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Robert M. Kacmarek - One of the best experts on this subject based on the ideXlab platform.
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bench evaluation of two bag squeezer disaster Ventilators
Respiratory Care, 2020Co-Authors: Esther H Chung, Carolyn J La Vita, Lorenzo Berra, Caio C A Morais, Keith A Marill, Aaron D Aguirre, Robert M. KacmarekAbstract:Background: The COVID-19 pandemic of 2020 created concern regarding the preparedness of the US Health Care System. One major concern was the availability of mechanical Ventilators. Consequently, the US government and many state and local health care systems called upon manufacturers of existing mechanical Ventilators as well as entrepreneurs, innovators, and scientists to rapidly manufacture or develop devices to provide assisted ventilation. The Partners HealthCare System developed an Innovation center with one group devoted to ventilator innovation that met regularly. We present here the results of our evaluation of 2 of two “bag squeezer” types Ventilators. Methods: We evaluated the performance of near final prototypes of the RISE and a version of the MIT “bag Squeezer” type Ventilators using the Michigan Instruments TTL adult patient lung simulator. A NICO respiratory monitor (Philips) was used to assess the difference between ventilator settings and actual delivered gas volume. The primary outcome was the ability of each ventilator to perform to its specification, and secondary outcomes included alarm system response. Each device was tested through the same range of specified ventilation and lung simulator conditions. A greater than 10% deviation of actual delivered from device set parameter in a given setting was considered unacceptable. Results: Neither the MIT nor RISE ventilator were able to perform to their specification. Both were unable to maintain delivery of set tidal volume as respiratory rate and inspiratory time were varied (Figure 1a and 1b). However, both performed best when the compliance was 50 mL/cm H2O and the resistance 5 cm H2O/ L/s. Specifically, the MIT ventilator was unable to provide the set tidal volume in 86% of the respiratory rate trials (1a) while the RISE ventilator was unable to provide the set tidal volume 75% of the time (1b). Similar finding occurred with inspiratory time variation vs. set tidal (79% vs, 82% respectively MIT then RISE). Alarms inappropriately sounded in 100% of trials with MIT Ventilators and 66% of trials with the RISE ventilator, with numerous alarms sounding unrelated to the clinical condition tested. However, it should be remembered that these Ventilators were developed over 4 to 6 weeks. Conclusions: These Ventilators were unable to meet specification. This data was provided to the manufacturers. Before these type Ventilators are put into use their performance should be carefully evaluated.
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neonatal invasive pressure support ventilation a comparison of new generation adult icu Ventilators
Respiratory Care, 2019Co-Authors: Carolyn J La Vita, Beverly Ejiofor, Esther H Chung, Robert M. KacmarekAbstract:Background: Essentially all new generation adult ICU Ventilators are designed to provide ventilation of neonates to adults. Nihon Kohden recently introduced a new ventilator to the market the NKV 500. To determine the performance of this ventilator during neonatal pressure support it needs to be compared to established ICU Ventilators. In this study we compared the gas delivery capabilities of the new Nihon Kohden 550 ventilator (NKV 550) to that of the Medtronic PB980 and the Drager V500 Ventilators. We hypothesized that if these Ventilators were optimally set in pressure support ventilation there would be no differences in trigger response, pressurization time and volume delivery. Methods: Evaluations were performed with the IngMar ASL 5000 computerized lung simulator using a dry circuit and the Fisher & Paykel RT260 neonatal ventilator circuit. The ASL 5000 was set to simulate neonatal lung mechanics with a weak, normal and strong ventilatory drive (P0.1 1, 4.2 and 7.3 cm H2O) and inspiratory time varying from 250 to 400 milliseconds (ms). Evaluations were performed without a leak and with a leak (1 to 1.5 L/min). Ventilator trigger sensitivity, rise time and termination criteria were optimally set. Each ventilator was set to deliver 5/5, 10/5 and 15/10 cm H2O pressure support above PEEP. A total of 18 trials were conducted on each ventilator. Each trial lasted 2 min. The last 10 breath of each trial were analyzed. Trigger time (TT, ms), max pressure to trigger (MaxTrigP, cm H2O), time to max trigger pressure (T-Tpress, ms), trigger pressure time product (PTP, cm H2O -ms), time to 90% of peak pressure (T90, ms), and tidal volume (VT, mL) were compared among Ventilators using ANOVA for repeated