Atrotech Atrostim PNS Anwenderhandbuch Seite 55

Training procedure and follow-up
amount of conditioned muscle would be just sufficient to cause the initially chosen TV.
Need for increased minute volume in quadriplegic patients most frequently is due to
fever and infection. Under these circumstances an increase of RR might cause fatigue.
To allow for a more natural increase of minute volume, by its sigh function, Atrostim
PNS allows creation and functioning of reserve of conditioned muscle. This reserve
may be used to increase TV immediately when needed without a need to increase RR
unduly high.
2 ADJUSTMENT OF STIMULATION PARAMETERS
2.1 Initial parameters
Connect the energy transfer coils and the programming module to the stimulus
controller (see User's Manual). Set the initial values on the module and on the stimulus
controller according to Form 2 (Appendix 5) (Code switches of the module should be
turned only by a snugly fitting screwdriver. The switches can be turned in both
directions. A distinct snap is felt when the switch has turned into the correct position of
a number):
Perform the following settings on the stimulus controller:
- press "LOCK" + "ON"
- rate: 20/min
- stimulation mode: "BILAT"
- volume: "HIGH" 100% 100%
Perform the following settings on the programming module:
- inspiration duration (ID): 1.5 s
- minimum and maximum pulse interval (PI): 40 ms
- sigh interval: 0 0 breaths
- left and right channel: all current switches of each combination to zero
- left and right TV slope: 50 % ID (inspiration duration).
When tuning the system the first step is to set the threshold excitation currents (I
each electrode combination. In the second step maximal tidal volume (TV
(I ) of the combinations is first searched for, which then are set to an appropriate
TVmax
submaximal value, (I
The switch "Threshold select" on the programming module is needed for tuning the
currents of each electrode combination (see Form 2). Positions 1 - 4 are for threshold
settings only, positions 5 - 8 are to adjust TV currents. In each position, only one
combination at a time is active. Pulse interval is not affected.
If a programming module switch fails, it may cause wrong programming of the
stimulus controller. Therefore, the operator of the programming module must observe
) when adjusting.the stimulus pattern of the PNS system.
TV
2
Atrostim PNS
) for
TH
) currents
max
April 2002