Comparing The Effects Of Rise Time And Inspiratory Cycling Criteria Between Four Different Mechanical Ventilators

Gonzales, Joshua; Russian, Chris J.; Marshall, Stephen; Collins, Kevin P; Farmer, Timothy A.

doi:10.1164/ajrccm-conference.2011.183.1_meetingabstracts.a1704

Cited by 2 publications

(4 citation statements)

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“…Through these years different studies have been finding differences in lung ventilators performance when assessing ventilation-modes (STAYER et al, 2000;MUELVER;KRATOHVIL, 2000;CALDERON, 2006;SUNISA;DEAN, 2001;AJNHORN, 2016;USAQUEN, 2008;MARCHESE et al, 2011;URIBE, 2011;GONZALES et al, 2011;GONZALES et al, 2013). Most of these studies did not use the same protocol for evaluation, which can be led to difficulties to compare these works.…”

Section: Secondary Objectivementioning

confidence: 99%

“…Previous studies have emphasized the variability in the delivered volume on account of differences in rise time. These studies evaluate the time elapsed to reach 90% of the respiratory pressure from the SI (GONZALES et al, 2011;GONZALES et al, 2013;MARCHESE et al, 2011). The rise time is related to the peak flow generating during inspiration; in addition, it helps to indicate the time remaining to hold the plateau.…”

Section: E%mentioning

confidence: 99%

“…There are not many works assessing CMV-PC mode in different ventilator models In order to address CMV-PC pressure waveform, we selected parameter from ABNT NBR 80601-2-12 (ASSOCIAÇÃO BRASILEIRA DE NORMAS TÉCNICAS, São Paulo, 2014b), and the literature (MARCHESE et al, 2011;GONZALES et al, 2011;GONZALES et al, 2013;SUNISA;DEAN, 2001). Parameters from the literature such as AI, AE, I% and E% were employed mostly to assess PS with a slight modification.…”

Section: E%mentioning

confidence: 99%

“…Over time, a body of literature has been developed on lung ventilator assessment with the aim of providing information about lung ventilator's operational variability. For instance, there are studies evaluating home care and anesthesia ventilators' performance (STAYER et al, 2000;AJNHORN, 2016 DEAN, 2001;CALDERON, 2006;USAQUEN, 2008;MARCHESE et al, 2011;URIBE, 2011;GONZALES et al, 2011;GONZALES et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

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Continuous mandatory ventilation with pressure-control: a comparison of airway-pressure waveform patterns.

Lino-Alvarado¹

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Continuous mandatory ventilation with pressure control (CMV-PC) was one of the first ventilation-modes to be introduced, and continues to be one of the most widespread ventilation-modes to manage patients with acute respiratory failure. In attempt to provide information regarding ventilation-modes performance to help clinicians, researchers have been evaluating ventilation-modes parameters over the years. Previous literature reported an operational variability across different models. These studies, however, have not had the same test scenarios, and they have mostly used top-line lung ventilators. Even more, the criteria used to measure the evaluated parameters were not fully detailed, and its calculation was based on commercial instruments. Thus, this research aims to compare different airway-pressure waveform patterns from different lung ventilators in CMV-PC, detailing the criteria used to measure the parameters and using lung ventilator models that are available on the Brazilian market. In this study, 12 lung ventilators were evaluated. For the experiments, flow and pressure signals were acquired at 100Hz. An experimental setup was chosen from ABNT NBR ISO IEC 80601-2-12: 2014. It comprises four test scenarios with different combinations of compliance and resistance: 1 (50 mL/cmH 2 O-5 cmH 2 O/L/s), 2 (50 mL/cmH 2 O-20 cmH 2 O/L/s), 3 (20 mL/cmH 2 O-5 cmH 2 O/L/s), and 4 (20 mL/cmH 2 O-20 cmH 2 O/L/s).Evaluated parameters were inspiratory pressure, positive end-expiratory pressure (P EEP ), inspiratory time (T I ), time interval to reach 90% of the set pressure (T 90 ), peak inspiratory pressure, peak inspiratory flow, inspiratory area (AI), expiratory area (AE), percentage of inspiratory area (I%) and percentage of expiratory area (E%). To address statistical differences, we conducted the Kruskal-Wallis test, and the Dunn's test for multiple comparisons. In addition, a standard-based assessment was performed for inspiratory pressure, P EEP and T I . Even though the lung ventilators had the same configurations for all the test scenarios and obeyed the same standard, statistical differences were found for all the evaluated parameters, and between some lung ventilators (P < 0.05). Surprisingly, there were 5 lung ventilators that could not reach 90% of the set pressure. Further, an overshooting of 2.95 cmH 2 O in test scenario 3 was measured. Relating to the standard-based assessment, inspiratory pressure test's results showed that 4, 8, 2 and 3 lung ventilators failed in test scenarios 1, 2, 3, and 4, respectively. For PEEP test's results, we had 3 lung ventilators that were reproved in test scenarios 1, 2, and 4; and 2 lung ventilators reproved in test scenario 3. With respect of T I , all the lung ventilators passed the test. This study evidenced that airway-pressure waveforms in CMV-PC varied among lung ventilators, mainly in T 90 (or understandably in rise time), and inspiratory pressure. Disparities were more noticeable in test scenario 3 that has higher values of compliance and resistance. An intriguing f...

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Section: Secondary Objectivementioning

confidence: 99%

Section: E%mentioning

confidence: 99%

Section: E%mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Continuous mandatory ventilation with pressure-control: a comparison of airway-pressure waveform patterns.

Lino-Alvarado¹

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Bench assessment of PC-CMVs modes in transport and emergency ventilators under ICU conditions

Lino-Alvarado,

de Lima Vitorasso,

de Oliveira Rosa

et al. 2024

Sci Rep

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Although there has been an increase in bench test evaluation of mechanical ventilators in recent years, a publication gap remains in assessing Pressure Control Continuous Mandatory Ventilation Modes with a set point targeting scheme PC-CMVs. This study evaluates the operational variability in PC-CMVs of eleven transport and emergency ventilators used in ICU units in Brazil during the COVID-19 pandemic. The assessment involved a comprehensive set of test scenarios derived from existing literature and the NBR ISO 80601-2-12:2014 standard. Nine parameters were computed for five consecutive breaths, offering a comprehensive characterization of pressure and flow waveforms. Most ventilators had Inspiratory pressure and PEEP values that fell outside of the tolerance ranges. Notably, three mechanical ventilators failed to reach the target pressures within the specified inspiratory times during test scenarios with a higher time constant (τ). We observed significant differences among emergency and transport ventilators in all assessed parameters, indicating a performance difference in PC-CMVs modes. The current results might help clinicians determine which ventilator models are suitable for specific clinical situations, particularly when unfavorable circumstances compel doctors to use ventilators that may not provide adequate support for patients in intensive care units. Supplementary Information The online version contains supplementary material available at 10.1038/s41598-024-73056-w.

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Comparing The Effects Of Rise Time And Inspiratory Cycling Criteria Between Four Different Mechanical Ventilators

Cited by 2 publications

References 0 publications

Continuous mandatory ventilation with pressure-control: a comparison of airway-pressure waveform patterns.

Continuous mandatory ventilation with pressure-control: a comparison of airway-pressure waveform patterns.

Bench assessment of PC-CMVs modes in transport and emergency ventilators under ICU conditions

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