Stephan Sophie Manual

Sophie
Neonatology Ventilator
Operating manual
Preface
Operating manual This manual provides clear answers to your questions about the operation
and care of the SOPHIE. It does not contain any information about repairs
or installation.
If any malfunctions occur while operating the device, please contact the
authorized FRITZ STEPHAN GMBH customer service team or the
authorized specialist dealer who supplied the device and familiarized you
with its function and operation.
The manufacturer only guarantees the safety and reliability of the SOPHIE
when it is operated according to this manual.
Fritz Stephan GmbH Equipment is subject to technical modification.

- Medizintechnik - Valid as of: January 2016
Kirchstraße 19 Version: V4.2
From software version: 2.2.x
56412 Gackenbach
Germany
2 GA-038-0116V4.2-HAO-EN  Fritz Stephan GmbH

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Table of contents
Table of contents
Table of contents ......................................................................................................................................3
1 General information ..................................................................................................................9
1.1 Product combination ............................................................................................................9
1.2 Device name and manufacturer .........................................................................................12
1.3 Intended use .......................................................................................................................12
1.4 Disposal .............................................................................................................................14
1.5 Introduction........................................................................................................................15
1.6 Abbreviations, definitions, and pictograms .......................................................................16
1.7 Specifications .....................................................................................................................21
1.7.1 General information ......................................................................................................21
1.7.2 Ambient conditions.......................................................................................................21
1.7.3 Power supply ................................................................................................................22
1.7.4 Interface ........................................................................................................................22
1.7.5 Gas supply ....................................................................................................................23
1.7.6 Sensors ..........................................................................................................................23
1.7.7 Operating modes ...........................................................................................................23
1.7.8 Pneumatic properties ....................................................................................................24
1.7.9 Humidifier performance ...............................................................................................24
1.7.10 Ventilation modes .........................................................................................................25
1.7.11 Reusable tube systems ..................................................................................................25
1.7.12 Disposable patient tube system.....................................................................................26
1.7.13 Adjustable parameters ..................................................................................................26
1.7.14 Curves displayed...........................................................................................................28
1.7.15 Measured values displayed ...........................................................................................29
1.7.16 Monitored measured values ..........................................................................................31
1.7.17 Materials used ...............................................................................................................32
2 Safety instructions...................................................................................................................33
2.1 General safety instructions.................................................................................................34
3 Design and functional description...........................................................................................39
3.1 Front view ..........................................................................................................................39
3.1.1 Power source indicator .................................................................................................41
3.1.2 Function buttons ...........................................................................................................43
3.2 Monitor unit .......................................................................................................................48
 Fritz Stephan GmbH GA-038-0116V4.2-HAO-EN 3

Table of contents
3.2.1 Measured value display ................................................................................................49

3.2.2 Main menu ....................................................................................................................51
3.2.3 Ventilation menu ..........................................................................................................52
3.2.4 Ventilation parameter display .......................................................................................53
3.2.5 Date and time display ...................................................................................................54
3.2.6 Special functions display ..............................................................................................54
3.2.7 Status, alarm, and info display......................................................................................55
3.2.7.1 Alarm messages .......................................................................................................56
3.2.7.2 Internal battery level indicator .................................................................................57
3.2.8 Graphic display .............................................................................................................58
3.2.9 External expiratory trigger status..................................................................................61
3.2.10 Apnea counter ...............................................................................................................61
3.3 Right side view ..................................................................................................................62
3.3.1 Patient component ........................................................................................................63
3.3.2 Reusable patient tube systems ......................................................................................65
3.3.2.1 Tube system for incubators......................................................................................66
3.3.2.2 Tube system for warming beds ................................................................................67
3.3.3 Disposable patient tube system.....................................................................................68
3.3.4 Connection panel ..........................................................................................................69
3.3.5 Automatic refill system (optional) ................................................................................70
3.3.5.1 Preparation...............................................................................................................71
3.3.5.2 Functional principle .................................................................................................74
3.4 Rear view ...........................................................................................................................76
3.4.1 Pneumatic module ........................................................................................................77
3.4.2 Power supply module and interfaces ............................................................................78
3.5 Mobile stand ......................................................................................................................79
4 Main menu ..............................................................................................................................81
4.1 Operating concept ..............................................................................................................82
4.2 Menu structure ...................................................................................................................85
4.2.1 “Alarmlimits” menu .....................................................................................................85
4.2.1.1 “Change” .................................................................................................................85
4.2.1.2 “FiO2 follow on/off” ...............................................................................................88
4.2.1.3 “VT filter” ...............................................................................................................88
4.2.1.4 “Transport on/off” ...................................................................................................88
4.2.2 “Curves” menu .............................................................................................................89
4.2.2.1 “2. panel” .................................................................................................................90

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Table of contents
4.2.2.2 “3. panel” .................................................................................................................90

4.2.2.3 “Scale” .....................................................................................................................91
4.2.2.4 “Trend on/off” .........................................................................................................92
4.2.3 “View” menu ................................................................................................................92
4.2.3.1 “Units on/off” ..........................................................................................................92
4.2.3.2 “Display VT” ...........................................................................................................93
4.2.3.3 “Limits on/off” ........................................................................................................93
4.2.3.4 “Day/Night” view ....................................................................................................94
4.2.4 “Measure” menu ...........................................................................................................95
4.2.5 “Heating” menu ............................................................................................................97
4.2.6 “Extra-func.” menu .....................................................................................................100
4.2.7 “Options” menu ..........................................................................................................101
4.2.7.1 “PNT-A/B/C/None” ..............................................................................................101
4.2.7.2 “O2 calibration”.....................................................................................................102
4.2.7.3 “Trigger press./flow/extern” ..................................................................................103
4.2.7.4 “Exp. trigger on/off” ..............................................................................................103
4.2.7.5 Freq. backup 10/30/60/off .....................................................................................104
4.2.7.6 “Communication” ..................................................................................................105
5 “Ventilation” menu ...............................................................................................................107
5.1 Operating concept ............................................................................................................107
5.1.1 Setting the ventilation mode after system start-up......................................................109
5.1.2 Presetting alarm limits ................................................................................................112
5.1.3 Changing the ventilation mode during operation .......................................................113
5.2 Special functions in the Ventilation menu .......................................................................115
5.2.1 “Standby” and “Off” ...................................................................................................115
5.2.2 “Break” .......................................................................................................................118
5.2.3 “Test” ..........................................................................................................................119
5.3 Adjustable ventilation parameters....................................................................................122
5.3.1 Special aspects of setting the VtLim/VtTar ................................................................124
5.3.2 Setting the expiration time or frequency ....................................................................125
5.4 Choosing the ventilation mode ........................................................................................126
5.4.1 IMV – intermittent mandatory ventilation ..................................................................127
5.4.2 S-IMV – synchronized IMV ventilation .....................................................................128
5.4.3 S-IMV with inspiratory time termination (ITT) .........................................................129
5.4.4 Ass./Co. – assist-controlled ventilation ......................................................................130
5.4.5 Ass./Co. with inspiratory time termination (ITT/PSV) ..............................................131

Table of contents
5.4.6 High frequency oscillation with IMV (optional) ........................................................132

5.4.7 High frequency oscillation with CPAP (optional) ......................................................133
5.4.8 NCPAP – non-invasive (nasal) CPAP ........................................................................135
5.4.8.1 NCPAP-B ..............................................................................................................137
5.4.9 NIPPV – non-invasive positive pressure ventilation ..................................................139
5.4.9.1 SNIPPV .................................................................................................................141
5.4.9.2 SNIPPV-B .............................................................................................................142
5.4.10 Invasive CPAP (optional) ...........................................................................................143
5.4.10.1 CPAP-B .................................................................................................................145
6 Preparation for use ................................................................................................................147
6.1 Setting up the device ........................................................................................................147
6.2 Connecting the gas and power supplies ...........................................................................148
6.2.1 Gas supply ..................................................................................................................148
6.2.2 Power supply ..............................................................................................................148
6.2.3 Patient component ......................................................................................................150
6.2.4 Filling the humidifier bottle ........................................................................................150
6.2.5 Reusable patient tube system for incubators...............................................................152
6.2.6 Reusable patient tube system for warming beds .........................................................154
6.2.7 Disposable tube system P3/P7 ....................................................................................155
6.2.8 Tube adapter ...............................................................................................................157
6.2.9 PNT A .........................................................................................................................158
6.2.10 EasyFlow NCPAP systems .........................................................................................159
6.2.11 Pneumatic medication nebulizer .................................................................................160
6.2.12 Aeroneb Solo medication nebulizer............................................................................162
6.2.13 Connection of the external respiration sensor (optional) ............................................162
7 Test before start-up ...............................................................................................................165
7.1 Testing requirements........................................................................................................165
7.2 Test list.............................................................................................................................166
8 Operation ..............................................................................................................................169
8.1 Switching on ....................................................................................................................169
8.2 Test mode.........................................................................................................................169
8.3 Choosing the ventilation mode ........................................................................................172
8.4 Non-invasive ventilation ..................................................................................................173
8.5 Switching off ...................................................................................................................174
8.6 Decommissioning the device ...........................................................................................174
9 Ventilation modes .................................................................................................................175

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Table of contents
9.1 General .............................................................................................................................175

9.2 External trigger (optional) ...............................................................................................176
9.3 Pressure-controlled ventilation (IMV) .............................................................................178
9.3.1 IMV with volume limitation .......................................................................................179
9.3.2 Pressure-controlled ventilation without PNT .............................................................181
9.4 Synchronized mechanical ventilation ..............................................................................182
9.4.1 Assisted controlled ventilation ...................................................................................183
9.4.2 S-IMV .........................................................................................................................183
9.4.3 Inspiratory time termination (ITT/PSV) .....................................................................185
9.5 S-IMV with ITT and pressure support .............................................................................187
9.6 High frequency oscillation ...............................................................................................188
9.7 Non-invasive CPAP (NCPAP) and CPAP.......................................................................190
9.7.1 Backup ventilation ......................................................................................................191
9.7.1.1 Standard backup ....................................................................................................192
9.7.1.2 Frequency-controlled backup ventilation ..............................................................193
9.8 Synchronized NIPPV .......................................................................................................196
9.8.1 Backup ventilation ......................................................................................................197
9.8.1.1 Standard backup ....................................................................................................199
9.8.1.2 Frequency-controlled backup ventilation ..............................................................199
10 Patient gas humidification.....................................................................................................203
10.1 General .............................................................................................................................203
10.2 Special features of the P7 patient system.........................................................................203
10.3 Humidity and flow ...........................................................................................................204
10.4 Condensation in the tube system......................................................................................204
10.4.1 Air conditioned rooms ................................................................................................205
10.4.2 Low incubator temperature .........................................................................................206
10.4.3 Sensor positioning ......................................................................................................209
11 Functional description ...........................................................................................................211
11.1 General .............................................................................................................................211
11.1.1 Description of the pneumatic system ..........................................................................211
11.2 Pneumatic diagram ..........................................................................................................214
12 Troubleshooting ....................................................................................................................215
12.1 List of errors ....................................................................................................................215
12.2 Heavily oscillating ventilation curves..............................................................................227
12.2.1 Patient valve ...............................................................................................................227
12.2.2 Humidity in the pneumotachograph ...........................................................................228

Table of contents
12.3 Prevention of condensate in PNT and tubes ....................................................................229

13 Care and maintenance ...........................................................................................................231
13.1 Treatment processes .........................................................................................................231
13.1.1 Information about cleaning agents and disinfectants ..................................................232
13.1.2 Automated cleaning and disinfection .........................................................................233
13.1.3 Manual cleaning and disinfection ...............................................................................234
13.2 Device overview ..............................................................................................................237
13.3 Device housing with park position, gas supply tubes, and power cable ..........................239
13.4 Reusable patient tube system ...........................................................................................240
13.5 Temperature sensor systems P7 .......................................................................................242
13.6 Connection cable P3/P7 for disposable patient tube system P3/P7 .................................243
13.7 Flow sensor (PNT), Y piece, pressure measurement tube ...............................................244
13.7.1 Preparing the flow sensor ...........................................................................................246
13.7.2 Post-treatment .............................................................................................................247
13.8 Test lung with tube adapter ..............................................................................................249
13.8.1 Preparing the test lung with the tube adapter ..............................................................250
13.9 Patient component P7 ......................................................................................................251
13.9.1 Preparation ..................................................................................................................253
13.9.1.1 Preparing the silencer ............................................................................................255
13.9.2 Post-treatment .............................................................................................................256
13.9.2.1 Sterilizing the patient component ..........................................................................257
13.10 Assembly .........................................................................................................................257
13.11 Treatment table ................................................................................................................258
13.12 Servicing ..........................................................................................................................259
13.12.1 Maintenance and inspection intervals .........................................................................259
13.12.2 Safety checks ..............................................................................................................260
14 Electromagnetic emissions and immunity ............................................................................261
14.1 Electromagnetic emissions ..............................................................................................261
14.2 Electromagnetic immunity ...............................................................................................262
14.3 Recommended separation distance ..................................................................................265
15 Spare parts and accessories ...................................................................................................267
16 Warranty ...............................................................................................................................271
17 List of figures ........................................................................................................................273
18 List of tables..........................................................................................................................279
19 Notes .....................................................................................................................................281

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1 General information
1.1 Product combination
Fritz Stephan GmbH disclaims any warranty with respect to the operation
of unauthorized device combinations with products not approved by the
manufacturer or without certified compatibility.
Certified product 1. Pneumatic medication nebulizer

combinations Manufacturer: Dräger AG Lübeck
Art. no.: 8405000
 Medication nebulizer set
Manufacturer: Fritz Stephan GmbH
Art. no.: 171060120
2. Ultrasonic nebulizer
Manufacturer: Schill GmbH & Co. KG
Art. no.: MN81100
 Medication nebulizer set
Art. no.: 103560800
3. Medication nebulizer Aeroneb® Solo system
Manufacturer: Inspiration Medical GmbH
Art. no.: AG-AS3000-NE
4. Flow sensors
 Type A pneumotachograph
Art. no.: 103561303
 Type B pneumotachograph
Art. no.: 103561300
 Type C pneumotachograph
Art. no.: 103561301
5. Respiration sensor for external trigger (disposable)
Manufacturer: Vio Healthcare
Art. no.: 103560103
(Only for Sophie ventilators with an external respiration sensor)

6. Reusable patient tube systems

 Heated with Y piece, pressure measuring tube, and connecting
plug for incubator, length 1200 mm, of which 800 mm are heated
Art. no.: 100761500
 Heated with Y piece, pressure measuring tube, and connecting
plug for warming beds, length 1300 mm, of which 1200 mm are
heated
Art. no.: 100761550
7. Disposable patient tube systems
 Heated with Y piece, pressure measuring tube, and NO adapter
Art. no.: 100761300
8. NCPAP patient interfaces
 EasyFlow NCPAP system
Manufacturer: J. Söllner GmbH
Art. no.: See accessories list in chapter 15
 Bonnets for EasyFlow NCPAP system
Art. no.: See accessories list in chapter 15
9. Device for regulating the metered dosing of NO to inhaled air
Name: Pulmonox mini
Manufacturer: Messer, Austria
Marketed by: Mallinckrodt – Nellcor – Puritan – Benett
The following accessories must be used:
 Flow box for measuring and dosing NO for connecting to the
patient component with RS 232 to reduce dead space including
PNT
Art. no.: 170561000
 NO dosing adapter
Art. no.: 103560067
 NO analysis adapter
Art. no.: 103561314
 Pneumotachograph – type NO with plug and silicone tubes, can
be autoclaved at 140°C, type B for determination of the flow
using the flow box
Art. no.: 1 035 61 302
 Adapter for NO suction
Art. no.: 100753082

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10. Device for regulating the metered dosing of NO to inhaled air

Name: Inovent
Manufacturer: Datex Ohmeda
 Adapter for INO flow box
Art. no.: 195361003
11. Device for regulating the metered dosing and measurement of NO
Name: NoxBox
Manufacturer: Bedfont Scientific Ltd
The following accessories must be used:
 Single use delivery and sampling kit 10 mm
Art. no.: NOXKIT-1-10
 Single use f22-15 mm straight vent. connector
Art. no.: NOXFLOW-CON
 Heating adapter for NoxBox connection
Art. no.: 170561006
CAUTION
Do not reuse disposable accessories!
The necessary reconditioning may lead to the deterioration of mechanical and
biological product properties, posing a significant risk to the patient. In addition,
reusing such accessories dangerously increases the risk of contamination for the
patient.

1.2 Device name and manufacturer
Device name SOPHIE
Manufacturer Fritz Stephan GmbH

- Medizintechnik -
Kirchstraße 19
56412 Gackenbach
 +49 (0)6439 9125 – 0

 +49 (0)6439 9125 – 111
 [email protected]
 www.stephan-gmbh.com
1.3 Intended use
The SOPHIE is suitable for the invasive and non-invasive ventilation of

preterm infants, infants, and small children up to 25 kg, but especially for
the ventilation of immature preterm infants with a very low birth weight.
Therapeutic scope The SOPHIE can be used for all approved conventional ventilation modes:
 Non-invasive ventilation with continuous positive airway
pressure (NCPAP) with or without backup ventilation
 Synchronized intermittent mandatory ventilation (SIMV) with or
without inspiratory time termination (ITT)
 Synchronized intermittent mandatory ventilation (SIMV) with
ITT and additional pressure support for spontaneous breathing
 Controlled ventilation (IMV)
 Assisted controlled ventilation (patient-triggered) with or without
ITT
 Controlled non-invasive positive pressure ventilation (NIPPV)
 Controlled and synchronized non-invasive positive pressure
ventilation (SNIPPV)
 Optional: high frequency oscillation (HFO) in combination with
IMV and CPAP ventilation options up to a body weight of 12 kg
 Optional: controlled and synchronized non-invasive positive
pressure ventilation (SNIPPV) with expiratory trigger

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Contraindication The safety instructions provided in chapter 2 must be observed. No

additional contraindications exist.
It is the sole responsibility of the user to select the most appropriate
ventilation mode based on the patient’s medical condition. The
continuous monitoring of the patient’s condition must be assured at all
times.
Area of use The ventilator’s areas of use comprise interdisciplinary and discipline-
specific intensive care units, primary care units for newborns, and the
intra-hospital transportation between units or departments.
The ventilator may only be used by authorized personnel such as
physicians, qualified medical specialists, health workers, nurses, and
respiratory therapists.
The prescribed safety checks and preventative maintenance must only be
conducted by the manufacturer or personnel qualified in line with the
German Medical Devices Operator Ordinance (MPBetriebV).
The SOPHIE must not be used:

- in the vicinity of magnetic resonance imaging systems (MRT, NMR,
NMI)
- in potentially explosive environments
- in positive pressure (hyperbaric) chambers

1.4 Disposal
Disposal of the The device packaging largely consists of recyclable or reusable materials.
packaging The cardboard packaging can be reused or disposed of as used paper.
Disposal of the device FRITZ STEPHAN GMBH will accept the return of any waste equipment
and the battery from our company free of charge and dispose of it correctly, thus making
a contribution to the environment.
Used batteries and the device itself must not be disposed of as domestic
waste. Proper disposal must be conducted by a certified electrical and
electronic waste recycling company. Disposal via municipal collection
points for waste electrical equipment is not permitted!
WARNING
Risk of explosion!
Do not throw the battery into a fire or open it with force!
NOTE
Before disposing of the device or any of its components, these must be cleaned and
disinfected.
Infectious disposable accessories must be disposed of as specified in the operating
manual!

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1.5 Introduction
Device setup, operation, and maintenance is only permitted by trained

personnel. All relevant national laws, guidelines, and regulations as well
as the following instructions must be observed:
 The device must be operated by trained personnel only. Thorough
knowledge of the operating manual is required.
 Only use the device for the intended purpose described in the
operating manual.
 Read the operating manual carefully and comply with its instructions;
lasting safety for the patient and user is only ensured when the device
is operated correctly.
 The operating manual must be kept readily available at the place of
use.
 Inadequate care and incorrect operation can cause downtime and
accidents.
Warranty The manufacturer does not accept any warranty claims resulting from
incorrect operation or inadequate care and maintenance. The
manufacturer only guarantees the safety and reliability of the device if it
is operated in compliance with the operating manual.

1.6 Abbreviations, definitions, and pictograms
Abbreviation/ Term Meaning

technical
term
Batt Battery Device for storing electrical energy in the form of
chemical energy
ApD Apnea duration
Apnea Respiratory arrest
Aqua dest. aqua destilata (lat.) Distilled, demineralized water
Arb Arbitrary unit Free parameter of the abdominal respiration
sensor for the external trigger (graphical display)
Ass./Co. assisted controlled (patient With this ventilation mode, the device delivers a
activated) mandatory breath whenever the inspiratory
volume flow exceeds the preset trigger threshold.
Bar Unit of measurement for pressure
1000 hpa = 1 bar
Bpm Breaths per minute Breaths per minute
BTPS Body temperature and ambient Measuring condition at body temperature, current
pressure saturated ambient pressure, and saturated gas
BU Backup Standard backup ventilation mode
FBU Frequency-controlled backup Frequency-controlled backup ventilation
cmH2O Unit of measurement for pressure
1 cm H2O = 0.9806 hPa
COM Serial interface
contr. Controlled With this ventilation mode, the device controls
the ventilation pressure on the Y piece and the
periodic process for the cyclic changes of this
pressure. Controlled ventilation modes:
 time controlled, pressure controlled
 time controlled, volume controlled
CPAP Continuous positive airway pressure Spontaneous breathing with continuous positive
airway pressure.
When breathing under CPAP, the device keeps
the pressure constant on the endotracheal tube’s
connection piece.

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technical
term
Diathermia Therapy where high frequency currents heat
HF diathermia High frequency diathermia through the tissues within the body.
DIN German Institute for Standardization
Disc. Disconnection Interruption (pneumatic) of a connection
Distal Away from the patient
EN European Standard
ETT Endotracheal tube
Exp. Expiration Exhalation
FHFO Frequency of high frequency oscillation
FiO2 Inspiratory oxygen fraction
Flow Symbol: Volume flow
HP High priority An alarm indicating the need for prompt
intervention by the user (IEC 60601-1-8).
hPa Hectopascal Unit of measurement for pressure
1 hPa = 1 mbar
Hz Hertz Unit of measurement for frequency
IGR Incremental encoder Push and turn knob for device operation
IMV Intermittent mandatory ventilation Intermittent mandatory ventilation
Insp Inspiration Inhalation
IP International protection code Code indicating the degree of protection against
dust and moisture
ITT Inspiratory time termination Inspiratory time termination

Communic. Communication
Connection Connection
Cont. Continuous
LED Light emitting diode Light emitting diode
Linear Pressure curve pattern:
MAP Mean airway pressure Mean airway pressure
mbar Unit of measurement for pressure


technical
term
MHP Alarm of at least medium priority An alarm of at least medium priority is evaluated
as a medium priority alarm (MP) when the alarm
situation occurs; it progresses to a high priority
alarm (HP) 30 seconds later.
Min Minute Unit of measurement for time
MP Medium priority An alarm indicating the need for prompt
intervention by the user (IEC 60601-1-8).
ms Millisecond Unit of measurement for time
NCPAP Non-invasive CPAP Non-invasive (nasal) CPAP
NCPAP-B Non-invasive CPAP with backup Non-invasive (nasal) CPAP with backup
ventilation
NIST Non-interchangeable screw thread Non-interchangeable screw thread
NIPPV Non-invasive positive pressure Non-invasive positive pressure ventilation
ventilation
PEEP Positive end expiratory pressure Positive end expiratory pressure
Pmax Peak pressure
Pmean Mean airway pressure
Pmin Minimum pressure
PNT Pneumotachograph Flow sensor
Proximal Close to the patient
Rectangle Flow or pressure curve pattern:
Resistive Creates a pneumatic resistance
Resp. Respiration
s Second Unit of measurement for time
SIMV Synchronized intermittent Ventilation mode synchronized to the patient
mandatory ventilation
Sinus Flow curve pattern:
Standby The device is ready for use
SNIPPV Synchronized non-invasive positive Synchronized non-invasive positive pressure
pressure ventilation ventilation

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technical
term
SNIPPV-B Synchronized non-invasive positive Synchronized non-invasive positive pressure
pressure ventilation with backup ventilation with backup
Temp. Temperature
TA Technical alarm
PU Packaging unit
VT Tidal volume Breathing volume
VTi Inspiratory breathing volume Inspiratory tidal volume
VTe Expiratory breathing volume Expiratory tidal volume
WB Water bath Humidifier bottle filled with water
CGS Central gas supply
Vo Oscillatory tidal volume
V Volume
V´ Flow
Tab. 1: Abbreviations and technical terms

Pictogram Meaning
Alarm suppression (see chapter 3.1.2)
Alarm menu (see chapter 3.1.2)
Stop (screen display frozen; see chapter 3.1.2)
Aerosol nebulization (see chapter 3.1.2)
Pre-oxygenation (see chapter 3.1.2)
Hold inspiration (see chapter 3.1.2)
Main menu (see chapter 3.1.2)
Remaining duration of alarm suppression (see chapter 3.2.7)
Charge indicator for internal battery (see chapter 3.2.7)
Heating switched off (see chapter 3.2.7)
Standard backup active (see chapters 9.7.1 and 9.8.1)
Frequency backup active (see chapters 9.7.1 and 9.8.1)
External trigger active
Flow trigger active

Flow measurement switched off (see chapter 5.4)
Indication of the active PNT (A, B, or C, see chapter 4.2.7.1)
Contains conventional or rechargeable batteries and must not be disposed of as
domestic waste.
Protective conductor
Type B applied part
Mains power
Battery status
On-board power supply (24 V DC)
Compressed air membrane dryer
Observe the operating manual
Tab. 2: Pictograms

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1.7 Specifications
1.7.1 General information
Class according to 93/42/EEC II b

Protection class IP 21
Protected against solid foreign bodies with a diameter of
12.5 mm or above and water droplets
Sound pressure level 47.5 dB(A)
Sound power level 58.5 dB(A)
UMDNS code 14-361
GMDN code 14361
Safety checks Every 6 months
Dimensions 470 x 342 x 332 mm (WxHxD)
Weight Basic device with patient 26 kg
component
Mobile stand 16.2 kg
Display Color – TFT 10.4”
1.7.2 Ambient conditions
Operation Temperature 15 – 40°C

Rel. humidity 10 – 80%
Air pressure 700 – 1060 hPa
Allow to reach room temperature before using device.
Storage Temperature 5 – 40°C
Relative humidity 10 – 80%
Air pressure 700 – 1060 hPa
Store in a dust-free place protected from humidity and frost

1.7.3 Power supply
Mains Connection 100 – 240 V AC; 50 – 60 Hz

Protection class I type B according IEC 60601-1
Supply line Safety plug with device socket
Power consumption 210 VA

Current consumption 2.1 – 0.87 A
Fuses 2x T3.15 AH/250 V; DIN 41571
Battery Type Lithium-ion
Nominal voltage 25.2 V DC
Nominal capacity 2.1 Ah
Battery life At least 60 min
(new/100% charge) (without heating)
Charge time At least 6 h to 100%
Max. no. of charge cycles 500
1.7.4 Interface
Serial interface Type RS-232-C Sub D

9-pin (male)
Isolation 5 kV
Pin assignment 2 RxD
3 TxD
5 GND
Port configuration Baud rate 9600 - 115200
Data bits 8
Start bits 1
Stop bits 1
Parity None
Logs VueLink, IntelliBridge, PDMS or Stephan log

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1.7.5 Gas supply
Supply pressure AIR 3 – 6 + 0.5 bar

O2 3 – 6 + 0.5 bar
Gas consumption Conventional Min. 4 l/min*
HFO Min. 18 l/min*
HFO transport Min. 14 l/min*
Aerosol Approx. 9 l/min
* + MV (max. 25 l/min)
System pressures System pre-pressure Max. 150 cmH₂O
Active expiration Max. -30 cmH₂O
Pneumatic medication nebulizer 1.5 bar
1.7.6 Sensors
Flow/volume Sensor Max. flow Dead space*

PNT type A ± 5 l/min 0.5 ml
PNT type B ± 12 l/min 0.6 ml
PNT type C ± 25 l/min 0.9 ml
*Dead space may differ depending on which tube adapter is used.
Abdominal Type Graseby respiration sensor

movement
FiO2 Type Electrochemical oxygen sensor, type M-11
T21-90 < 15 s
1.7.7 Operating modes
Pressure-controlled Pressure pattern Linear

Sinus
Rectangle
Pressure-controlled/ Adjustment to expiratory tidal volume
volume-controlled

1.7.8 Pneumatic properties
Inspiration resistance during operation Max. 1 cmH₂O at 5 l/min

(PNT B)
Expiration resistance during operation Max. 1 cmH₂O at 5 l/min
(PNT B)
Inspiration resistance on device failure No PNT Max. 0.09 cmH₂O at 5 l/min
PNT B Max. 1.54 cmH₂O at 5 l/min
PNT C Max. 1.32 cmH₂O at 5 l/min
Expiration resistance on device failure No PNT Max. 0.08 cmH₂O at 5 l/min
PNT B Max. 1.52 cmH₂O at 5 l/min
PNT C Max. 1.34 cmH₂O at 5 l/min
Patient tube system compliance P7 0.12 ml/cmH₂O
1.7.9 Humidifier performance
Recommended ambient temperature 18 – 26°C

Liquid reservoir for humidifier Max. 144 ml
Flow rate 5 – 25 l/min
Chamber temperature 26 – 45°C
Humidifier release at 38°C (proximal) Humidity Flow aH1 (rH2)
level
0 6 l/min > 33 mg/l (> 75%)
++ 12 l/min > 33 mg/l (> 75%)
++++ 20 l/min > 33 mg/l (> 75%)
Warm-up time ~ 20 min
Displayed temperature Temperature at the end of the inspiration tube
1
Absolute humidity
2
Relative humidity based on 37°C (BTPS)

®
1.7.10 Ventilation modes
NCPAP Spontaneous breathing using non-invasive patient interface

(prong/nasal mask) with continuous positive airway pressure
NCPAP B Non-invasive (nasal) CPAP with backup ventilation
SIMV Synchronized intermittent mandatory ventilation
Ass./Co. Assisted controlled mandatory ventilation
IMV (contr.) Controlled mandatory ventilation
ITT Inspiratory time termination in addition to the ventilation modes
SIMV and Ass./Co. For SIMV, with additional pressure support
VG Volume guarantee in addition to all conventional ventilation
modes through VtTar/VtLim
HFO High frequency oscillation
NIPPV Non-invasive positive pressure ventilation
SNIPPV Synchronized non-invasive positive pressure ventilation
SNIPPV B Synchronized non-invasive positive pressure ventilation with
backup ventilation
CPAP (optional) Spontaneous breathing at continuous positive airway pressure
CPAP B (optional) CPAP with backup ventilation
1.7.11 Reusable tube systems
Tube system P7 tube system for incubators P7 tube system for warming beds
(Art. no. 100761500) (Art. no. 100761550)
Total length 1.225 m 1.300 m
Length of cold section 425 mm 125 mm
Resistance < 2 mbar @ 22 l/min < 2 mbar @ 22 l/min
Compliance < 0.1 ml/mbar < 0.1 ml/mbar
Volume 191 ml 191 ml
Inner diameter 10 mm 10 mm

