Clinical guide

English
Contents
Introduction .......................................................................................................................... 1
Indications for use ............................................................................................................ 1
Contraindications .............................................................................................................. 1
Adverse effects ................................................................................................................ 1
General warnings and cautions......................................................................................... 2
The Astral system ................................................................................................................ 4
The Astral device .............................................................................................................. 5
The Astral device interface ............................................................................................... 6
Touch screen .................................................................................................................... 7
Information bar ................................................................................................................. 8
Menu bar .......................................................................................................................... 9
Bottom bar ....................................................................................................................... 9
Main screen ..................................................................................................................... 9
Pressure bar ................................................................................................................... 10
Settings bar .................................................................................................................... 10
Circuits and patient interfaces ........................................................................................... 11
Patient circuit accessories ................................................................................................. 11
Power accessories.............................................................................................................. 11
Power supplies ............................................................................................................... 12
Astral External Battery .................................................................................................... 12
ResMed Power Station II (RPSII) .................................................................................... 12
Remote Alarm II ............................................................................................................. 12
Pulse oximeter ............................................................................................................... 12
Optional accessories .......................................................................................................... 13
Astral Mobility bag.......................................................................................................... 13
Astral SlimFit Mobility bag .............................................................................................. 13
ResMed Homecare Stand .............................................................................................. 13
Astral Table Stand .......................................................................................................... 13
Aerogen® nebuliser......................................................................................................... 13
ResMed Connectivity Module (RCM) ............................................................................. 13
ResMed Connectivity Module Hospital (RCMH) ............................................................. 13
Using the Astral device...................................................................................................... 14
Connecting to mains power............................................................................................ 14
Powering on the device .................................................................................................. 14
Powering off the device ................................................................................................. 15
Accessing Clinical mode ................................................................................................. 15
Using the Setup Assistant .............................................................................................. 16
Enhanced access feature ............................................................................................... 19
Starting and stopping ventilation .................................................................................... 20
Locking and unlocking the touch screen ......................................................................... 21
 Navigating the menus .....................................................................................................21
Monitors menu ............................................................................................................................... 22
Setup menu .................................................................................................................................... 23
Alarms menu .................................................................................................................................. 23
Information menu ........................................................................................................................... 24
Programs ........................................................................................................................24
Working with programs .................................................................................................................... 24
Setting up a new program ................................................................................................................ 26
Adjusting patient settings ................................................................................................................. 28
Monitoring ventilation .....................................................................................................29
Device settings ...............................................................................................................31
Adjusting device settings ................................................................................................................. 32
Copying device settings ................................................................................................................... 32
Exporting device settings onto USB stick ........................................................................................ 33
Importing device settings from the USB stick.................................................................................. 33
Service reminders............................................................................................................................. 34
Using the Service reminders ............................................................................................................ 34
Circuit options.....................................................................................................................36
Assembling patient circuits .............................................................................................36
Fitting the circuit adapter .................................................................................................................. 38
Connecting a single limb circuit with intentional leak ....................................................................... 38
Connecting a single limb circuit for invasive use .............................................................................. 39
Connecting a single limb circuit with expiratory valve ...................................................................... 40
Connecting a double limb circuit (Astral 150 only)............................................................................ 42
Connecting a mouthpiece circuit ...................................................................................................... 43
Changing the circuit selection .......................................................................................................... 44
Learn Circuit ..................................................................................................................................... 44
Accessories .........................................................................................................................48
Attaching patient circuit accessories ...............................................................................48
Attaching a humidifier .....................................................................................................48
Attaching a Heat Moisture Exchange (HME) ...................................................................50
Attaching an antibacterial filter ........................................................................................50
Adding supplemental oxygen ..........................................................................................51
Monitoring delivered oxygen ...........................................................................................53
Attaching a nebuliser.......................................................................................................53
Attaching other accessories ............................................................................................54
Attaching a pulse oximeter ............................................................................................................... 54
Attaching a remote alarm ................................................................................................................. 56
Astral Carry Bag ..............................................................................................................57
Travelling with the Astral device......................................................................................58
Power management ...........................................................................................................59
Connecting to mains power ............................................................................................60
Connecting the Astral External Battery ...........................................................................61
Using the External Battery................................................................................................................ 61
Connecting to a ResMed Power Station (RPSII) ..............................................................62
Connecting to an external DC power source ...................................................................62
Using the internal battery ................................................................................................63
Battery run time................................................................................................................................ 63
Storing and recharging...................................................................................................................... 64
Device power source indicators ......................................................................................64
Using the Astral device for the first time .......................................................................... 66
Ventilation modes .............................................................................................................. 67
(A)CV mode - Assisted volume-controlled ventilation...................................................... 68
P(A)CV mode - Assisted pressure-controlled ventilation ................................................. 69
P-SIMV - Pressure Synchronised Intermittent Mandatory Ventilation ............................. 71
V-SIMV - Volume Synchronised Intermittent Mandatory Ventilation ............................... 72
PS mode - Pressure support ........................................................................................... 74
(S)T mode - Spontaneous Ventilation with backup rate ................................................... 76
P(A)C mode .................................................................................................................... 77
CPAP mode .................................................................................................................... 78
iVAPS (intelligent Volume Assured Pressure Support) mode .......................................... 79
Target alveolar ventilation ............................................................................................... 80
intelligent Backup Rate (iBR) .......................................................................................... 81
Configuring iVAPS .......................................................................................................... 81
Adopting recently learnt targets ........................................................................................................81
Adopting recently learnt targets ........................................................................................................82
Entering the target values manually ..................................................................................................84
AutoEPAP....................................................................................................................... 86
Flow shape settings ....................................................................................................... 87
Interdependence of controls........................................................................................... 88
Dynamic settings limits .....................................................................................................................88
Making use of Astral's High Pressure limit .......................................................................................88
Triggering and cycling ..................................................................................................... 89
Triggering with intentional leak circuits .............................................................................................90
Cycling with intentional leak circuits .................................................................................................90
Triggering with valve circuits .............................................................................................................91
Changing the Trigger Type ................................................................................................................92
Cycling with valve circuits .................................................................................................................93
Triggering with mouthpiece circuits ..................................................................................................93
Supplementary features .................................................................................................... 94
Manual breath settings ................................................................................................... 94
Sigh settings .................................................................................................................. 96
Apnoea Settings ............................................................................................................. 97
Control settings for Apnoea ventilation .............................................................................................97
(A)CV Breath pattern .........................................................................................................................98
P(A)CV breath pattern ........................................................................................................................99
Safety volume settings ................................................................................................. 100
Non-invasive ventilation (NIV) ........................................................................................ 101
Mask NIV...................................................................................................................... 101
Mouthpiece NIV ........................................................................................................... 101
Mouthpiece ventilation ................................................................................................. 101
Safety considerations for mouthpiece ventilation ......................................................... 102
Alarms .............................................................................................................................. 103
Alarm priority ................................................................................................................ 104
Viewing the active alarms ............................................................................................. 106
Muting alarms .............................................................................................................. 106
Resetting alarms .......................................................................................................... 107
 Adjusting alarm settings................................................................................................108
Setting the alarm volume ..............................................................................................109
Testing the alarm sounders and indicators ....................................................................109
Testing the Remote Alarm ............................................................................................110
Testing the alarms ............................................................................................................111
Testing the power alarms .............................................................................................111
Testing the pressure alarms ..........................................................................................111
Testing the ventilation monitoring alarms......................................................................112
Testing the oximetry alarms ..........................................................................................112
Testing the oxygen alarms ............................................................................................113
Testing the breathing circuit alarms ..............................................................................113
Testing the disconnection alarm ...................................................................................113
Alarm settings and conditions .........................................................................................114
Tidal volume alarms ......................................................................................................114
Minute volume alarms ..................................................................................................114
Respiratory rate alarms .................................................................................................115
Pressure alarms/limits ...................................................................................................115
High pressure ................................................................................................................................. 115
Obstruction ..................................................................................................................................... 116
Low pressure.................................................................................................................................. 116
PEEP ............................................................................................................................................... 116
Breathing circuit alarms.................................................................................................117
High leak ......................................................................................................................................... 117
NV Mask/Rebreathing..................................................................................................................... 117
Flow sensor not calibrated ............................................................................................................. 117
Circuit configuration alarms ............................................................................................................ 118
Disconnection alarm ....................................................................................................................... 118
Oxygen alarms ..............................................................................................................118
Oximetry alarms............................................................................................................119
SpO2............................................................................................................................................... 119
Pulse rate........................................................................................................................................ 119
Apnoea alarm ................................................................................................................119
Ventilation stopped alarm ..............................................................................................119
Power alarms ................................................................................................................120
System alarms ..............................................................................................................120
Detecting circuit disconnection and de-cannulation ......................................................121
Astral Disconnection Alarm .............................................................................................122
Adjusting the Disconnection Alarm ...............................................................................122
Setting and testing Disconnection Tolerance ................................................................122
Setting Activation Time .................................................................................................................. 124
Disabling (or enabling) the Disconnection Alarm ...........................................................125
Data management process ..............................................................................................127
Data management summary .........................................................................................128
Deleting patient data........................................................................................................ 129
Cleaning and maintenance .............................................................................................. 130
Single patient use ......................................................................................................... 130
Weekly ............................................................................................................................................130
Monthly ...........................................................................................................................................130
Multi-patient use .......................................................................................................... 131
Replacing components ................................................................................................. 132
Replacing the air filter ......................................................................................................................132
Replacing the expiratory flow sensor and antibacterial filter (Astral 150 only) ................................132
Replacing the double limb adapter (expiratory valve) ......................................................................134
Replacing the Oxygen sensor .........................................................................................................134
Replacing the internal battery ..........................................................................................................135
Servicing....................................................................................................................... 136
Maintenance Timetable ...................................................................................................................136
Internal Battery ................................................................................................................................136
Device information ..........................................................................................................................137
Upgrading software .........................................................................................................................137
Additional considerations for hospital or healthcare facilities ........................................ 137
Technical specifications ................................................................................................... 138
Monitoring........................................................................................................................ 143
Time parameters .......................................................................................................... 143
Volume and flow parameters........................................................................................ 143
Pressure parameters .................................................................................................... 144
Other parameters ......................................................................................................... 144
Accuracy of controls ........................................................................................................ 145
Measurement System and Accuracy .............................................................................. 148
Functional variants........................................................................................................... 148
Guidance and Manufacturer’s Declaration Electromagnetic Emissions
& Immunity....................................................................................................................... 149
Guidance and manufacturer’s declaration—electromagnetic emissions ....................... 149
Guidance and manufacturer’s declaration – electromagnetic immunity ........................ 150
Recommended separation distances between portable and mobile RF
communications equipment and the life support device............................................... 152
Potential impact of electromagnetic disturbances ........................................................ 152
Symbols............................................................................................................................ 153
Standards compliance ..................................................................................................... 154
Training and support ....................................................................................................... 154
Troubleshooting............................................................................................................... 155
Alarm troubleshooting .................................................................................................. 155
Learn Circuit troubleshooting........................................................................................ 160
General troubleshooting ............................................................................................... 163
Recommendations for suctioning ...................................................................................164
Limited warranty ..............................................................................................................165
Appendix A: Definitions ...................................................................................................166
Ventilation settings definitions ......................................................................................166
Measured and calculated parameter definitions ............................................................168
Appendix B: Ventilation parameters................................................................................170
Ventilation Parameters summary table ..........................................................................170
Ventilation displayed parameters...................................................................................174
Supplementary Features ...............................................................................................174
Supplementary Features displayed parameters.............................................................177
Appendix C: Alarm parameters .......................................................................................179
 Introduction

Introduction
The Astral device provides mechanical ventilation to both ventilation dependent and non-dependent
patients. It delivers pressure and volume ventilation through either a valve or leak circuit, and is
compatible with a range of accessories to support specific use cases.
The information in this guide applies to both the Astral 100 and the Astral 150 devices. Where
information applies to only one of these devices, that device will be specified.
Note: Some features may not be available on your device.

WARNING
• Read the entire manual before using the Astral device.
• Use the Astral device only as directed by a physician or healthcare provider.
• Use the Astral device only for the intended use as described in this manual. Advice contained
in this manual does not supersede instructions given by the prescribing physician.
• Install and configure the Astral device in accordance with the instructions provided in this
guide.

Indications for use

The Astral 100/150 provides continuous or intermittent ventilatory support for patients weighing more
than 5 kg who require mechanical ventilation. The Astral device is intended to be used in home,
institution/hospital and portable applications for both invasive and non-invasive ventilation.

CAUTION
The Astral device is not intended for use as an emergency transport ventilator.

Contraindications
The Astral device is contraindicated in patients with the following pre-existing conditions:
• pneumothorax or pneumomediastinum
• pathologically low blood pressure, particularly if associated with intravascular volume depletion
• cerebrospinal fluid leak, recent cranial surgery or trauma
• severe bullous lung disease
• dehydration.

WARNING
AutoEPAP is contraindicated when using an invasive interface.

Adverse effects
Report unusual chest pain, severe headache or increased breathlessness to your physician. The following
side effects may arise during use of the device:
• drying of the nose, mouth or throat
• nosebleed
• bloating
• ear or sinus discomfort
• eye irritations
• skin rashes.

English 1
Introduction

General warnings and cautions

The following are general warnings and cautions. Further specific warnings, cautions and notes appear
next to the relevant instruction in the manual.
A warning alerts you to possible injury.

WARNING
• If you notice any unexplained changes in the performance of the device, if it is making unusual
or harsh sounds, if the device or the power supply are dropped or mishandled discontinue use
and contact your healthcare provider.
• For ventilator-dependent patients, always have alternate ventilation equipment available, such
as a back-up ventilator, manual resuscitator or similar device. Failure to do so may result in
patient injury or death.
• The Astral device is a restricted medical device intended for use by qualified, trained personnel
under the direction of a physician. Clinical supervision is required in critical care/intensive care
unit environments.
• Ventilator-dependent patients should be continuously monitored by qualified personnel or
adequately trained carers. These personnel and carers must be capable of taking the necessary
corrective action in the event of a ventilator alarm or malfunction.
• The internal battery is not intended to serve as a primary power source. It should only be used
when other sources are not available or briefly when necessary; for example, when changing
power sources.
• The Astral device is not intended to be operated by persons (including children) with reduced
physical, sensory or mental capabilities without adequate supervision by a person responsible
for the patient's safety.
• The Astral device is not intended to be operated by patients unless they have been given
adequate instruction concerning the operation of the device by a person responsible for the
patient's safety.
• The Astral device must not be used in the vicinity of an MRI or diathermy device.
• The effectiveness of ventilation and alarms should be verified including after any ventilation or
alarm setting change, any change in circuit configuration, or after a change to co-therapy (eg,
nebulisation, oxygen flow).
• The Astral device and AC Power Supply can get hot during operation. To prevent possible skin
damage do not leave the Astral device or AC Power Supply in direct contact with the patient for
extended periods of time.
• The device can provide therapies typically associated with both ventilator-dependent and
non-dependent patients. The mode of ventilation, circuit type, and alarm strategies should be
chosen after a clinical evaluation of each patient’s needs.
• The device must not be used at an altitude above 3000m or outside the temperature range of
0–40°C. Using the device outside these conditions can affect device performance which can
result in patient injury or death.

2
 Introduction

A caution explains special measures for the safe and effective use of the device.

CAUTION
• Repairs and servicing of the device should only be performed by an authorised ResMed service
representative.
• The temperature of the airflow for breathing produced by the device can be as much as 6ºC
higher than the temperature of the room. Caution should be exercised if the room temperature
is warmer than 35ºC.
• Do not expose the device to excessive force, dropping or shaking.
• Dusty environments may affect device performance.
• The Astral device may experience interference in the vicinity of electronic article surveillance
(EAS). Keep the Astral device at least 20 cm away from the EAS.

A note advises of special product features.

Notes:
• When using Astral for long term invasive ventilation in the home, due consideration should be given to relevant
practice guidelines such as the AARC Clinical Practice Guideline for Long Term Invasive Mechanical Ventilation
in the Home - 2007 Revision & Update (www.rcjournal.com/cpgs/pdf/08.07.1056.pdf)
• For assistance and reporting of issues associated with the Astral device, contact your Health Care Provider or
authorised ResMed representative.

English 3
The Astral system

The Astral system

The Astral system comprises a number of components, including:
• Astral device with:
- hypoallergenic air inlet filter
- internal battery
• Power Supply Unit (PSU)
• AC Power cord
• Astral carry bag
• Single limb adapter
• Single limb leak adapter
• Double limb adapter (Astral 150)
• ResMed USB stick
• Astral User Guide
• Astral Clinical Guide CD.
Optional accessories are also available for use with the Astral device, and include:
• Remote Alarm II
• Astral External Battery
• ResMed Power Station II (RPS II)
• Astral Mobility Bag
• Astral SlimFit Mobility Bag
• ResMed Homecare Stand
• Astral Table Stand
• Pulse oximeter
• Aerogen® nebuliser
• ResMed Connectivity Module (RCM)
• ResMed Connectivity Module Hospital (RCMH).
Note: Some accessories may not be available in all regions.
For a full list of accessories, see Ventilation accessories on www.resmed.com under the Products page.
If you do not have internet access, please contact your ResMed representative.

WARNING
Before using any accessory, always read the accompanying User Guide.

4
 The Astral system

The Astral device

The following images describe the components of the Astral device.

Description
1 Adapter port
Can be fitted with single limb adapter, single limb leak adapter or double limb adapter (Astral 150 only).

2 Handle
3 Inspiratory port (to patient)
Provides an outlet for pressurised air to be delivered to the patient via the patient circuit. Includes FiO2 sensor on the
Astral 150. The FiO2 sensor is an optional accessory on the Astral 100.
4 Ethernet connector (service use only)
5 USB connector (for download to ResScan and connection of approved accessories)
6 Mini USB connector (for connection to RCM or RCMH)

English 5
The Astral system

Description
7 DC power inlet
8 Device on/off push button
9 SpO2 Sensor connector
10 Remote alarm five pin connector
11 Low flow oxygen input (up to 30 L/min)
12 Air inlet (complete with hypoallergenic filter)

The Astral device interface

The interface of the Astral device comprises several different features described in the following image.

Description
1 Touch screen
2 Power source indicators
AC (mains power supply)
DC (external battery or car accessory adapter or RPSII)
Internal battery

6
 The Astral system

Description
3 Therapy on/off indicator
Device ready
Constant green display when the device is turned on but not ventilating.
Device ventilating
Flashes blue when the device is ventilating and the Ventilation LED setting is 'ON'.
Otherwise is 'OFF'.
4 Alarm mute/reset button
Illuminates when an alarm is triggered and flashes when the sound is muted.

5 Alarm bar

Flashing red High priority alarm

Flashing yellow Medium priority alarm

Constant yellow Low priority alarm

Touch screen
The main method of interacting with the Astral device is via the touch screen. The display on the touch
screen changes according to the function being performed.

Description

1 Clinical mode access button

Locked Unlocked
2 Manual breath button

only shown if enabled

3 Information bar

English 7
The Astral system

Description

4 Internal battery indicator

5 Lock touch screen button

6 Menu bar
7 Bottom bar
8 Start/Stop ventilation button
9 Main screen
10 Sub-menus
11 Pressure bar

Information bar
The Information bar is displayed at the top of the touch screen. The Information bar displays the
operating status of the device, including patient type, current circuit configuration, programs, information
messages, ventilation status, alarms and power status.

Description
Patient type – Adult

Patient type – Paediatric

Circuit type – Single limb with intentional leak

Circuit type – Single limb with expiratory valve

Circuit type – Double limb

Circuit type – Mouthpiece

P1:DAY Program number and program name

(A)CV Ventilation mode
Multiple alarms are active simultaneously. The highest priority active alarm is displayed first.

Message Will display alarms or information. Image above shows device in Standby. (Displayed when the device is powered
window on but not ventilating). Date and time will be displayed when the device is ventilating and there are no active
alarms.
Information messages are displayed in blue text. If the device Alert tone setting is 'On', you will be alerted to new
information messages by a single beep.

8
 The Astral system

Menu bar
The Menu bar provides access to the four main menus in the Astral device.
Monitors menu
View real-time patient data in either waveform or monitoring formats including pressure, flow, leak, tidal
volume, synchronisation and oximetry.
Setup menu
Configure and view ventilation therapy or device settings; and import/export data.

Alarms menu
Configure and view alarms including alarm volume.

Information summary menu

View therapy statistics, used hours, events, reminder and device information.

Bottom bar
The Bottom bar changes with the function of the device.
It can display buttons to Stop or Start ventilation and Apply or Cancel functions. It can also display
real-time readings.

Main screen
The Main screen displays the monitoring data, ventilation and device controls. Each function is accessed
through the various menus and tabs.

English 9
The Astral system

Pressure bar
The Pressure bar displays real-time therapy data while the Astral device is ventilating.
Patient pressure is shown as a bar graph. Peak inspiratory pressure is shown as a numerical value and
watermark. Spontaneously triggering and cycling is indicated by and .
The example below displays the pressure bar when a patient is spontaneously breathing.

Description
1 Peak inspiratory pressure (PIP) value
2
Spontaneous cycled breath marker—indicates patient-cycled breath
3 Peak inspiratory pressure marker
4 Current pressure
5 Positive end expiratory pressure (PEEP) setting
6
Spontaneous triggered breath marker—indicates patient-triggered breath

Settings bar
The settings bar appears on the right hand side of the touch screen when a therapy or alarm setting has
been selected for adjustment. The settings bar allows the settings to be adjusted via the up and down
scroll arrows or the minimum and maximum buttons. The example below displays the settings bar when
a setting has been selected for adjustment.

Description
1 Maximum button—adjusts setting to maximum limit
2 Up scroll arrow—increases setting by single increment
3 Down scroll arrow—decreases setting by single increment

4 Minimum button—adjusts setting to minimum limit

10
 Circuits and patient interfaces

Circuits and patient interfaces

The following circuits are available for use with the Astral device.
• Single limb circuit with intentional leak (provides a leak compensated estimate of patient flow and
exhaled tidal volume)
• Single limb circuit with expiratory valve
• Double limb circuit (exhaled gas returns to the device for monitoring) (Astral 150 only)
• Mouthpiece circuit (tube-only circuit for use with mouthpiece interfaces)
The Astral device is compatible with the following invasive and non-invasive patient interfaces:

Invasive
• endotracheal tubes
• tracheostomy tubes

Non-invasive
• vented and non-vented masks
• mouthpiece.

WARNING
The measurement of patient exhaled gas volume may be affected by leak.

Patient circuit accessories

The following patient circuit accessories are available for use with the Astral device:
• Humidifier
• Heat Moisture Exchange (HME)
• Antibacterial filter
For information on attaching and using patient circuit accessories, refer to Attaching patient circuit
accessories (see page 48).

Power accessories
WARNING
• The Astral device should only be used with accessories recommended by ResMed. Connection
of other accessories could result in patient injury or damage to the device.
• Connecting the Astral device to the battery of a battery-powered wheelchair may affect the
device performance and may result in patient harm.

The Astral device can be connected to a range of accessories as follows:

• Astral External Battery
• ResMed Power Station II
• Astral DC adapter
• ResMed Remote Alarm II
• Pulse Oximeter.

English 11
Power accessories

Power supplies
In addition to the internal battery and mains power sources, the Astral device can be powered from the
following sources:
• Astral External Battery
• ResMed Power Station II
• Astral DC adapter.

Astral External Battery

The Astral External Battery has been designed specifically for use with the Astral series of ventilators. It
is intended to provide Astral ventilators with eight hours of power when mains power is unavailable
during typical use.

ResMed Power Station II (RPSII)

The RPSII is an external lithium-ion battery that provides power when mains power is unavailable.

Remote Alarm II
The Remote Alarm II is self-powered (via battery) and connected to the Astral device via a cable. If
required, a second Remote Alarm can be attached to the first Remote Alarm. This enables Remote
Alarms to be placed in two separate locations. The Remote Alarm II can also be connected to a hospital
alarm management system. For more information, see the Remote Alarm II user guide.

Pulse oximeter
Attaching a pulse oximeter to the Astral device enables real-time SpO2 and pulse readings to be viewed
from the Monitoring menu. For further information, refer to Attaching a pulse oximeter (see page 54).

12
 Optional accessories

Optional accessories
The Astral device can be used with a range of optional accessories as follows:
• Astral Mobility Bag
• Astral SlimFit Mobility Bag
• ResMed Homecare Stand
• Astral Table Stand
• Aerogen® nebuliser
• ResMed Connectivity Module (RCM)
• ResMed Connectivity Module Hospital (RCMH).
Note: Some accessories may not be available in all regions.

Astral Mobility bag

The Astral Mobility Bag offers extra protection to the Astral device and enables patients to easily
transport the device while ventilating. The bag may be carried by hand, worn as a backpack or attached
to a wheelchair.
The bag holds the Astral device, optional battery pack and an Astral power supply unit.

Astral SlimFit Mobility bag

The Astral SlimFit Mobility Bag is a slim, light-weight bag that allows discrete, mobile use of the Astral
device. The bag may be carried by hand, worn as a backpack or attached to a wheelchair.
The bag holds the Astral device, with an optional detachable pouch for storage of an external battery or
power supply unit.

ResMed Homecare Stand

The ResMed Homecare Stand is designed to hold and move compatible ResMed ventilators and
accessories between points of therapy in the hospital and limited care facilities. For further information,
see the Homecare Stand user guide.

Astral Table Stand

The Astral Table Stand provides an ergonomic and convenient solution for placing the Astral device on a
bedside table. The stand holds the Astral at an inclined angle for convenient operation by both the carer
and the patient. The stand holds both the Astral device and its external power supply.

Aerogen® nebuliser
If required, a nebuliser can be used in conjunction with the Astral device. ResMed recommends
Aerogen® nebuliser products. For more information, refer to Attaching a nebuliser (see page 53).

ResMed Connectivity Module (RCM)

The RCM provides cellular connection between a compatible ResMed ventilation device and the ResMed
AirView™ system. For further information, see the RCM user guide.

ResMed Connectivity Module Hospital (RCMH)

The RCMH provides connection between compatible ResMed ventilation devices and hospital Electronic
Medical Record (EMR) systems. For further information, see the RCMH user guide.

English 13
Using the Astral device

Using the Astral device

WARNING
Make sure the area around the device is dry, clean and clear of bedding or clothes or other objects
that could block the air inlet. Blocking the cooling vents could lead to overheating of the device.
Blocking the air inlet could lead to patient injury.

CAUTION
• To prevent possible damage to the ventilator, always secure it to its stand or place it on a flat,
stable surface. For mobile situations, ensure the Astral device is contained within its
mobility bag.
• Ensure the device is protected against water if used outdoors.

Connecting to mains power

To connect to mains power:
1. Connect the DC plug of the supplied ResMed external power supply unit to the rear of the Astral
device.
2. Connect the power cord to the ResMed power supply unit.
3. Plug the other end of the power cord into the power outlet.
For further information on powering the Astral device, refer to Power management (see page 59).

Powering on the device

To power on the Astral device, simply press the green power on/off button at the back of the device. The
device will perform a system check as shown on the main screen.
On completion of the system check, the Patient Home screen and active program is displayed.
The Astral device is factory pre-set with one active program.
If more than one program displays on the Patient Home screen, the active program will be highlighted
orange. For further information, refer to Programs (see page 24).
Note: Settings configured in the active program will be used when ventilation is started.

14
 Using the Astral device

Powering off the device

The Astral device can only be powered off when ventilation is stopped.
Removing AC power does not power off the device. The device remains powered on internal battery.
Turning off the device must be done manually and must be performed before leaving the device
disconnected from AC power for any extended period of time. Failure to do so may result in battery
depletion and activation of alarms.
To power off the device, press the green on/off button at the back of the device and follow the on-screen
prompts. To ensure the device is fully powered down, touch the screen.
Note: While the device remains connected to external mains power, the internal battery continues to charge.

Accessing Clinical mode

The closed padlock indicates the device is in Patient mode. To access clinical functions, such as the
Setup Assistant and program configurations, you must enter Clinical mode.
Clinical mode can be accessed from any screen, whether or not the Astral device is ventilating.

To access Clinical mode:

1. From the patient home screen, press and hold for 3 seconds, then release.
2. Select:
20 minutes—the device will return to patient mode after 20 minutes of inactivity, or
Unlimited—the device will remain unlocked until powered off or manually locked.

CAUTION
Only select Unlimited if the device will remain under the continuous supervision of qualified
trained personnel under the direction of a physician. When clinical access is no longer required,
exit Clinical mode to return to Patient mode.

The padlock is unlocked and the Main Settings screen is displayed.

English 15
Using the Astral device

To exit Clinical mode:

1. Press . The Exit Clinical Mode screen is displayed.

2. Press Confirm. The padlock is locked and the Patient Home screen is displayed.
Note: If you do not make a selection within 7 seconds, the device returns to the previous screen.

Using the Setup Assistant

To quickly set up the Astral device and start ventilation, use the Setup Assistant.
The Setup Assistant guides you through the process of setting up the device for use by a new patient.
The Setup Assistant prompts you to assemble components and automates testing of the circuit. For
detailed instructions on assembling patient circuits, and other components and accessories, refer to
Assembling patient circuits (see page 36).
The Setup Assistant can only be accessed when the Astral device is in Clinical mode.
Note: Using the Setup Assistant will clear the current settings of the active program.

To use the Setup Assistant:

1. Access Clinical mode.

2. From the Main menu press Setup . The Setup menu is displayed.
3. Select Setup Assistant and press Start.

4. A warning message will display. Select Continue.

16
 Using the Astral device

5. Select the Patient type. This will automatically configure default alarm and setting ranges.

6. The Select Circuit type screen is displayed. Select the circuit type to be connected to the device.

7. The Learn Circuit screen is displayed. Press Start.

8. Follow the prompts to attach and test the circuit. For detailed instructions on how to attach the
circuit, refer to Assembling patient circuits (see page 36).
When the Learn Circuit is complete, you will be prompted to select your required Interface type. The
interface type selection is used to determine if the disconnection alarm can be turned off and also
sets a suggested setting for the disconnection alarm.

Note: If the circuit is single with leak and Mask is selected as the Patient interface, the Select Mask Type screen
will appear.

English 17
Using the Astral device

9. Select the required Ventilation mode.

The default settings for the mode are displayed.

10. Review and adjust the settings and alarms as required.

For further information on adjusting setting parameters and alarm settings, refer to Adjusting patient
settings (see page 28) and Adjusting alarm settings (see page 108).

11. Press to start ventilation.

18
 Using the Astral device

Enhanced access feature

The Astral device offers an enhanced access feature ('Big buttons' mode) to provide easier usability and
accessibility for starting and stopping ventilation as well as Alarm mute.
The 'Big buttons' mode can be switched on and off as required in either Clinical or Patient mode.

WARNING
To prevent inadvertent alarm mute or reset, do not leave the patient in contact with the device
screen.

To enable the 'Big buttons' mode:

1. From the Main menu press Setup . The Setup menu is displayed.
2. Select the Patient Access tab from the Device Config. menu.

3. Move the Big buttons slider to On.

English 19
Using the Astral device

Your enhanced access feature is now enabled.

