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A bench-to-bedside study about trigger asynchronies induced by the introduction of external gas into the non-invasive mechanical ventilation circuit

Treatments that require the introduction of external gas into the non-invasive ventilation (NIV) circuit, such as aerosol and oxygen therapy, may influence the performance of the ventilator trigger system. The aim of the study was to determine the presence and type of asynchronies induced by externa...

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Autores principales: Lalmolda, Cristina, Flórez, Pablo, Grimau, Carles, Larrosa, Roberto, Corral, Marta, Sayas, Javier, Luján, Manel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8664954/
https://www.ncbi.nlm.nih.gov/pubmed/34893679
http://dx.doi.org/10.1038/s41598-021-03291-y
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author Lalmolda, Cristina
Flórez, Pablo
Grimau, Carles
Larrosa, Roberto
Corral, Marta
Sayas, Javier
Luján, Manel
author_facet Lalmolda, Cristina
Flórez, Pablo
Grimau, Carles
Larrosa, Roberto
Corral, Marta
Sayas, Javier
Luján, Manel
author_sort Lalmolda, Cristina
collection PubMed
description Treatments that require the introduction of external gas into the non-invasive ventilation (NIV) circuit, such as aerosol and oxygen therapy, may influence the performance of the ventilator trigger system. The aim of the study was to determine the presence and type of asynchronies induced by external gas in the NIV circuit in a bench model and in a group of patients undergoing chronic NIV. Bench study: Four ventilators (one with two different trigger design types) and three gas sources (continuous flow at 4 and 9 l/min and pulsatile flow at 9 l/min) were selected in an active simulator model. The sensitivity of the trigger, the gas introduction position, the ventilatory pattern and the level of effort were also modified. The same ventilators and gas conditions were used in patients undergoing chronic NIV. Bench: the introduction of external gas caused asynchronies in 35.9% of cases (autotriggering 73%, ineffective effort 27%). Significant differences (p < 0.01) were detected according to the ventilator model and the gas source. In seven patients, the introduction of external gas induced asynchrony in 20.4% of situations (77% autotriggering). As in the bench study, there were differences in the occurrence of asynchronies depending on the ventilator model and gas source used. The introduction of external gas produces alterations in the ventilator trigger. These alterations are variable, and depend on the ventilator design and gas source. This phenomenon makes it advisable to monitor the patient at the start of treatment.
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spelling pubmed-86649542021-12-15 A bench-to-bedside study about trigger asynchronies induced by the introduction of external gas into the non-invasive mechanical ventilation circuit Lalmolda, Cristina Flórez, Pablo Grimau, Carles Larrosa, Roberto Corral, Marta Sayas, Javier Luján, Manel Sci Rep Article Treatments that require the introduction of external gas into the non-invasive ventilation (NIV) circuit, such as aerosol and oxygen therapy, may influence the performance of the ventilator trigger system. The aim of the study was to determine the presence and type of asynchronies induced by external gas in the NIV circuit in a bench model and in a group of patients undergoing chronic NIV. Bench study: Four ventilators (one with two different trigger design types) and three gas sources (continuous flow at 4 and 9 l/min and pulsatile flow at 9 l/min) were selected in an active simulator model. The sensitivity of the trigger, the gas introduction position, the ventilatory pattern and the level of effort were also modified. The same ventilators and gas conditions were used in patients undergoing chronic NIV. Bench: the introduction of external gas caused asynchronies in 35.9% of cases (autotriggering 73%, ineffective effort 27%). Significant differences (p < 0.01) were detected according to the ventilator model and the gas source. In seven patients, the introduction of external gas induced asynchrony in 20.4% of situations (77% autotriggering). As in the bench study, there were differences in the occurrence of asynchronies depending on the ventilator model and gas source used. The introduction of external gas produces alterations in the ventilator trigger. These alterations are variable, and depend on the ventilator design and gas source. This phenomenon makes it advisable to monitor the patient at the start of treatment. Nature Publishing Group UK 2021-12-10 /pmc/articles/PMC8664954/ /pubmed/34893679 http://dx.doi.org/10.1038/s41598-021-03291-y Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Article
Lalmolda, Cristina
Flórez, Pablo
Grimau, Carles
Larrosa, Roberto
Corral, Marta
Sayas, Javier
Luján, Manel
A bench-to-bedside study about trigger asynchronies induced by the introduction of external gas into the non-invasive mechanical ventilation circuit
title A bench-to-bedside study about trigger asynchronies induced by the introduction of external gas into the non-invasive mechanical ventilation circuit
title_full A bench-to-bedside study about trigger asynchronies induced by the introduction of external gas into the non-invasive mechanical ventilation circuit
title_fullStr A bench-to-bedside study about trigger asynchronies induced by the introduction of external gas into the non-invasive mechanical ventilation circuit
title_full_unstemmed A bench-to-bedside study about trigger asynchronies induced by the introduction of external gas into the non-invasive mechanical ventilation circuit
title_short A bench-to-bedside study about trigger asynchronies induced by the introduction of external gas into the non-invasive mechanical ventilation circuit
title_sort bench-to-bedside study about trigger asynchronies induced by the introduction of external gas into the non-invasive mechanical ventilation circuit
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8664954/
https://www.ncbi.nlm.nih.gov/pubmed/34893679
http://dx.doi.org/10.1038/s41598-021-03291-y
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