1.7.12 Disposable patient tube system
NOTE
For information about using the device as intended, about warnings and safety
instructions, as well as technical data, refer to the operating manual provided with the
tube system.
1.7.13 Adjustable parameters
Hospital-
Parameter Meaning Range Resolution Default
specific
Insp Inspiration time 0.1 – 2.00 s 0.01 s 0.35 s
Exp* Expiration time 0.10 – 2.00 s 0.01 s 1.15 s
2.00 – 6.00 s 0.10 s
6.00 – 60.00 s 1.00 s
Freq* Frequency 1 – 300/min 1/min 40/min
Pmax Inspiratory peak pressure 5 – 10 cmH₂O 0.5 cmH₂O 15 cmH₂O
10 – 60 cmH₂O 1.0 cmH₂O
FiO2 Insp. oxygen fraction 21 – 100% 1% 21%
PEEP Positive end expiratory 0 – 5 cmH₂O 0.1 cmH₂O 5 cmH₂O
pressure 5 – 10 cmH₂O 0.5 cmH₂O
10 – 30 cmH₂O 1.0 cmH₂O
MAP Mean airway pressure 0 – 5 cmH₂O 0.1 cmH₂O Pmean +2 ---
5 – 10 cmH₂O 0.5 cmH₂O
10 – 30 cmH₂O 1.0 cmH₂O
PPSV% Pressure support level for 0 – 100% 5% 20%
SIMV – ITT(PSV)
MaxV‘ Maximum gas flow 6 – 20 l/min/OFF 1 l/min 12 l/min
(flow limitation)
Trig Trigger threshold 0.2 – 2.9/OFF 0.1 1.2 l/min
(sensitivity) l/min l/min 1.2
cmH₂O cmH₂O cmH₂O
Arb Arb 0.5 Arb
VtTar Target volume under 2 – 5 ml 0.1 ml OFF ---
ITT(PSV) 5 – 10 ml 0.5 ml
10 – 150 ml 1.0 ml
OFF

®
Hospital-
specific
VtLim Tidal volume limitation 2 – 5 ml 0.1 ml OFF ---
5 – 10 ml 0.5 ml
10 – 150 ml 1.0 ml
OFF
KV’ Factor of the inspiratory 5 – 40% 1% 5%
peak flow, for inspiration
end
ApD Apnea duration 1 – 16 s/OFF 1s 4s
HF freq Oscillation frequency for 5 – 15 Hz 0.5 Hz 10 Hz
HFO
HF-IE Inspiration ratio for HFO 33 – 50% 1% 40%
HF-AM Oscillation pressure 5 – 100% 1% 20%

amplitude for HFO
HFO-INSP Switches oscillation “ON” ON/OFF --- OFF
or “OFF” during
inspiration
FLim Flow limit line setting for 0.2 –10 l/min/ 0.1 l/min 1.0 l/min
HFO OFF
Temp Respiratory gas 30 – 40°C 0.5°C 38°C
temperature
Humidity Difference Conv: -4 – +6 1 0
between the HFO +2
humidifier NCPAP +2
temperature
and the
respiratory gas
temperature
FBU Interval of the frequency- 10 / 30 / 60 s / --- OFF
controlled backup OFF
ventilation
Preoxy % FiO2 for preoxygenation
(can be
Preoxy % (direct setting) 21 – 100% 1% 80%
configured,
see chapter Delta 1 – 79% 1% 20%
4.2.6) (FiO2+Preoxy %)
FiO2 X 1.1 – 2.0 x FiO2 0.1 x FiO2 1.2

Hospital-
specific
(FiO2 x Preoxy %)
Preoxy T Duration of the OFF/ 30 s 180 s
preoxygenation 30 – 420 s
Insp Hold Maximum insp. hold time Insp / 1s Insp
1–7s
Aerosol T Medication nebulization 30 – 420 s 30 s 300 s
duration
Pressure limit for patient component 40 – 70 / Infinite --- ---
125 cmH₂O
NOTE
* Depending on the customer’s wishes, the Sophie can be supplied with either a
selectable expiration time or a selectable breathing frequency. The selection does not
affect the inspiration time setting.
1.7.14 Curves displayed
Real-time curves Airway pressure P(t) -5 – 15 / -10 – 30 / -20 – 60 / -30 – 90 cmH₂O

Volume V(t) -5 – 15 / -5 – 45 / -30 – 150 / -50 – 450 ml
Flow V’(t), +/- 3 / 6 / 15 / 45 l/min
Abdominal movement E(t) +/- 3 / 6 / 9 / 24 Arb
Time axis 4 s / 8 s / 16 s*
Loops Volume/pressure V(P)
Flow/volume V’(V)
Flow/pressure V’(P)
Trends Airway pressure Pmean(t) -5 – 15 / -10 – 30 / -20 – 60 / -30 – 90 cmH₂O
Minute volume MV(t) 0 – 1 / 0 – 2 / 0 – 5 / 0 – 10 l/min
Tidal volume Vt(t) -5 – 15 / -5 – 45 / -30 – 150 / -50 – 450 ml
Time axis 30 min / 1 h / 2 h / 4 h / 12 h / 24 h
*For trend display, the time axis is automatically halved

®
1.7.15 Measured values displayed
Pressure Pmax -20 – 99 cmH₂O

Pmean -20 – 99 cmH₂O
PEEP -20 – 99 cmH₂O
POSC -20 – 99 cmH₂O
Accuracy: P =  (4 %  P + 2 cmH₂O)
Volume (BTPS) MV 0 – 999 l/min
Vte 0 – 999 ml
VTi 0 – 999 ml
Vleak 0 – 999 ml
MVo 0 – 999 l/min
Vo 0 – 999 l/min
Accuracy: V =  (15%  V + 4 ml)
Breathing rate 0 – 999 /min

Inspiration ratio 0.1 – 100%
FiO2 0 – 100%
Accuracy:  5 Vol %
Respiratory gas 12 – 60°C
temperature
Resistance 0 – 999 cmH₂O /l/s
Compliance 0 – 999 ml/cmH₂O
DCO2 0 – 999 ml2/s

NOTE
 The values displayed are generated from mean values. The number of
measurement points used depends on the measured value.
 The measured values are recorded every 2 ms.
 The values for the pressure and volume flow are averaged over a period of
10 ms.
 The values for the temperature measurement are averaged over a period of
100 ms.
 The values for the oxygen concentration measurement are averaged over a
period of 500 ms.
 The pressure and volume flow measured variables are subjected to 15 Hz low
pass filtering using an IIR filter to prevent interference.
 These filtered measured variables are used in the graphical representation and
to determine the ventilation-related parameters PEEP, Pmax, Pmean,
inspiratory and expiratory Vt and leakage volume.
 The parameters under HFO are determined using the non-filtered pressure and
volume flow measured variables with subsequent exponential smoothing of
the ventilation-related measured values determined for Posc and Vosc.
 Exponential smoothing is also used to smooth the measured values for the
minute volume, frequency, and I:E.

®
1.7.16 Monitored measured values
All alarms are shown in the display area in plain text format and
highlighted in different colors based on their level of priority. In addition
to the visual alarm messages, an acoustic alarm sounds with a different
sound sequence for each priority level.
Parameter Unit Lower limit Upper limit Resolution Default Default

lower limit upper limit
Pmax cmH₂O 1 – 60 2 – 70 1 12 25
Posc cmH₂O 0 – 149 1 – 150 1 10 30
Pmean cmH₂O 0 – 40 1 – 60 1 0 30
PEEP cmH₂O – 0 – 30 1 --- 20
MV, MVo l/min OFF – 0.10 – 0.01 0.10 2
0.10 – 9.90 – 0.05
– 0.2 – 19.9 0.1
VTE, Vo ml 0 – 10 0 – 10 0.5 0 20
10 – 50 10 – 50 2
50 – 150 50 – 225 5
FiO2 % 18 – 99 21 – 100 1 20 40
TEMP °C 29 – 40 36 – 41 1 33 39

1.7.17 Materials used
Patient valve Housing Nickel silver

Piston PEEK
Humidifier bottle Polysulfone (PSU),
yellow
Patient component Block, inspiration, and Anodized aluminum
expiration nozzles
Humidifier tube PTFE (Teflon)
Patient tube (reusable) Silicone rubber,
transparent, green, red
Y piece (reusable) Polysulfone (PSU),
yellow
Pneumotachograph Body PEEK, green
Centering tubes Stainless steel V4A
Pressure measurement lines (reusable) Pressure, pressure difference Silicone rubber,
transparent
Safety valves Valve disk Stainless steel
X5CrNi18-10
Glass filament fabric
Hgw 2372.1

®
2 Safety instructions
NOTE
Identifies additional information that is useful for device operation and intended to
avoid problems during use.
The following safety instructions are repeated at relevant points in the

operating manual and must be observed at all times.
DANGER
Identifies potentially dangerous situations that result in death or life-threatening injury

if not avoided.
WARNING
Identifies potentially dangerous situations that may result in death or serious injury if
not avoided.
CAUTION
Identifies potentially dangerous situations that may result in minor or moderate injury
if not avoided.

2.1 General safety instructions
The following general safety instructions relate to the operation of this

ventilator. Special safety instructions for functions or components of the
ventilator can be found in the corresponding chapters of this operating
manual.
DANGER
The ventilator may only be used by trained and authorized medical specialists.
The device must be operated according to the instructions in this operating manual.
DANGER
Risk of explosion!
Do not use any combustible or anesthetic gases.
DANGER
Use of the device in the vicinity of magnetic resonance imaging systems may degrade
its functionality, which can potentially put the patient and operator at risk.
DANGER
Never close the ventilation outlet behind the silencer. This may cause the device to
malfunction and put the patient at great risk.
DANGER
Always have a separate manual breathing bag handy.
Lack of an alternative ventilation method may result in patient death if the ventilator
fails.

®
DANGER
Only use original pressure measurement lines from FRITZ STEPHAN GMBH.
The use of pressure measurement lines made from different materials, of different
lengths or diameters, or with different compliance to those/that intended by the
ventilator’s manufacturer can impair the pressure measurement. This can sometimes
lead to the safety valve opening and ventilation being interrupted.
WARNING
The ventilator must not be covered or positioned so as to impair its operation or

performance.
WARNING
Burns may be caused by antistatic or electro-conductive patient tubing when using
electrical high-frequency surgical instruments at the same time. Therefore, do not use
antistatic or electro-conductive patient tubing or lines.
WARNING
Never operate the ventilator with helium or mixtures containing helium.
WARNING
Only use the patient tubing and accessories listed in chapters 1.1 (Product
combination) and 15 (List of accessories). Using other patient tubing or accessories
not intended for use with the ventilator may impair device performance and safety.
WARNING
Do not operate the ventilator outside the specified ambient conditions

(see chapter 1.7). Its functionality may otherwise be impaired.

WARNING
Short wave therapy devices, RF diathermy devices, defibrillators, and similar
equipment in close proximity of the device may impair device functionality. In such
cases, the patient and device must be monitored continuously.
WARNING
Never use the ventilator in a hyperbaric chamber.
This can impair the operation of the device and thereby pose a risk to the patient’s
safety.
WARNING
Non-invasive ventilation is not intended for patients without sufficient spontaneous
breathing (e.g. diaphragm or abdominal wall defects, meconium aspiration, or high
grades of postpartal asphyxia).
WARNING
IEC 60601-1 and IEC 62353 must be observed specifically for medical devices with
an electrical connection. According to these directives, such devices must only be
repaired by the manufacturer or an entity explicitly authorized by the manufacturer for
this purpose.
WARNING
Never use the ventilator in a hyperbaric chamber.
This can impair the operation of the device and thereby pose a risk to the patient’s
safety.
WARNING
Only authorized customer service staff of FRITZ STEPHAN GMBH are permitted to
alter, modify, repair, or open the device, or to replace the battery. This does not
include the dismantling of the patient component according to the operating
instructions. When servicing the device, only use spare parts from FRITZ STEPHAN
GMBH.
WARNING
The device must be secured using a supporting bracket when attached to wall rails.

®
WARNING
When analyzing the composition of the respiratory gas for research purposes, please
note:
 The respiratory gas outlet behind the silencer must not be closed!
 The device must only be operated under the permanent monitoring of
appropriately trained staff.
 The outlet tube must be rated with a tube diameter of >1 cm and a length of
< 20 cm.
WARNING
Medical electrical equipment or systems should not be used adjacent to or stacked
with other equipment. If adjacent or stacked use is necessary, the medical electrical
equipment or system should be monitored to verify its intended operation in the
configuration in which it is used.
WARNING
Adding system parts or other components or sub-assemblies to the ventilator’s
ventilation system can negatively affect the pressure gradient across the ventilator’s
ventilation system, measured at the patient connection port.

®
3 Design and functional description
3.1 Front view
Fig. 1: Front view
1 Function buttons 5 »IGR« control knob

2 »ON« button 6 Patient component
3 Power source indicator 7 Selection buttons
(right-hand parameter display)
4 Selection buttons 8 Monitor unit
(bottom parameter display)

»ON« button Press »ON« to start the ventilator. The SOPHIE performs a system selftest
and automatically calibrates the pressure and O2 sensors. The “Ventilation”
menu then opens and enables the user to select the desired ventilation
mode.
The LED above the »ON« button is lit only when it can be used to switch
on the ventilator. It is not lit during operation or in standby, test, or break
mode.
NOTE
For units with touch-sensitive buttons (manufactured
until 2010), the design of the »ON« button differs
from the model described here, but its function is
identical.
»ON« button
»IGR« control knob Use the »IGR« push and turn knob to select and activate all indirect
functions on the SOPHIE.
The »IGR« can be used to:
 Switch within the menus
 Select and execute menu functions
 Set parameters
Turn the »IGR« clockwise or counterclockwise to scroll through the
available menu options. While scrolling, the individual options are
highlighted in succession. Press a menu option to execute the
corresponding function or open a sub-menu.
»Selection« buttons »Selection« buttons are located along the right and bottom edge of the
monitor. Pressing them triggers a short acoustic signal and opens the
corresponding menu or parameter field. Turn the »IGR« knob to change
the value. Finish your input by clicking with the »IGR« knob or pressing
the selection button again.
NOTE
More information on using the »IGR« and the »Selection« buttons can be found in
chapter 4.1 from page 82 and chapter 5.1 from page 107.

®
NOTE
Only available on devices with touch-sensitive
buttons (manufactured until 2010).
Alternately, use the »-« and »+« buttons instead of
the »IGR« to scroll through the menu options or
»-/+« buttons
switch between parameter fields.
3.1.1 Power source indicator
Fig. 2: Power source indicator
1 Mains power indicator 3 External DC power source

indicator (optional)
2 Internal battery indicator
If the ventilator is connected to a power source and the power switch is

switched on (see chapter 3.4.2 from page 78), the display indicates which
power source is active and shows the charge status of the internal battery as
follows:
 Green LED Battery level between 50 and 100%
 Yellow LED Battery level between 20 and 50%
 Red LED Battery level between 0 and 20%
Mains power The mains power indicator lights up green. The internal battery is
(100 – 240 V) recharged automatically as needed. The current battery level is shown by
the internal battery indicator.
Battery operation Only the internal battery indicator lights up and indicates the current
battery level.

External power source The external power source indicator lights up green. The internal battery is
(24 V) (optional) recharged automatically as needed. The current battery level is shown by
the internal battery indicator.
WARNING
In case of a power failure, the internal battery supplies power to the device for a
minimum of 60 minutes. The battery must be recharged at least every 14 days. A
safety circuit prevents the battery from being overcharged.
WARNING
If the maximum number of charge cycles has been reached, the battery must be
replaced. This can only be done by the authorized FRITZ STEPHAN GMBH customer
service team.
WARNING
FRITZ STEPHAN GMBH does not recommend operating the ventilator with a low
battery (capacity < 10%) as the device will switch off immediately in the event of a
power failure.
WARNING
The humidity must not exceed 80% during storage and operation, otherwise the
battery may be damaged.
WARNING
The ambient temperature must not exceed 40°C during storage and operation,
otherwise the battery may be damaged.

®
3.1.2 Function buttons
a b
Fig. 3: Function buttons
1 »Alarm suppression/ 5 »Preoxy« button

acknowledgment« button
2 »Alarm menu« button 6 »Inspiration hold« button
3 »Stop« button 7 »Main menu« button
4 »Aerosol« button
NOTE
A short acoustic signal can be heard when one of the function buttons is pressed.

NOTE
For devices with touch-sensitive buttons (manufactured until 2010), the design of
some keys in the function area is different (see Fig. 3b), but its function is identical.
»Alarm suppression/ Briefly pressing this button will suppress acoustic alarms for 120 s. This is
acknowledgment« indicated by a yellow symbol in the status, alarm, and info display
button (see chapter 3.2.7 from page 55). Acoustic alarm suppression only applies
to the current alarm. Every new alarm immediately cancels the acoustic
alarm suppression again. Alarm suppression can also be canceled by
pressing the button again.
If the »alarm suppression« button is pressed twice within a period of three

seconds, all incoming acoustic alarms are suppressed completely for 120 s.
This is indicated by a red symbol in the status, alarm, and info display.
Alarm suppression can also be canceled by pressing the button again.
Fig. 4: Status, alarm, and info display with activated alarm suppression
The LED on the »Alarm suppression/acknowledgment« button also

indicates the current alarm status:*
 Green No alarm
 Yellow Low-priority alarm
 Yellow Flashing Medium-priority alarm
 Red Flashing rapidly High-priority alarm
 Red Acoustic alarm suppressed
After eliminating the causes of an alarm, the alarm remains stored in the
SOPHIE alarm history and displayed in green font. Press the »Alarm
suppression/acknowledgment« button to clear the alarm list.
WARNING
When using the special alarm suppression mode, ensure that the alarm is reactivated
before leaving the child.

®
»Alarm menu« button

Opens the “Alarmlimits” menu for setting the alarm limits during ongoing
ventilation. Use the »IGR« to select the settings (see also chapter 4.2.1
from page 85).
Press the »Stop« button to freeze the graphic display for better observation
»Stop« button
of a ventilation event. This also opens the Measure menu for measuring the
curves. The status, alarm, and info display together with the measured
value display continue to provide information about the current ventilation
situation. Press the button again to cancel this function. If the function is
activated, the special functions area lights up blue and the “S” symbol
appears (see chapter 3.2.6 from page 54).
»Aerosol« button Press the »Aerosol« button to switch on aerosol nebulization. The aerosol
nebulization duration can be set between 30 and 420 s under “Extra-func.”
 “Aerosol-time” in the Main menu (see chapter 4.2.6 from page 100).
The nebulization ends automatically at the end of the set time or when the
button is pressed again. The current time setting is displayed in the special
functions area of the monitor (see Fig. 5/item 5). If the function is
activated, the special functions area lights up blue, the symbol “A” appears,
and the countdown starts (see chapter 3.2.6 from page 54).
NOTE
For devices with touch-sensitive buttons (manufactured until
2010), the design of the »Aerosol« button differs from the
model described here, but its function is identical.
»Aerosol«
button
WARNING
Aerosols can impair or damage the patient component and thus pose a risk to the
patient! When administering medication using nebulization, an expiration filter must
always be fitted between the EXP connection piece and the expiration tube.
»Preoxy« button Press the »Preoxy« button to administer a pre-configurable inspiratory

oxygen concentration for a certain preset interval. The time can be set
between 30 and 420 s in the Main menu under “Extra-func.”  “Preoxy
time” or switched off entirely. The current time setting is displayed in the
special functions area of the monitor (see Fig. 5/item 5).

The inspiratory oxygen concentration can be set in the Main menu under
“Extra-func.”  “Preoxy %” (see chapter 4.2.6 from page 100). If the
function is activated, the special functions area lights up blue, the symbol
“P” appears, and the countdown starts (see chapter 3.2.6 from page 54). At
the same time, the display of the set oxygen concentration changes to the
pre-set "preoxy" value. The oxygen concentration alarm limits are adjusted
automatically.
NOTE
If the “Pmean high” alarm is activated, the »Insp.hold« button is automatically

deactivated.
NOTE
For devices with touch-sensitive buttons (manufactured
until 2010), the design of the “Preoxy” button differs from
the model described here, but its function is identical.
»Preoxy« button
»Insp.hold« button Press the »Insp. hold« button during:

Inspiration: To hold inspiration at the final inspiration pressure level
after the end of normal inspiration for the duration of the
set inspiration time (when selecting the option »Tinsp«) or
for 1 to 7 s.
Expiration: To trigger mandatory inspiration with the set ventilation
parameters.
Set the required time or the »Tinsp« option in the Main menu under
“Extra-func.”  “Insp. hold” (see chapter 4.2.6 from page 100). The
current time setting is displayed in the special functions area of the monitor
(see Fig. 5/item 5).
If the function is activated, the special functions area lights up blue, the
symbol “I” appears, and the countdown starts (see chapter 3.2.6 from page
54).
NOTE
If the “Pmean high” alarm is activated, the »Insp.hold« button is automatically

deactivated.

®
»Main menu« button

Press this button to open the Main menu. Use the »IGR« to scroll through
the menu options. Activate the menu options by clicking with the »IGR« or
by pressing the »Main menu« button again (see chapter 4.1 from page 82).
Pressing this button while in the Ventilation menu or parameter settings
closes them. In this case, changed settings are not applied.
NOTE
A detailed description of the Main menu and its corresponding functions can be found
in chapter 4 from page 81.

3.2 Monitor unit
Fig. 5: Monitor unit
1 Measured value display with 6 Date and time display

configurable alarm limits
2 Main menu 7 Status, alarm, and info display
3 Ventilation menu 8 Graphic display
(ventilation mode indication and
selection)
4 Parameter display 9 Expiratory trigger status (if an
external trigger is activated)
5 Special functions display 10 Apnea counter for non-invasive
ventilation

®
3.2.1 Measured value display
This display provides a quick view of the relevant measured values

together with the alarm limits shown after the measured value. The alarm
limits can be can be adjusted manually in the Main menu or by pressing the
»Alarm menu« button (see chapter 3.1.2). A detailed description of how to
set the alarm limits can be found in chapter 4.2.1 from page 85.
a) b) c) d)
Fig. 6: Measured value displays
a) Measured value display with PNT

b) Measured value display without PNT
c) Measured value display CPAP with HFO
d) Measured value display NCPAP

NOTE
If a value violates the upper or lower active alarm limit, the corresponding measured
value field is highlighted in red. In addition, an error message appears in the status,
alarm, and info display.
No. Measured Description Unit

value
1 Pmax Maximum end inspiratory breathing pressure cmH₂O
2 Posc Pressure amplitude during oscillation cmH₂O
3 Pmean Mean airway pressure cmH₂O
4 PEEP Positive end expiratory pressure cmH₂O
5 MV Respiratory minute volume l/min
MVO Respiratory minute volume during oscillation l/min
6 VTI Inspiratory tidal volume ml
VTE Expiratory tidal volume ml
VTo Tidal volume during oscillation ml
7 Leak Leak volume ml
8 FiO2 Inspiratory oxygen concentration %
9 Temp Proximal respiratory gas temperature °C
10 Insp% Relative inspiration time %
11 f Breathing frequency /min
12 R Patient and tube resistance cmH₂O l/s
13 C Patient compliance ml / cmH₂O
14 DCO2 Gas transport coefficient ml2/s.
Tab. 3: Measured value display
NOTE
Active alarm limits are shown in red font behind the measured values. If the alarm
limits are not active, they are shown in gray in night mode and in yellow in day mode.

®
3.2.2 Main menu
Fig. 7: Main menu opened
Select the Main menu using the »IGR«. The field turns green.
Click with the »IGR« or press the »Main menu« button to open
the menu (see chapter 3.1.2 from page 43).
NOTE
A detailed description of the Main menu and its corresponding functions can be found
in chapter 4 from page 81.

3.2.3 Ventilation menu
Fig. 8: Ventilation menu opened
Open the Ventilation menu using the »IGR« or the corresponding selection
button. The field turns green. In the Ventilation menu, use the »IGR« to
select the ventilation mode. The selected field is highlighted in blue. Click
with the »IGR« or press the selection button to confirm the selection.
NOTE
A detailed description of the Ventilation menu can be found in chapter 5 from page
107.

®
3.2.4 Ventilation parameter display
Fig. 9: Parameter display
1 Parameter display 2 Parameter display

(bottom edge of monitor) (right edge of monitor)
The parameter setting fields are located along the right and bottom edge of
the monitor. When selecting a ventilation mode, a pop-up menu appears
listing all the necessary parameters.
To change a ventilation parameter during ongoing ventilation, open the
corresponding parameter field using the »IGR« or directly using the
corresponding »selection button«.
Use the »IGR« to make the adjustment. Click with the »IGR« or press
the corresponding »selection« button to save and exit the setting
(see chapter 3.1 from page 39).
NOTE
More information on setting the ventilation parameters can be found in chapter 5,

from page 107.

3.2.5 Date and time display
The current date (DD.MM:YY) and time are shown in the first two lines of
the parameter display on the right side of monitor (see Fig. 5).
NOTE
If the trend display is activated in the curve area, the time is not displayed.
3.2.6 Special functions display
Fig. 10: Special functions display
1 Aerosol nebulization display 3 Preoxygenation display

2 Active special functions display 4 Inspiration hold display
The special functions display constantly shows the current time settings for
aerosol nebulization, preoxygenation, and inspiration hold in seconds.
If the »Preoxy«, »Insp.hold«, »Aerosol«, or »Stop« buttons are pressed
(see chapter 3.1.2 from page 43), the color of the special functions display
changes to blue while in use; the corresponding symbol appears and the set
time starts to count down.
The following symbols are used:

»Preoxy« P
»Insp. hold« I
»Aerosol« A
»Stop« S

®
3.2.7 Status, alarm, and info display
Fig. 11: Status, alarm, and info display
1 Latest alarm according to priority 6 Heating on/off

(e.g. Min. volume low)
2 Acoustic alarm suppression 7 Ventilation mode
3 Trigger type 8 Other alarm messages (in order
of priority/chronological)
4 Backup ventilation mode 9 Charge indicator for the
internal battery or remaining
run time
5 PNT type 10 Transport mode on
Tab. 4: Status, alarm, and info display

3.2.7.1 Alarm messages
The SOPHIE has several alarms that protect the patient and inform the user
about changes in the patient’s condition or possible faults with the device.
The visual and acoustic alarms are compliant with IEC 60601-1-8. All
alarms are emitted not only acoustically, but also visually in plain text
format with color coding depending on their priority.
High priority alarm An alarm indicating that the user should intervene without delay.
Color: Red
Sequence:
Alarm of at least An alarm of at least medium priority is evaluated as a medium priority

medium priority alarm (MP) when the alarm situation occurs; it progresses to a high priority
alarm (HP) 30 seconds later.
Color: Yellow/red (after 30 s)
Sequence:
Medium priority alarm An alarm indicating that the user should intervene immediately.
Color: Yellow
Sequence:
NOTE
All notification and alarm messages together with their causes and remedies can be
found in chapter 11 from page 211.
Deleting alarm Once the causes for an alarm have been eliminated, the corresponding
messages alarm appears with a green background. Press the »Alarm
suppression/acknowledgment« button to clear the alarm list
(see chapter 3.1.2).

®
3.2.7.2 Internal battery level indicator
When the device is running on mains power, the battery level is depicted
by a bar graph. If the Sophie switches to battery power, the display shows
the ventilator’s remaining run time in minutes.
Display Battery level
80% - 100%
60% - 80%
40% - 60%
20% - 40%
0% - 20%
Battery 60 min Remaining
run time
Tab. 5: Battery level
NOTE
The power source indicator on the front of the SOPHIE housing also shows the
internal battery level (see chapter 3.1.1 from page 41).
NOTE
The battery should be completely discharged and recharged twice in a row every
6 – 12 months. This re-calibrates the calculation of the battery capacity to ensure
maximum accuracy of the battery level indicator.

3.2.8 Graphic display
You can choose to display two or three curves.

This can be set in the Main menu under “Curves”
(see chapter 4.2.2.1 from page 88)
Fig. 12: Default graphic display (two curves)
Fig. 13: Alternate graphic display (three curves)

®
Fig. 14: Graphic display with activated trend
NOTE
If curves 2 and 3 show the same information, the two displays are automatically
combined into an enlarged screen for better readability (see Fig. 15). This view is
particularly useful for loops and trends.
Fig. 15: Enlarged window showing identical information for curves 2 and 3

No. Display Description

1 PMAX UL (red) Displays the upper limit for the alarm limit value PMAX
2 Pressure curve Mean value of the inspiration and expiration tube pressures
(yellow) of the ventilation tube
To monitor the pressure alarm limit value, the inspiration
and expiration pressures are measured.
3 PMAX LL (green) Displays the lower limit for the alarm limit value PMAX
4 C Controlled breath
Ax Assisted breath / x: backup stage (1-5)
Bx Backup breath / x: backup stage (1-5)
S Spontaneous breath without pressure support
5 Trigger Corresponds to the settings in the “Trigger” menu
(blue) (see chapter 4.2.7.3):
Flow trigger Light blue trigger line in the curve V’(t)
Pressure trigger Brown trigger line in the curve P(t)
Ext. trigger Brown trigger line in the curve E(t)
Flow limit line The flow limit line can be set in the Ventilation menu by
(blue) selecting HFO ventilation (see chapter 5.4.2 from page 127
and chapter 5.4.7 from page 133). It monitors the mean flow
6 2. panel The second curve (2. panel) can be selected in the “Curves”
menu (see chapter 4.2.2.1 from page 88).
You can select the curves for volume flow V’(t), volume
V(t), and external trigger E(t), as well as the loops V(P),
V’(P), and V’(V).
7 3. panel The third curve (3. panel) can be selected in the “Curves”
menu (see chapter 4.2.2.1 from page 88).
You can select the curves for volume flow V’(t), volume
V(t), and external trigger E(t), as well as the loops V(P),
V’(P), and V’(V).
8 Trend Pmean Displays the progress of the mean airway pressure over a
defined period
9 Trend volume Displays the progress of the respiratory minute volume or
the tidal volume, depending on the selected option for 2.
or 3. panel.
2. / 3. panel V’(t): respiratory minute volume trend
2. / 3. panel V(t): tidal volume trend
Tab. 6: Graphic display

®
3.2.9 External expiratory trigger status
When selecting the external trigger, the respiration sensor can also be used
to record the inspiration end. The status of the expiratory trigger is then
displayed on the left, below the bottom graphic display.
Fig. 16: External expiratory trigger status and apnea counter with NIV
3.2.10 Apnea counter
With non-invasive ventilation, an apnea counter is displayed to the right

and below the bottom graphic display (see Fig. 16). It shows the number of
apneas detected by the ventilator during the last hour.

3.3 Right side view
Fig. 17: Right side view
1 Patient component 5 Gas supply connections

2 Connection panel 6 Sterile water bag holder
3 HFO label 7 Respiration sensor connection
(optional)
4 Fill level sensor for humidifier
bottle
HFO label Detailed descriptions for using the »HFO« sealing plug can be found in
chapter 9.6 from page 188.

®
3.3.1 Patient component
Fig. 18: Front and side views of the patient component
1 Inspiration tube connection 7 Luer lock connection

2 Positive pressure safety valve Intake fitting for filling the
Pmax humidifier bottle
3 Expiration tube connection 8 Silencer
4 Locking screw 9 »HFO« sealing plug
5 Pressure measurement nozzle 10 Humidifier bottle
with attached pressure
measurement tube
6 Patient valve
DANGER
Only use original pressure measurement lines from FRITZ STEPHAN GMBH.
The use of pressure measurement lines made from different materials, of different
lengths or diameters, or with different compliance to those/that intended by the
ventilator’s manufacturer can impair the pressure measurement. This can sometimes
lead to the safety valve opening and ventilation being interrupted.

DANGER
Never close the ventilation outlet behind the silencer.

This may cause the device to malfunction and put the patient at great risk.
WARNING
Never unscrew the humidifier bottle during operation! The humidifier chamber is
pressurized.
NOTE
Make sure that the pressure measurement tube is connected correctly.
HFO sealing plug Instructions for using the HFO sealing plug can be found in chapter 9.6
from page 188.
Positive pressure safety Name: Pmax

valve Pmax Setting range: 40 – 70
Unit: cmH₂O
WARNING
The set value for the positive pressure safety valve Pmax must always be higher than
the value for inspiratory peak pressure Pmax set via »IGR« in the Ventilation menu

®
3.3.2 Reusable patient tube systems
Intended use Heated tube systems used to deliver and return the patient's respiratory gas
in connection with the ICU respirators STEPHANIE and SOPHIE from Fritz
Stephan GmbH. This patient tube system is reusable (see chapter 13.4).
CAUTION
Always hold the patient tube by the sleeve when connecting and disconnecting it to
prevent damage.
Do not stretch, compress or twist the tube system!
CAUTION
Do not cover the tube system with blankets, towels or similar items! This could cause
the tube system to overheat.
CAUTION
Do not use tube supports that are too narrow or have sharp edges!
CAUTION
If the gas supply is interrupted or deactivated, the heating function must be switched
off!
CAUTION
Before using the tube system, check that all connection plug screws are tight!
CAUTION
Avoid prolonged direct contact with the patient's skin!

