Performance of noninvasive ventilation modes on ICU ventilators during pressure support: a bench model study.

Details

Serval ID
serval:BIB_015354B97717
Type
Article: article from journal or magazin.
Collection
Publications
Title
Performance of noninvasive ventilation modes on ICU ventilators during pressure support: a bench model study.
Journal
Intensive Care Medicine
Author(s)
Vignaux L., Tassaux D., Jolliet P.
ISSN
0342-4642 (Print)
ISSN-L
0342-4642
Publication state
Published
Issued date
2007
Peer-reviewed
Oui
Volume
33
Number
8
Pages
1444-1451
Language
english
Notes
Publication types: Journal ArticlePublication Status: ppublish
Abstract
OBJECTIVE: Noninvasive ventilation (NIV) is often applied with ICU ventilators. However, leaks at the patient-ventilator interface interfere with several key ventilator functions. Many ICU ventilators feature an NIV-specific mode dedicated to preventing these problems. The present bench model study aimed to evaluate the performance of these modes.
DESIGN AND SETTING: Bench model study in an intensive care research laboratory of a university hospital.
METHODS: Eight ICU ventilators, widely available in Europe and featuring an NIV mode, were connected by an NIV mask to a lung model featuring a plastic head to mimic NIV conditions, driven by an ICU ventilator imitating patient effort. Tests were conducted in the absence and presence of leaks, the latter condition with and without activation of the NIV mode. Trigger delay, trigger-associated inspiratory workload, and pressurization were tested in conditions of normal respiratory mechanics, and cycling was also assessed in obstructive and restrictive conditions.
RESULTS: On most ventilators leaks led to an increase in trigger delay and workload, a decrease in pressurization, and delayed cycling. On most ventilators the NIV mode partly or totally corrected these problems, but with large variations between machines. Furthermore, on some ventilators the NIV mode worsened the leak-induced dysfunction.
CONCLUSIONS: The results of this bench-model NIV study confirm that leaks interfere with several key functions of ICU ventilators. Overall, NIV modes can correct part or all of this interference, but with wide variations between machines in terms of efficiency. Clinicians should be aware of these differences when applying NIV with an ICU ventilator.
Keywords
Equipment Design, Equipment Failure, Equipment Failure Analysis, Hospitals, University, Humans, Intensive Care Units, Respiration, Artificial/instrumentation, Respiration, Artificial/standards, Switzerland
Pubmed
Web of science
Create date
27/06/2013 14:08
Last modification date
20/08/2019 12:23
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