User Manual - Imtmedical Downloads
Contents
1. Display Real time curves Interfaces AC input Battery operation Dimensions BxTxH Weight Calibration interval Memory card Approvals Note 26 x 33 mm Flow pressure volume temperature oxygen respiratory parameters RS 232 USB Ethernet CAN Analog Out TTL 100 240 VAC 50 60 Hz 4 hours 11 4x6x7cm 0 4 kg annually yes CE CAN CSA C22 2 No 61010 1 12 UL Std No 61010 1 3rd Edition EN 61326 1 2006 IEC 61326 2 2005 EMC ETSI EN 300 328 V1 7 1 2006 10 FCC part 15 subpart C Digial Devices emission Class B General requirements The greater tolerance is valid tolerance related to the measured value absolute tolerance In this user manual the unit sl min is based on ambient conditions of 0 C and 1013 mbar DIN 1343 9 68 2015 09 Operation principle of flow measurement A differential pressure measurement is used to determine the flow in the flow channel In order to achieve the pres sure difference a linear flow element is used as a flow resistance Pressure Difference Ap Linear flow element GasFowQ Ap c 7 O c p 0 n dynamic viscosity of the gas Pa s p gas density kg m c1 c2 device specific constants channel geometry Dynamic viscosity e The viscosity of a medium is its resistance to flow and tear off of the flow e The viscosity depends strongly on the temperature e The viscosity of the medium is slightly dependent on pres2. 300 sl min yes yes yes 140 sl min yes yes yes 300 sl min yes yes yes 80 sl min yes yes yes 1 9 or 0 1 sl min 50 600 mbar 1 9 or 0 1 sl min 50 600 mbar 3 or 0 1 sl min 25 C 30 C 50 600 mbar 4 or 0 3 sl min 25 C 30 C 50 600 mbar 4 or 0 3 sl min 25 C 30 C 50 600 mbar 7 68 2015 09 Pressure High Difference In the flow channel Barometer Measurement variables Flow Pressure 0 10 bar 200 mbar 50 150 mbar 500 1150 mbar l min l s cfm ml min ml s bar mbar cmH20 inH2O Torr inHg hPa kPa mmHg PSI 1 or 10 mbar 0 75 or 0 1 mbar 0 75 or 0 1 mbar 1 or 5 mbar Additional measuring variables Measurement range Accuracy Oxygen concentration pressure comp lt 150mbar 0 100 1 O2 Gas temperature 0 50 C 1 75 oder 0 5 C Type of gas Gas standard Note Air Air O2 N20 02 Heliox 21 O2 N2 CO2 ATP ATPD ATPS AP21 STP STPH BTPS BTPS A BTPD BTPD A 0 1013 20 981 15 1013 25 991 20 1013 NTPD NTPS The greater tolerance is valid tolerance related to the measured value absolute tolerance In this user manual the unit sl min is based on ambient conditions of 0 C and 1013 mbar DIN 1343 CITREX measures the temperature of the ga
3. 302 239 000 SmartLung Adult 300 162 000 SmartLung Infant 300 400 004 EasyLung 300 756 000 For further accessories and spare parts see www imtmedical com 15 Disposal e The operating company is responsible for disposal of the device The device must be delivered free and with duty paid to the manufacturer for disposal e The device can be handed over to a licensed private or public collecting company e The device can be dismantled into individual components and recycling or disposing of these then be carried out in the correct manner e f disposal is carried out by the operating company itself the regulations for disposal depend on the country concerned and are subject to its laws and legal requirements The rules and regulations concerned can be obtained from the re sponsible authority In this regard waste is to be recycled or disposed of e without danger to human health e without using procedures or methods harmful to the environment particularly to the water air soil flora and fauna e without creating noise or smell 62 68 2015 09 16 Appendix A abbreviations and glossary A A Amp AC Alternating current AT Amp time lag B bar 1 bar 14 50 psi Base flow The base flow is a constant flow which should not be considered for the calculation of the volume C C Degrees Celsius Conversion of Celsius C to Fahrenheit F F 9 C 5 32 Cstat Statistical complian
4. oxygen sensor and a connection cable 1 Remove the protective cap rubber stopper from the sensor opening 2 Secure the O2 sensor by turning it in the clockwise direction and connect the sensor with the device using the sensor cable 55 68 2015 09 12 Measuring of respiratory data General To be able to measure key respiratory data it is mandatory that the CITREX can read out a breathing cycle from the measured pressure and or flow chart curves This is controlled via the triggers Therefore it is of great importance to correctly define the start and stop triggers as this can significantly influence the measurement results The set triggers are used to trigger the breathing cycles Thus it is very important that the triggers are set correctly before starting respiratory data measurement 56 68 2015 09 Connection to the respiratory Basically there are three different methods of connecting the CITREX to the respiratory apparatus apparatus Downstream of the Y piece CITREX OR Ventilator Test Lung In the inspiration duct upstream of the Y piece CITREX Ventilator Test Lung In the expiration duct upstream of the Y piece CITREX gt lt D Ventilator Test Lung Standard trigger values As the CITREX can measure flow in both directions it makes sense to use connection method A In this measurement setup flow is usually chosen as the trigger value For this reason the flow triggers are
5. some noise it makes sense to average the values over a certain period of time This is the meaning of the filter function You can select one of the following filters None Display of the latest measured value without thresholds Low Mean value over 240ms Medium Mean value over 480ms High Mean value over 960ms The standard filter is High The filter setting can be changed in the CITREX configuration tool For more information please see chapter 9 Configuration Tool 6 8 Saving data By pressing and holding down the O symbol for approximately 5 seconds the current measured data will be stored on the micro SD card During the data saving operation the following message is displayed on the screen Data saved to DATAxx CSV For further information on outputting measurement data see Chapter 8 Reading out measurement data Data saved to DATAxx CSV 30 68 2015 09 6 9 Zero point calibration By pressing and holding down the X symbol for approximately 5 seconds zero point calibration of the pressure and flow sensors is carried out During the calibration operation the following message is displayed on the screen Zero Calibration Running Calibrating Please wait 6 10 Warm up time The CITREX sensors take approximately 10 minutes to warm up 31 68 2015 09 6 11 Touch lock touch unlock By pressing and holding down the Bluetooth button for 2 seconds the touch lock gets enabled disabled Bluetoo