CAUTION
Check the tube system for the accumulation of condensation at short intervals over the
course of its use.
3.3.2.1 Tube system for incubators
Fig. 19: Tube system for incubators (Art. no. 100761500)
1 Distal temperature sensor 6 Inspiration tube

2 Proximal temperature sensor 7 Expiration tube
3 Y piece 8 Heated part
4 Pneumotachograph 9 Unheated part
5 Pneumotachograph plug

®
3.3.2.2 Tube system for warming beds
Fig. 20: Tube system for warming beds (Art. no. 100761550)
1 Distal temperature sensor 6 Inspiration tube

2 Proximal temperature sensor 7 Expiration tube
3 Y piece 8 Heated part
4 Pneumotachograph 9 Unheated part
5 Pneumotachograph plug

3.3.3 Disposable patient tube system
NOTE
For information about using the device as intended, about warnings and safety
instructions, as well as technical data, refer to the operating manual provided with the
tube system.
CAUTION
Always hold the patient tube by the sleeve when connecting and disconnecting it to
prevent damage.
Fig. 21: Disposable tube system P3/P7 (Art. no. 100761300)
1 Distal temperature sensor for 5 Pneumotachograph plug

disposable patient tube system (reusable)
(Art. no. 100761300)
2 Proximal temperature sensor for 6 Inspiration tube
disposable patient tube system
(Art. no. 100761300)
3 Y piece 7 Expiration tube
4 Pneumotachograph (reusable) 8 Tube heater adapter (reusable)

®
3.3.4 Connection panel
Fig. 22: Connection panel
1 Aerosol nebulizer 4 Pressure measurement tube

2 Tube heater 5 Pneumotachograph
3 Temperature sensor

3.3.5 Automatic refill system (optional)
The advantage of the optional automatic refill system is that the humidifier
bottle retains an almost constant fill level. This allows optimal breathing
gas conditioning.
CAUTION
Only fill the humidifier bottle with distilled demineralized water.
Fig. 23: Sophie with automatic refill system
1 Driving gas outlet 6 Aqua dest. tube

2 Tube pinch valve with push 7 Transfer spike
button for inserting the tube
3 Aqua dest. inlet 8 Aqua dest. bottle
4 Driving gas tube 9 Bottle holder
5 Fill level sensors

®
NOTE
The connection piece (Art. no. 103860035) for the automatic refill system is only
intended for single use.
CAUTION
Do not reuse disposable accessories! The necessary reconditioning may lead to the
deterioration of mechanical and biological product properties, posing a significant risk
to the patient. In addition, reusing such accessories dangerously increases the risk of
contamination for the patient.
3.3.5.1 Preparation
The automatic refill system is to be connected as shown below:
 Insert the transfer spike (7) with the tubes for aqua dest. (6) and driving
gas (4) into the bottle (8) containing aqua dest.
Fig. 24: Inserting the transfer spike into bottle containing aqua dest.

 Attach the tube (4) to the driving gas outlet (1) on the patient
component.
Fig. 25: Attaching the tube to the driving gas outlet
 Connect the aqua dest. tube (6) to the aqua dest. inlet (3) on the patient
component.
 Fold down the tube pinch valve (2).
Fig. 26: Attaching the tube and folding down the pinch valve

®
 Press the push-button on the pinch valve (2) and insert the tube (6).
Fig. 27: Pressing the push-button and inserting the tube
 Attach the aqua dest. bottle (8) to the holder (9).
Fig. 28: Attaching the aqua dest. bottle to the holder
The installation of the automatic refill system is now complete.

NOTE
When changing bottles or disconnecting tube from the automatic refill system, we
recommend removing the bottle from the holder first and turning it upside down to
avoid spilling distilled water.
NOTE
The automatic refill system is switched off as soon as the tube pinch valve (2) is
folded up.
3.3.5.2 Functional principle
The automatic refill system can be switched on and off in the “Heating”
menu (see chapter 4.2.5). When the system is active, it monitors the water
level of the humidifier bottle via three sensors and refills it automatically if
required.
After starting the system, a test of the sensors is initiated. If all three
sensors are inactive and the fill level of the humidifier bottle is therefore
below the minimum level, the heater is switched off automatically and the
MP alert “Waterlevel low” is generated. The automatic refill system now
pumps driving gas into the bottle of distilled water and the tube pinch valve
is opened automatically. The humidifier bottle starts to fill.
NOTE
If the system is not filled sufficiently after 20 minutes, the MHP alarm “Waterlevel?”
is generated. In this case, all connections, tubes and the container with distilled water
should be re-checked.
When the minimum level is exceeded, the first sensor will emit a signal.
The MP alarm “Waterlevel low” is switched off.
It is now possible to turn on the heater. The filling of the humidifier bottle
will continue until the optimal fill level is reached, which is then signaled
by the second sensor. The automatic refill system now turns off the driving
gas and the tube pinch valve is closed.

®
Should the fill level drop below the optimum level during operation, a
timer is activated and the refill process starts again after five minutes. As a
result, the water level of the humidifier bottle is kept constant during the
entire ventilation process, and optimal breathing gas conditions are
reached.
NOTE
A timer-based delay function prevents the continuous activation and deactivation of

the automatic refill system.
Should the maximum fill level of the humidifier bottle be exceeded due to
a malfunction, this is immediately signaled by the third sensor and the HP
alarm “Waterlevel high” is activated. In this case, check that the sensors
and pinch valve are functioning correctly and notify the FRITZ STEPHAN
GMBH customer service team if necessary.
NOTE
The sensor signals are constantly checked for plausibility during operation of the refill
system. Should a malfunction results in a logical error, the automatic refill system is
switched off and the MP alarm “Refill fail” is triggered. In this case, check that the
sensors are functioning correctly and notify the FRITZ STEPHAN GMBH customer
service team if necessary.

3.4 Rear view
Fig. 29: Rear view
1 Pneumatic module 3 Interface

2 Power supply module 4 Y piece park position

®
3.4.1 Pneumatic module
Fig. 30: Pneumatic module
1 Oxygen sensor 3 Water separator with filter

2 O2 connection (NIST) 4 AIR connection (NIST)

3.4.2 Power supply module and interfaces
Fig. 31: Power supply module and interfaces
1 Mains fuses 5 Power socket

2 »Reset« button 6 »ON/OFF« power switch
3 Equipotential bonding 7 On-board power supply
(24 V DC) (optional)
4 Serial interface RS 232
(galvanically isolated)
»Reset« button The SOPHIE is typically shut down by activating the »Standby/OFF«
special function in the “Ventilation” menu (see chapter 5.2.1 from page
115). If the Sophie does not shut down due to a malfunction, proceed as
follows:
 Switch off the »ON/OFF« power switch.
 Use a pen to press the »Reset« button to shut down the unit.
CAUTION
If this situation arises, contact the FRITZ STEPHAN GMBH customer service team.

®
3.5 Mobile stand
Fig. 32: Mobile stand
1 Support for the Sophie 4 Tube holder (optional)

2 Handle 5 Storage basket (optional)
3 Tube holder (optional) 6 Castors (4, 2 with brakes)

®
4 Main menu
4 Main menu
The Main menu contains six sub-menus, some of them branching into as
many as five sub-levels.
Alarmlimits
Curves
View
Measure
Heating
Extra-func.
Options
Exit
Main menu
Fig. 33: Main menu opened
The following section provides a brief description and explanation of the

operating concept and all sub-menus.

4 Main menu
4.1 Operating concept
Operation using »IGR« The entire Main menu can be controlled using the central »IGR« push
and turn knob:
 Turn the »IGR« to select the “Main menu” field. The field turns
green.
 Click (press) the »IGR« to open the Main menu.
 Turn the »IGR« clockwise or counterclockwise to scroll through
the available menu options. The selected option is highlighted in
red.
 Click the »IGR« to carry out the corresponding function or open
a sub-menu.
 Set parameters or switch functions on and off by turning the
»IGR«.
 Click the »IGR« to exit the setting.
NOTE
The Main menu can also be opened and closed using the »Main menu« button.
Detailed information on the »Main menu« button can be found in chapter 3.1.2 from
page 43.
NOTE
Detailed information on the »IGR« can be found in chapter 3.1 from page 39.
Switching functions Some functions in the Main menu (e.g. Heating) can be switched on and
on and off/setting off, while others require numerical values to be set (e.g. Temperature). To
numerical values do so, select and open the function. Above the menu, a yellow field
shows the current status or current numerical value of the function. Turn
the »IGR« to select the desired setting, then press the »IGR« knob to
confirm the new entry.

®
4 Main menu
Off On
Man. modify Man. modify Man. modify
FiO2 follow off FiO2 follow on FiO2 follow on
VT filter VT filter VT filter
Transport Transport Transport
Return Return Return
Exit Exit Exit
Alarmlimits Alarmlimits Alarmlimits
Fig. 34: Setting the function “FIO2 follow on/off”
NOTE
“On” or “off” after a function always indicates the current function status. For
example, if “FiO2 follow on” is displayed, this indicates that the function “FiO2
follow” is activated. For clarity purposes, the functions with a status indicator are
always shown with both options in the operating manual (e.g.: “FiO2 follow on/off”).
Temp °C
37
Heating on/off
Temperature
Humidity
Refill on/off
Return
Exit
Heating
Fig. 35: Setting the respiratory gas temperature

4 Main menu
“Return” function The “Return” function can be found in every sub-menu. When activated,
it takes the user back to the next higher menu. The next higher menu is
always shown in the bottom green field of every sub-menu.
“Exit” function The “Exit“ function can be found in every menu. When activated, the
Main menu closes and previously changed settings are applied.
Non-selectable The Sophie has several optional components such as the refill system.
functions Depending on the device version, this means that it may not be possible
to select some of the menu functions. These functions are grayed out (see
the “Refill” function in Fig. 35).

®
4 Main menu
4.2 Menu structure
4.2.1 “Alarmlimits” menu
The “Alarmlimits” sub-menu offers the following functions which are

explained below:
Change
FiO2 follow on/off
VT filter
Transport on/off
Return
Exit
Alarmlimits
Fig. 36: “Alarmlimits” menu
4.2.1.1 “Change”
The “Change” function in the “Alarmlimits” menu lets you adjust the
alarm limits to the specific needs of the patient during ongoing
ventilation. This can also be done by pressing the »Alarm menu« button
(see chapter 3.1.2).
In both cases, a pop-up menu opens, showing the effective upper and
lower alarm limits together with the current measured values. To change
the alarm limits:
 Use the »IGR« to select the desired alarm limit and click to open the
setting. The alarm limit is highlighted in yellow.
 Adjust the value by turning the »IGR«. Click again to exit. The new
value takes effect immediately for the ongoing ventilation.
 Proceed accordingly to adjust the next value.
 When you are happy with the settings, use the »IGR« to select the
»Close« box and click to close the pop-up menu.

4 Main menu
Fig. 37: “Alarmlimits” pop-up menu
1 Effective alarm limit 5 Current measured value

2 “Auto” field 6 Lower alarm limit
3 Name and unit 7 “Close” field
4 Upper alarm limit
Parameter Unit Lower limit Upper limit

Pmax cmH₂O 1 – 60 2 – 70
POSC cmH₂O 0 – 149 1 – 150
Pmean cmH₂O 0 – 40 1 – 60
MV l/min 0.1 – 9.90 0.2 – 19.9
MVO
VTE ml 0 – 150 1 – 225
VO ml 0 – 150 –
FiO2 % 18 – 99 21 – 100
TEMP °C 29 – 40 36 – 41
Tab. 7: Adjustable alarm limits
NOTE
If the MAP or PEEP levels are changed, the alarm limits for the mean airway pressure
(only CPAP-HFO/NCPAP) will be adjusted automatically. If the alarm limit was
previously set manually, this setting will be automatically overwritten!

®
4 Main menu
»Auto«
Selecting the »Auto« field will automatically fix the alarm limits within
specific limits above and below the corresponding settings/measured
values and immediately apply them for the ongoing ventilation.
Selecting the »Close« field closes the pop-up menu.
The following table illustrates how the automatic alarm limits are
calculated.
NOTE
The automatic setting of the alarm limits cannot cover all conceivable ventilation
situations. To ensure optimal patient safety, all alarm limits must be checked before
starting ventilation.

Pmax cmH₂O PEEP + x  (Pmax – PEEP) Pmax + 10
x = 0.4 VolLim on
x = 0.5 HFO on
x = 0.7 general
Posc cmH₂O 0.7  Posc 1.3  Posc
Pmean cmH₂O PEEP -3 (actual value) PEEP + 3 (actual value)
MAP -3 (actual value) MAP + 3 (actual value)
V´ l/min 0.5  measured V´ 2  measured V´
MVo l/min MVo – 0.75 * MVo MVo + 0.75 * MVo
Vo ml Vo – 0.75 * Vo
VT ml VT – 0.75 * VT VtLim (Tar) + 0.5* VtLim (Tar)
FiO2 % set FiO2 – 10 set FiO2 + 10
but not less than 18% but not greater than 100%
TEMP °C set TEMP – 3 set TEMP + 3
but not less than 29°C but not greater than 41°C
Tab. 8: Automatic alarm limits

4 Main menu
NOTE
If the alarm limits are set automatically, the default minimum value for VT and MV is
0.1 ml. Values below 0.1 ml have to be set manually.
4.2.1.2 “FiO2 follow on/off”
Switches the function for automatically adjusting the FiO2 alarm limit
value following changes to the »FiO2« parameter on or off.

FiO2 % FiO2 – 5 FiO2 + 5
4.2.1.3 “VT filter”
This function can be used to set the minimum tidal volume for SIMV
ventilation between 0.2 and 10 ml. This determines the threshold value
for the tidal volume above which a spontaneous breath is evaluated as
complete and is thus taken into account for alarm generation and
frequency determination.
4.2.1.4 “Transport on/off”

This function has been developed especially for the transport of a patient.
If activated, the Air inlet and Oxygen inlet alarm can be permanently
switched off by pressing the »Alarm suppression« button. The alarm will
be re-activated if the cause of the alarm is eliminated by restoring the gas
supply or if the “Transport” function is switched off.
WARNING
Prior to transportation, always verify that the SOPHIE fresh gas reservoir (compressed
gas cylinder) is sufficient for the planned transport.
If the Transport function is activated, this is shown in the status, alarm

and info display.

®
4 Main menu
Fig. 38: Transport function display
NOTE
The two alarms can only be switched off individually by pressing the »Alarm
suppression« button.
NOTE
In case of simultaneous failure of both the O2 and AIR supplies, the “Gas supply”
alarm is triggered automatically. This alarm cannot be permanently silenced.
4.2.2 “Curves” menu
2. panel
3. panel
Scale
Trend on/off
Return
Exit
Curves
Fig. 39: “Curves” menu
In the “Curves” menu, the second and third reference curve in the graphic
display can be selected and the trend display can be switched on or off.
The scale of the graphic displays can also be adjusted.

4 Main menu
4.2.2.1 “2. panel”
V(t) Volume time curve
V´(t) Flow time curve

V(p) Volume pressure loop
V´(V) Flow volume loop
V´(p) Flow pressure loop
E(t) Respiration sensor signal
Return
Exit
2. panel
Fig. 40: “2. panel” sub-menu
The “2. panel” sub-menu can be used to select the second reference curve
in the graphic display (see chapter 3.2.8 from page 58).
The currently selected curve is highlighted in blue when opening the
menu.
4.2.2.2 “3. panel”
V(t) Volume time curve
V´(t) Flow time curve

V(p) Volume pressure loop
V´(V) Flow volume loop
V´(p) Flow pressure loop
E(t) Respiration sensor signal
3. panel on/off Switches the third reference curve on or off
Return
Exit
3. panel
Fig. 41: “3. panel” sub-menu

®
4 Main menu
The “3. panel” sub-menu can be used to select the second reference curve
in the graphic display (see chapter 3.2.8 from page 58).
The currently selected curve is highlighted in blue when opening the
menu.
NOTE
If curves 2 and 3 show the same information, the two displays are automatically
combined into an enlarged screen for better readability (see Fig. 15). This view is
particularly useful for loops and trends.
4.2.2.3 “Scale”
Use the »IGR« to select all the scale values and change them according to
the following table.
Scale value Possible settings

P [cmH₂O] 15, 30, 60, 90
t [s] 4, 8, 16 (2, 4, 8 with activated trend display)
V [ml] 15, 45, 150, 450
V’ [l/min] 3, 6, 15, 45
E Arb 3, 6, 15, 45
P Trend [cmH₂O] 15, 30, 60, 90
MV Trend [l/min] 1.0, 2.0, 5.0, 10
VT Trend [ml] 15, 45, 150, 450
t Trend [min]/[h] 30 min, 1 h, 2 h, 4 h, 12 h, 24 h
Tab. 9: Scale
NOTE
The “Scale” function can only be activated during ongoing ventilation. If there is no
ongoing ventilation, the function is grayed out and cannot be selected.

4 Main menu
Scaling Scale value Scale from – to

P / P Trend [cmH₂O] -5 – 15 -10 – 30 -20 – 60 -30 – 90
t [s] 0–2 0–4 0–8 0 – 16
V / Vt Trend [ml] -5 – 15 -5 – 45 -30 – 150 -50 – 450
V’ [l/min] -3 – 3 -6 – 6 -15 – 15 -45 – 45
E Arb -3 – 3 -6 – 6 -15 – 15 -45 – 45
MV Trend [l/min] 0 – 1.0 0 – 2.0 0 – 5.0 0 – 10
t Trend [min]/[h] -30 min -1 h -2 h -4 h -12 h -24 h
Tab. 10: Scaling
4.2.2.4 “Trend on/off”
This function switches the trend display on and off.
4.2.3 “View” menu
Units on/off
Display VT
Limits on/off
Day/Night
Return
Exit
View
Fig. 42: “View” menu
The “View“ menu can be used to select the graphic options for the
monitor and to switch them on and off. You can also choose between day
and night view. The individual functions are described below.
4.2.3.1 “Units on/off”
These functions switch the monitor units on and off.

®
4 Main menu
4.2.3.2 “Display VT”
Use this function to select the type of tidal volume to appear in the
measured value display.
VT insp
VT exp
Return
Exit
Display VT
Fig. 43: “Display VT” sub-menu
VT insp The measured value display shows the inspiratory tidal volume VTi
(see chapter 3.2.1 from page 49).
VT exp The measured value display shows the expiratory tidal volume VTe
The currently selected VT is highlighted in blue when opening the menu.
NOTE
The “Display VT” menu cannot be selected during ventilation modes without PNT or
high frequency oscillation.
4.2.3.3 “Limits on/off”
Use this function to switch the alarm limits display on and off in the
measured value display.
NOTE
The alarm limits continue to be monitored even when the display is switched off.

4 Main menu
4.2.3.4 “Day/Night” view
Use this function to switch to day or night view.
Fig. 44: Day view
Fig. 45: Night view

®
4 Main menu
4.2.4 “Measure” menu
Cursor 1
Cursor 2
Return
Exit
Measure
Fig. 46: Measure menu
The Measure function freezes the curves in the graphic display.

Ventilation continues in the background.
“Cursor 1” and “Cursor 2” can be used to select two points on the curve.
The absolute values and the differences between the points are displayed
on the right-hand side of the screen.
Select “Return” to close the menu.
Cursor 1 Press the function to show a red crosshair on the graphic display, which
can be navigated on both curves using the »IGR«.
Cursor 2 Press the function to show a green crosshair in the graphic display, which
can be navigated on both curves using the »IGR«.
Reference x,y x and y value of the red cursor 1

Meas x,y x and y value of the green cursor 2
x, y x = xMEAS – xREF
y = yMEAS – yREF
y
y/x
x
NOTE
The Measure menu can only be selected with ongoing ventilation. If there is no
ongoing ventilation, the function is grayed out and cannot be selected.

4 Main menu
Fig. 47: Measure menu (arrows show the measured points)
1 Cursor 1 6 Quotient of differences between cursor 2

and cursor 1 from curve 1
2 Cursor 2 7 Measured values of cursor 1 from curve 2
3 Measured values of cursor 1 from curve 1 8 Measured values of cursor 2 from curve 2
4 Measured values of cursor 2 from curve 1 9 Difference between cursor 2 and cursor 1
from curve 2
5 Difference between cursor 2 and cursor 1 10 Quotient of differences between cursor 2
from curve 1 and cursor 1 from curve 2
NOTE
The Measure menu should only be used with the 2-curve view to eliminate screen
clutter.

®
4 Main menu
4.2.5 “Heating” menu
Heating on/off
Temperature
Humidity
Refill on/off
Return
Exit
Heating
Fig. 48: Heating menu
Heating on/off This function switches the humidifier system’s heater on or off.
Temperature Temperature setting for the respiratory gas at the Y piece. A temperature
of between 30 and 40°C can be selected.
NOTE
The heater switches off automatically if the level of the water bath in the humidifier
bottle is too low. In this case, an MP alarm “Waterlevel low” is generated and the
message “Heating off” is displayed.
NOTE
The water bath in the humidifier bottle needs a certain time to heat up after the heater
has been switched on. During this time, the acoustic alarms for the “Temperature low”
and “Temp. wb” alarms are suppressed for 30 minutes.
Humidity Use this sub-menu to increase or reduce the humidity of the respiratory
gas using the slider if necessary.
NOTE
To reach a saturation of 90-95% relative humidity, the default setting should generally
be adequate in all ventilation modes. Depending on the ventilation situation, an
adjustment of the humidity may, however, be necessary.

4 Main menu
If this function is activated, a humidity slider is displayed. It can be

adjusted in ten steps between -4 and +6 using the »IGR« knob. The
vertical bar marks the default setting for the current ventilation mode.
Heating on/off
Temperature
Humidity
Refill on/off
Return
Exit
Heating
Fig. 49: Setting the humidity using the slider
The selected humidity level is shown in the box below the temperature
display. The number of plus (+) and minus symbols (-) indicates the
positive or negative humidity level setting. If the humidity level differs
from the default setting, the temperature and humidity display has a
yellow background.
Fig. 50: Humidity level 0
Fig. 51: Humidity level +6 (maximum humidity)

®
4 Main menu
Fig. 52: Humidity level -4 (lowest humidity)
NOTE
A humidity level of 0 is the default preset for conventional ventilation modes. If the
humidity level is changed during conventional ventilation, this value is saved for the
ongoing ventilation and will be retained if switching to another conventional mode of
ventilation.
Ventilation modes with high flow levels (HFO, NCPAP, and SNIPPV) require a
higher humidity level to ensure optimum humidification. In these ventilation modes,
the default humidity level has therefore been preset to +2.
The default humidity levels can be individually adjusted. To do so, contact the
authorized Fritz Stephan GmbH customer service team.
NOTE
If the humidity is changed during HFO ventilation, this value is saved for the ongoing
ventilation and will be retained if switching to another HFO ventilation mode.
NOTE
If the humidity is changed during non-invasive ventilation, this value is saved for the
ongoing ventilation.
NOTE
Changes to the humidity are saved in all ventilation modes for the ongoing ventilation
only. Re-starting the ventilator will automatically restore the factory defaults.
Refill on/off (optional) This function switches the Sophie automatic refill system on or off; see
chapter 3.3.5 from page 70.

4 Main menu
4.2.6 “Extra-func.” menu
This menu can be used to adjust the parameters for the »Aerosol«,
»Preoxy«, and »Insp.hold« function buttons (see chapter 3.1.2
from page 43).
Neb. Time
Preoxy %
Preoxy-time
Insp. Hold
Return
Exit
Extra-func.
Fig. 53: Extra-func. menu
Neb. Time Setting for the aerosol nebulization time (30 – 420 s).
Aerosol nebulization is triggered by pressing the »Aerosol« button.
Preoxy % Setting for the inspiratory oxygen concentration administered when

pressing the »Preoxy« button. An inspiratory oxygen concentration
between 21 and 100% can be selected.
NOTE
The setting of the inspiratory oxygen concentration during preoxygenation can be
configured at the factory upon request. Three setting modes are available:
 Set absolute value in % (default setting). The set oxygen concentration is
delivered during preoxygenation. Selecting “Preoxy %” from the menu will
display “Preoxy” in the adjuster.
 Set as summand for current FiO2 concentration. The set value is added to the
FiO2 value for preoxygenation. Selecting “Preoxy %” from the menu will
display “Delta” in the adjuster.
 Set as factor of current FiO2 concentration. The set factor is multiplied by
the current FiO2 value and delivered during preoxygenation. Selecting
“Preoxy %” from the menu will display “FiO2x” in the adjuster.
Preoxy-time Setting for the preoxygenation time (30 – 420 s) triggered when pressing
the »Preoxy« button. The menu can also be used to completely switch off
preoxygenation.

®
4 Main menu
Insp. hold Setting for the maximum time for which inspiration is maintained at the
end expiratory pressure level when pressing the »Insp.hold« button.
The selectable time interval is 1 – 7 s. When using the »Tinsp« option,
the inspiration time setting is automatically applied.
Inspiration ends immediately when the »Insp.hold« button is pressed
again.
The settings made can be viewed in the special functions area of the
monitor (see 3.2 and 4.2.6).
4.2.7 “Options” menu
PNT A/B/C/None
O2 calibration
Trigger press./flow/extern
Exp. trigger on/off
Freq. backup 10/30/60/off
Communic.
Return
Exit
Options
Fig. 54: Options menu
4.2.7.1 “PNT-A/B/C/None”
The PNT type can be changed in this sub-menu. The following options
are possible:
PNT A Selection of PNT type A (flow up to 10 l/min / deadspace: 0.5 ml)
PNT B Selection of PNT type B (flow up to 15 l/min / deadspace: 0.6 ml)
PNT C Selection of PNT type C (flow up to 25 l/min / deadspace: 0.9 ml)
None No PNT is selected.

4 Main menu
CAUTION
Always check if the PNT which has been set in the menu matches the PNT type which
is actually connected. Setting the PNT type incorrectly leads to inaccurate
measurements.
4.2.7.2 “O2 calibration”
When “O2 calibration” is selected, O2 calibration starts automatically.

“CAL” flashes conspicuously in the FiO2 measured value display on the
left side of the monitor (see chapter 3.2.1).
Fig. 55: FiO2 display
NOTE
The “O2 calibration” function cannot be selected again while a calibration is in

progress! It is therefore grayed out in the menu during calibration.
If the O2 sensor is defective or not connected, the “O2 sensor fail” alarm
appears in the alarm display. If this situation arises, check the O2 sensor,
replace it if necessary, and repeat the calibration.
Fig. 56: “O2 sensor fail” alarm

®
4 Main menu
4.2.7.3 “Trigger press./flow/extern”
Use this sub-menu to select the type of trigger.
Pressure Selects the pressure-controlled trigger. This acts as a differential pressure

trigger (relative to PEEP).
Flow Selects the flow-controlled trigger. Activated when the inspiratory flow
exceeds the trigger threshold set.
NOTE
The flow trigger can only be used for the “S-IMV” and “Ass./Co.” ventilation modes.
When switching to a non-invasive ventilation mode, the flow sensor is automatically
disabled.
NOTE
The Sophie flow trigger is a relative trigger. The trigger threshold can automatically
adapt to the measured leak.
Extern Selects the external trigger. Activated when the abdominal movements
(optional) measured by the respiration sensor exceed the trigger threshold set.
WARNING
Incorrectly selected trigger thresholds or major leaks can cause auto-triggering! In this
case, the trigger threshold has to be manually adjusted.
4.2.7.4 “Exp. trigger on/off”
This sub-menu can be used to activate or deactivate the expiratory

trigger.
Expiratory trigger The expiratory trigger synchronizes the start of the expiration phase with
mechanical ventilation with the end of the spontaneous inspiration based
on the patient’s respiratory movements recorded by the respiration
sensor.

4 Main menu
If no expiration effort of the patient is detected, expiration is

automatically triggered at the end of the specified inspiration time.
NOTE
The expiratory trigger deactivates the termination criterion »KV‘%« in ventilation
modes with inspiratory time termination. In this case, ITT is fully controlled by the
expiratory trigger.
The default setting for the expiratory trigger in non-invasive ventilation modes is
»On«.
With linear and sinusoidal pressure patterns, the set inflation pressure
(Pmax) is typically not reached until the set inflation time has elapsed. If
the inflation is terminated by the expiratory trigger before the set inflation
time has elapsed, the applied inflation pressure drops as well.
Consequently, the applied inflation pressure also depends on the duration
of the spontaneous inspiration of the patient. Further information on the
expiratory trigger can be found in chapter 9.2.
4.2.7.5 Freq. backup 10/30/60/off
Use this sub-menu to set the backup ventilation mode for the ventilation
modes NCPAP B and SNIPPV B.
If set to “Off”, the SOPHIE automatically uses standard backup
ventilation, which immediately stops mandatory backup ventilation upon
restoration of spontaneous breathing. If set to 10, 30 or 60 s, frequency-
controlled backup ventilation is activated. In this case, mandatory backup
ventilation is not stopped immediately upon restoration of spontaneous
breathing, but is instead reduced incrementally. The set interval of 10, 30
or 60 s determines the duration of the individual backup stages. Detailed
information on the two backup ventilation options can be found in
chapters 5.4.8.1 and 9.7.1.

®
4 Main menu
4.2.7.6 “Communication”
Use this sub-menu to select the transmission speed for the interface and
the system language. It also shows the system data.
Com1
System
Language
Return
Exit
Communic.
Fig. 57: Communication menu
“Com1” Configuration of the transmission speed for the SOPHIE serial RS232
interface. The sub-menu offers the following transmission speeds.
9600
19200
38400
57600
115200
Return
Exit
Com1
Fig. 58: Selecting the transmission speed
The currently selected transmission speed is highlighted in blue when you

open the menu.

4
“System” Selecting this function opens a screen with the following data:
 Date and time
 Software and device version
 Operation and service time
 Serial number
“Language” Use this sub-menu to set the SOPHIE menu and system language. English
is pre-installed on the ventilator. The second language can be optionally
selected on request.
German
English
Return
Exit
Language
Fig. 59: Language sub-menu

®
5 “Ventilation” menu
5.1 Operating concept
Ventilation
Test
IMV
S-IMV
ASS./CO.
HFO
Non-invasive
Off
Break
Return
Fig. 60: Ventilation menu opened
The entire “Ventilation” menu can be controlled using the central »IGR«
push and turn knob:
 Turn the »IGR« to select the “Ventilation” menu. The field turns
green.
 Click (press) the »IGR« to open the “Ventilation” menu.
 Turn the »IGR« clockwise or counterclockwise to scroll through the
available menu options. The selected option is highlighted in blue.
 Click the »IGR« to carry out the corresponding function or open a
sub-menu.
 After selecting the required ventilation mode, a pop-up menu appears
with the necessary ventilation parameters.

NOTE
The innovative pop-up menu control is extremely convenient to use and makes it far
easier to adjust the ventilation parameters. The user only sees the parameters relevant
to the chosen ventilation mode and can adapt these quickly and easily to the patient’s
needs.
 Turn the »IGR« clockwise or counterclockwise to scroll through the

ventilation parameters; the selected field turns green.
 Click to open the selected field (the field turns yellow), then turn the
»IGR« to set the ventilation parameter.
 Click again to finish the entry; the field turns green again. Selecting
the »Start« field and clicking to activate it now starts ventilation.
NOTE
Alternatively, the “Ventilation” menu and the corresponding ventilation parameters

can also be opened or closed using the corresponding selection buttons. Detailed
information on the »IGR« and the selection buttons can be found in chapter 3.1 from
page 39.
Direct setting mode In addition to the “Push/turn/push” method, a direct setting mode can also
be used for the parameters »PEEP«, »MAP«, and »HFO-AM«. This
mode allows real-time value changes like when using a standard turning
knob. Proceed as follows:
 Select the desired parameter using the button or »IGR«; the field
turns green.
 Push and hold the »IGR« for approx. 2 seconds. The parameter field
now begins to flash.
 Turn the »IGR« to continuously increase or decrease the value. The
ventilator immediately applies the selected oscillation amplitude.
 Push and hold the »IGR« again to finish the direct setting mode.
The direct setting mode automatically exits after 30 s without any user
interaction or when pushing another button.