measures. Potentially important clinical differences were defined as a P 10% difference among Ventilators. Results: The only potentially clinically important difference identified among variables evaluated was maximum trigger pressure(see table). Even this difference, although it met our criteria (P 10%), is small (-0.23 vs -0.28 cm H2O across Ventilators) and unlikely clinically important. Conclusions: The NKV500, PB980 and V500 all performed similarly during this evaluation. The only potentially important difference was maximum trigger pressure. Disclosures: Robert Kacmarek is a consultant for Medtronic’s and Orange Medical and has received research grants from Medtronic’s and Venner Medical. All other authors report no conflict of interest
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gas delivery during adult patient triggered mechanical ventilation in new generation icu Ventilators
Respiratory Care, 2019Co-Authors: Carolyn J La Vita, Beverly Ejiofor, Esther H Chung, Robert M. KacmarekAbstract:Background: New generation ICU Ventilators frequently enter the market. To determine the performance of these Ventilators they need to be compared to established ICU Ventilators. In this study we compared the gas delivery capabilities of the new Nihon Kohden 550 ventilator (NKV 550) to that of the Medtronic PB980 and the Drager V500 Ventilators. We hypothesized that if these Ventilators were optimally set in pressure support ventilation there would be no differences in trigger response, pressurization time and volume delivery. Methods: Evaluations were performed with the IngMar ASL 5000 computerized lung simulator using a dry circuit and the Fisher & Paykel RT380 adult ventilator circuit. The ASL 5000 was set to simulate normal, COPD and ARDS lung mechanics with two ventilatory drives 1.7 and 6.7 cm H2O and inspiratory times varying from 500 to 900 milliseconds, ms. Ventilator trigger sensitivity, rise time and termination criteria were optimally set. Each ventilator was set to deliver 5/5, 10/5 and 15/10 cm H2O pressure support above PEEP. A total of 18 trials were conducted on each ventilator. Each trial lasted 2 min. The last 10 breath of each trial were analyzed. Trigger time (TT, ms), max pressure to trigger (MaxTrigP, cm H2O), time to max trigger pressure (T-Tpress, ms), trigger pressure time product (PTP, cm H2O -ms) time to 90% of peak pressure (T90, ms), and tidal volume (VT, mL) were compared among Ventilators using ANOVA for repeated measures. Potentially important clinical differences were defined as a P 10% difference among Ventilators. Results: Potentially clinically important differences were identified among all variables except tidal volume(see table). Variables differed among Ventilators with a P 10% difference except for tidal volume. These differences were a result of increased time to trigger during COPD lung mechanics and a low ventilatory drive. Both independently increased time to trigger (data not shown). Conclusions: There are clinically important difference in the performance of the NKV 500, PB 980 and V500 Ventilators during adult pressure support ventilation. Disclosures: Robert Kacmarek is a consultant for Medtronic’s and Orange Medical and has received research grants from Medtronic’s and Venner Medical. All other authors report no conflict of interest
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are we fully utilizing the functionalities of modern operating room Ventilators
Current Opinion in Anesthesiology, 2017Co-Authors: Shujie Liu, Robert M. Kacmarek, Jun OtoAbstract:Purpose of review The modern operating room Ventilators have become very sophisticated and many of their features are comparable with those of an ICU ventilator. To fully utilize the functionality of modern operating room Ventilators, it is important for clinicians to understand in depth the working principle of these Ventilators and their functionalities. Recent findings Piston Ventilators have the advantages of delivering accurate tidal volume and certain flow compensation functions. Turbine Ventilators have great ability of flow compensation. Ventilation modes are mainly volume-based or pressure-based. Pressure-based ventilation modes provide better leak compensation than volume-based. The integration of advanced flow generation systems and ventilation modes of the modern operating room Ventilators enables clinicians to provide both invasive and noninvasive ventilation in perioperative settings. Ventilator waveforms can be used for intraoperative neuromonitoring during cervical spine surgery. Summary The increase in number of new features of modern operating room Ventilators clearly creates the opportunity for clinicians to optimize ventilatory care. However, improving the quality of ventilator care relies on a complete understanding and correct use of these new features. VIDEO ABSTRACT: http://links.lww.com/COAN/A47.