6. 09 Make sure the following files are stored on the micro SD card e ClientBin folder including ConfigurationWeb xap e clientaccesspolicy xml e index html In any case the micro SD card got lost or the files were deleted please contact the distributor or directly imtmedical support Keep in mind that the micro SD card has to be inserted the CITREX during the usage of the configuration tool Otherwise the settings won t be saved For the first connection choose between Default and DHCP Client and open an internet browser To start the configu ration tool enter the IP Address which is displayed on the CITERX screen in the address bar of your browser The Con figuration Tool is downloaded to the computer and establishes a connection WARNING There is a limitation of one connection per device This means as long as the configuration tool is open the CITREX device cannot be configured from another computer ere CC PT i tes Y Fluke FDP Server Home E Einheitenkonverter Einh amp W rterbuch Dictionary 4 Google Wikipedia Die freie Enzy We i 46 68 2015 09 5 After a few seconds the CITREX is successfully connected to the computer The screen below appears CITREX imtmediical Hans Muster choose things to configure Click above to see the configuration possibilities for your connected favicon Version Citrex H4 Serial number BB100201 Owner Hans Muster Company imt AG Next calibrati
7. 2 Serial interface T Ti TCycle Ratio inspiration time to time of one breathing cycle V V Volt VA Apparent power consumption of the device VAC Volt alternating current VDC Volt direct current um Micrometre 1 um 10 m 64 68 2015 09 17 Appendix B measured values and units Pressure values Measured value Description Units Ambient pressure P Atmo High pressure P High mbar bar inHzO cmH O High pressure flow chan P HF psi Torr inHg mmHg nels hPa kPa Pressure difference P Diff Flow values Measured value Description Units Flow Flow l min ml min cfm l s ml s Meteorological values Measured value Description Units Temperature Temp C K F Oxygen content O2 Volume Vol HF ml cf Gas concentrations Measured value Description Units Gas concentration Partial pressure Gas concentration Partial pressure 65 68 2015 09 mbar bar inH20 cmH2O psi Torr inHg mmHg hPa kPa Breathing values Measured value Description Units Positive End Expiratory Pressure PEEP mbar bar inHzO cmH2O Mean pressure Pmean psi Torr inHg mmHg Peak pressure Ppeak hPa kPa Plateau pressure Pplateau Volume per min expiration Ve Volume per min inspiration Vi ae ml min cfm l s Peak flow inspiration PF Insp ms Peak flow expiration PF Exp Expiration volume Vte ml cf Inspiration volume Vti ml cf Breathing rate Rate bpm Breathing time ratio I E 7 Expiration time Te S Inspi
8. 2003 XP SP2 and SP3 Macintosh OS 10 5 7 Intel based Ethernet network connection Screen resolution 1024 x 768 1280 x 1024 recommended 15 68 2015 09 5 Start up 5 1 Included in delivery CITREX H4 USB Cable Power supply Micro SD card Dustfilter Inlet pipe 16 68 2015 09 5 2 Power supply The CITREX can be operated from the mains supply or using the built in rechargeable battery The USB port the analogue interface or the CAN interface on the upper side of the CITREX are used for connecting to the power supply Use the USB cable in combination with the supplied universal power adaptor or connect the USB cable analogue cable or CAN cable directly to the laptop PC A battery symbol is displayed at the front until the battery is fully charged USB port Analogue interface CAN interface Supply voltage Permissible mains voltage of the adaptor supplied is 100 to 240 VAC at 50 to 60 Hz 17 68 2015 09 5 3 Mechanical connections Flow channel The flow port can be used bi directionally for the following measurements Flow chanel Flow channel Flow Air Measurement range 300 300 sl min Accuracy 1 9 rdg or 0 1 sl min Volume Measurement range 0 10 sl Accuracy 2 rdg or 0 2 sml gt 6 sL min Temperature Measurement range 0 50 C Accuracy 1 75 rdg or 0 5 C Oxygen Measurement range 0 100 Accuracy 1 O2 Pressure in channel Measure
9. C 77 F l 760mmHg Pressure 760mmHg Pressure Saturated 760mmHg 11 68 2015 09 Type of gas The appropriate gas type has to be set on the CITREX depending on which type of gas is to be measured The following types of gas can be selected e Air 100 e Air O2 Man Air oxygen mixture in accordance with manual input Default is 100 O2 e Air O2 Auto Air oxygen mixture in accordance to sensor measurements of the internal oxygen cell e N2O0 O2 Man Nitrous oxide oxygen mixture in accordance with manual input Default is 100 Oz e Heliox 21 O2 e N2 100 e CO2 100 Standard conditions refer to defined conditions of pressure temperature and in some cases humidity which are the basis for the conversion of the effectively measured flow It is therefore essential to check precisely which standard conditions the displayed values are based on The currently set standard is shown in the numerical display 12 68 2015 09 4 3 Power supply Input voltage of the power supply 100 240 VAC 50 60 Hz Supply voltage 5 V DC Power consumption 2 5 6W 4 4 Battery operation Operating time on battery power 4 h Recharging the battery Depending on which port is used a full recharge takes 5 to 8 hours The useful life of the battery is increased if the battery is only recharged when prompted by the device Whenever the CITREX is recalibrated at our factory the battery is tested If batt
10. CITREX User Manual 302 904 000_01 2015 09 imtmedical Contents oo N O GV A OO N gt 11 12 13 14 15 16 17 FOFO WONG airen a ee ee 3 mended USC i e aa 4 Safety instruclions aan ana 5 Technical specifications 00222002220002nne nennen 7 len Ups aueh 16 Operadlo anne 24 Connecting up the device uuussnesnennnenneenennnnnnennnennennn 34 Reading out measurement data u222022s002eneneneennno 39 Configuration Tools 43 PronleEdilorn eu ei 53 OS ENSOR zu ee ee ee 55 Measuring of respiratory data ccccccecceseeeeeeeeeeeeeaeeees 56 Care and maintenance ccccseececcseeeeceeseecseeeeesseneeeees 61 Accessories and spare parts ccccccseceseeeceeeeaeeeseeeeaees 62 DISPOSAal 2 tie ee eh 62 Appendix A abbreviations and glossary e 63 Appendix B measured values and units 65 2 68 2015 09 1 Foreword Scope This documentation is valid for the product named CITREX You will find the name CITREX on the bottom of the casing of the device Software and firmware versions This operating manual is valid from the following versions e CITREX Software 3 8 e CITREX Hardware 3 Older or newer versions may differ slightly from this manual A word to our female users In this operating manual the male form he is used for simplicity and better understanding However this notwithsta