With this feature enabled, it is possible to switch between ‘Big buttons’ mode and standard. Simply
select the Home button from left hand corner of the Bottom bar.
Your screen will return to standard button size and the Home icon will be replaced by the Big buttons

icon .
To return to 'Big buttons' mode, simply select the Big buttons icon from the bottom bar.

Note: With the enhanced access feature enabled, your screen will return to 'Big buttons' mode once the screen
locks (after two minutes of inactivity).

Starting and stopping ventilation

WARNING
Always ensure that the values in the ventilation therapy and alarm settings are appropriate before
starting therapy.

Note: If using the device for the first time, ResMed recommends performing a functional test before starting
ventilation. Refer to Using the Astral device for the first time (see page 66).

To start ventilation:
1. Press the green on/off button at the back of the device (if power is not already on).

2. Press . Ventilation is started.

3. Add oxygen if required.

20
 Using the Astral device

To stop ventilation:
Ventilation can be stopped at any time and from any screen.
1. If oxygen is connected, turn off the oxygen.

2. Press and hold .

3. Release when prompted.

4. Press Confirm. Ventilation is stopped.

Locking and unlocking the touch screen

The touch screen can be unlocked at any time in both Patient and Clinical modes.

To manually lock the touch screen, from the Information bar press . When the touch screen is
locked the button is highlighted orange.

Unlocking the touch screen

Touch the screen anywhere and follow the on-screen prompts.

Navigating the menus

The Astral device has four menus accessible via the Menu bar. Each menu is further broken down into
various sub-menus.
This chapter focuses on what the menus are and their structure. For information on adjusting and
configuring features, refer to Using the Astral device (see page 14).
Waveforms
Monitors
Monitoring
Trends
Programs*
Setup Setup Assistant*
Circuit
Settings Main Settings
Manual Breath
Sigh breath
USB Patient Data
Settings
Upgrade
Device Config. Device
Date / Time
Units
Patient access

English 21
Using the Astral device

Alarms 1 & 2 Tidal Volume (Vt)

Minute Ventilation (Mv)
Alarms Respiratory Rate
Pressure
Low PEEP
Ventilation Stop
Leak
Non-vented Mask (NV Mask) / Rebreathing
Alarm 3 FiO2
SpO2
Pulse
Apnoea Response Apnoea Response
Apnoea Detection
Alarm Volume Alarm Level
Alarm Minimum Volume
Alarm Test
Disconnection Alarm Disconnection Alarm
Events Alarms
Information Settings
System
Delete
Device Basic
Advanced
Battery Charge
Maintenance
* Available in Clinical mode only.

Monitors menu
The Monitors menu allows you to view real-time ventilation data and is comprised of three sub-menus:
• Waveforms
• Monitoring
• Trends

22
 Using the Astral device

Setup menu
The Setup menu displays six different sub-menus:
• Programs—to configure therapy programs
• Setup Assistant—guides you through device setup
• Circuit—to set up the circuit
• Settings—to change the ventilation mode and related settings
• USB—to save patient data and import/export settings
• Device config.—to change the device configuration.

Alarms menu
Display the Alarms menu to view/update the individual thresholds for each alarm to trigger. Real-time
values are displayed between the upper and lower thresholds. The options available for adjustment
change depending on the circuit configuration.

English 23
Using the Astral device

Information menu
The Information menu is comprised of three sub-menus:
• Events—all logged event activity that has taken place is displayed. A breakdown of specific alarms,
settings or system events can also be viewed.
• Device—information about the actual device is displayed, eg, Model and Serial numbers, Software
version, and Next service due date.
• Battery—information about the state of charge of the internal and external batteries when connected
including the combined total battery charge.

Programs

WARNING
The safety and effectiveness of ventilation therapy and alarms settings should be verified for each
enabled Program.

Working with programs

The Astral device comes factory preset with one active program. Additional programs can be enabled.
Astral 100 provides a maximum of two programs. Astral 150 provides for a maximum of four programs.
Programs allow for different circuit, ventilation and alarm settings. Programs provide convenient patient
access to different device configurations to suit their needs such as sleeping, daytime use, and exercise
or physiotherapy. A list of options is available to allow for each program to be named accordingly. Once
configured, enabled programs can be selected from the Patient Home Screen.
When configuring each new program, connect the appropriate circuit and perform a Learn Circuit.

24
 Using the Astral device

To enable / disable additional programs:

1. Access Clinical mode.
2. From the Setup main menu, select Programs.
3. Enable additional programs by pressing the slider.
Note: The current active program is highlighted in orange and cannot be disabled.
In the screen below, P1: (A)CV is the current active program. P2 has been enabled and is showing
the factory preset mode.

4. Rename the program by pressing the Rename button.

Within the Rename window, a name for the current active program can be chosen from the list provided. In the
screen below, the selected name DAY is highlighted.

Note: A selected name can be removed by pressing the delete button .

5. When selected, the program name is displayed on the program label and on the information bar
when that program is active.

English 25
Using the Astral device

To change programs:
1. Select P2: (A)CV. P2 becomes the active program.

2. Select and start the Setup assistant. Refer to Using the Setup Assistant (see page 16).
Once the Setup assistant is complete, P2 will now be configured to the settings you have chosen
and is ready to Start ventilation. In the example below, P2 has been changed from (A)CV mode to
P(A)CV.

Note: Each program retains its own circuit configuration. When switching between programs, ensure you use the
correct circuit as 'learned' for that program.

Setting up a new program

Adjustments to program settings can only be made to the current active program. To make changes to
settings of other programs, you must first activate that program.
Adjustments to patient settings can be made while the device is Ventilating or in Standby mode.

WARNING
Always review and adjust alarm Settings when setting up a new program. For information, refer to
Adjusting alarm settings (see page 108).

26
 Using the Astral device

To adjust the Ventilation mode of the current active program:

1. Access Clinical mode, the Main Settings screen will be displayed automatically.
2. The current active Ventilation mode and settings are displayed.

3. Press the Ventilation mode button. The Select Ventilation Mode screen will display, the current
active Ventilation mode will be highlighted orange. Select your required Ventilation mode.

4. You will be returned to the Main Settings page. All changes you have made will be outlined in
orange, indicating a pending status until you press Apply. If the mode change is cancelled you will be
returned to the current active mode's primary settings page. Any modifications will be disregarded.

5. Once settings have been applied the program is updated with the new Mode selection. Perform a
Learn Circuit.

English 27
Using the Astral device

6. To make changes to the patient settings within this mode, refer to Adjusting patient settings (see
page 28).

Note: If the mode change is cancelled you will be returned to the current active mode's primary
settings page. All modifications will be disregarded.

Adjusting patient settings

To adjust patient settings of the current active program:
1. Access Clinical mode.
The Main settings screen will be displayed.

2. Select the setting that you want to adjust. The selected setting is highlighted in orange and the
Settings bar appears on the right side of the screen.

3. Increase or decrease the selected setting as desired.

4. If adjustments to other selected settings are required, select the desired settings and repeat this
process. All settings that have been adjusted are shown with an orange outline.
5. If no further adjustments are required, select Apply.
Review and adjust alarm settings as required. Refer to Adjusting alarm settings (see page 108) for more
information.

28
 Using the Astral device

Notes:
• The Apply button is disabled if one or more settings cannot be applied. Refer to Interdependence of controls
(see page 88). A message is displayed indicating the reason.
• If the mode change is cancelled you will be returned to the current active mode's primary settings page. All
modifications will be disregarded.

Monitoring ventilation
During ventilation, ventilation parameters are continuously monitored and displayed in real-time. The
measures are displayed as follows:
• Numerical values on the Monitoring screen and a summary of critical values in the bottom bar.
• Graphically on the Waveforms, Trends screen and Pressure bar.

Monitoring screen
The Monitoring screen displays all measured parameters in numerical form.

For details on the available monitoring parameters refer to the Ventilation Parameters Summary Table
(see page 170).

Waveforms
The Waveforms screen displays the last 15 seconds of patient airway pressure and flow in a graph. The
graph updates in real-time and when necessary the vertical axis will auto scale to accommodate changes
in amplitude.

Description

1 Spontaneous trigger breath marker—indicates patient-triggered breath.

2 Break in graph—indicates the current position and moves from left to right.

English 29
Using the Astral device

Continuously displayed monitors

During ventilation, the Bottom bar displays the current measures for VT, MV, Resp.rate, Ti, % Spont Trig,
and Leak. For a detailed description of the Bottom bar refer to Getting to know the Astral device (see
page 6).
During ventilation, the Pressure bar displays real-time airway pressure, PEEP and PIP. For a detailed
description of the Pressure bar refer to Getting to know the Astral device (see page 6).
Both the Bottom bar and Pressure bar remain visible from other screens. This permits critical ventilation
parameters to be continuously monitored while performing other tasks on the Astral device.
Note: The ventilation measures on the Bottom bar will be hidden while an action request is displayed. For example
Apply/Cancel.

Trends screen
The Trends screen shows the 5th and 95th percentile values, as well as the median for the last 30 days
for each of the following parameters:
• Leak
• Minute ventilation
• Peak inspiratory pressure
• Tidal volume
• Respiratory rate
• Inspiratory time
• SpO2
• Pulse rate
• FiO2
• Alveolar ventilation.

Information is displayed as bar graphs, with two graphs per screen.

Use the up and down scroll arrows to cycle through the graphs.

30
 Using the Astral device

Device settings
All device configuration settings are stored independently of patient programs. The configurable settings
are described in the following table.

Device setting Adjustable Description

by patient
Inspiratory Phase N Determines how to set-up the inspiratory phase for volume controlled breaths.
Duration Options
Can be set to either Ti Option or PIF Option.
Default: Ti Option

Alert tone Y Sets alert tones to on or off.

Default: On
Note: When 'On' you will be alerted to the display of new information messages by a single
beep.
Minimum alarm N Allows a minimum volume level to be set for the device. Any setting less than the set
volume minimum will be visible, but not able to be selected.
Default: 3
Alarm volume Y Sets the volume level of the alarm system.
Settings from 1, 2, 3, 4 or 5.
Default: 3
Auto power off Y Automatically powers off the device after 15 minutes of inactivity.
Conditions: The device is in Ventilation standby mode (not ventilating), is being powered by the
Internal battery or an External battery
Default: On
Display brightness Y Sets the brightness of the screen from Auto with a selection of five different brightness levels.
Default: Auto
Backlight timeout Y Allows the screen backlight to turn off (go black) if the screen has not been touched for two
minutes or more and there are no active alarms.
Setting to 'Off' will mean the screen back-light will be permanently on.
Default: On
Rotate display Y Flips the current orientation of the display.
Device Vent LED Y Sets the status of the Ventilation active LED to On or Off during ventilation.
Default: On
Date Y Allows setting of the day, month and year of the current date.
Time Y Allows setting of the hours and minutes of the current time.
Language Y Sets the current language of the device selected from the list of available languages.
Pressure unit N Specifies displayed units for all pressure data and settings as cmH2O, mBar or hPa.
Note: The reference unit for all accuracy and monitoring claims is hPa. The conversion factor
between units in accordance with industry practice is one.
Height unit N Specifies displayed units for the patient's height as inches or cm.
Big buttons Y Sets Big buttons feature to On or Off.

English 31
Using the Astral device

Adjusting device settings

Access adjustable device settings from the Setup menu and select Device config.

The current active selections are highlighted in orange.

To change settings, simply select another of the available options. The revised setting is highlighted in
orange.
Note: In Patient mode, only the settings that are able to be adjusted by the patient are enabled.

Copying device settings

The Astral device allows for all settings to be copied from one device to another via a USB stick.
Ventilation settings for all available patient programs, and device configuration settings can be copied.
Settings can only be copied between compatible Astral devices. To be compatible, both devices must:
• be the same variant (eg, both Astral 150 or both Astral 100)
• have same product code
• have same software version*
*Subsequent releases will be backwards compatible.

32
 Using the Astral device

Exporting device settings onto USB stick

Exporting of device settings can be performed at any time.

To export device settings:

1. Insert a USB stick into the USB connector at the rear of the device. Refer to Data Management
process (see page 127).

2. From the Main menu, press Setup . The Setup menu is displayed.
3. Select the Settings tab from the USB sub-menu.
When the USB is ready, the Export > button will become active.
4. Press Export >.
Any Astral settings currently on the USB stick will be deleted and replaced with the settings from the current
device.
5. Press Confirm to proceed with the export.
When the export is complete, a status message is displayed.

Importing device settings from the USB stick

Settings can only be imported when the device is in Clinical Mode and not ventilating.
Notes:
• All settings should be verified to be appropriate for the patient prior to commencing ventilation.
• Learn circuit must be performed for each enabled program prior to commencing ventilation.
To import device settings:
1. Insert a USB stick into the USB connector at the rear of the device. Refer to Data Management
process (see page 127).
2. Enter Clinical mode.

3. From the Main menu, press Setup . The Setup menu is displayed.
4. Select the Settings tab from the USB sub-menu.
The Import > button will become active if there are settings from a compatible device available on the USB stick
and the device is not ventilating.
5. Press Import >.
A warning will be displayed to indicate that all device and patient program settings will be replaced.
6. Press Confirm to proceed with the import.
A progress bar will be displayed while the settings are being imported and applied.
When the import is complete, a status message is displayed as well as a reminder to check all settings have
been applied correctly.
Learn Circuit results will be reset to default parameters for each enabled program. Learn Circuit needs to be
performed with the appropriate patient breathing circuit for each enabled program.
All device configuration settings and all patient program settings should be verified to be appropriate for the
patient prior to commencing ventilation.

English 33
Using the Astral device

Service reminders
The Service reminders provide information that device servicing is required in the near future.
There are two types of Service reminders:
• Preventative maintenance reminder—the two year service interval is approaching.
Note: This reminder is linked to the Next service due date as displayed on the Device information page.
• Battery replacement reminder—the internal battery is approaching the end of service life.

Using the Service reminders

When either a Preventative maintenance or Battery replacement reminder is present, a reminder
button is displayed in the right corner of the bottom bar.
Note: Service reminders are only visible in Patient mode.

Select the reminder button to display the reminder prompt. Acknowledgment of the prompt will clear the
reminder prompt and reminder button. The reminder button will remain if the user prompt has not been
acknowledged or the Next service due date has passed.

Note: More than one Service reminder can be present at a given time. In this case, the Service
reminders will be displayed sequentially after each confirmation.

34
 Using the Astral device

To enable a Service reminder:

The Service reminders can only be enabled or disabled in Clinical mode.
1. Access Clinical mode.

2. From the Main menu, press Setup . The Setup menu is displayed.
3. Select the Reminders tab from the Device Config. sub-menu.

4. Move the Preventative maintenance or Battery replacement reminder to ON.

5. Access Patient mode.
Your Service reminder is now enabled.

English 35
Circuit options

Circuit options
The Astral device supports a range of circuits (the device and accessories assembled together) to suit
individual patient needs. The device uses interchangeable circuit adapters.
The following table may assist in selecting suitable circuits and settings for different patient types:

Tidal volume range Recommended patient type setting Suitable circuit diameters
50 mL to 300 mL Paediatric 10 mm, 15 mm or 22 mm
> 300 mL Adult 15 mm or 22 mm

Assembling patient circuits

WARNING
• Use a double limb circuit for direct measurement of exhaled volumes. In this configuration, the
expired volume is returned to the ventilator for independent measurement. (Astral 150 only)
• The Astral device does not support monitoring of exhaled volumes when used with a single
limb circuit with expiratory valve.
• The patient circuit should be arranged so as not to restrict movement or pose a strangulation
risk.
• Only use circuit components that comply with the relevant safety standards including
ISO 5356-1 and ISO 5367.

CAUTION
For paediatric use, ensure that the patient circuit type fits and is suitable for use with a child. Use a
paediatric patient type for patients that weigh less than 23 kg and normally require less than
300 mL tidal volume.

36
 Circuit options

There are three circuit adapters:

Adapter For use with

1 Single limb leak Single limb circuit with intentional leak or mouthpiece circuit

2 Single limb Single limb circuit with expiratory valve (expiratory valve integrated into the circuit)

3 Double limb Double limb circuit (expiratory valve integrated into the adapter) OR single limb circuit with
(Astral 150 only) intentional leak or mouthpiece circuit

A Learn Circuit should be performed after any change of circuit. Astral will provide accurate therapy as long as the Learn Circuit
is completed. Refer to Learn Circuit (see page 44) for further information.

English 37
Circuit options

Fitting the circuit adapter

Before connecting the patient circuit, the adapter specific to the required circuit type must be fitted.

To fit the adapter:

1. Turn over the device and place on a soft surface (to protect the LCD screen).
2. Press and hold the eject button. Pull the cover out towards you.
3. Lift the adapter out of the socket.
4. Replace with the new adapter, ensuring it sits firmly in the socket.
5. Place the cover over the enclosure, ensuring the runners on the device and the cover are aligned.
Slide the cover back into place until the latch clicks.

Connecting a single limb circuit with intentional leak

An intentional leak may be provided in-line using the ResMed Leak Valve or via an integrated mask vent.
When using a circuit with intentional leak, estimation of the patient respiratory flow is enhanced by
ResMed's automatic leak management feature Vsync. Vsync technology allows the device to estimate
the patient respiratory flow and tidal volume in the presence of unintentional leak.

WARNING
• At low pressures, the flow through the mask vents may be inadequate to clear all exhaled
gases, and some rebreathing may occur when using a single limb circuit with intentional leak.
• Ensure the vent holes at the mask or at the ResMed Leak Valve are unobstructed. Ensure the
area around the vent holes is clear of bedding, clothes, or other objects and that the vents
holes are not directed towards the patient.

To connect a single limb circuit with intentional leak:

1. Check the device is fitted with the single limb leak adapter. Otherwise, change the adapter.
Note: The Astral 150 can also support a single limb circuit with intentional leak using a double limb adapter.
2. Connect the inspiratory limb to the inspiratory port.
3. Attach any required circuit accessories (eg, humidifier or filter).
4. Select the circuit type and perform a Learn Circuit.
5. If using a non-vented mask or tracheostomy connector, attach a ResMed Leak Valve to the free end
of the air tubing ensuring that the Leak Valve is as close as possible to the patient.
38
 Circuit options

6. Attach the patient interface (eg, mask) to the Leak valve or the free end of the air tubing as
appropriate and adjust the mask type setting on the Astral device.
Note: If using the ResMed Leak Valve, select Leak Valve for the Mask type setting.

Connecting a single limb circuit for invasive use

CAUTION
Always set up the ResMed Leak Valve in the breathing circuit with the arrows and the symbol
pointing in the direction of air flow from the Astral device to the patient.

For invasive ventilation, since the patient's upper respiratory system is bypassed by an artificial airway
device (for example endotracheal or tracheostomy tube) humidification of the inspired gas is required to
prevent lung injury.

English 39
Circuit options

Connecting a single limb circuit with expiratory valve

In a single limb circuit with expiratory valve, air pressure at the patient is monitored using the proximal
pressure sensor line.
To enable fast and accurate connection, use an Astral Quick Connect Single Limb Circuit. This custom
accessory with its integrated proximal pressure sensor and expiratory valve control line, is designed
specifically for use with Astral ventilators.

To connect an Astral 'Quick Connect' Single Limb Circuit with expiratory valve:
1. Check the device is equipped with the single limb adapter (otherwise change the adapter).
2. Connect the air tubing to the inspiratory port on the device.
3. Attach the Astral Quick Connect circuit to the single limb adapter on the device (see diagram below).
4. Attach any required circuit accessories (eg, humidifier or filter).
5. Select the circuit type and perform a Learn Circuit.
6. Attach a patient interface (eg, mask) to the connector on the expiratory valve.

40
 Circuit options

To connect a standard single limb valved circuit to the Astral:

1. Connect the Proximal pressure line to the upper connector of the Astral device single limb adapter.
2. Connect the PEEP control line to the lower connector of the Astral device single limb adapter.
3. Connect the air tubing to the inspiratory port of the device.
4. Attach any required circuit accessories (eg, humidifier or filter).
5. Select the circuit type and perform a Learn Circuit.
6. Attach a patient interface (eg, mask) to the connector on the expiratory valve.

English 41
Circuit options

Connecting a double limb circuit (Astral 150 only)

A flow sensor within the Astral device measures exhaled air flowing through the expiratory valve
integrated into the double limb circuit adapter. (This arrangement enables patient-exhaled tidal volume to
be accurately measured and monitored).

To connect a double limb circuit:

1. Ensure the device is fitted with the double limb adapter (otherwise change the adapter).
2. Connect the ends of the air tubing to the inspiratory and adapter ports on the device.
3. Attach any required circuit accessories (eg, humidifier or filter).
4. Select the circuit type and perform a Learn Circuit.
5. Attach a patient interface (eg, mask) to the end of the air tubing.

42
 Circuit options

Connecting a mouthpiece circuit

The mouthpiece circuit is a single limb circuit with no expiratory valve or intentional leak. This circuit is
not intended to support continuous exhalation into the circuit. For patients that may prefer continuous
exhalation into the circuit, a circuit with expiratory valve or intentional leak should be considered.

To connect a mouthpiece circuit:

1. Check the device is fitted with a single limb leak adapter. Otherwise, change the adapter.
Note: The Astral 150 can also support mouthpiece circuit using a double limb adapter.
2. Connect the inspiratory limb to the inspiratory port.
3. Attach any required circuit accessories (eg, filter).
4. Select the circuit type and perform a Learn Circuit.
5. Attach the patient interface (eg, mouthpiece) to the free end of the air tubing as appropriate.

English 43
Circuit options

Changing the circuit selection

To change the circuit selection on the Astral device:
1. From the Setup main menu, select Circuit.
2. Select Circuit Type. (The current circuit type will be shown in orange).

3. Select the circuit you want to change to which will be highlighted orange. You will be taken to the
Learn Circuit screen.
4. Press Start to run the Learn Circuit and follow the on-screen prompts.

Learn Circuit
In order to support a wide range of circuit configurations and accessories, the Astral device provides a
Learn Circuit function to determine the characteristics of the circuit. As part of the Learn Circuit
functionality the Astral performs a device self-test and a calibration of the FiO2 sensor (if installed).

CAUTION
To ensure optimum and accurate performance, it is recommended that the Learn Circuit function
be performed with every change of circuit configuration and at regular intervals not less than once
every three months.

Do not connect patient interfaces prior to performing the Learn Circuit. Patient interfaces include any
components placed after the single circuit's expiratory valve or exhalation port, or double limb circuit's 'Y'
piece (eg, HMEF, catheter mount, mask, tracheostomy tube).
The following table may assist in selecting suitable circuits and settings for different patient types:

Tidal volume range Recommended patient type setting Suitable circuit diameters
50 mL to 300 mL Paediatric 10 mm, 15 mm or 22 mm
> 300 mL Adult 15 mm or 22 mm

44
 Circuit options

To perform a Learn Circuit:

1. From the Setup main menu, select the Circuit sub-menu.
2. Press Start and follow the on-screen prompts.

Note: Trigger type sets whether a pressure-based or flow-based trigger threshold is used when a Double circuit
is selected.

The prompts will guide you through a number of steps including:

- With the patient interface disconnected from the patient connection port, the Astral device will
characterise the impedance of the inspiratory path.
- With the patient connection port sealed, the Astral device will characterise the total circuit
compliance, and then the impedance of the expiratory path.
After completing these steps, a test result screen is displayed. You can access this Results screen
later using the Results button in the Circuit setting up screen.

English 45
Circuit options

The following icons are used to report the Learn Circuit results:

Learn Circuit Results

Icon Description
Learn Circuit completed
Learn Circuit not tested. Default circuit characteristics will be applied. Accuracy of control and monitoring may not be
met. Ensure that ventilation and alarms are effective before proceeding further.
Learn Circuit completed. Circuit resistance is high.* The device will use the learned circuit characteristics. Accuracy of
control and monitoring may not be met. Ensure that ventilation and alarms are effective before proceeding further.
*The International Standards Organisation (ISO) has judged that patients ventilated with tidal volumes in excess of
300 mL (Adult range) should use breathing circuits with a resistance no more than 6 cmH2O pressure drop at a flow
rate of 30 L/min and 6 cmH2O at 15 L/min for tidal volumes less than 300 mL (Paediatric range).
This circuit configuration may be appropriate for particular patients and hence clinical discretion is
required. Should ventilation cease for any reason, the patient must overcome this resistance in order to breath.
Note: Patient/carer should be informed that this icon will appear each time Learn Circuit is performed using this
configuration.
Learn Circuit has failed. Default circuit characteristics will be applied.
Below are general steps to resolve the Learn Circuit issue. Refer to Learn Circuit Troubleshooting (see page 160) for
suggested actions on the error code.
1. Inspect the circuit and proximal lines for disconnection or excessive leak.
2. Check that the circuit is correctly connected and matches the selected circuit type.
3. Check that the correct circuit adapter is installed for the selected circuit type.
4. Check the module, the blue membrane and sensor are pressed all the way in and sit flush with the enclosure.
Accuracy of control and monitoring will be degraded. Ensure that ventilation and alarms are effective before
proceeding further.

Device Test Results

Icon Description
Device Test has passed.
Device Test has not been run. This only occurs on setting up a new therapy program.
Device Test has failed. Learn Circuit cannot be run.
Below are general steps to resolve the Learn Circuit issue. Refer to Learn Circuit Troubleshooting (see page 160) for
suggested actions on the error code.
1. Inspect the air inlet for foreign materials.
2. Inspect the air filter and replace it, if necessary. Refer to Cleaning and maintenance (see page 132) for further
instructions.
3. Remove the expiratory module and inspect the module and blue membrane for any foreign materials.
4. Re-install the module, ensuring that it is securely in place.
5. Repeat Learn Circuit. If problem persists, refer to Learn Circuit Troubleshooting (see page 160) for suggested
actions on the error code.
If you choose to proceed with ventilation, accuracy of control and monitoring will be degraded. Ensure that ventilation
and alarms are effective before proceeding further.

46
 Circuit options

Oxygen (FiO2) Sensor Results

Icon Description
Oxygen sensor calibration has passed.
Oxygen sensor not tested or not installed.
1. If your device was supplied without an oxygen sensor, ignore this message and proceed with therapy.
2. If possible, check that the oxygen sensor is securely attached as described in Replacing the oxygen sensor (see
page 134).
3. Repeat Learn Circuit. If the oxygen sensor is still not detected, return the device for servicing by an authorised
ResMed Service Centre.
Oxygen sensor calibration has failed.
Below are general steps to resolve the oxygen sensor calibration issue. Refer to Learn Circuit Troubleshooting (see
page 160) for suggested actions on the error code.
1. If possible, replace the oxygen sensor as described in Replacing the oxygen sensor (see page 134).
2. Repeat Learn Circuit. If problem persists, return the device for servicing by an authorised ResMed Service Centre.
If you choose to proceed with ventilation, FiO2 alarms will be disabled. An alternate method for monitoring FiO2 is
required.

Expiratory Flow Sensor Results

Icon Description
Expiratory flow sensor calibration has passed.
Expiratory flow sensor not tested or not installed.
Expiratory flow sensor calibration has failed.
Below are general steps to resolve the expiratory flow sensor calibration issue. Refer to Learn Circuit Troubleshooting
(see page 160) for suggested actions on the error code.
1. Remove the adapter, seal, and expiratory flow sensor.
2. Inspect the module, seal, and flow sensor for any foreign materials.
3. Re-install the module and flow sensor, ensuring that it is securely in place.
4. If possible, replace the expiratory flow sensor as described in Replacing the expiratory flow sensor (see page
132).
5. Repeat Learn Circuit. If problem persists, return the device for servicing by an authorised ResMed Service Centre.
If you choose to proceed with ventilation, check Vte and MVe alarms are effective.

English 47
Accessories

Accessories
For a full list of accessories, see Ventilation accessories on www.resmed.com under the Products page.
If you do not have internet access, please contact your ResMed representative.

Attaching patient circuit accessories

WARNING
• Adding or removing circuit components can adversely affect ventilation performance. ResMed
recommends performing a Learn circuit every time an accessory or component is added to or
removed from the patient circuit. If the circuit configuration is changed, the Disconnection
Alarm needs to be checked for correct operation.
• Do not use electrically conductive or anti-static air tubing.

Attaching a humidifier
A humidifier or HME is recommended for use with the Astral device.

WARNING
• For invasive ventilation, since the patient's upper respiratory system is bypassed by an artificial
airway device (for example endotracheal or tracheostomy tube) humidification of the inspired
gas is required to prevent lung injury.
• Always place the humidifier on a level surface below the level of the device and the patient to
prevent the mask and tubing filling with water.
• Only use humidifiers that comply with the relevant safety standards, including ISO 8185 and
set up the humidifier according to the manufacturer's instructions.
• Monitor the air tubing for water condensation and / or spillage from the humidifier. Use
appropriate precautions to prevent water in the circuit transferring to the patient (eg, a water
trap).

For non-invasive ventilation, for patient experiencing dryness of the nose, throat or mouth, humidification
of the inspired gas will prevent subsequent irritation and discomfort.

CAUTION
Make sure that the water tub is empty and thoroughly dried before transporting the humidifier.

48
 Accessories

To attach a humidifier to a patient circuit:

1. Connect a length of air tubing to the inspiratory port on the device.
2. Connect the other end of the air tubing to the inlet port on the humidifier.
3. Connect the patient circuit to the outlet port on the humidifier.
The image below shows proper use of a humidifier in combination with a double limb circuit.

When using heated humidification with a double limb circuit, condensation may form in the expiratory
flow sensor if the air is cooled to below its dew point. Condensation may also form in the patient circuit
and is most likely to form at high humidity settings and low ambient temperatures.
Condensation forming in the expiratory flow sensor may cause a loss of expiratory flow measurement
and compromised therapy (ie, auto-triggering, increased PEEP and activation of the leak alarm.
To prevent condensation at the Expiratory flow sensor, always follow the humidifier manufacturer's
instructions on how to prevent condensation and regularly check the patient circuit for condensation.
To ensure accurate therapy, Astral's Learn Circuit function should be performed prior to filling the water
tub.

English 49
Accessories

Attaching a Heat Moisture Exchange (HME)

HME's are passive humidification systems that retain heat and moisture from the patient's exhaled
gases via an internal membrane. An HME should not be used with active humidification. An HME can be
used with the Astral device with a double limb circuit or single limb circuit with integrated valve.

WARNING
Only use HMEs that comply with the relevant safety standards, including ISO 9360-1 and
ISO 9360-2.

Place the HME between the patient end of the circuit and the patient interface.

Do not connect patient interfaces prior to performing the Learn Circuit. Patient interfaces include any
components placed after the single circuit's expiratory valve or exhalation port, or double limb circuit's 'Y'
piece (eg, HMEF, catheter mount, mask, tracheostomy tube).

Attaching an antibacterial filter

WARNING
• Regularly check the antibacterial filter and expiratory valve for signs of moisture or other
contaminants, particularly during nebulisation or humidification. Failure to do so could result
in increased breathing system resistance and/or inaccuracies in expired gas measurement.
• Only use antibacterial filters that comply with the relevant safety standards, including
ISO 23328-1 and ISO 23328-2.

CAUTION
The antibacterial filter must be used and replaced according to the manufacturer's specifications.

