Hospital

respiratory care

Pocket guide
Philips Respironics V60 ventilator

Dedicated to successful NIV

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Introduction
We are passionate about providing solutions that lead
to healthier patients, healthier practices, and healthier
businesses. This pocket guide is designed to help
familiarize clinicians with the set-up and application
of the Philips Respironics V60 ventilator.

The Philips Respironics V60 ventilator is a microprocessor-

controlled, bi-level positive airway pressure ventilatory
assist system that provides noninvasive and invasive
ventilatory support for adult and pediatric patients (> 20 kg).

Use this guide for a step-by-step explanation of how to

use the V60 ventilator, from initial setup to mask and
port settings to changing modes. This guide also includes
suggestions for increasing tank life during transport.

The value of NIV

Noninvasive ventilation (NIV) has been shown to
significantly reduce many of the complications associated
with conventional mechanical ventilation, including the
incidence of ventilator-acquired pneumonia,1 while at the
same time reducing the overall cost of care by shortening
lengths of stay.2,3

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Table of Contents
Device overview
Front 4
Back 4
Side 4
Air inlet filter 5
Patient circuits 5

General operation
Mask and port settings 6
Setting changes 6
Setting rate 6
Rise time 6
I-Time 7
Mode changes 7
Batch changes 8
Alarm message navigation 8
Alarm settings 9
Low rate 9
Menu tab 10
Screen Lock 10
Patient data and waveforms 11
Standby 12
Help button 12
Mask leak symbols 13
Exhalation port settings 14
Exhalation port test 14

Features, modes, and options

Auto-Trak/Auto-Trak+ 15
100% O2 key 15
Ramp 15
C-Flex 16
Pressure-controlled ventilation 16
AVAPS (average volume-assured pressure support) 16
Patient transport 18

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Device overview
Front

Alarm status and information bar

Navigation ring
and Accept

Patient data window

Waveform graphics
Pause window
button
Scale
buttons Proximal
Cursor pressure port
Ventilator
On/Shutdown outlet
button

Battery LED Alarm LED Setting tabs

Back

Option labels

High pressure oxygen

inlet connector

Power cord
Cooling and retainer
fan filter
Remote
alarm and
nurse call
RS-232 serial and analog I/O connector connector

Side

Bracket
holding
filter
Air inlet
filter Air inlet

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Air inlet filter
The air inlet filter should be inspected every month
and replaced if needed.

To change the air inlet filter

1. Power down the V60 ventilator and disconnect
it from AC power.
2. Turn the D-ring fastener (bottom of side panel)
counter-clockwise one-quarter turn and release.
3. Remove the side panel.
4. Remove the air inlet filter by pinching it out of
the recess in the bracket.
5. Install the new air filter by tucking it into the recessed area.
6. Replace the side panel, push in the D-ring fastener,
then turn one-quarter rotation or until it locks.

Patient circuits
Assemble the patient circuit, including main flow
bacterial filter, proximal line, and humidifier (if desired).

Standard patient circuit includes main flow bacterial filter

and proximal pressure line. Not for use with a humidifier.

The standard humidifier patient circuit includes a main flow

bacterial filter, a short tube, water trap, proximal pressure line,
and elbow.
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General operation
Once the circuit and filter are attached, press the On/
Shutdown button. Informational messages are displayed
on the screen; one that informs the clinician to ensure
a bacterial filter has been added to the machine outlet*,
the second message indicating which mask and leak port
match the displayed data. Continue to Mode settings.
Otherwise, follow the instructional steps to change the
mask and port settings.

Mask and port settings

1. Press the Menu setting tab.
2. Press the Mask and Port button.
3. Press desired patient interface type (see Mask leak
symbols for more information) and press Accept to apply.
4. Press the desired exhalation port (see Exhalation port
settings for more information) and press Accept to apply.
5. Run the exhalation port test only if required.

Setting changes
1. In the Settings window, touch the setting to be changed.
2. Adjust the setting by using either the arrow keys or the
navigation ring.
3. Once the correct value has been chosen, press Accept.

Setting rate
Because the V60 is intended to augment ventilation in patients
who are spontaneously breathing, the rate should be set
as a back-up rate in the case of apnea. If the patient fails
to trigger a breath through Auto-Trak within the interval
determined by the rate setting, the ventilator triggers a
mandatory breath.

*Available with 2.30 software only - not available in all countries.