11. ITREX as an USB mass storage device When connecting the CITREX to a computer the device is asking if it should be used as a USB mass storage device The following screen appears Use as USB mass storage device YES NO If there was no choice taken during 5 seconds the device won t be recognized as USB mass storage device 2 Pressing the micro SD card once releases it from the CITREX 40 68 2015 09 Reading out the data on the computer The following files exist on the card Home Share View Manage v T ee ThisPC CITREX D gt y ab Music A E e iE Pictures BE Videos ts ProfileEdito clientacces D gi System C r html spolicy xml D m CITREX Ds Profiles v lihim G Calame 172 16 10 188 S Marketing intranet irr GF P intranet imt ch dfs J USB Driver Formatter 10 items Directory File Search en Ls J CITREX D Description CFG SCR TRG The CFG SCR and TRG files are needed by CITREX to activate internal pro cesses Clientaccesspolicy xml This file is needed for the configuration tool ClientBin ConfigurationWeb xap This folder is needed for the configuration tool DATA The saved measurement values are stored in this folder Formatter AboutReportFormatter txt This TXT file describes the procedure for formatting saved data in an Excel file Formatter ReportFormatter xisb This is the actu
12. al Excel file template in in which the saved data is formatted Formatter SetupReportFormatter bat This batch file is needed to format the data in an Excel file index html This file is needed for the configuration tool logs The CITREX continuously records information about its functions and saves them as Log Files This information is used exclusively for correcting problems and errors ProfileEditor html Browser based editor to create and edit settings profiles Profiles profile Profile settings file can be loaded via Profiles in the x menu USB Driver ubs_cdc_ser inf Driver for the USB device identification User Manual Contains user manuals in PDF format 41 68 2015 09 Creation of an Excel file with the saved values 1 Open the file SetupReportFormatter bat with a double click This file creates a macro for importing the data onto your computer 2 You can now open CSV files individually in the DATA folder with a double click An Excel template is opened and the following message displayed 3 Confirmed the formatting with YES A CITREX test report will be created tome bwert Pagetayout Mama ss Renem view Ace ar dir 1 z eh E autesus Bis a moas Seme Zum mn E 3m wn Da mr A Ni prarmatvoven PE A Emm uean Ge 2429 oana Sera E a E st Dani reran ces Heat Seat bows Fore En em gt Nuebel s TEk N er She aaa G ae LE rs at i M N Te a a Ta
13. ark the triggers that should be used here The top figure shows that a small faulty signal is still visible at this measuring point after the inspiration which has been caused by switching the valves This results in faulty triggering 58 68 2015 09 Pressure curve upstream of the Y piece 2 00 2 50 3 00 Time s In this case the standard triggers can be used for the pressure curve gt 1 mbar lt 1 mbar Special cases In measurement technology there can basically always be a deviation from the standard variants to achieve an even more exact result However it must be observed that very ex act results are achieved with the settings described so far exceeding the accuracy of all respiratory equipment Measurement errors inherent in the overall system occur both in the respiratory apparatus and in the CITREX H4 However the values displayed may vary as it may be that not ex actly the same thing has been measured and compared 59 68 2015 09 Inspiration volume Vti If the breathing curve shows a plateau or a break a tiny flow can still be measured during this time A lot of breathing equipment does not include these tiny flows in their Vti calculations Using the following trigger settings this can also be prevented in the CITREX Breath Cycle Expiration Inspiration Start and End Trigger Vo In this diagram S corresponds to the start trigger and E to the end trigger Expiration
14. ce D DAC Direct access control dBA Decibel measured with A filter DC Direct current DIN Deutsche Industrienorm German Industry Standard E EMC Electro magnetic compliance F F Degrees Fahrenheit Conversion of Fahrenheit F to Celsius C C F 32 5 9 FCC RJ 10 Plug for external trigger telephone plug according to FCC registration U S Federal Communications Commission RJ Registered Jack G GND Ground H h Hour HF High frequency Hz Hertz 1 Hz 1 s 1 IE Breathing time ratio inspiration to expiration IP Protection class according to standard L Litre Ib Ibs Pound LED Light emitting diode l s Litre per second 63 68 2015 09 Max max Maximal mbar Millibar 1 mbar 10 bar min Minute Min min Minimal ml Millilitre 1 ml 10 I mm Millimetre 1 mm 10 m N nl min Standard litre per minute converted to ambient conditions of 0 C and 1013 mbar P PEEP Positive End Expiratory Pressure PF Exp Peak flow during expiration PF Insp Peak flow during inspiration Pmean Mean pressure Ppeak Peak pressure Pplateau Plateau pressure at the end of inspiration ppm Parts per million 1 10 prox Proximal psi Pressure per square inch 1 bar 14 50 psi R rdg reading from the measured value RH Relative humidity RJ 10 FCC Plug for external trigger telephone plug according to FCC registration U S Federal Communications Commission RJ Registered Jack RS 23
15. configuration or change the analog outputs measurement values by using the pull down menus CITREX imtmedical configuration Re f Configure interfaces Ethernet IP configuration 49 68 2015 09 11 Configuration miscellaneous Change different specific measurement parameters by using the pull down CITREX imtmedlical B onf gquration Gas type Ar Gas humidity 0 00 Standardization ATP Volume and Flow at actual ambient Oxygen concentration Pressure compensation Pressure High Baseflow enabled Baseflow value Screen rotation locked Graphical screen x axis resolution Numeric screen update rate filter menus 50 68 2015 09 9 2 Monitoring option The monitoring option is optional and not included in the scope of delivery To activate this option subsequently please contact the distributor or the imtmedical support 12 Monitoring numerics View real time measurement values direct on the computer monitor Actual measurement value as well as minimum maxi mum and average is calculated for each value By pressing the button Reset statistics the statistic calculation can be re set To export the actual displayed measurement values press the button Export An explorer window will open in which the file type as well as the file location has to be defined The following storage types are possible Excel XML xml and CSV csv CITREX imtmedical y nonitoring Monitor numerics Respi