50
 Accessories

To attach an antibacterial filter:

1. Fit the antibacterial filter to the inspiratory port of the device.
2. Connect the air tubing to the other side of the filter.
3. Perform the Learn Circuit function.
4. Attach the patient interface to the free end of the air tubing.

WARNING
• To prevent the risk of cross-contamination, an antibacterial filter is mandatory if the device is to
be used on multiple patients.
• The expiratory module, internal antibacterial filter, expiratory flow sensor and blue membrane
come into contact with exhaled gases but do not form part of the inspiratory pathway.

Adding supplemental oxygen

The Astral device is designed to be compatible with levels of supplemental oxygen up to 30 L/min.
At a fixed rate of supplemental oxygen flow, the inhaled oxygen concentration will vary depending on the
Ventilation mode and settings, patient breathing pattern, mask selection, and leak rate.

English 51
Accessories

WARNING
• Use only medical grade oxygen sources.
• Always ensure that the device is ventilating before the oxygen supply is turned on.
• Oxygen flow must be turned off when the device is not ventilating so that oxygen does not
accumulate within the device enclosure. Explanation: Accumulation of oxygen presents a risk
of fire. This applies to most types of ventilators.
• Oxygen supports combustion. Oxygen must not be used while smoking or in the presence of
an open flame. Only use oxygen in well-ventilated rooms.
• Supplemental oxygen must be added into Astral’s oxygen inlet at the rear of the device.
Adding oxygen elsewhere, ie, into the breathing system via a side port or at the mask, has
potential to impair triggering and accuracy of therapy/monitoring and impair alarms (eg, High
Leak alarm, Non-vented mask alarm)
• The patient circuit and the oxygen source must be kept at a minimum distance of 2 m away
from any sources of ignition.
• Monitor supplemental oxygen using the integrated FiO2 sensor and alarms or use an external
O2 monitor compliant with ISO 80601-2-55.
• When operating Astral in its mobility bag do not add more than 6 L/min of supplemental
oxygen.
• Astral is not designed for use with heliox, nitric oxide or anaesthetic gases.
• Do not position the Astral device on its side as this may affect FiO2 monitoring accuracy.

To add supplemental oxygen:

1. Unlock the low flow oxygen inlet at the rear of the device by pushing up on the locking clip.
2. Insert one end of the oxygen supply tubing into the oxygen port connector. The tubing will
automatically lock into place.
3. Attach the other end of the oxygen supply tubing to the oxygen supply.
4. Start ventilation.
5. Turn on oxygen and adjust (at the oxygen supply) to the prescribed flow rate or FiO2 level.

Supplemental oxygen can also be added from an oxygen bottle however, a flow regulator must be fitted
to ensure the delivered oxygen remains at or below 30 L/min.
Before you remove supplemental oxygen from the device, ensure the Oxygen supply has been turned
off.

52
 Accessories

To remove supplemental oxygen:

1. Unlock the low flow oxygen inlet at the rear of the device by pushing up on the locking clip.
2. Remove the oxygen port connector from the low flow oxygen inlet.

Monitoring delivered oxygen

The FiO2 sensor is a standard inclusion on the Astral 150 and an optional accessory on the Astral 100.
The sensor measures the average of percentage of oxygen delivered to the circuit through the inspiratory
limb.
Prior to using the FiO2 monitor, a Learn Circuit needs to be performed to calibrate the sensor. Repeat the
calibration at regular intervals at least once every three months.
Note: It may take up to 30 minutes for the FiO2 sensor readings to meet the specified accuracy after
powering on the device from off state or when all power source indicators are off.
The FiO2 sensor performance can be adversely affected by relative humidity, condensation on the sensor
or unknown gas mixtures.

WARNING
Do not position the Astral device on its side as this may affect FiO2 monitoring accuracy.

Attaching a nebuliser
If required, a nebuliser can be used in conjunction with the Astral device. ResMed recommends
Aerogen® nebuliser products—designed to operate in-line with standard ventilator circuits and
mechanical ventilators without changing ventilator parameters or interrupting ventilation.

WARNING
• Always connect antibacterial filters to both the inspiratory port and the expiratory inlet of the
Astral device to protect the device.
• Regularly check the antibacterial filter and expiratory valve for signs of moisture or other
contaminants, particularly during nebulisation or humidification. Failure to do so could result
in increased breathing system resistance and/or inaccuracies in expired gas measurement.
• Only operate the nebuliser when the device is ventilating. If ventilation is stopped, switch off
the nebuliser.
• Use of a gas jet nebuliser may affect ventilator accuracy. Monitor the patient and compensate
for the gas volume introduced by the gas jet nebuliser as appropriate.
• For full details on using a nebuliser, see the User Guide that comes with that device.

English 53
Accessories

Connect the nebuliser unit with a T-piece into the inspiratory limb of the breathing circuit before the
patient. If one of the Aerogen nebuliser models is being used (ie, Aeroneb Solo and Aeroneb Pro), it can
be powered via the USB connector at the rear of the Astral device, or the Aerogen USB AC/DC adapter.

Pictured above: Aeroneb® Solo in-line.

For full instructions for use, please consult the Aeroneb Solo System Instruction Manual.

Attaching other accessories

Attaching a pulse oximeter

WARNING
• Only use compatible NONIN™ finger pulse sensors*.
• Pulse oximeter sensors must not be used with excessive pressure for prolonged periods as this
can cause patient pressure injury.
• The pulse oximeter sensor and cable needs to be verified for compatibility with Astral,
otherwise patient injury can result.

CAUTION
Factors that may degrade pulse oximeter performance or affect the accuracy of the measurement
include the following: excessive ambient light, excessive motion, electromagnetic interference,
blood flow restrictors (arterial catheters, blood pressure cuffs, infusing lines, etc.), moisture in the
sensor, improperly applied sensor, incorrect sensor type, poor pulse quality, venous pulsations,
anaemia or low haemoglobin concentrations, cardiogreen or other intravascular dyes,
carboxyhaemoglobin, methaemoglobin, dysfunctional haemoglobin, artificial nails or fingernail
polish, or a sensor not at heart level.

54
 Accessories

To connect the pulse oximeter:

1. Connect the plug of the finger pulse sensor to the plug of the pulse oximeter.
2. Connect the plug of the pulse oximeter to the SpO2 (pulse oximeter) connector at the rear of the
device.

*Please refer to the Ventilation accessories on www.resmed.com under the Products page for part
numbers of oximeter accessories with confirmed compatibility. For information on how to use these
accessories, refer to the user guide that comes with these accessories.
Once you have attached the pulse oximeter, a message will briefly display in the information bar.
Real-time SpO2 and Pulse readings can be viewed from the Monitoring menu.
Notes:
• Values from the SpO2 sensor are averaged over 4 heartbeats.
• Included SpO2 sensor is calibrated for the display of functional oxygen saturation.
• The No SpO2 monitoring alarm will activate if the pulse oximeter has been disabled or has a degraded
signal for more than 10 seconds or has been disconnected.

English 55
Accessories

Attaching a remote alarm

The ResMed Remote Alarm II has been designed for use with Astral devices. The Remote Alarm II alerts
you to an alarm that requires immediate attention. It triggers an audible and visual alarm when an alarm
is triggered on the Astral device. For full instructions on using the Remote Alarm II, see the User Guide
that comes with that device.

To connect the Remote Alarm II to the Astral device:

1. Connect one end of the alarm cable to the (3 pin) input connector on the remote alarm.
2. Connect the other end to the (5 pin) output connector located at the rear of the Astral device.

CAUTION
To remove the cable, pull firmly on the connector. Do not twist.

56
 Accessories

Astral Carry Bag

The Astral device should always be packed in its Carry Bag when not in use to prevent damage to the
device.

WARNING
The Astral should not be operated while in the Carry Bag. To ventilate while travelling, use the
Astral Mobility bag or SlimFit mobility bag.

To use the Carry Bag

1. Prior to placing the device in the Carry Bag, remove:
- the power connection from the rear of the device
- all patient circuit components
- all accessories, including Remote Alarm and oximeter
- the USB Stick.
2. Place the Astral device carefully into the Carry Bag, ensuring the handle is at the top and the screen
faces the printed image on the bag.
3. Secure the Astral device in place by using the Velcro strap. (To ensure the most secure position,
thread the Velcro strap through the handle and attach.)
4. Place the Power Supply unit and any heavy components in the side zippered pocket.
5. Ensure all zippers are completely closed and the device secure before lifting the Carry Bag.

CAUTION
Do not place any heavy or bulky objects in the zippered pocket on the inside front of the bag. This
could result in damage to the LCD Touch screen.

English 57
Accessories

Travelling with the Astral device

WARNING
The Astral device should not be operated while in the Carry Bag. To ventilate while travelling, use
the Mobility Bag or SlimFit Mobility bag.

When travelling with the Astral device:

• The Astral device should always be packed in its carry bag when not in use to prevent damage to the
device.
• The carry bag is for carry-on luggage only. The carry bag will not protect the Astral device if it is put
through checked baggage.
• For your convenience at security stations, it may be helpful to keep a printed copy of the user guide
in the Astral carry bag to help security personnel understand the device and refer them to the
following statement.
• ResMed confirms that the Astral device meets the Federal Aviation Administration (FAA)
requirements (RTCA/DO-160, section 21, category M) for all phases of air travel.
• For power management tips, refer to Power management (see page 59).

58
 Power management

Power management
Helpful hints!
• Connect the ventilator to the mains power whenever possible. In the event of battery failure, connect
to mains power immediately to resume ventilation.
• An external power source (Astral External Battery or RPSII) should always be available for
ventilator-dependent patients.
• An external power source (Astral External Battery or RPSII) should be in use in mobile situations,
including when mains power is unavailable or disrupted. Do not rely solely on the internal battery for
mobile use.
• Ensure the external battery is sufficiently charged before using in mobile situations.

WARNING
• Beware of electrocution. Do not immerse the device, power supply or power cord in water.
• Make sure the power cord and plug are in good condition and the equipment is not damaged.
• Keep the power cord away from hot surfaces.
• Explosion hazard—do not use in the vicinity of flammable anaesthetics.

The Astral device can be used with different power sources:

• Mains power
• Astral External Battery
• External DC power supply (eg, car 12V power outlet)
• ResMed Power Station II
• Internal battery
For information on power supplies and sources, refer to the Technical Specifications (see page 138).

English 59
Power management

Connecting to mains power

WARNING
Ensure that the power cord does not pose a tripping or choking hazard.

To connect to mains power:

1. Connect the DC plug of the supplied ResMed external power supply unit to the rear of the Astral
device.
2. Before connecting the power cord to the ResMed power supply unit, ensure the end of the
connector of the power cord is correctly aligned with the input socket on the power supply unit.
3. Plug the other end of the power cord into the power outlet.

Note: The power cord is equipped with a push-pull locking connector. To remove, grasp the power cord housing and
gently pull the connector from the device. Do not twist its outer housing or pull on the cord.

60
 Power management

Connecting the Astral External Battery

The Astral External Battery has been designed specifically for use with the Astral Series of ventilators. It
is intended to provide Astral ventilators with eight hours of power during typical use.
For full details on using the Astral External Battery, refer to the External Battery user guide.

Using the External Battery

Connecting a fully charged External Battery to the Astral device can provide 8 hours of power during
typical use. A second fully charged External Battery can be connected to the Astral device to provide a
further 8 hours of power during typical use. A maximum of two external batteries can be connected to
the Astral device.
Once the External Battery is connected to the Astral device, the DC mains indicator on the user interface
will illuminate.

WARNING
• Do not attempt to connect more than two external batteries. Battery specific messages and
alarms on the Astral device will not operate for any additional units.
• In the unlikely event of an issue occurring with the external battery, Astral will sound an alarm
and notify the user indicating that the device is operating on internal battery power. Ventilation
will continue, however, users should connect to an alternative external power source (eg, AC
power or another external battery) as soon as possible.

Alarms and messages relating to the External Battery may occur from time to time. All message
information will be displayed on the Astral user interface, and will be accompanied by an audible signal.
Refer to the Alarms Troubleshooting (see page 155) for further information.

English 61
Power management

Connecting to a ResMed Power Station (RPSII)

The RPSII provides the Astral device with eight hours of power during typical use. To use, connect the
power cord of the RPSII to the DC inlet port on the device.

CAUTION
• When using the Astral device with an RPSII, the internal battery will not be charged.
• Do not use the RPSII and external battery together.

Connecting to an external DC power source

CAUTION
• When using a car auxiliary adapter, start the car before plugging in the device's DC adapter.
• If the external DC power source drops to below 11V, the Astral will switch to internal battery.
• When the device is turned off while connected to the DC adapter, it will continue to draw
power from the external DC power source.

To connect DC power:
1. Connect the DC plug of the external DC power supply unit to the rear of the device.
2. Plug the other end of the power cord into the power outlet.

62
 Power management

Using the internal battery

An internal battery is included in the Astral device. It ensures a continuous power supply when mains
power is disrupted and no external battery is connected to the device. When the Astral starts using the
internal battery as its power source, you are notified by the Using internal battery alert and with the
internal battery power source indicator.
The internal battery operates for approximately eight hours under typical conditions. During ventilation,
alarms will alert the user to a low battery condition. During standby, no alarms will be announced. The
user should regularly check the battery status.

WARNING
• When using the Astral device as a backup ventilator, ensure the internal battery level is
checked on a regular basis.
• As the battery ages, the available capacity decreases. When the remaining battery capacity is
low, do not rely on the internal battery as the primary power supply.
• The internal battery should be replaced every two years or sooner when there is a noticeable
reduction in usage time when fully charged.
• The internal battery is not intended to serve as a primary power source. It should only be used
when other sources are not available or briefly when necessary; for example, when changing
power sources.

CAUTION
• Revert to AC mains power when the remaining capacity of the battery is low.
• The internal battery may stop charging when ambient temperatures of 35°C or more are
reached. This will be indicated with a Power fault/No charging alarm message.
• The internal battery will be depleted if the device is left in storage for an extended period of
time. During storage, ensure the internal battery is recharged once every six months.
• Storing the Astral device at temperatures exceeding 50°C for extended periods will accelerate
battery ageing. This will not affect the safety of the battery or the device.

While connected to mains power, the internal battery continues to charge when the device is operating
or in standby.
For more information on the expected operating time of the internal battery, see the Technical
Specifications.

Battery run time

The internal battery powers the Astral device for eight hours under conditions typical to the chronic home
ventilator-dependent patient.
Internal battery run time is determined by the:
• percent charge
• environmental conditions (such as temperature and altitude)
• condition and age of the battery
• device settings
• patient circuit setup and unintentional leak.
The internal battery should be replaced every two years or sooner when there is a noticeable reduction in
usage time when fully charged.

English 63
Power management

Storing and recharging

If the internal battery is not used, it must be recharged every six months.
It takes approximately four hours to fully recharge the internal battery from depletion; however this can
vary depending on environmental conditions and the device operating state.

To prepare the internal battery for long-term storage:

1. Check that the battery charge level is between 50 and 100%. If not, charge the device to at least
50% prior to storage.
2. Remove the power cord from the Astral.
3. Turn off the device.

To recharge the internal battery:

1. Connect the device to mains power.
2. Charging commences as indicated by a flashing battery charging indicator symbol in the Information
bar.
Notes:
• When charging a completely depleted battery, it will normally take up to 30 minutes to increase battery capacity
from 0% to 1%.
• If the device has been stored outside the operating temperature range, an alarm message (Power fault / No
charging) may appear. You can still continue using the device, however, if the alarm persists for more than 2
hours the battery may need replacement.

Device power source indicators

Information on system and battery charge levels can be accessed in one of two ways:
1. Battery Indicator
The capacity of all connected batteries will be added to the RunTime indicator on the Information bar
of the Astral interface. (This may take a couple of minutes). The total will be the sum of the Astral
internal battery plus either one or two external batteries.
Under normal operating conditions, the ventilator will display:
- Total system state of charge as a percentage when in ventilation standby mode or connected to
mains power.
- Estimated remaining run time while delivering therapy.

Display Description
When either the external or internal battery is in use, but the device is not ventilating, the battery charge
level is displayed. The battery percentage is an average of all batteries connected to the system. Full
details of individual battery capacities can be reviewed in the Battery information page.
When either the external or internal battery is in use during ventilation, the remaining usage is displayed as
estimated by current operating conditions. The total will be the sum of all batteries connected to the
system.
When either the external or internal battery is charging, the charge battery symbol and percentage charged
is displayed.

Note: Only the Astral external and internal batteries are included in battery indicator calculations. RPSII battery levels are
not displayed.

64
 Power management

2. Battery information
The battery information can be accessed from the Battery sub-menu in the Information menu. This
menu has two tabs:
- Charge—displays the current charge level (0-100%) for any batteries currently detected by the
system, as well as the total system charge.
- Maintenance—displays the full charge capacity and the charge cycle count for any batteries
currently detected by the system.

Regularly check the charge level of the internal battery and any connected external batteries. It is
recommended to replace any batteries at 400 charge cycles.

English 65
Using the Astral device for the first time

Using the Astral device for the first time

When using the Astral device for the first time, ResMed recommends you first perform a functional test.
A functional test will ensure the device is in proper working order before starting therapy. Information to
assist you in resolving any issues is available in the Troubleshooting (see page 155) section.

CAUTION
If any of the following checks fail, contact your Healthcare provider or ResMed for assistance.

To perform a functional test:

1. Turn off the device by pressing the power switch at the back of the device.
2. Check the condition of the device and accessories.
Inspect the device and all accessories. Damaged components should not be used.
3. Check the patient circuit setup.
Check the integrity of the patient circuit (device and provided accessories) and that all connections are secure.
4. Turn on the device and test alarms.

WARNING
If no alarm sounds, do not use the ventilator.

Press the power switch at the back of the device to turn on the device. Check that the alarm sounds
two test beeps and the LEDs for the alarm signal and the alarm mute/reset button flash. The device
is ready for use when the Patient Home screen is displayed.
5. Disconnect the device from the mains and external battery (if in use) so that the device is powered
by the internal battery. Check that the Battery Use alarm is displayed and the battery LED is on.
Note: If the charge state of the internal battery is too low an alarm occurs. Refer to Troubleshooting (see page
155).
6. Reconnect the external battery (if in use) and check that the LED for the DC power supply is lit. The
External DC Power Use alarm will be displayed and the Alarm LED will light.
7. Reconnect the device to mains power.
8. Check the pulse oximeter sensor (if in use).
Attach the accessories according to the set up descriptions. From the Monitoring menu, go to the
Monitoring screen. Check that the values for SpO2 and pulse are displayed.
9. Check the oxygen connection (if in use). Check for damage to hoses or leaks. Check remaining
capacity of oxygen cylinders.
10. Perform a Learn Circuit.

66
 Ventilation modes

Ventilation modes
Astral supports a variety of ventilation modes. Available modes will vary depending on the circuit type
chosen. Mode settings can be accessed from Main Settings tab from the Settings menu.
Note: Some features may not be available on your device.

Mode Circuit type Supplementary feature

Leak Valve Mouthpiece Apnoea Safety Vt Manual Sigh breath
circuits circuits circuits ventilation breath
(A)CV   *  *

P(A)CV   * *  *

P-SIMV   

V-SIMV   

PS   * * 

CPAP   *

(S)T  

P(A)C  

iVAPS 

* For valve circuits only

English 67
Ventilation modes

(A)CV mode - Assisted volume-controlled ventilation

(A)CV is a volume target ventilation mode delivering volume-controlled mandatory breaths:
- Inspiration can either be initiated by the ventilator at a set respiratory rate (time-triggered breath)
or the patient (spontaneous-triggered breath). A spontaneous breath re-schedules the next
time-triggered breath. Both Trigger and Resp. rate can be set to Off, but not at the same time.
When Trigger is set to Off, the mode name will be shown on the Information bar as CV.
- End of inspiration (switch from inspiration to expiration) is controlled by the ventilator (time-cycled
breath).
Parameter Setting
Resp. rate (per min) Adult: Off, 2 to 50 [15]
Paed: Off, 5 to 80 [15]

PEEP (cmH2O) Off, 3.0 to 20.0 [5.0]

Vt (mL) Adult: 100 to 2500 [500]
Paed: 50 to 300 [100]*
PIF (L/min) When Volume Breath option is set to PIF:
Adult: 10 to 120 [50]
Paed: 5 to 60 [10]
Ti (sec) When Volume Breath option is set to Ti:
Adult: 0.3 to 3.0 [1.0]
Paed: 0.3 to 3.0 [0.6]
Flow shape (%) 100 (Constant), 75, 50, 25 [100]
Trigger Type Flow / Pressure
Trigger When Trigger Type is set to Flow
(double limb circuit only)
Adult: Off, 0.5 to 15 [1.0] (L/min)
Paed: Off, 0.5 to 15 [0.5] (L/min)
When Trigger Type is set to Pressure
(double and single limb circuit)
Off, Very low to Very high [Medium]
Note: Some default settings are different for Mouthpiece circuit.

*The International ventilator standard indicates that Paediatric patient type is intended to be used for a patient receiving less
than 300 mL, however Astral permits adjustment of ‘Vt’ setting parameter up to 500 mL for cases where ‘Vt’ is set such that it
compensates for leak in the breathing circuit.

WARNING
ResMed does not recommend 500 mL as the upper limit for the pediatric tidal volume use;
however, clinicians may choose this upper limit based on their clinical determination.

Supplementary features:
• Apnoea response
• Sigh breath (Astral 150 only)
• Manual breath (Astral 150 only)
68
 Ventilation modes

(A)CV breath pattern showing one patient triggered breath amongst time triggered breaths, with
inspiratory duration defined by Ti. The patient-triggered breath re-schedules the next time-triggered
breath.

P(A)CV mode - Assisted pressure-controlled ventilation

P(A)CV is a pressure target ventilation mode delivering pressure-controlled mandatory breaths:
- Inspiration can either be initiated by the ventilator at a set respiratory rate (time-triggered breath)
or the patient (spontaneous-triggered breath). Spontaneous-triggered breaths re-schedule the
next time-triggered breath. Both Trigger and Resp. rate can be set to Off, but not at the same
time. When Trigger is set to Off, the mode name will be shown on the Information bar as PCV.
- End of inspiration (switch from inspiration to expiration) is controlled by the ventilator (time-cycled
breath).
Parameter Setting
Resp. rate (per min) Adult: Off, 2 to 50 [15]
Paed: Off, 5 to 80 [15]

PEEP (cmH2O) Off, 3.0 to 20.0 [5.0]

P control (cmH2O) Adult: 2 to 50 [7]
Paed: 2 to 50 [7]
Ti (sec) Adult: 0.2 to 5.0 [1.0]
Paed: 0.2 to 5.0 [0.6]
Trigger type Flow / Pressure
Available with double limb circuits only.

English 69
Ventilation modes

Parameter Setting
Trigger When Trigger Type is set to Flow:
Adult: Off, 0.5 to 15 [1.0] (L/min)
Paed: Off, 0.5 to 15 [0.5] (L/min)
When Trigger Type is set to Pressure:
Off, Very Low to Very High [Medium]
Rise Time (msec) Min, 150 to 900 [200]
Note: Some default settings are different for Mouthpiece circuit.

Supplementary features:
• Safety Vt (Tidal Volume)
• Apnoea response
• Sigh breath (Astral 150 only)
• Manual breath (Astral 150 only)

The P(A)CV breath pattern showing one patient triggered breath amongst time-triggered breaths. The
Safety Vt feature is turned off.

70
 Ventilation modes

P-SIMV - Pressure Synchronised Intermittent Mandatory Ventilation

P-SIMV is a mixed ventilation mode delivering pressure-controlled mandatory breaths and
pressure-supported spontaneous breaths.
Mandatory breaths are delivered at a set frequency and spontaneous breaths are permitted between
mandatory breaths.
For mandatory breaths
The inspiratory pressure support is set using P control and is initiated by either:
- the ventilator at a set respiratory rate
- the patient - if the patient effort is close enough to the next scheduled mandatory breath. This
time is 60% of the breath period or 10 seconds, whichever is less.
End of inspiration (switch from inspiration to expiration) is controlled by the ventilator (time-triggered
breath)
For spontaneous breaths
The inspiratory pressure support is set using PS. Inspiration is either:
- Initiated by the patient (spontaneous-triggered breath)
- Ended by the patient (spontaneous-cycled breath)
The patient is free to take any number of spontaneous breaths between mandatory breaths.

Parameter Setting
Resp.rate (per min) Mandatory breaths:
Adult: 2 to 50 [10]
Paed: 5 to 80 [20]
PEEP (cmH2O) Off, 3.0 to 20.0 [5.0]
P control (cmH2O) Mandatory breaths:
Adult: 2 to 50 [7]
Paed: 2 to 50 [7]
PS (cmH2O) Spontaneous breaths:
Adult: 2 to 50 [7]
Paed: 2 to 50 [7]
Ti (sec) Mandatory breaths
Adult: 0.2 to 5.0 [1.0]
Paed: 0.2 to 5.0 [0.6]
Cycle (%) Spontaneous breaths:
5 to 90, Auto [Auto]
Trigger type Flow / Pressure
Trigger When Trigger Type is set to Flow:
(double limb circuit only)
Adult: 0.5 to 15 [1.0] (L/min)
Paed: 0.5 to 15 [0.5] (L/min)
When Trigger Type is set to Pressure:
(double and single limb circuit)
Very Low to Very High [Medium]
Rise Time (msec) Min, 150 to 900 [200]

English 71
Ventilation modes

Supplementary features:
• Apnoea response
• Manual breath

Spontaneous breaths are permitted between mandatory breaths as shown in the figure above. In order
to promote synchrony with the patient's spontaneous efforts, mandatory breaths may be patient
triggered. Such patient triggering will cause some variation in the mandatory ventilation respiratory rate.

V-SIMV - Volume Synchronised Intermittent Mandatory Ventilation

V-SIMV is a mixed ventilation mode delivering volume-controlled mandatory breaths and
pressure-supported spontaneous breaths.
Mandatory breaths are delivered at a set frequency and spontaneous breaths are permitted between
mandatory breaths.
For mandatory breaths
The inspiratory volume is set using Vt and is initiated by either:
- the ventilator at a set respiratory rate
- the patient - if the patient effort is close enough to the next scheduled mandatory breath. This
time is 60% of the breath period or 10 seconds, whichever is less.
End of inspiration (switch from inspiration to expiration) is controlled by the ventilator (time-triggered
breath)
For spontaneous breaths
The inspiratory pressure support is set using PS. Inspiration is:
- initiated by the patient (spontaneous-triggered breath) and
- ended by the patient (spontaneous-cycled breath)
The patient is free to take any number of spontaneous breaths between mandatory breaths.

72
 Ventilation modes

Parameter Setting
Resp.rate (per min) Mandatory breaths:
Adult: 2 to 50 [15]
Paed: 5 to 80 [15]
PEEP (cmH2O) Off, 3.0 to 20.0 [5.0]
PS (cmH2O) Spontaneous breaths:
Adult: 2 to 50 [7]
Paed: 2 to 50 [7]
Vt (Tidal Volume) (mL) Mandatory breaths:
Adult: 100 to 2,500 [500]
Paed:50 to 300 [100]*
PIF (L/min) When Volume Breath option is set to PIF
Mandatory breaths:
Adult: 10 to 120 [50]
Paed: 5 to 60 [10]
Ti (Inspiratory time) (sec) When Volume Breath option is set to Ti
Mandatory breaths:
Adult: 0.3 to 3.0 [1.0]
Paed: 0.3 to 3.0 [0.6]
Flow shape (%) Mandatory breaths:
100 (Constant), 75, 50, 25 [100]
Cycle (%) Spontaneous breaths:
5 to 90, Auto [Auto]
Trigger type Flow/Pressure
Trigger When Trigger Type is set to Flow:
(double limb circuit only)
Adult: 0.5 to 15 [1.0] (L/min)
Paed: 0.5 to 15 [0.5] (L/min)
When Trigger Type is set to Pressure:
(double and single limb circuit)
Very Low to Very High [Medium]

Rise Time (msec) Spontaneous breaths:

Min, 150 to 900 [200]
*The International ventilator standard indicates that Paediatric patient type is intended to be used for a patient receiving less
than 300 mL, however Astral permits adjustment of ‘Vt’ setting parameter up to 500 mL for cases where ‘Vt’ is set such that it
compensates for leak in the breathing circuit.

WARNING
ResMed does not recommend 500 mL as the upper limit for the pediatric tidal volume use;
however, clinicians may choose this upper limit based on their clinical determination.
English 73
Ventilation modes

Supplementary features:
• Apnoea response
• Manual breath (Astral 150 only)

Spontaneous breaths are permitted between mandatory breaths as shown in the figure above. In order
to promote synchrony with the patient's spontaneous efforts, mandatory breaths may be patient
triggered. Such patient triggering will cause some variation in the mandatory ventilation respiratory rate.

PS mode - Pressure support

PS is a pressure target ventilation mode delivering pressure-supported spontaneous breaths:
- Inspiration is either initiated by the ventilator at a set rate (time-triggered breath), or the patient
(spontaneous-triggered breath). Spontaneous-triggered breaths re-schedule the next
time-triggered breath. Set respiratory rate can be disabled.
- End of inspiration (switch from inspiration to expiration) is controlled by the patient
(spontaneous-cycled breath).
Parameter Setting

Resp. rate (per min) Adult: Off, 2 to 50 [15]

Paed: Off, 5 to 80 [15]
PEEP (cmH2O) Off, 3 to 20.0 [5.0]
PS (cmH2O) Adult: 2 to 50 [7]
Paed: 2 to 50 [7]
Cycle (%) 5 to 90, Auto [Auto]
Trigger type Double limb: Flow/Pressure
Single limb: Pressure

74
 Ventilation modes

Parameter Setting

Trigger Double limb circuit:

When Trigger Type is set to Flow:
Adult: 0.5 to 15 [1.0] (L/min)
Paed: 0.5 to 15 [0.5] (L/min)
When Trigger Type is set to Pressure:
Very Low to Very High [Medium]
Single limb circuit:
Very Low to Very High [Medium]
Rise Time (msec) Min, 150 to 900 [200]
Ti Min (sec) 0.2 to 4.0 [0.2]
Ti Max (sec) Adult: 0.3 to 4.0 [1.5]
Paed: 0.3 to 4.0 [0.8]
Note: Some default settings are different for Mouthpiece circuit.

Supplementary features:
• Apnoea response
• Safety Vt (Tidal Volume)
• Manual breath (Astral 150 only)

• This graph shows PS mode with Resp. rate enabled with a transition from spontaneous-triggered to
time-triggered breaths. Cycling is constrained within the limits of Ti Min and Ti Max.
• To allow the patient sufficient time to exhale, Ti cannot exceed two-thirds of the breath period.
(Breath period is equal to 60/Resp. rate).
• To allow sufficient time to reach the targeted inspiratory pressure, Rise time cannot exceed
two-thirds of Ti Max.