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assisted mechanical ventilation the future is now
BMC Anesthesiology, 2015Co-Authors: Robert M. Kacmarek, Massimiliano Pirrone, Lorenzo BerraAbstract:Assisted ventilation is a highly complex process that requires an intimate interaction between the ventilator and the patient. The complexity of this form of ventilation is frequently underappreciated by the bedside clinician. In assisted mechanical ventilation, regardless of the specific mode, the ventilator’s gas delivery pattern and the patient’s breathing pattern must match near perfectly or asynchrony between the patient and the ventilator occurs. Asynchrony can be categorized into four general types: flow asynchrony; trigger asynchrony; cycle asynchrony; and mode asynchrony. In an article recently published in BMC Anesthesiology, Hodane et al. have demonstrated reduced asynchrony during assisted ventilation with Neurally Adjusted Ventilatory Assist (NAVA) as compared to pressure support ventilation (PSV). These findings add to the growing volume of data indicating that modes of ventilation that provide proportional assistance to ventilation – e.g., NAVA and Proportional Assist Ventilation (PAV) – markedly reduce asynchrony. As it becomes more accepted that the respiratory center of the patient in most circumstances is the most appropriate determinant of ventilatory pattern and as the negative outcome effects of patient-ventilator asynchrony become ever more recognized, we can expect NAVA and PAV to become the preferred modes of assisted ventilation!
Masaji Nishimura - One of the best experts on this subject based on the ideXlab platform.
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Intrahospital transport of critically ill patients using ventilator with patient-triggering function.
Chest, 2016Co-Authors: Toshiaki Nakamura, Yuji Fujino, Akinori Uchiyama, Takashi Mashimo, Masaji NishimuraAbstract:Objective To compare a new transport ventilator to manual ventilation in terms of maintaining the respiratory and hemodynamic levels of critically ill patients. Design Prospective, randomized, single-center study. Setting ICU in a university hospital. Patients A total of 16 patients (22 transports) who were spontaneously breathing and required ventilatory assistance on excursions from the ICU. Methods For each transport, the patient was randomly assigned to receive either manual ventilation (group M) or mechanical ventilation (group V). For transports in group V, the Ventilators were set the same as in the ICU. Respiratory and hemodynamic variables were measured 30 min before transport (T 0 ), on arrival at the site of procedure (T 1 ), on return to the ICU (T 2 ), and 30 min after return the ICU (T 3 ). Results After transport, five patients in group M showed a significant deterioration in Pa o 2 /fraction of inspired oxygen ratio, while one patient in group V showed deterioration (p = 0.056). The mean (± SD) respiratory rate in group M at T 2 (32 ± 9 breaths/min) was significantly higher (p 0 (19 ± 6 breaths/min) and also was higher (p 2 (19 ± 6 breaths/min). The mean tidal volume and positive end-expiratory pressure in group M at T 2 showed significantly larger variation (p Conclusions The transport ventilator that was recently approved by the US Food and Drug Administration reliably provides more stable ventilatory support than does manual ventilation. Generally, the use of this transport ventilator for intrahospital transport is preferable to manual ventilation.
