A Comparison of Leak Compensation in Acute Care Ventilators During Noninvasive and Invasive Ventilation: A Lung Model Study.
BACKGROUND: Although leak compensation has been widely introduced to acute care ventilators to improve patient-ventilator synchronization in the presence of system leaks, there are no data on these ventilators' ability to prevent triggering and cycling asynchrony. The goal of this study was to evalu...
| Published in: | Respiratory Care Vol. 58; no. 12; pp. 2027 - 2038 |
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| Main Authors: | , , , |
| Format: | research tables/charts Journal Article |
| Published: |
Mary Ann Liebert, Inc.
Dec2013
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=104160525&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 104160525 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00201324 4GG jtl: Respiratory Care issn: 00201324 maglogo: N pubinfo: dt: Dec2013 vid: 58 iid: 12 pid: 1365 pub: Mary Ann Liebert, Inc. place: New Rochelle, New York artinfo: ui: 104160525 92014509 10.4187/respcare.02466 NLM23696688 104160525 ppf: 2027 ppct: 11 formats: fmt: @attributes: type: P tig: atl: A Comparison of Leak Compensation in Acute Care Ventilators During Noninvasive and Invasive Ventilation: A Lung Model Study. aug: au: Jun Oto Chenelle, Christopher T. Marchese, Andrew D. Kacmarek, Robert M. affil: Respiratory Care Services, Massachusetts General Hospital, Boston, Massachusetts sug: subj: Respiration, Artificial Equipment and Supplies Ventilators, Mechanical Evaluation Acute Care Respiratory Mechanics Noninvasive Procedures Invasive Procedures Models, Anatomic Simulations Positive End-Expiratory Pressure Comparative Studies Funding Source Descriptive Statistics Tidal Volume Data Analysis Software Education, Continuing (Credit) ab: BACKGROUND: Although leak compensation has been widely introduced to acute care ventilators to improve patient-ventilator synchronization in the presence of system leaks, there are no data on these ventilators' ability to prevent triggering and cycling asynchrony. The goal of this study was to evaluate the ability of leak compensation in acute care ventilators during invasive and noninvasive ventilation (NIV). METHODS: Using a lung simulator, the impact of system leaks was compared on 7 ICU ventilators and 1 dedicated NIV ventilator during triggering and cycling at 2 respiratory mechanics (COPD and ARDS models) settings, various modes of ventilation (NIV mode [pressure support ventilation], and invasive mode [pressure support and continuous mandatory ventilation]), and 2 PEEP levels (5 and 10 cm H2O). Leak levels used were up to 35-36 L/min in NIV mode and 26-27 L/min in invasive mode. RESULTS: Although all of the ventilators were able to synchronize with the simulator at baseline, only 4 of the 8 ventilators synchronized to all leaks in NIV mode, and 2 of the 8 ventilators in invasive mode. The number of breaths to synchronization was higher during increasing than during decreasing leak. In the COPD model, miss-triggering occurred more frequently and required a longer time to stabilize tidal volume than in the ARDS model. The PB840 required fewer breaths to synchronize in both invasive and noninvasive modes, compared with the other ventilators (P < .001). CONCLUSIONS: Leak compensation in invasive and noninvasive modes has wide variations between ventilators. The PB840 and the V60 were the only ventilators to acclimate to all leaks, but there were differences in performance between these 2 ventilators. It is not clear if these differences have clinical importance. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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