English 75
Ventilation modes

(S)T mode - Spontaneous Ventilation with backup rate

(S)T is a bilevel ventilation mode delivering pressure-supported spontaneous breaths:
- Inspiration is either initiated by the ventilator at a set rate (time-triggered breath) or the patient
(spontaneous-triggered breath). Spontaneous-triggered breaths re-schedule the next
time-triggered breath. Resp. rate and Trigger can be set to Off, but not at the same time. When
Trigger is set to Off, the mode name will be shown on the Information bar as T. When Trigger is
active, and Resp.rate is set to Off, the mode name will be shown on the information bar as S.
- End of inspiration (switch from inspiration to expiration) is controlled by the patient
(spontaneous-cycled breath) between Ti Min and Ti Max.
Parameter Setting
Resp. rate (per min) Adult: Off, 2 to 50 [15]
Paed: Off, 5 to 80 [15]
EPAP (cmH2O) 2 to 25 [5]
IPAP (cmH2O) Adult: 4 to 50 [12]
Paed: 4 to 50 [12]
Trigger Off, Very Low to Very High [Medium]
Rise Time (msec) Min, 150 to 900 [200]
Ti Min (sec) 0.1 to 4.0 [0.2]
Ti Max (sec) Adult: 0.3 to 4.0 [1.5]
Paed: 0.3 to 4.0 [0.8]
Cycle (%) 5 to 90 [25]

76
 Ventilation modes

P(A)C mode
P(A)C is a bilevel ventilation mode delivering pressure-controlled mandatory breaths:
- Inspiration is either initiated by the ventilator at a set rate (time-triggered breath) or the patient
(spontaneous-triggered breath). Spontaneous-triggered breaths re-schedule the next
time-triggered breath. Resp. rate and Trigger can be set to Off, but not at the same time. When
Trigger is set to Off, the mode name will be shown on the Information bar as PC.
- End of inspiration is controlled by the ventilator (time-cycled breath).
Parameter Setting
Resp. rate (per min) Adult: Off, 2 to 50 [15]
Paed: Off, 5 to 80 [15]
EPAP (cmH2O) 2 to 25 [5]
IPAP (cmH2O) Adult: 4 to 50 [12]
Paed: 4 to 50 [12]
Ti (sec) Adult: 0.3 to 4.0 [1.0]
Paed: 0.3 to 4.0 [0.6]
Trigger Off, Very Low to Very High [Medium]
Rise Time (msec) Min, 150 to 900 [200]

• To allow the patient sufficient time to exhale, Ti cannot exceed two-thirds of 60/Resp. rate.
• To allow sufficient time to reach the targeted inspiratory pressure, Rise time cannot exceed
two-thirds of Ti.

English 77
Ventilation modes

CPAP mode
CPAP mode delivers a constant level of pressure during inspiration and expiration.
With CPAP administered via a valved breathing system, the inspiratory triggering level is settable to
optimise the control of the exhalation valve and minimise the patient's work of breathing. Adjust trigger
sensitivity to accurately report patient respiratory rate.
In a vented system, the inspiratory triggering level is settable to optimise monitoring and alarm
performance.

Parameter Setting
CPAP (cmH2O) All circuits:
3.0 to 20.0 [5.0]
Trigger type Double limb circuit:
Flow/Pressure
Trigger Double limb circuit:
When Trigger Type is set to Flow:
Adult: 0.5 to 15 [1.0] (L/min)
Paed: 0.5 to 15 [0.5] (L/min)
When Trigger Type is set to Pressure:
Very Low to Very High [Medium]
Single limb circuit:
Very Low to Very High [Medium]
Single with intentional leak:
Very Low to Very High [Medium]

Supplementary features:
• Apnoea response (Valve circuits only)

CPAP operation with a single limb circuit with intentional leak is displayed.

78
 Ventilation modes

iVAPS (intelligent Volume Assured Pressure Support) mode

Note: This feature may not be available on your device.
iVAPS is designed to maintain a preset target alveolar minute ventilation by monitoring delivered
ventilation, adjusting the pressure support automatically and providing intelligent backup breaths. The
iVAPS therapy mode is indicated for patients weighing 30 kg and above.
iVAPS offers the comfort and synchrony of pressure support, but with the assurance offered by a volume
target.
Pressure support is adjusted continuously, breath to breath, aiming to maintain target alveolar ventilation.
If ventilation falls, pressure support is increased until the target is reached. Conversely, if alveolar
ventilation rises above target, pressure support falls. The range of pressure support adjustment is
constrained within Min PS and Max PS.
The actual mask pressure achieved during iVAPS or iVAPS-AutoEPAP therapy is the sum of the EPAP
and pressure support, limited to 2 cmH2O below the set High Pressure limit. As a result, High Pressure
limit can be a useful way to constrain overall therapy pressure, eg, during Mask NIV on page 101.
The rate of increase in pressure support can reach up to 0.7 cmH2O/sec. The breath to breath changes in
pressure support depend on the breath rate and how far the patient is from the target alveolar
ventilation. Typically, the change in pressure support does not exceed 3 cmH2O per breath.

Parameter Setting
Target Va (L/min) 1.0 to 30.0 [5.2]

Target Pt rate (per min) Adult: 8 to 30 [15]

Pt Height cm: 110 to 250 [175]
inches: 44 to 100 [70]
EPAP (cmH2O) 2.0 to 25.0 [5.0]
Min EPAP (cmH2O) 2.0 to 25.0 [5.0] when AutoEPAP is ON
Max EPAP (cmH2O) 2.0 to 25.0 [15.0] when AutoEPAP is ON
Min PS (cmH2O) 0.0 to 50.0 [2.0]
Max PS (cmH2O) 0.0 to 50.0 [20.0] when AutoEPAP is OFF
8.0 to 50.0 [20.0] when AutoEPAP is ON
Rise Time (msec) Min, 150 to 900 [200]
Ti Min (sec) 0.1 to 4.0 [0.5]
Ti Max (sec) 0.3 to 4.0 [1.5]
Trigger Very Low to Very High [Medium]
Cycle (%) 5 to 90 [25]

English 79
Ventilation modes

Target alveolar ventilation

iVAPS targets alveolar ventilation. Alveolar ventilation was chosen because gas exchange occurs at the
alveoli level. Total ventilation includes the ventilation devoted to the conducting airways, whereas
alveolar ventilation best represents the useful portion of ventilation that reaches the alveoli.
Alveolar ventilation cannot be measured directly, so iVAPS estimates it using a height approximated
value of anatomical deadspace as shown in the graph below. Anatomic deadspace is the amount of
breath that remains in the conducting airways, that does not reach alveoli and does not contribute to gas
exchange. Its contribution is proportional to breath rate. By using alveolar ventilation as a
servo-ventilation target, as opposed to tidal volume or minute ventilation, the effect of respiratory rate
change on effective ventilation is compensated for.
Note: When ventilating in iVAPS mode, the current Va value is displayed on the Monitoring screen.

80
 Ventilation modes

intelligent Backup Rate (iBR)

Instead of mandating a fixed backup rate, the intelligent Backup Rate (iBR) will shift automatically
between two limits.
During sustained apnoea, the iBR will adopt a pre-configured Target Patient Rate. This Target Patient
Rate defines the upper boundary for iBR. Set the Target Patient Rate to match the patient’s average
spontaneous rate (unlike a traditional backup rate).
1. During spontaneous ventilation, the iBR adjusts to remain in the background, at two-thirds of the
Target Patient Rate. This ‘background’ backup rate is lower than a traditional (S)T rate, so gives the
patient maximum opportunity to spontaneously trigger.
2. When spontaneous triggering ceases (eg, at the onset of an apnoea/hypopnoea), the iBR adjusts
from its background frequency to its Target Patient Rate in iVAPS mode and adjusts quickest
(typically within 4 to 5 breaths) when ventilation is below the target ventilation.
3. A single spontaneous triggered breath resets the iBR to its background rate (two-thirds of Target
Patient Rate).

Configuring iVAPS
There are two ways in which you can configure iVAPS mode:
• Adopting the recently learnt targets, from any vented mode (CPAP, (S)T or PAC)—learns the patient's
breathing pattern and calculates the target values automatically, or
• Entering the target values manually.

Adopting recently learnt targets

While ventilating the patient on the Vented mode of your choice (CPAP, (S)T or PAC), the patient’s
resting ventilation is monitored, with the goal of learning the patient’s Target Alveolar Ventilation (Target
Va) and Target Patient Rate (Target Pt Rate) in preparation for iVAPS mode.
After the final circuit configuration (includes patient’s height, EPAP, appropriate mask settings and any
supplemental oxygen added) is achieved, follow the procedure below.
Over the last five minutes of ventilation, Tidal Volume and Respiratory Rate are recorded for each breath.
Target Va and Target Pt Rate are then calculated over those last five minutes. Ensure the patient remains
comfortable, breathing is stable and leak is minimised.
Note: iVAPS and AutoEPAP will only be initiated once Learn Target values are accepted.

English 81
Ventilation modes

Adopting recently learnt targets

To adopt recently learnt targets
1. From the Setup main menu, select Settings.
2. From the Settings menu, select the Main settings tab

3. From the on-screen selections, press Ventilation Mode, then select iVAPS.

4. From the on-screen selections, press Review.

Note: The Review option will only be available for selection if there is at least five minutes worth of patient data
available.

82
 Ventilation modes

5. Review the Learnt Targets and make adjustment to Pt Height if required. Select Confirm.

6. Select Apply.

You have now successfully configured iVAPS.

Note: With AutoEPAP switched on, the information window name is updated to iVAPS.AutoEPAP.

English 83
Ventilation modes

Entering the target values manually

The Target Va can also be determined to adopt a Target Patient Rate using a settable Target Va
parameter and patient height. Target Pt Rate should match the patient's normal breathing rate.

To enter the target values manually

1. From the Setup main menu, select Settings.
2. From the Settings menu, select the Main Settings tab.

3. From the on-screen selections, press Ventilation Mode, then select iVAPS.

4. Select Skip.

84
 Ventilation modes

5. From the iVAPS main settings screen select Apply.

iVAPS has been successfully applied.

English 85
Ventilation modes

AutoEPAP
iVAPS mode only.
Note: This feature may not be available on your device.
The purpose of EPAP is to maintain upper airway patency. AutoEPAP automatically adjusts pressure in
response to flow limitation or obstruction of the upper airway. EPAP is adjusted within Min EPAP and
Max EPAP settings with the response depending on the degree of the upper airway obstruction.

WARNING
AutoEPAP is contraindicated when using an invasive interface.

Pressure support is adjusted on top of the EPAP. The maximum delivered pressure, EPAP plus pressure
support, is limited to 2 cmH2O below the set High Pressure limit. If the sum of EPAP plus pressure
support exceeds the maximum pressure limit, pressure support is sacrificed to maintain airway patency
(ie, EPAP). However, pressure support will not drop below the set minimum pressure (Min PS).

(a) For flow limitation, EPAP will increase at a maximum rate of 0.5 cmH2O (0.5 hPa) per breath.
(b) For obstructive apnoea, EPAP will increase at a rate of approximately 1 cmH2O (1 hPa) per second
spent in inspiration on termination of the apnoea.
(c) EPAP will start to decrease from the first breath after upper airway obstruction has resolved and will
continue to decrease slowly until either another upper airway flow limitation/obstruction occurs or Min
EPAP is reached.
The AutoEPAP algorithm does not address any other titration target such as lung recruitment to improve
oxygenation or offset intrinsic PEEP. Min EPAP should be set to treat lower airway conditions. AutoEPAP
will increase airway pressure to treat upper airway conditions.

86
 Ventilation modes

Flow shape settings

The Astral device supports four flow shape settings:
1. 100% (Constant)
2. 75%
3. 50%
4. 25%

The figure illustrates how Flow Shape affects breath delivery for a fixed volume. With volume breath
option set to PIF (Peak Inspiratory Flow), adjusting the flow shape alters the inspiratory duration,
whereas with volume breath option set to Ti (Inspiratory time), adjusting the flow shape alters the Peak
Inspiratory Flow.
When the flow shape is set to 100%, the flow is generally constant during inspiration. For decreasing
percentages, the flow starts at the peak flow and declines to approximately the percentage setting of
this value at the end of inspiration.

To select between Ti and PIF options:

1. From the Setup menu select Device config.
2. Select Units
3. Select Ti or PIF.

English 87
Ventilation modes

Interdependence of controls
Dynamic settings limits
The adjustable range of one setting may be restricted by the value of another. When a dynamic limit of
this kind is reached, a message describing the limitation (interdependence) is displayed on the
Information bar and the Apply button is disabled.

To enable the Apply button, modify one of the conflicting settings. For example in this case, to continue
IPAP must be increased or EPAP decreased.

Making use of Astral's High Pressure limit

Astral’s High Pressure limit acts as a traditional High Pressure alarm for volume target therapies and fault
situations. For pressure modes and volume-assured pressure modes, the High Pressure setting acts as
an overall pressure limit, keeping the maximum delivered pressure to 2 cmH2O less than the High
Pressure setting, regardless of the individual control settings.
For example, reducing the High Pressure limit may constrain the following parameters:
• P control
• PS
• P control max
• Max PS
• PEEP
• IPAP
• EPAP
• CPAP
• Apnoea breath settings
• Sigh breath Magnitude
• Manual breath Magnitude

88
 Ventilation modes

When making adjustments to the high pressure alarm limit, you are prompted to confirm the changes to
any affected settings. If these setting changes are not accepted, the change to the high pressure alarm
limit is not applied.

Triggering and cycling

• The Astral device has adjustable trigger and cycle sensitivities to provide optimal synchrony between
the patient and the device and to minimise work of breathing.
• Triggering is the device response to an increase in patient effort. Once the set inspiratory trigger
threshold is reached, the device starts the inspiratory phase.
• Cycling (also called expiratory triggering) is the response to a decrease in patient inspiratory flow.
Once the set cycling threshold is reached the device cycles from the inspiratory to expiratory phase.
The higher the sensitivity selected, the smaller the patient effort required to trigger inspiration, and the
smaller the reduction in patient inspiratory flow to initiate expiration.
The triggering method depends on the circuit type.

Circuit type Trigger type Trigger detection

Single limb circuit with intentional Flow Vsync
leak
Very Low to Very High
Single limb circuit with integrated Pressure NIV+
valve
Very Low to Very High
Double limb circuit Choice between
Pressure: Very Low to Very High NIV+
Flow: 0.5 - 15 L/min Flow
Mouthpiece circuit Flow Touch
Touch, Low to High

English 89
Ventilation modes

Triggering with intentional leak circuits

When using a circuit with intentional leak, estimation of the patient respiratory flow is enhanced by
ResMed's automatic leak management feature—Vsync.
Vsync technology allows the device to estimate the patient respiratory flow in the presence of
unintentional leak. Using the respiratory flow signal, the device is able to trigger and cycle closely with
the patient's effort.
The Astral device has five trigger sensitivity levels (Very Low to Very High). The higher the sensitivity
selected the smaller the patient effort required to trigger inspiration.

Cycling with intentional leak circuits

The Astral device is able to detect a decrease in patient respiratory flow during inspiration, indicating the
optimum point to commence exhalation.
The Astral device provides an adjustable cycle sensitivity set point expressed as a percentage of the
maximum flow. The higher the sensitivity selected, the smaller the reduction in inspiratory flow to cycle
to expiration.

Note: Cycling is constrained within the limits of TiMin and TiMax. This means that the inspiratory period cannot be
less that TiMin or longer than TiMax.

90
 Ventilation modes

Triggering with valve circuits

When using single or double limb valve circuits, the Astral device uses ResMed's NIV+ trigger sensitivity
technology. Unlike simple conventional triggering which only considers the magnitude of the pressure
change, NIV+ also considers the shape of the pressure waveform to significantly improve trigger
sensitivity.

Pressure trigger with single and double limb circuits

The Astral device is able to detect a negative change of pressure, relative to the pressure base line at the
end of expiration, indicating the start of a patient spontaneous breath. There are five sensitivity levels of
trigger sensitivity from Very Low to Very High.

Flow trigger with double limb circuits

Flow triggering is suitable for use with double limb circuits for invasive applications with no expected
leak eg, cuffed tracheostomy. By monitoring the exhaled gas, the Astral device is able to detect an
increase in patient respiratory flow at the end of expiration, indicating the start of a spontaneous breath.
The flow trigger threshold represents the increase in patient respiratory flow at the end of expiration.
When that threshold is reached the device starts the inspiratory phase.

Flow trigger range L/min

Adult: 0.5-15 [Default = 1.0]
Paediatric: 0.5-15 [Default = 0.5]

The lower the setting number, the higher the sensitivity.

English 91
Ventilation modes

Changing the Trigger Type

For double limb circuits, changing Trigger type can be done while the device is ventilating or in Standby.

To change between pressure and flow trigger types on double circuits:

1. From the Setup menu, select Circuit.

2. From the Trigger type option, press Change. The current Trigger Type is highlighted.

3. Select Flow. You will be returned to the Circuit screen where the changed Trigger type will be
displayed.

92
 Ventilation modes

Cycling with valve circuits

Cycling in the Astral device is based on flow and can be set to automatic or manual.
Automatic cycling adjustment
Allows for the duration of the inspiratory phase (Ti) to vary from one breath to another, according to the
characteristics of the patient's spontaneous breathing. Therefore, Ti varies according to the shape of the
flow curve and the maximum flow value.
In the figure below, a dotted line is drawn between the start of inspiration and point (A) marked at the
peak inspiratory flow (PIF) at 2.3 seconds. Cycling occurs when the decelerating flow curve intersects
with this dotted line (B). The two breaths in the figure have different PIF values and therefore different Ti
times.

Manual cycling adjustment

The manual cycling set point is expressed as a percentage of the maximum flow. Cycling to expiration
occurs when the decreasing patient respiratory flow reaches the set cycling threshold. The higher the
percentage, the more sensitive the cycling.

Note: Cycling is constrained within the limits of TiMin and TiMax. This means that the inspiratory period
cannot be less that TiMin or longer than TiMax.

To change between automatic and manual cycling features

1. From the Setup main menu, select Settings.
2. From the Settings menu, select the Main settings tab.
3. From the on-screen selections, press Cycle.

Triggering with mouthpiece circuits

When using a mouthpiece circuit, the Astral device monitors the flow during the expiration phase for
changes in the magnitude and shape of the flow measurement to improve trigger sensitivity.
There are four sensitivity levels: Low, Medium, High and Touch.
Low, Medium and High trigger sensitivity levels are based on the detection of a change in flow during
expiration indicating the start of a spontaneous breath. The higher the sensitivity selected, the smaller
the patient effort required to trigger inspiration.
The Touch trigger setting combines the standard trigger with ResMed’s Touch trigger technology to
detect the patient engaging or blocking the mouthpiece to trigger inspiration.

English 93
Supplementary features

Supplementary features
Manual breath settings

Manual breath feature allows the user to manually insert a breath within the currently delivered
breathing pattern.
The Manual breath feature is used to trigger manual breath(s) and can be pressed at any time.
• If pressed during expiration, the manual breath will be delivered immediately.
• If pressed during inspiration, the manual breath will be delivered 300 ms after the end of the current
inspiration.
The manual breath can be configured as a magnified version of the primary breath (magnification factor
set from 100 to 250%).
For pressure-target breaths, the inspiratory duration and pressure are magnified proportionally.
For volume-target breaths, the delivered volume is magnified proportionately.

Adjustable parameters:

Parameter Setting
Manual Breath Off, On [Off]
Magnitude (%) 100 to 250 [150]
Note: The Magnitude (%) value is clipped at 2500 mL and 500 mL for Adult and Paediatric patient types respectively.

For pressure-controlled mandatory breaths, the P control and breath duration are magnified by the
magnification factor. This applies to mandatory breaths in P(A)CV mode and in P-SIMV and V-SIMV
modes.

94
 Supplementary features

For pressure-assisted spontaneous breaths only the PS is magnified.

For volume-controlled mandatory breaths, the volume is magnified by firstly flattening the flow shape,
then by extending the Ti and finally by increasing the PIF. This applies to mandatory breaths in (A)CV and
V-SIMV modes.

English 95
Supplementary features

Sigh settings
The Sigh breath feature allows the user to program the delivery of a 'sigh breath' at a regular interval
(sigh interval) within the currently delivered breathing pattern.
The sigh breath is a magnified version of the primary breath (Magnification factor set from 120 to 250%).
For pressure-target breaths, the inspiratory duration and P control are magnified proportionally.
For volume-target breaths, volume is magnified.
Adjustable parameters − (A)CV & P(A)CV Modes only:

Parameter Setting
Sigh Breath Off, On [Off]
Sigh Alert Off, On [Off]
Interval (min) 3 to 60 [10]
Magnitude (%) 120 to 250 [150]
Note: The Magnitude (%) value is clipped at 2500 mL and 500 mL for Adult and Paediatric patient types respectively.

96
 Supplementary features

Apnoea Settings
The Astral device allows the clinician to define what should happen when the device detects an apnoea.
An apnoea refers to the absence of breath within a configurable period: T apnoea (Apnoea Interval).
Apnoea can be defined as an absence of patient-triggered breaths (No Spont Breath), or an absence of
any breaths (No Breath), whether they are patient, time, or manually-triggered breaths.
Three types of Apnoea response settings can be selected on the Astral device:
1. Alarm only
2. Alarm + apnoea ventilation ((A)CV breath pattern)
3. Alarm + apnoea ventilation (P(A)CV breath pattern)
4. Off
When Alarm + apnoea ventilation ((A)CV or P(A)CV) is selected, apnoea ventilation is automatically
triggered following the detection of an apnoea event. Apnoea ventilation is displayed on the Information
bar.
The Apnoea response will deactivate when the patient triggers three consecutive breaths.
ResMed recommends that Apnoea ventilation is enabled whenever the Resp. rate is set to Off.

Control settings for Apnoea ventilation

Parameter Setting
Apnoea response
All modes Alarm only
Valve ventilation modes only (A)CV + Alarm (for (A)CV breath pattern)
Valve ventilation modes only P(A)CV + Alarm (for P(A)CV breath pattern)
All modes (Adult) Off
Apnoea Detection No breath, No Spont. breath [No breath]*
*Adult: [Off] when the mouthpiece interface is selected.
T apnoea (min:sec) Adult: 15s to 60s [20s]*
Paed: 5s to 30s [10s]
*Adult T apnoea can be extended to 15min when the mouthpiece
interface is selected.

WARNING
Setting Apnoea Detection to No breath and T apnoea to a value greater than 60s will make the
Apnoea Alarm and Response ineffective.

English 97
Supplementary features

(A)CV Breath pattern

Parameter Setting
Vt (mL) Adult: 100 to 2,500 [500]
Paed: 50 to 300 [100]*
Ti (sec) When Volume Breath option is set to Ti:
Adult: 0.3 to 3.0 [1.0]
Paed: 0.3 to 3.0 [0.6]
PIF (L/min) When Volume Breath option is set to PIF:
Adult: 10 to 120 [50]
Paed: 5 to 60 [10]
Resp. rate (per min) Adult: 4 to 50 [15]
Paed: 12 to 80 [15]
*The International ventilator standard indicates that Paediatric patient type is intended to be used for a patient receiving less
than 300 mL, however Astral permits adjustment of ‘Vt’ setting parameter up to 500 mL for cases where ‘Vt’ is set such that it
compensates for leak in the breathing circuit.

WARNING
ResMed does not recommend 500 mL as the upper limit for the pediatric tidal volume use;
however, clinicians may choose this upper limit based on their clinical determination.

98
 Supplementary features

P(A)CV breath pattern

Parameter Setting
P control (cmH2O) Adult: 2 to 50 [7]
Paed: 2 to 50 [7]
Ti (sec) Adult: 0.2 to 5.0 [1.0]
Paed: 0.2 to 5.0 [0.6]
Resp. rate (per min) Adult: 4 to 50 [15]
Paed: 12 to 80 [15]

English 99
Supplementary features

Safety volume settings

Astral's Safety Volume feature is an optional adaptive control mechanism that provides volume
assurance to pressure modes (P(A)CV, PS, S(T) and PAC only). It combines the benefits of
pressure-targeted ventilation with the assurance of a volume target.
A target Safety Volume (Safety Vt) can be set and the respective pressure value (PS, P Control or IPAP) is
automatically adjusted to achieve the target.
The maximum inspiratory assistance is constrained by PS Max, P control max or IPAP Max.
The maximum breath-to-breath change in pressure assistance is limited to +/- 2 cmH2O.
Adjustable parameters:

Parameter Setting
Safety Vt (mL) Adult: Off, 100 to 2500 [Off]
Paed: Off, 50 to 300 [Off]*
PS Max (PS mode) PS to 50 [PS + 5]
P control max (P(A)CV) P control to 50 [P control + 5]
IPAP Max (S(T), PAC modes) IPAP to 50 [IPAP + 5]
*The International ventilator standard indicates that Paediatric patient type is intended to be used for a patient receiving less
than 300 mL, however Astral permits adjustment of ‘Vt’ setting parameter up to 500 mL for cases where ‘Vt’ is set such that it
compensates for leak in the breathing circuit.

WARNING
ResMed does not recommend 500 mL as the upper limit for the pediatric tidal volume use;
however, clinicians may choose this upper limit based on their clinical determination.

100
 Non-invasive ventilation (NIV)

Non-invasive ventilation (NIV)

Mask NIV
Mask ventilation is supported by Astral on all circuit types and modes. NIV is commonly associated with
leak, and minimising leak will promote optimal therapy. Astral’s vented (intentional leak) circuit therapies
(CPAP, S, ST, iVAPS, and T modes) possess advanced leak management methods optimised for mask
ventilation. Note however that in situations of highly variable leak, pressure-target therapies (CPAP, S,
ST, T modes) may offer advantage over volume-target or volume-assured pressure modes.
During NIV therapy, peak applied pressures are chosen to address the ventilation needs as well as
patient tolerance, mask leak, and the potential for gastric distention (an adult's lower oesophageal
sphincter pressure is 25-30 cmH2O). Various guidelines suggest a typical maximum pressure for mask
NIV of 20-30 cmH2O.
Astral features an adjustable High Pressure limit which can be a convenient means of imposing a
maximum pressure during Astral's pressure-target modes (including those with volume-assurance),
regardless of the prevailing PEEP and PS. This is further discussed in Pressure alarms/limits.

Mouthpiece NIV
The decision to use mouthpiece ventilation is generally a consultative process between clinician and
patient after considering the risks and advantages of this form of therapy. For example, the patient must
possess adequate cognition, head/neck/mouth control, and oropharyngeal function, and significant
individualized training may be required compared to other forms of ventilation.
To independently assess the patient condition during mouthpiece ventilation, SpO2 can be monitored
using a pulse oximeter. Should the oximeter sensor become disconnected from the patient's finger, the
No SpO2 monitoring alarm will activate.

CAUTION
Mouthpiece ventilation may not be appropriate for particular patients and hence clinical discretion
is essential.

Mouthpiece ventilation
The settings below are suggested for ‘open’ or ‘sip’ mouthpiece ventilation where the patient exhales to
atmosphere frequently or continuously, eg, for on-demand daytime ventilation via a 15 mm non-vented
mouthpiece. Other circuit types, modes and settings are also available if required.

Ventilation setting Selection Detail/ explanation

Patient type Adult
Circuit Mouthpiece circuit 15mm or 22mm circuit without intentional leak or expiratory valve
(Tube only) Note: Not designed to support continuous exhalation into the circuit.
Interface Mouthpiece
Ventilation mode (A)CV (A)CV mode allows the patient to stack breaths as a set volume is delivered
with each breath.
Patient settings Vt, Trigger, Flow shape Set based on patient comfort and preference.
Resp. Rate As appropriate Resp. Rate shall be set appropriately for patients who may rely on the
backup rate. Otherwise, it can be turned Off.
Trigger Low, Medium, High, The Touch trigger setting will allow a breath to be delivered upon
Touch engagement of the mouthpiece. If the patient experiences false triggering
then the trigger sensitivity should be reduced.
Vented (intentional leak) therapies are not recommended for highly discontinuous ventilation such as ‘sip’ mouthpiece
ventilation.

English 101
Non-invasive ventilation (NIV)

Safety considerations for mouthpiece ventilation

The Disconnect Alarm allows detection of circuit disconnection (for example, when the mouthpiece has
fallen out of reach of the patient), and whether the patient is able to reliably trigger ventilation or not.
Regardless of whether the Disconnection Alarm is active or not, other mitigations may need to be put in
place to ensure that patient safety is not compromised, such as the Apnoea alarm, external monitoring,
an SpO2 alarm, or full-time supervision.

Alarm setting Selection Detail/ explanation

Disconnection Alarm On Enables Disconnection Alarm.
Disconnection As appropriate Sets a higher or lower tolerance to the degree of circuit disconnection
Tolerance (%) required to activate the Disconnection Alarm.
Refer to Setting and testing Disconnection Tolerance (see page 122).
Alarm Activation Time As appropriate The time it takes for the alarm to activate once the disconnection threshold
is satisfied. It can be adjusted from 5 seconds to 15 minutes for mouthpiece
interface, as appropriate for the patient’s ventilator dependency.
Refer to Setting Activation Time (see page 124).
Apnoea Response Off It may be appropriate to configure Apnoea Response to OFF if the
Disconnection Alarm is appropriately configured.

Low pressure alarms are sometimes used to imply circuit disconnection and are quick to activate. Should
this be an annoyance, for example when the patient is receiving a partial breath or missing a breath, or if
a false triggered breath occurs, it is at the discretion of the Clinician to turn OFF. Other mitigations may
need to be put in place to ensure that patient safety is not compromised. This may include external
monitoring, SpO2 alarm, or full-time supervision.
Mouthpiece Ventilation with Astral 100/150 mouthpiece circuit is not intended to support continuous
exhalation into the circuit. The non-user adjustable NV Mask/Rebreathing alarm will activate if the device
detects continuous exhalation into the circuit. For patients that may prefer continuous exhalation into the
circuit, a circuit with an expiratory valve or intentional leak should be considered.

102
 Alarms

Alarms
The Astral device activates alarms to alert you to conditions that require attention to ensure patient
safety. When an alarm is activated, the Astral device provides both audible and visual alerts, and displays
an alarm message in the Alarm display on the Information bar.
As part of the alarm system (eg, the overpressure protection and system alarms), Astral may perform an
automatic restart. An automatic restart checks systems and ensures correct operation of the alarm.

Indicator Description

1 Alarm display Displays either the alarm message for the highest priority active alarm, or the last
alarm not yet reset.
Press the Alarm display for further alarm information.

Certain conditions may result in multiple alarms. indicates that there are

multiple active alarms. Press when displayed to view all alarms and
respond appropriately. Alarms are displayed in order of priority.
2 Active Alarms screen Displays the full set of active alarms. Will automatically display upon activation of
an alarm in Patient mode.
3 Information menu Some alarms clear automatically. To view a history of alarms, view the alarm log
through the Information menu.

English 103
Alarms

Indicator Description

4 Alarm mute/reset button State:

• no light – no active alarms
• steady light – active alarm/s
• flashing light – alarm mute on.
This button also allows you to:
• mute the audible alert
• reset the currently displayed alarm (if permitted).
5 Alarm bar Indicates the priority of the alarm in the Alarm display.

Alarm priority
Alarms are classified into relative priority (high, medium and low) according to the severity and urgency
of the alarm condition. Respond to all alarms. An immediate response is required for high priority alarms.