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Temperature of gas delivered from Ventilators
Journal of Intensive Care, 2013Co-Authors: Yusuke Chikata, Mutsuo Onodera, Hideaki Imanaka, Masaji NishimuraAbstract:BackgroundAlthough heated humidifiers (HHs) are the most efficient humidifying device for mechanical ventilation, some HHs do not provide sufficient humidification when the inlet temperature to the water chamber is high. Because portable and home-care Ventilators use turbines, blowers, pistons, or compressors to inhale in ambient air, they may have higher gas temperature than Ventilators with piping systems. We carried out a bench study to investigate the temperature of gas delivered from portable and home-care Ventilators, including the effects of distance from ventilator outlet, fraction of inspiratory oxygen (F_IO_2), and minute volume (MV).MethodsWe evaluated five Ventilators equipped with turbine, blower, piston, or compressor system. Ambient air temperature was adjusted to 24°C ± 0.5°C, and ventilation was set at F_IO_2 0.21, 0.6, and 1.0, at MV 5 and 10 L/min. We analyzed gas temperature at 0, 40, 80, and 120 cm from ventilator outlet and altered ventilator settings.ResultsWhile temperature varied according to Ventilators, the outlet gas temperature of Ventilators became stable after, at the most, 5 h. Gas temperature was 34.3°C ± 3.9°C at the ventilator outlet, 29.5°C ± 2.2°C after 40 cm, 25.4°C ± 1.2°C after 80 cm and 25.1°C ± 1.2°C after 120 cm (P < 0.01). F_IO_2 and MV did not affect gas temperature.ConclusionGas delivered from portable and home-care ventilator was not too hot to induce heated humidifier malfunctioning. Gas soon declined when passing through the limb.
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Exhaled tidal volume is overestimated due to cardiogenic oscillation: effects of ventilator and mode
Masui. The Japanese journal of anesthesiology, 2005Co-Authors: Hideaki Imanaka, Kazuya Tachibana, Yuji Takauchi, Noriko Inamori, Muneyuki Takeuchi, Masaji NishimuraAbstract:BACKGROUND: We investigated effects of cardiogenic oscillation on overestimation of tidal volume using a lung model, with three Ventilators and two ventilatory modes. METHODS: We simulated cardiogenic oscillation at a rate of 90 breaths x min(-1) by ventilating one bellow of a two-bellow-type lung model. The magnitude of cardiogenic oscillation was defined as peak expiratory flow fluctuation when the airway was opened to the atmosphere. The lung model was mechanically ventilated with three Ventilators (Bird 8400 STi, Servo-300, and Nellcor Puritan-Bennett 840), two ventilatory modes (volume- and pressure-controlled ventilation), and two respiratory rates (5 and 10 breaths x min(-1)) in random order. We recorded tidal volume on a ventilator monitor and calculated the discrepancy from the set tidal volume. RESULTS: With Bird 8400 STi, monitored tidal volume exceeded set tidal volume, regardless of volume- or pressure-controlled ventilation. The overestimation in tidal volume was larger with smaller respiratory rate and with larger cardiogenic oscillation. In contrast, with the other Ventilators, the discrepancy was small. CONCLUSIONS: Exhaled tidal volume is overestimated during mechanical ventilation when cardiogenic oscillation is large.
