Effect of Leak and Breathing Pattern on the Accuracy of Tidal Volume Estimation by Commercial Home Ventilators: A Bench Study
BACKGROUND: New home ventilators are able to provide clinicians data of interest through built-in software. Monitoring of tidal volume (V-T) is a key point in the assessment of the efficacy of home mechanical ventilation. OBJECTIVE: To assess the reliability of the V-T provided by 5 ventilators in a...
| Autores: | , , , , , |
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| Tipo de recurso: | artículo |
| Estado: | Versión publicada |
| Fecha de publicación: | 2013 |
| 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:p6431 |
| Acceso en línea: | https://i3pt.portalinvestigacion.com/publicaciones/6431 |
| Access Level: | acceso abierto |
| Palabra clave: | noninvasive ventilation tidal volume leaks |
| Sumario: | BACKGROUND: New home ventilators are able to provide clinicians data of interest through built-in software. Monitoring of tidal volume (V-T) is a key point in the assessment of the efficacy of home mechanical ventilation. OBJECTIVE: To assess the reliability of the V-T provided by 5 ventilators in a bench test. METHODS: Five commercial ventilators from 4 different manufacturers were tested in pressure support mode with the help of a breathing simulator under different conditions of mechanical respiratory pattern, inflation pressure, and intentional leakage. Values provided by the built-in software of each ventilator were compared breath to breath with the V-T monitored through an external pneumotachograph. Ten breaths for each condition were compared for every tested situation. RESULTS: All tested ventilators underestimated V-T (ranges of -21.7 mL to -83.5 mL, which corresponded to -3.6% to -14.7% of the externally measured V-T). A direct relationship between leak and underestimation was found in 4 ventilators, with higher underestimations of the V-T when the leakage increased, ranging between -2.27% and -5.42% for each 10 L/min increase in the leakage. A ventilator that included an algorithm that computes the pressure loss through the tube as a function of the flow exiting the ventilator had the minimal effect of leaks on the estimation of V-T (0.3%). In 3 ventilators the underestimation was also influenced by mechanical pattern (lower underestimation with restrictive, and higher with obstructive). CONCLUSIONS: The inclusion of algorithms that calculate the pressure loss as a function of the flow exiting the ventilator in commercial models may increase the reliability of V-T estimation. |
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