16. ernal trigger for operation with the mains power supply and to charge the device battery The RS232 interface is used as a data interface The device s CAN interface is ready but not supported yet by the firmware The CAN interface can be used for operation with the mains power supply and for charging the device battery The Ethernet interface is used to configure the device as well as a data interface The micro SD card is used for software updates and device configurations In addition measurement data can be output via the micro SD card For more information s see Chapter 8 Reading out measurement data The device s Bluetooth interface is ready but is not supported yet by the firmware 22 68 2015 09 Interface definition 3 Analog OUT 4 RS232 5 CAN 1200hm L Pin1 Pin1 Pin 1 Pin 2 Pin 3 Pin 4 Pin 5 Pin 1 Pin 2 Pin 3 Pin 4 Pin 1 Pin 2 Pin 3 Pin 4 Pin 5 Pin 6 Analog OUT 1 Analog OUT 2 Trigger Input VIN GND NC RxD Input TxD Output GND VIN CANH CANL 0 5VDC 1 8 last 25kOhm 0 5VDC 1 8 last 25kOhm 2 5 lt 24VDC 12VDC 20 24VDC 20 12VDC 20 24VDC 20 Connectible electrical end resistance GND Pin1 23 68 2015 09 6 Operation 6 1 Switching the device on and off Q The device is switched on and off using the power button 6 2 The start screen When the CITREX is switched on the start screen a
17. ery ca pacity is below 70 the battery will be replaced 4 5 Regulations and approval CE CAN CSA C22 2 No 61010 1 12 UL Std No 61010 1 3rd Edition EN 61326 1 2006 IEC 61326 2 2005 EMC ETSI EN 300 328 V1 7 1 2006 10 FCC part 15 subpart C Digial Devices emission Class B General requirements Note Operation time will be reached in standalone operation this means without any interfaces under use 13 68 2015 09 4 6 Device label and symbols The following labels and symbols can be found on the CITREX RS232 USB SN BBXXXX lil oN m gt Rt DEEOD RS232 Interface USB interface Serial number Consult operating instructions The device may not be disposed of in the household waste Conforms to European Union directives Important information refer to manual Recyclable packaging Manufacturer s specification and date of manufacture Date of manufacturing Environment caution Lead free components Temperature range for storage and transport CSA monogram with C US subscript No hazardous material 14 68 2015 09 4 7 Minimal PC requirements Microsoft Silverlight 5 or higher Windows x86 oder x64 64 bit mode support for IE only 1 6 GHz or higher with 512 MB RAM Macintosh Intel based Intel Core Duo 1 83 GHz or higher with 512 RAM Microsoft Windows 8 Windows Server 2012 7 7 SP1 Windows Server 2008 SP2 Windows Server 2008 R2 SP1 Vista Windows Server
18. fault settings contain triggers for adults pediatrics and high fre quency The trigger setting can be changed to customers need For more information see chapter 9 Configuration Tool For more information see chapter 12 Measuring of respiratory data Set back Trigger to default To set back the trigger settings to factory default press and hold the O Button a few second The screen shows question Set to default to set to default con firm with the O Button 25 68 2015 09 Gas Standard screen Ambient temp and pressure Current gas temperature Current ambient pressure Current gas humidity Gas types screen Humidity screen X Axis screen Setting the gas standard The CITREX calculates the devices measured flow and volume values according to the standard selected For more information see Chapter 4 2 Standards for gas flow and volume values Setting gas types Depending on the gas to be measured the appropriate gas type must be selected for the CITREX For more information on the type of gas see Chapter 4 2 Standards for gas flow and volume values Setting humidity To get the best measurement accuracy the humidity of the measured gas can be selected by tapping the O Button in 10 steps Set the percentage closest to the humidity of the measured gas Setting the x axis Here you can set the time window for the x axis of the curve representation 26 68 2015 09 O2 Calibration screen Ox
19. following settings IP Address 192 168 1 2 or any IP Address between 192 168 1 2 192 168 1 255 Subnet Mask 255 255 255 0 To take over this configuration open the network connection on the computer Control Panel gt Network and Internet gt Change adapter settings gt di ear a gt Control Panel iy P Adjust your computer s settings unbe Category System and Security User Accounts Review your computer s status Change account type Back up your computer is P Find and fix problema Appearance and Personalization Change the therne Network and Internet n rw Vew teetwark clatus and taui _ rf Choate hoenegroug anci chu m GO La e Control Pane p Klemmen and ieee r d Sean teen P Hardware and Sound 4 A View deweer and printer re nk l Parel Hana k Adda denet Fell Network and Sharing Center j Vipa eramri staba ond tasky sernec bo a nemak gt ber and Seurt 2 y Programs Sr T Vina artak oneal ad diiri Add worried rect bn Ihe ren S 3 Urenssail a program a MHetwaork and Internet a Get programs Harmer pe Hinh and Sound P Ohoose homsgr up ted Haana dptr Programm mtt Optio Tn p T Internet Options FZ Charge yourhemepege Mangge browser gid anp Appearance and Delete beeing Peony and cookies Perenahtitbsr 2 e Dik Language and Region ls Ease of Axcess EIF HE k Conny Pacel Bennet k Mepenik anid thatiny Center y Te