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performance characteristics of bilevel pressure Ventilators a lung model study
Chest, 1997Co-Authors: Thananchai Bunburaphong, Hideaki Imanaka, Masaji Nishimura, Dean R Hess, Robert M. KacmarekAbstract:Bilevel pressure Ventilators are being used increasingly to provide noninvasive ventilatory support in the management of obstructive sleep apnea, chronic ventilatory failure, and acute respiratory failure. However, the ability of these Ventilators to respond to inspiratory demand without imposing expiratory loads has not been evaluated extensively. We evaluated the performance of nine bilevel pressure Ventilators in a lung model, as compared with the Nellcor Puritan-Bennett 7200ae adult critical care ventilator. All Ventilators were set to provide pressure support ventilation (PSV) and positive end-expiratory pressure (PEEP) at a rate of 10 breaths/min with an inspiratory time of 1.0 s. Simulated pleural pressure, airway pressure, and flow at airway opening were continuously monitored. We studied the effects of three PSV levels (5, 10, and 15 cm H2O) with 5 cm H2O PEEP at two lung compliances (50 and 80 mL/cm H2O) and four peak inspiratory flow demands (20, 40, 60, and 80 L/min) on seven dependent variables: inspiratory delay time (D-I), inspiratory trigger pressure (P-I), inspiratory area percent (Area I%), expiratory delay time (D-E), supraplateau expiratory pressure change (P-E), expiratory area (Area E), and ventilator peak flow (VPF). Most Ventilators performed as well as or significantly (p<0.05) better than the 7200ae in all studied variables. Compliance did not significantly affect ventilator performance. Increasing inspiratory flow demand significantly (p<0.05) increased D-I, P-I, P-E, and VPF and decreased Area I% with most Ventilators. As ventilatory demand increased, D-E and Area E significantly (p<0.05) changed. With some units, D-E and Area E increased, while with others they decreased. Most bilevel pressure Ventilators evaluated were able to respond to high ventilatory demands and outperformed the Nellcor Puritan-Bennett 7200ae ventilator.
Laurent Argaud - One of the best experts on this subject based on the ideXlab platform.
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Bilevel positive airway pressure ventilation: factors influencing carbon dioxide rebreathing
Intensive Care Medicine, 2010Co-Authors: Zbigniew Szkulmowski, Kheirallah Belkhouja, Dominique Robert, Laurent ArgaudAbstract:Purpose Use of bilevel positive airway pressure (BLPAP) Ventilators for noninvasive ventilation (NIV) is an established treatment for both acute and chronic ventilatory failure. Although BLPAP ventilator circuits are simpler than those of conventional Ventilators, one drawback to their use is that they allow variable amounts of rebreathing to occur. The aim of this work is to measure the amount of CO_2 reinsufflated in relation to the BLPAP ventilator circuit in patients, and to determine predictive factors for rebreathing. Methods Eighteen adult patients were ventilated on pressure support, either by intubation or with mask ventilation, during a weaning period. The mean inspiratory fraction of CO_2 (tidal FiCO_2) reinsufflated from the circuit between the intentional leak and the ventilator was measured for each breath. The influence of end-tidal CO_2 concentration (ETCO_2), respiratory rate (RR), percentage of inspiratory time ( T _i/ T _TOT), application of expiratory positive airway pressure (EPAP), and inspiratory tidal volume on magnitude of tidal FiCO_2, as well as the influence of intubation versus NIV, were studied by univariate comparisons and logistic regression analysis. Results In a total of 11,107 cycles, tidal FiCO_2 was 0.072 ± 0.173%. Of fractions measured, 8,976 (81%) were under 0.10% and 2,131 (19%) were over 0.10%, with mean values of 0.026 ± 0.027% and 0.239 ± 0.326%, respectively. ETCO_2, EPAP, NIV versus intubation, and RR had significant predictive value for tidal FiCO_2 >0.10%. Conclusions BLPAP Ventilators present a specific rebreathing risk to patients. However, that risk remains modest, even in intubated patients, provided that EPAP is applied.
John N Van Den Anker - One of the best experts on this subject based on the ideXlab platform.