®
5.1.1 Setting the ventilation mode after system start-up
After the SOPHIE has been switched on or rebooted and a successful

system test has been carried out, the Ventilation menu opens
automatically. Proceed as follows to configure the settings:
 Select the ventilation mode; the selected field is highlighted in blue.

 Confirm the selection by clicking the »IGR« or pressing the selection
button.
 A sub-menu appears, listing all available ventilation options (e.g.
ITT) for the selected ventilation mode. Select the desired option and
confirm by clicking the »IGR« or pressing the selection button.
NOTE
If the ventilator is not ventilating, the »Break« field cannot be selected and is grayed
out. The “Standby” function will appear in the menu as soon as ventilation begins.
Ventilation
Test S-IMV
IMV Standard
S-IMV ITT(PSV)
ASS./CO. Return
HFO
Non-invasive
Off
Break
Return
Fig. 61: Ventilation options S-IMV

 A pop-up menu appears, listing all parameters required for the

selected ventilation mode.
Fig. 62: Pop-up menu for S-IMV ventilation
NOTE
When opening the “Ventilation” menu, the second and third curves (2. panel and 3.
panel) are frozen.
NOTE
After ventilation has started, the values in the two upper rows of the pop-up menu are
shown in the parameter bar on the right edge of the monitor. The values of the lower
row are shown in the parameter bar at the bottom edge of the monitor (see chapter
3.2.4 from page 53).
 To change a value, select it using the »IGR«. The selected field turns
green.
Fig. 63: Pop-up menu for S-IMV – selecting the expiration time

®
 Click or press the selection button to open the corresponding field. It

is highlighted in yellow.
 Turn the »IGR« to change the value. Click again or press the
selection button to finish the entry. The other values can be changed
the same way.
Fig. 64: Pop-up menu – setting the expiration time
 After correctly making all the necessary settings, you have the option
of setting the default alarm limits for the selected ventilation mode
using the “Alarms” field (see chapter 5.1.2).
 To start the ventilation mode, select the “Start” field and activate it by
clicking the »IGR« or pressing the selection button. The pop-up
menu closes and ventilation begins.
Fig. 65: Starting ventilation

5.1.2 Presetting alarm limits
The “Alarms” field lets you manually adjust the alarm limits before
starting ventilation.
Fig. 66: Selecting the “Alarms” field
Selecting the “Alarms” field opens a pop-up menu, showing all the alarm
limits for the relevant ventilation mode. These alarm limits can be
adjusted using the »IGR« (just like the ventilation parameters).
Fig. 67: Setting alarm limits
Selecting the »Parameter« field completes the entry of alarm limits and
returns you to the screen for setting the ventilation parameters.
Ventilation can be started as usual.

®
NOTE
Unlike the alarm limit settings made in the Main menu (see chapter 4.2.1.1) or using
the “Alarm menu” button (see chapter 3.1.2), the settings made in the Ventilation
menu do not take effect until the selected ventilation mode is started.
5.1.3 Changing the ventilation mode during operation
Proceed as follows to change the ventilation mode during ongoing

ventilation:
 Open the Ventilation menu.

 Select the desired ventilation mode from the menu. Select available
ventilation options (e.g. ITT/PSV) for the chosen ventilation mode
from the sub-menu and confirm with the »IGR« or selection button.
NOTE
While setting a new ventilation mode and its parameters, the ongoing ventilation
continues unchanged. The ventilator only switches to the new ventilation mode after
the “Start” function is activated in the pop-up menu for the new ventilation mode.
Ventilation
Test
IMV HFO
S-IMV IMV
Ass./co. CPAP
HFO Return
Non-invasive
Off
Break
Return
Fig. 68: Changing the ventilation mode during ongoing ventilation

NOTE
For safety reasons, the “Off” and “Test” functions can only be selected in “Standby”
mode (see chapter 5.2 from page 115).
 A pop-up menu appears, listing all the parameters needed for

ventilation (see Fig. 62). To change a value, select it using the »IGR«.
The selected field turns green.
 Click or press the selection button to open the corresponding field. It
is now highlighted in yellow and the set value flashes.
 Turn the »IGR« to change the value. Click again or press the
selection button to finish the entry. The other values can be changed
the same way.
 Once all the settings have been correctly selected, ventilation can
begin. Select the »Start« field and activate ventilation with the »IGR«
or by pressing the selection button in the menu.
 The pop-up menu is closed and the ventilator switches to the new
ventilation mode.
NOTE
After ventilation has started, the values in the upper row of the pop-up menu are
shown in the parameter bar on the right edge of the monitor. The values of the lower
row are shown in the parameter bar at the bottom edge of the monitor (see chapter
3.2.4 from page 53).
NOTE
To change a ventilation parameter during ongoing ventilation, open the corresponding
parameter field directly with the corresponding selection button or the »IGR«. Use the
»IGR« to make the adjustment. Click with the »IGR« or press the corresponding
»selection« button to save and exit the setting (see chapter 3.1 from page 39).

®
5.2 Special functions in the Ventilation menu
5.2.1 “Standby” and “Off”
The “Standby” function ends the current ventilation process and puts the
ventilator into standby mode or shuts it down completely. Proceed as
follows:
 Open the Ventilation menu using the »IGR« or selection button.
 Select and activate the “Standby” function.
 The confirmation prompt “Exit ventilation ?” appears.
Fig. 69: Confirmation prompt “Exit ventilation ?”
NOTE
The selected confirmation prompt field is highlighted in blue and indicated by two
inside facing arrows.

 Answering “No” causes ventilation to continue unchanged.

Selecting “Yes” causes the ventilator to switch to standby mode
and displays the following message:
Fig. 70: Standby mode
 Selecting “Off” will completely shut down the device.

 Another confirmation prompt appears.
Fig. 71: Confirmation prompt before shutting down
 If the confirmation prompt is answered “Yes”, the device shuts down

completely.
 The message “System shut down” appears and the ventilator saves
the internal logbook.

®
Fig. 72: Shutting down the Sophie
After saving the logbook, the ventilator shuts down and can only be
switched on again by pressing the »On« button (see chapter 3.1 from
page 39).
NOTE
If there is no ongoing ventilation, e.g. after completing the system test or in standby
mode, the ventilator can be turned off directly by selecting the “Off” function in the
Ventilation menu.
If the ventilator remains in standby mode, the screen saver appears after a
brief time.
Fig. 73: Screen saver in standby mode

NOTE
Pressing the »IGR« or selection button in “Standby” mode restores the screen. You
can again configure settings in the Main menu and Ventilation menu and the
ventilator switches back to operating mode. To shut down the SOPHIE completely,
select the “Off” function in the Ventilation menu. If no input is made, the screen again
blanks out after a short time.
NOTE
If there is no ongoing ventilation, e.g. after completing the system test or in standby
mode, the ventilator can be turned off directly by selecting the “Off” function in the
Ventilation menu.
5.2.2 “Break”
The “Break” function stops current the ventilation. It is intended to
briefly interrupt the operation of the device. The monitor remains on and
the selected ventilation parameters are preserved as long as ventilation
continues in the same mode after the break. The “Break” function can
only be selected during ongoing ventilation. Proceed as follows to switch
the device to the “Break“ mode:
 Select and activate the “Break” function.
 The confirmation prompt “Break ventilation ?” appears.
Fig. 74: Confirmation prompt “Break ventilation ?”

®
 Select “Yes” and confirm.

 The ventilator now ends the ongoing ventilation and switches to
“Break” mode.
 The screen remains switched on. “Break” appears in the field of the
Ventilation menu.
Press the »IGR« or selection button to re-open the “Ventilation” menu.

Click on the “Continue” function to continue the ventilation using the
same mode as before the break; the ventilation parameters remain the
same. To continue with a different ventilation mode, this can simply be
selected in the “Ventilation” menu.
NOTE
“Break” can only be selected during ongoing ventilation.
5.2.3 “Test”
If the “Test” function is selected, the ventilator proceeds with an internal

selftest. For safety reasons, this function is only available in “Standby”
mode. A system test can be carried out after ventilation as follows:

 Select and click on “Standby/Off”.
 The confirmation prompt “Exit ventilation ?” appears.
 Select “Yes” and confirm.
 Another confirmation prompt “Power off Yes/No?” appears.
 Select “No” and confirm.
 The Sophie now ends the ongoing ventilation and switches to
“Standby” mode.
 Re-open the Ventilation menu and select “Test”.
 The ventilator carries out an internal selftest; the pressure and O2
sensors are automatically calibrated.

Fig. 75: System test
 This completes the system test. A message appears on the monitor.

A new ventilation can now begin.
Fig. 76: Test mode completed successfully
CAUTION
If the system test is not passed, the ventilator must be shut down and re-started
(possible causes can be found in Tab. 11).
If the device fails the test again, it must be decommissioned (see chapter 8.6 from
page 174) and the Fritz Stephan GmbH customer service team must be notified
immediately.

®
Message Color Meaning Remedy

Test mode finished GREEN  No errors
Select ventilation
mode
Test mode finished RED  Safety-related errors have  Check the connection
System not ok occurred during the tubes, patient component,
selftest and tube system
System not operational!  Notify the FRITZ
STEPHAN GMBH
customer service team
PC-MC version RED  The installed software is  Check the software
mismatch. not compatible version and repeat
System not ok System not operational! installation if necessary
 Notify the FRITZ
STEPHAN GMBH
Configuration error YELLOW  Configuration file  Check the configuration
System limited ok! corrupted or not available file and repeat the
 Product key does not installation process if
match serial number necessary
System operational with  Notify the FRITZ
default settings! STEPHAN GMBH
Tab. 11: System test overview table

5.3 Adjustable ventilation parameters
Parameter IMV HFO SIMV SIMV Ass./Con Ass./Con SNIPPV HFO NCPAP
IMV ITT ITT CPAP
Tinsp X X X X X X X X X
Texp (Freq) X X X X X X X X1
Trigger X X X X X X
Pmax X X X X X X X X X
PEEP X X X X X X X X
PPSV% X
MAP X
VtLim X X X
VtTar X X
Pattern X X X X X X X1
KV% X X
ApD X X
HF Freq X X
Exp. trigger X X X X X2 X2
HF Am X X
HF IE X X
FLim X X
MaxV‘ X X
HFO-INSP X
1
With the backup function switched on only
2
With an external respiration sensor only (ext. trigger)
Tab. 12: Adjustable ventilation parameters

®
Name Meaning Adjustable

in menu in the range of
Insp Inspiration time 0.1 – 2 s
Exp* Expiration time 0.1 – 60 s
Freq* Frequency 1 – 300/min
Pmax Inspiratory peak pressure 5 – 60 cmH₂O
PPSV% Pressure support level for spontaneous 0 – 100%
breathing under SIMV – ITT(PSV)
PEEP Positive end expiratory pressure 0 – 30 cmH₂O
MAP Mean airway pressure 0 – 30 cmH₂O
MaxV‘ Maximum gas flow (flow limitation) 6 – 20 l/min/ OFF
FiO2 Inspiratory oxygen fraction 21 – 100%
Trig Trigger threshold (sensitivity) 0.2 – 2.9 l/min
0.2 – 2.9 cmH₂O
0.2 – 2.9 Arb/OFF
VtTar Target volume under ITT(PSV) 2 – 150 ml/OFF
VtLim Tidal volume limitation 2 – 150 ml/OFF
KV’ Factor of the insp. peak flow at which 5 – 40%
inspiration is ended
ApD Apnea duration – time after which backup 1 – 16 s/OFF
ventilation occurs according to the set
ventilation parameters once spontaneous
breathing fails (apnea).
HF freq Oscillation frequency for HFO 5 – 15 Hz
HF-IE Inspiration ratio for HFO 33 – 50%
HF-AM Oscillation pressure amplitude for HFO 5 – 100%
HFO-INSP Switches oscillation “on” or “off” during ON/OFF
inspiration
FLim Flow limit line setting for HFO 0.2 –10 l/min/OFF
Pattern Ventilation pressure pattern setting Linear, Sinus
Rectangle
* Depending on the customer’s wishes, the Sophie can be delivered with either a selectable expiration
time or a selectable breathing frequency. The selection does not affect the inspiration time setting!
Tab. 13: Setting the ventilation parameters

CAUTION
When using a closed suction procedure during pressure-controlled ventilation, the
PEEP should be at least 5 cmH₂O to prevent excessive negative pressure during
suction. When using a closed suction procedure, the trigger threshold should be
temporarily disabled to prevent auto-triggering.
5.3.1 Special aspects of setting the VtLim/VtTar
Setting the VtLim or VtTar parameter activates the “Volume guarantee”

function. This automatically reduces the inspiratory pressure if the
measured expiratory tidal volume exceeds the set volume limit/volume
target.
For safety reasons, the pressure cannot drop lower than the set PEEP +
4 cmH₂O.
NOTE
For VtLim and VtTar, the volume is limited by the pressure “Pmax”. If VtLim or
VtTar is exceeded, the set inspiratory pressure Pmax can therefore no longer be
reached.
CAUTION
When using a closed suction catheter with VtLim or VtTar, the effect on the volume
measurement can cause inspiration to be stopped due to the volume limitation and
pose a risk to the patient.

®
5.3.2 Setting the expiration time or frequency
Depending on the customer’s wishes, the Sophie can be delivered with

either a selectable expiration time or a selectable breathing frequency.
The selection does not affect the inspiration time setting!
Fig. 77: Version with selectable expiration time
Fig. 78: Version with selectable breathing frequency

5.4 Choosing the ventilation mode
The following section explains how to select the ventilation mode and
shows the corresponding pop-up windows and their parameters. The
innovative pop-up menu control is extremely convenient to use and
makes it far easier to adjust the ventilation parameters. The user only sees
the parameters relevant to the chosen ventilation mode and can adapt
these quickly and easily to the patient’s needs.
NOTE
More information about the ventilation modes can be found in chapter 9 from page
175. More details about the ventilation parameters can be found in chapter 5.3 from
page 122.
NOTE
High frequency oscillation (HFO) is an optional SOPHIE component. This option

cannot be selected on versions without HFO; it is grayed out in the menu.
NOTE
The external trigger is an optional SOPHIE component. It allows the connection of an
external respiration sensor for detecting spontaneous breathing efforts of the patient.
This trigger mode cannot be selected on versions without external triggering and is
grayed out in the menu. If the external trigger is available, selecting a non-invasive
ventilation mode automatically activates the respiration sensor as trigger mode. The
PNT setting is automatically set to “No PNT”. The external respiration sensor’s curve
is shown in the graphic display as the second curve.
If the external trigger is not available, selecting a non-invasive ventilation mode
automatically activates the pressure trigger as trigger mode.
WARNING
If the external respiration sensor is used, volume monitoring is automatically disabled.
In this case, the patient should be monitored using additional SpO2 and transcutaneous
CO2 measurement.

®
5.4.1 IMV – intermittent mandatory ventilation
Ventilation
Test
IMV
S-IMV
ASS./CO.
HFO
Non-invasive
Off
Break
Return
Fig. 79: Selecting IMV
Fig. 80: Parameter settings for IMV

5.4.2 S-IMV – synchronized IMV ventilation
Ventilation SIMV
Test Standard
IMV ITT(PSV)
S-IMV Return
ASS./CO.
HFO
Non-invasive
Off
Break
Return
Fig. 81: Selecting S-IMV
Fig. 82: Parameter settings for S-IMV

®
5.4.3 S-IMV with inspiratory time termination (ITT)
Ventilation SIMV
Test Standard
IMV ITT(PSV)
S-IMV Return
ASS./CO.
HFO
Non-invasive
Off
Break
Return
Fig. 83: Selecting S-IMV with ITT (PSV)
Fig. 84: Parameter settings for S-IMV-ITT (PSV)

5.4.4 Ass./Co. – assist-controlled ventilation
Ventilation
Test ASS./CO.
IMV Standard
S-IMV ITT(PSV)
ASS./CO. Return
HFO
Non-invasive
Off
Break
Return
Fig. 85: Selecting ASS./CO.
Fig. 86: Parameter settings for ASS./CO

®
5.4.5 Ass./Co. with inspiratory time termination (ITT/PSV)
Ventilation
Test ASS./CO.
IMV Standard
S-IMV ITT(PSV)
ASS./CO. Return
HFO
Non-invasive
Off
Break
Return
Fig. 87: Selecting Ass./Co. with ITT (PSV)
Fig. 88: Parameter settings for Ass./Co. with ITT (PSV)

5.4.6 High frequency oscillation with IMV (optional)
Ventilation
Test
IMV HFO
S-IMV IMV
Ass./Co. CPAP
HFO Return
Non-invasive
Off
Break
Return
Fig. 89: Selecting high frequency oscillation (HFO) with IMV
Fig. 90: Parameter settings for HFO with IMV
NOTE
When switching from a conventional ventilation mode to an HFO ventilation mode,
the most recent Pmax and PEEP settings are saved. When switching from the HFO
ventilation mode to a conventional ventilation mode, the previously saved values are
suggested for ongoing ventilation.
Always check all ventilation settings prior to starting the new ventilation!

®
NOTE
The alarms limit for PEEP are adjusted automatically after changing the PEEP. If the
alarm limit was previously set manually, this setting will be automatically
overwritten!
WARNING
When using HFO ventilation in transport mode, gas consumption can be reduced by
up to 20% by setting the amplitude to < 50% or the frequency to < 12 Hz.
5.4.7 High frequency oscillation with CPAP (optional)
Ventilation
Test
IMV HFO
S-IMV IMV
Ass./Co. CPAP
HFO Return
Non-invasive
Off
Break
Return
Fig. 91: Selecting HFO with CPAP
Fig. 92: Parameter settings for HFO CPAP

MAP – The PEEP start value is used as reference setting for MAP when selecting
mean airway pressure the ventilation mode “HFO+CPAP” from “Test”, “Break”, or “Standby”
modes. When switching from another ventilation mode to “HFO+CPAP”,
the measured mean airway pressure (Pmean) + 2 cmH₂O is used.
Gas transport For the “HFO+CPAP” ventilation mode, the system displays the
coefficient DCO2 gas transport coefficient DCO2 instead of the resistance (R) and
compliance (C). It uses ml2/s for the unit.
NOTE
When switching from a conventional ventilation mode to an HFO ventilation mode,
the most recent Pmax and PEEP settings are saved. When switching from the HFO
ventilation mode to a conventional ventilation mode, the previously saved values are
suggested for ongoing ventilation.
Always check all ventilation settings prior to starting the new ventilation!
NOTE
The alarm limits for the mean airway pressure are adjusted automatically after
changing the MAP. If the alarm limit was previously set manually, this setting will be
automatically overwritten!
NOTE
The two parameters »Insp.« and »Pmax« are shown in the parameter display, but
hidden in the parameter settings because they are only relevant to the “HFO+CPAP”
ventilation mode if the special function »Insp.hold« is used (see chapter 3.1.2). In this
case, »Pmax« determines the inflation pressure and »Insp.« the duration of the manual
inflation if the setting »Tinsp« is used instead of a specific time. Both values, »Insp.«
and »Pmax«, can be selected in the parameter display via the selection button and
changed using the »IGR«.

®
NOTE
When using HFO ventilation in transport mode, gas consumption can be reduced by
up to 20% by setting the amplitude to < 50% or the frequency to < 12 Hz.
5.4.8 NCPAP – non-invasive (nasal) CPAP
Ventilation
Test
IMV
S-IMV Non-
invasive
Ass./Co. NCPAP
HFO NIPPV
Non-invasive Return
Off
Break
Return
Fig. 93: Selecting NCPAP
Fig. 94: Parameter settings for NCPAP (with frequency-controlled

backup ventilation)
NOTE
Non-invasive ventilation must not be used with intubated patients.

WARNING
When switching from non-invasive to invasive ventilation modes, the flow
measurement and flow trigger will be automatically activated! Always check all
ventilation parameters prior to starting the new ventilation!
If the ventilation mode is changed to NCPAP, the ventilation pattern

»SINUS« is preset automatically, but only used for the special function
»Insp.Hold« and for optional backup ventilation. The pattern can still be
modified if needed.
The CPAP pressure level is set by the parameter »PEEP«. The alarm
limits for the mean airway pressure are adjusted automatically after
changing the parameter »PEEP«. If the alarm limits were previously set
manually, these settings will be overwritten automatically!
Leak alarm When the function »Leak alarm« is switched on, the actual leak situation
is determined. The determined leak is the basis for the generation of a
combined leakage/disconnection alarm if the leak increases by more than
50%.
NOTE
Only use masks and prongs that fit properly! Poorly fitting masks and prongs can lead
to major leaks.
If the leak situation changes, e.g. when switching out the prong, the alarm threshold
for the leak alarm may need to be reset by switching the »Leak alarm« function off
and back on.
Flow limitation By setting a flow limitation, the maximum flow available for the
(MaxV’) compensation of leaks can be limited.
The flow limitation can be set between 20 and 6 l/min or switched off
completely.
WARNING
If flow limitation is activated, it may not be possible to reach the set ventilation
pressures, depending on the amount of leakage. Therefore, set the flow limitation to a
value at which the desired pressures are just reached.

®
Trigger threshold By setting a trigger threshold using the pressure trigger or an external
(Trig) respiration sensor, spontaneous breathing of the patient can be monitored
when using NCPAP ventilation. The trigger threshold can be set between
0.2 and 2.9 or switched off completely.
WARNING
When the trigger threshold »Trigger« is switched off, the patient’s spontaneous
breathing activity is not monitored. Apnea monitoring must be ensured by
independent monitoring devices.
WARNING
If non-invasive ventilation is used, the patient should be monitored using additional

SpO2 and transcutaneous CO2 measurement.
5.4.8.1 NCPAP-B
Advanced apnea monitoring is available when using the ventilation mode

NCPAP B. It starts mechanical backup ventilation “BU” in the absence of
spontaneous breathing. To activate apnea monitoring, an apnea duration
in the range of 4 to 16 s must be set for the »ApD« parameter. The suffix
“B” for backup ventilation is shown in the status display for the
ventilation mode. At the same time, the backup ventilation mode is
indicated by a corresponding backup symbol (BU for standard backup,
FBU 10/30/60 s for frequency-controlled backup).
Fig. 95: NCPAP with activated standard backup ventilation

In addition, the parameters »ApD«, »Insp«, »Exp«, and »Freq« are

colored orange for standard backup or purple for frequency-controlled
backup for better clarity.
If the apnea duration interval is switched off, backup ventilation is

deactivated and the parameters »Exp« (»Freq«) and »Pattern« are
automatically hidden.
The parameters «Insp« and «Pmax« are only relevant if the special
function «Insp.hold« is used.
Without backup ventilation, the »Apnoe« alarm is triggered after 15 s

without spontaneous breathing activity by the patient. The apnea counter
increases by 1.
Backup modes A differentiation is made between the following backup options:

 Standard backup (BU)
 Frequency-controlled backup (FBU)
If no spontaneous breath is detected, mandatory backup ventilation starts

automatically in both modes with the parameter settings for »Pmax«,
»Insp«, »Exp« (»Freq«), and »Pattern«.
The apnea counter increases by 1.
Detailed information on the two backup ventilation options can be found

in chapters 9.7.1 and 9.8.1.
The backup mode is selected in the »Options« menu (see chapter 4.2.7.5).

®
5.4.9 NIPPV – non-invasive positive pressure ventilation
Ventilation
Test
IMV
S-IMV Non-
invasive
Ass./Co. NCPAP
HFO NIPPV
Non-invasive Return
Off
Break
Return
Fig. 96: Selecting NIPPV
Fig. 97: Parameter settings for NIPPV (with frequency-controlled backup

ventilation)
NOTE
Non-invasive ventilation must not be used with intubated patients.

WARNING
When switching from non-invasive to invasive ventilation modes, the flow
measurement and flow trigger will be automatically activated! Always check all
ventilation parameters prior to starting the new ventilation!
If the ventilation mode is changed to NIPPV, the ventilation pattern

»SINUS« is preset automatically. It can still be changed if needed.
The PEEP level is set by the corresponding parameter. The PEEP alarm
limits are adjusted automatically after changing the parameter. If the
alarm limits were previously set manually, these settings will be
overwritten automatically. The level of pressure support is set by the
parameter »Pmax«.
Leak alarm When the function »Leak alarm« is switched on, the actual leak situation
is determined. The determined leak is the basis for the generation of a
combined leakage/disconnection alarm if the leak increases by more than
50%.
NOTE
Only use masks and prongs that fit properly! Poorly fitting masks and prongs can lead
to major leaks. If the leak situation changes, e.g. when switching out the prong, the
alarm threshold for the leak alarm may need to be reset by switching the »Leak
alarm« function off and back on.
Flow limitation By setting a flow limitation, the maximum flow available for the
(MaxV’) compensation of leaks can be limited. The flow limitation can be set
between 20 and 6 l/min or switched off completely.
WARNING
If flow limitation is activated, it may not be possible to reach the set ventilation
pressures, depending on the amount of leakage.
Therefore, set the flow limitation to a value at which the desired pressures are just
reached.

®
5.4.9.1 SNIPPV
By setting a trigger threshold using the pressure trigger or an external

respiration sensor, the spontaneous breathing of the patient can be
synchronized with the mechanical pressure support when using NIPPV
ventilation. To activate the synchronization, the parameter »Trig« must
be used to set the trigger threshold between 0.2 and 2.9. This ventilation
mode now corresponds to an SNIPPV ventilation. This is also indicated
by showing the ventilation mode in the status display.
Fig. 98: SNIPPV ventilation

5.4.9.2 SNIPPV-B
With SNIPPV backup, the SOPHIE enables the patient to achieve better
control of the ventilation frequency. This function can be activated by
switching on apnea monitoring. Therefore, the parameter »ApD« must be
set between 4 and 16 s.
Fig. 99: SNIPPV with frequency-controlled backup ventilation
The expiration time is now deactivated as long as the apnea monitoring

detects sufficient spontaneous breathing. The patient is able to
independently control the ventilation frequency. If the optional expiratory
trigger is activated, the inspiration time is also deactivated.
The suffix “B” for backup ventilation is shown in the status display for
the ventilation mode. At the same time, the backup ventilation mode is
FBU 10/30/60 s for frequency-controlled backup). In addition, the
parameters »ApD«, »Insp«, »Exp«, and »Freq« are automatically colored
orange for standard backup or purple for frequency-controlled backup.

®

in chapter 9.8.1.
WARNING
If non-invasive ventilation is used, the patient should be monitored using additional

SpO2 and transcutaneous CO2 measurement.
5.4.10 Invasive CPAP (optional)
NOTE
An optional invasive CPAP mode can be pre-configured on the device at the request
of the customer. This results in a change to the Ventilation menu (see. Fig. 100).
Ventilation
Test
IMV
S-IMV NIV/CPAP
Ass./Co. NCPAP
HFO NIPPV
NIV/CPAP CPAP
Off Return
Break
Return
Fig. 100: Selecting CPAP

Fig. 101: Parameter settings for CPAP (with frequency-controlled backup

ventilation)
If the ventilation mode is changed to CPAP, the ventilation pattern

»Sinus« is preset automatically, but only used for the special function
»Insp.Hold« and for optional backup ventilation. The pattern can still be
modified if needed.
The CPAP pressure level is set by the parameter »PEEP«. The alarm
limits for the mean airway pressure are adjusted automatically after
changing the parameter »PEEP«. If the alarm limits were previously set
manually, these settings will be overwritten automatically!
Trigger threshold By setting a trigger threshold using the pressure trigger or an external
(Trig) respiration sensor, spontaneous breathing of the patient can be monitored
when using CPAP ventilation. The trigger threshold can be set between
0.2 and 2.9 or switched off completely.
WARNING
When the trigger threshold »Trigger« is switched off, the patient’s spontaneous
breathing activity is not monitored. Apnea monitoring must be ensured by
independent monitoring devices.

®
5.4.10.1 CPAP-B
Advanced apnea monitoring is available when using the ventilation mode

CPAP B. It starts mechanical backup ventilation “BU” in the absence of
spontaneous breathing. To activate apnea monitoring, an apnea duration
in the range of 4 to 16 s must be set for the »ApD« parameter. The suffix
“B” for backup ventilation is shown in the status display for the
ventilation mode. At the same time, the backup ventilation mode is
FBU 10/30/60 s for frequency-controlled backup).
Fig. 102: CPAP with activated standard backup ventilation
In addition, the parameters »ApD«, »Insp«, »Exp«, and »Freq« are

colored orange for standard backup or purple for frequency-controlled
backup for better clarity.
If the apnea duration interval is switched off, backup ventilation is

deactivated and the parameters »Exp« (»Freq«) and »Pattern« are
automatically hidden.
The parameters «Insp« and «Pmax« are only relevant if the special
function «Insp.hold« is used.
Without backup ventilation, the »Apnoe« alarm is triggered after 15 s

without spontaneous breathing activity by the patient. The apnea counter
increases by 1.




in chapters 9.7.1 and 9.8.1.

®
6 Preparation for use
WARNING
Only use correctly prepared parts for operation (see chapter 13).
6.1 Setting up the device
The SOPHIE must be placed in the middle of the support on the mobile
stand.
The front castors of the mobile stand are equipped with brakes to prevent
any unintended movement of the SOPHIE.
Press the brake lever down with your foot to apply the brake and stop the
castors from moving. Lift the brake lever with your foot to release the
brake again.
CAUTION
Risk of tipping over: when moving the device trolley, ensure that the brakes are
released. Reapply the brakes when the device is in position.

6.2 Connecting the gas and power supplies
6.2.1 Gas supply
DANGER
Risk of explosion: do not use flammable gases.
WARNING
Only use dry compressed air! Humidity in the gas line can lead to technical
malfunctions of the device. If compressed air of the required quality is not present, a
special membrane dryer (Art. no. 1 60060214) available from FRITZ STEPHAN GMBH
must be used.
Central gas supply 1. Connect the O2 tube to the O2 connection on the back of the device
(CGS) and the CGS wall outlet.
2. Connect the AIR tube to the AIR connection on the back of the device
and the CGS wall outlet.
6.2.2 Power supply
Mains power The SOPHIE can be operated with mains voltages of 100 – 240 V AC.
1. Check whether the mains voltage corresponds to the voltage range

stated on the nameplate.
2. Connect the power cable to the power socket on the back of the
device. Connect the other end of the power cable to the wall socket.
3. Switch on the »On/Off« power switch on the back of the device. The
mains power and battery indicator on the front of the Sophie lights up
(see chapter 3.1.1 from page 41). The battery is now being charged
and the SOPHIE can be switched on using the »On« switch.
Battery operation In case of a power failure, the internal battery supplies power to the
device. The mains power indicator on the front of the Sophie goes out
(see chapter 3.1.1 from page 41). Instead of the bar indicator for the
battery level, the remaining run time in minutes is now displayed.

®
CAUTION
Depending on the device design, the humidifier system’s heater automatically
switches off immediately or if the remaining capacity is < 50% when operated in
battery mode.
The device’s internal battery should always be fully charged. To this end,
when not in use:
1. The device should be continually connected to mains power.
2. The mains switch on the back of the device should be in the »On«
position. The battery indicator on the front of the Sophie lights up
If this is not possible, the battery must be fully charged at least every two
weeks.
A safety circuit prevents the battery from being overcharged.
CAUTION
Up to generation 2.2.0 of the power supply, the SOPHIE cannot be operated when the
battery is completely discharged. As of generation 2.2.0 of the power supply, the
confirmation prompt “Low state of charge ok?” indicates that the battery is low.
Answering “Yes” allows you to continue operating the device despite the lower
battery. Answering “No” causes the device to power off.
You can check the power supply version in the Communic./System menu
(see chapter 4.2.7.6).
WARNING
Fritz Stephan GmbH does not recommend operating the ventilator with a low battery
(capacity < 10%) as the device will switch off immediately in the event of a power
failure.
CAUTION
Failure to comply can cause total discharge of the battery so that it no longer
functions. Failure to comply with this safety instruction is considered to be an
operating error on the part of the user.
If the maximum number of charge cycles has been reached, the battery
must be replaced. This can only be done by the authorized Fritz Stephan
GmbH customer service team.

