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Combined effects of leaks, respiratory system properties and upper airway patency on the performance of home ventilators: a bench study
BACKGROUND: Combined effects of leaks, mechanical property of respiratory system and upper airway (UA) patency on patient-ventilator synchrony (PVA) and the level of clinically “tolerable” leaks are not well established in home ventilators. METHODS: We comparatively assessed on a bench model, the hi...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5697337/ https://www.ncbi.nlm.nih.gov/pubmed/29157220 http://dx.doi.org/10.1186/s12890-017-0487-2 |
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author | Zhu, Kaixian Rabec, Claudio Gonzalez-Bermejo, Jésus Hardy, Sébastien Aouf, Sami Escourrou, Pierre Roisman, Gabriel |
author_facet | Zhu, Kaixian Rabec, Claudio Gonzalez-Bermejo, Jésus Hardy, Sébastien Aouf, Sami Escourrou, Pierre Roisman, Gabriel |
author_sort | Zhu, Kaixian |
collection | PubMed |
description | BACKGROUND: Combined effects of leaks, mechanical property of respiratory system and upper airway (UA) patency on patient-ventilator synchrony (PVA) and the level of clinically “tolerable” leaks are not well established in home ventilators. METHODS: We comparatively assessed on a bench model, the highest leak level tolerated without inducing significant asynchrony (“critical leak”) in three home ventilators (Astral 150, Trilogy 100 and Vivo 60; noted as A150, T100 and V60 respectively) subjected to three simulated diseased respiratory conditions: chronic obstructive pulmonary disease (COPD), obesity hypoventilation (OHS) and neuromuscular disorders (NMD), with both open and closed UA. Also, total leak values in the device reports were compared to the bench-measured values. RESULTS: With open UA, all ventilators were able to avoid asynchrony up to a 30 L/min leak and even to 55 L/min in some cases. UA closure and respiratory diseases especially OHS influenced PVA. With closed UA, the critical leak of A150 and T100 remained higher than 55 L/min in COPD and OHS, while for V60 decreased to 41 and 33 L/min respectively. In NMD with closed UA, only T100 reached a high critical leak of 69 L/min. Besides, inspiratory trigger sensitivity change was often necessary to avoid PVA. CONCLUSIONS: Home ventilators were able to avoid PVA in high-level leak conditions. However, asynchrony appeared in cases of abnormal mechanical properties of respiratory system or closed UA. In case of closed UA, the EPAP should be adjusted prior to the inspiratory trigger. TRIAL REGISTRATION: Not applicable. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12890-017-0487-2) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-5697337 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-56973372017-12-01 Combined effects of leaks, respiratory system properties and upper airway patency on the performance of home ventilators: a bench study Zhu, Kaixian Rabec, Claudio Gonzalez-Bermejo, Jésus Hardy, Sébastien Aouf, Sami Escourrou, Pierre Roisman, Gabriel BMC Pulm Med Research Article BACKGROUND: Combined effects of leaks, mechanical property of respiratory system and upper airway (UA) patency on patient-ventilator synchrony (PVA) and the level of clinically “tolerable” leaks are not well established in home ventilators. METHODS: We comparatively assessed on a bench model, the highest leak level tolerated without inducing significant asynchrony (“critical leak”) in three home ventilators (Astral 150, Trilogy 100 and Vivo 60; noted as A150, T100 and V60 respectively) subjected to three simulated diseased respiratory conditions: chronic obstructive pulmonary disease (COPD), obesity hypoventilation (OHS) and neuromuscular disorders (NMD), with both open and closed UA. Also, total leak values in the device reports were compared to the bench-measured values. RESULTS: With open UA, all ventilators were able to avoid asynchrony up to a 30 L/min leak and even to 55 L/min in some cases. UA closure and respiratory diseases especially OHS influenced PVA. With closed UA, the critical leak of A150 and T100 remained higher than 55 L/min in COPD and OHS, while for V60 decreased to 41 and 33 L/min respectively. In NMD with closed UA, only T100 reached a high critical leak of 69 L/min. Besides, inspiratory trigger sensitivity change was often necessary to avoid PVA. CONCLUSIONS: Home ventilators were able to avoid PVA in high-level leak conditions. However, asynchrony appeared in cases of abnormal mechanical properties of respiratory system or closed UA. In case of closed UA, the EPAP should be adjusted prior to the inspiratory trigger. TRIAL REGISTRATION: Not applicable. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12890-017-0487-2) contains supplementary material, which is available to authorized users. BioMed Central 2017-11-21 /pmc/articles/PMC5697337/ /pubmed/29157220 http://dx.doi.org/10.1186/s12890-017-0487-2 Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Zhu, Kaixian Rabec, Claudio Gonzalez-Bermejo, Jésus Hardy, Sébastien Aouf, Sami Escourrou, Pierre Roisman, Gabriel Combined effects of leaks, respiratory system properties and upper airway patency on the performance of home ventilators: a bench study |
title | Combined effects of leaks, respiratory system properties and upper airway patency on the performance of home ventilators: a bench study |
title_full | Combined effects of leaks, respiratory system properties and upper airway patency on the performance of home ventilators: a bench study |
title_fullStr | Combined effects of leaks, respiratory system properties and upper airway patency on the performance of home ventilators: a bench study |
title_full_unstemmed | Combined effects of leaks, respiratory system properties and upper airway patency on the performance of home ventilators: a bench study |
title_short | Combined effects of leaks, respiratory system properties and upper airway patency on the performance of home ventilators: a bench study |
title_sort | combined effects of leaks, respiratory system properties and upper airway patency on the performance of home ventilators: a bench study |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5697337/ https://www.ncbi.nlm.nih.gov/pubmed/29157220 http://dx.doi.org/10.1186/s12890-017-0487-2 |
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