A Comparison of Leak Compensation During Pediatric Noninvasive Ventilation: A Lung Model Study.
BACKGROUND: Ventilators used for noninvasive ventilation (NIV) must be able to synchronize in the presence of system leaks. We compared the ability of 7 ICU ventilators and 3 dedicated NIV ventilators to compensate for leaks during pediatric NIV. METHODS: Using a lung simulator, we compared the Maqu...
| Publicado en: | Respiratory Care Vol. 59; no. 2; pp. 241 - 252 |
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| Autores principales: | , , , |
| Formato: | equations & formulas pictorial research tables/charts Journal Article |
| Publicado: |
Mary Ann Liebert, Inc.
Feb2014
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=104015738&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 104015738 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00201324 4GG jtl: Respiratory Care issn: 00201324 maglogo: N pubinfo: dt: Feb2014 vid: 59 iid: 2 pid: 1365 pub: Mary Ann Liebert, Inc. place: New Rochelle, New York artinfo: ui: 104015738 94082075 10.4187/respcare.02616 NLM23821761 104015738 ppf: 241 ppct: 11 formats: fmt: @attributes: type: P tig: atl: A Comparison of Leak Compensation During Pediatric Noninvasive Ventilation: A Lung Model Study. aug: au: Oto, Jun Chenelle, Christopher T. Marchese, Andrew D. Kacmarek, Robert M. affil: Respiratory Care Services, Massachusetts General Hospital, Boston, Massachusetts sug: subj: Noninvasive Procedures Pediatric Care Respiration, Artificial Equipment and Supplies Ventilators, Mechanical Evaluation Respiratory Mechanics Human Funding Source Comparative Studies Simulations Models, Anatomic Descriptive Statistics Acute Care Tidal Volume Positive End-Expiratory Pressure Analysis of Variance Post Hoc Analysis Data Analysis Software ab: BACKGROUND: Ventilators used for noninvasive ventilation (NIV) must be able to synchronize in the presence of system leaks. We compared the ability of 7 ICU ventilators and 3 dedicated NIV ventilators to compensate for leaks during pediatric NIV. METHODS: Using a lung simulator, we compared the Maquet Servo-i, Dräger V500, Dräger Carina, Covidien PB840, Respironics V60, Respironics Vision, GE Healthcare/Engström Carestation, CareFusion Avea, Hamilton C3, and Hamilton G5 during increasing (n = 6) and decreasing leaks (n = 6). With a lung simulator we tested 4 leak levels (baseline [BL] 2-3 L/min, L1 5-6 L/min, L2 9-10 L/min, and L3 19-20 L/min); 3 patient weights (10, 20, and 30 kg); and 3 lung mechanics scenarios (normal, obstructive, and restrictive). The ventilator settings were NIV mode, pressure support of 10 cm H2O, and PEEP of 5 cm H2O. The synchronization rate (synchronized cycles/total simulated respirations) was recorded for each ventilator and each leak scenario. Synchronization was defined as triggering without auto-triggering, miss-triggering, delayed cycling, or premature cycling. RESULTS: The mean synchronization rate across all ventilators was 68 ± 27% (range 23-96%) and marked differences existed between the ventilators (P < .001). Significant differences in synchronization rate were observed between the 10-kg model (mean 57 ± 30%, range 17-93%), the 20-kg model (69 ± 30%, 25-98%), and the 30-kg models (77 ± 22%, 28-97%) (P < .001). The synchronization rate for the obstructive model (60 ± 30%, 9-94%) was significantly different from the normal model (71 ± 29%, 18-98%) and the restrictive model (72 ± 28%, 23-98%) (P < .001). The PB840 and the C3 had synchronization rates over 90% overall across all body weights, all lung mechanic profiles, and all leak levels. CONCLUSIONS: Leak compensation in NIV for pediatric use can partially compensate for leaks, but varies widely among ventilators, patient weights, and lung mechanics. pubtype: Academic Journal doctype: equations & formulas pictorial research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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