20. iew Manage SD memory card Microsoft Internet Explorer or the Silver gt Ras ThisPC gt CITREX D Searc light browser plugin is required to run Profile Editor ameo a 5 E W ClientBin amp N DATA e m F ProfileEdito clientacces index html User ClientBin DEREN r html spolicy xml Manual eo logs ta z2 DB Profiles J DD J i USB Driver h User Manual Formatter Profiles USB Driver logs 10 items Load and save configured profiles to SD card D Profiles di rectory The file name is the profile name Profile Editor Note limit to 15 characters to fit CITREX display a i choose things to configure rested profile losded on the device from the settings screen Profile description Save profile Load profite Profile editor version Minimum firmware version 38 000 53 68 2015 09 Configure all CITREX settings via the different screens available Setup of numeric and curve displays trigger set Profile Editor tings units gas standards connguravoen configure triggers 54 68 2015 09 11 O2 sensor Activation The CITREX has an interface for an oxygen sensor If the device has not been configured in the factory for the oxygen option this must be done subsequently by entering an activation code You can obtain the oxygen option and the activation code from your CITREX supplier Installation With the oxygen option you will receive a kit consisting of an
21. ment range 50 150 mbar Accuracy 0 75 rdg or 0 1 mbar Average flow throughout inspiration 18 68 2015 09 Differential Pressure The differential pressure connections can be used for differential pressure measurements Differential Pressure Measurement range 200 200 mbar Accuracy 0 75 rdg or 0 1mbar 19 68 2015 09 High pressure The high pressure port can be used for measuring pressures above 200 mbar High pressure Measurement range 0 10 bar Accuracy 1 rgd or 10 mbar 20 68 2015 09 O2 Measuring cell optional The CITREX has an interface for an O2 measuring cell For more information on this see Chapter 11 O2 sensor O2 Measuring cell Measurement range 0 100 Accuracy 1 O2 21 68 2015 09 5 4 Electrical interfaces Connection to external circuits 1 O2 interface 2 USB 3 Analog OUT 4 RS232 5CAN 6 Ethernet 7 Micro SD Card Slot 8 Bluetooth To connect to IEC XXXXX approved equipment only e g IEC EN 60950 1 or IEC EN 61010 1 To connect to telecom network not allowed The O2 interface is used to connect the O2 sensor to the CITREX The USB port is used for operating with the mains power supply to charge the device battery and can be used as an data interface For more information s see Chapter 8 Reading out measurement data The Analog Out port is used for reading out analog signals for connecting to an ext
22. nding it expressly includes all female users as well 3 68 2015 09 2 Intended use The Product is intended to be used to test and verify the basic operation of medical devices or systems that produce a flow of gas or gas pressure including ventilators and anesthesia systems The intended user is a trained biomedical equipment techni cian who performs periodic preventative maintenance checks on patient monitors in service Users can be associated with hos pitals clinics original equipment manufacturers and independent service companies that repair and service medical equipment The end user is an individual trained in medical instrumentation technology This Product is intended to be used in the laboratory environment outside of the patient care area and is not intended for use on patients or to test devices while connected to patients It is intended for over the counter use The CITREX is a compact portable and easy to use measuring instrument The CITREX is the right solution for measurements in the following areas Flow Volume Pressure differences High pressure Ambient pressure Oxygen Temperature In addition various respiratory parameters can be measured Breathing rate Time Ratios Ti Tcyc Tidal volume Volumes per minute Peak flow Pressure Compliance Triggers 4 68 2015 09 3 Safety instructions 3 1 Symbol for danger caution and notes This manual uses the symbols below to specifically poi
23. nt out residual dangers during correct application and usage as well as to emphasise important technical requirements 3 2 Personnel 5 68 2015 09 3 3 Responsibility and warranty The manufacturer assumes no responsibility or warranty nor will he accept any liability if the user or third parties do not use the device as intended violate the technical specifications modify the device in any way through modifications changes etc use the device with accessories not indicated in the related product documentation 3 4 Lifespan The maximum lifespan of the device is 10 ten years when handled according to the present user manual 6 68 2015 09 4 Technical specifications 4 1 Measurement variables Flow and pressure measurements Measurement range Accuracy Air und N2 Flow measurements Ambient pressure compensated Temperature compensated Channel pressure compensated O2 Air mixtures Flow measurements Ambient pressure compensated Temperature compensated Channel pressure compensated CO Flow measurements Ambient pressure compensated Temperature compensated Channel pressure compensated Heliox 21 O 79 He Flow measurements Ambient pressure compensated Temperature compensated Channel pressure compensated N20 O2 mixtures Flow measurements Ambient pressure compensated Temperature compensated Channel pressure compensated 300 sl min yes yes yes
24. og A Control Panel Home i f i Wie OLD basic network infermation and set up connecthans Lngrge plapter gelbes A i i Sen full up Change advanced shari sang ii WS 00811 intranet imech internet This computer Wew your Mime retreats Teamen ar diseenneri ktrametdmth Biers type Inberrerl Darii narlsec rk Conneriser local Aree Comeection Liane yout ethedrang sirga T Ser upa pea oonnechon or reisenrk Setup a wireles broadband dial up ad hoz or VPM connection or pet up a couber or dieti pia Cera jo a netam ers or einne ba neh vr al up oe VPM network conned ber Beute hemegeoup bnd maneg apuoni J Access files ans piren locsted an other network computers cr change thang Homer el Internet Cpeions Tioyubleihont problem Windi Fines gl 2 Dhagnase and igpar rerlwenik problems or geil drouble hosting acl grenade vii 44 68 2015 09 Choose the network card the CITREX is connected to and open its the properties Open the properties of the Internet Protocol 4 TCP IPx4 The IP Address can now be changed Save the settings and close the win dows OU F Network and Internet Network Connections gt Organize v Disable this network device Diagnose this connection gt M te Local Area Connection gt intranet imt ch 7 Intel R 82567LM 3 Gigabit Netweo Local Area Connection Properties x Networking Connect using EP Intel R 82567LM 3 Gigabit Network Connecti
