Are all ventilators for NIV performing the same? A bench analysis

Global pandemic due to COVID-19 has increased the interest for ventilators & PRIME; use worldwide. New devices have been developed and older ones have undergone a renewed interest, but we lack robust evidence about performance of each ventilator to match appropriate device to a given patient and...

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Detalhes bibliográficos
Autores: Martinez-Castro, S, Nacher, FJB, Bernabeu, JP, Domingo, MBS, Navarro, CD, Pons, HO
Formato: artículo
Estado:Versión publicada
Fecha de publicación:2023
País:España
Recursos:INCLIVA
Repositorio:r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA
OAI Identifier:oai:incliva.fundanetsuite.com:p17669
Acesso em linha:https://incliva.portalinvestigacion.com/publicaciones/17669
Access Level:acceso abierto
Palavra-chave:Bench study
Breathing mechanics
Computer simulation
Noninvasive ventilation
Respiratory mechanics
Ventilator performance
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spelling Are all ventilators for NIV performing the same? A bench analysisMartinez-Castro, SNacher, FJBBernabeu, JPDomingo, MBSNavarro, CDPons, HOBench studyBreathing mechanicsComputer simulationNoninvasive ventilationRespiratory mechanicsVentilator performanceGlobal pandemic due to COVID-19 has increased the interest for ventilators & PRIME; use worldwide. New devices have been developed and older ones have undergone a renewed interest, but we lack robust evidence about performance of each ventilator to match appropriate device to a given patient and care environment. The aim of this bench study was to investigate the performance of six devices for noninvasive ventilation, and to compare them in terms of volume delivered, trigger response, pressurization capacity and synchronization in volume assisted controlled and pressure support ventilation. All ventilators were tested under thirty-six experimental conditions by using the lung model ASL5000 & REG; (IngMar Medical, Pittsburgh, PA). Two leak levels, two muscle inspiratory efforts and three mechanical patterns were combined for simulation. Trigger function was assessed by measurement of trigger-delay time. Pressurization capacity was evaluated as area under the pressure-time curve over the first 500 ms after inspiratory effort onset. Synchronization was evaluated by the asynchrony index and by incidence and type of asynchronies in each condition. All ventilators showed a good performance, even if pressurization capacity was worse than expected. Leak level did not affect their function. Differences were found during low muscle effort and obstructive pattern. In general, Philips Trilogy Evo/EV300 and Hamilton C3 showed the best results. NIV devices successfully compensate air leaks but still underperform with low muscle effort and obstructive lungs. Clinicians & PRIME; must have a clear understanding of the goals of NIV both for devices & PRIME; choice and set main parameters to achieve therapy success.KLUWER ACADEMIC PUBL2023info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://incliva.portalinvestigacion.com/publicaciones/17669JOURNAL OF CLINICAL MONITORING AND COMPUTINGISSN: 13871307ISSNe: 15732614reponame:r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVAinstname:INCLIVAInglésinfo:eu-repo/semantics/openAccessoai:incliva.fundanetsuite.com:p176692026-06-07T16:35:31Z
dc.title.none.fl_str_mv Are all ventilators for NIV performing the same? A bench analysis
title Are all ventilators for NIV performing the same? A bench analysis
spellingShingle Are all ventilators for NIV performing the same? A bench analysis
Martinez-Castro, S
Bench study
Breathing mechanics
Computer simulation
Noninvasive ventilation
Respiratory mechanics
Ventilator performance
title_short Are all ventilators for NIV performing the same? A bench analysis
title_full Are all ventilators for NIV performing the same? A bench analysis
title_fullStr Are all ventilators for NIV performing the same? A bench analysis
title_full_unstemmed Are all ventilators for NIV performing the same? A bench analysis
title_sort Are all ventilators for NIV performing the same? A bench analysis
dc.creator.none.fl_str_mv Martinez-Castro, S
Nacher, FJB
Bernabeu, JP
Domingo, MBS
Navarro, CD
Pons, HO
author Martinez-Castro, S
author_facet Martinez-Castro, S
Nacher, FJB
Bernabeu, JP
Domingo, MBS
Navarro, CD
Pons, HO
author_role author
author2 Nacher, FJB
Bernabeu, JP
Domingo, MBS
Navarro, CD
Pons, HO
author2_role author
author
author
author
author
dc.subject.none.fl_str_mv Bench study
Breathing mechanics
Computer simulation
Noninvasive ventilation
Respiratory mechanics
Ventilator performance
topic Bench study
Breathing mechanics
Computer simulation
Noninvasive ventilation
Respiratory mechanics
Ventilator performance
description Global pandemic due to COVID-19 has increased the interest for ventilators & PRIME; use worldwide. New devices have been developed and older ones have undergone a renewed interest, but we lack robust evidence about performance of each ventilator to match appropriate device to a given patient and care environment. The aim of this bench study was to investigate the performance of six devices for noninvasive ventilation, and to compare them in terms of volume delivered, trigger response, pressurization capacity and synchronization in volume assisted controlled and pressure support ventilation. All ventilators were tested under thirty-six experimental conditions by using the lung model ASL5000 & REG; (IngMar Medical, Pittsburgh, PA). Two leak levels, two muscle inspiratory efforts and three mechanical patterns were combined for simulation. Trigger function was assessed by measurement of trigger-delay time. Pressurization capacity was evaluated as area under the pressure-time curve over the first 500 ms after inspiratory effort onset. Synchronization was evaluated by the asynchrony index and by incidence and type of asynchronies in each condition. All ventilators showed a good performance, even if pressurization capacity was worse than expected. Leak level did not affect their function. Differences were found during low muscle effort and obstructive pattern. In general, Philips Trilogy Evo/EV300 and Hamilton C3 showed the best results. NIV devices successfully compensate air leaks but still underperform with low muscle effort and obstructive lungs. Clinicians & PRIME; must have a clear understanding of the goals of NIV both for devices & PRIME; choice and set main parameters to achieve therapy success.
publishDate 2023
dc.date.none.fl_str_mv 2023
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://incliva.portalinvestigacion.com/publicaciones/17669
url https://incliva.portalinvestigacion.com/publicaciones/17669
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv KLUWER ACADEMIC PUBL
publisher.none.fl_str_mv KLUWER ACADEMIC PUBL
dc.source.none.fl_str_mv JOURNAL OF CLINICAL MONITORING AND COMPUTING
ISSN: 13871307
ISSNe: 15732614
reponame:r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA
instname:INCLIVA
instname_str INCLIVA
reponame_str r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA
collection r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA
repository.name.fl_str_mv
repository.mail.fl_str_mv
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