Alarm priority Alarm bar Audible alert

High Red flashing light 10 beeps every 5 seconds

Medium Yellow flashing light 3 beeps every 15 seconds

Low Yellow steady 2 beeps every 25 seconds

104
 Alarms

The following list of alarms is ordered by relative importance within priority. Adjustable alarms can be
changed to suit therapy and care requirements.

High priority alarms Medium priority alarms Low priority alarms

Total power failure** High Pressure* Using internal battery
High pressure protection Low PEEP* Battery 1 fault
Circuit disconnection* High PEEP Battery 2 fault
Low Pressure* Low pulse rate* Power fault/No charging
Obstruction* High pulse rate* PEEP blower failure
High Pressure* Device overheating
Apnoea* Pressure line disconnected
Low MVe* Last self-test failed
Low MVi* Flow sensor not calibrated
High MVi* No SpO2 monitoring
High MVe* No FiO2 monitoring
Low Vte* Internal battery degraded
High Vte* Low internal battery
Low Vti* Circuit fault
High Vti*
Low Resp rate*
High Resp rate*
High leak*
Ventilation stopped*
Low SpO2*
High SpO2*
Low FiO2*
High FiO2*
NV mask/Rebreathing
Incorrect circuit adapter
Critically low battery
Incorrect circuit attached
Safety reset complete
Battery inoperable
*Alarm is adjustable.
**No LED will flash during a Total power failure alarm.

English 105
Alarms

Viewing the active alarms

in the Alarm display indicates that there are multiple active alarms. Although multiple alarms can be
active simultaneously, the Alarm display only shows the highest priority alarm. The full set of active
alarms is displayed in the Active alarms screen.
When the highest priority alarm is cleared, the next highest priority alarm displays in the Alarm display.

To view the active alarms:

1. From any screen, press the Alarm display on the Information bar. The Active alarms screen is
displayed. This screen contains a full list of currently active alarms, displayed in order of their relative
priority.
2. Press OK to close the Active alarms screen and return to the previous screen.

Muting alarms
You can temporarily mute the audible alert on the Astral device for a two minute period. The Alarm
display and Alarm bar continue to display the alarm as usual. If after two minutes the alarm condition is
still present, the audible alert will sound again.
You can also use the Alarm Mute in advance, to 'pre-silence' alarms that you expect to occur. This can
be helpful during suctioning procedures or when intending to disconnect the patient from the ventilator
for a short period.
If any of the following high priority alarms are triggered, the Alarm mute is automatically cancelled:
• Total power failure
• Critically low battery
• Incorrect circuit.

To mute the audible alert on an active alarm:

Press .

The alarm is silenced for two minutes. During that period, is displayed on the Information bar and

flashes.
Note: Pressing the Alarm mute/reset button again during the Alarm Mute period will reset the displayed alarm. Refer
to Resetting alarms (see page 107).

106
 Alarms

To silence alarms before they activate:

1. Press . Alarm mute is active for two minutes. During that period, is displayed on the

Information bar and flashes.

2. To cancel Alarm mute, press the flashing again.

Resetting alarms
The following alarms cannot be manually reset. For these alarms you must correct the cause of the
alarm. Resolving the alarm will automatically clear the display.
• Total power failure
• Critically low battery
• Low pressure
• Pressure line disconnected
• Battery inoperable
• Circuit disconnection
• Incorrect circuit adapter.
Resetting an alarm removes that alarm from the Alarm display and the Active alarms screen, and turns
off the visual and audible alerts. An active alarm should only be reset after the situation that caused the
alarm has been attended to. If the alarm condition has not been corrected, the alarm will activate again.
The Astral device may automatically clear an alarm when the condition that triggered the alarm is
corrected. When an alarm is cleared it no longer displays in the Active alarms screen and the audible and
visual alerts cease.
When an alarm is cleared or manually reset, the Alarm display then shows the next highest priority active
alarm.
To view a complete alarm history, see the Events log available from the Information menu.

To reset the displayed active alarm:

1. Press to mute the alarm. The button illuminates and flashes.

2. Press again to reset the alarm. The alarm message is removed from the Alarm display. It
is also cleared from the Active alarms screen.
Note: You can carry out this procedure with the Active alarms screen open, if you want visibility of all the active
alarms as you perform the reset.

To reset all active alarms:

1. Press the Alarm display on the Information bar. The Active alarms screen is displayed.

English 107
Alarms

2. Press Reset all to reset multiple alarms. Only those alarms that can be reset, will be reset. Any
remaining alarms will require user intervention and correction.
3. Complete any required action to resolve the remaining alarms.
4. Press OK to close the Active alarms screen and return to the previous screen.

Adjusting alarm settings

CAUTION
Adjusting alarm thresholds to maximum or minimum values may render the alarm ineffective.

WARNING
The safety and effectiveness of alarms settings should be verified for each enabled Program.

Note: To adjust the volume of the audible alert, refer to Device settings (see page 31).

To adjust the alarm settings for the current active program:

1. Access Clinical mode. The Settings screen is displayed.

2. Press .
3. Press the alarm setting that you want to adjust. The selected setting is highlighted in orange and the
up and down scroll arrows appear. Minimum and maximum settable values appear with the scroll
arrows.

4. Increase or decrease the alarm setting as required.

5. To adjust other alarm settings, select the desired settings and repeat this process. All settings that
have been adjusted are displayed with an orange outline.
6. When no further adjustments are required, press Apply.
Note: If a change to the High Pressure alarm setting conflicts with one or more ventilation parameter settings, a
confirmation screen is displayed providing a summary of the revised ventilation parameter settings. To accept
these settings press Confirm.

108
 Alarms

Setting the alarm volume

The volume level of the Astral device can be set from one to five (with five being the loudest and the
default being three).
It is also possible to set a minimum volume level, where any settings below the minimum are greyed out
and disabled from use. This feature is configurable in the Clinical menu only.

WARNING
• Alarm volume cannot be adjusted separately for individual alarms. Adjusting the alarm volume
will change the volume of all alarms, independent of alarm priority level.
• When adjusting alarm volume, ensure that the alarm can be heard above the ambient noise
levels that the patient may experience in a variety of settings, including use in noisy
environments or inside mobility bags.

In the example below the current alarm volume is '5' however the minimum alarm volume has been set
at '3'. The '1' and '2' volume options are now disabled and not able to be selected by the patient or carer.

Testing the alarm sounders and indicators

To confirm the alarm will sound as intended, regularly test the alarm.
The Astral device incorporates two alarm sounders. During an alarm condition both sounders are
operated in parallel. To confirm the correct operation of each sounder, regularly perform the Alarm test
function. During this test each sounder will be operated separately and in sequence.

To test the alarm sounders and indicators:

1. Press . The Alarms screen is displayed.

2. Press . The Alarm volume screen is displayed.

English 109
Alarms

3. Press Test to test the alarm. The alarm beeps twice and the LED flashes to indicate it is working
correctly. Confirm the alarm beeps twice. Confirm the Alarm bar flashes red, then yellow. Confirm
the mute button flashes.

WARNING
If no alarm sounds, do not use the ventilator.

CAUTION
If only one beep is heard, or the Alarm bar does not flash red, then yellow, return the device for
servicing.

Testing the Remote Alarm

The Remote Alarm generates an audible and visual signal when an alarm is triggered on the ventilator.

CAUTION
A test of the Remote Alarm should be performed prior to initial use and every change of battery.
Test the alarm periodically as per the facility policy. For dependent patients perform a test on a
daily basis.

To test the Remote alarm, press on the Remote Alarm.

The following will occur:
• The alarm LED illuminates and the alarm sounds.
• The LED corresponding to the set volume illuminates.
• The Disconnect LED blinks if the alarm is not connected to the device and lights permanently if
connected.
• The battery level LED corresponding to the battery level illuminates. Yellow LED if battery life is low,
or green LED if battery life is good. (Replace the battery if the battery life is low).
• If a second Remote Alarm is connected, the second Remote Alarm will also sound.

110
 Testing the alarms

Testing the alarms

WARNING
Do not perform alarm tests while the patient is connected to the ventilator.

This section describes functional tests to confirm correct technical operation of Astral alarms. The
efficacy of therapy alarm limits should be assessed clinically.
It is recommended that alarms be tested individually. To do so, turn off all alarms except the alarm that is
going to be tested. If the ventilator fails any of the alarm tests, see Troubleshooting.
It is not necessary to test all alarms for every alarm condition. There is no specific sequence in which the
alarms must be tested.
Many of the following tests require use of a passive test lung.

CAUTION
When the alarm tests are completed ensure the Astral device is restored to its original state.

Testing the power alarms

Alarm Test procedure
Using internal battery 1. Ensure the Astral device is connected to an external power source.
(External power disconnected) 2. Power on the Astral device.
3. Disconnect the power cord.
Using internal battery 1. Ensure the Astral device is not connected to an external power source.
(On device start up) 2. Power on the Astral device.
Low internal battery 1. Ensure the Astral device is powered on and is operating on the internal
battery.
Critically low battery
2. With a test lung attached continue ventilation until the battery discharges
and the alarms activate.
Battery inoperable 1. Remove the internal battery.
2. Connect the Astral device to an external power source.
3. Power on the Astral device.
Total power failure 1. Remove the internal battery.
2. Connect the Astral device to an external power supply.
3. Power on the Astral device. (This will activate the Battery inoperable alarm).
4. Wait five minutes and remove the power cord from the external power
source.

Testing the pressure alarms

All pressure alarm tests are conducted using a test lung, single limb circuit and in (A)CV mode.

Alarm Test procedure

High Pressure 1. Start ventilation.
2. Record the peak inspiratory pressure (PIP).
3. Set the Pressure alarm limit to less than PIP.
Obstruction 1. Start ventilation.
2. Block the exhalation port (eg, when using a proximal valve, pinch the control
tube during inspiration).

English 111
Testing the alarms

Alarm Test procedure

Low PEEP 1. Start ventilation.
2. Set the PEEP setting to 10 cmH2O.
3. After 30 seconds disconnect the test lung.
Low Pressure 1. Start ventilation.
2. Record the peak inspiratory pressure (PIP).
3. Set the Low PIP alarm limit above PIP.

Testing the ventilation monitoring alarms

For Astral 150, all ventilation monitoring alarm tests are conducted using a test lung and double limb
circuit in (A)CV mode.
For Astral 100, all ventilation monitoring alarm tests are conducted using a test lung and single limb
circuit in (A)CV mode.
Set (A)CV mode to defaults and start ventilation.

Alarm Test procedure

Low Vte Set the alarm limit above the current volume.
High Vte Set the alarm limit below the current volume.
Low Vti Set the alarm limit above the current volume.
High Vti Set the alarm limit below the current volume.
Low MVe Set the alarm limit above the current minute volume.
High MVe Set the alarm limit below the current minute volume.
Low MVi Set the alarm limit above the current minute volume.
High MVi Set the alarm limit below the current minute volume.
Low Resp Rate Set the alarm limit above the set respiratory rate.
High Resp Rate Set the alarm limit below the set respiratory rate.
Apnoea Set the respiratory rate to Off.

Testing the oximetry alarms

To test oximetry alarms attach a pulse oximeter to the Astral device and connect the sensor to a person.

Alarm Test procedure

Low SpO2 Set the alarm limit to 99%.
High SpO2 Set the alarm limit below the current SpO2 measure.
Low pulse rate Set the alarm limit above the current pulse rate.
High pulse rate Set the alarm limit below the current pulse rate.
No SpO2 monitoring With at least one other oximetry alarm enabled, disconnect the oximeter.

112
 Testing the alarms

Testing the oxygen alarms

To perform these tests an oxygen sensor must be fitted. Tests are performed without supplementary
oxygen. Run a Learn Circuit prior to testing.

Alarm Event Test procedure

Low FiO2 Start ventilation. Set the alarm limit to 24%.
High FiO2 Start ventilation. Set the alarm limit to 19%.

Testing the breathing circuit alarms

All breathing circuit alarm tests are conducted in (S)T mode using default settings and a single limb circuit
with intentional leak.

Alarm Test procedure

Disconnection Refer to Testing the disconnection alarms (see page 113).
High leak Leave the circuit open and start ventilation.
NV mask/Rebreathing Block the circuit (no mask attached) and start ventilation.
For Mouthpiece circuit only: Attach circuit to test lung via 22mm to 10mm
adapter for testing.

Testing the disconnection alarm

Testing of the disconnection alarm should be conducted using a representative breathing circuit
configuration, oxygen flow into the circuit (if any), and the final ventilation settings.
The circuit used to test the alarm should include the patient interface (eg, tracheostomy tube /
endotracheal tube / mask / mouthpiece) to simulate the patient interface being accidentally detached
from the patient. This is a more challenging disconnection for a ventilator to detect than disconnections
elsewhere along the circuit.
For invasive interfaces, consider testing with a tracheal tube one size smaller than the patient’s tube.
This checks that disconnection may still be detected even if the circuit resistance increases somewhat,
such as due to secretions within the cannula.

Alarm Test procedure

Disconnection 1. Ensure patient type and interface type have been correctly configured.
2. Start ventilation and wait a few cycles for ventilation to stabilise.
3. Disconnect the entire circuit (including patient interface, ie, mask, tracheal
tube, mouthpiece) then check that the alarm(s) configured to detect circuit
disconnection activate.
4. If the disconnection alarm does not sound, the alarm parameters may need
adjusting. Refer to Adjusting the disconnection alarm (see page 122).

English 113
Alarm settings and conditions

Alarm settings and conditions

This section details the alarms and their activation conditions. If the alarm has adjustable settings these
are described. Unless otherwise noted, alarms are applicable to all modes. Values provided within
[square brackets] are the default settings.
As soon as the activation condition is met, the Astral device provides both audible and visual alerts
without delay.

Tidal volume alarms

Tidal volume alarms activate when the monitored tidal volume parameter (Vti or Vte) exceeds the Vt
alarm setting.
Tidal volume alarms may be used to detect:
• change in patient lung condition
• leak or obstruction in patient circuit or valve.
Alarm Activates when Alarm setting (mL)

Low Vti Inspiratory tidal volume is less than Low Vt for the duration Adult: Off, 50 to 2990 [100]
of three breaths at the current average respiratory rate. Paed: Off, 10 to 995 [25]

High Vti Inspiratory tidal volume is greater than High Vt for three Adult: Off, 60 to 3000 [2500]
consecutive breaths. Paed: Off, 25 to 1000 [500]

Low Vte Expiratory tidal volume is less than Low Vt for the duration Adult: Off, 50 to 2990 [100]
of three breaths at the current average respiratory rate. Paed: Off, 10 to 995 [25]

High Vte Expiratory tidal volume is greater than High Vt for three Adult: Off, 60 to 3000 [2500]
consecutive breaths Paed: Off, 25 to 1000 [500]

WARNING
The measurement of tidal volumes may be affected by leak.

Minute volume alarms

Minute volume alarms activate when the monitored minute volume parameter (MVi or MVe) exceeds the
MV alarm setting (no delay).
Minute volume alarms will not activate during the first 60 seconds of ventilation.
Minute volume alarms may be used to detect:
• change in patient lung condition
• leak or obstruction in patient circuit or valve.
Alarm message Activates when Alarm setting (L)

Low MVi Inspiratory minute ventilation is less than Low MV Adult: Off, 0.5 to 59.9 [3]
Paed: Off, 0.2 to 59.9 [0.5]

High MVi Inspiratory minute ventilation is greater than High MV Adult: Off, 0.6 to 60 [20]
Paed: Off, 0.3 to 60 [10]

Low MVe Expiratory minute ventilation is less than Low MV Adult: Off, 0.5 to 59.9 [3]
Paed: Off, 0.2 to 59.9 [0.5]

High MVe Expiratory minute ventilation is greater than High MV Adult: Off, 0.6 to 60 [20]
Paed: Off, 0.3 to 60 [10]

114
 Alarm settings and conditions

Respiratory rate alarms

Respiratory rate alarms activate when the average respiratory rate (Resp. rate) exceeds the
corresponding alarm setting (no delay).
Respiratory rate alarms will not activate during the first 60 seconds of ventilation.

Alarm message Activates when Alarm setting (per min)

Low Resp Rate Respiratory rate is less than the Low Resp rate setting Adult: Off, 2 to 79 [4]
Paed: Off, 5 to 98 [12]

High Resp Rate Respiratory rate is greater than the High Resp rate setting Adult: Off, 3 to 80 [80]
Paed: Off, 6 to 99 [99]

Pressure alarms/limits
Pressure alarms include:
• High Pressure
• Obstruction
• Low Pressure
• PEEP.

High pressure
For pressure-target modes, the High Pressure setting acts as a pressure limit, holding pressure-target
therapies to 2 cmH2O less than the High Pressure setting. Refer to Making use of Astral's High Pressure
limit on page 88. This allows the clinician to globally limit pressure therapies if required (eg, in the context
of mask NIV).
The Astral High Pressure limit acts as a traditional High Pressure alarm for volume target therapies and
fault situations, as described below.
When a high inspiratory pressure is detected during volume target modes, the Astral device immediately
cycles to the expiratory phase and an information message is displayed. Sustained high pressure will
result in the following alarms.
High pressure may be caused by change in patient conditions.

Alarm Activates when Alarm setting (cmH2O)

High Pressure For 3 consecutive breaths, the Monitored Pressure exceeds 10 to 80* [40]
(Medium priority) the Pressure alarm setting or the Inspiratory port pressure
exceeds 85* cmH2O.
High Pressure For 10 consecutive breaths, the Monitored Pressure 10 to 80* [40]
(High priority) exceeds the Pressure alarm setting or the Inspiratory port
pressure exceeds 85* cmH2O.
*Not applicable on all device variants
Note: A high pressure alarm will initially be raised as a Medium priority and will be escalated to High priority if the
condition persists.

English 115
Alarm settings and conditions

Obstruction

WARNING
When an obstruction is detected, ventilation is suspended. Ventilation can only resume when the
monitored pressure reduces to below 3 cmH2O and the monitored expiratory flow reduces below 1
L/min.

Obstruction may be caused by a circuit obstruction. Obstruction can typically be caused by a pinched
PEEP valve control tube or a blocked exhalation valve outlet.
Note: The Obstruction alarm will not be triggered if there is an obstruction after the vent, proximal expiratory valve,
or Y piece depending on which circuit is used. To detect such a condition, use the Apnoea, Low Vt and/or Low MV
alarms.

Alarm Activates when

Obstruction Using Single Valved and Dual Valved circuits, there is a complete obstruction of the expiratory tube
or exhalation valve or inspiratory tube within 5 seconds or 2 breaths, whichever is longer.
Using Vented circuits, there is a complete obstruction of the inspiratory tube (ie, between the
ventilator and the vent) within 10 seconds.
Using Mouthpiece circuits, there is a complete obstruction of the inspiratory tube within 35 seconds
or 5 breaths, whichever is longer.

Low pressure
Low pressure may be caused by severe leak.
Note: To allow for mouthpiece ventilation and other exhale to atmosphere configurations, this alarm may be turned
off. For more information, refer to Mouthpiece Settings (see page 101).

Alarm Activates when Alarm setting (cmH2O)

Low Pressure Monitored PIP is less than or equal to the Low PIP alarm Volume modes
setting for two consecutive breaths. ((A)CV, V SIMV)
Off, PEEP+2 to 79 [5]
(Min is 2 when PEEP set to 'Off')
Monitored pressure reaches less than half of the set Pressure modes (excluding CPAP)
pressure support for two consecutive breaths where
Off / On [On]
measure Ti is greater than or equal to Rise time.
Monitored PIP is less than or equal to set CPAP - 2 cmH2O. CPAP mode
Off / On [On]

PEEP
PEEP alarms activate when the monitored positive expiratory end pressure parameter (PEEP) exceeds
the corresponding alarm setting. When ventilation starts, or after a PEEP setting change, PEEP alarms
are temporarily disabled until:
• the monitored PEEP is within 2 cm H2O of the PEEP setting for three consecutive breaths, or
• 30 seconds has passed.
PEEP alarms may be caused by:
• circuit disconnection
• high leak
• device fault
• obstruction.

116
 Alarm settings and conditions

Alarm Activates when Alarm setting

Low PEEP Monitored PEEP is less than or equal to 2 cmH2O below the Low PEEP
PEEP ventilation setting for 10 consecutive breaths.
Off / On [On]
High PEEP Monitored PEEP is greater than 2 cmH2O above the PEEP N/A
setting for 10 consecutive breaths.

Breathing circuit alarms

Breathing circuit alarms detect adverse conditions in the breathing circuit or circuit configuration.
Breathing circuit alarms may activate under conditions of:
• High leak
• NV mask/Rebreathing
• Flow sensor not calibrated
• Circuit incorrectly configured
• Circuit disconnection.

High leak
Alarm Activates when Alarm setting
High Leak The difference between MVe and MVi is greater than the Off, 20 to 80 [Off] (%)
(double limb) Leak alarm setting for a 10 second period.

High Leak Estimated unintentional leak is greater than the Leak alarm 5 to 80, Off [40] (L/min)
(single limb with setting for a 20 second period.
intentional leak)

NV Mask/Rebreathing
Alarm Activates when Alarm setting
NV mask/Rebreathing A non-vented mask is used in a vented circuit. Off / On [On]
An obstruction of the vents in a vented circuit leading to Note: Non-selectable in Mouthpiece
rebreathing. mode.
Rebreathing on a vented circuit using a non-vented mask or
on a mouthpiece circuit during continuous exhalation into
the circuit.
Rebreathing is greater than 20% for vented circuit or 50%
for mouthpiece circuit, for 10 consecutive breaths.

Flow sensor not calibrated

Alarm Activates when Alarm setting
Flow sensor not The expiratory flow sensor is not calibrated. A Learn Circuit N/A
calibrated should be performed.
(double limb)

English 117
Alarm settings and conditions

Circuit configuration alarms

Alarm Activates when Alarm setting
Incorrect circuit The circuit connected to the ventilator differs from the N/A
attached circuit type setting.
Incorrect circuit A single limb circuit with intentional leak or mouthpiece N/A
adapter circuit is attached to the ventilator but an incorrect adapter
has been fitted.
Pressure line A single limb circuit with expiratory valve is attached but N/A
disconnected the proximal pressure line is disconnected.

Disconnection alarm
The disconnection alarm monitors multiple parameters to assess whether the ventilator breathing circuit
has become disconnected from the patient.
Note: This alarm should be configured in conjunction with other alarms that can be used to detect circuit
disconnection. Refer to the Detecting circuit disconnection and de-cannulation (see page 121) section.

Alarm Activates when Alarm setting

Disconnection alarm The degree of circuit disconnection exceeds a configurable 5% (low tolerance to disconnection /
Disconnection Tolerance threshold continuously over a leak from the circuit) to 95% (high
given time period. The alarm will be cleared automatically tolerance to disconnection / leak from
if the circuit disconnection is resolved. the circuit)
The alarm will not activate if patient expiratory effort is
detected, indicated by the symbol below the measured
Disconnection value.
Note: The alarm can be turned off when a mouthpiece interface is selected or a mask interface is selected while a single limb
with intentional leak circuit is in use.

CAUTION
Be certain that all forms of patient disconnection can be successfully detected, including the
patient interface (mask / cannula / endotracheal tube / mouthpiece) detaching from the patient.
Refer to Testing the disconnection alarm on page 113.

Oxygen alarms
High and low FiO2 alarms are only available when an oxygen sensor is installed. The absence at the start
of ventilation, or loss during ventilation, of oxygen monitoring is indicated by the No FiO2 alarm.

Alarm Activates when Alarm setting (FiO2 %)

Low FiO2 Measured oxygen is less than FiO2 for a continuous period Off, 18 to 99 [18]
of 30 seconds.
High FiO2 Measured oxygen is greater than FiO2 for a continuous Off, 19 to 100 [70]
period of 30 seconds.
No FiO2 monitoring FiO2 alarms are on, and the connected O2 sensor is not N/A
operating or calibrated correctly.

118
 Alarm settings and conditions

Oximetry alarms
The oximetry alarms are only available when the pulse oximeter is connected to the Astral device. The
alarms are enabled even when the ventilator is in standby.
The SpO2 and Pulse rate alarms are automatically disabled when the pulse oximeter is disconnected
from the Astral device.

SpO2
Oxygen saturation alarms activate when the monitored SpO2 parameter exceeds the corresponding
alarm setting (no delay).

Alarm Activates when Alarm setting (SpO2 %)

Low SpO2 Saturation of peripheral oxygen is less than the low SpO2 setting as Off, 50 to 99 [85]
measured by the pulse oximeter.
High SpO2 Saturation of peripheral oxygen is greater than the high SpO2 Off, 51 to 100 [Off]
setting as measured by the pulse oximeter.
No SpO2 monitoring SpO2 alarm settings are on and the pulse oximeter has been N/A
disabled or disconnected, or has a degraded signal for more than 10
seconds.

Pulse rate
Pulse rate alarms activate when the average pulse rate (Pulse) exceeds the corresponding alarm setting
(no delay).

Alarm Activates when Alarm setting (per/min)

Low pulse rate Pulse rate is less than the low Pulse setting as measured by the Off, 20 to 249 [30]
pulse oximeter.
High pulse rate Pulse rate is greater than the high Pulse setting as measured by the Off, 21 to 250 [150]
pulse oximeter.

Apnoea alarm
For details on how to configure the Apnoea alarm and activation conditions refer to Apnoea settings (see
page 97).

Ventilation stopped alarm

The ventilation stopped alarm alerts the carer that a user has stopped the ventilator.
This alarm should be enabled if unexpected user intervention is possible.

Alarm Activates when Alarm setting

Ventilation stopped The Stop Vent. button is pressed and Stop Vent. prompt is Off / On [Off]
confirmed.

English 119
Alarm settings and conditions

Power alarms
Power alarms are not adjustable.

CAUTION
Data cannot be saved while there is a Critically low battery or Battery inoperable alarm. Program
selections made while these alarms are active may be lost if the device is restarted. Recording of
ventilation data and alarms is suspended.

Alarm Activates when

Low internal battery Approximately 20 minutes of ventilation time remaining on internal battery power.
Critically low battery Approximately 10 minutes of ventilation time remaining on internal battery power.
Total power failure There is total loss of power due to failure of the internal battery, or a loss of external power while
the internal battery is removed.
Power disconnected The power source is changed from an external source to the internal battery.
Using internal battery The Astral device is powered on and is using battery power.
Battery inoperable The internal battery is faulty or has been removed.
Internal battery The internal battery is degraded and may not provide a reliable indication of remaining time.
degraded

System alarms
System alarms are not adjustable.

Alarm message Activates when

Safety reset complete the device activated a restart to resume normal operation.
Last device test failed ventilation is started after the device self-test fails.
Device overheating internal component/s of the device are becoming too hot.
System fault a technical fault is detected within the Astral device at initial power up or during
ventilation.
Safety system fault a technical fault is detected within the Astral device at initial power up or during
ventilation.

120
 Detecting circuit disconnection and de-cannulation

Detecting circuit disconnection and de-cannulation

Inadvertent disconnection of a circuit component or accidental removal of a cannula poses a hazard to a
dependent patient. Astral is equipped with a number of alarms that when used in conjunction with the
Disconnection Alarm are able to reliably detect circuit disconnection (including de-cannulation).
The optimal alarm may depend on the therapy target and circuit type as shown in the table below.

CAUTION
Be certain that all forms of patient disconnection can be successfully detected, including the
patient interface (mask / tracheal tube / mouthpiece) detaching from the patient.
Refer to Testing the disconnection alarm on page 113.
Multiple alarms may be required. Independent monitoring can be used as an alternative.

WARNING
Alarm settings may be sensitive to any changes to the circuit, ventilation settings or co-therapy.
Test the effectiveness of the alarm after any of these changes are made.

The following table provides the most appropriate alarms for use in detecting circuit disconnection.

Pressure target modes Volume target modes

Single with leak Disconnection alarm N/A
Low pressure alarm
Low Vte alarm
Low MVe alarm
Apnoea alarm
Leak alarm
SpO2 alarm
Single with valve Disconnection alarm Disconnection alarm
Low pressure alarm Low pressure alarm
Low Peep alarm Low PEEP alarm
High Vti alarm Apnoea alarm
High MVi alarm SpO2 alarm
Apnoea alarm
SpO2 alarm
Double with valve Disconnection alarm
Low pressure alarm
Low Vte alarm
Low MVe alarm
Apnoea alarm
Leak alarm
SpO2 alarm
Mouthpiece Disconnection alarm Disconnection alarm
Low pressure alarm Low pressure alarm
High Vti alarm Apnoea alarm
High MVi alarm SpO2 alarm
Apnoea alarm
SpO2 alarm

English 121
Astral Disconnection Alarm

Astral Disconnection Alarm

The Astral Disconnection Alarm constantly measures circuit resistance to calculate the degree of
disconnection (displayed as a percentage). The high priority Disconnection Alarm will activate when the
measured disconnection value is greater than the set tolerance for the alarm Activation Time.
The alarm will only activate if the measured disconnection value is continuously above the Disconnection
Tolerance for the alarm Activation Time. If the monitored value drops below the set Disconnection
Tolerance during this time, the time to alarm activation will reset.
The alarm will not activate if patient expiratory effort is detected, indicated by the symbol below the
measured Disconnection value.

Any active alarm will clear when the monitored value drops below the set Disconnection Tolerance.

Adjusting the Disconnection Alarm

There are three settings that can be adjusted to the Disconnection Alarm to suit patient needs:
1. Disconnection Tolerance – to set a higher or lower tolerance to activate the Disconnection Alarm
2. Alarm Activation Time – the time it takes (in seconds) following disconnection for the alarm to
activate
3. Disconnection Alarm On/ Off (selected interfaces only).

CAUTION
Be certain that patient disconnection can be detected, including if the patient interface becomes
accidentally detached from the patient (eg, if the tracheostomy tube / endotracheal tube / mask /
mouthpiece remains attached to the circuit). For example, to check that accidental decannulation
of a tracheostomised patient can be detected, simulate disconnection using a tracheostomy tube
one size smaller than the patient’s tube.
Refer to Testing the disconnection alarm on page 113.

Setting and testing Disconnection Tolerance

The Disconnection Tolerance threshold represents how ‘leaky’ a circuit can be -- or degree of
‘disconnection’ -- before the Disconnection Alarm is asserted. Disconnection Tolerance is adjustable from
5% (little ‘disconnection’ will be tolerated before alarm) through to 95% (large degree of ‘disconnection’
tolerated without alarm).
To assist with alarm adjustment, leakage from the circuit is continuously measured and displayed after
each breath. The measured value is scaled to permit direct comparison against the Disconnection
Tolerance adjustment range. A measured value greater than or equal to the configured Disconnection
Tolerance will be displayed in red, along with an icon depicting a ‘disconnected’ circuit. If this level of
leakage from the circuit were sustained for the Activation Time, the alarm would assert.

122
 Astral Disconnection Alarm

So if simulating disconnection, the measured disconnection should consistently exceed the

disconnection tolerance (disconnected icon). By contrast, during ventilation of the patient, the measured
disconnection percentage should be mostly below the configured disconnection tolerance.
Some interface types (vented mask and mouthpiece) will allow for the alarm to be turned off.
The default Disconnection Tolerance will change according to the Pediatric/Adult setting and the
Interface type selected. Interfaces offering a very high resistance (eg, small diameter tracheal tubes) may
require a Lower Disconnection Tolerance setting than the default value.

