-6 Label, 12-18
Low Backup Battery Alarm, 9-6 remote alarm, 5-1
Low EPAP Alarm, 9-6
Low Insp Pressure Alarm, 9-6 O
Low Minute Volume Alarm, 9-6 O2, 10-2
Low O2 Alarm, 9-6 Cylinder Bracket, 13-1
Low O2 Supply Alarm, 9-6 High Pressure Hose, 13-1
Low PEEP Alarm, 9-7 Manifold, 13-1
Low Tidal Volume Alarm, 9-7 Sensor, 13A-1
Low Vt Mandatory Alarm, 9-7 sensor, 4-5
Low Vt Spontaneous Alarm, 9-7 Sensor Kit, 13-1
Sensor Tee, 13A-1
M O2 Valve Stuck Closed Alarm, 9-7
Maintenance, 10-7 occlusion, 10-7
Mandatory breaths, 8-23 Occlusion - SVO Alarm, 9-7
mandatory breaths, 7-3 OIM
manometer, 8-10 Operator Initiated Breath, 8-6
MANUAL BREATH, 8-6 On/Off
Medium/Low Urgency Alarm, 12-9 Power, 5-5
Modes, 12-1 On/Off Switch, 5-2
Common to NPPV, 7-6 Open, 7-7
common to VCV & PCV, 7-2 Safety Valve, 7-7, 7-8
Emergency, 7-7 open
modes, 8-1 safety valve, 8-4, 9-8, 9-9
mount Operating

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Index

Instructions, 8-1 POST, 11-9

Theory, 7-1 Power Cord, 5-3
operating Power On Self Test (POST), 11-9
conditions, 9-1 Pressure Support Ventilation (PSV), 7-4
Options
Color, 13-1 R
Communications, 13-1 Restart, 11-10
Flow-Trak, 13-1 Alarm, 9-7
Graphics, 13-1 Rise Time Setting, 7-5
NICO-Esprit Interface, 13-1
Respiratory Mechanics, 13-1 S
RS-232 Communications 2, 13-1 Safety Valve Open, 12-9
Output Schedule for Periodic Maintenance, 10-7
Analog label, 3-1 SCREEN LOCK, 8-6
Serial label, 3-2 Screen Locked, 12-9
output Self-Test Hardware, 11-9
analog port, 6-7 Serial Port, 5-1
field, A-1 SIMV, 7-3
port, 6-1 Software Options, 13-1
Oxygen Options, 13-1
Source Connection, 4-9 Spont Rate, 8-26
Oxygen sensor, 13A-1 Spontaneous Respiratory Rate (Spont Rate),
G-6
P Spontaneous Volume Exhaled (Spont VE), G-
Panel, Back 6
Connections & Controls, 5-1 SST, 11-2
Panel, Front Synchronized Intermittent Mandatory Venti-
Controls, 8-7 lation (SIMV), 7-3
Dispay, 8-7
indicators, 8-3 T
Keys, 8-5 Tidal Volume, G-6
Patient Initiated Breath Triggering, 7-5 Time Format, 5-8
Patient Leak Display, 7-5 Time Setting, 5-8
Pediatric Total Rate, 8-26
Disposable Patient Circuit, 13-2 Total VE, 8-26
Patient Circuit Kit, 13-2 Touch Display, 8-7
Positive End Expiratory Pressure (PEEP), 7-4

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 Index

U
Using Default Altitude Alarm, 9-7
Using Default Compliance Alarm, 9-7
Using Default Settings Alarm, 9-7

V
Ventilator Inoperative, 12-9

W
Warnings, 2-1
Warranty, 13A-3, B-1

REF 580-1000-01P Esprit® Ventilator Operator’s Manual © Respironics, Inc. I-5

Index

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I-6 Esprit® Ventilator Operator’s Manual © Respironics, Inc. REF 580-1000-01P