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Erschienen in: Intensive Care Medicine 9/2008

01.09.2008 | Original

Trigger performance of mid-level ICU mechanical ventilators during assisted ventilation: a bench study

verfasst von: Juliana C. Ferreira, Daniel W. Chipman, Robert M. Kacmarek

Erschienen in: Intensive Care Medicine | Ausgabe 9/2008

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Abstract

Objective

To compare the triggering performance of mid-level ICU mechanical ventilators with a standard ICU mechanical ventilator.

Design

Experimental bench study.

Setting

The respiratory care laboratory of a university-affiliated teaching hospital.

Subject

A computerized mechanical lung model, the IngMar ASL5000.

Interventions

Ten mid-level ICU ventilators were compared to an ICU ventilator at two levels of lung model effort, three combinations of respiratory mechanics (normal, COPD and ARDS) and two modes of ventilation, volume and pressure assist/control. A total of 12 conditions were compared.

Measurements and main results

Performance varied widely among ventilators. Mean inspiratory trigger time was <100 ms for only half of the tested ventilators. The mean inspiratory delay time (time from initiation of the breath to return of airway pressure to baseline) was longer than that for the ICU ventilator for all tested ventilators except one. The pressure drop during triggering (Ptrig) was comparable with that of the ICU ventilator for only two ventilators. Expiratory Settling Time (time for pressure to return to baseline) had the greatest variability among ventilators.