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Rise time
Rise time is the speed at which inspiratory pressure rises
to the set (target) pressure. Set to the fastest rise time
tolerated (1 for the fastest rise; 5 for the slowest rise).
• Too slow of a rise may exacerbate dyspnea in the ARF
patient, possibly depriving the patient of needed flow.
• If rise time is insufficient to reach the desired inspiratory
pressure or time, decrease the rise time setting (e.g., change
from 5 to 3, therefore resulting in a faster rise time).

I-Time
Setting I-Time adjusts the inspiratory time for a machine-
triggered breath, therefore influencing the I:E ratio in V60
machine-triggered breaths. Inspiratory time is controlled
by the patient in a patient-triggered breath.

Mode changes
The active ventilation mode is displayed in the upper
left corner of the screen. To set or change a mode,
do the following:

1. Select the Modes setting tab.

2. Select the desired mode (active mode will be displayed
in blue).
3. Adjust settings as desired. Newly adjusted setting values
will be displayed in yellow.
4. Select Activate Mode to apply.

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General operation
Batch changes
Batch changes are available in only the active mode.
Batch changes allow simultaneous activation of multiple
ventilation setting changes. To make batch changes follow
these steps.
1. Press the Modes setting tab.
2. Press the active mode (it will state “Batch” and be
displayed in blue).

3. Adjust settings as desired so that newly adjusted

values are displayed in yellow.
4. Press Activate Batch Change to apply all changes
at once.

Alarm message navigation

To hide alarms or informational messages in the Alarms
or Messages list, press the Alarm button (flashing if high
priority) or the Informational Messages button when
up arrows are present. To display messages, touch the
Informational Messages button when down arrows are
present. For a list of alarms, see the Philips Respironics
V60 Ventilator User Manual.

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Alarm settings
1. Press the Alarm settings tab.
2. Press and change the appropriate alarm value.
3. Press Accept.

Low rate
On the V60 ventilator, the low rate alarm may also serve as
an apnea alarm. It is recommended to set the low rate alarm
higher than the backup rate but lower than the patient’s
spontaneous rate. If the low rate alarm value is set at or
below the set rate, the low rate alarm cannot be triggered,
and the alarm is essentially disabled. A text warning will
appear on the left side of the Settings screen if the user
sets the low rate at or below the set (backup) rate.

Set (backup) rate

Warning that alarm Low rate alarm setting

will not work with
current backup rate

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General operation
Menu tab
User preferences can be adjusted using the Menu window.
There is a Brightness setting button for day or night view.
The Loudness setting button adjusts the volume of alarms
and the audible feedback click. The Alarm Volume Escalation
feature*, if enabled, will escalate alarm volume when a
high priority alarm is not responded to within 40 seconds.
Ventilator alarm volume increases to maximum volume
over a 20-second period. When the function is active and
a touchscreen or a button press is detected, the ventilator
automatically returns the alarm volume to the user setting.

There is a Mask/Port menu button to choose various mask

leak values and to choose the correct port (see Mask Leak
symbols). The Vent Info menu button displays the software
version and other information specific to the ventilator.
There is also a Screen Lock button.

Screen Lock
Screen Lock deactivates all buttons and tabs on the
touchscreen except the 100% O2 key (available in 2.30
software*), Alarm Silence, Alarm Reset, the Alarm Message
button, and Help icon. The tabs will be grayed out.

To unlock the screen, press the Accept button (√)

in the center of the navigation ring.

*Available with 2.30 software only – not available in all countries.

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Patient data and waveforms
The data screen displays alarms and patient data, which
include rate, estimated tidal volume, estimated minute
ventilation, peak inspiratory pressure, patient trigger %,
TI /TTOT %, and leak. The breath-type indicator color
corresponds to waveform color: turquoise for spontaneously
triggered, orange for timed triggered and blue for exhale.

• Pt. Trig: Patient-triggered breaths as a percentage

of total breaths over the last 15 minutes.
• Rate: Total breath rate (Spont and Timed), a moving
average over the last 6 breaths or 15 seconds.
• TI /TTOT %: Inspiratory time divided by the total cycle time
over the last 8 breaths.
• Pt. or Tot. Leak: Estimated unintentional leak (Pt. Leak)
or total of intentional plus unintentional leak (Tot. Leak).
• Breath indicator bar: Changes color depending on
breath type and inspiratory phase. Spontaneous breath
is turquoise (Spont), machine-triggered breath is orange
(Timed), and exhalation is blue (Exhale).

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General operation
Standby
Standby suspends ventilation and retains current settings
when the clinician wants to temporarily disconnect the
patient from the ventilator. Ventilator settings and most
menu functions can be changed during the Standby mode.

