Influence of Dynamic Leaks in Volume-Targeted Pressure Support Noninvasive Ventilation: A Bench Study
INTRODUCTION: The effect of leaks on volume-targeted pressure support noninvasive ventilation mode has only been tested with continuous simulated leaks. The objective of the study was to assess the influence of random leaks occurring either during inspiration or expiration. METHODS: Analysis of the...
| Autores: | , , , , , |
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| Tipo de recurso: | artículo |
| Estado: | Versión publicada |
| Fecha de publicación: | 2015 |
| País: | España |
| Institución: | Institut d'Investigació i Innovació Parc Taulí (I3PT) |
| Repositorio: | r-I3PT. Repositorio Institucional Producción Científica del Institut d'Investigació i Innovació Parc Taulí |
| OAI Identifier: | oai:i3pt.fundanetsuite.com:p5671 |
| Acceso en línea: | https://i3pt.portalinvestigacion.com/publicaciones/5671 |
| Access Level: | acceso abierto |
| Palabra clave: | dual-control mode noninvasive ventilation leaks volume-targeted pressure support |
| Sumario: | INTRODUCTION: The effect of leaks on volume-targeted pressure support noninvasive ventilation mode has only been tested with continuous simulated leaks. The objective of the study was to assess the influence of random leaks occurring either during inspiration or expiration. METHODS: Analysis of the volume-targeted pressure support mode in 6 commercial ventilators with single-limb circuits and intentional leak in a bench study (restrictive model). Unintentional leaks were introduced through a mechanical system during inspiration (threshold valve with 2 levels of leaks) or during expiration (active valve). Results of delivered tidal volume (V-T) and pressure support were externally recorded. A pre-set V-T of 550 mL was programmed, with a wide range of pressure support values. RESULTS: All the ventilators showed a deviation of delivered versus programmed V-T below 10% in the period without unintentional leaks. In the model with unintentional inspiratory leaks, a progressive drop in delivered V-T and pressure support was observed for all ventilators. The reduction in the delivered V-T for the highest inspiratory leak ranged between 21 and 40%, corresponding to a decrease in pressure support between 3.09 and 10.15 cm H2O after 5 min. Conversely, in the expiratory model, increases in delivered V-T and pressure support were observed, ranging between 16 and 33% and between 2.7 and 6.5 cm H2O, respectively. CONCLUSIONS: The introduction of random leaks influences the performance of commercial ventilators with single-limb circuits and intentional leak. The decrease in delivered V-T with inspiratory leaks reaches a magnitude that may have clinically important impacts. (C) 2015 Daedalus Enterprises |
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