To access the Disconnection Alarm:

1. Access Clinical mode. The Settings screen is displayed.

2. Select . The Alarms screen is displayed.

3. Select the Disconnection Alarm tab.

Note: The Disconnection Alarm default setting is ON.

To set the Disconnection Tolerance:

These steps should be performed prior to starting ventilation on the patient.
1. Attach all components of the patient circuit, including interface (a test cannula should be used in the
case of a tracheostomy).
2. Start ventilation at the appropriate therapy settings, circuit configuration, and supplemental oxygen (if
required).
3. If necessary, adjust the Disconnection Tolerance value until it is exceeded by the measured
disconnection value which will turn red.
Note: The Disconnection Tolerance value should not be set above the measured disconnection value otherwise
disconnection or de-cannulation will not be detected.

English 123
Astral Disconnection Alarm

4. Connect patient to the ventilator and allow breathing to stabilise.

5. Check that the measured disconnection value is below the Disconnection Tolerance value.
6. Adjust the Disconnection Tolerance value based on patient dependency.
7. Press Apply to confirm settings.
Note: Setting the Disconnection tolerance too low may result in annoyance alarms and may render the alarm
ineffective.

To test the Disconnection Tolerance:

1. Ensure the patient is being ventilated with the appropriate therapy settings, circuit configuration,
patient interface and supplemental oxygen (if required).
2. Simulate disconnections to ensure the disconnection value exceeds the Disconnection Tolerance
setting. The value and icon will turn red.

Setting Activation Time

The Disconnection Alarm will only activate if the measured disconnection value is continuously greater
than or equal to the Disconnection Tolerance for the alarm activation time. If the monitored value drops
below the set Disconnection Tolerance during this time, the time to alarm activation will reset.

To set alarm Activation Time:

1. Press Activation Time.
2. Increase or decrease the time based on patient dependency and to take into account activities such
as speaking.

3. Press Apply to confirm your changes.

124
 Astral Disconnection Alarm

Disabling (or enabling) the Disconnection Alarm

The Disconnection Alarm default setting is ON. To disable the Disconnection Alarm, the patient interface
setting must be set to:
• Mouthpiece (for valved circuits), or
• Mask (for leak circuits).

To disable or enable the Disconnection Alarm function:

1. Select the Disconnect Alarm tab.
2. Press the slider to turn ON/OFF. A warning message will be displayed. The slider will not be shown
for invasive interfaces or mask with valve circuits.
3. Select Apply from the bottom bar to proceed. An alert message will be displayed.

4. Press Confirm on the bottom bar to continue.

5. Once confirmed, the Disconnect Alarm is disabled and the Disconnect Alarm OFF icon will be
displayed next to Standby on the Information bar.

English 125
Astral Disconnection Alarm

To test the Disconnection Alarm:

These steps should be performed prior to connecting patient to the ventilator.
1. Attach all components of the patient circuit, including interface (a test cannula should be used in the
case of a tracheostomy).
2. Start ventilation at the appropriate therapy settings, circuit configuration, and supplemental oxygen (if
required).
3. Check that the measured disconnection value turns red and that the Disconnection Alarm activates
after the Alarm activation time.

126
 Data management process

Data management process

Monitoring data from the Astral device can be viewed in the ResScan™ patient management software.
Data is transferred from the device to ResScan using a USB stick. Once downloaded to ResScan, the
data can be viewed in several report formats to easily monitor treatment results and compliance.

To connect the ResMed USB to the Astral device:

Plug a USB stick into the USB connector at the rear of the device. The symbol is displayed in the
Information bar to indicate the USB is attached.

To remove the USB stick, simply pull it out of the USB connector on completion of transfer. If data was
being transferred at the time, a message in the Information bar alerts you to a failed transfer.

WARNING
Only connect devices specially designed and recommended by ResMed to the data
communication ports. Connecting other devices could result in patient injury, or damage to the
Astral device.

To transfer data:
1. From the Settings menu select Patient Data from the USB sub-menu.
2. Press Save >. When the transfer is complete a status message is displayed.

3. Remove the USB stick from the Astral device.

4. At the computer where ResScan is installed, plug the USB stick into the USB port.
5. Follow the download procedure specified in the ResScan User Guide.

English 127
Data management process

Data management summary

The table below summarises the data available for use in ResScan.

Detailed data Summary data1

Logged for the last 7 days (5th, Median, 95th)
Logged for the last 365 days
Pressure 25 Hz
Flow 25 Hz
Volume 25 Hz
PIP 1 Hz 

PEEP 1 Hz 
Avg. P 1 Hz 
Maximum Inspiratory flow 1 Hz 
Leak 1 Hz 
SpO2 1 Hz 
Pulse 1 Hz 
FiO2 1 Hz 
Vt 1 Hz 
MV 1 Hz 
Va 1 Hz 
Resp. rate 1 Hz 
I:E ratio 1 Hz 
Ti 1 Hz 
Te 1 Hz 
% Spont. trig 
% Spont. cyc 
RSBI 1 Hz 
AHI2 Median
AI2 Median
1
One set of summary data is provided per day for each program used.
2
The Apnoea Index (AI) and Apnoea Hypopnoea Index (AHI) are only recorded when a single limb circuit with intentional leak is
used. AI indicates the number of times per hour that patient flow reduces by more than 75% of nominal flow for a period of
10 seconds or more. AHI indicates the number of times per hour that patient flow reduces by more than 50% of nominal flow for
a period of 10 seconds or more.

128
 Deleting patient data

Deleting patient data

To delete patient data
1. Access Clinical mode.

2. From the main menu, select .

3. From the Events sub menu, select the Delete tab.
4. Select delete. All patient data and event logs will be deleted and patient hours will reset to zero.

English 129
Cleaning and maintenance

Cleaning and maintenance

The cleaning and maintenance described in this section should be carried out regularly.
Refer to the user guides for the patient interface, humidifier and other accessories in use for detailed
instructions for care and maintenance of those devices.

WARNING
• A patient treated by mechanical ventilation is highly vulnerable to the risks of infection. Dirty or
contaminated equipment is a potential source of infection. Clean the Astral device and its
accessories regularly.
• Always turn off and unplug the device before cleaning and be sure it is dry before plugging
back in.
• Do not immerse the device, pulse oximeter or power cord in water.

The Astral device can be cleaned using an anti-bacterial solution on a clean, non-dyed disposable cloth.
After replacing any accessory in the patient circuit, ResMed recommends you perform a Learn Circuit.

CAUTION
Clean only exterior surfaces of the Astral device.

The following cleaning solutions are compatible for use on a weekly basis (except as noted) when
cleaning the external surfaces of the Astral device:
• Actichlor Plus
• Bleach (1:10) (May also be known as 'dilute hypochlorite').
• Isopropanol
• Cavicide*
• Mikrozid*
*Suitable for cleaning on a monthly basis only.

Single patient use

For all circuit components, follow the manufacturer's recommendations for cleaning and maintenance.

Weekly
1. Wipe the exterior of the device with a damp cloth using a mild cleaning solution.
2. Inspect the condition of the circuit adapter for entry of moisture or contaminants. Replace as
necessary, or at regular intervals not less than once every six months.
3. Test the alarm sounders, refer to Testing the alarm sounders (see page 109).

Monthly
1. Inspect the condition of the air filter and check whether it is blocked by dirt or dust. With normal use,
the air filter needs to be replaced every six months (or more often in a dusty environment).
2. Check the charge level of the internal battery by:
- removing external power and operating the device on internal battery for a minimum of
10 minutes.
- reviewing the remaining battery capacity, refer to Using the Internal battery (see page 63).
- restoring external power once the test is complete.

130
 Cleaning and maintenance

Multi-patient use

WARNING
• To prevent the risk of cross-contamination, an antibacterial filter, placed on the inspiratory port
is mandatory if the device is to be used on multiple patients as under some fault conditions,
expired gas may be returned through the inspiratory port.
• The expiratory module, internal antibacterial filter, expiratory flow sensor and blue membrane
come into contact with exhaled gases but do not form part of the inspiratory pathway.

In addition to the cleaning and maintenance instructions for single patient use, you must perform the
following before the device is provided to a new patient.

Component Cleaning/ Maintenance method

Device Refer to Cleaning and maintenance (see page 130).

Double limb adapter (used with Double limb circuits) For general hygiene the Double limb adapter should be replaced or
protected with an antibacterial filter.
Mask Masks should be reprocessed when used between patients. Refer
to the User guide provided with the mask in use.
Patient circuits Replace or sterilise. Refer to the manufacturer's recommended
cleaning instructions.
Humidifier Refer to the User Guide provided with the humidifier in use.
Internal battery Check the charge level by removing the external power and
operating the device on internal battery for a minimum of ten
minutes. Review the remaining battery capacity and restore
external power.

English 131
Cleaning and maintenance

Replacing components
Replacing the air filter
Inspect the condition of the air filter and check whether it is blocked by dirt or dust. With normal use, the
air filter needs to be replaced every six months (or more often in a dusty environment).

CAUTION
Do not wash the air filter. The air filter is not washable or reusable.

To remove and replace the air filter

1. Unlock the air filter cover by turning in an anti-clockwise direction.
2. Pull the air filter cover from the device.
3. Pull the air filter from the cover and discard.
4. Insert a new filter into the cover.
5. Insert the air filter and cover back into the device.
6. Turn in a clockwise direction to secure in place.

Replacing the expiratory flow sensor and antibacterial filter (Astral 150 only)

CAUTION
• Regularly check the double limb adapter (expiratory valve) for moisture and contaminants.
Particular care should be taken when using nebulisers or humidifiers.
• When replacing the expiratory flow sensor and antibacterial filter also replace the blue
membrane and adapter.

132
 Cleaning and maintenance

To remove and replace the expiratory flow sensor and antibacterial filter:
Before replacing the expiratory flow sensor, turn off the device and remove mains power and/or external
battery.
1. Turn over the device and place on a soft surface (to protect the LCD screen).
2. Press and hold the eject button. Pull the cover out towards you.
3. Lift out the adapter and discard.
4. Remove the blue membrane (including the white antibacterial filter) and discard.
5. Remove and insert a new expiratory flow sensor.
6. Insert a new antibacterial filter.
7. Insert a new blue membrane ensuring the rear tab and surrounds sit flush in the enclosure.
8. Insert a new adapter, gently pushing down so it sits firmly in place.
9. Place the cover over the enclosure, ensuring the runners on the device and the cover are aligned.
Slide the cover back into place until the latch clicks.

CAUTION
Following the replacement of the Expiratory flow sensor, you must run a Learn Circuit to calibrate
the new sensor and ensure accurate therapy and monitoring.

To calibrate the Expiratory flow sensor, connect a double limb circuit. Prior to performing the Learn
Circuit, ensure double circuit is selected on the Circuit sub-menu.

English 133
Cleaning and maintenance

Replacing the double limb adapter (expiratory valve)

Regularly check the double limb adapter for moisture and contaminants. Replace as necessary using the
procedure as described in Connecting circuits.

Replacing the Oxygen sensor

To remove and replace the oxygen sensor (O2 cell):
Before replacing the O2 sensor, turn off the device and remove from mains power and/or external
battery.
1. Unscrew the cover of the O2 enclosure.
2. Remove the cover of the O2 enclosure.
3. Holding on to the tab of the O2 cell, gently pull the cell up and out of the enclosure. Gently pull the
wire to remove it from the connector in the device.
The device is now ready for the new O2 cell to be installed.
4. Carefully insert the connector of the new O2 cell into the socket. This connector can only be inserted
one way with the flat section to the wall of the enclosure. Press into place using a blunt tool (eg, a
flat-bladed screwdriver).
5. Holding on to the tab of the O2 cell, gently place the O2 cell into the enclosure ensuring the wires are
tucked into place.
6. Replace the cover and screw into place.

CAUTION
Following the replacement of the Oxygen sensor, you must run a Learn Circuit to calibrate the new
sensor and ensure accurate therapy and monitoring.

134
 Cleaning and maintenance

Replacing the internal battery

WARNING
Turn off and disconnect oxygen before replacing the internal battery.

CAUTION
• Lithium-ion batteries have built-in safety protection circuits, but can still be dangerous if they
are not used correctly. Damaged batteries can fail or catch fire.
• As the battery ages, the available capacity decreases. When the remaining battery capacity is
low, do not rely on the internal battery as the primary power supply.
• Only recharge the internal battery inside the device or by using a ResMed approved charger.
Avoid hard, physical impact on the device.
• Use the internal battery in accordance with the intended use stated in this guide. Damage to
equipment or injury can result from modifying the equipment or its operation.
• The internal battery should be replaced every two years or sooner when there is a noticeable
reduction in usage time when fully charged.

To remove and replace the internal battery:

Before replacing the internal battery, turn off the Astral device and remove from mains power.
1. Turn over the device and unscrew the battery cover.
2. Remove the battery cover from the device.
3. Remove the battery from the device.
4. Insert a new battery into the battery enclosure. Ensure the connectors on the battery sit face down
into the enclosure against the battery connection points on the device.
5. Replace the battery cover.
6. Screw the battery cover securely in place.

English 135
Cleaning and maintenance

Servicing

WARNING
Inspection and repair should only be performed by an authorised agent. Under no circumstances
should you attempt to service or repair the device yourself. Failure to do so could void your Astral
device warranty, damage the Astral device or result in possible injury or death.

Note: Retain the original packaging of the Astral device for use when shipping to/from an authorised ResMed Service
Centre.

Maintenance Timetable
The Astral device should be serviced by an authorised ResMed Service Centre according to the following
schedule. The Astral device is intended to provide safe and reliable operation provided that it is operated
and maintained in accordance with the instructions provided by ResMed. As with all electrical devices, if
any irregularity becomes apparent, you should exercise caution and have the device inspected by an
authorised ResMed Service Centre.
With regular servicing, the expected service life of an Astral device is 8 years.
Servicing schedule from the date of first use:

Recommended service interval Conducted by Instructions

Every six months Personnel who have been trained in the Replacement of the air filter (replace
use of Astral earlier if dirty).
Replacement of Single or Double limb
circuit adapters if used.
Two years Qualified technician Two year Preventative maintenance.
Replacement of the internal battery and
FiO2 sensor if fitted.
35,000 hours Qualified technician Pneumatic block Preventative
maintenance.

Helpful hint!
If Service Reminders are enabled you will get a notification on the device when two year preventative
maintenance is nearly due.

Internal Battery
The expected life of the internal battery is two years. The internal battery should be replaced every two
years or sooner when there is a noticeable reduction in usage time when fully charged. During storage
ensure that internal battery is recharged once every six months.

Helpful hint!
If Service reminders are enabled you will get a notification on the device when there is a measurable
reduction in battery usage time.

136
 Cleaning and maintenance

Device information
Device information, including the Next service due date indicating when the next preventative

maintenance is due, can be found by pressing and selecting Device.

Upgrading software
Software upgrades can only be performed by an authorised service representative. Astral has the ability
to be upgraded with a USB stick containing the appropriate software. Please contact your authorised
agent for further information.

Additional considerations for hospital or healthcare facilities

Component Hospital or healthcare facility
Device Follow the cleaning and maintenance protocol and schedule of the hospital/healthcare facility.

Double limb adapters For general hygiene, the double limb adapter should be replaced between patients or protected with an
antibacterial filter.
Air filter Replace every six months (or more if necessary).
Mask Masks should be reprocessed or replaced between patients. Cleaning, disinfection and sterilisation
instructions are available from the ResMed website, www.resmed.com/downloads/masks. If you do
not have internet access, please contact your ResMed representative.
Patient circuits Follow the protocol of the hospital/healthcare facility and the recommendations of the manufacturer.
Humidifier Follow the protocol of the hospital/healthcare facility and the recommendations of the manufacturer.
Antibacterial filter Replace as required and between patients.

English 137
Technical specifications

Technical specifications
Operating pressure range Single limb with valve or double limb with valve: 3 to 50 hPa
Single limb with intentional leak: 2 to 50 hPa
CPAP: 3 to 20 hPa
Maximum working pressure limit: 10 to 80* hPa
*Not applicable on all device variants
Forced cycling occurs if the Pressure alarm limit is exceeded.
Operating tidal volume range (volume Adult patient type: 100 to 2500 mL
control modes) Paediatric patient type: 50 to 300 mL*
Circuit resistance and compliance range Paediatric patient setting:
for stated accuracy of monitoring and Circuit resistance range (circuit with intentional leak): 0 to 8 hPa at
control** 60 L/min
Circuit resistance range (circuit with valve): 0 to 20 hPa at 60 L/min
Circuit resistance range (mouthpiece circuit): 0 to 5 hPa at 60 L/min
Circuit compliance range: 0 to 4 mL / hPa
Adult patient setting:
Circuit resistance range (circuit with intentional leak): 0 to 20 hPa at
120 L/min
Circuit resistance range (circuit with valve): 0 to 35 hPa at 120 L/min
Circuit resistance range (mouthpiece circuit): 0 to 15 hPa at 120 L/min
Circuit compliance range: 0 to 4 mL / hPa
Breathing resistance under single Paediatric circuit
fault*** Inspiration: 2.2 hPa (at 15 L/min), 5.3 hPa (at 30 L/min)
Expiration: 2.4 hPa (at 15 L/min), 5.0 hPa (at 30 L/min)
Adult circuit
Inspiration: 5.7 hPa (at 30 L/min), 8.3 hPa (at 60 L/min)
Expiration: 4.2 hPa (at 30 L/min), 6.2 hPa (at 60 L/min)
Maximum flow 220 L/min
Inspiratory trigger (nominal) Inspiratory trigger occurs when patient flow exceeds trigger setting.
characteristics Double limb with valve (flow trigger): 0.5 to 15.0 L/min
Single limb with valve or double limb with valve: 1.6 to 10.0 L/min (in five
steps)****
Single limb with intentional leak: 2.5 to 15.0 L/min (in five steps)
Mouthpiece (tube only) circuit: 2.0 to 4.0 L/min (in four steps)
Expiratory cycle (nominal) Cycle occurs when inspiratory flow declines to the set percentage of peak
characteristics inspiratory flow.
5 to 90%
Sound pressure level 35 ± 3 dBA as measured according to ISO 80601-2-72:2015
Sound power level 43 ± 3 dBA as measured according to ISO 80601-2-72:2015
Alarm volume range 56–85 dBA (in five steps) as measured according to IEC 60601-1-8:2012
Data storage 7 days of high-resolution airway pressure, respiratory flow and delivered
volume (sampled at 25 Hz).
7 days of breath-related therapy data (sampled at 1 Hz).
365 days of statistical data per program.
138
 Technical specifications

Dimensions (L x W x H) 285 mm x 215 mm x 93 mm

Display screen size: 150 mm x 90 mm
Weight 3.2 kg
Inspiratory port / double limb adapter 22 mm taper, compatible with ISO 5356-1:2004
Anaesthetic & Respiratory Equipment – Conical Connectors
Pressure measurement Internally mounted pressure transducers
Flow measurement Internally mounted flow transducers
Power supply AC 100–240V, 50–60Hz, 90 W 3.75 A continuous, 120 W / 5A peak
110V/400 Hz
External DC Power Supply 12 - 24V DC 90 W, 7.5 A / 3.75 A
Internal Battery Lithium-Ion battery, 14.4 V, 6.6 Ah, 95 Wh
Operating hours (standard case): 8 hours with a new battery under normal
conditions
Test conditions: Adult, (A)CV mode, Vt = 800 mL, PEEP = 5 cmH2O,
Rate = 20 bpm, Ti = 1.0 sec. All other parameters remain at default
settings.
Operating hours (worst case) > 4 hour run time under the following
conditions:
Test conditions: Adult, non-vented, PACV mode, Double limb circuit,
Pressure Assist = 30 cmH2O, PEEP = 20 cmH2O Rate: 20 bpm,
Ti: 1.0 sec, Rise Time = Min, Safety Vt = Off, Trig = Off. All other
parameters remain at default settings.
Total lifetime: up to 3,000 hours of normal operation on internal battery
Note: Time may vary with different settings and environmental conditions.
Housing construction Flame retardant engineering thermoplastic
Environmental conditions Operating temperature: 0°C to 40°C
Charging temperature: 5°C to 35°C
Operating humidity: 5 to 93% non-condensing
Storage and transport temperature: -25°C to 70°C for up to 24 hours
Storage and transport temperature: -20°C to 50°C for greater than 24 hours
Note: Storing the Astral device at temperatures exceeding 50°C for
extended period of time may accelerate battery aging. This will not affect
the safety of the battery or device. Refer to Using the internal battery (see
page 63)
Storage and transport humidity: 5 to 93% non-condensing
It takes 40 minutes* for the device to be ready for use on a patient when
removed from storage at the minimum long term temperature and at an
ambient temperature of 20°C.
*Assumes that the device is connected to an external AC power.
It takes 60 minutes for the device to be ready for use on a patient when
removed from storage at the maximum long term temperature and at an
ambient temperature of 20°C.
Air pressure: 1100 hPa to 700 hPa
Altitude: 3000 m
Note: The performance may be limited below 800 hPa or at altitudes above
2000m.
English 139
Technical specifications

IP22 (Protected against finger sized objects. Protected against dripping

water when tilted up to 15 degrees from specified orientation.) when
placed horizontally on flat surface, or vertically with handle up.
IP21 (Protected against finger sized objects and against vertically dripping
water.) when placed on a table stand, when used with the ResMed
Homecare Stand, or when attached to the RCM or RCMH.
Oxygen measurement Internally mounted oxygen sensor.
1,000,000 % hours at 25°C
Electromagnetic compatibility Product complies with all applicable electromagnetic compatibility
requirements (EMC) according to IEC 60601-1-2 for Medical Equipment in
the home and professional healthcare environments; and emergency
medical service environment.
It is recommended that mobile communication devices are kept at least one
metre away from the device.
For further details see "Guidance and manufacturer’s declaration –
electromagnetic emissions and immunity" (see page 149).
Aircraft use Medical-Portable Electronic Devices (M-PED) that meet the Federal
Aviation Administration (FAA) requirements of RTCA/DO-160 can be used
during all phases of air travel without further testing or approval by the
airline operator.
ResMed confirms that the Astral meets the Federal Aviation Administration
(FAA) requirements (RTCA/DO-160, section 21, category M) for all phases
of air travel.
IATA classification for internal battery: UN 3481 – Lithium-Ion batteries
contained in equipment.
Automotive use Product complies with ISO 16750-2 Road Vehicles - Environmental
Conditions and Testing for Electrical and Electronic Equipment - Part 2:
Electrical Loads" - 2nd Edition 2006, Tests 4.2, 4.3.1.2, 4.3.2, 4.4, 4.6.1 and
4.6.2. The functional status classification shall be Class A.
Product complies with ISO7637-2 "Road Vehicles - Electrical Disturbance by
Conduction and Coupling - Part 2 Electrical Transient Conduction Along
Supply Lines Only" - 2nd Edition 2004, Section 4.4 Transient Immunity Test.
The functional status classification shall be Class A to test level III and
Class C to test level IV.
Data connections The Astral device has three data connection ports (USB connector, mini
USB connector, and Ethernet port). Only the USB and mini-USB connectors
are for customer use.
The USB connector is compatible with the ResMed USB stick.
Recommended patient circuit Refer to www.resmed.com/astral/circuits.
components and compatible
accessories
IEC 60601-1 classifications Class II double insulation
Type BF
Continuous operation
Suitable for use with oxygen.

140
 Technical specifications

Applied parts Patient interface (Mask, endotracheal tube, tracheostomy tube or

mouthpiece).
Oximeter.
Intended operator Only a Clinician or health care provider can setup and configure the device.
A Clinician, health care provider, patient or carer are intended operators of
the device.
Operator position The device is designed to be operated within arm's length. An operator
should position their line of sight within an angle of 30 degrees from a
plane perpendicular to the screen.
The Astral device complies with IEC60601-1:2005 legibility requirements.
Software release compatibility For information on your device software version, contact your ResMed
representative.
This device is not suitable for use in the presence of a flammable anaesthetic mixture.
*The International ventilator standard indicates that Paediatric patient type is intended to be used for a patient receiving less
than 300 mL, however Astral permits adjustment of ‘Vt’ setting parameter up to 500 mL for cases where ‘Vt’ is set such that it
compensates for leak in the breathing circuit.

WARNING
ResMed does not recommend 500 mL as the upper limit for the pediatric tidal volume use;
however, clinicians may choose this upper limit based on their clinical determination.

** To achieve specified accuracies, a successful Learn Circuit must be performed.

*** Limits are the sum of device and circuit impedance under single fault leading to device shutdown.
**** Individual configurations may be more sensitive.
The life of oxygen cells is described by hours used multiplied by the % of oxygen used. For example 1 000 000 % hours oxygen
cell will last for 20 000 hours at 50% FiO2 (20 000 x 50 = 1 000 000) or 40 000 hours at 25% FiO2 (40 000 x 25 - 1 000 000). Astral's
oxygen cell will last for 25,000 hours (1041 days) at 40% FiO2

English 141
Technical specifications

Pneumatic flow path

WARNING
Under normal or single fault conditions the entire pneumatic flow path can become contaminated
with body fluids or expired gases if antibacterial filters are not installed on the ventilator outlet and
double limb adapter exhalation port.

142
 Monitoring

Monitoring
This section specifies the monitored parameters of the Astral device. Monitored therapy parameters are
only displayed during ventilation. Other parameters (eg, battery charge level and oximetry data) are
monitored even when not ventilating.
The Astral device monitors the following parameters:

Time parameters
Parameter Updates Units Range Resolution Accuracy
Ti End of sec 0 to 10 0.01 ±(20 ms + 5%)
inhalation
Te End of sec 0 to 15 0.01 ±(20 ms + 5%)
exhalation
I:E End of breath N/A 1:9.9 to 9.9:1 0.1 ±10%
Resp. rate End of breath 1/min 0 to 99 1 ±1/min

Volume and flow parameters

Parameter Updates Units Range Resolution Accuracy
Flow Continuous L/min -250 to +250 0.1 ±1 L/min or 10%*,
whichever is
greater
Vti End of mL 0 to 3000 1 ±10 mL or 10%,
inhalation whichever is
greater
Vte End of breath mL 0 to 3000 1 For double limb
circuit:
±10 mL or 10%,
whichever is
greater
For single limb with
intentional leak:
±15 mL or 15%*,
whichever is
greater
Va End of breath L/min 0 to 99 0,1 ±(0.1+15%) L/min*
MVi End of breath L/min 0 to 99 0.1 ±15% (VTi ≥
100 mL)
MVe End of breath L/min 0 to 99 0.1 ±15% (VTe ≥
100 mL)
Peak Inspiratory Flow (PIF) End of L/min 0 to 250 0.1 ±3 L/min or 35%
inhalation whichever is
greater
Measured Unintentional Once per L/min 0 to 250 1 N/A
Leak (for intentional leak second
circuits)

English 143
Monitoring

Parameter Updates Units Range Resolution Accuracy

Measured Unintentional End of breath % 0 to 100 1 N/A
Leak
(for double limb circuit
with expiratory valve)
* When Resp. rate ≥ 8/min, and Pressure ≤ 30 hPa for circuits with intentional leak, and with non-compliant interface.

Pressure parameters
Parameter Updates Units Range Resolution Accuracy
Pressure Continuous cmH2O or hPa 0 to 99 0.1 ±(0.5 hPa + 4% of
or mbar actual pressure)
PIP End of cmH2O or hPa 0 to 99 0.1 ±15%
inhalation or mbar
PEEP End of cmH2O or hPa 0 to 30 0.1 ±(0.5 hPa + 4% of
exhalation or mbar actual pressure)
Avg. P End of breath cmH2O or hPa 0 to 99 0.1 ±(0.5 hPa + 4% of
or mbar actual pressure)

Other parameters
Parameter Updates Units Range Resolution Accuracy
RSBI End of breath 1/min-L 0 to 999 1 N/A
% Spont. Trig. Start of % 0 to 100 1 N/A
inhalation
% Spont. Cyc. End of % 0 to 100 1 N/A
inhalation
Measured Battery Time Once per HH:MM N/A 1 min N/A
minute
Measured Battery Charge Once per % 0 to 100 1 N/A
Level minute
FiO2* End of % 18 to 100 1 ±(2.5% + 2.5% of
inhalation actual oxygen
concentration)**
SpO2 Once per % SpO2 0 to 100 1 Refer to Nonin
second Xpod 3012
technical
specifications at
www.nonin.com
Pulse rate Once per 1/min 18 to 321 1 Refer to Nonin
second Xpod 3012
technical
specifications at
www.nonin.com.
* FiO2 monitoring automatically compensates for atmospheric pressure variation.
** The measured FiO2 sampled at 25 Hz has a response time of <12s to 90% of the final value. The long term output drift is <1% volume oxygen
per month.

144
 Accuracy of controls

Notes:
• All flows and volumes are measured at BTPS conditions.
• To achieve specified accuracies, a successful Learn Circuit must be performed prior to measurement testing.
Specified accuracies exclude mask compliance.
• Pressure may be displayed in cmH2O, hPa or mbar. The conversion factor of the pressure units is 1. This means
the displayed pressure will have the same values regardless of the unit selected.