If equipotential bonding is necessary, a ground wire for equipotential

Equipotential bonding bonding has to be connected to the socket provided on the back of the
device. Connect the other end to the point provided inside the ICU.
6.2.3 Patient component

Connect the patient component to the right side panel of the SOPHIE and
use the locking screw to firmly attach it to the side panel.
6.2.4 Filling the humidifier bottle
WARNING
Never unscrew the humidifier bottle during operation. The humidifier chamber is
pressurized. Make sure that the pressure does not force the plunger out of the syringe.
CAUTION
Check the water level of the humidifier bottle regularly during operation.
CAUTION
Never fill the humidifier bottle with “aqua dest.” distilled water up to the “MAX”
marking before screwing on the bottle, as the water may rise above the maximum
permitted level when the humidifier tube is immersed.
CAUTION
During operation, only fill the humidifier bottle with the automatic refill system or
through the Luer lock connection using a syringe (see chapter 6.2.4 on page 150).
NOTE
“Temperature low” and “Temp. wb” alarms potentially triggered by refilling cold
water can be suppressed by selecting the »Heating« menu and briefly switching off
the heater for approx. 1 second and then switching it back on. The acoustic alarm is
then suppressed for 30 minutes (see chapter 4.2.5 from page 97).

®
Fig. 103: Filling the humidifier bottle
1 Container with “aqua dest.” 4 Connection for container

distilled water with distilled water
2 Syringe 5 Syringe connection
3 3-way valve 6 Luer lock patient component
connection
1. Connect the 3-way valve to the Luer lock connection at the top of the
patient component.
2. Connect the syringe to the 3-way valve using a tube.
3. Connect the container with the “aqua dest.” distilled water to the 3-
way valve using a tube.

4. Move the 3-way valve into position a) and fill the syringe with the
appropriate amount of water from the container with distilled water
“aqua dest”.
5. Move the 3-way valve into position b) and fill the humidifier bottle of
the patient component with distilled water up to “MAX” mark.
CAUTION
Always move the 3-way valve into position a) when filling is complete!
Otherwise, the system pressure of the humidifier may force the plunger out of the
syringe, which may in turn cause a pressure drop in the system.
6.2.5 Reusable patient tube system for incubators
Art. no. 100761500
WARNING
When connecting and disconnecting patient tubes, always hold them by the sleeve.
This prevents damage to the tube system.
1. Connect the red inspiration tube to the red »INS« connection on the
front of the patient component.
2. Connect the expiration tube to the »EXP« connection on the front of
the patient component.
3. Connect the inspiration and expiration tube to the Y piece.
4. Attach the sealing cap to the Y piece and close the cap.
5. Connect the pneumotachograph (PNT) to the Y piece on the front.
6. Connect the PNT plug to the pneumotachograph connection on the
right side of the SOPHIE.
7. Connect the tube heating plug to the tube heating connection on the
8. Connect the temperature sensors to the temperature sensors
connection on the right side of the SOPHIE.

®
WARNING
Only use temperature sensors for the reusable patient tube system for incubators
(Art. no. 100761100)!
Temperature sensors other than those intended for this tube system can impair the
device’s functioning and put the patient at risk!
9. Insert temperature sensor T1 at the end of the heated section of the

inspiration tube (distal) into the intended port.
10. Insert temperature sensor T2 at the end of the inspiration tube
(proximal) into the intended port.
11. Connect the pressure measurement tube from the pressure
measurement nozzle on the patient component to the pressure
measurement tube connection on the right side of the SOPHIE.
The patient tube system must be positioned for operation so that the
heated part of the tube system is outside the incubator.
Fig. 104: Sensor position with tube system for incubator
1 Expiration tube 4 Temperature sensor connection

2 Inspiration tube T1 Distal temperature sensor
3 Tube heating connections T2 Proximal temperature sensor
CAUTION
To measure the temperature accurately, the distal temperature sensor (T1) must be
positioned outside the incubator.

6.2.6 Reusable patient tube system for warming beds
Art. no. 100761550
WARNING
1. Connect the red inspiration tube of the patient tube system to the red
»INS« connection on the front of the patient component.
2. Connect the expiration tube of the patient tube system to the »EXP«
connection on the front of the patient component.
3. Connect the inspiration and expiration tube to the Y piece.
4. Attach the sealing cap to the Y piece and close the cap.
7. Connect the tube heating plug to the tube heating connection on the
8. Connect the temperature sensor plug to the temperature sensor
WARNING
Only use temperature sensors for the reusable patient tube system for warming beds
(Art. no. 100761110)!
Temperature sensors other than those intended for this tube system can impair the
device’s functioning and put the patient at risk!
9. Insert temperature sensor T1 at the end of the heated section of

the inspiration tube (distal) into the intended port.
(proximal) into the intended port.
measurement nozzle of the patient component to the pressure
measurement tube connection on the side of the SOPHIE.

®
Fig. 105: Sensor position with tube system for warming bed

6.2.7 Disposable tube system P3/P7
Art. no. 100761300
WARNING
1. Connect the red inspiration tube adapter to the red »INS« connection
on the front of the patient component.
2. Connect the white expiration tube adapter to the colorless »EXP«
connection on the front of the patient component.
side of the SOPHIE.
5. Connect the tube heating adapter to the tube heating connections on
the right side of the SOPHIE.
6. Connect the tube heating adapter to the connections of both patient
tubes.
measurement nozzle on the patient component to the pressure
measurement tube connection on the right side of the SOPHIE.
8. Connect the temperature sensor plug to the temperature sensor

WARNING
Only use temperature sensors for disposable patient tube systems
(Art. no. 100763009)! Temperature sensors other than those intended for
this tube system can impair the device’s functioning and put the patient at risk!
9. Insert temperature sensor T1 at the end of the heated section of the

inspiration tube (distal) into the intended adapter.
(proximal) into the intended adapter.
11. Ensure that all of the tube system adapters are firmly connected to
one another and the temperature sensors are fully inserted into the
adapters.
Fig. 106: Sensor position with disposable patient tube system (Art. no.
100761300)

CAUTION

®
Fig. 107: Inserting the temperature sensor into the adapter
CAUTION
patient.
6.2.8 Tube adapter
WARNING
When selecting the tube adapter, make sure that the outlet openings inside the PNT
are not blocked by the adapter!
Fig. 108: Tube adapter

6.2.9 PNT A
Based on its special design, the PNT A must be locked manually before
use. To do this, move the nose of the turning ring into the appropriate
position (see Fig. 109)
Fig. 109: Locking of PNT A
CAUTION
When using a PNT A, always ensure that it is correctly locked into place. If the PNT
A is not correctly locked into place, the tube adapter can dislodge and cause
disconnection.

®
6.2.10 EasyFlow NCPAP systems
1. Connect the mask or prong to the applicator.

2. Disconnect the two decoupling tubes from each other and create an
arc (see Fig. 110).
3. Connect the smooth ends of the decoupling tubes to the applicator.
4. Remove the Y piece from the patient tube system.
5. Connect the decoupling tubes to the patient tube system.
Fig. 110: Connecting an EasyFlow NCPAP
1 Patient tube system 3 Applicator

2 Decoupling tubes 4 Mask/prong
CAUTION
patient.

6.2.11 Pneumatic medication nebulizer
WARNING
Due to tolerances in the nebulizer flow, the minute and breathing volume displayed
during medication nebulization may differ significantly from the actual values. As a
result, FRITZ STEPHAN GMBH recommends using a pressure-controlled ventilation
mode for nebulization.
WARNING
patient!
When administering medication using nebulization, an expiration filter must always
be fitted between the EXP connection piece and the expiration tube.
The pneumatic medication nebulizer is operated with gas mixture in the

preset O2 concentration in order to retain a constant FiO2.
Preparing the 1. Assemble the medication nebulizer according to its operating manual.
medication nebulizer
2. Use the silicone plug supplied to seal the nebulizer input (1).
3. Use the silicone tube to connect the nebulizer output (2) to the
connecting piece (3) of the reusable Y piece (Art. no. 1 701 60 416).
4. Connect the driving gas tube to the bushing on the nebulizer housing.
Fig. 111: Nebulizer in reusable tube system
5. Connect the Luer connector for the driving gas to the ventilator’s
“Aerosol” connecting piece.
6. Connect the Y piece to the patient tube system (4).
7. Insert the expiration filter into the expiration tube.
8. Position the medication nebulizer upright in the tube duct outside the
incubator or in a tube bracket if using warming beds.

®
Fig. 112: Installing the pneumatic medication nebulizer
The salt crystals generated during the nebulization of medication in a

saline solution environment are capable of destroying the patient
component within just a few weeks.
For this reason, for all nebulization of medication using the aerosol
nebulizer, a special expiration filter must be fitted between the connecting
piece for the expiration tube and the expiration tube itself.

6.2.12 Aeroneb Solo medication nebulizer
WARNING
patient!
When administering medication using nebulization, an expiration filter must always
be fitted between the EXP connection piece and the expiration tube.
Installing the Install the medication nebulizer in the tube system according to the
medication nebulizer operating manual for the Aeroneb Solo nebulizer.
When operating the Aeroneb nebulizer, always observe the
manufacturer’s usage and safety instructions!
NOTE
Do not use the special »Aerosol« function with the Aeroneb nebulizer!
The Aeroneb medication nebulizer does not require any driving gas from the
ventilator’s aerosol connection.
6.2.13 Connection of the external respiration sensor

(optional)
The external respiration sensor connection is on the right side, just above
the SOPHIE patient component. The sensor simply plugs in.
Fig. 113: Connection of the external respiration sensor

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Positioning the sensor 1. For ideal positioning, the patient should be in the supine position.
2. Position the sensor in the abdominal area. Secure the sensor using
medical tape. Fit tape across sensor and let it protrude at least 3 cm on
both sides.
Fig. 114: Positioning of the sensor on the abdomen
3. Check that clear, strong signals from the patient are being displayed
on the device (2nd E(t) curve).
4. Verify that synchronization with the respiration sensor works in the
prone and supine position of the patient.

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7 Test before start-up

All tests must be carried out before the device is used. The staff carrying
out the tests must be well acquainted with the operating manual.
7.1 Testing requirements
 The last safety check must have been carried out as scheduled. Visual
check of the safety check label.
 The device is completely assembled and connected.
DANGER
Never operate device if it has failed one of the tests!
DANGER
Always switch on the device, use the test mode and test the alarms without a patient!

7.2 Test list

Device type: Date:
SN: Signature:
WHAT HOW TARGET ACTUAL

Operating The operating manual is part of Manual is present.
manual the device and must always be
kept with the device.
CGS Visual check of the color coding ISO color code
gas connection of the gas types O2 (oxygen) white
lines Observe any hospital regulations AIR (compr. air) black-and-
white
Mechanical non- O2 ( oxygen)
interchangeability of angled
AIR (compressed air)
connectors and gas connections
Mains power Visual check of the mains Undamaged and strain relief
supply connection Mains switch »On/Off« set to “On”
»On« button illuminated
Patient All patient components must be connected properly
connections
Patient component Firmly connected
with humidifier fleece
Patient tube system Connected properly
Temperature sensor Connected properly
Pressure measurement tube Connected properly (expiration)
Pneumotachograph (PNT) Connected properly
(optional) (pressure measurement tubes point
upwards at the PNT head)
Ext. respiration sensor (optional) Connected properly
Test mode Carry out test mode Test mode completed successfully
Alarm triggering Check if alarms are triggered “Low pressure/disc” and “Vt(exsp)
low” are visually and acoustically
triggered during the test mode
Manual breathing Self-filling, present, within reach Functions correctly
bag
Tab. 14: Test list

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7.3 Alarm tests
During the system test, the visual and acoustic alarms are checked by
generating HP and MP alarms (see chapter 8.2). The most important
alarms can also be tested manually. To do this, prepare the device for
operation (as described in the operating manual), connect the tube system
and the test lung and switch the device on. Next, proceed as follows:
7.3.1 Peak pressure alarm
 Select pressure-controlled ventilation “IMV”

 Set the upper Pmax alarm limit below the Pmax measured
 Check whether the “Peak pressure” alarm is triggered
 Set the upper Pmax alarm limit above the Pmax measured
 Check whether the “Peak pressure” alarm is reset
7.3.2 Min. volume low alarm

 Set the lower MV alarm limit above the MV measured
 Check whether the “Min. volume low” alarm is triggered
 Set the lower MV alarm limit below the MV measured
 Check whether the “Min. volume low” alarm is reset
7.3.3 FiO2 low alarm

 Set FiO2 to 21%
 Set the lower limit for FiO2 above 21%
 Check whether the “FiO2 low” alarm is triggered
 Set the lower limit for FiO2 below 21%
 Check whether the “FiO2 low” alarm is reset

7.3.4 Low pressure/disc alarm

 Disconnect the test lung
 Check whether the “Low pressure/disc” alarm is triggered
 Reconnect the test lung
 Check whether the “Low pressure/disc” alarm is reset
7.3.5 Pressure diff. alarm

 Carefully pinch the expiratory pressure measurement tube
 Check whether the “Pressure diff.” alarm is triggered
 Release the expiratory pressure measurement tube
 Check whether the “Pressure diff.” alarm is reset
7.3.6 Apnea alarm ("Apnoe")
 Select pressure-controlled ventilation “NCPAP”

 Set the trigger to 1.5 Arb or cmH₂O
 Set ApD to “OFF”
 Do not activate the trigger
 Check whether the “Apnoe” alarm is triggered after 15 s
 Activate the trigger
 Check whether the “Apnoe” alarm is reset

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8 Operation
8 Operation
DANGER
Always have a separate manual breathing bag handy.
Lack of an alternative ventilation method may result in patient death if the ventilator
fails!
8.1 Switching on
Press »ON« to start the SOPHIE. The software version and release date
are displayed and an automatic system test is then carried out.
NOTE
The Y piece must be closed before switching on the device, preferably by connecting
it to the parking position on the back of the patient component.
When using non-invasive patient interfaces, the patient connection port must be
sealed, for example by pinching it with a sterile glove.
8.2 Test mode
After switching on the Sophie, an automatic system test is carried out.

This is indicated by the message “System test! Please wait”. During the
system test, the pressure sensors are automatically calibrated.
NOTE
If the ventilator is in “Standby” mode, a system test can be carried out at any time by
selecting the special function »Test« in the Ventilation menu (see 5 from page 115).

8 Operation
The following checks are performed during the selftest:

1. Check of the humidifier and tube heating temperature sensors
2. Check of the oxygen sensor
3. Check of the humidifier and tube heating
4. Electrical check of the speaker
5. Check of the gas supply pressures
6. Check of the HP alarm – visual (Low pressure/disc) and acoustic
7. Calibration of the pressure sensors
8. Electrical check of the emergency air valve
9. Check of the MP alarm – visual (Vt(exsp) low) and acoustic
10. Leak check of the entire ventilation system
11. Check of the EDA measure
12. Check of the mechanical function of the emergency air valve
13. Check of the electronic blender
14. Check of the high frequency oscillation
15. Check of the system configuration and the SW versions
The alarm messages “Low pressure/disc” and “Vt(exsp) low” are solely
used to check whether the alarms are triggered and are automatically
cleared once the system test is complete.
WARNING
If the “Low pressure/disc” and “Vt(exsp) low” alarms are not visually or acoustically
triggered, potentially hazardous situations for patients cannot be detected. Do not
operate the device!
This completes the system test. A message appears on the monitor. If the
system test was successful, the desired ventilation mode can be selected.
NOTE
Calibration of the O2 sensor takes place automatically after a successful system test
and is repeated automatically during operation. Manual calibration of the O2 sensor is
also possible using the Main menu (see chapter 4.2.7.2 from page 102).

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8 Operation
Fig. 115: System test successful
CAUTION
If an error message appears, the system test can be repeated or the device shut down.
If the system test is not passed, the device is not ready for use and no ventilation mode
can be selected!
Fig. 116: System test not successful

8 Operation
8.3 Choosing the ventilation mode
All ventilation modes can be selected in the Ventilation menu using the
»IGR«. A pop-up menu then opens automatically with all parameters
necessary for the ventilation mode. After configuring these parameters,
select the »Start« field to start ventilation.
NOTE
Detailed information on the ventilation modes and their selection can be found in
chapters 5 and 9.
Overview of the
ventilation modes
Ventilation IMV S-IMV Ass./Co. HFO Non-
mode invasive
Standard   
HFO+IMV 
HFO+CPAP 
ITT (PSV)  
NCPAP 
SNIPPV 
Tab. 15: Possible combinations of the ventilation modes

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8 Operation
8.4 Non-invasive ventilation
If a non-invasive ventilation mode has been selected, the parameter

displays at the bottom and on the right side of the monitor are displayed
in light gray to clearly indicate non-invasive ventilation mode.
Fig. 117: Parameter display with non-invasive ventilation
Fig. 118: Parameter display with invasive ventilation

8 Operation
8.5 Switching off
To switch off the Sophie, first select the »Standby« function in the
Ventilation menu. The confirmation prompt “Exit ventilation?” is
displayed. Answering “Yes” puts the SOPHIE into standby mode. If you
then select the »Off« function, the confirmation prompt “Power off?” is
displayed. Answering “Yes” again switches the device off completely,
and it can only be switched on again using the »On« button
WARNING
In the event of a power failure or the failure of the optional 24 V DC supply, the
internal battery supplies power to the ventilation system for a minimum of
60 minutes. The SOPHIE should therefore remain connected to the power supply with
the power switch turned on so that the battery is charged and the device ready for use.
8.6 Decommissioning the device
1. Proceed in the same way as described in chapter 8.5 on page 174.

2. In addition, disconnect the SOPHIE from the central gas supply (CGS)
to prevent any gas reflux and thus the contamination of the lines.

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9 Ventilation modes
9 Ventilation modes
9.1 General
CMV (controlled mandatory ventilation) means that the ventilator

completely manages the breathing process. The patient has no influence
on ventilation. Mandatory ventilation “forces” insufflation of the lung for
a preset inspiration time TInsp.. During this inspiration time TInsp., an
inspiratory tidal volume (Vt) is provided to sustain the exchange of gas
within the lungs.
At the end of the inspiration time TInsp., the ventilator switches to a preset
expiration time TExp.. The elastic restoring forces of the lung are now
responsible for passive expiration, during which the pressure between the
lung and ventilator is equalized. The exhaled expiratory tidal volume is
measured by the pneumotachograph PNT and shown on the display.
The expiratory breathing volume is defined as the tidal volume. Only the
VTE is used as basis for calculating the minute volume (MV). The
ventilation rate within one minute is referred to as the breathing
frequency (BPM = breaths per minute or f = frequency) It is determined
by the inspiration and expiration time. SOPHIE displays the ratio of the
two breathing times as the percentage inspiratory ratio “Insp.%”. The
patient’s spontaneous breathing is not hindered during the expiration
time, although the ventilator is not synced with the patient’s spontaneous
breathing.
During mandatory ventilation, the patient has a virtually “pressure-tight”

connection to the ventilator consisting of an endotracheal tube (ETT) and
a tube system. His breathing therefore depends on the flexibility and
efficiency of the ventilator.
The endotracheal tube (ETT) positioned in the intubated patient’s trachea
prevents the patient from breathing. The smaller the diameter of the ETT,
the more difficult it is to breathe in (and breathe out). Increased airway
pressure during expiration (PEEP = positive end expiratory pressure)
improves alveolar ventilation/pulmonary exchange of gases.
For patients to breathe in spontaneously, they first have to overcome the
resistance of the ETT before respiratory gas can flow into their lungs. The
respiratory gas flowing into the lungs causes the pressure at the ETT inlet
to decrease slightly. The faster the ventilator compensates for this drop in

9 Ventilation modes
pressure, the less effort the patient must make to breathe. The ability of
the ventilator to react to these fluctuations in pressure resulting from
spontaneous breathing activity by the patient depends on the inner
resistance. This ability is the best measure for the quality of a ventilator.
NOTE
Detailed information on selecting the following ventilation modes and setting the
corresponding parameters can be found in chapter 5.
9.2 External trigger (optional)
Spontaneous breathing efforts of a newborn or premature patient are

typically accompanied by characteristic abdominal movements. The
SOPHIE can detect these movements by means of a pressure capsule
filled with soft foam, known as a respiration sensor. During spontaneous
breathing, the pressure inside the capsule changes according to the
abdominal movement.
The foam inside the capsule allows it to return to its original pressure at
end of the inspiration phase. A highly sensitive pressure sensor inside the
ventilator detects these pressure changes. In addition, a software filter
eliminates artifacts. This makes it possible to sync the mandatory
inflation with the spontaneous efforts of the patient without “auto-trigger”
interference. The abdominal movement can be graphically displayed as a
second curve on the ventilator display. Its units are arbitrary units and
dimensionless. The scale of the curve E(t) can be adjusted to the
magnitude of the abdominal movement in increments of 0, 3, 6 and 9.
External inspiratory As with the conventional flow and pressure trigger methods, an external
trigger trigger threshold can be defined. This is adjusted to the spontaneous
breathing efforts of the patient according to the E(t) curve. The SOPHIE
detects spontaneous inspiration when the trigger threshold is exceeded.
For SNIPPV, this is used to sync mandatory inflation. For NCPAP, the
trigger is used to monitor apnea and measure the breathing rate.
External expiratory The external trigger lets you detect both the start and the end of a
trigger spontaneous inspiration. As soon as the movement stops or the signal no
longer rises, the ventilator acknowledges this as the start of expiration
and automatically terminates the mechanical inflation. This enables the
SOPHIE to sync both inflation and expiration. As a result, the patient is
able to completely control the ventilation. With linear and sinusoidal

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9 Ventilation modes
pressure patterns, the set inflation pressure (Pmax) is typically not

reached until the set inflation time has elapsed. If the inflation is
terminated by the expiratory trigger before the set inflation time has
elapsed, the applied inflation pressure drops as well. Consequently, the
applied inflation pressure also depends on the duration of the spontaneous
inspiration of the patient.
Fig. 119: Inspiratory and expiratory triggers
The abdominal movement signal has to drop below the trigger threshold
before another assisted inflation can be triggered. For this purpose,
triggers are suppressed for 150 ms at the end of the inflation.
The external expiratory trigger can be switched off using the
corresponding function in the »Options« menu.

9 Ventilation modes
9.3 Pressure-controlled ventilation (IMV)
During pressure-controlled ventilation, all respiratory phases are adjusted

to the ventilation pressure. This is known as a pressure control loop and it
compares the preset nominal parameters such as inspiratory peak pressure
»Pmax« and positive end expiratory pressure »PEEP« with the pressure
values measured during inspiration (PMAX) and expiration (PEEP). Any
deviations caused, for example, by spontaneous breathing activity during
inspiration or expiration are compensated quickly. SOPHIE offers a very
fast control response time. As a result, the ventilator can be said to have a
very low internal resistance which does not hinder spontaneous breathing.
Under IMV, the time required for mandatory insufflation is set in the
»Insp.« field in the pop-up menu (see chapter 5.4.1 and 5.4.2 from page
127). The set inspiratory peak pressure »Pmax« is reached during this
time. The magnitude of the tidal volume depends on the compliance of
the patient’s lungs and results from the »PEEP« and »Pmax« settings.
Pressure-controlled ventilation is not affected by any tube leaks; only the
tidal volume can fluctuate. Spontaneous breathing attempts by the patient
during inspiration are not restricted by pressure-controlled ventilation
IMV. The patient can breathe in and out freely at every pressure level.
The pressure is controlled, that is, it remains constant.
The graphic display of flow over time V’(t) is useful when determining
the corresponding inspiration time.
At the start of every inspiration phase, the inspiratory flow increases
rapidly to a maximum value. At the end of inspiration, this flow
decreases and approaches zero. At this point in time, there is a balance of
pressure between the ventilator and the lung after which there is no
further flow between the Y piece and the lung due to the pressure
gradient. The lung has now been filled within the time indicated on the
time axis. The inspiratory patterns (linear, sinus, rectangle) which can be
set in the pop-up menu determine how the ventilation pressure reaches its
maximum value within the inspiration time »Insp.«.
NOTE
Detailed information on selecting the ventilation mode »IMV« and setting the
corresponding parameters can be found in chapters 5.4.1 and 5.4.2 from page 127.

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9 Ventilation modes
9.3.1 IMV with volume limitation
A principle characteristic of pressure-controlled ventilation is the

comparatively uncontrolled tolerance of tidal volumes as lung
compliance changes. Until now, inadvertent increases in pressure were
presumed to cause lung damage (barotrauma) in infant patients on
ventilation systems. Today, it is presumed that uncontrolled supplied
volume (volutrauma) is the real cause rather than an uncontrolled
increase in pressure.
Entrainment In the worst case, effects of syncing ventilated patients with the ventilator
phenomena (Herin-Breuer reflex, Head’s paradoxical reflex or negative feedback
phenomena) in particular can be associated with major increases of tidal
volume under pressure-controlled ventilation. Therefore, limitation to the
expiratory tidal volume can be activated during pressure-controlled
ventilation.
Fig. 120: IMV with VTE limitation
IMV with volume In this type of limitation the regulation of the pressure begins after the
limitation increased volume was applied. The inspiration pressure of the following
mandatory breath is selected lower than the previous breath. The benefit
of this kind of control is that it reliably prevents too large a volume.
Furthermore, limiting ventilation to the expiratory volume compensates
for any possible inspiratory ETT leak.

9 Ventilation modes
Volume limitation safeguards the special benefits of pressure-controlled

ventilation while the patient breathes spontaneously.
Procedure In order to use volume limitation, the inspiratory peak pressure »Pmax«,
the positive end expiratory pressure »PEEP«, the inspiration time »Insp.«,
and the expiration time »Exp.« should be set as usual. In this case,
however, the »VtLim« parameter field has special significance because it
is used to adjust the expiratory volume limitation. Volume limitation
should be set slightly above the expected or already breathed tidal
volume. If the expiratory tidal volume now exceeds the volume
limitation, pressure-controlled ventilation is limited starting with the next
breath. However, to ensure a minimum pressure, it is not possible to
reduce the inspiration pressure below the minimum limit of PEEP +
4 cmH₂O. Development of volume limitation based on the entrainment
phenomena described above has revealed that volume limitation under
pressure-controlled ventilation can be used as an ideal volume target.
Volume target After setting the ideal tidal volume for a patient (5 ml/kg/bodyweight) in
the »VtLim« parameter field and allowing for a max. ventilation pressure
of »Pmax«, the preset tidal volume automatically adjusts to the lowest
possible inspiratory ventilation pressure. In addition, there is also up to
50% leakage compensation.
Procedure In order to use volume target ventilation, the positive end expiratory
pressure »PEEP«, the inspiration time »Insp.«, and the expiration time
»Exp.« should be set as usual. In this case, however, the »VtLim«
parameter field has special significance because it is used to adjust the
volume target. The desired tidal volume is set using the »IGR«.
The ventilation pressure »Pmax« is set to the anticipated peak pressure.

Again, it is vital to know the lung compliance C. The SOPHIE now selects
the ventilation pressure for every inspiration so that the expiratory tidal
volume is delivered with the lowest possible pressure. If lung compliance
deteriorates, the ventilation pressure increases at maximum to the
»Pmax« setting. As of this pressure, it will no longer be possible to
deliver the set tidal volume in full. The ventilator reverts to pressure-
controlled-only ventilation.

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9 Ventilation modes
CAUTION
When using a closed suction catheter with VtLim or VtTar, influencing the volume
measurement can cause the inspiration to be canceled due to the volume limitation
and put the patient at risk.
NOTE
With VtLim and VtTar, the volume is limited by the pressure “Pmax”. If VtLim or
VtTar is exceeded, the set inspiratory pressure Pmax can therefore no longer be
reached.
9.3.2 Pressure-controlled ventilation without PNT
To use pressure-controlled ventilation without PNT, first select the

function “No PNT” by navigating to “Main menu”  “Options” 
“PNT” (see chapter 4.2.7.1 from page 101). During ventilation without
PNT, tidal volumes, minute volumes, resistance, and compliance are no
longer displayed and calculated.
Reasons for ventilation without PNT may include PNT dead space
influence on alveolar ventilation.
PNT dead space  PNT A = 0.5 ml

 PNT B = 0.6 ml
 PNT C = 0.9 ml
The trigger required for syncing spontaneous breathing is automatically

switched from the flow to the pressure signal.
If the “External trigger” option is available, syncing can also be based on
the abdominal movement of the patient.

9 Ventilation modes
9.4 Synchronized mechanical ventilation
Controlled ventilation may result in asynchrony between the spontaneous

breathing efforts of the patient and the fixed ventilation cycles of the
ventilator. In this case, the mandatory breaths randomly coincide with
different phases of spontaneous breathing. Due to the possible resulting
adverse effects, syncing between a spontaneously breathing patient and
the ventilator is especially important.
The SOPHIE uses different trigger signals for syncing.
1. Respiratory gas flow signal of the pneumotachograph

2. Differential pressure signal of the pressure sensors
3. Abdominal movement from respiration sensor (optional)
The trigger threshold is set using the “Trigger” parameter field. The
higher the setting for this trigger threshold in the expiratory pause, the
more the patient has to breathe in to activate the trigger.
Pneumotachograph The SOPHIE uses the pneumotachograph (PNT) to measure the patient’s
inspiratory flow. If the inspiratory flow exceeds a value set by the
operator, a mandatory breath is triggered. The trigger threshold appears
as a blue line in the respiratory gas flow window V‘(t).
Respiration sensor The respiratory sensor is used to detect the patient’s abdominal
(optional) movements. If the trigger threshold set by the operator is exceeded, a
mandatory breath is triggered.
The trigger threshold appears as a blue line in the external trigger window
E(t).
Differential pressure The differential pressure trigger is only automatically activated when the
sensor “No PNT” function has been selected in “Main menu”  “Options” 
“PNT” (see chapter 4.2.7.1 from page 101). All displays, calculations,
and signals belonging to the flow signal are now switched off
automatically. The trigger signal then changes to a differential pressure
trigger. The blue trigger line appears below the PEEP line in the
ventilation pressure window. When the patient attempts to breathe
spontaneously, the PEEP drops slightly.

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9 Ventilation modes
The trigger threshold can detect the PEEP drop and trigger a mandatory
breath. The lower the trigger threshold is positioned below the PEEP line,
the more the patient has to breathe in to trigger a breath. In turn, too little
distance to the PEEP line can cause unintended triggering due to artifacts.
9.4.1 Assisted controlled ventilation
The SOPHIE delivers a mandatory breath whenever the selected trigger

threshold is exceeded. Mandatory inspiration is triggered by the patient,
but the characteristics are controlled by the device.
After every inspiration, the trigger is suppressed for 200 milliseconds.