To activate Standby
1. Press the Standby tab. The Entering Standby
window appears.
2. Disconnect the patient from the ventilator.

The ventilator will not enter Standby until the patient is

disconnected. It continues ventilation while waiting for
the patient to be disconnected. The Standby mode gives
the clinician up to 60 seconds to disconnect the patient
from the ventilator. If after 60 seconds no disconnection
is detected, the Standby mode cancels.

Help button
Press the Help icon (?) to display additional information.
Touch the screen anywhere to return to normal operation.

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Mask leak symbols

Leak symbol
(printed on mask) Patient interface

Leak 1 PerformaTrak full-face mask

(no exhalation PerformaTrak nasal mask
port on mask) Image 3 full-face mask
Contour Deluxe nasal mask
AF811 (CapStrap gel mask)
AF531 (EE or SE Leak 1)
AF421 (EE or SE Leak 1)
AF541 (EE or SE Leak 1)

Leak 2 PerforMax with EE elbow

(exhalation port AF531 (EE elbow Leak 2)
within mask) AF421 (EE elbow Leak 2)
AF541 (EE elbow Leak 2)

Leak 3 AP111 (OptiLife Interface)

Leak 4 (exhalation Respironics total face mask

port within mask)

The Leak symbol represents the intentional leak

characteristics of the mask, and the proper V60 mask/port
settings will ensure the greatest accuracy and optimum
performance. If the Leak symbol does not appear on
a Respironics patient interface, use the chart above to
determine the proper V60 setting. When using an interface
other than a Respironics mask, choose the Leak setting
Other. This selection results in Total Leak, not Patient Leak,
being displayed on the patient data screen.

Leak 1 symbol on mask

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General operation
Exhalation port settings
After pressing the appropriate mask setting, press
the correct exhalation port setting. The chart below
references the various exhalation port settings and when
an exhalation port test is recommended. An exhalation
port test is only recommended when using a PEV (plateau
exhalation valve) or non-Respironics exhalation ports with
unknown leak characteristics.

Port Exhalation port

selections test recommended

Respironics
Disposable
No
Exhalation
Port (DEP)

Respironics
Whisper No
Swivel

Respironics
Plateau
Yes
Exhalation
Valve (PEV)

Other
exhalation Yes
port

Exhalation port test

If a port test is required, follow the instructions provided
on the screen.

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Features, modes,
and options
Auto-Trak/Auto-Trak+
Auto-Trak automatically maintains appropriate trigger
and cycle thresholds to maintain patient-ventilator
synchrony even with changing leak. An optional upgrade,
Auto-Trak+ allows the clinician to customize Auto-Trak’s
trigger and E-cycle sensitivity.

100% O2 key*
Upon pressing the 100% O2 key the V60 delivers 100% O2
for 2 minutes. The clinician is also given the option to cancel
the action or add an additional 2 minutes of 100% O2.

Ramp
The ramp time allows the patient to adapt to ventilation
gradually by increasing inspiratory and expiratory pressures
(IPAP and EPAP/CPAP) from sub-therapeutic to user-set
pressures over a user-set interval (5-45 minutes).

How to set a ramp time

1. Press the Ramp Time button in the Mode settings window.
2. As the ramp progresses, the Ramp Time button graphic
fills in.
3. To change the ramp interval or end the ramp, press
the Ramp Time button again, and the Ramp in Progress
window opens.
4. To end the ramp and apply the full IPAP and EPAP/CPAP
pressures immediately, press End Ramp.
5. To end the ramp and start a new one, press Start New
Ramp, and the Ramp Time setting window opens again
to allow a new ramp time to be set.

*Available with 2.30 software only - not available in all countries.

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Features, modes,
and options
C-Flex
C-Flex improves the comfort of traditional CPAP by
reducing the pressure at the beginning of exhalation and
returning it to the set level before the end of exhalation.
C-Flex may not be appropriate for patients where even
a transient drop in CPAP is deemed undesirable.

The amount of pressure relief is determined by the C-Flex

setting and the expiratory flow of the patient. Pressure
relief is increased with a higher setting number (1, 2, or 3)
and greater patient expiratory flow. This applies only during
the active part of exhalation.

The
illustration
correlates
with the
C-Flex
setting

Pressure-controlled ventilation
In pressure-controlled ventilation (PCV), breaths with a
user-set IPAP and I-Time are delivered to the patient. The
patient can trigger an inspiration and, therefore, control the
rate. However, the patient does not control the inspiratory
time. Also be aware that any changes in EPAP without an
equal change in IPAP will change the pressure support.