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variation of inhaled nitric oxide concentration with the use of a continuous flow ventilator
Critical Care Medicine, 1997Co-Authors: Anne De Jaegere, Frans I Jacobs, Claudia Laheij, John N Van Den AnkerAbstract:Objective: To investigate the homogeneity of nitric oxide concentrations at different ventilator settings in a delivery system using a continuous flow ventilator. Design: A prospective bench study using a nitric oxide delivery system, mixing a nitrogen/nitric oxide gas mixture in the ventilator circuit with two types of continuous flow Ventilators (Babylog 8000 TM , Draeger, Luebeck, Germany; Infant Star TM , Infrasonics, San Diego, CA). Setting: A biomedical laboratory. Interventions: A nitrogen/nitric oxide gas mixture was injected at three different sites in the ventilator circuit (just before and just behind the humidifier, and 20 cm before the Y-connector). Ventilator flow (12, 15, and 20 Umin) and rates (30 to 110 breaths/min with increments of 10 breaths/min) were changed as well as the compliance of the test lung (0.36, 0.5, and 1.0 mUcm H 2 O). Carbon dioxide, instead of nitrogen/nitric oxide, was injected at the same points in the circuit. Measurements and Main Results: The mean nitric oxide concentration increased significantly (p <.001) with increasing ventilator rates (although the flow ratio of the ventilator gas and the nitrogen/nitric oxide gas mixture was kept constant) when the nitrogen/nitric oxide injection site was near to the Y-connector of the ventilator circuit with both Ventilators. The mean nitric oxide concentration did not change significantly when the nitrogen/nitric oxide gas mixture was mixed to the ventilator gas at the inlet of the humidifier, using the Babylog 8000 ventilator. Analysis of ventilator circuit flow patterns showed fluctuations during the respiratory cycle. The magnitude of the flow changes was different at the three injection sites in the ventilator circuit. Real-time measurements of the CO 2 concentration showed fluctuations during the distinct respiratory phases that differed at the separate injection sites. Mean CO 2 concentrations showed a similar pattern as compared with the mean nitric oxide concentration data at the same settings. Conclusions: Mixing a nitrogen/nitric oxide gas mixture 20 cm before the Y-connector results in an increase of the mean nitric oxide concentration with increasing ventilator rates. This phenomenon does not occur with the nitrogen/nitric oxide gas mixture mixed at the inlet of the humidifier, using a ventilator with a throughout constant flow at the inspiratory outlet of the ventilator. The fluctuations of the main ventilator circuit flow result in changing ratios of nitrogen/nitric oxide gas mixture and the ventilator gas flow. We speculate this changing flow ratio produces the increase in mean nitric oxide concentration within the ventilatory circuit. To ensure a constant concentration of nitric oxide by blending a nitrogen/nitric oxide gas mixture in the ventilator circuit of a continuous flow ventilator, the site of injection of the nitrogen/nitric oxide gas mixture should be at the point where ventilator circuit flow fluctuations are minimal.
Laurent Brochard - One of the best experts on this subject based on the ideXlab platform.
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sleep in hypercapnic critical care patients under noninvasive ventilation conventional versus dedicated Ventilators
Critical Care Medicine, 2013Co-Authors: Ana Cordobaizquierdo, Arnaud W Thille, Xavier Drouot, Fabrice Galia, Ferran Rochecampo, Frederique Schortgen, Enric Pratssoro, Laurent BrochardAbstract:OBJECTIVE To compare sleep quality between two types of Ventilators commonly used for noninvasive ventilation: conventional ICU Ventilators and dedicated noninvasive Ventilators; and to evaluate sleep during and between noninvasive ventilation sessions in critically ill patients. DESIGN Physiological sleep study with a randomized assessment of the ventilator type. SETTING Medical ICU in a university hospital. PATIENTS Twenty-four patients admitted for acute hypercapnic respiratory failure requiring noninvasive ventilation. INTERVENTIONS Patients were randomly assigned to receive noninvasive ventilation with either an ICU Ventilators (n = 12) or a dedicated noninvasive Ventilators (n = 12), and their sleep and respiratory parameters were recorded by polysomnography from 4 PM to 9 AM on the second, third, or fourth day after noninvasive ventilation initiation. MEASUREMENTS AND MAIN RESULTS Sleep architecture was similar between ventilator groups, including sleep fragmentation (number of arousals and awakenings/hr), but the dedicated noninvasive Ventilators group showed a higher patient-ventilator asynchrony-related fragmentation (28% [17-44] vs. 14% [7.0-22]; p = 0.02), whereas the ICU Ventilators group exhibited a higher noise-related fragmentation. Ineffective efforts were more frequent in the dedicated noninvasive Ventilators group than in the ICU Ventilators group (34 ineffective efforts/hr of sleep [15-125] vs. two [0-13]; p < 0.01), possibly as a result of a higher tidal volume (7.2 mL/kg [6.7-8.8] vs. 5.8 [5.1-6.8]; p = 0.04). More sleep time occurred and sleep quality was better during noninvasive ventilation sessions than during spontaneous breathing periods (p < 0.05) as a result of greater slow wave and rapid eye movement sleep and lower fragmentation. CONCLUSIONS There were no observed differences in sleep quality corresponding to the type of ventilator used despite slight differences in patient-ventilator asynchrony. Noninvasive ventilation sessions did not prevent patients from sleeping; on the contrary, they seem to aid sleep when compared with unassisted breathing.