The patient cannot request a new breath until the trigger suppression
period has elapsed. Similar to IMV ventilation, assisted controlled
ventilation supports volume limitation.
NOTE
Detailed information on selecting the ventilation mode “Ass./Co.” and setting the
9.4.2 S-IMV
In this mode, the operator defines a maximum mandatory breathing
frequency which the patient can sync with spontaneous breathing efforts.
This breathing frequency should be significantly lower than the patient’s
spontaneous breathing frequency to prevent asynchronies. For this
purpose, a sufficiently long expiration time must be set during which the
patient is able to “trigger” (i.e. request) mechanical pressure support.
Spontaneous breaths outside the trigger expectation window (in the first
half of the expiration time) are not mechanically supported.
The expiration time is divided into 2 equal halves. In the first half, the
patient can only breathe spontaneously. Even when the trigger threshold
is crossed, there is no mandatory support from the ventilator. However, a
spontaneous breath which is greater than the trigger threshold is used to
calculate the minute volume MV, breathing frequency, and inspiration
ratio in %.
The actual total breathing frequency is shown in the “F” measured value
display of the monitor. This is also where the measured values for the
minute volume “MV” and the actual inspiratory ratio “Insp/%” are
located. If the patient does not start to breathe spontaneously during the

9 Ventilation modes
trigger expectation window, the ventilator performs a mandatory breath

immediately after the end of the set expiration time. Similar to the
previous ventilation modes, SIMV ventilation can also be combined with
volume limitation.
Ignoring weak If a patient breathes weakly in the CPAP phase of SIMV, the “VT low”
spontaneous breaths alarm is triggered. Previously, this could only be prevented by setting the
lower limit of the “Vt(exp) low” alarm to a very low value. However, this
has the result that mandatory breaths with less than the desired tidal
volume do not trigger alarms either. To optimally set the alarm limit
while still preventing alarm triggering due to weak spontaneous breaths, a
“VT filter” threshold with a configuration range of 0.2 to 10 ml has been
incorporated. Only breaths that exceed the configured threshold are
registered and taken into account for alarm generation and frequency
determination (see chapter 4.2.1).
NOTE
Detailed information on selecting the ventilation mode “S-IMV” and setting the

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9 Ventilation modes
9.4.3 Inspiratory time termination (ITT/PSV)
NOTE
Inspiratory time termination (ITT) can be selected as an option for the ventilation
modes S-IMV and ASS./CO. in the »Ventilation« menu (see chapters 5.4.3 and 5.4.5
from page 129).
Inspiratory time A modified form of patient-triggered ventilation, known as inspiratory

termination (ITT) time termination (ITT), can be used to achieve greater sensitization and
enhanced adjustment of the ventilation control to the patient’s
physiological needs. This is designed to allow the patient to determine
both the start and end of the inspiratory breath.
Using the set trigger threshold, the ventilator detects the patient’s
inhalation effort.
The inspiratory peak flow is stored during inspiration. With increasing
inspiration progress, the inspiratory flow drops and approaches zero
towards the end when the lung has been filled completely.
This effect can be used for better syncing of the ventilation process. This
new method of patient-synced ventilation lets you adjust the inspiratory
peak flow value as a percentage (KV’ %). Inspiration ends when the
value falls below this peak flow value.
Fig. 121: Inspiratory time termination ITT
The abort criterion can be set between 5 and 40% of the peak inspiratory
flow. This enables the ventilator to adjust the degree to which the lungs
are filled to the physiological conditions. If the patient reduces or

9 Ventilation modes
completely discontinues spontaneous breathing, the pre-set target volume

(VtTar) is applied.
This function only works with the following ventilation methods:

 S-IMV
 Ass./Co.
The “KV’ %” function can be used to adjust the inspiratory peak flow
factor as a percentage at which inspiration ends.
NOTE
More information on setting the parameters “KV’ %” and “VtTar” can be found in
chapter 5.3 from page 122 and in chapters 5.4.3 and 5.4.5 from page 129.

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9 Ventilation modes
9.5 S-IMV with ITT and pressure support
SIMV permits spontaneous breaths between the mandatory inflations,

which can receive additional ventilator support.
PPSV% With spontaneous breathing between the mandatory inflations, the patient
is responsible for part of the breathing effort. These spontaneous breaths
receive pressure support according to the »PPSV%« setting. The
»PPSV%« parameter sets the supporting pressure for the patient’s
spontaneous breaths in proportion to the actually applied inflation
pressure. »PPSV%« is adjustable within the range of 0 – 100%.
NOTE
If PPSV% is set to 0%, the pressure support for the spontaneous breaths is switched
off.
Pressure-supported spontaneous breaths are generally ITT inflations with

inspiratory and expiratory syncing.
Pressure-supported
inflation
Mandatory
inflation
Fig. 122: SIMV with ITT and pressure support
If the pressure of the mandatory/assisted inflations is reduced by the

VtTar volume control, the supporting pressure for spontaneous breaths is
automatically adjusted to the new inflation pressure.

9 Ventilation modes
9.6 High frequency oscillation
NOTE
High frequency oscillation (HFO) is an optional Sophie component. For versions
without HFO, the HFO option cannot be selected and is grayed out in the Ventilation
menu.
Settings High frequency oscillation is supported in the ventilation modes IMV and
CPAP. It can be set in the Ventilation menu (see chapters 5.4.6 and
5.4.7).
High frequency oscillation (HFO) causes a sort of vibration in the lung by

imposing pressure oscillation around a mean pressure at the tube
connector. The oscillation is generated by the SOPHIE’s proportional
valve, which oscillates between a positive and negative pressure source.
The following variables must be preset by the user:

 Mean airway pressure using the »MAP« parameter (for CPAP)
 Positive end expiratory pressure using the »PEEP« parameter
(for IMV)
 Oscillation pressure amplitude
 Oscillation frequency
 I/E oscillation ratio
 Pressure limit and time period of the insp. hold function
HFO can be combined with the conventional ventilation modes IMV and
CPAP in pressure-controlled mode. Typically, CPAP ventilation is
selected as the basis for HFO.
The corresponding parameters can be set in the HFO pop-up menu,
particularly the inspiration/expiration time ratios. HFO is monitored by
an upper and lower alarm limit for the oscillating pressure amplitude, the
mean airway pressure, and the oscillating minute volume together with a
lower alarm limit for PEEP (IMV mode), MAP (CPAP mode), and tidal
volume. The alarm limits can be changed automatically or manually.

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9 Ventilation modes
A possible disconnection of the patient from the oscillation pressures is

hardly detectably with HFO because of the strong influence of airway
resistance. One of the greatest airway resistances in this system is the
endotracheal tube. As a result, unintentional extubation of the child from
the endotracheal tube cannot be detected reliably based on a change in the
oscillation amplitude.
However, the mean oscillation flow shows a marked positive increase in
the case of such a large leak or extubation. On the other hand, the
oscillation amplitude remains nearly the same. Only the subsequent
volume alarm informs the user of this critical situation.
The SOPHIE has a new monitoring method that can detect the mean flow
during HFO.
If the mean flow shows a marked positive increase during HFO, that is, a
very large portion of the flow exits the tube system without returning
during expiration, this can be presumed to indicate disconnection. A blue
line appears in the flow display under HFO.
The position of this line can be adjusted in the pop-up menu or in the
corresponding parameter field of the selected HFO ventilation
(see chapter 5.3 from page 122, chapter 5.4.2 from page 127 and chapter
5.4.7).
The line is referred to as the flow limit line. If the determined mean flow
rises above the blue flow limit line, the “Flowlimit/disc?” alarm is
activated immediately.
Patient component The SOPHIE patient component has various safety features for the event
preparation of a device malfunction or gas supply failure. If the gas supply fails, the
emergency air valve of the test block always switches the system so that
there is no resistance between the patient and the atmosphere.
This safety feature is checked automatically every time the device starts
up. In the unlikely event that this emergency air valve is blocked, the
patient can breathe spontaneously by means of a mechanical safety valve.
However, this valve does not open until a negative pressure of approx.
-6 cmH₂O is reached.
When using HFO, larger amplitude settings result in a negative pressure,
which quickly reaches the value of -6 cmH₂O at which the safety valve
opens. To avoid losing the therapeutic benefits of a large pressure
amplitude due to the secondary safety function, the safety valve may be
disabled during HFO therapy using the »HFO« sealing plug.

9 Ventilation modes
Always comply with the instructions on the warning label attached to the
Fig. 123: HFO label
9.7 Non-invasive CPAP (NCPAP) and CPAP
The NCPAP and CPAP ventilation modes presume sufficient

spontaneous breathing by the patient. The patient can breathe in and out
freely at the set CPAP level. The CPAP level can be set using the
»PEEP« parameter.
The SOPHIE ventilator generates a stable pressure level and compensates
for pressure level changes due to leakage by automatically adjusting the
amount of continuous flow characteristic of NCPAP and CPAP to the
current ventilation situation.
By setting a flow limitation with NCPAP, the flow that is available for
leakage compensation can be limited. The »MaxV’« flow limitation can
be set between 20 and 6 l/min or switched off completely.
Spontaneous breathing
Fig. 124: Spontaneous breathing in NCPAP and CPAP

®
9 Ventilation modes
9.7.1 Backup ventilation
To activate enhanced apnea monitoring, the »ApD« parameter must be

set to an interval between 4 and 16 s. This time should be set in
accordance with the magnitude of the functional residual capacity (FRC),
the oxygen reservoir of the patient.
The »ApD« parameter determines the time the ventilator waits for a
detected spontaneous breath before it starts the backup ventilation. A
spontaneous breath is detected as soon as an inspiratory effort of the
patient, represented by the trigger signal, exceeds the preset trigger
threshold.
If no spontaneous breath is detected within the apnea duration (ApD), the
apnea counter increases by one. At the same time, a mandatory backup
ventilation using the »Pmax«, »Insp«, »Exp« (»Freq«), and »Pattern«
parameters is initiated.
Fig. 125: NCPAP backup ventilation
These parameters must be set to ensure safe and sufficient ventilation in

the case of an apnea event (discontinued spontaneous breathing).

9 Ventilation modes

9.7.1.1 Standard backup
The standard backup mode is indicated by the “BU” icon in the status
bar. In addition, the »ApD«, »Insp«, »Exp«, and »Freq« parameters are
automatically colored orange.
With the first spontaneous breath that exceeds the set trigger threshold,
backup ventilation is stopped with an assisted breath.
Fig. 126: NCPAP standard backup mode

®
9 Ventilation modes
9.7.1.2 Frequency-controlled backup ventilation
Frequency-controlled backup mode is indicated by the “FBU” icon and

the associated interval (10, 30 or 60 s) in the status bar. In addition, the
»ApD«, »Insp«, »Exp«, and »Freq« parameters are automatically colored
purple.
If a spontaneous breath is detected after an apnea in frequency-controlled
backup mode, backup ventilation is gradually reduced by 1/3 of the set
backup frequency. The duration until the complete shutoff of backup
ventilation is at least five times the duration of the set FBU interval (for
example, 5 minutes with “FBU 60”). The apnea counter is reset when
ApD is switched off, upon restart, or when the ventilation mode is
changed.
The frequency of the backup ventilation should be set above the expected
spontaneous frequency of the patient to eliminate the apnea-related
accumulated excessive CO2 during the first stage.
 In the first stage of the backup ventilation (B1), at least one

spontaneous breath must be detected to enable the second stage,
which will then start automatically once the first stage has elapsed.
Fig. 127: Backup stages 1 and 2
 The second stage of the backup ventilation (B2) reduces the backup
frequency by 1/3 by extending the expiration time. The extended
expiration time allows patients to better sync their spontaneous
breathing with the ventilator.

9 Ventilation modes
 If no additional apnea is detected, the third stage of backup

ventilation (B3) will be enabled, which will then start automatically
once the second stage has elapsed. This reduces the backup frequency
by another 1/3 by extending the expiration time. This allows the
patient to breathe spontaneously between mandatory backup
inspirations. From this stage of the backup ventilation, the ventilator
also monitors the patient’s average spontaneous respiration rate. The
patient has to breathe spontaneously for at least 2/3 of the set backup
frequency to enable the subsequent stage.

®
9 Ventilation modes
 In stages four (B4) and five (B5) of the backup ventilation, there is no
further reduction of the backup frequency. If the spontaneous
breathing continues for at least 2/3 of the set backup frequency and
no additional apnea is detected, the backup ventilation switches off
automatically once the fifth stage has elapsed. The total duration of
backup ventilation is therefore at least five times the duration of one
FBU interval.
 If the conditions for enabling the next stage are not met within each
stage (B1-B5), the backup ventilation automatically switches back to
stage B1.
Fig. 130: Backup stage 5 and backup off
The current stage is indicated below the inflation pressure curve. A »B«
indicates a controlled mandatory inflation and an »A« indicates an
assisted inflation. The number after the character indicates the current
stage. Pure spontaneous breaths are marked by a single »S«.

9 Ventilation modes
9.8 Synchronized NIPPV
SNIPPV ventilation presumes sufficient spontaneous breathing by the

patient. Spontaneous breaths are supported by assisted mechanical
inflation. The inflation is synced with the patient’s inspiratory efforts
using the inspiratory trigger (pressure trigger or, optionally, external
trigger). If the external trigger was selected, the trigger signal also works
as an expiratory trigger, syncing the end of the inspiration phase.
SNIPPV To allow the patient maximum respiration control, the »Insp« and »Exp«
(»Freq«) parameters can be inactivated by switching on apnea monitoring
with the external respiration sensor activated. The parameters take effect
only if no spontaneous breath was detected and backup ventilation is
initiated after the apnea duration time (ApD) elapses.
Fig. 131: Pressure support during SNIPPV
The inspiration time, and therefore the duration of pressure support, is

determined by patients themselves when apnea monitoring is switched
on.

®
9 Ventilation modes
The target duration of the linear and sinusoidal pressure pattern is still
determined by the »Insp« parameter. If the spontaneous inspiration is
longer than »Insp«, a pressure plateau forms until the start of expiration.
For safety reasons, the inspiration is ended automatically after 700 ms.
If the spontaneous inspiration is shorter than »Insp«, the support pressure
preset using the »Pmax« parameter is no longer reached with a linear or
sinusoidal pressure pattern.
Fig. 132: Expiratory trigger during SNIPPV
9.8.1 Backup ventilation
To activate SNIPPV-B, the »ApD« parameter must be set to an interval

between 4 and 16 s. This time should be set in accordance with the
magnitude of the functional residual capacity (FRC), the oxygen reservoir
of the patient. The »ApD« parameter determines the time the ventilator
waits for a detected spontaneous breath before it starts the backup
ventilation.
A spontaneous breath is detected as soon as an inspiratory effort of the
patient, represented by the trigger signal, exceeds the preset trigger
threshold.

9 Ventilation modes
If no spontaneous breath is detected within the apnea duration (ApD), the

apnea counter increases by one. At the same time, a mandatory backup
ventilation using the »Pmax«, »Insp«, »Exp« (»Freq«), and »Pattern«
parameters is initiated.
Fig. 133: SNIPPV with apnea monitoring
The »Pmax«, »Insp«, »Exp« (»Freq«), and »Pattern« parameters must be

set to ensure safe and sufficient ventilation in the case of an apnea event
(discontinued spontaneous breathing).


®
9 Ventilation modes
9.8.1.1 Standard backup
The standard backup mode is indicated by the “BU” icon in the status
bar. In addition, the »ApD«, »Insp«, »Exp«, and »Freq« parameters are
automatically colored orange.
On the first spontaneous breath that exceeds the set trigger threshold,
backup ventilation is stopped.
Fig. 134: SNIPPV standard backup mode
9.8.1.2 Frequency-controlled backup ventilation
Frequency-controlled backup mode is indicated by the “FBU” icon and

the associated interval (10, 30 or 60 s) in the status bar. In addition, the
»ApD«, »Insp«, »Exp«, and »Freq« parameters are automatically colored
purple.
If a spontaneous breath is detected after an apnea in frequency-controlled
backup mode, backup ventilation is gradually reduced by 1/3 of the set
backup frequency. The duration until the complete shutoff of backup
ventilation is at least five times the duration of the set FBU interval (for
example, 5 minutes with “FBU 60”). The apnea counter is automatically
reset when ApD is switched off, upon restart, or when the ventilation
mode is changed. The frequency of the backup ventilation should be set
above the expected spontaneous frequency of the patient to eliminate the
apnea-related accumulated excessive CO2 during the first stage.

9 Ventilation modes
 In the first stage of the backup ventilation (B1), at least one

spontaneous breath must be detected to enable the second stage,
which will then start automatically once the first stage has elapsed.
 The second stage of the backup ventilation (B2) reduces the backup
frequency by 1/3 by extending the expiration time. The extended
expiration time allows patients to better sync their spontaneous
breathing with the ventilator. If no additional apnea is detected, the
third stage of backup ventilation (B3) will be enabled, which will
then start automatically once the second stage has elapsed.

®
9 Ventilation modes
 The third stage of the backup ventilation (B3) reduces the backup
frequency by another 1/3 by extending the expiration time. This
allows the patient to breathe spontaneously between mandatory
backup inspirations.
From this stage of the backup ventilation, the ventilator also monitors
the patient’s average spontaneous respiration rate. The patient has to
breathe spontaneously for at least 2/3 of the set backup frequency to
enable the subsequent stage.
 In stages four (B4) and five (B5) of the backup ventilation, there is no
further reduction of the backup frequency. If the spontaneous
breathing continues for at least 2/3 of the set backup frequency and
no additional apnea is detected, the backup ventilation switches off
automatically once the fifth stage has elapsed. The total duration of
backup ventilation is at least five times the duration of the set FBU
interval (for example, 5 minutes with “FBU 60”).

9 Ventilation modes
Fig. 138: Backup stage 5 and backup off
 If the conditions for enabling the next stage are not met within each
stage (B1-B5), the backup ventilation automatically switches back to
stage B1.
The current stage is indicated below the inflation pressure curve. A »B«
indicates a controlled mandatory inflation and an »A« indicates an
assisted inflation. The number after the character indicates the current
stage.
NOTE
The SOPHIE controls the ventilation pressure by continually adjusting the flow
through the tube system to the current ventilation situation. By setting a flow
limitation, this flow is limited. The desired ventilation pressure may no longer be
reached. The flow limitation limit must therefore be set to a level where the target
ventilation pressure is just reached.

®
10 Patient gas humidification
10.1 General
The patient gas temperature set in the heating menu is the target
temperature that the patient gas should reach at the patient connection
port. The measured temperature value displayed on the screen
corresponds to the temperature measured at end of the inspiration tube
(proximal). The built-in humidifier in the P7 patient system features an
automatically regulated water bath heater. This allows you to modify the
humidity of the patient gas. Setting the humidity level determines the
temperature of the humidifier. Increasing the humidity level results in an
increase of the temperature in the water bath relative to the set patient gas
temperature. The humidity capacity of the gas, and therefore the
humidity, is increased due to the increased temperature. Lowering the
humidity level, in turn, reduces the humidity capacity, and therefore the
humidity.
10.2 Special features of the P7 patient system
One of the unique features of the P7 system is the combined

inspiration/expiration valve located downstream of the humidifier.
The humidification chamber therefore has no effect on the compressible
volume of the system. This is especially useful when ventilating very
small premature infants and in HFO.
Because of this valve arrangement, the humidification chamber is
pressurized to the system pressure for the SOPHIE.
The pressurized gas is charged with a certain amount of water in the
humidifier. When the patient gas expands to breathing pressure in the
patient tube, its volume increases. However, the increased volume of
patient gas still contains the same amount of water.
This means that a smaller amount of water is transported for every liter of
patient gas. As a result, the gas becomes drier. The SOPHIE automatically
compensates this effect by adjusting the humidifier temperature.

10.3 Humidity and flow
Like nearly all standard commercial humidifiers, the P7 is what is known

as an evaporator. It uses the principle of evaporation and enriches the gas
with water molecules. The quantity of water molecules depends on the
temperature and the surface area available for evaporation. For
conventional ventilation, the ventilation system has a continual flow of
about 5 l/min. Under these flow conditions, the humidifier is capable of
sufficiently saturating the gas for the patient. For special therapies, such
as nasal “CPAP” or “HFO”, however, the flow can easily more than
double. In order to compensate for a reduction in the humidity at high
flow rates, more water molecules must be available in the humidifier.
This can be compensated by a higher humidity level.
NOTE
The SOPHIE provides a separate humidity level for each of the three basic ventilation
modes “conventional”, “HFO”, and “NIV”. If the ventilation mode is changed, the
corresponding level is automatically set.
The default humidity levels can be individually adjusted by the FRITZ STEPHAN
GMBH customer service team.
10.4 Condensation in the tube system
Active patient gas humidifiers typically generate a relative humidity of

close to 100%, that is, near the saturation limit. The amount of water that
the gas can absorb depends on the temperature of the gas. The maximum
amount of water in one liter of air at a temperature of 37°C is about
44 mg. The amount of water in the gas is also called the absolute
humidity. The relative humidity is then 100%.
If the gas cools, the humidity capacity of the gas is also reduced. The gas
can no longer retain the amount of water it has previously absorbed. The
excess water condenses and forms a fine mist. This mist, in turn,
precipitates on the walls of the patient tubes. In order to prevent the
patient gas from cooling below this “dew point”, the patient tubes are
electrically heated. There are situations, however, in which merely
heating the tubes is not sufficient to stabilize the temperature in the tube
system:

®
10.4.1 Air conditioned rooms
Air conditioners, conforming to international standards, generate laminar

air flows along the walls. These cold air flows can negatively affect the
heating performance of the reusable patient tube systems and promote
condensation. The reusable patient tube systems can be protected with the
following optional insulating tube warmers:
1 007 60 007 Length 730 mm for heated section of the incubator tube
system
1 007 60 004 Length 1130 mm for heated section of the warming bed
tube system
.
WARNING
Do not use tube warmers for reusable patient tube systems with the disposable patient
tube system (Art. no. 100761300)!
The insulation can cause heat buildup that weakens the material and can damage the
tube!
The tube warmers are wrapped around the heated sections of the
inspiration and expiration tubes like a jacket and fastened using a Velcro
strip.
Fig. 139: Using the tube warmer 100760007


CAUTION
10.4.2 Low incubator temperature
If the incubator temperature is more than 4°C below the set patient gas
temperature, the heating system can no longer compensate for the
difference in temperature. The target temperature for the patient gas at the
Y piece is therefore no longer reached. If the patient gas temperature falls
below the dew point, condensate forms.
The reusable patient tube system for incubators can be fitted with the
optional insulated tube warmer:
1 007 60 003 Length 390 mm for cold section
to reduce the drop in temperature of the patient gas along the cold section
in the incubator.
WARNING
Do not use tube warmers for reusable patient tube systems with the disposable patient
tube system (Art. no. 100761300)!
The insulation can cause heat buildup that weakens the material and can
damage the tube!


®
CAUTION
The tube warmer is wrapped around the non-heated sections of the

inspiration and expiration tubes like a jacket and fastened using a Velcro
strip. The disposable patient tube system (Art. no. 100761300) can be
fitted with the optional insulated tube warmer:
1 007 60 507 Length 390 mm for cold section
to reduce the drop in temperature of the patient gas along the cold section
in the incubator.
NOTE
The disposable patient tube system (Art. no. 100761300) is heated along the entire
expiration tube and does not require insulation. The tube warmer is only used for the
inspiration tube!

CAUTION

NOTE
At differences of > 4°C between the incubator temperature and the patient gas
temperature, use a tube warmer inside the incubator.
Alternatively, the reusable patient tube system for warming beds can be
used in these types of situations. This tube system has a longer heating
section, which was designed to prevent condensation in open warming
beds.

The heated section of the reusable tube system for warming beds can be
insulated with an optional tube warmer if ambient conditions require it.

®
10.4.3 Sensor positioning
The temperatures of the P7 patient system are controlled by an intelligent

temperature management program. It measures the patient gas
temperature at the outlet of the water bath, at the end of the heating
section, and at the end of the inspiration tube. Depending on the situation,
the heaters for the humidifier and the patient tubes are regulated. If the
distal sensor at the end of the heating section is accidentally positioned
inside the incubator, then its temperature will cause a misreading.
Direct irradiation of the sensor by a heating lamp can also lead to the
temperature reading being too high.
CAUTION
Avoid direct irradiation of temperature sensors!
Direct irradiation can negatively affect the temperature measurement and thus the
humidity of the patient gas!

®
11 Functional description
11.1 General
Older ventilators are based on the constant flow principle:

After configuring a constant basic flow, mechanical ventilation occurs by
opening or closing an expiration valve. By altering the basic flow, the
inspirational pressure pattern can be altered to a certain extent. The
drawbacks of this method are a severely limited choice of desired
inspiration patterns and unnecessarily high gas consumption.
The SOPHIE, on the other hand, embodies a new generation of ventilators
for infants, with a different valve principle that permits a choice of three
different inspiration pressure patterns. This presents a new level of
ventilation quality by offering the physician a much greater variety of
options. There is no longer a need for variable basic flow setup.
For improved purging of the expired gases in the Y piece, the SOPHIE has
a fixed basic flow of about 3–5 l/min.
11.1.1 Description of the pneumatic system
The SOPHIE ventilator is made up of several different pneumatic

functional units, which are explained in this chapter.
Oxygen and compressed air are fed into the device via the gas inlet block
sub-assembly (A). Safety valves (SV1/SV2) restrict the input pressures to
a maximum of 7 bar. In addition to the inlet filters (F1/F2), the
compressed air inlet can also be fitted with a membrane dryer (TR1). The
O2 sensor measures the inspiratory oxygen concentration using the
sidestream technique. For calibration purposes, compressed air from the
blender is directed at the sensor via the valve MV2.
The oxygen and compressed air are mixed in the EGB sub-assembly (B).
The oxygen concentration is regulated by two proportional valves
(PV1/PV2) while a further proportional valve (PV3) regulates the
pressure in the buffer volume.
The gas mixture is then fed through two filters (F3/F4) to the connection
block (C) on which the patient component (D) is docked.
Here, additional valves release the gas supply for the optional refill
system (MV3) and control the emergency air valve (MV4).

When the device is in standby or in the event of a fault, the pneumatic

emergency air valve (E) for the patient component opens to enable the
patient free inspiration and expiration. The check valves RV1 and RV2
control the direction of the gas flow and reduce the level of CO2 re-
inhalation. The additional valve (RV3) prevents excessively high
negative pressures. The adjustable positive pressure valve (ÜV1) limits
the pressure in the inspiration tube.
The system is designed so that when operating normally or in the event of
the first fault, only the patient component is contaminated. It can be fully
decoupled from the ventilator for cleaning. At the patient component inlet
(D), the fresh gas is fed through the integrated humidifier to the patient
valve (double piston valve).
Patient valve The patient valve controls both the inspiration and expiration of the
mechanical ventilation. In essence, it consists of valve housing with slots
for fresh gas intake, inspiration, expiration, and a patient gas outlet. A
valve piston is fitted in this housing, which can be moved lengthwise.
The valve piston is magnetically coupled to an electrodynamic drive used
to move the piston.
Fig. 143: Patient valve P7, valve piston in the inspiration position
1 Valve housing 5 Magnetic coupling

2 Outlet 6 Visual path measurement
3 Patient inspiration 7 Valve piston movement
4 Fresh gas

®
During inspiration, the fresh gas is supplied to the patient at a continuous

positive pressure via the inspiration path, causing the ventilation pressure
to rise. When the setpoint value for the ventilation pressure is reached,
the piston is retracted and the inspiration path for fresh gas is closed.
When entering the expiration phase, the piston is moved to the expiration
position, which opens the expiration path and evacuates the expiration
gas from the lungs.
During high frequency oscillation (HFO), an ejector in the patient
component creates an additional negative pressure, which allows active
expiration. The ejector is driven by the valves (MV8/MV9) at two levels.
During normal operation and with HFO, the expiration gases are expelled
from the system via a silencer.
Pressure and flow Both the inspiratory and the expiratory pressure are measured using two
measurement separate pressure sensors (DS5/DS6). These values are used to calculate
the airway pressure at the Y piece.
The volume flow to the patient is determined using a pneumotachograph
(PNT) by means of a differential pressure measurement.
The valves MV5 and MV6 cyclically switch the differential pressure
sensor (DDS1) to atmospheric pressure for zero point calibration.
The pressure measurement tubes are continually purged with fresh gas
via the chokes D2-D5 to remove any condensate from the lines.
Medication A pneumatic medication nebulizer can be connected to the aerosol outlet.
nebulization A gas mixture is used as the driving gas and supplied via the valve
(MV10) with the same oxygen concentration as the inspiratory gas at the
aerosol port. This has little impact on the inspiratory oxygen
concentration.
Refill system The optional refill system (A03861009) controls the water level in the
humidifier to ensure steady humidification. The tube for the sterile water
bag is inserted into a pinch valve (QV1), which releases the water flow
into the humidifier. The pinch valve (QV1) is pneumatically controlled
by the valve MV3.
The sterile water bag is additionally pressurized by a pressure regulator
(DR1) to enable water inflow against the positive pressure of the
humidifier. The check valve (RV4) prevents the water from flowing back
into the ventilator.
External trigger The use of an external trigger makes it possible to record spontaneous
breaths without any contact with the ventilator’s gas system.
The pressure changes to the pressure capsule are recorded by the pressure
sensor (DS7) in the “external trigger” sub-assembly (A03861099). The
valve (MV7) cyclically activates the capsule with respect to the
atmosphere to calibrate the zero point.