Accuracy of controls
The following table shows the setting range and accuracy for the adjustable parameters.
Parameter Range Resolution Accuracy
Delivered Pressure 2 to 50 hPa ±(0.5 hPa + 5% of target)
IPAP 4 to 50 hPa 0.2 hPa Refer to delivered pressure
EPAP 2 to 25 hPa 0.2 hPa Refer to delivered pressure
CPAP 3 to 20 hPa 0.2 hPa Refer to delivered pressure
PEEP Off, 3 to 20 hPa 0.2 hPa Refer to delivered pressure
PS 2 to 50 hPa (Valved circuits) 0.2 hPa Refer to delivered pressure
0 to 50 hPa (iVAPS)
P control 2 to 50 hPa 0.2 hPa Refer to delivered pressure
Vt (Tidal volume) Adult: 100 to 2500 mL 10 mL Valved circuits:
Paed: 50 to 300 mL* 5 mL ±12 mL or 10%, whichever is greater
Safety Vt (Safety tidal Adult: 100 to 2500 mL 10 mL Vented circuits:
volume) Paed: 50 to 300 mL* 5 mL ±15 mL or 15%, whichever is greater
Valved circuits:
±12 mL or 10%, whichever is greater
Target Va 1 to 30 L/min 0.1 L/min ±(0.1 +30% of target) L/min;
Resp.rate < 12 bpm
±(0.1 +15% of target) L/min;
Resp.rate ≥ 12 bpm
Resp. rate Adult: Off, 2 to 50 bpm 1 bpm ±2%
Paed: Off, 5 to 80 bpm
Target patient rate Adult: 8 to 30 bpm 1 bpm ±2%
Ti (Inspiration time) (A)CV, V-SIMV (mandatory Adult: 0.1 sec ±(20 ms + 5% of setting)
breaths): Paed: 0.05 sec
0.3 to 3.0 sec
P(A)CV, P-SIMV (mandatory
breaths):
0.2 to 5.0 sec
P(A)C:
0.3 to 4.0 sec
PIF (Peak Inspiratory Flow) (A)CV, V-SIMV (mandatory 1 L/min N/A
breaths):
Adult: 10 to 120 L/min
Paed: 5 to 60 L/min
Cycle (expiratory trigger) 5 to 90%, Auto 5% N/A

English 145
Accuracy of controls

Parameter Range Resolution Accuracy

Trigger (inspiratory trigger) (A)CV, P(A)CV: 0.5 L/min N/A
Off, 0.5 to 15 L/min
V-SIMV, PSIMV, PS, CPAP:
0.5 to 15 L/min
Inspiratory Pressure Trigger (A)CV, P(A)CV: N/A
Off, Very Low to Very High
PS, P-SIMV, V-SIMV, CPAP:
Very Low to Very High
Trigger sensitivity – Vented (S)T, P(A)C: N/A
Very Low to Very High, Off
CPAP:
Very Low to Very High
Trigger sensitivity – (A)CV, P(A)CV, PS N/A
Mouthpiece Off, Low to High, Touch
Rise Time Min, 150 to 900 msec 50 ms N/A
Flow Shape 100 (Constant), 75, 50, 25% N/A
Ti Min PS: Adult: 0.1 sec N/A
0.2 to 4.0 sec Paed: 0.05 sec
(S)T, iVAPS:
0.1 to 4.0 sec
Ti Max 0.3 to 4.0 sec Adult: 0.1 sec N/A
Paed: 0.05 sec
Apnoea Interval Adult: 15 to 60 sec 1 sec ±0.5 s
Paed: 5 to 30 sec
Apnoea Resp Rate Adult: 4 to 50 bpm 1 bpm ±2%
Paed: 12 to 80 bpm
Apnoea Ti When Volume Breath Adult: 0.1 sec ±(20 ms + 5% of setting)
option is set to Ti. Paed: 0.05 sec
If Apnoea Response is
(A)CV + Alarm:
0.3 to 3 sec
If Apnoea Response is
P(A)CV + Alarm:
0.2 to 5 sec
Apnoea Vt If Apnoea Response is Adult: 10 mL Valved circuits:
(A)CV + Alarm: Paed: 5 mL ±12 mL or 10%, whichever is greater
Adult: 100 to 2500 mL
Paed: 50 to 300 mL**
Apnoea flow shape Constant N/A

146
 Accuracy of controls

Parameter Range Resolution Accuracy

Apnoea PIF When Volume Breath is set 1 L/min N/A
to PIF.
If Apnoea Response is
(A)CV + Alarm:
Adult: 10 to 120 L/min
Paed: 5 to 60 L/min
Apnoea P control When Apnoea Response is 0.2 hPa
P(A)CV + Alarm: ±(0.5 hPa+ 5% of target)
2 to 50 hPa
Manual Breath Magnitude 100 to 250% 10% N/A
Sigh Interval 3 to 60 min 1 min N/A
Sigh Magnitude 120 to 250% 10% N/A
* When Resp. rate ≥ 8/min and Pressure ≤ 30 hPa.
**The International ventilator standard indicates that Paediatric patient type is intended to be used for a patient receiving less
than 300 mL, however Astral permits adjustment of ‘Vt’ setting parameter up to 500 mL for cases where ‘Vt’ is set such that it
compensates for leak in the breathing circuit.

WARNING
ResMed does not recommend 500 mL as the upper limit for the pediatric tidal volume use;
however, clinicians may choose this upper limit based on their clinical determination.

Notes:
• All flows and volumes are measured at BTPS conditions.
• To achieve specified accuracies, a successful Learn Circuit must be performed prior to measurement testing.
• Delivered pressure is regulated at the patient port.

English 147
Measurement System and Accuracy

Measurement System and Accuracy

The Technical Specifications published above are provided in accordance with ISO 80601-2-72 2015.
Due to the introduction of a new home care standard, manufacturers are required to declare
measurement uncertainty.
In accordance with ISO 80601-2-72 2015 the measurement uncertainty of the manufacturer's test
equipment is:
For measures of flow ± 2%
For measures of volume ± 2 mL
For measures of pressure ± 1%
For measures of time ± 10 ms

In accordance with ISO 80601-2-72 2015 the tolerance of monitoring parameters inclusive of
measurement uncertainty is:
Time parameters ± (30ms + 5%)
Flow parameters ± 12%
Volume parameters ± 12 ml or 12% whichever is greater
Pressure parameters ± (0.5 hPa + 5%)

Ventilator performance comparisons should be made on the basis of wholly including or excluding
measurement uncertainty.

Functional variants
Functional variations between Astral 100 and Astral 150.
Feature Astral 100 Astral 150
Single limb with expiratory valve Y Y
Single limb intentional leak Y Y
Circuit
Mouthpiece (tube only) Y Y
Double limb N Y
Preset programs 2 4
Leak therapy modes Y Y
Valve therapy modes Y Y
Apnoea ventilation Y Y
Therapy
Manual breath button N Y
Sigh (pre-programmed) N Y
SpO2 monitoring Y Y
FiO2 monitoring Optional extra Y*
O2 Oxygen inlet Low flow Low flow
*Not applicable on all device variants.

148
 Guidance and Manufacturer’s Declaration Electromagnetic Emissions & Immunity

Guidance and Manufacturer’s Declaration Electromagnetic

Emissions & Immunity
Medical electrical equipment needs special precautions regarding EMC and needs to be installed and put
into service according to EMC information provided in this document.
This declaration currently applies for the following ResMed devices:
• Astral™ Series of Ventilators.

Guidance and manufacturer’s declaration—electromagnetic emissions

These devices are intended for use in the electromagnetic environment specified below. The customer
or the user of the device should assure that the device is used in such an environment.
Emissions test Compliance Electromagnetic environment—guidance
RF emissions CISPR 11 Group 1 The device uses RF energy only for its internal
function. Therefore, its RF emissions are very low
and are not likely to cause any interference in
nearby electronic equipment.
RF emissions CISPR 11 Class B The device is suitable for use in all establishments,
with or without USB adapter including domestic establishments and those
directly connected to the public low-voltage
with or without Oximeter adapter
network that supplies buildings used for domestic
purposes.
Harmonic Emissions Class A
IEC 61000-3-2
with or without specified accessories
Voltage Fluctuations/Flicker Emissions Complies
IEC 61000-3-3
with or without specified accessories

WARNING
• The device should not be used adjacent to or stacked with other equipment. If adjacent or
stacked use is necessary, the device should be observed to verify normal operation in the
configuration in which it will be used.
• The use of accessories other than those specified for the device is not recommended. They
may result in increased emissions or decreased immunity of the device.
• Additional equipment connected to medical electrical equipment must comply with the
respective IEC or ISO standards (eg, IEC 60950 for data processing equipment). Furthermore all
configurations shall comply with the requirements for medical electrical systems (see
IEC 60601-1-1 or clause 16 of the 3Ed. of IEC 60601-1, respectively). Anybody connecting
additional equipment to medical electrical equipment configures a medical system and is
therefore responsible that the system complies with the requirements for medical electrical
systems. Attention is drawn to the fact that local laws take priority over the above mentioned
requirements. If in doubt, consult your local representative or the technical service department.
• Portable RF communications equipment (including peripherals such as antenna cables and
external antennas) should be used no closer than 30 cm to any part of the device, including
cables specified by the manufacturer. Otherwise, degradation of the performance of this
equipment could result.

English 149
Guidance and Manufacturer’s Declaration Electromagnetic Emissions & Immunity

Guidance and manufacturer’s declaration – electromagnetic immunity

These devices are intended for use in the electromagnetic environment specified below. The customer
or the user of the device should assure that the device is used in such an environment.
Immunity test IEC60601-1-2 test Compliance level Electromagnetic environment—guidance
level, Ed. 4
Electrostatic ±8 kV contact ±8 kV contact Floors should be wood, concrete or ceramic tile. If
discharge (ESD) ±15 kV air ±15 kV air floors are covered with synthetic material, the
IEC 61000-4-2 relative humidity should be at least 30%.
Electrical fast ±2 kV for power ±2 kV for power Mains power quality should be that of a typical
transient/burst supply lines supply lines commercial or hospital environment.
IEC 61000-4-4 ±1 kV for ±1 kV for input/output
input/output lines lines
Surge ±1 kV differential ±1 kV differential Mains power quality should be that of a typical
IEC 61000-4-5 mode mode commercial or hospital environment.
±2 kV common mode ±2 kV common mode
Voltage dips, <5% Ut (>95% dip in <12V (>95% dip in Mains power quality should be that of a typical
short Ut) for 0.5 cycle 240V) for 0.5 cycle commercial or hospital environment.
interruptions 40% Ut (60% dip in 96V (60% dip in 240V) If the user of the device requires continued
and voltage Ut) for 5 cycles for 5 cycles operation during power mains interruptions, it is
variations on recommended that the device be powered from an
70% Ut (30% dip in 168V (30% dip in
power supply uninterruptible power source.
Ut) for 25 cycles 240V) for 25 cycles
input lines
<5% Ut (>95% dip in <12V (>95% dip in The internal battery will provide backup power of
IEC 61000-4-11
Ut) for 5 sec 240V) for 5 sec eight hours.
Power 30 A/m 30 A/m Power frequency magnetic fields should be at levels
frequency characteristic of a typical location in a typical
(50/60 Hz) commercial or hospital environment.
magnetic field
IEC 61000-4-8
Conducted RF 3 Vrms 10 Vrms Portable and mobile RF communications equipment
for life support outside ISM bands 150 kHz to 80 MHz should be used no closer to any part of the device,
IEC 61000-4-6 10 Vrms including cables, than the recommended separation
inside ISM bands distance calculated from the equation applicable to
the frequency of the transmitter. See separation
distance table below.
d = 0.35 √P outside ISM bands
d = 1.2 √P inside ISM bands

150
 Guidance and Manufacturer’s Declaration Electromagnetic Emissions & Immunity

Immunity test IEC60601-1-2 test Compliance level Electromagnetic environment—guidance

level, Ed. 4
Radiated RF 10 V/m 10 V/m Recommended separation distance for life
IEC 61000-4-3 80 MHz to 2.5 GHz 80 MHz to 2.5 GHz support equipment
for Home d = 1.2 √P 80 MHz to 800 MHz
environment
d = 2.3 √P 800 MHz to 2.5 GHz
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). Field strengths
from fixed RF transmitters, as determined by an
electromagnetic site survey,a should be less than the
compliance level in each frequency range.b
Interference may occur in the vicinity of equipment
marked with the following symbol:
a
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 device is used exceeds the applicable RF compliance level above, the device should be
observed to verify normal operation. If abnormal performance is observed, additional measures may be necessary, such as
reorienting or relocating the device.
b
Over the frequency range 150 kHz to 80 MHz, field strengths should be less than 10 V/m.

Notes:
• Ut is the AC mains voltage prior to application of the test level.
• At 80 MHz and 800 MHz, the higher frequency range applies.
• These guidelines may not apply in all situations. Electromagnetic propagation is affected by absorption and
reflection from structures, objects and people.
• ISM bands: 6.765 to 6.795MHz, 13.533 to 13.567MHz, 26.957 to 27.283MHz and 40.66 to 40.70Mz

English 151
Guidance and Manufacturer’s Declaration Electromagnetic Emissions & Immunity

Recommended separation distances between portable and mobile RF

communications equipment and the life support device
These devices are intended for use in an environment in which radiated RF disturbances are controlled.
The customer or the user of the device can help prevent electromagnetic interference by maintaining a
minimum distance between portable and mobile RF communications equipment (transmitters) and the
device as recommended below, according to the maximum output power of the communications
equipment.

Rated maximum Separation distance according to frequency of transmitter (m)

output power of
150 kHz to 80 MHz 150 kHz to 80 MHz 80 MHz to 800 MHz 800MHz to 2.5 GHz
transmitter (W)
Outside ISM bands Inside ISM bands
d = 0.35 √P d = 1.2 √P d = 1.2 √P d = 2.3 √P
0.01 0.1 0.1 0.1 0.2
0.1 0.1 0.4 0.4 0.7
1 0.4 1.2 1.2 2.3
10 1.1 3.8 3.8 7.3
100 3.5 12.0 12.0 23.0

For transmitters rated at a maximum output power not listed above, the recommended separation
distance d in metres (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.
Notes:
• At 80 MHz and 800 MHz, the separation distance for the higher frequency range applies.
• These guidelines may not apply in all situations. Electromagnetic propagation is affected by absorption and
reflection from structures, objects and people.

Potential impact of electromagnetic disturbances

The loss or degradation of the following clinical functions due to electromagnetic disturbances could
result in compromised patient safety:
• Accuracy of ventilation control
• Accuracy of monitoring of airway pressure, expired volume and FiO2
• Therapy alarms.
Detection of this degradation could be observed by the following device behaviour:
• Erratic ventilation delivery
• Rapid fluctuations in monitored parameters
• False activation of therapy or technical alarms (eg, System Fault or Battery comms lost alarms)

152
 Symbols

Symbols
The following symbols may appear on your product or packaging.

Indicates a Warning or Caution Type BF applied part

Follow instructions for use Class II equipment

Batch code
8 years of China environmental protection use period
Catalogueue number
Serial number European RoHS

Humidity Limitation On/Off

Power plug
Temperature Limitation
Oximeter connector
Keep upright
Ventilation indicator
Keep dry Alternating current

Fragile, handle with care Direct current

Battery
Recyclable
Fire if damaged Alarm Mute / Reset (Audio Pause)

Manufacturer Oxygen supply inlet connector

European Authorised Representative Connector for control line of external expiratory valve

CE Labelling in accordance with EC directive 93/42/EEC Connector for the breathing pressure measuring line

Canadian Standards Association Expiratory Connector (From Patient)

Inspiratory Connector (To Patient)
Prescription only (In the US, Federal law restricts
these devices to sale by or on the order of a physician.) USB connector

Device weight Ethernet connector

Protected against finger sized objects. Protected Remote Alarm connector

against dripping water when tilted up to 15 degrees from Remote Alarm Test button
specified orientation.
MR unsafe (do not use in the vicinity of an MRI device).
Lithium Ion battery

Environmental information
This device should be disposed of separately, not as unsorted municipal waste. To dispose of your
device, you should use appropriate collection, reuse and recycling systems available in your region. The
use of these collection, reuse and recycling systems is designed to reduce pressure on natural resources
and prevent hazardous substances from damaging the environment.
If you need information on these disposal systems, please contact your local waste administration. The
crossed-bin symbol invites you to use these disposal systems. If you require information on collection
and disposal of your ResMed device please contact your ResMed office, local distributor or go to
ResMed.com/environment.

English 153
Standards compliance

Standards compliance
The Astral meets the following standards:
• IEC 60601-1 Medical Electrical Equipment - General Requirements for Basic Safety and Essential
Performance
• IEC 60601-1-2 Medical electrical equipment - Part 1-2: General requirements for basic safety and
essential performance - Collateral standard: Electromagnetic compatibility -Requirements and tests
• IEC 60601-1-8 General requirements, test and guidance for alarm systems in medical electrical
equipment and medical electrical systems
• IEC 60601-1-11 Medical electrical equipment - Part 1-11: General requirements for basic safety and
essential performance - Collateral standard: Requirements for medical electrical equipment and
medical electrical systems used in the home healthcare environment
• ISO 80601-2-72 Medical electrical equipment - Part 2-72: Particular requirements for basic safety and
essential performance of home healthcare environment ventilators for ventilator-dependent patients

Training and support

For training and support materials, please contact your ResMed representative.

154
 Troubleshooting

Troubleshooting
If there is a problem, try the following suggestions. If the problem cannot be solved, contact your care
provider or ResMed.

Alarm troubleshooting
The most common reason for an alarm to sound is because the system has not been properly
assembled or a Learn Circuit has not been correctly performed for each program.
Notes:
• The alarm actions listed below are based on having the appropriate alarm settings for the patient's therapy.
When an adjustable alarm is activated, re-confirm the alarm settings.
• The alarm log and alarm settings are maintained when the device is powered down and in the event of a power
loss.
• If an alarm activates repeatedly, discontinue use, switch to a backup ventilator and return the device for
servicing.
If the alarm log reaches its storage capacity, the oldest data will be discarded to allow new entries to be
written to the log.

Alarm message Action

Apnoea 1. Check the patient's status and airway.

2. Verify that the therapy and alarm settings are appropriate.
3. Consider adjusting the trigger settings.
4. Inspect the circuit and proximal lines for leak. Perform a Learn Circuit.
Battery 1 fault Check battery connections. If problem persists replace External Battery 1 with new
external battery.
Battery 2 fault Check battery connections. If problem persists, replace External Battery 2 with a new
external battery.
Battery Inoperable 1. If the device has been stored in extreme temperatures, wait until the device returns
to room temperature.
2. If the device has been stored for long periods of time, the battery may have
discharged. Connect to mains power.
3. If the alarm persists, replace the battery.
Circuit fault 1. Check the circuit for water or leaks.
2. Perform a Learn Circuit.
3. If the alarm persists, replace the circuit.
Critically low battery Connect the Astral to mains AC power and allow the battery to recharge.
Device overheating 1. Move the device to a cooler location.
2. Inspect the air inlet for foreign materials.
3. Inspect the air inlet filter. If necessary, replace the air inlet filter.
4. Inspect the cooling fan inlet and outlet for foreign materials.
5. Remove the Astral from the mobility bag.
6. Check the circuit for obstructions.
7. Switch to a lower impedance circuit (if available).
8. Perform a Learn Circuit.
Disconnection alarm 1. Check the patient's status and airway.
2. Inspect the circuit and proximal lines for disconnection or excessive leak.
3. Verify that the therapy and alarm settings are appropriate.
4. Perform a Learn Circuit.

English 155
Troubleshooting

Alarm message Action

Flow sensor fault Replace expiratory flow sensor.

Flow sensor not calibrated Perform a Learn Circuit.
High FiO2 1. Check the patient's status.
2. Check and adjust the oxygen supply.
3. Verify that therapy and alarm settings are appropriate.
4. Perform a Learn Circuit to recalibrate the oxygen sensor.
High Leak 1. Check the patient's status.
2. Inspect the circuit, expiratory valve and proximal lines for leak. When in use, check
for leaks around the mask.
3. When using vented therapy, check the mask type setting.
4. Verify that therapy and alarm settings are appropriate.
5. Perform a Learn Circuit.
High MVe 1. Check the patient's status.
2. Inspect the double limb adapter. If necessary, replace the expiratory valve.
3. Verify that therapy and alarm settings are appropriate.
4. Perform a Learn Circuit.
High MVi 1. Check the patient's status.
2. Inspect the circuit and expiratory module for leaks.
3. Verify that therapy and alarm settings are appropriate.
4. Perform a Learn Circuit.
High PEEP 1. Check the patient's status.
2. Inspect the circuit and expiratory valve for obstruction. When in use, check for
obstruction in proximal lines.
3. Verify that therapy and alarm settings are appropriate.
4. Perform a Learn Circuit.
High pressure 1. Check the patient's status and airway.
2. Inspect the circuit for obstruction.
3. Verify that therapy and alarm settings are appropriate.
4. Perform a Learn Circuit.
High pressure protection The hardware pressure safety limit was exceeded. If problem reoccurs, return the device
for service.
High Pulse Rate 1. Check the patient's status.
2. Verify that therapy and alarm settings are appropriate.
High Resp Rate 1. Check the patient's status.
2. Verify that therapy and alarm settings are appropriate.
3. Check and adjust the trigger settings.
4. Check for and correct leak.
5. Perform a Learn Circuit.
High SpO2 1. Check the patient's status.
2. Verify that therapy and alarm settings are appropriate.

156
 Troubleshooting

Alarm message Action

High Vte 1. Check the patient's status.

2. Check double limb circuit adapter for contaminants or water.
3. Inspect the double limb circuit adapter. If necessary, replace the circuit adapter.
4. Verify that therapy and alarm settings are appropriate.
5. Perform a Learn Circuit.
High Vti 1. Check the patient's status.
2. Inspect the circuit and expiratory module for leaks.
3. Verify that therapy and alarm settings are appropriate.
4. Perform a Learn Circuit.
Incorrect circuit adapter 1. Check that the correct circuit adapter is installed for the selected circuit type.
2. Perform a Learn Circuit.
Incorrect circuit attached 1. Check that the circuit is correctly connected and matches the circuit type selected.
2. Inspect the circuit, expiratory valve and proximal lines.
3. Perform a Learn Circuit.
Internal battery degraded 1. Connect the Astral to mains AC power.
2. Return the device for service to replace the internal battery.
The internal battery run time indicator may no longer be accurate and should not be relied
upon.
Last self-test failed 1. Perform a Learn Circuit.
2. If problem persists, return the device for service.
Low internal battery Connect the Astral to mains AC power to allow the battery to recharge.
Low FiO2 1. Check the patient's status.
2. Check for leak.
3. Check the oxygen supply and connections to the device.
4. Verify that therapy and alarm settings are appropriate.
5. Perform a Learn Circuit to recalibrate the oxygen sensor.
Low MVe 1. Check the patient's status and airway.
2. Inspect the circuit and the expiratory valve for obstruction or leaks.
3. Verify that therapy and alarm settings are appropriate.
4. Perform a Learn Circuit.
Low MVi 1. Check the patient's status and airway.
2. Inspect the circuit for obstruction.
3. Verify that therapy and alarm settings are appropriate.
4. Perform a Learn Circuit.
Low PEEP 1. Check the patient's status.
2. Verify that therapy and alarm settings are appropriate.
3. Inspect the circuit and the expiratory valve for obstruction or leaks. When in use,
check for obstructions in proximal lines.
4. Perform Learn Circuit.
Low pressure 1. Check all circuit connections, especially the patient interface and the proximal sense
line.
2. Verify that therapy and alarm settings are appropriate.
3. Inspect the circuit and expiratory valve for damage or secretions.
4. Perform a Learn Circuit.

English 157
Troubleshooting

Alarm message Action

Low Pulse Rate 1. Check the patient's status.

2. Verify that therapy and alarm settings are appropriate.
Low Resp Rate 1. Check the patient's status.
2. Inspect the circuit and the proximal lines for leak.
3. Check and adjust settings.
4. Verify that therapy and alarm settings are appropriate.
5. Perform a Learn Circuit.
Low SpO2 1. Check the patient's status.
2. Verify that therapy and alarm settings are appropriate.
Low Vte 1. Check the patient's status and airway.
2. Inspect the circuit and the circuit adapter for obstruction or leaks or water.
3. Verify that therapy and alarm settings are appropriate.
4. Perform a Learn Circuit.
Low Vti 1. Check the patient's status and airway.
2. Inspect the circuit for obstruction.
3. Verify that therapy and alarm settings are appropriate.
4. Perform a Learn Circuit.
No FiO2 monitoring Perform a Learn Circuit to calibrate the oxygen sensor.
No SpO2 monitoring 1. Check the SpO2 connection to patient's finger and the Astral.
2. If the alarm persists, use another SpO2 oximeter or finger sensor.
NV Mask/Rebreathing For vented circuit:
1. Check that the mask vents are clear and unobstructed.
2. Check the mask type setting.
3. Perform a Learn Circuit.
For mouthpiece circuit:
Check that the interface is a mouthpiece and that the patient is not continuously exhaling
into the circuit.
Obstruction 1. Check the patient's status and airway.
2. Inspect the circuit and the expiratory valve for obstruction. When in use, check for
kinks in proximal lines.
3. Check the circuit for water.
4. Perform a Learn Circuit.
PEEP blower failure 1. Check the patient's status.
2. Switch to a back-up ventilator and return the device for service.
Power fault / no charging 1. Check all connections between the ventilator and external battery.
2. Check connection to mains power (if present). This can be caused by the battery
temperature being out of range.
If problem persists, contact your ResMed Service Centre.
Pressure Line disconnected 1. Check the connection of the proximal sense line.
2. Check the circuit for water.
3. Perform a Learn Circuit.
Safety reset complete The device detected a fault and was reset.
1. Check the patient's status.
2. If the alarm persists, switch to a back-up ventilator and return the device for service.

158
 Troubleshooting

Alarm message Action

Safety system fault 1. Check the patient's status.

2. Transfer the patient to an alternate means of ventilation.
3. Return the device for servicing.
System fault 1. Check the patient's status.
2. Perform a Learn circuit.
3. If problem persists, or the device fails self-test, return the device for service.
Total power failure 1. Check the patient's status and airway.
2. Connect the device to AC mains.
3. Check the battery charge level of the internal and external (if applicable) battery.
The total power failure alarm can only be silenced by connecting the device to
AC mains power.
Using internal battery Confirm operation on internal battery is intended or restore external power.
If intending to use external power:
1. Check the power cable connection between the mains or battery, the power supply
pack and the device.
2. If using an external battery, check the external battery charge level and
replace/charge if empty.
3. If using mains AC, check the supply output.
4. If the problem continues, try an alternative external supply type (ie, Mains AC, Mains
DC or External Battery).
Ventilation stopped Confirm it is appropriate to stop ventilation.

English 159
Troubleshooting

Learn Circuit troubleshooting

Error code Action

001 Hardware fault detected. Contact an authorised Service Centre.

104, 105 During the first step of the Learn Circuit, check that the inspiratory port and air inlet filter
of the Astral device are clear of obstructions; and the circuit is not connected to the
inspiratory port.
Repeat Learn Circuit. If the problem persists, contact an authorised Service Centre.
106 Hardware fault detected. Contact an authorised Service Centre.
113 1. Check that supplemental oxygen is not added during the Learn Circuit.
2. During the first step of the Learn Circuit, check that the inspiratory port and air inlet
filter of the Astral device are clear of obstructions; and the circuit is not connected to
the inspiratory port.
Repeat Learn Circuit. If the problem persists, contact an authorised Service Centre.
121 Device Test cannot detect the correct circuit adapter.
Single limb with expiratory valve:
1. Check that the valve control line and proximal pressure line are connected to the
single limb adapter correctly. Refer to Connecting a single limb circuit with expiratory
valve (see page 40) for further information.
2. Check that the single limb circuit adapter is firmly inserted and adapter cover is
installed correctly. Refer to Fitting the circuit adapter (see page 38) for further
information.
Double limb:
1. Check that the double limb circuit adapter is firmly inserted and adapter cover is
installed correctly. Refer to Fitting the circuit adapter (see page 38) for further
information.
Single limb with intentional leak:
1. Check the single limb leak adapter is firmly inserted and adapter cover is installed
correctly. Refer to Fitting the circuit adapter (see page 38) for further information.
Repeat Learn Circuit. If the problem persists, contact an authorised Service Centre.
122 Hardware fault detected. Contact an authorised Service Centre.
123 Air Inlet Filter is not detected.
Check that the air inlet filter is clean, dry and correctly installed. Replace if necessary.
Refer to Replacing the air filter (see page 132).
Repeat Learn Circuit. If the problem persists, contact an authorised Service Centre.
124 Ensure that all filters and circuits are disconnected from the inspiratory port. Repeat Learn
Circuit. If the problem persists, contact an authorised Service Centre.
125 Hardware fault detected. Contact an authorised Service Centre.

160
 Troubleshooting

Error code Action

204 Unable to learn the circuit.

1. Ensure that the circuit is not moved until completion of the test.
2. Check the circuit and attached accessories for blockages.
3. Ensure that there are no sharp bends or kinks in the circuit and the patient end is not
blocked.
4. If using humidification, ensure that the humidifier tub is not overfilled.
5. Follow the on-screen instructions carefully:
• circuit should not be blocked during step 2
• circuit should be completely blocked during step 3.

If problem persists, this circuit may not be compatible with the Astral device. Consider
selecting another circuit configuration.
205 The measured circuit resistance exceeds safe operating limits for this device.
1. Check the circuit and attached accessories for blockages.
2. Ensure that there are no sharp bends or kinks in the circuit and the patient end is not
blocked.
3. If using humidification, ensure that the humidifier tub is not overfilled.
4. Follow the on-screen instructions carefully:
• circuit should not be blocked during step 2
• circuit should be completely blocked during step 3.

If problem persists, this circuit may not be compatible with the Astral device. Consider
selecting another circuit configuration.
206 Hardware fault detected. Contact an authorised Service Centre.
303 Unable to calibrate oxygen sensor.
1. Check that supplemental oxygen is not added during the Learn Circuit.
2. Repeat Learn Circuit. If the problem persists, replace the oxygen sensor as described
in Replacing the Oxygen sensor.
404, 405, 406 Hardware fault detected. Contact an authorised Service Centre.
409 Learn Circuit was unable to complete due to excessive leak from the circuit.
1. Check that the circuit is completely blocked during the third step of the Learn Circuit.
2. Check that the circuit is assembled correctly and there are no leaks in the circuit.
3. Check that the circuit adapter is firmly inserted.
4. This circuit may not be compatible with the Astral device. Try another circuit.
Repeat Learn Circuit. If the problem persists, contact an authorised Service Centre.
415 Hardware fault detected. Contact an authorised Service Centre.
420 The measured circuit compliance exceeds safe operating limits for this device.
Check that the circuit is assembled correctly and completely blocked during the third step
of the Learn Circuit.
If problem persists, this circuit may not be compatible with the Astral device. Consider
selecting another circuit configuration.
426 Hardware fault detected. Contact an authorised Service Centre.

English 161
Troubleshooting

Error code Action

504 Unable to learn the circuit.

1. Ensure that the circuit is not moved until completion of the test.
2. Check the circuit and attached accessories for blockages.
3. Ensure that there are no sharp bends or kinks in the circuit and the patient end is not
blocked.
4. If using humidification, ensure that the humidifier tub is not overfilled.
5. Follow the on-screen instructions carefully:
• circuit should not be blocked during step 2
• circuit should be completely blocked during step 3.

If problem persists, this circuit may not be compatible with the Astral device. Consider
selecting another circuit configuration.
505 The measured circuit resistance exceeds safe operating limits for this device.
1. Check the circuit and attached accessories for blockages.
2. Ensure that there are no sharp bends or kinks in the circuit and the patient end is not
blocked.
3. If using humidification, ensure that the humidifier tub is not overfilled.
4. Follow the on-screen instructions carefully:
• circuit should not be blocked during step 2
• circuit should be completely blocked during step 3.

If problem persists, this circuit may not be compatible with the Astral device. Consider
selecting another circuit configuration.
506, 512 Hardware fault detected. Contact an authorised Service Centre.
600 Unable to calibrate Expiratory Flow Sensor.
1. Check the circuit adapter is clean, dry and firmly inserted.
• If the adapter is wet, then removing the adapter and vigorously shaking to clear
water can be effective. Re-insert adapter firmly and repeat Learn Circuit.
• If the adapter is not clean, then it will need to be replaced.
2. If using a small diameter paediatric breathing circuit, consider using an anti-bacterial
filter or a 22-mm adapter on the expiratory adapter port.
3. Repeat Learn Circuit and ensure that the circuit is not moved until completion of the
test.
If problem persists, then the expiratory flow sensor may need to be replaced.