25. on This connection uses the following items v 9 Client for Microsoft x You can get IP settings assigned automatically if your network supports M OF Client for a this capability Otherwise you need to ask your network administrator M JB File and Printer Sharing for Microsoft Netwo re gt A eier ee Obtain an IP address automatically Intemet ersion i k M Link Layer Topology Discovery M vo Dal Use the following IP address M Link Layer Topology Discovery Responder IP address 192 168 1 J Subnet mask 256 255 258 D mizan Uninste Pr Default gateway ER ba ereere Control E Np peer The Obtain DNS server address automatically ide area network proto at provides communica across diverse interconnected networks Use the following DNS server addresses Preferred DNS server Alternate DNS server F Validate settings upon exit Configured recommended for network without DHCP Server To set a customized IP Address it is necessary to open first a Default or DHCP Client connection With the configuration tool under Configuration interface a customized IP Address and Subnet Mask can be allo cated Connect the CITREX to the network DHCP Client recommended for network with DHCP Server Connect the CITREX to a network by using a merchantable Ethernet cable After a few seconds the CITREX has reconfiguring an IP Address and the Subnet Mask 45 68 2015
26. on date Dezember 2013 Firmware version 3 1110 WebConfig version 0 98 10 Hardware version Options Oxygen Monitonng 6 Device summary Change the owner name or the company name to personalize the CITREX CITREX imtmedical pie Hans Muster choose things to configure above to see the configuration possibelities for your connected Version Citrex H4 Serial number 88100201 Owner Hans M Company imt AG Next calibration date Dezember 2013 Firmware version WebConfig version 0 98 10 Hardware version Options 47 68 2015 09 7 Configuration values Change the displayed numeric values or the corresponding units on the CITREX by using the pull down menus configure values Screen 1 8 Configuration curves Change the displayed curves or the corresponding units on the CITREX by using the pull down menus contigure curves Screen 1 48 68 2015 09 9 Configuration Triggers Set one of the three preconfigured trigger on the CITREX by using the button Active The active trigger is differently col oured from the non active The trigger parameters can be changed by using the pull down menus It s possible to take over the preconfigured trigger settings by pressing the button Reset to defaults Learn more about trigger configuration in Chapter 12 Measuring of respiratory data CITREX nt juratior configure triggers 10 Configuration Interface Change the Ethernet IP
27. play 1 Standard The values displayed will be calculated using the selected standards Choose from several common gas standards 2 Trigger Indication This icon indicates the detection of a trigger at the actual ventilation cycle The icon is displayed for Y2 second and indicates the start of a new inspiration If this icon does not appear the trigger settings need to be ad justed 3 Gas type currently selected Depending on what type of gas is being measured the device must be set accordingly 4 Reading Shows the actual measured value 5 Measured variable Shows the variable Variables can be changed in the configuration monitor 6 Unit of measurement Shows the unit of the variable Units can be changed in the configuration monitor The individual values and units can be configured via the configuration tool See Chapter 9 Configuration Tool 6 6 Graphics values By pressing the A symbol different screens with measured curves can be displayed You can change between one or two meas ured curves per screen The individual values and units can be configured via the online application See Chapter 9 Configuration Tool 29 68 2015 09 6 7 Filter The display of the CITREX is updated every 500ms or in other words twice a second The acquisition of new measuring values takes place every 5 8ms Without using a filter the latest measured value will be displayed when updating the screen Since each measurement is showing
28. ppears After about 3 seconds the numerical measurement values will be displayed 6 3 Controls Displays changes measurement curves Displays changes numerical measurement values Changes settings saves data Shows menu changes menu zero calibration On off Pe a ae OS 10 Battery on charge LED indicates flow direction LED function error Screen Bluetooth on off Touch lock on off hold for 2 seconds 24 68 2015 09 6 4 Settings By pressing the X symbol the info screen appears This displays the device data Tapping X again displays additional menu items for making adjustments By pressing the O symbol you can change the individual settings Info screen Owner Company Next Calib Software Hardware Battery screen Ethernet screen IP 192 168 1 1 Subnet 255 255 255 0 Trigger screen rising gt 3 0 l min falling gt 3 0 l min Info screen The info screen displays the device data Battery screen This shows the current state of the battery charge Setting the Ethernet interface The Ethernet interface can be configured as followed e Default e Configured e DHCP Client The Ethernet interface is preconfigured with the Default setting For more information see chapter 9 Configuration Tool Setting the trigger The start and stop of volume calculations as well as the determination of respira tory parameters is controlled by trigger events The factory de
29. ration time Ti S Compliance Cstat ml mbar I mbar 66 68 2015 09 ml cmH20 ml cmH20 Conversion factors 1 mbar equivalent to 1 bar equivalent to 67 68 2015 09 0 001 bar 100 Pa 1hPa 0 1 kPa 0 75006 Torr 760 Torr 1 atm 0 75006 mmHg at 0 C 0 02953 inHg at 0 C 1 01974 cmH20 at 4 C 0 40147 inH2O at 4 C 0 01450 psi psia 1000 mbar 0 1 Pa 1000 hPa 100 kPa 750 06 Torr 760 Torr 1 atm 750 06 mmHg at 0 C 29 53 inHg at 0 C 1019 74 cmH20 at 4 C 401 47 inH2O at 4 C 14 50 psi psia imtmedical Imtmedical ag Gewerbestrasse 8 9470 Buchs Switzerland T 41 81 750 66 99 www imtmedical com
30. ratory urmang parameters Pressure im Flow Pressure High Pressure Atmospheric Temperature Oxygen PEEP Pplateau 51 68 2015 09 13 Monitoring panels View real time curves direct on the computer monitor Change the chart value by using the pull down menus Record meas urement values over a time range of 300 seconds by pressing Run Press Freeze and the record will stop Once in freeze mode the sliders of the time bar are activated Choose with the sliders the time period to visualize data in the detailed charts Press the button Exporf to export the actual displayed chart An explorer window will open in which the file type as well as the file location has to be defined The following storage types are possible Png png CITREX monitor panels M 0 Scale down Scale up Run Freeze 30 60 60 0 90 1205 120 150s 150 180s 180 210s 210 240s 240 270s Row i Min value mutes 1 seconds 40 1 33 7 70 80 90 100 x Time s ava min max Pressure in Flow mbar ue SaaS 00 10 20 30 40 SO 60 70 80 9 100 110 120 130 140 150 160 170 180 190 200 Time s 52 68 2015 09 10 Profile Editor 10 1 Create a Profile Create or edit a profile using the Profile Editor available on CITREX SD memory card or on www imtmedical com Use a profile on CITREX via it s x menu see chapter 6 4 Settings E Access the Profile Editor and all stored profiles on CITREX Home Share V