11.2 Pneumatic diagram

A B C D
SV1
Ejektor Schalldämpfer
O2 (2,8-6bar)
PV1 MV8
F1
MV1 MV9
Doppel-
Kolbenventil
Trockner
AIR (2,8-6bar)
Befeuchter
optional
F3 F4
Puffer- PNT
PV2 PV3 Volumen
F2 TR1
MV4 RV1 RV2
MV2 Puffer- Druck-

SV2
Volumen Kapsel
MV3
O2- MV10
Sensor RV3
ÜV1
DDS1 DS5 DS6

∆P P P
E E E
MV5 MV6
D4 DR1 EDA
D5 E
D2 D3
F
QV1
RV4
H G
Anschlussschlauch
Refill H2O Aerosol
MV7
DS7
P
E
Fig. 144: Sophie: pneumatic diagram with patient component P7
O2 flow SV1 O2 safety valve MV9 Ejector control valve

AIR flow SV2 AIR safety valve MV10 Aerosol control valve
Gas mixture F1/F2 Inlet filter F3/F4 Attenuation filter
Exp. gas TR1 Membrane dryer RV1 Emergency air circuit valve (exp.)
H2O PV1 O2 proportional valve RV2 Emergency air circuit valve (insp.)
Measurement tube PV2 AIR proportional valve RV3 Negative pressure safety valve
A Gas inlet block PV3 Fresh gas proportional valve RV4 Refill check valve
B Electrical gas blender (EGB) MV1 Substitution valve DR1 Refill pressure regulator
C Connection block MV2 O2 calibration valve QV1 Refill pinch valve
D Patient component P7 MV3 Refill control valve DDS1 Differential pressure sensor
Control valve for emergency
E Emergency air valve MV4 DS5 Inspiration pressure sensor
air valve
F Refill control block MV5 Flow calibration valve DS6 Expiration pressure sensor
G Refill pinch arm MV6 Flow calibration valve DS7 Pressure capsule pressure sensor
Pressure capsule calibration
H Flow zeroing block MV7 ÜV1 Positive pressure safety valve
valve
I External trigger MV8 Ejector control valve D2-D5 Purge flow chokes
Tab. 16: Sophie pneumatic diagram key

®
12 Troubleshooting
12 Troubleshooting
12.1 List of errors
The SOPHIE has a monitoring concept which ensures patient safety and
reacts immediately to errors.
Safety mode The emergency air valve connects the patient tube system to the
atmosphere – the patient can breathe spontaneously.
All valves are switched off, including the valves for the compressed air
(AIR) and oxygen (O2). The patient is connected to the atmosphere by the
emergency air valve.
The patient valve control is switched off.
Observe and do not leave the patient unattended.
If necessary, use the breathing bag and prepare a second ventilator.
NOTE
In order to ensure optimal service, note the version number of the installed software
before contacting the Fritz Stephan GmbH customer service team. The version
number can be found in the “Main menu” under “Options“  “Communic.” 
“System”.
Corrective action Corrective action Explanation

and explanation
Switch off the SOPHIE Disconnect the patient from the device
Ventilate the patient manually
Then switch the device off
Notify the FRITZ Ventilation is only ensured conditionally. Do
STEPHAN GMBH not restart the SOPHIE until the error cause
customer service team has been eliminated.
Safety mode is activated The safety mode is sustained for at least 2 s
for 2 seconds after the error condition has occurred.
Tab. 17: Corrective action and explanation

12 Troubleshooting
TA Technical alarm
Test mode message
LP alarms Low priority alarm
MP alarms Medium priority alarm
MHP alarms Alarm of at least medium priority. This alarm
starts out as an MP alarm and becomes an HP
alarm after 30 seconds.
HP alarms High priority alarm
Alarm text Priority/ Cause Corrective action

type of
alarm
Battery service Notifi-  Maximum number of  Replace the battery
cation charge cycles has been  Notify the FRITZ STEPHAN
reached GMBH customer service
team
EEPROM values ? Notifi-  Error in checksum of  Reboot the device
cation calibration data memory  Switch off the SOPHIE and
notify the FRITZ STEPHAN
GMBH customer service
team
Init MC xxxxxxxx Notifi-  Microcontroller  Check the sensor
cation initialization error connections
 Notify the FRITZ STEPHAN
team
Init PC xxxxxxxx Notifi-  PC initialization error  Check the sensor
cation connections
team
Power supply? LP  SOPHIE was disconnected  Check the mains supply
TA from mains supply
Battery low MP  Battery charge level < 50%  Check the mains supply and
TA charge the battery

®
12 Troubleshooting

type of
alarm
Apnea MP  No spontaneous inspiration  PNT connected?
within 15 sec  Does the patient actually
exhibit apnea?
Air inlet MP  AIR input pressures less  Check the connection to the
TA than 2.8 bar central gas supply (CGS)
 Switch off the SOPHIE and
team
Pressure diff. MP  Pressure difference too  Check and possibly replace
TA large between inspiratory the patient tube system and
and expiratory pressure the pressure measurement
sensor tube
 Safety mode if the pressure  Notify the FRITZ STEPHAN
difference exceeds GMBH customer service
20 cmH₂O for 20 ms or team
10 cmH₂O for 400 ms
EEPROM timeout MP  Write/read error in the  Switch off the SOPHIE and
TA calibration data memory notify the FRITZ STEPHAN
team
Ext. Trigger MP  Board for external trigger  Disable external trigger and
TA (optional) malfunctioning select a different suitable
ventilation mode
 Contact FRITZ STEPHAN
FiO2 high MP  Measured FiO2 above the  Check the FiO2 upper limit
set upper alarm limit and adjust if necessary
 Compare the set FiO2 value
with the measured value
 In the case of larger
deviations, notify the
FRITZ STEPHAN GMBH

12 Troubleshooting

type of
alarm
FiO2 low MP  Measured FiO2 below the  Check the FiO2 lower limit
set lower alarm limit and adjust if necessary
 Compare the set FiO2 value
with the measured value
 In the case of larger
deviations, notify the
FRITZ STEPHAN GMBH
Flow sensor fail MP  Error reading the flow  Check PNT
TA sensor  Notify the FRITZ STEPHAN
team
Heating H1 fail MP  Humidifier’s heating  Replace the patient
TA element is defective component
Heating off MP  Battery capacity too low  Restore the mains power
TA (< 20%) supply
 Temperature sensors  Check the temperature
defective sensor
 Temperature > 41°C  Check the patient
component
 Check the set alarm limits
 Humidifier fill level is too  Fill the humidifier bottle
low
VT leak > 50% MP  The measured inspiratory  Check the patient’s
volume (Vt insp) condition
is at least twice the  Check the tube system
expiratory volume (Vt exp)
 Check the ETT
 The measured PEEP is >
 Check the patient
10%, but at least 2 cmH₂O
component
below the set PEEP
(only if leak alarm is ON)  Check MaxV’ and increase
if necessary
Min. volume high MP  Expiratory breathing  Check that the manual
volume above the set upper settings are correct and
alarm limit plausible, adjust if necessary
Blender MP  Fault in electronic gas  Notify the FRITZ STEPHAN
TA blender GMBH customer service
team

®
12 Troubleshooting

type of
alarm
Refill fail MP  Sensor error in the  Check the water level in the
TA automatic refill system reservoir
 Switch off the refill system
and notify the
FRITZ STEPHAN GMBH
PSU temperature MP  PSU temperature increased  Check the fan and
TA with less than 50% battery ventilation openings
capacity remaining.  Replace the dust filter on the
Battery charging stops fan
O2 sensor fail MP  Oxygen sensor defective or  Monitor the oxygen
TA depleted externally
 Check the oxygen sensor
and replace if necessary
P-Osc high MP  Measured POSC above the  Check that the manual
set upper alarm limit settings are correct and
plausible, adjust if necessary
P-Osc low MP  Measured POSC below the  Check that the manual
set lower alarm limit settings are correct and
P-Mean low MP  Measured Pmean below the  Check that the manual
set lower alarm limit settings are correct and
Oxygen inlet MP  O2 input pressures less than  Check the connection to the
2.5 bar, central gas supply (CGS)
FiO2 display drops to 21%  Switch off the SOPHIE and
team
Tube heating fail MP  Tube heating defective or  Check whether the
not plugged in connector is securely
connected
 Replace the patient tube
system

12 Troubleshooting

type of
alarm
Low sys. pressure MP  Internal pre-pressure of the  Check the patient tube
TA patient gas mixture is system for disconnected
below 10% of the nominal parts
value for at least 5 s  Prepare manual ventilation
 Ventilation only possible of patient using breathing
with lower ventilation bag
pressure  Do not leave patient
unattended
Temperature high MP  Measured proximal  Check that the manual
temperature is above the set settings are correct and
upper alarm limit plausible, adjust if necessary
 Temperature sensor is  Replace the temperature
defective sensor
Waterlevel? MP  Refill water level not  Check the water level in the
TA reached within the humidifier bottle
predefined time.  Check the water supply lines
 Check the connections
 Switch off the refill system
and notify the
FRITZ STEPHAN GMBH
Temp. sensor MP  Temperature sensor  Check the temperature
TA defective, cable defective sensor and cable
connections, replace the
temperature sensor if
necessary.
Temp. wb MP  Water bath (WB)  Replace the patient
temperature sensor component
defective  Switch off the SOPHIE and
 Heating deactivated notify the FRITZ STEPHAN
team stating the water bath
temperature (“Temp. wb”)

®
12 Troubleshooting

type of
alarm
Temperature low MP  Measured proximal  Check that the manual
temperature is below the set settings are correct and
lower alarm limit plausible, adjust if necessary
 Incorrect patient tube  Replace the patient tube
system for the application system with one that has an
extended heating section
 Tube heating is defective  Check the tube heating (H1
and H2 displays in the alarm
 Temperature sensor is field) and replace the patient
defective tube system if necessary
Replace the temperature
sensor
VT low/Pmax? MP  Target volume (VtTar)  Check the Pmax setting and
cannot be reached with the adjust if necessary
set maximum pressure
(Pmax) (PSV only)
Vt(exp) high MP  Measured breathing volume  Check the setting and adjust
is above the set limit if necessary
Waterlevel low MP  Water level in the  Check the water level, top
TA humidifier too low up if necessary
team
EDA measure MP  Error in monitoring the  Notify the FRITZ STEPHAN
TA patient valve GMBH customer service
team
Min. volume low MHP  Expiratory breathing  Check that the manual
TA volume below the set alarm settings are correct and
limit plausible, adjust if necessary
 Check the patient tube
system for disconnected
parts
 PNT connected?
 Leaks?
 Flow curve visible?

12 Troubleshooting

type of
alarm
Negative pressure MHP  Pressure at the Y piece is  Check the calibration of the
TA below -7 cmH₂O for longer pressure sensor
than 0.6 s  Check the tube system
 Safety mode is activated for  Check the pressure
2 seconds measurement tube
 Check the patient
component
Temperature MHP  Proximal temperature  Heating is switched off
> 41°C above 41°C automatically
Vt(exsp) low MHP  Measured breathing volume  Check that the manual
below the set limit settings are correct and
system
 Tube blocked?
 PNT connected?
 PNT measurement tubes
defective?
Measurement tubes must
always have the same length
(120 cm)
 Water in the PNT?
Battery low HP  Remaining battery life  Check the mains supply and
TA < 5 min charge the battery
Battery fail HP  Internal battery defective  Replace the battery

TA  Switch off the SOPHIE and
notify the
FRITZ STEPHAN GMBH
Main control fail HP  System error  Switch off the SOPHIE and
TA notify the
FRITZ STEPHAN GMBH

®
12 Troubleshooting

type of
alarm
Controller fail HP  Micro controller defective  Switch off the SOPHIE and
TA  Time monitoring circuit is notify the
not activated FRITZ STEPHAN GMBH
 Alarm suppression is not
possible
 Safety mode
Press.sensor fail HP  Measured value outside  Check measuring line for
TA measuring range stenosis
 If the pressure sensor fails,
team
Fio2 < 18% HP  Oxygen cell defective  Check and possibly replace
the oxygen cell
Low pressure/disc HP  End inspiratory pressure  Check that the manual
below the set limit settings are correct and
system for disconnected
parts
Flowlimit/disc.? HP  For CPAP and HFO, the  Check the patient tube
mean flow is higher than system for disconnected
the set flow limit line parts
 Probable disconnection  Check the settings
 Possible PNT in the
limitation
 Select a larger PNT type:
size C
Waterlevel high HP  Water level in the  Check the humidifier bottle
humidifier is too high  Switch off the refill system
 The middle fill level sensor and notify the
is defective FRITZ STEPHAN GMBH
 Water droplets on the bottle customer service team
Hardware error HP  Internal selftest error  Switch off the SOPHIE and
TA  Alarm suppression is not notify the
possible FRITZ STEPHAN GMBH
 Safety mode

12 Troubleshooting

type of
alarm
Prol. high press. HP  “Pmeant” setting is above  Check the upper Pmean limit
upper Pmean alarm limit setting and adjust if
for more than 15 s necessary
 In the case of nebulization,
replace the expiratory filter
if necessary
PSU temperature HP  Power supply temperature  Check the fan and
TA too high ventilation openings
Battery is switched off;  Replace the dust filter on the
does not take over fan
ventilation in case of power
failure
Safety valve HP  Emergency air valve  Switch off the SOPHIE and
TA defective notify the
 Ventilation pressure is FRITZ STEPHAN GMBH
discharged to atmosphere customer service team
Patient can breathe
spontaneously
Safety valve open HP  Emergency air valve open  Check that the manual
TA  Ventilation pressure is settings are correct and
discharged to atmosphere plausible, adjust if necessary
Patient can breathe
spontaneously
Patient valve HP  Malfunction of the patient  Check the seat of the patient
TA valve in the patient valve and replace the patient
component component if necessary (it
 Safety mode must be possible to move the
black piston of the patient
valve easily by approx. 6
mm)
PC-failure HP  PC defective  Switch off the SOPHIE and
TA  Time monitoring circuit is notify the
not activated FRITZ STEPHAN GMBH
possible
 Safety mode

®
12 Troubleshooting

type of
alarm
Peep high HP  “PEEP” setting higher than  Check the “PEEP” setting
the upper PEEP alarm limit and adapt to the selected
ventilation mode if
necessary
 Check the upper PEEP limit
setting and adjust if
necessary
 Check the tube system for
blockages and water droplets
P-mean high HP  Measured Pmean above the  Check that the manual
set upper alarm limit settings are correct and
Software failure HP  System error  Switch off the SOPHIE and
TA notify the
FRITZ STEPHAN GMBH
Peak pressure HP  Inspiratory pressure limit  Check that the manual
exceeded for longer than settings are correct and
50 ms plausible, adjust if necessary
 Inspiration aborted  Check that pressure
Pressure regulated to PEEP measuring adapter is
correctly connected
 Check for kinks in the
pressure measurement tube
Therapie startup HP  System error in start phase  Switch off the SOPHIE and
TA notify the
FRITZ STEPHAN GMBH
Gas supply HP  AIR and O2 input pressure  Check the connection to the
TA is below 2.8 bar central gas supply (CGS)
Peak press. >0.3 s HP  Measured pressure is above  Check that the manual
the set upper alarm limit settings are correct and
value PMAX for more than plausible, adjust if necessary
0.3 seconds  Check that pressure
 Inspiration aborted measuring adapter is
Pressure regulated to PEEP correctly connected
 Safety mode is activated for  Check for kinks in the
2 seconds pressure measurement tube

12 Troubleshooting

type of
alarm
PSU fail HP  Internal technical fault in  Switch off the SOPHIE and
TA the PSU notify the
FRITZ STEPHAN GMBH
Communication HP  Communication error  Switch off the SOPHIE and
TA between the micro notify the
controller and the PC FRITZ STEPHAN GMBH
Alarm limits that can be set customer service team
on the monitor are not
transmitted
possible
Tab. 18: Troubleshooting

®
12 Troubleshooting
12.2 Heavily oscillating ventilation curves
12.2.1 Patient valve
Fig. 145: Oscillating ventilation curves – patient valve
Corrective action  Check that the patient component is properly connected to the side
panel of the SOPHIE.
 Screw the patient valve into the patient component with the
installation wrench, adjusting to the correct position if necessary with
a half turn to the left and right.

12 Troubleshooting
12.2.2 Humidity in the pneumotachograph
Humidity or even water droplets in the pressure measurement tubes of the

pneumotachograph (PNT) can distort the volume flow measurement. The
flow signals cross the border of the monitor display or begin to oscillate.
Fig. 146: Humidity in the pneumotachograph
Fig. 147: Humidity in the PNT – measurement tube

®
12 Troubleshooting
Corrective action  Switch the Sophie to standby mode.

 Remove the pneumotachograph from the Y piece and disconnect the
plug from the side panel.
 Switch the Sophie back to ventilation mode.
 Press the »Aerosol« button.
 Hold the pneumotachograph itself or the pressure measurement tubes
to the aerosol nebulizer outlet (see chapter 3.3.4 from page 69) to let
any moisture escape.
12.3 Prevention of condensate in PNT and tubes
In practice, a certain degree of condensation cannot be prevented.

However, following these 5 suggestions can reduce it to an acceptable,
non-interfering level.
1. Check the temperature settings

The difference between the incubator temperature and the patient gas
temperature should not exceed 4–5°C. Should this be necessary for
therapy, the cold section of the tube should be insulated using a tube
warmer.
2. Check the temperature sensors

Should the distal sensor of the incubator tube system be placed inside the
incubator or be directly exposed to a heating lamp (this also applies to the
proximal sensor), the temperature may be overestimated.
Should the distal sensor be too far away from the incubator, condensate
may form in the unheated section of the tube, especially in colder rooms.
3. Set the humidity

Gradually set the humidity level until the condensate disappears. Settings
for high flow therapies such as NCPAP and HFO (++ to ++++++),
settings for normal flow therapies (0).

12
4. Choose the correct tube system

When using warming beds or incubator temperatures of < 33°C, switch to
the patient tube system with a long heated section.
5. Position the PNT

Turn the measurement tube connectors upward to prevent condensate
from entering the measurement tubes.
Fig. 148: Turning the measuring tube connectors upward

®
13 Care and maintenance
13.1 Treatment processes
NOTE
These instructions were formulated in accordance with DIN EN ISO 17664 and
explain how to treat the P7 ventilation accessory for the SOPHIE device.
CAUTION
Cleaning and disinfection of the device must only be performed by trained employees.
CAUTION
The processes for the treatment of this medical device as described in this manual are
recommendations only. The requirements regarding hygiene and workplace safety
must always be observed during the treatment of medical products.
Routine cleaning must be carried out at regular intervals according to

local hospital guidelines.
All disposable parts must be disposed of in an environmentally friendly
manner according to local hospital guidelines.
NOTE
Automated thermal treatment should be used wherever possible.

13.1.1 Information about cleaning agents and disinfectants
CAUTION
When using cleaning agents and disinfectants, pay attention to the correct
concentration and dwell time to prevent damage to the materials.
CAUTION
When using agents other than those specified, please contact the manufacturer of the
disinfectant to confirm its compatibility.
CAUTION
Ask the manufacturer of the disinfectant you are using to provide information about
compatibility with regard to use for ventilation and inhalation systems (safety data
sheet, toxicity).
CAUTION
Disinfectants based on amines and their derivatives can damage silicone parts
(e.g. patient tubes) and are therefore not suitable for use on the device.
CAUTION
When using cleaning agents and disinfectants, observe the rules established by the
professional associations on the use of cleaning agents and disinfectants.

®
13.1.2 Automated cleaning and disinfection
For automated cleaning, configure the automated cleaning and

disinfection equipment according to the manufacturer’s operating
instructions.
CAUTION
Use only automated cleaning and disinfection equipment that complies with
DIN EN ISO 15883-1!
The parts to be cleaned must be disassembled according to the

instructions in this operating manual before treatment. Load the
automated cleaning and disinfection equipment in such a way that the
inner and outer surfaces of the parts can be reached by the cleaning agent
and no spots are missed.
All parts must be arranged to avoid the formation of water pockets, e.g.
with slack or kinked tubing.
Select a suitable program (e.g. anesthesia program). Cleaning should take
at least 5 minutes at 40–60°C.
Cleaning is followed by thermal disinfection at 80–95°C. The dwell time

Thermal disinfection
depends on the temperature of the disinfection program as follows:
Efficacy ranges:
A: Suitable for killing vegetative bacteria (including
mycobacteria) and fungi (including fungal spores)
AB: Same as A, and for the inactivation of viruses
Efficacy range A Efficacy range AB

Ao 600 3000
Disinfection at 80°C 10 min. 50 min.
Disinfection at 85°C 3.2 min. 15.8 min.
Disinfection at 90°C 1 min. 5 min.
Disinfection at 95°C 0.1 min. 0.5 min.
Tab. 19: Efficacy ranges according to EN ISO 15883-1
Demineralized water must be used for all interim rinses and the final
rinse.

Once the disinfection program has finished, remove the parts from the
automated cleaning and disinfection equipment and check the visible
surfaces for visible residual contamination. If necessary, repeat the
cleaning and disinfection process. After this, dry the treated parts
thoroughly (in a drying cabinet if necessary).
Cleaning agents With regard to material compatibility, suitable cleaning agents are
enzymatic and mildly alkaline cleaning agents, such as neodisher®
Mediclean from Dr. Weigert GmbH in Hamburg.
CAUTION
Highly alkaline cleaning agents can severely corrode and damage anodized surfaces.
To neutralize alkaline cleaning agents, do not use phosphoric acid!
Phosphoric acid can severely corrode and damage anodized surfaces.
NOTE
Always closely follow the instructions of the cleaning agent manufacturer for using
the cleaning agent!
13.1.3 Manual cleaning and disinfection
Manual cleaning For manual cleaning, clean the individual parts carefully under running
water using a standard commercial cleaning agent. All secretions and
other visible deposits and contamination must be completely removed.
After cleaning, all parts must be thoroughly rinsed under running water
until no more visible residues of the cleaning agent are present. Once
manual cleaning is complete, check the visible parts for visible residual
contamination. If necessary, repeat the manual cleaning process.

®
Manual disinfection To manually disinfect the individual parts, immerse them in the ready-to-
use disinfectant solution (instrument disinfection agent). All of the parts
must be fully covered by the disinfectant. The parts must be moved
around in the solution several times until all air bubbles have been
removed.
After the dwell time, the disinfectant must be completely rinsed off using
cold water (at least drinking water quality). Afterwards, the parts must be
dried thoroughly.
Once manual disinfection is complete, check the parts for visible residual
contamination. If necessary, repeat the manual cleaning and disinfection
process.
Cleaning agents With regard to material compatibility, suitable cleaning agents and
disinfectants are instrument disinfection agents that use alcohol and
aldehydes as the active ingredient, such as gigasept® ff from Schülke &
Mayr. The efficacy of the disinfectant that is used must be proven.
NOTE
the cleaning agent!
Disinfectants containing oxygen or chlorine donors or phenols and their

derivatives are not suitable. Disinfectants based on amines and their
derivatives can damage silicone parts (e.g. patient tubes) and are
therefore also not suitable for use on the device.
Disinfecting surfaces Use ready-to-use disinfectant solution to disinfect the device surfaces.
Completely wipe down the surfaces using the wiping cloth. The wiping
cloth should only be moist.
WARNING
When using wipe disinfection, ensure that no liquid enters the device. Liquid ingress
can impair the operation of the device and thereby pose a risk to the patient.
All disinfectant residue must be completely removed afterwards.

Disinfectants With regard to material compatibility, suitable for wipe disinfection are
aldehyde-free quick disinfecting wipes such as Bacillol® wipes or tissues
from Paul Hartmann AG.
NOTE
the cleaning agent!
13.1.4 Sterilization
Components labeled in this operating manual as suitable for sterilization

can be sterilized with hot steam at temperatures of up to 134°C.
NOTE
Only use vacuum steam sterilizers – preferably ones with a fractionated vacuum.
The hot steam sterilizer must be loaded according to the manufacturer’s

instructions for use and the corresponding program started.
Temperature Hold/dwell time

134°C 3–18 min
Tab. 20: Standard procedure for steam sterilization*
*All standard steam sterilization procedures can be used.

®
13.2 Device overview
Fig. 149: Sophie with

accessories
Fig. 150: Test lung
Fig. 151: Reusable tube system P7
Fig. 152: Connection cable P3/P7 for disposable patient tube system

1 Sophie ventilator 9 Test lung with tube adapter

(main device)
2 Patient component P7 10 Connection sleeve
3 Expiratory pressure measurement 11 Support bracket with heating
tube wire
4 Duplex pressure measurement 12 Tube heating plug
tube flow sensor
5 Y piece 13 Ports for temperature sensors
6 Flow sensor (PNT) 14 Tube heating cable bridge
7 Patient tube system P7 15 Tube heating plug for
disposable patient tube system
8 Temperature sensor system P7

®
13.3 Device housing with park position, gas supply

tubes, and power cable
WARNING
When disconnecting the patient tubes, always hold them by the sleeve and not by the
support bracket.
Instructions
Place of use Remove surface dirt with a disposable cloth/paper towel
Storage and transport No particular requirements
Cleaning preparations Remove the patient component, tube system, pressure measurement
tube, temperature sensor system, and flow sensor
Cleaning: automatic Not possible
Cleaning: manual Wipe the surfaces with ready-to-use disinfectant solution (surface
Disinfection disinfectant).
Drying Further information on manual cleaning and disinfection can be found in
chapter 13.1.3.
Maintenance Not necessary with cleaning
Inspection and functional Before using the Sophie after cleaning, a functional check must be
checks performed (see chapter 7 of the operating manual).
Packaging Standardized packaging material can be used for the packable parts. The
bag must be large enough for all components so that there is no strain on
the seal.
Sterilization Not possible
Storage Store in a dry place free from dust and frost
Additional information Ensure mains supply for keeping the battery charged

13.4 Reusable patient tube system
CAUTION
When disconnecting the patient tubes, always hold them by the connection sleeves
and not by the support bracket.
CAUTION
Do not allow the tubes from the tube system to twist around or catch on the cable
bridge!
If the tubes become twisted or caught on the cable bridge, the tube heating may be
damaged and not work properly.
Instructions
Storage and transport Do not allow the patient tube system to catch on the cable bridge!
Cleaning preparations 1. Disconnect the tube heating plug from the ventilator.
2. Disconnect the temperature sensor system plug from the ventilator.
3. Disconnect the flow sensor’s duplex pressure measurement tube
from the ventilator.
4. Remove the inspiration and expiration tubes from the respective
connecting pieces on the patient component.
5. Remove the temperature sensors from the patient tube system.
6. Remove the flow sensor from the Y piece.
7. Remove the Y piece from the inspiration and expiration tube.
Cleaning: automatic 1. Load the automated disinfection equipment according to the
manufacturer’s instructions for use and start the appropriate
program.
2. Dry the disinfected parts (in a drying cabinet if necessary), unless
this happens inside the automated disinfection equipment.
Further information on automatic cleaning and disinfection can be found
in chapter 13.1.2.

®
Instructions
Cleaning: manual 1. Immerse the individual parts in ready-to-use disinfectant solution.
Disinfection All of the parts must be fully covered by the disinfectant.
Drying 2. Move the parts around in the solution several times until all air
bubbles have been removed.
3. After the dwell time, the disinfectant must be completely rinsed off
using cold water (at least drinking water quality).
4. Dry the parts thoroughly.
5. After completion, check the parts for visible external residual
contamination. If necessary, repeat the manual cleaning and
disinfection process.
Further information on manual cleaning and disinfection can be found in
chapter 13.1.3.
Maintenance Not necessary with cleaning
Inspection and functional Before using the ventilator after cleaning, a functional check must be
the seal.
Sterilization The reusable tube system can be autoclaved with steam at up to 134°C.
Load the autoclave according to the manufacturer’s instructions for use
and start the appropriate program.
Further information on sterilization can be found in chapter 13.1.4.
Additional information Do not allow the tubes from the tube system to twist around or catch on
the cable bridge!
If the tubes become twisted or caught on the cable bridge, the tube
heating may be damaged and not work properly.

13.5 Temperature sensor systems P7
CAUTION
The temperature sensor P7 for the patient tube system cannot be sterilized using hot
steam. Sterilization with hot steam leads to the destruction of the sensor!
Instructions
Cleaning preparations 1. Disconnect the temperature sensor system plug from the ventilator.
2. Remove the temperature sensors from the patient tube system.
chapter 13.1.3.
Maintenance Check that the connection plug screws (item 12) are tight
the seal.
Additional information None

®
13.6 Connection cable P3/P7 for disposable patient

tube system P3/P7
CAUTION
The connection cable P3/P7 for disposable patient tube systems is not suitable for
automatic treatment or sterilization with hot steam.
Sterilization with hot steam leads to the destruction of the adapter!
Instructions
Cleaning preparations 1. Disconnect the connection cable plug from the ventilator
2. Remove the connection cable from the patient tube system
chapter 13.1.3.
Maintenance Check that the connection plug screws (item 12) are tight
the seal.

13.7 Flow sensor (PNT), Y piece, pressure

measurement tube
CAUTION
Only use the intended assembly tools to remove the flow sensor’s vortex bodies!
The PNT’s inner tubes and webs could be damaged during cleaning.
Instructions
Cleaning preparations 1. Remove the flow sensor from the Y piece.
2. Disconnect the flow sensor’s duplex pressure measurement tube
from the ventilator.
3. Remove the Y piece from the inspiration and expiration tube.
4. Pull the pressure measurement tubes off the PNT connectors.
5. Carefully pull the vortex body out on both sides of the PNT using the
assembly tool.
6. Remove the pressure measurement tube from the patient component
and the side panel.
Further information on preparation can be found in chapter 0.
Cleaning: automatic 1. Connect the pressure measurement tubes (silicone tubes) to the
injector nozzles of the cleaning and disinfection equipment.
2. Place the PNT and vortex body in small parts containers.
3. Load the automated disinfection equipment according to the
manufacturer’s instructions for use and start the program for
anesthesia materials.
in chapter 13.1.2.

®
Instructions
contamination or disinfectant. If necessary, repeat the manual
cleaning and disinfection process.
chapter 13.1.3.
Maintenance 1. Check for residual water and carefully purge with compressed air if
necessary.
2. Pick up the vortex bodies with the flat end of the assembly tool and
insert them into the PNT housing.
3. Attach the duplex silicone tube (marked by a black dot on the plug
and PNT housing).
Inspection and functional Following disinfection, conduct a visual inspection. There must be no
checks visible cracks or material damage. Check the silicone tube for damage,
especially at the ends. Further information on post-treatment and
inspection can be found in chapter 13.7.2.
Before using the ventilator after cleaning, a functional check must be
performed (see chapter 7).
the seal.
Sterilization All flow sensor parts and the Y piece can be autoclaved with steam at
134°C.
and start the appropriate program. Further information on sterilization
can be found in chapter 13.1.4.

13.7.1 Preparing the flow sensor
1. Pull the pressure measurement tubes off the PNT connectors.

2. Carefully pull both vortex bodies out on both sides of the flow sensor
using the assembly tool.
Preparing the PNT B/C
Fig. 153: Preparing the PNT B/C
1 Pressure measurement tube 5 Vortex body

2 Connector 1 6 Hook
3 Connector 2 7 PNT B/C assembly tool
4 Pneumotachograph
Preparing the PNT A
Fig. 154: Inserting the assembly tool into the PNT A
Fig. 155: Turning the assembly tool clockwise
Fig. 156: Pulling out the assembly tool with the vortex body

®
13.7.2 Post-treatment
1. Check that all parts are mechanically undamaged and complete.

 2 vortex bodies with one O-ring each
 PNT housing with concentric tube system, held by three webs on
each side
Check that the tube system is securely seated in the housing.
 2 connectors
2. Carefully purge the parts with compressed air so that there is no water
in the connectors.
3. Attach the vortex bodies to the assembly tool
Post-treatment
PNT B/C
Fig. 157: Post-treatment PNT B/C
4 PNT housing
5 Vortex body a O-ring of the vortex body
7 Assembly tool b Flat end of the assembly tool
8 Concentric tube system

Post-treatment PNT A
Fig. 158: Attaching the vortex bodies to the assembly tool
4. Insert the assembly tool until the end stop, then rotate slightly until
the vortex body locks into place.
Fig. 159: Inserting the assembly tool and rotating slightly
Fig. 160: Repeating the procedure for the second vortex body
CAUTION
The pneumotachographs type A, B and C have different vortex bodies with different
bore diameters.
The vortex bodies are labeled with the letter of the relevant PNTs and must not be
confused. Otherwise, significant measuring errors must be expected.
During assembly, ensure that the seals and O-rings are positioned correctly and not
crushed.
Preparation for use 1. Connect the red pressure measurement tube (proximal pressure
measurement tube) to connector 1 near the attachment fitting (wide
port) of the PNT (marked by a black dot on the plug and PNT
housing).
2. Connect the second pressure measurement tube to connector 2.
Function test Before using the flow sensor, leak and functional checks must be
performed (see chapter 7 of the operating manual).

®
13.8 Test lung with tube adapter
Instructions
Cleaning preparations 1. Remove the connection tube from the test lung together with the tube
adapter and tube sleeve.
2. Remove the tube adapter and tube sleeve from the silicone tube.
Further information on preparation can be found in chapter 0.
Cleaning: automatic 1. Connect the silicone tube to the injector rail of the cleaning and
disinfection equipment.
2. Position the test lung to ensure that the cavity will be fully rinsed and
that no spots are missed. Excess water must be able to run off freely.
3. Place the tube sleeve in a small parts container.
anesthesia materials.
in chapter 13.1.2.
chapter 13.1.3.
Maintenance 1. Check for residual water and carefully purge with compressed air if
necessary.
2. Connect the tube adapter and tube sleeve to the silicone tube.
3. Connect the connection tube to the test lung together with the tube

Instructions
Inspection and functional Following disinfection, conduct a visual inspection. There must be no
checks visible cracks or material damage.
the seal.
Sterilization All test lung parts can be autoclaved with steam at 134°C. Load the
autoclave according to the manufacturer’s instructions for use and start
the appropriate program. Further information on sterilization can be
found in chapter 13.1.4.
13.8.1 Preparing the test lung with the tube adapter
1. Remove the connection tube from the test lung together with the tube
2. Remove the tube adapter and tube sleeve from the silicone tube.
Preparing the test lung
Fig. 161: Test lung with tube adapter
1 Pediatric test lung (silicone) 3 Silicone connection tube

2 Tube sleeve 4 Tube adapter

®
13.9 Patient component P7
Instructions
Cleaning preparations 1. Disconnect the patient component from the side panel of the
ventilator
2. Unscrew the silencer from the patient component
3. Unscrew and drain the humidifier bottle
4. Disconnect the humidifier tube and remove and dispose of the
humidifier fleece
5. Place the fixing sleeve on the proportional valve’s piston
Further information on preparing the patient component can be found in
chapter 13.9.1.
Cleaning: automatic 1. Connect the expiration nozzle to the injector rail of the cleaning and
disinfection equipment.
2. Position the patient component to ensure that it will be fully rinsed
and that no spots are missed. Excess water must be able to run off
freely.
anesthesia materials. Dry the disinfected parts (in a drying cabinet if
necessary), unless this happens inside the automated disinfection
equipment.
Further information on automatic cleaning can be found in chapters
13.1.2 and 13.9.1.
Only wipe-disinfect the silencer!
4. Then dry it thoroughly.
chapter 13.1.3.

Instructions
Maintenance 1. Attach the humidifier tube and insert the humidifier fleece.
2. Attach the silencer.
Further information on post-treatment can be found in chapter 13.9.2.
Inspection and functional Before using the Sophie after cleaning, a functional check must be
the seal.
Sterilization All patient component parts can be autoclaved with steam at up to
134°C. Load the autoclave according to the manufacturer’s instructions
for use and start the appropriate program. Further information on
sterilizing the ventilation system can be found in chapters 13.1.4 and
13.9.2.1.