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patient ventilator asynchrony during noninvasive ventilation a bench and clinical study
Chest, 2012Co-Authors: Guillaume Carteaux, Laurent Brochard, Aissam Lyazidi, Ana Cordobaizquierdo, Laurence Vignaux, Philippe Jolliet, Arnaud W Thille, Jeanchristophe M RichardAbstract:Background Different kinds of Ventilators are available to perform noninvasive ventilation (NIV) in ICUs. Which type allows the best patient-ventilator synchrony is unknown. The objective was to compare patient-ventilator synchrony during NIV between ICU, transport—both with and without the NIV algorithm engaged—and dedicated NIV Ventilators. Methods First, a bench model simulating spontaneous breathing efforts was used to assess the respective impact of inspiratory and expiratory leaks on cycling and triggering functions in 19 Ventilators. Second, a clinical study evaluated the incidence of patient-ventilator asynchronies in 15 patients during three randomized, consecutive, 20-min periods of NIV using an ICU ventilator with and without its NIV algorithm engaged and a dedicated NIV ventilator. Patient-ventilator asynchrony was assessed using flow, airway pressure, and respiratory muscles surface electromyogram recordings. Results On the bench, frequent auto-triggering and delayed cycling occurred in the presence of leaks using ICU and transport Ventilators. NIV algorithms unevenly minimized these asynchronies, whereas no asynchrony was observed with the dedicated NIV Ventilators in all except one. These results were reproduced during the clinical study: The asynchrony index was significantly lower with a dedicated NIV ventilator than with ICU Ventilators without or with their NIV algorithm engaged (0.5% [0.4%-1.2%] vs 3.7% [1.4%-10.3%] and 2.0% [1.5%-6.6%], P Conclusions Dedicated NIV Ventilators allow better patient-ventilator synchrony than ICU and transport Ventilators, even with their NIV algorithm. However, the NIV algorithm improves, at least slightly and with a wide variation among Ventilators, triggering and/or cycling off synchronization.
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Evaluation of the ventilator-user interface of 2 new advanced compact transport Ventilators.
Respiratory Care, 2007Co-Authors: Francois Templier, Patrick Miroux, F. Dolveck, N.-s. Goddet, Charles Jeleff, Michel Baer, Marcel Chauvin, Alexis Descatha, Laurent Brochard, Dominique FletcherAbstract:BACKGROUND: Mechanical ventilation during patient transport frequently utilizes compact portable pneumatic Ventilators that have limited ventilator-settings options. New advanced transport Ventilators should yield quality improvements, but their user-friendliness needs to be tested. OBJECTIVE: To evaluate the ventilator-user interface of 2 new transport Ventilators. METHODS: This was a 2-center descriptive study in which the ventilator-user interfaces of the Oxylog 3000 and Elisee 250 were compared by 20 French senior emergency physicians who were initially unfamiliar with these Ventilators. Each physician carried out 15 tasks with each ventilator and then assigned each ventilator a satisfaction score. RESULTS: With the Elisee 250 the task success rate was significantly higher (85.6% vs 66.6% with the Oxylog 3000, p CONCLUSIONS: The Elisee 250 ventilator-user interface was easier to use than that of the Oxylog 3000. The applicability of these results to other types of users will require further studies, but the types of errors found in our study might help future users.