31. s inside its measurement chamber As the CITREX warms up it also warms the temperature of the measurement chamber and thereby the temperature of the gas in the measurement chamber The measurement chamber capacity is small even for relatively high flows of gas e g PIF 60 L min When compared with the temper ature of the gas entering the CITREX flow channel inlet the temperature of the gas inside the measurement chamber is higher and the difference greater as the measurement channel warms up Do not expect the temperature of the gas entering the CITREX flow channel inlet to be the same as the temperature of the gas displayed on the numeric screen of the CITREX since the displayed temperature is what is measured inside the CITREX measurement chamber 8 68 2015 09 Respiratory parameters Measurement range Accuracy Breathing Rate AZ min Time Ti Te Ration I E Ti Tcyc Tidal volume Vti Vte Volume per minute Vi Ve Peakflow Insp Exp Pressure Ppeak Pmean PEEP Pplateau Compliance Cstat Trigger Adult Pediatric HFO General informationen 1 1000 bpm 0 05 60 s 1 300 300 1 0 100 10 0 300 sl min 300 sl min 0 150 mbar 0 1000 ml mbar Flow and volume from default settings and adjustable levels 1 bpm or 2 5 0 02 s 2 5 5 2 or 0 20 ml gt 6 sl min 2 5 1 9 or 0 1 sl min 0 75 or 0 1 mbar 3 or 1 ml mbar
32. sis the actual flow is displayed Press again the O symbol to continue 3 The oxygen 100 calibration has started and will take duration of 114 seconds Do not interrupt the gas flow through the flow channel under any circumstances 4 Apply 30l min of air to the flow channel Inside the parenthesis the actual flow is displayed Press again the O symbol to continue 5 The air calibration has started and will take duration of 114 seconds Do not interrupt the gas flow through the flow channel under any circum stances 6 At the end of the calibration a message will appear if the calibration was successful The calibration can be stopped at any time by pressing the X symbol Apply 30 l min 0 Flow 30 l min Apply 30 l min 0 ey 21 Time rem 114s A to start Z to start Flow 30 l min ey 21 Time rem 114s The Calibration with Oxygen and air increases the accuracy of the oxygen meas urement This screen loads profiles stored on the SD memory card in directory Profiles The profile name file name is displayed in green text The Profile description is displayed as white text O browses through all profiles A loads the selected profile Details see chapter 10 Profile Editor 28 68 2015 09 6 5 Numerical values By pressing the o symbol different screens with numerical values can be displayed You can change between one two four or six measured values per screen Specification for the Numerical Dis
33. sitiv Negative flow direction Flow direction negativ 36 68 2015 09 Set up for dusty or contaminated gases Are the measured gases dusty or contaminated the usage of the delivered RT 19 filter upstream of the inlet pipe is recom mended Measurement setup Flow direction 37 68 2015 09 Measurement set up for gases with high pressure CITREX compensates automatically the gas pressure in the flow channel up to 150mbar For gas measurement with higher pressure the high pressure port can be used Therefore connect the gas outlet with the high pressure port Flow direction Flow direction 38 68 2015 09 8 Reading out measurement data Storing measurement data on the micro SD card By pressing and holding down the O symbol for approximately 5 seconds the current measurement data will be stored on the micro SD card During the storage operation the following message is displayed on the screen Data saved to DATAXX csv A file with the name Dataxx csv will be created on the micro SD card 39 68 2015 09 Connection to the computer There are two ways to get to the data on the micro SD card 1 Connect the CITREX to a computer via an USB port When first connecting the CITREX to a computer it s necessary to install a device driver Please ask your system administrator for further support The driver file usb_cdc_ser inf is stored on the micro SD card Usage of the C
34. stored as standard values in the device and can be reset any time The standard trigger values for the flow trigger for adult breathing for example are Starttrigger Flow gt 3 l min Endtrigger Flow lt 3 l min With the connection methods B and C pressure is usually chosen as the trigger signal In this case the standard values are as follows Starttrigger Pressure gt 1 mbar Endtrigger Pressure lt 1 mbar Baseflow The base flow designates a constant flow which should not be considered for the calcula tion of the volume If there is a defined leakage in the system for example where 3 l min air is discharged constantly the 3 l min do not count as inspiration volume By entering Base flow on 3 0 l min the volume calculation in our example could be corrected Finding the correct trigger When you set a trigger for the first time it is important to know the curve of the signal settings used for the trigger flow or pressure Here are some examples that also indicate possi ble problems 57 68 2015 09 Flow curve downstream the Y piece a u nenn Me dee be 0 00 0 50 1 00 1 50 2 00 Time s This is an example of a flow curve downstream of the Y piece The standard triggers gt 3 I min lt 3 l min can be used without any problem Flow curve upstream of the Y piece 2 00 2 50 3 00 Time s This curve shows the flow curve in the inspiration duct upstream of the Y piece The first two circles m