AVAPS (average volume-assured pressure support)

AVAPS is a volume-targeted mode and is intended for
use with stable chronic patients who do not require rapid
pressure support changes to maintain a target VT.
At start-up, AVAPS applies an inspiratory pressure equal
to one of the following, whichever is greater
• EPAP + (target volume/60 ml/cmH2 O)
• EPAP + 8 cmH2O
• Pmin

The V60 ventilator will automatically adjust IPAP (up to

2.5 cmH2O per minute), to maintain a tidal volume target.

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IPAP
Min
EPAP

Target VT

AVAPS automatically adapts pressure support (< 2.5 cmH2O

per minute) to guarantee an average tidal volume

Note: when adjusting AVAPS minimum and maximum

pressures, remember that IPAP is adjusted to meet the target
value. If calculated target pressure is outside of the set
pressure range, the target volume will not be achieved.

Starting AVAPS
1. When switching from S/T mode to AVAPS, set the Min P
at the current IPAP pressure.
2. During AVAPS startup, there may be a period of time
before the target tidal volume is achieved. If the target
VT is not achieved at the current Min P setting, increase
the Min P until the target VT is reached. Remember,
the VT displayed on the V60 is a six-breath average,
so the effect of a settings change may not be fully
reflected for several breaths.
3. Once the target VT is reached, reduce Min P slightly
to allow the AVAPS algorithm to adjust.
4. If target VT is not achieved due to a low Min P setting,
an informational message will appear. Adjust Min P
accordingly unless the maximum pressure for the patient
has been reached.
5. If target VT is exceeded because Min P is set too high,
an informational message will appear. Adjust Min P
accordingly unless the minimum pressure for the patient
has been reached.
6. Set the high and low VT alarms appropriately.
7. In AVAPS, the EPAP setting must be at least 1 cmH2O below
the Min P setting. In some cases, an increase in the Min P
setting is required before increasing the EPAP setting.

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Features, modes,
and options
Patient transport
Tips to maximize E-cylinder oxygen tank duration
• Make sure all cylinders are full (2000 psig or more).
• We recommend that you do not use any oxygen delivery
devices that will limit flow such as Grab ’N Go cylinder/
regulators (flow is limited to 100 l/min). The pressure
will be maintained, but the oxygen concentration will be
reduced and the low oxygen pressure alarm will activate.
• Make sure the cylinder regulators are turned off while
the V60 is connected to wall oxygen.
• Never turn the cylinder regulator on until ready to
transport the patient.
• Turn on only one cylinder regulator at a time. If both
cylinders are turned on, they may become simultaneously
depleted, leaving no backup oxygen.
• Whenever possible, reduce FIO2 prior to transport.
The higher the FIO2 setting, the greater the oxygen
consumption. This is particularly important during
transport in high-leak situations such as NIV.
• Minimize all patient leaks. Adjust mask prior to
transport, and loosen appropriately when patient
is back on wall oxygen.
• Avoid using masks that have an exhalation port built
into the mask when there is already an exhalation port
in the circuit.

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Below are graphs representing oxygen tank duration at
various leak values. These are estimates only, based on
2000 psig. Time may vary depending on the V60 settings
used and the patient’s changing ventilatory demand.

VT 500; RR 40; IPAP 18; EPAP 6

Duration in (minutes)

90
80
70
60
50
40
30
20
10
0
30 35 40 45 50 55 60 65 70 75 80 85 90 95 100
FIO2 (%)

Leak 10 Leak 20 Leak 30 Leak 40 Leak 50

VT 500; RR 20; IPAP 18; EPAP 6

Duration in (minutes)

140
120
100
80
60
40
20
0 30 35 40 45 50 55 60 65 70 75 80 85 90 95 100
FIO2 (%)

Leak 10 Leak 20 Leak 30 Leak 40 Leak 50

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 Hill NS, Brennan J, Garpestad E, Nava S. Noninvasive ventilation in acute
1 
respiratory failure. Crit Care Med. 2007 Oct;35(10):2402-7.
Keenan SP, Gregor J, Sibbald WJ, Cook D, Gafni A. Noninvasive positive
2 
pressure ventilation in the setting of severe, acute exacerbations of chronic
obstructive pulmonary disease: more effective and less expensive.
Crit Care Med. 2000 Jun;28(6):2094-102.
3 Hubble MW, Richards ME, Wilfong DA. Estimates of cost effectiveness of
prehospital continuous positive airway pressure in the management of acute
pulmonary edema. Prehosp Emerg Care. 2008 Jul-Sep;12(3):277-85.

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4522 991 29431 * AUG 2017

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