162
 Troubleshooting

General troubleshooting
Issue Action
Condensation forming in circuit Condensation may form due to high humidity settings and low ambient temperatures.
Adjust humidifier settings in accordance with manufacturer's instructions.
Touch screen damaged or If you are unable to power off the Astral device normally, use the following forced
non-responsive shutdown procedure:
1. Disconnect any external power source (eg, AC mains or external battery).
2. Press and hold the green on/off button and the alarm mute/reset button for at least
10 seconds. After 10 seconds the alarm bar will flash yellow.
3. Release both buttons. Astral will then power off.
4. The Astral device can be powered back on by pressing the on/off button and used as
intended.
Unable to save data from Astral to 1. Remove and reinsert the USB stick.
USB or USB is not detected by 2. Use a new USB stick.
device. 3. Remove the AC or external DC power supply, the restart the Astral by switching it off
then on.
4. Reformat your USB stick. Note that any data currently saved on the USB will be lost.
Learn Circuit failed If the Learn Circuit fails and a warning message appears on the top of the Learn Circuit
results page, try the following:
1. Check the circuit for Leak.
2. Check the module, the blue membrane and sensor are pressed all the way in and sit
flush with the enclosure.
3. Select the paediatric patient type. This will allow higher resistance circuits to pass.
(10mm and 15mm corrugated circuits will not pass Learn Circuit with adult patient
type selected).
4. Hold the circuit straight to reduce resistance.
5. Ensure that the ventilation and alarms are effective before proceeding further.
Note: It is acceptable to use a circuit that gives a caution message as the Astral device
will compensate for circuit resistance and compliance.
Flow Sensor failed If the Flow Sensor fails and a message appears on the bottom of the Learn Circuit results
(Astral 150 only) page, try the following:
1. Check the circuit for Leak.
2. Check the expiratory valve, the blue membrane and sensor are pressed all the way in
and sit flush with the enclosure.
3. If required, replace the flow sensor by following the instructions in 'Replacing
components" in the Cleaning and maintenance section.

English 163
Recommendations for suctioning

Recommendations for suctioning

Suctioning involves application of negative pressure (vacuum) to the airway through a catheter tube to
remove airway secretions causing airway obstruction.
Astral supports two methods of suctioning based on the selection of catheter  open and closed.
The need for suctioning can be detected by the ventilator through:
• Increased peak inspiratory pressure during volume-controlled ventilation. To detect this condition,
appropriately configure the High Pressure alarm.
• Decreased tidal volume during pressure-controlled ventilation. To detect this condition, appropriately
configure the Low Vti alarm
• A deterioration of oxygen saturation. To detect this condition, use a Pulse Oximeter and appropriately
configure the Low SpO2 alarm.
If patient pre or post suctioning oxygenation is required, it can be achieved by the following means (or a
combination of the following means):
• adjusting the low flow oxygen input to increase delivered FiO2
• patient hyperventilation using the Astral Manual breath feature (take care to allow sufficient
exhalation time to avoid breath stacking).
SpO2 monitoring can be used during pre and post oxygenation, during and after suctioning to assess the
patient condition.
For open suctioning, the ventilation circuit may be temporarily disconnected to allow suctioning. Due to
this disconnection the PEEP, Low Inspiratory Pressure, and/or Minute Ventilation alarms may be

triggered. Press to pre-silence alarms for two minutes.

To facilitate suctioning, the SpO2 and Pulse rate monitors continue to display if ventilation is temporarily
stopped.
For closed suctioning, due to the vacuum pressure applied while ventilating, Tidal volume, Minute volume

and/or PEEP alarms may be triggered. Press to pre-silence alarms for two minutes.

CAUTION
Following open or closed suctioning, restore the patient circuit and check ventilation is correctly
restored.

To assess the patient condition and the effectiveness of the secretions removal, peak inspiratory flow
(during pressure-controlled ventilation), peak inspiratory pressure (during volume-controlled ventilation) or
tidal volume during pressure-controlled ventilation, as well as SpO2 can be monitored.
Astral places no restrictions on which ventilation mode is used while suctioning. Astral may respond
differently depending on the mode and therapy settings. It is recommended that the 'expected response'
is clearly documented in the patient care plan.

164
 Limited warranty

Limited warranty
ResMed Ltd (hereafter 'ResMed') warrants that your ResMed product shall be free from defects in
material and workmanship from the date of purchase for the period specified below.
Product Warranty period
• Mask systems (including mask frame, cushion, headgear and tubing)—excluding 90 days
single-use devices
• Accessories—excluding single-use devices
• Flex-type finger pulse sensors
• Humidifier water tubs
• Batteries for use in ResMed internal and external battery systems 6 months
• Clip-type finger pulse sensors 1 year
• CPAP and bilevel device data modules
• Oximeters and CPAP and bilevel device oximeter adapters
• Humidifiers and humidifier cleanable water tubs
• Titration control devices
• CPAP, bilevel and ventilation devices (including external power supply units) 2 years
• Battery accessories
• Portable diagnostic/screening devices

This warranty is only available to the initial consumer. It is not transferable.

If the product fails under conditions of normal use, ResMed will repair or replace, at its option, the
defective product or any of its components.
This Limited Warranty does not cover: a) any damage caused as a result of improper use, abuse,
modification or alteration of the product; b) repairs carried out by any service organisation that has not
been expressly authorised by ResMed to perform such repairs; c) any damage or contamination due to
cigarette, pipe, cigar or other smoke; and d) any damage caused by water being spilled on or into an
electronic device.
Warranty is void on product sold, or resold, outside the region of original purchase.
Warranty claims on defective product must be made by the initial consumer at the point of purchase.
This warranty replaces all other expressed or implied warranties, including any implied warranty of
merchantability or fitness for a particular purpose. Some regions or states do not allow limitations on
how long an implied warranty lasts, so the above limitation may not apply to you.
ResMed shall not be responsible for any incidental or consequential damages claimed to have resulted
from the sale, installation or use of any ResMed product. Some regions or states do not allow the
exclusion or limitation of incidental or consequential damages, so the above limitation may not apply to
you.
This warranty gives you specific legal rights, and you may also have other rights which vary from region
to region. For further information on your warranty rights, contact your local ResMed dealer or ResMed
office.

English 165
Appendix A: Definitions

Appendix A: Definitions
Ventilation settings definitions
The available settings will vary with the selection of the ventilation mode. Each mode details the settings
available.

Setting Definition
Apnoea Definition Apnoea Definition sets the type of breath which must be delayed for an apnoea to be
detected.
Apnoea Interval Apnoea Interval (T apnoea) sets the period without breath or spontaneous breath
(T apnoea) required for an apnoea to be detected.
Apnoea Response Apnoea Response sets the behaviour of the ventilator when an apnoea is detected.
Circuit Type Circuit Type sets whether a Double limb circuit, Single limb circuit with expiratory valve
or Single limb circuit with intentional leak is in use.
CPAP Continuous Positive Airway Pressure (CPAP) sets the pressure maintained throughout a
spontaneous breath.
Cycle Cycle (also known as Expiratory Trigger) sets the threshold where start of expiration
within a breath is detected.
EPAP Expiratory Positive Airway Pressure (EPAP) sets the pressure to be delivered to the
patient during expiration.
Flow shape Sets the target flow waveform for the delivery of mandatory controlled volume breaths.
Inspiratory duration option Inspiratory duration option (Insp Duration Option) sets whether Inspiration Time (Ti) or
(Insp Duration Option) Peak Inspiratory Flow (PIF) is used to configure volume controlled breaths.
Interface type Invasive, mask, or mouthpiece
Interval Sigh interval sets the period between sigh breaths.
IPAP Inspiratory Positive Airway Pressure (IPAP) sets the pressure to be delivered to the
patient during inspiration.
Magnitude Magnitude sets the size of the manual or sigh breath delivered relative to the size of the
normal ventilation breath. Separate magnitude settings are available for configuration of
manual or sigh breaths.
Manual Breath Manual Breath sets whether a manual breath is available for delivery.
Mask Type Mask Type sets the type of mask or in-line vent in use when the circuit type is single
with leak.
Max EPAP Maximum Expiratory Positive Airway Pressure (Max EPAP) sets the maximum pressure to
be delivered to the patient during expiration to maintain upper airway patency.
Max PS Maximum Pressure Support (Max PS) sets the maximum pressure support above EPAP
allowed to achieve the Target Va.
Min EPAP Minimum Expiratory Positive Pressure (Min EPAP) sets the minimum pressure allowed to
be delivered to the patient during expiration to maintain upper airway patency.
The Min EPAP should be set to treat any lower airway condition.
Min PS Minimum Pressure Support (Min PS) sets the minimum pressure support above EPAP
allowed to achieve the Target Va (iVAPS).
P control Pressure control (P control) sets the pressure support above PEEP to be delivered during
inspiration for pressure assisted breaths.

166
 Appendix A: Definitions

Setting Definition
P control max Maximum allowed pressure control (P control max) sets the maximum pressure control
above PEEP allowed to achieve the target safety volume.
Patient type Select from Adult or Paediatric. This setting configures the default values and ranges
available for ventilation settings and determines circuit resistance acceptance criteria
applied in the Learn Circuit.
PEEP Positive End Expiratory Pressure (PEEP) sets the pressure maintained during exhalation.
PIF Peak Inspiratory Flow (PIF) sets the maximum delivered flow for volume controlled
breaths.
PS Sets the pressure support above PEEP to be delivered during inspiration for pressure
supported breaths (spontaneous breaths).
PS Max Maximum allowed Pressure Support (PS Max) sets the maximum pressure support above
PEEP allowed to achieve the target safety tidal volume.
Pt Height Patient Height (Pt Height) is used to estimate the patient's anatomical deadspace and
Ideal Body Weight (IBW).
Resp. rate Respiratory rate (Resp. rate) sets the breaths per minute (bpm) to be delivered by the
ventilator to the patient. The measured respiratory rate may be greater due to patient
triggered breaths.
Rise Time Rise time sets the time taken for the ventilator to reach inspiratory pressure for pressure
controlled breaths.
Safety Vt Safety tidal volume sets the target minimum tidal volume (Vt) for each ventilator
delivered breath.
Sigh Alert Sigh alert sets whether the ventilator gives a single beep just prior to delivery of a sigh
breath.
Sigh Breath Sigh Breath sets whether a magnified breath (a sigh breath) will be delivered at the sigh
interval.
Target Pt Rate Target Patient Rate (Target Pt Rate) sets the upper boundary for the iVAPS intelligent
Backup Rate (iBR).
Target Va Target Alveolar Minute Ventilation (Target Va) sets the servo-ventilation target for
iVAPS.
Ti Inspiration time (Ti) sets the duration of the inspiratory phase of a breath.
Ti Max Maximum inspiratory time (Ti Max) sets the maximum duration of the inspiratory phase
of a breath.
Ti Min Minimum Inspiratory Time (Ti Min) set the minimum duration of the inspiratory phase of
a breath.
Trigger Sets the trigger threshold above which the ventilator triggers a new breath.
The trigger is blocked for the first 300 ms following the start of exhalation.
Trigger type Trigger type sets whether a pressure based trigger threshold or flow based trigger
threshold is used when a Double circuit is selected.
Vt The Tidal Volume (Vt) sets the volume of gas, measured in mL, to be delivered to the
patient in a mandatory controlled volume breath.

English 167
Appendix A: Definitions

Measured and calculated parameter definitions

The following measured and calculated parameters are displayed during configuration or during
ventilation. Each Ventilation mode details the parameters displayed.

Parameter Definition
FiO2 Average of percentage of Oxygen delivered to circuit.
I:E I:E is the ratio of the inspiratory period to the expiratory period.
The measured I:E ratio is displayed as a monitored parameter during ventilation.
The expected I:E ratio is calculated and displayed on the settings screens if the Resp.
rate setting is not set to Off.
Leak Leak is the average unintentional leak. It is reported as a percentage for Double limb
circuits and as a flow for Single limb circuits with intentional leak.
The measured Leak is displayed as a monitored parameter during ventilation.
MV Minute Ventilation (MV) is the product of the Target Patient Rate (Target Pt Rate) and
expired tidal volume averaged over the last eight breaths.
The MV is displayed as a calculated parameter during iVAPS configuration.
MVe Expiratory Minute Volume (MVe) is the product of the respiratory rate and expired tidal
volume averaged over the last eight breaths.
The measured MVe is displayed as a monitored parameter during ventilation.
MVi Inspiratory Minute Volume (MVi) is the product of the respiratory rate and inspired tidal
volume averaged over the last eight breaths.
The measured MVi is displayed as a monitored parameter during ventilation.
Pressure Pressure is the current airway pressure of the patient as measured at the patient port.
The measured Pressure is displayed as a monitored parameter during ventilation.
PEEP End expiratory pressure (PEEP) is the airway pressure measured 50 ms prior to the end of
the last expiration.
The measured PEEP is displayed as a monitored parameter during ventilation.
Pmean Mean airway pressure of the patient over the last breath.
% Spont cycle % Spont cycle is the percentage of breaths that are spontaneously cycled over the past
20 breaths.
% Spont trig % Spont trig is the percentage of breaths that are spontaneously triggered over the last
20 breaths.
The measured %Spont Trig is displayed as a monitored parameter during ventilation.
PIF Peak Inspiratory Flow (PIF) is the maximum flow reached during the last inspiration.
The measured PIF is displayed as a monitored parameter during ventilation.
The expected PIF is calculated and displayed for volume controlled breaths on the
settings screens when the Inspiratory Phase Duration Option is set to Ti.
PIP Peak Inspiratory Pressure (PIP) is the maximum airway pressure reached during the last
inspiration.
The measured PIP is displayed as a monitored parameter during ventilation.
Pulse rate The measured Pulse rate (pulse) is displayed as a monitored parameter when a pulse
oximeter is used.

168
 Appendix A: Definitions

Parameter Definition
Resp. rate Respiratory rate (Resp. rate) is the number of breaths per minute averaged over the last
eight breaths.
The measured Resp. rate is displayed as a monitored parameter during ventilation.
RSBI Rapid Shallow Breathing Index (RSBI) is calculated by dividing the breath rate by Tidal
Volume.
The measured RSBI is displayed as a monitored parameter during ventilation.
SpO2 The measured functional Oxygen Saturation (SpO2) is displayed as a monitored
parameter when a pulse oximeter is used.
Te Expiratory time Te is the period in seconds of the last expiratory phase.
Ti Inspiratory time Ti is the period in seconds of the last inspiratory phase.
The measured Ti is displayed as a monitored parameter during ventilation.
The expected Ti is calculated and displayed for volume controlled breaths on the settings
screens when the Inspiratory Phase Duration Option is set to PIF.
Va Alveolar Minute Ventilation (Va) is calculated by (Tidal Volume - Deadspace) x Resp.
Rate.
The measured Va is shown as a monitored parameter during ventilation.
Vte Expiratory Tidal Volume (Vte) is the volume expired during the last breath.
The measured Vte is displayed as a monitored parameter during ventilation.
Vti Inspiratory Tidal Volume (VTi) is the volume inspired during the last breath.
The measured VTi is displayed as a monitored parameter during ventilation.
Average Vt Average Tidal Volume (Average Vt) is the average volume expired during the last five
minutes of ventilation.
The Average Vt is displayed as a calculation parameter during iVAPS configuration.
Average Vt/kg Average Tidal Volume per kg (Average Vt/kg) is the Average Vt divided by Ideal Body
Weight (IBW).
The Average Vt is displayed as a calculation parameter during iVAPS configuration.

English 169
Appendix B: Ventilation parameters

Appendix B: Ventilation parameters

The following table provides a summary of the Astral device parameter ranges and the [default settings].

Ventilation Parameters summary table

Valve Ventilation and Mouthpiece
Parameter Leak Ventilation Setting
Circuit

V-SIMV
P-SIMV
P(A)CV

iVAPS
CPAP

CPAP
P(A)C
ACV

(S)T
Respiratory rate   PS
      (A)CV, P(A)CV, P(A)C
• Adult: Off, 2 to 50 [15]
• Paed: Off, 5 to 80 [15]
Mandatory breaths: V-SIMV,
P-SIMV
• Adult: 2 to 50 [15],
• Paed: 5 to 80 [15]
PS, (S)T
• Adult: Off, 2 to 50 [15]
• Paed: Off, 5 to 80 [15]
EPAP    2 to 25 [5]
(cmH2O)

Min EPAP  2 to 25 [5] Only when

(cmH2O) AutoEPAP is turned ON.

Max EPAP  2 to 25 [15] Only when

(cmH2O) AutoEPAP is turned ON.

PEEP      Off, 3.0 to 20.0 [5.0]

(cmH2O)

CPAP   3.0 to 20.0 [5.0]

(cmH2O)

P Control   Adult: 2 to 50 [7]

(cmH2O)
Paed: 2 to 50 [7]

170
 Appendix B: Ventilation parameters

Valve Ventilation and Mouthpiece

Parameter Leak Ventilation Setting
Circuit

V-SIMV
P-SIMV
P(A)CV

iVAPS
CPAP

CPAP
P(A)C
ACV

(S)T
PS
PS    PS
(cmH2O) • Adult: 2 to 50 [7]
• Paed: 2 to 50 [7]
Spontaneous breaths: V-SIMV,
P-SIMV
• Adult: 2 to 50 [7]
• Paed: 2 to 50 [7]
Min PS  0 to 50 [2]
(cmH2O)

Max PS  AutoEPAP Off: 0 to 50 [20]

(cmH2O)
AutoEPAP On: 8 to 50 [20]

IPAP   Adult: 4 to 50 [12]

(cmH2O)
Paed: 4 to 50 [12]

Vt   V-SIMV (mandatory breaths),

(mL) (A)CV
• Adult: 100 to 2,500 [500]
• Paed: 50 to 300 [100]*
PIF   When Volume Breath option is
(L/min) set to PIF:
(A)CV, V-SIMV (mandatory
breaths)
• Adult: 10 to 120 [50]
• Paed: 5 to 60 [10]
Ti      When Volume Breath option is
(sec) set to Ti:
(A)CV, V-SIMV (mandatory
breaths)
• Adult: 0.3 to 3.0 [1.0]
• Paed: 0.3 to 3.0 [0.6]
P(A)CV, P-SIMV (mandatory
breaths)
• Adult: 0.2 to 5.0 [1.0]
• Paed: 0.2 to 5.0 [0.6]
P(A)C
• Adult: 0.3 to 4.0 [1.0]
• Paed: 0.3 to 4.0 [0.6]

English 171
Appendix B: Ventilation parameters

Valve Ventilation and Mouthpiece

Parameter Leak Ventilation Setting
Circuit

V-SIMV
P-SIMV
P(A)CV

iVAPS
CPAP

CPAP
P(A)C
ACV

(S)T
PS
Cycle (%)      P-SIMV, V-SIMV (spontaneous
breaths), PS
5 to 90 [25%] (leak)
5 to 90 [Auto] (valve)
Cycle is fixed at 15% for valve,
10% for leak.
Trigger type       Flow/Pressure
(double limb circuit only)

Trigger (sensitivity)       When Trigger Type is set to

[Trigger type = Flow] Flow trigger
(L/min) (double limb circuit only)
(A)CV, P(A)CV
• Adult: Off, 0.5 to 15 [1.0]
• Paed: Off, 0.5 to 15 [0.5]
V-SIMV, PSIMV, PS, CPAP
• Adult:0.5 to 15 [1.0]
• Paed:0.5 to 15 [0.5]
Trigger (sensitivity)       When Trigger Type is set to
[Trigger type = Pressure] Pressure trigger
(double and single limb circuit)
(A)CV, P(A)CV
Off, Very Low to Very High
[Medium]
PS, P-SIMV, V-SIMV, CPAP
Very Low to Very High
[Medium]
Trigger (sensitivity)     (S)T, P(A)C
[Vented]
Off, Very Low to Very High
[Medium]
CPAP, iVAPS
Very Low to Very High
[Medium]
Rise Time        Min, 150 to 900 [200]
(msec)

Flow Shape   100 (Constant), 75, 50, 25 [100]

(%)

172
 Appendix B: Ventilation parameters

Valve Ventilation and Mouthpiece

Parameter Leak Ventilation Setting
Circuit

V-SIMV
P-SIMV
P(A)CV

iVAPS
CPAP

CPAP
P(A)C
ACV

(S)T
PS
Ti Min    PS
(sec)
0.2 to 4.0 [0.2]
(S)T, iVAPS
0.1 to 4.0 [0.2]
Ti Min is fixed at:
• 0.2 for P-SIMV, V-SIMV,
and CPAP (valved)
• 0.1 for CPAP (leak)
Ti Max (Maximum    Adult: 0.3 to 4.0 [1.5]
Inspiration Time)
Paed: 0.3 to 4.0 [0.8]
(sec)
Ti Max is fixed at:
• The lesser of
( (2/3) x (60/f) ) or 4 for
P-SIMV and V-SIMV
• 4 for CPAP (leak)
• 3 for CPAP (valved) Adult
• 1.5 for CPAP (valved)
Paediatric
Pt Height     Adult:
cm: 110 to 250 [175]
inches: 44 to 100 [70]
Target Pt  8 to 30 [15]
Rate

Target Va  1 to 30 [5.2]
(L/min)

*The International ventilator standard indicates that Paediatric patient type is intended to be used for a patient receiving less
than 300 mL, however Astral permits adjustment of ‘Vt’ setting parameter up to 500 mL for cases where ‘Vt’ is set such that it
compensates for leak in the breathing circuit.

WARNING
ResMed does not recommend 500 mL as the upper limit for the pediatric tidal volume use;
however, clinicians may choose this upper limit based on their clinical determination.

English 173
Appendix B: Ventilation parameters

Ventilation displayed parameters

The following therapy parameters are displayed on the device but cannot be changed directly. They are
determined by the adjustable parameters and internal algorithms.

Valve Ventilation and Mouthpiece

Parameters Leak Ventilation Setting
Circuit

V-SIMV
P-SIMV
P(A)CV

iVAPS
CPAP

CPAP
P(A)C
ACV

(S)T
PS
I:E Ratio    Displayed if Respiratory Rate
not set to Off

PIF   When Volume Breath option is

(L/min) set to Ti, PIF is display only.

Ti   When Volume Breath option is

(sec) set to PIF, Ti is display only.

MV  Displayed in iVAPS Settings

(L/min) page

Average Vt  Displayed in iVAPS Settings

(mL) page

Average Vt/kg  Displayed in iVAPS Settings

(mL/kg (IBW)) page

Supplementary Features
The following table indicates the supplementary features applicable to each ventilation mode. The
adjustable parameters, the available setting range and default are displayed.

Valve Ventilation and Mouthpiece

Features Leak Ventilation Setting
Circuit
V-SIMV
P-SIMV
P(A)CV

iVAPS
CPAP

CPAP
P(A)C
ACV

(S)T
PS

Manual Breath      Off / On [Off]

Manual Breath      100 to 250 [150]

Magnitude
(%)

174
 Appendix B: Ventilation parameters

Valve Ventilation and Mouthpiece

Features Leak Ventilation Setting
Circuit

V-SIMV
P-SIMV
P(A)CV

iVAPS
CPAP

CPAP
P(A)C
ACV

(S)T
PS
Sigh Breath   Off / On [Off]

Sigh Alert   Off / On [Off]

Sigh Interval   3 to 60 [10]

(min)

Sigh Magnitude   120 to 250 [150]

(%)

Apnoea Response           Valve Ventilation:

(%)
Alarm Only, (A)CV+Alarm,
P(A)CV+Alarm, Off
Leak Ventilation:
Alarm Only, Off
Apnoea Interval (Tapnoea)           Adult: 15s to 60s [20s]*
(min: sec)
Paed: 5s to 30s [10s]

Apnoea Resp Rate       Adult: 4 to 50 [15]

(1/min)
Paed: 12 to 80 [15]

Apnoea Detection           No Breath / No Spont Breath

[No Breath]

Apnoea Ti       When Volume Breath option is

(sec) set to Ti:
If Apnoea Response is (A)CV +
Alarm:
• Adult: 0.3 to 3 [1.0]
• Paed: 0.3 to 3 [0.6]
If Apnoea Response is P(A)CV +
Alarm:
• Adult: 0.2 to 5.0 [1.0]
• Paed: 0.2 to 5.0 [0.6]

English 175
Appendix B: Ventilation parameters

Valve Ventilation and Mouthpiece

Features Leak Ventilation Setting
Circuit

V-SIMV
P-SIMV
P(A)CV

iVAPS
CPAP

CPAP
P(A)C
ACV

(S)T
PS
Apnoea Vt       If Apnoea Response is (A)CV +
(mL) Alarm:
Adult: 100 to 2500 [500]
Paed: 50 to 500 [100]
Apnoea Flow Shape       Constant
(%)

Apnoea PIF       When the Volume Breath is set

(L/min) to PIF.
If Apnoea Response is (A)CV +
Alarm:
• Adult: 10 to 120 [50]
• Paed: 5 to 60 [10]
Apnoea P Control       If Apnoea Response is P(A)CV +
(cm H2O) Alarm:
• Adult: 2 to 50 [7]
• Paed: 2 to 50 [7]
Safety Vt (mL)     Adult: Off, 100 to 2500 [Off]
Paed: Off, 50 to 500 [Off]

Max PS  PS setting to 50 [PS +5]

P control max (cm H2O)  P control to 50 [P control +5]

IPAP Max   IPAP to 50 [IPAP +5]

*Adult Tapnoea can be extended to 15min when the mouthpiece interface is selected.

176
 Appendix B: Ventilation parameters

Supplementary Features displayed parameters

The following therapy parameters are displayed on the device but cannot be changed directly. They are
determined by the adjustable parameters and internal algorithms.

Parameter Valve Ventilation and Mouthpiece Circuit Leak Ventilation

V-SIMV
P-SIMV
P(A)CV

iVAPS
CPAP

CPAP
P(A)C
ACV

(S)T
PS
Manual Breath Ti     
(sec)

Manual Breath PIF  

(L/min)

Manual Breath Vt  
(mL)

Manual Breath P Control  

(cmH2O)

Manual Breath PS 
(cmH2O)

Sigh Ti  
(sec)

Sigh PIF  
(L/min)

Sigh Vt 
(mL)

Sigh P Control 

Apnoea I:E      

Apnoea Flow Shape      

(%)
Flow shape = Constant

English 177
Appendix B: Ventilation parameters

Parameter Valve Ventilation and Mouthpiece Circuit Leak Ventilation

V-SIMV
P-SIMV
P(A)CV

iVAPS
CPAP

CPAP
P(A)C
ACV

(S)T
PS
Apnoea PIF Display      
(L/min)

Apnoea Ti Display (Inspiration Time)      

Apnoea Rise Time      

(msec)

178
 Appendix C: Alarm parameters

Appendix C: Alarm parameters

The following table provides a summary of the Astral device alarm settings and the default settings.

Valve Ventilation and Mouthpiece

Alarm Leak Ventilation Setting
Circuit

V-SIMV
P-SIMV
P(A)CV

iVAPS
CPAP

CPAP
P(A)C
ACV

(S)T
PS
Vti - Low       Adult: Off, 50 to 2990 [100]
(Tidal Volume)
Paed: Off, 10 to 995 [25]
(mL)

Vti - High       Adult: Off, 60 to 3000 [2500]

(Tidal Volume)
Paed: Off, 25 to 1000 [500]
(mL)

Vte - Low * * * * * *     Adult: Off, 50 to 2990 [100]

(Tidal Volume)
Paed: Off, 10 to 995 [25]
(mL)

Vte - High * * * * * *     Adult: Off, 60 to 3000 [2500]

(Tidal Volume)
Paed: Off, 25 to 1000 [500]
(mL)

MVi - Low       Adult: Off, 0.5 to 59.9 [3.0]

(Minute ventilation) (L/min)
Paed: Off, 0.2 to 59.9 [0.5]

MVi- High (Minute       Adult: Off, 0.6 to 60 [20.0]

ventilation) (L/min)
Paed: Off, 0.3 to 60 [10.0]

MVe - Low * * * * * *     Adult: Off, 0.5 to 59.9 [3.0]

(Minute ventilation (L/min)
Paed: Off, 0.2 to 59.9 [0.5]

MVe- High (Minute * * * * * *     Adult: Off, 0.6 to 60 [20.0]

ventilation) (L/min)
Paed: Off, 0.3 to 60 [10.0]

Low Resp rate           Adult: Off, 2 to 79 [4]

(1/min)
Paed: Off, 5 to 98 [12]

High Resp rate           Adult: Off, 3 to 80 [80]

(1/min)
Paed: Off, 6 to 99 [99]

Pressure - High           10 to 80* [40]

(High Airway Pressure) *Not applicable on all device
(cmH2O) variants

English 179
Appendix C: Alarm parameters

Valve Ventilation and Mouthpiece

Alarm Leak Ventilation Setting
Circuit

V-SIMV
P-SIMV
P(A)CV

iVAPS
CPAP

CPAP
P(A)C
ACV

(S)T
PS
Pressure - Low   Off, 2 to 79 [5]
(Peak Inspiratory Pressure)
(cmH2O)

Pressure - Low         Off / On [On]

(Peak Inspiratory Pressure)
(cmH2O)

Disconnection           Off# / On [On]

(L/min)
#only allowed with a
mouthpiece interface or mask
interface in single vented
circuit
Disconnection tolerance           Invasive/mouthpiece: 5 to 95
(%) [40]
Mask: 5 to 95 [60]

Disconnection alarm           Invasive and Mask:

activation time (sec)
Adult: 5 to 60 [9]
Paed: 5 to 30 [8]
Mouthpiece:
Adult: 5 to 900 [15]
Paed: 5 to 30 [13]
Low PEEP ** ** **        Off / On [On]

Vent Stopped           Off / On [Off]

Leak * * * * * * Off, 20 to 80 [Off]

(%)

Leak     Off / 5 to 80 [40]

(L/min)

NV mask/Rebreathing        Off / On [On]

180
 Appendix C: Alarm parameters

Valve Ventilation and Mouthpiece

Alarm Leak Ventilation Setting
Circuit

V-SIMV
P-SIMV
P(A)CV

iVAPS
CPAP

CPAP
P(A)C
ACV

(S)T
PS
FiO2 - Low (%)           Off, 18 to 99 [Off]

FiO2 - High (%)           Off, 19 to 100 [Off]

SpO2 - Low (%)           Off, 50 to 99 [85]

SpO2 - High (%)           Off, 51 to 100 [Off]

Pulse - Low           Off, 20 to 249 [30]

(1/min)

Pulse - High           Off, 21 to 250 [150]

(1/min)

* For Double limb circuits only.

** Not applicable for Mouthpiece circuit.
Note: Some default settings are different for Mouthpiece circuit.

English 181
 ResMed Ltd
1 Elizabeth Macarthur Drive, Bella Vista NSW 2153 Australia
See ResMed.com for other ResMed locations worldwide. Astral, AirView and ResScan are trademarks and/or registered trademarks of the ResMed family of companies.
For patent and other intellectual property information, see ResMed.com/ip. Actichlor is a trademark of Ecolab US. Inc. Aerogen and Aeroneb are registered trademarks of Aerogen,
Inc. CaviCide is a trademark of Metrex. Mikrozid is a trademark of Schülke & Mayr. NONIN is a trademark of Nonin Medical, Inc. Velcro is a trademark of Velcro Industries B.V.
© 2018 ResMed Ltd. 278579/1  2018-05

ResMed.com