35. sure and humidity of the medium Density e Density is the unit of mass per unit volume of the medium e Density depends strongly on the pressure and temperature The influence of environmental conditions is therefore the reason why the flow is occasionally transformed to standard conditions Operating data Temperature 15 to 40 C 59 to 104 F Humidity 10 to 90 RH Ambient pressure 500 to 1150 mbar Storage and transportation conditions 10 to 60 C 14 to 140 F for 5 to 95 RH 10 68 2015 09 4 2 Standards for gas flow and volume values Gas Standard Volume measurement The CITREX calculates the measured flow and volume values based on the conditions in the standard specified The following gas standards are supported by CITREX ee eee RH Pressure sure Pressure D sure Pressure Saturated sure sure 760mmHg mid 760mmHg Body Temperature and Ambi BTPS A Current ambient pres 37 0 C 99 F 100 ent Pressure Saturated ac sure cording to ISO 80601 2 F F F Body Temperature and Pres BIPS Current ambient pres 37 0 C 99 F 100 sure Saturated sure channel pressure l F 12 2011 Body Temperature and Pres BTPD Current ambient pres 37 0 C 99 F sure Dry sure channel pressure F ent Pressure Dry sure DIN1343 760mmHg 1975 DIN 102 API Standard Conditions 15 1013 1013 25 mbar 14 7 psia 15 0 C 60 F l l Cummings Standard 25 991 991mbar 500ft Height 25 0
36. th button if Hold any key for 2s to unlock When the touch lock is activated and a symbol is pressed a message on the screen appears To disable the touch lock hold down any symbol or the Bluetooth button for 2 seconds 32 68 2015 09 6 12 Screen saver By default the screen brightness is reduced after 1 minute without touch activity to reduce display burn in and extend the operat ing time on battery power The screen saver setting can be changed in the CITREX configuration tool For more information please see chapter 9 Configuration Tool 33 68 2015 09 7 Connecting up the device General Set Up The measurement setup can affect the accuracy of measurements Tight bends kinks or dents must be avoided Flow direction Good general set up s p r lt x Worse set up Kink T piece elbow piece etc at gas inlet 34 68 2015 09 Measurement set up for ventilators For check and calibration of ventilators the usage of the inlet pipe in the following set up is recommended Breathing circuit Inlet Pipe CITREX Testlung Positive flow direction 35 68 2015 09 Set up for precise flow measurement For precise flow measurement the usage of the inlet pipe in the following set up is recommended In any case the flow is very turbulent it is recommended to use between the inlet pipe and the CITREX the delivered RT 19 filter Positive flow direction Flow direction po
37. volume Vte This is the analogue setting for Vte Breath Cycle Inspiration Expiration nal Start Trigger Y Vo End Trigger t Here too the start trigger must be set to S and the end trigger to E 60 68 2015 09 13 Care and maintenance Guidelines for care and mainteneance Careful maintenance according to the guidelines is a precondition for assuring safe and reliable operation of the CITREX Only components recommended by the man ufacturer may be used Notes on the replacement of components Preventive cleaning and maintenance To maintain the accuracy and reliability of your appliance in the long term the fol lowing maintenance tasks must be carried out on a regular basis During operation Use the filter supplied Every four weeks Check the filter for contamination To do this connect the filter inlet and outlet with the differential pressure connection using two T pieces In this way the pressure loss across the filter can be measured The pressure loss for a flow of 60 l min may not exceed 2 mbar If it does the filter must be replaced Every 12 months Factory calibration to ensure reliable measurement 61 68 2015 09 14 Accessories and spare parts Ordering adress imtmedical ag Gewerbestrasse 8 CH 9470 Buchs Switzerland Tel 41 0 81 750 66 99 E Mail sales imtmedical com Options Item Item number Oxygen option 301 863 000 Monitoring option
38. wre vi Ee ua Citrex Testreport 2 Oby entmedical Switzerland q Hi t REIR ak Brand Name Type j out Lf ou 4 You can now use the Excel file as you want for your own purposes 42 68 2015 09 9 Configuration Tool 9 1 Device configuration It is possible to configure the CITREX by the Ethernet interface Real time measurement data as well as real time curves can be displayed and even analysed on the computer monitor The communication between the CITREX and the computer is bidirec tional These means wherever settings were changed those will be take over on both sides To ensure that the configuration properly runs on the computer it is necessary to have Silverlight 5 installed on one of the follow ing internet browsers e Internet Explorer 7 e Safari 4 e Firefox 3 6 1 Connect the CITREX to a network or directly to a computer by using the Ethernet interface There are three different ways how to configure the Ethernet interface Press the X symbol on the device until the Ethernet screen appears Use the O symbol to change between Default Configured and DHCP Client 43 68 2015 09 Default recommended for direct connection Connect the CITREX directly to a computer by using a merchantable Ethernet cable In this configuration the IP address of the CITREX is preconfigured to IP Address 192 168 1 1 Subnet Mask 255 255 255 0 Configure the Computer network to the
39. ygen Calibration only with air If the O2 option is enabled on the device this menu allows the O2 cell to be cali brated The device will guide through the steps of calibration 1 For starting an oxygen calibration with air press the X symbol until the first screen appears Press the O symbol to continue 2 Apply 30l min of air to the flow channel Inside the parenthesis the actual flow is displayed Press again the O symbol to continue 3 The air calibration has started and will take duration of 114 seconds Do not interrupt the gas flow through the flow channel under any circum stances 4 Atthe end of the calibration a message will appear if the calibration was successful The calibration can be stopped at any time by pressing the X symbol Apply 30 l min 0 Flow 30 l min ey 21 Time rem 114s Draco A ta atart Press A to start The Calibration only with air is a shorter and easier process The measurement accuracy is not as good as the calibration with oxygen and air 27 68 2015 09 Profiles screen Evita standard profile Oxygen Calibration with oxygen and air If the O2 option is enabled on the device this menu allows the O2 cell to be cali brated The device will guide through the steps of calibration 1 For starting an oxygen calibration with oxygen press the X symbol until the first screen appears Press the O symbol to continue 2 Apply 30l min of oxygen to the flow channel Inside the parenthe
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