Performance of an ICU ventilator and two turbin-based ventilators dedicated to non invasive ventilation (NIV) in simulated high inspiratory effort and rate: a NIV-bench-study.

Details

Serval ID
serval:BIB_2CE3776142AA
Type
Inproceedings: an article in a conference proceedings.
Publication sub-type
Abstract (Abstract): shot summary in a article that contain essentials elements presented during a scientific conference, lecture or from a poster.
Collection
Publications
Institution
Title
Performance of an ICU ventilator and two turbin-based ventilators dedicated to non invasive ventilation (NIV) in simulated high inspiratory effort and rate: a NIV-bench-study.
Title of the conference
ESICM 25th Annual Congress, European Society of Intensive Care Medicine
Author(s)
Piquilloud L., Reichmuth P., Thevoz D., Jolliet P., Revelly J.P.
Address
Lisbon, Portugal, October 13-17, 2012
Publication state
Published
Issued date
2012
Volume
38
Series
Intensive Care Medicine
Pages
S67
Language
english
Abstract
INTRODUCTION. The role of turbine-based NIV ventilators (TBV) versus ICU ventilators
with NIV mode activated (ICUV) to deliver NIV in case of severe respiratory failure
remains debated.
OBJECTIVES. To compare the response time and pressurization capacity of TBV and
ICUV during simulated NIV with normal and increased respiratory demand, in condition of
normal and obstructive respiratory mechanics.
METHODS. In a two-chamber lung model, a ventilator simulated normal (P0.1 = 2 mbar,
respiratory rate RR = 15/min) or increased (P0.1 = 6 mbar, RR = 25/min) respiratory
demand. NIV was simulated by connecting the lung model (compliance 100 ml/mbar;
resistance 5 or 20 l/mbar) to a dummy head equipped with a naso-buccal mask. Connections
allowed intentional leaks (29 ± 5 % of insufflated volume). Ventilators to test: Servo-i
(Maquet), V60 and Vision (Philips Respironics) were connected via a standard circuit to the
mask. Applied pressure support levels (PSL) were 7 mbar for normal and 14 mbar for
increased demand. Airway pressure and flow were measured in the ventilator circuit and in
the simulated airway. Ventilator performance was assessed by determining trigger delay
(Td, ms), pressure time product at 300 ms (PTP300, mbar s) and inspiratory tidal volume
(VT, ml) and compared by three-way ANOVA for the effect of inspiratory effort, resistance
and the ventilator. Differences between ventilators for each condition were tested by oneway
ANOVA and contrast (JMP 8.0.1, p\0.05).
RESULTS. Inspiratory demand and resistance had a significant effect throughout all
comparisons. Ventilator data figure in Table 1 (normal demand) and 2 (increased demand):
(a) different from Servo-i, (b) different from V60.CONCLUSION. In this NIV bench study, with leaks, trigger delay was shorter for TBV
with normal respiratory demand. By contrast, it was shorter for ICUV when respiratory
demand was high. ICUV afforded better pressurization (PTP 300) with increased demand
and PSL, particularly with increased resistance. TBV provided a higher inspiratory VT (i.e.,
downstream from the leaks) with normal demand, and a significantly (although minimally)
lower VT with increased demand and PSL.
Create date
19/11/2012 18:31
Last modification date
20/08/2019 13:11
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