®
13.9.1 Preparation
Fig. 162: Patient component P7
1 Locking lever 6 Humidifier tube locking ring

2 Silencer 7 Patient valve piston
3 HFO plug 8 Expiration tube connection
4 Humidifier bottle 9 Inspiration tube connection
5 Humidifier tube
Preparing the patient 1. Disconnect the patient component from the side panel
component P7 2. Unscrew the silencer
3. Unscrew and drain humidifier bottle.
4. Pull humidifier tube down and off.
5. Turn the locking ring of the humidifier tube (item 6) clockwise and
remove.
6. Remove the humidifier fleece and dispose of it correctly.
7. Attach the proportional valve’s piston using the fixing sleeve
(Art. no. 100761002).

Fig. 163: Attaching the proportional valve’s piston
8. Remove the HFO plug.

9. Attach the rinse tube (10) including rinse adapter (11) to the
expiration tube connection.
10. Position the patient component to ensure that it will be fully rinsed
and that no spots are missed.
11. Attach the rinse tube (100761006) (10) to one of the injector rail
nozzles (13) on the drawer of the cleaning and disinfection
equipment.
Fig. 164: Example for positioning on the drawer of the cleaning and
disinfection equipment

manufacturer’s instructions for use and start the program. Dry the
disinfected parts (in a drying cabinet if necessary), unless this
happens inside the automated disinfection equipment.

®
CAUTION
After each manual or automated thermal treatment, any residual water must be
removed from the patient component by purging with compressed air.
13.9.1.1 Preparing the silencer
CAUTION
Do not clean the silencer automatically or by immersing it in disinfectant solution!

Only use wipe disinfection!
Wipe the surfaces with ready-to-use disinfectant solution (surface

disinfectant).
NOTE
Like all parts of the patient component, the silencer can be autoclaved with steam at
up to 134°C. Load the autoclave according to the manufacturer’s instructions for use

13.9.2 Post-treatment
Post-treatment of the 1. Place the humidifier fleece over the fleece inserting tool without
patient component P7 covering the cut-out with fleece.
2. Push the fleece inserting tool with the humidifier fleece into the
humidifier tube until the fleece is no longer visible in the cut-out of
the outer tube.
3. Push in the locking ring and tighten it counterclockwise.
4. Attach the complete humidifier tube to the holding bush at the bottom
of the patient component.
Fig. 165: Inserting the humidifier fleece
1 Inner tube 4 Fleece inserting tool

2 Outer tube 5 Locking ring
3 Humidifier fleece
5. Attach the silencer to the patient component.

®
13.9.2.1 Sterilizing the patient component
All patient component parts can be autoclaved with steam at up to 134°C.

Sterilization 1. Attach the humidifier tube to the patient component together with the
humidifier fleece and the silencer
2. Separately place the patient component and the humidifier bottle into
autoclave
3. Sterilize the patient component and humidifier bottle according to the
instructions for the autoclave
4. Allow the patient component and humidifier bottle sufficient time to
dry following sterilization
13.10 Assembly
Storage Store in a dry and dust-free place for subsequent use.
Preparation for use Instructions on the preparation for use can be found in the respective
chapters of the operating manual.
Function test Before the SOPHIE is used, a check must always be performed. Details
of the check can be found in the respective chapters of the operating
manual.
Procedures in the event If you notice any damage on the device or accessories during or after
of damage treatment, please contact your medical technology department or the
authorized FRITZ STEPHAN GMBH customer service team immediately.

13.11 Treatment table
CAUTION
The processes for the treatment of the medical device described in this table are
recommendations only.
Always observe the specific procedural instructions given by the responsible hygiene
officer.
CAUTION
In case of infectious patients, all parts of the patient system carrying breathing gas
must also be sterilized.
System components Automated Manual Sterilization

thermal treatment
treatment
Device housing with park position, power cable, No Surfaces No
and connection tubes
Patient component body with fixing sleeve, Yes Yes Yes
emergency air valve, patient valve, humidifier
bottle, and humidifier tube (without humidifier
fleece)
Humidifier fleece (inserted into humidifier tube) No No Yes
Tool for humidifier fleece No Surfaces Yes
Silencer No Surfaces Yes
Patient tube system (reusable), Y piece, Yes Yes Yes
silicone cap, and pressure measurement tube
Temperature sensor system No Surfaces No
Connection cable P3/P7 for disposable patient No Surfaces No
tube system P3/P7
Pneumotachograph A, B, C Yes Yes Yes
Test lung with tube adapter Yes Yes Yes
Pneumatic medication nebulizer Yes Yes Yes
Observe the manufacturer’s instructions for
use!
Mobile stand, drawer set, and brackets No Surfaces No
Tab. 21: Treatment table

®
13.12 Servicing
WARNING
Only authorized customer service staff of FRITZ STEPHAN GMBH are permitted to
alter, modify, repair, or open the device, or to replace the battery. This does not
include the intended dismantling of the patient component according to the operating
instructions. When servicing the device, only use spare parts from FRITZ STEPHAN
GMBH.
CAUTION
The SOPHIE and all its accessories must be cleaned and disinfected before all
servicing activities, as well as before being returned for repair.
13.12.1 Maintenance and inspection intervals
Interval Tasks
After every patient Replace the humidifier fleece

Monthly Clean the filter of the device fan on the back, replace if necessary
Every 6 months Check the O-rings on the pressure measurement nipples P7 and PNT,
replace if necessary
Every 6 months Discharge and re-charge the internal battery (battery calibration)
Every 6 months Perform a safety check (see also chapter 13.12.2)
Annually Replace the filter of the device fan on the back
Annually Maintenance and inspection by the authorized customer service team
Every 3 years Have the internal battery replaced by the authorized customer service team
Tab. 22: Maintenance and inspection intervals

13.12.2 Safety checks
WARNING
If the safety checks are not performed, the safety of the device may be compromised!
The safety checks must always be performed at the specified intervals.
CAUTION
The safety checks must not be used as a substitute for the maintenance and
replacement of wear parts as prescribed by the manufacturer.
Visual inspection  Visible safety deficiencies on the device or accessories

 Lock on the patient component works correctly and securely
 All labeling and markings on the device are present and
legible, operating manual available
Electrical safety  Inspection according to DIN EN 62353
Checking the  Perform an automatic selftest

safety functions  Function of the alarm speaker
 Function of control elements
 Function of the water level sensors
 Function of refill system (optional), crimper opens and closes
smoothly
 Check of the differential pressure alarm, emergency air valve
opens, pressure drops to 0 cmH₂, no suction effect on
restarting the device
 Check of the gas supply alarm and substitution, FiO2 at 21%
and > 98% with substitution
Checking the  Function test of the pressure measurement

device functions  Function test of the volume measurement
 Function test of FiO2
 Function test of the heating
 Function test of the external trigger (optional)
 Check of the internal battery

®
14 Electromagnetic emissions and immunity
14 Electromagnetic emissions and

immunity
NOTE
Electrical medical devices are subject to special precautions regarding
electromagnetic compatibility (EMC) and must be installed and put into service
according to the EMC information provided in the accompanying documentation.
NOTE
Portable and mobile RF communications equipment can affect electrical medical

devices.
14.1 Electromagnetic emissions
The SOPHIE ventilator is intended for operation in the electromagnetic

environment specified below. The customer or user of the SOPHIE
ventilator should assure that it is used in such an environment.
Emissions Compliance Electromagnetic environment guideline
RF emissions as defined in Group 1 The SOPHIE ventilator uses RF energy for its internal
CISPR 11 function only. Therefore, its RF emissions are very low
and are not likely to cause any interference with nearby
electronic equipment.
RF emissions as defined in Class B The SOPHIE is suitable for use in establishments other
CISPR 11 than homes and those directly connected to the public
low-voltage power supply network that also supplies
Harmonics as defined in Class B buildings used for domestic purposes.
IEC 61000-3-2
Voltage fluctuations/ Met
flicker as defined in
IEC 61000-3-3
Tab. 23: Electromagnetic emissions (IEC 60601-1-2)

WARNING
Portable and mobile RF communications equipment can affect electrical medical
devices!
Electrical medical devices or systems should not be used adjacent to or stacked with
other equipment. If adjacent or stacked use is necessary, the electrical medical device
or system should be monitored to verify its intended operation in the configuration in
which it will be used.
14.2 Electromagnetic immunity
The SOPHIE ventilator is intended for operation in the electromagnetic

environment specified below. The customer or user of the SOPHIE
ventilator should assure that it is used in such an environment.
Immunity test IEC60601 test level Compliance level Electromagnetic

environment guideline
Electrostatic discharge +6 kV (contact) +6 kV (contact) Floors should be wood,
(ESD) as defined in +8 kV (air) +8 kV (air) concrete or ceramic tile. If
IEC 61000-4-2 floors are covered with
synthetic material, the relative
humidity should be at least
30%.
Electrical fast transient/ +2 kV for mains cables +2 kV for mains cables Mains power quality should be
burst as defined in +1 kV for input and +1 kV for input and that of a typical commercial or
IEC 61000-4-4 output cables output cables hospital environment.
Surges as defined in +1 kV Line-to-line +1 kV Line-to-line Mains power quality should be

IEC 61000-4- +2 kV Line-to-earth +2 kV Line-to-earth that of a typical commercial or
hospital environment.
Voltage dips, short < 5% UT (> 95% dip in < 5% UT (> 95% dip in Mains power quality should be
interruptions, and UT) for 0.5 cycles UT) for 0.5 cycles that of a typical commercial or
voltage variations as 40% UT (60% dip in 40% UT (60% dip in hospital environment.
defined in UT) for 5 cycles UT) for 5 cycles The battery run time specified
IEC 61000-4-11 in the documentation must be
70% UT (30% dip in 70% UT (30% dip in
UT) for 25 cycles UT) for 25 cycles taken into account.
< 5% UT (> 95% dip in < 5% UT (> 95% dip in

UT) for 5 seconds UT) for 5 seconds

®
Immunity test IEC60601 test level Compliance level Electromagnetic

environment guideline
Power frequency 3 A/m 3 A/m Power frequency magnetic
(50/60 Hz) magnetic fields should be at levels
field as defined in characteristic of a typical
IEC 61000-4-8 location in a typical
commercial or hospital
environment.
UT is the AC mains voltage prior to application of the test level.
Tab. 24: Electromagnetic immunity (IEC60601-1-2)
Immunity test IEC60601 Compliance level Electromagnetic environment

test level guideline
Portable and mobile RF communications
equipment should be used no closer to any
part of the SOPHIE ventilator, including
the cables, than the recommended
separation distance calculated from the
equation applicable to the frequency of the
transmitter.
3 Veffective value 3 Veffective value Recommended separation distances:

150 kHz to d  1,2 P
80 MHz outside
ISM bands a
Conducted RF
disturbances as defined 10 Veffective value 3 Veffective value
d 4 P
in IEC 61000-4-6 150 kHz to
80 MHz in ISM d  4 P for 80 MHz to 800 MHz
bands a

Immunity test IEC60601 Compliance level Electromagnetic environment

test level guideline
Radiated RF 10 V/m 3 V/m
IEC 61000-4-3 80 MHz to 2.5 d  7,7 P for 800 MHz to 2.5 GHz
GHz
where P is the maximum output power
rating of the transmitter in watts (W)
according to the transmitter manufacturer
and d the recommended separation distance
in meters (m).b
Field strengths from fixed RF transmitters,
as determined by an electromagnetic site
survey,c should be less than the compliance
level in each frequency range. d
Interference may occur in the vicinity of
equipment marked with the following
symbol.
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.
a The ISM (industrial, scientific, and medical) bands between 150 kHz and 80 MHz are 6.765 MHz to
6.795 MHz, 13.553 MHz to 13.567 MHz, 26.957 MHz to 27.283 MHz and 40.66 MHz to 40.70 MHz.
b The compliance levels in the ISM frequency bands between 150 kHz and 80 MHz and in the frequency range
80 MHz to 2.5 GHz are intended to decrease the likelihood that mobile/portable communications equipment
could cause interference if it is inadvertently brought into patient areas. For this reason, an additional factor of
10/3 is used in calculating the recommended separation distance in these frequency ranges.
c Field strengths from fixed transmitters, such as base stations for mobile telephones, mobile terrestrial radio
equipment, amateur radio stations, AM and FM radio stations, and TV stations cannot theoretically be predicted
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 SOPHIE ventilator is
used exceeds the compliance levels above, the SOPHIE ventilator should be observed to verify normal
operation. If abnormal performance is observed, additional measures may be necessary, such as re-orienting or
relocating the SOPHIE ventilator.
d Over the frequency range 150 kHz to 80 MHz, field strength is less than 10 V/m.

®
14.3 Recommended separation distance
The SOPHIE ventilator is intended for operation in an electromagnetic

environment in which radiated RF disturbances are controlled. The
customer or user of the SOPHIE ventilator can help prevent
electromagnetic interference by maintaining a minimum distance between
portable and mobile RF communications equipment (transmitters) and the
SOPHIE ventilator as recommended below, according to the maximum
output power of the communications equipment.
Recommended separation distances between portable and mobile RF communications equipment

and the SOPHIE ventilator
Distance based on the transmitter frequency (m)
80 MHz – 800 MHz 800 MHz – 2.5 GHz

150 kHz to 80 MHz in
Maximum
150 kHz to 80 MHz ISM bands a
transmission
power of the outside ISM bands a
transmitter (W) d  1,2 P d  7,7 P
d 4 P d 4 P
0.01 0.12 m 0.4 m 0.4 m 0.77 m
0.1 0.38 m 1.26 m 1.26 m 2.43 m
1 1.2 m 4m 4m 7.7 m
10 3.8 m 12.65 m 12.65 m 24.35 m
100 12 m 40 m 40 m 77m
For transmitters without a rated output listed in the table above, the distance can be determined using the equation in the corresponding column,
where P is the transmitter’s rated output in watts (W) according to the transmitter manufacturer.
1 At 80 MHz and 800 MHz, the higher frequency range applies.

2 The ISM bands between 150 kHz and 80 MHz are 6.765 MHz to 6.795 MHz; 13.553 MHz
to 13.567 MHz; 26.957 MHz to 27.283 MHz and 40.66 MHz to 40.70 MHz.
3 An additional factor of 10/3 has been incorporated into the formula and is used to calculate
the recommended separation distance for transmitters in the ISM frequency bands between
150 kHz and 80 MHz and in the frequency range 80 MHz to 2.5 GHz to decrease the
likelihood that mobile/portable communications equipment could cause interference if it is
inadvertently brought into patient areas.
4 These guidelines may not apply in all situations. Electromagnetic propagation is affected by
absorption and reflection from structures, objects, and people.
Tab. 25: Recommended separation distance (IEC 60601-1-2, Table 5)

®
15 Spare parts and accessories
Item Description Art. No.

1 Patient component P7 with heated respiratory gas humidifier 100761000
2 Humidifier fleece 100753131
3 Reusable patient tube system P7, heated, with Y piece, pressure
measurement tube, and connecting plug for:
 Closed incubator
Length 1200 mm, incl. 800 mm heated 100761500
 Open incubator
Length 1300 mm, incl. 1200 mm heated 100761550
4 Temperature sensors for reusable patient tube system
 Closed incubator 100761110
 Open incubator 100761100
5 Disposable patient tube system P3/P7, heated, with Y piece, pressure 100761300
measurement tube, and NO adapter
6 Connection cable P3/P7 for 100760021
disposable patient tube system P3/P7 (100761300)
7 Temperature sensor P7 for 100763009

disposable patient tube system P3/P7 (100761300)
8 External pneumotachographs
 PNT type A neonatology 103561303
 PNT type B neonatology 103561300
 PNT type C pediatrics 103561301
9 Tube warmer to compensate for larger differences in temperature
- For reusable patient tube systems:
 Closed incubator for cold section (390 mm) 100760003
 Closed incubator for heated section (730 mm) 100760007
 Open incubator for heated section (1130 mm) 100760004
- For disposable patient tube system (Art. no. 100761300):

 For cold section (390 mm) 100760507
10 Medication nebulizer set, pneumatic, autoclavable 171060120
11 Expiration filter for medication nebulizer 171060210
12 Y piece, autoclavable, with sealing cap 170160416


13 Breathing mask
 Silicone size 0 170060000
14 Self-filling breathing bag, silicone
 250 ccm with breathing masks for newborns 170060038
 500 ccm with breathing masks for children 170060039
15 Connection piece for the automatic refill system 103860035
16 Set consisting of aqua dest. bottle and connection fittings for automatic 103861038
refill system
17 EasyFlow_n CPAP
Prongs (PU: 5)
 S 170161001
 M 170161002
 L 170161003
 XL 170161004
Mask (PU: 5)
 XS 170161005
 S 170161012
 M 170161013
 L 170161014
 XL 170161015
Applicator with magnet and pressure sealing cap (PU: 5) 170161161
Decoupling tube set with connectors (Ø 10 mm) (PU: 5) 170163408
Decoupling tube set with connectors (Ø 12mm, F&P) (PU: 5) 170163409
Bonnets including forehead pad and fixing straps (PU: 1)
 XS 170161019
 S 170161020
 M 170161021
 L 170161022
 XL 170161023
 XXL 170161024
 3XL 170161025
 4XL 170161026

®

 5XL 170161027
 6XL 170161028
 7XL 170161029
Headband complete with 2 fixing straps and forehead pad (PU: 1)
 micro 170161019
 mini 170161020
 maxi 170161021
18 Respiration sensor (abdominal movement) for external trigger (disposable) 103560103
19 Test lung with tube adapter 170060092
20 Fixing sleeve for piston for mechanical treatment of the patient component 100761002
P7
21 Connection cable, 24V DC, 2 m, on-board power supply for Sophie 160561031
transport, with 4-pin plug
22 Connection tube for cleaning and disinfection equipment for mechanical 100761006
treatment of the patient component P7
23 Fleece inserting tool for humidifier system P7 100753129
24 Pneumotachograph type A assembly tool 103553016
25 Pneumotachograph type B/C assembly tool 103553019
26 Sophie operating manual 103890000
Tab. 26: Accessory list

®
16 Warranty
16 Warranty
The manufacturer, FRITZ STEPHAN GMBH, warrants the product for
24 months from the purchase date.
This assumes regular safety checks and device maintenance by the
manufacturer or by personnel authorized by FRITZ STEPHAN GMBH.
See the corresponding chapters in this operating manual for additional
information.
Only FRITZ STEPHAN GMBH or authorized professionals are allowed to
manipulate or repair the device. Non-compliance voids the warranty.
Improper handling of the device also voids the warranty.

®
17 List of figures
17 List of figures
Fig. 1: Front view 39
Fig. 2: Power source indicator 41
Fig. 3: Function buttons 43
Fig. 4: Status, alarm, and info display with activated alarm suppression 44
Fig. 5: Monitor unit 48
Fig. 6: Measured value displays 49
Fig. 7: Main menu opened 51
Fig. 8: Ventilation menu opened 52
Fig. 9: Parameter display 53
Fig. 10: Special functions display 54
Fig. 11: Status, alarm, and info display 55
Fig. 12: Default graphic display (two curves) 58
Fig. 13: Alternate graphic display (three curves) 58
Fig. 14: Graphic display with activated trend 59
Fig. 15: Enlarged window showing identical information for curves 2 and 3 59
Fig. 16: External expiratory trigger status and apnea counter with NIV 61
Fig. 17: Right side view 62
Fig. 18: Front and side views of the patient component 63
Fig. 19: Tube system for incubators (Art. no. 100761500) 66
Fig. 20: Tube system for warming beds (Art. no. 100761550) 67
Fig. 21: Disposable tube system P3/P7 (Art. no. 100761300) 68
Fig. 22: Connection panel 69
Fig. 23: Sophie with automatic refill system 70
Fig. 24: Inserting the transfer spike into bottle containing aqua dest. 71
Fig. 25: Attaching the tube to the driving gas outlet 72
Fig. 26: Attaching the tube and folding down the pinch valve 72
Fig. 27: Pressing the push-button and inserting the tube 73
Fig. 28: Attaching the aqua dest. bottle to the holder 73
Fig. 29: Rear view 76
Fig. 30: Pneumatic module 77

17 List of figures
Fig. 31: Power supply module and interfaces 78

Fig. 32: Mobile stand 79
Fig. 33: Main menu opened 81
Fig. 34: Setting the function “FIO2 follow on/off” 83
Fig. 35: Setting the respiratory gas temperature 83
Fig. 36: “Alarmlimits” menu 85
Fig. 37: “Alarmlimits” pop-up menu 86
Fig. 38: Transport function display 89
Fig. 39: “Curves” menu 89
Fig. 40: “2. panel” sub-menu 90
Fig. 41: “3. panel” sub-menu 90
Fig. 42: “View” menu 92
Fig. 43: “Display VT” sub-menu 93
Fig. 44: Day view 94
Fig. 45: Night view 94
Fig. 46: Measure menu 95
Fig. 47: Measure menu (arrows show the measured points) 96
Fig. 48: Heating menu 97
Fig. 49: Setting the humidity using the slider 98
Fig. 50: Humidity level 0 98
Fig. 51: Humidity level +6 (maximum humidity) 98
Fig. 52: Humidity level -4 (lowest humidity) 99
Fig. 53: Extra-func. menu 100
Fig. 54: Options menu 101
Fig. 55: FiO2 display 102
Fig. 56: “O2 sensor fail” alarm 102
Fig. 57: Communication menu 105
Fig. 58: Selecting the transmission speed 105
Fig. 59: Language sub-menu 106
Fig. 60: Ventilation menu opened 107
Fig. 61: Ventilation options S-IMV 109
Fig. 62: Pop-up menu for S-IMV ventilation 110
Fig. 63: Pop-up menu for S-IMV – selecting the expiration time 110

®
17 List of figures
Fig. 64: Pop-up menu – setting the expiration time 111

Fig. 65: Starting ventilation 111
Fig. 66: Selecting the “Alarms” field 112
Fig. 67: Setting alarm limits 112
Fig. 68: Changing the ventilation mode during ongoing ventilation 113
Fig. 69: Confirmation prompt “Exit ventilation ?” 115
Fig. 70: Standby mode 116
Fig. 71: Confirmation prompt before shutting down 116
Fig. 72: Shutting down the Sophie 117
Fig. 73: Screen saver in standby mode 117
Fig. 74: Confirmation prompt “Break ventilation ?” 118
Fig. 75: System test 120
Fig. 76: Test mode completed successfully 120
Fig. 77: Version with selectable expiration time 125
Fig. 78: Version with selectable breathing frequency 125
Fig. 79: Selecting IMV 127
Fig. 80: Parameter settings for IMV 127
Fig. 81: Selecting S-IMV 128
Fig. 82: Parameter settings for S-IMV 128
Fig. 83: Selecting S-IMV with ITT (PSV) 129
Fig. 84: Parameter settings for S-IMV-ITT (PSV) 129
Fig. 85: Selecting ASS./CO. 130
Fig. 86: Parameter settings for ASS./CO 130
Fig. 87: Selecting Ass./Co. with ITT (PSV) 131
Fig. 88: Parameter settings for Ass./Co. with ITT (PSV) 131
Fig. 89: Selecting high frequency oscillation (HFO) with IMV 132
Fig. 90: Parameter settings for HFO with IMV 132
Fig. 91: Selecting HFO with CPAP 133
Fig. 92: Parameter settings for HFO CPAP 133
Fig. 93: Selecting NCPAP 135
Fig. 94: Parameter settings for NCPAP (with frequency-controlled backup ventilation) 135
Fig. 95: NCPAP with activated standard backup ventilation 137
Fig. 96: Selecting NIPPV 139

17 List of figures
Fig. 97: Parameter settings for NIPPV (with frequency-controlled backup ventilation) 139
Fig. 98: SNIPPV ventilation 141
Fig. 99: SNIPPV with frequency-controlled backup ventilation 142
Fig. 100: Selecting CPAP 143
Fig. 101: Parameter settings for CPAP (with frequency-controlled backup ventilation) 144
Fig. 102: CPAP with activated standard backup ventilation 145
Fig. 103: Filling the humidifier bottle 151
Fig. 104: Sensor position with tube system for incubator 153
Fig. 105: Sensor position with tube system for warming bed 155
Fig. 106: Sensor position with disposable patient tube system (Art. no. 100761300) 156
Fig. 107: Inserting the temperature sensor into the adapter 157
Fig. 108: Tube adapter 157
Fig. 109: Locking of PNT A 158
Fig. 110: Connecting an EasyFlow NCPAP 159
Fig. 111: Nebulizer in reusable tube system 160
Fig. 112: Installing the pneumatic medication nebulizer 161
Fig. 113: Connection of the external respiration sensor 162
Fig. 114: Positioning of the sensor on the abdomen 163
Fig. 115: System test successful 171
Fig. 116: System test not successful 171
Fig. 117: Parameter display with non-invasive ventilation 173
Fig. 118: Parameter display with invasive ventilation 173
Fig. 119: Inspiratory and expiratory triggers 177
Fig. 120: IMV with VTE limitation 179
Fig. 121: Inspiratory time termination ITT 185
Fig. 122: SIMV with ITT and pressure support 187
Fig. 123: HFO label 190
Fig. 124: Spontaneous breathing in NCPAP and CPAP 190
Fig. 125: NCPAP backup ventilation 191
Fig. 126: NCPAP standard backup mode 192
Fig. 127: Backup stages 1 and 2 193

®
17 List of figures
Fig. 130: Backup stage 5 and backup off 195

Fig. 131: Pressure support during SNIPPV 196
Fig. 132: Expiratory trigger during SNIPPV 197
Fig. 133: SNIPPV with apnea monitoring 198
Fig. 134: SNIPPV standard backup mode 199
Fig. 138: Backup stage 5 and backup off 202
Fig. 139: Using the tube warmer 100760007 205
Fig. 143: Patient valve P7, valve piston in the inspiration position 212
Fig. 144: Sophie: pneumatic diagram with patient component P7 214
Fig. 145: Oscillating ventilation curves – patient valve 227
Fig. 146: Humidity in the pneumotachograph 228
Fig. 147: Humidity in the PNT – measurement tube 228
Fig. 148: Turning the measuring tube connectors upward 230
Fig. 149: Sophie with accessories 237
Fig. 150: Test lung 237
Fig. 151: Reusable tube system P7 237
Fig. 152: Connection cable P3/P7 for disposable patient tube system 237
Fig. 153: Preparing the PNT B/C 246
Fig. 154: Inserting the assembly tool into the PNT A 246
Fig. 155: Turning the assembly tool clockwise 246
Fig. 156: Pulling out the assembly tool with the vortex body 246
Fig. 157: Post-treatment PNT B/C 247
Fig. 158: Attaching the vortex bodies to the assembly tool 248
Fig. 159: Inserting the assembly tool and rotating slightly 248
Fig. 160: Repeating the procedure for the second vortex body 248
Fig. 161: Test lung with tube adapter 250
Fig. 162: Patient component P7 253

17 List of figures
Fig. 163: Attaching the proportional valve’s piston 254

Fig. 164: Example for positioning on the drawer of the cleaning and disinfection equipment 254
Fig. 165: Inserting the humidifier fleece 256

®
18 List of tables
18 List of tables
Tab. 1: Abbreviations and technical terms 19

Tab. 2: Pictograms 20
Tab. 3: Measured value display 50
Tab. 4: Status, alarm, and info display 55
Tab. 5: Battery level 57
Tab. 6: Graphic display 60
Tab. 7: Adjustable alarm limits 86
Tab. 8: Automatic alarm limits 87
Tab. 9: Scale 91
Tab. 10: Scaling 92
Tab. 11: System test overview table 121
Tab. 12: Adjustable ventilation parameters 122
Tab. 13: Setting the ventilation parameters 123
Tab. 14: Test list 166
Tab. 15: Possible combinations of the ventilation modes 172
Tab. 16: Sophie pneumatic diagram key 214
Tab. 17: Corrective action and explanation 215
Tab. 18: Troubleshooting 226
Tab. 19: Efficacy ranges according to EN ISO 15883-1 233
Tab. 20: Standard procedure for steam sterilization* 236
Tab. 21: Treatment table 258
Tab. 22: Maintenance and inspection intervals 259
Tab. 23: Electromagnetic emissions (IEC 60601-1-2) 261
Tab. 24: Electromagnetic immunity (IEC60601-1-2) 263
Tab. 25: Recommended separation distance (IEC 60601-1-2, Table 5) 265
Tab. 26: Accessory list 269

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19 Notes
19 Notes

Fritz Stephan GmbH
- Medizintechnik -
Kirchstraße 19
56412 Gackenbach
Germany
 +49 (0)6439 9125 – 0

 +49 (0)6439 9125 – 111
 [email protected]
 www.stephan-gmbh.com

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Sophie

Fritz Stephan GmbH Equipment is subject to technical modification.

2 GA-038-0116V4.2-HAO-EN  Fritz Stephan GmbH

 Fritz Stephan GmbH GA-038-0116V4.2-HAO-EN 3

3.2.1 Measured value display ................................................................................................49

4 GA-038-0116V4.2-HAO-EN  Fritz Stephan GmbH

4.2.2.2 “3. panel” .................................................................................................................90

 Fritz Stephan GmbH GA-038-0116V4.2-HAO-EN 5

5.4.6 High frequency oscillation with IMV (optional) ........................................................132

6 GA-038-0116V4.2-HAO-EN  Fritz Stephan GmbH

9.1 General .............................................................................................................................175

 Fritz Stephan GmbH GA-038-0116V4.2-HAO-EN 7

12.3 Prevention of condensate in PNT and tubes ....................................................................229

8 GA-038-0116V4.2-HAO-EN  Fritz Stephan GmbH

1.1 Product combination

Certified product 1. Pneumatic medication nebulizer

 Fritz Stephan GmbH GA-038-0116V4.2-HAO-EN 9

6. Reusable patient tube systems

10 GA-038-0116V4.2-HAO-EN  Fritz Stephan GmbH

10. Device for regulating the metered dosing of NO to inhaled air

 Fritz Stephan GmbH GA-038-0116V4.2-HAO-EN 11

1.2 Device name and manufacturer

Device name SOPHIE

Manufacturer Fritz Stephan GmbH

 +49 (0)6439 9125 – 0

1.3 Intended use

The SOPHIE is suitable for the invasive and non-invasive ventilation of

12 GA-038-0116V4.2-HAO-EN  Fritz Stephan GmbH

Contraindication The safety instructions provided in chapter 2 must be observed. No

The SOPHIE must not be used:

 Fritz Stephan GmbH GA-038-0116V4.2-HAO-EN 13

14 GA-038-0116V4.2-HAO-EN  Fritz Stephan GmbH

Device setup, operation, and maintenance is only permitted by trained

 Fritz Stephan GmbH GA-038-0116V4.2-HAO-EN 15

1.6 Abbreviations, definitions, and pictograms

Abbreviation/ Term Meaning

16 GA-038-0116V4.2-HAO-EN  Fritz Stephan GmbH

Abbreviation/ Term Meaning

ITT Inspiratory time termination Inspiratory time termination

 Fritz Stephan GmbH GA-038-0116V4.2-HAO-EN 17

Abbreviation/ Term Meaning

18 GA-038-0116V4.2-HAO-EN  Fritz Stephan GmbH

Abbreviation/ Term Meaning

 Fritz Stephan GmbH GA-038-0116V4.2-HAO-EN 19

Alarm menu (see chapter 3.1.2)

Stop (screen display frozen; see chapter 3.1.2)

Aerosol nebulization (see chapter 3.1.2)

Pre-oxygenation (see chapter 3.1.2)

Hold inspiration (see chapter 3.1.2)

Main menu (see chapter 3.1.2)

Remaining duration of alarm suppression (see chapter 3.2.7)

Charge indicator for internal battery (see chapter 3.2.7)

Heating switched off (see chapter 3.2.7)

Standard backup active (see chapters 9.7.1 and 9.8.1)

Frequency backup active (see chapters 9.7.1 and 9.8.1)

External trigger active

Flow trigger active

Observe the operating manual

20 GA-038-0116V4.2-HAO-EN  Fritz Stephan GmbH

1.7.1 General information