Conclusions

Triggering differences among these mid-level ICU ventilators and with the ICU ventilator were identified. Some of these ventilators had a much poorer triggering response with high inspiratory effort than the ICU ventilator. These ventilators do not perform as well as ICU ventilators in patients with high ventilatory demand.
Literatur
1.
Zurück zum Zitat Takeuchi M, Williams P, Hess D, Kacmarek RM (2002) Continuous positive airway pressure in new-generation mechanical ventilators: a lung model study. Anesthesiology 96:162–172PubMedCrossRef Takeuchi M, Williams P, Hess D, Kacmarek RM (2002) Continuous positive airway pressure in new-generation mechanical ventilators: a lung model study. Anesthesiology 96:162–172PubMedCrossRef
2.
Zurück zum Zitat Richard JC, Carlucci A, Breton L, Langlais N, Jaber S, Maggiore S, Fougere S, Harf A, Brochard L (2002) Bench testing of pressure support ventilation with three different generations of ventilators. Intensive Care Med 28:1049–1057PubMedCrossRef Richard JC, Carlucci A, Breton L, Langlais N, Jaber S, Maggiore S, Fougere S, Harf A, Brochard L (2002) Bench testing of pressure support ventilation with three different generations of ventilators. Intensive Care Med 28:1049–1057PubMedCrossRef
3.
Zurück zum Zitat Chatmongkolchart S, Williams P, Hess DR, Kacmarek RM (2001) Evaluation of inspiratory rise time and inspiration termination criteria in new-generation mechanical ventilators: a lung model study. Respir Care 46:666–677PubMed Chatmongkolchart S, Williams P, Hess DR, Kacmarek RM (2001) Evaluation of inspiratory rise time and inspiration termination criteria in new-generation mechanical ventilators: a lung model study. Respir Care 46:666–677PubMed
4.
Zurück zum Zitat Tassaux D, Strasser S, Fonseca S, Dalmas E, Jolliet P (2002) Comparative bench study of triggering, pressurization, and cycling between the home ventilator VPAP II and three ICU ventilators. Intensive Care Med 28:1254–1261PubMedCrossRef Tassaux D, Strasser S, Fonseca S, Dalmas E, Jolliet P (2002) Comparative bench study of triggering, pressurization, and cycling between the home ventilator VPAP II and three ICU ventilators. Intensive Care Med 28:1254–1261PubMedCrossRef
5.
Zurück zum Zitat Stell IM, Paul G, Lee KC, Ponte J, Moxham J (2001) Noninvasive ventilator triggering in chronic obstructive pulmonary disease. A test lung comparison. Am J Respir Crit Care Med 164:2092–2097PubMed Stell IM, Paul G, Lee KC, Ponte J, Moxham J (2001) Noninvasive ventilator triggering in chronic obstructive pulmonary disease. A test lung comparison. Am J Respir Crit Care Med 164:2092–2097PubMed
6.
Zurück zum Zitat Bunburaphong T, Imanaka H, Nishimura M, Hess D, Kacmarek RM (1997) Performance characteristics of bilevel pressure ventilators: a lung model study. Chest 111:1050–1060PubMedCrossRef Bunburaphong T, Imanaka H, Nishimura M, Hess D, Kacmarek RM (1997) Performance characteristics of bilevel pressure ventilators: a lung model study. Chest 111:1050–1060PubMedCrossRef
7.
Zurück zum Zitat Battisti A, Tassaux D, Janssens JP, Michotte JB, Jaber S, Jolliet P (2005) Performance characteristics of 10 home mechanical ventilators in pressure-support mode: a comparative bench study. Chest 127:1784–1792PubMedCrossRef Battisti A, Tassaux D, Janssens JP, Michotte JB, Jaber S, Jolliet P (2005) Performance characteristics of 10 home mechanical ventilators in pressure-support mode: a comparative bench study. Chest 127:1784–1792PubMedCrossRef
8.
Zurück zum Zitat Miyoshi E, Fujino Y, Mashimo T, Nishimura M (2000) Performance of transport ventilator with patient-triggered ventilation. Chest 118:1109–1115PubMedCrossRef Miyoshi E, Fujino Y, Mashimo T, Nishimura M (2000) Performance of transport ventilator with patient-triggered ventilation. Chest 118:1109–1115PubMedCrossRef
9.
Zurück zum Zitat Zanetta G, Robert D, Guerin C (2002) Evaluation of ventilators used during transport of ICU patients—a bench study. Intensive Care Med 28:443–451PubMedCrossRef Zanetta G, Robert D, Guerin C (2002) Evaluation of ventilators used during transport of ICU patients—a bench study. Intensive Care Med 28:443–451PubMedCrossRef
10.
Zurück zum Zitat Ramar K, Sassoon CS (2005) Potential advantages of patient–ventilator synchrony. [review] [50 refs]. Respir Care Clin N Am 11:307–317PubMedCrossRef Ramar K, Sassoon CS (2005) Potential advantages of patient–ventilator synchrony. [review] [50 refs]. Respir Care Clin N Am 11:307–317PubMedCrossRef
11.
Zurück zum Zitat Tobin MJ, Jubran A, Laghi F (2001) Patient–ventilator interaction. Am J Respir Crit Care Med 163:1059–1063PubMed Tobin MJ, Jubran A, Laghi F (2001) Patient–ventilator interaction. Am J Respir Crit Care Med 163:1059–1063PubMed
12.
Zurück zum Zitat Kondili E, Xirouchaki N, Georgopoulos D (2007) Modulation and treatment of patient–ventilator dyssynchrony. Curr Opin Crit Care 13:84–89PubMedCrossRef Kondili E, Xirouchaki N, Georgopoulos D (2007) Modulation and treatment of patient–ventilator dyssynchrony. Curr Opin Crit Care 13:84–89PubMedCrossRef
13.
Zurück zum Zitat Bigatello LM, Nishimura M, Imanaka H, Hess D, Kimball WR, Kacmarek RM (1997) Unloadiing of the work of breathing by proportional assist ventilation in a lung model. Crit Care Med 25:267–272PubMedCrossRef Bigatello LM, Nishimura M, Imanaka H, Hess D, Kimball WR, Kacmarek RM (1997) Unloadiing of the work of breathing by proportional assist ventilation in a lung model. Crit Care Med 25:267–272PubMedCrossRef
14.
15.
Zurück zum Zitat Prinianakis G, Kondili E, Georgopoulos D (2005) Patient–ventilator interaction: an overview. Respir Care Clin N Am 11:201–224PubMedCrossRef Prinianakis G, Kondili E, Georgopoulos D (2005) Patient–ventilator interaction: an overview. Respir Care Clin N Am 11:201–224PubMedCrossRef
16.
Zurück zum Zitat Williams P, Kratohvil J, Ritz R, Hess DR, Kacmarek RM (2000) Pressure support and pressure assist/control: are there differences? an evaluation of the newest intensive care unit ventilators. Respir Care 45:1169–1181PubMed Williams P, Kratohvil J, Ritz R, Hess DR, Kacmarek RM (2000) Pressure support and pressure assist/control: are there differences? an evaluation of the newest intensive care unit ventilators. Respir Care 45:1169–1181PubMed
17.
Zurück zum Zitat Ferreira CJ, Chipman DW, Kacmarek RM (2006) (Abstract) Performance of mechanical ventilators in the setting of patient effort: a bench study. Respir Care 51:1284 Ferreira CJ, Chipman DW, Kacmarek RM (2006) (Abstract) Performance of mechanical ventilators in the setting of patient effort: a bench study. Respir Care 51:1284
18.
Zurück zum Zitat Lofaso F, Brochard L, Hang T, Lorino H, Harf A, Isabey D (1996) Home versus intensive care pressure support devices. experimental and clinical comparison. Am J Respir Crit Care Med 153:1591–1599PubMed Lofaso F, Brochard L, Hang T, Lorino H, Harf A, Isabey D (1996) Home versus intensive care pressure support devices. experimental and clinical comparison. Am J Respir Crit Care Med 153:1591–1599PubMed
Metadaten
Titel
Trigger performance of mid-level ICU mechanical ventilators during assisted ventilation: a bench study
verfasst von
Juliana C. Ferreira
Daniel W. Chipman
Robert M. Kacmarek
Publikationsdatum
01.09.2008
Verlag
Springer-Verlag
Erschienen in
Intensive Care Medicine / Ausgabe 9/2008
Print ISSN: 0342-4642
Elektronische ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-008-1125-5

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