Harms of unintentional leaks during volume targeted pressure support ventilation

Khirani, Sonia; Louis, Bruno; Leroux, Karl; Delord, Vincent; Fauroux, Brigitte; Lofaso, Frédéric

doi:10.1016/j.rmed.2013.03.013

Cited by 37 publications

(31 citation statements)

References 20 publications

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“…Nevertheless, in a study collecting data from 209 individuals with NMD, 82 (39%) patients were using the pressure-controlled mode, while 122 (59%) were on a volume-controlled mode [46]. Although pressure-controlled modes better compensate with nonintentional leaks [41], the best results have been found when pressure-controlled modes are coupled with a bilevel ventilator in vented configuration [27, 28, 47, 48]. …”

Section: Modes and Monitoringmentioning

confidence: 99%

“…On the other hand, the nonvented circuit configuration undercompensated in order to maintain the preset VT [47, 48]. …”

Section: Modes and Monitoringmentioning

confidence: 99%

“…Alternatively, a pressure-controlled breath can be delivered according to the patient’s need and comfort. The setting of the ventilator is crucial to avoid nuisance alarm [48, 64]. …”

Section: Modes and Monitoringmentioning

confidence: 99%

See 2 more Smart Citations

Long-Term Ventilation in Neuromuscular Patients: Review of Concerns, Beliefs, and Ethical Dilemmas

Crimi

Pierucci²,

Carlucci

et al. 2019

Respiration

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Background: Noninvasive mechanical ventilation (NIV) is an effective treatment in patients with neuromuscular diseases (NMD) to improve symptoms, quality of life, and survival. Summary: NIV should be used early in the course of respiratory muscle involvement in NMD patients and its requirements may increase over time. Therefore, training on technical equipment at home and advice on problem solving are warranted. Remote monitoring of ventilator parameters using built-in ventilator software is recommended. Telemedicine may be helpful in reducing hospital admissions. Anticipatory planning and palliative care should be carried out to lessen the burden of care, to maintain or withdraw from NIV, and to guarantee the most respectful management in the last days of NMD patients’ life. Key Message: Long-term NIV is effective but challenging in NMD patients. Efforts should be made by health care providers in arranging a planned transition to home and end-of-life discussions for ventilator-assisted individuals and their families.

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Section: Modes and Monitoringmentioning

confidence: 99%

“…On the other hand, the nonvented circuit configuration undercompensated in order to maintain the preset VT [47, 48]. …”

Section: Modes and Monitoringmentioning

confidence: 99%

See 1 more Smart Citation

Long-Term Ventilation in Neuromuscular Patients: Review of Concerns, Beliefs, and Ethical Dilemmas

Crimi

Pierucci²,

Carlucci

et al. 2019

Respiration

View full text Add to dashboard Cite

show abstract

“…[158][159][160] In 2 recently published bench studies, the effect of unintentional leaks on target-volume ventilation was investigated under different conditions. In a study by Khirani et al, 161 single-limb circuits with intentional leaks estimated the expiratory target volume more accurately compared with single circuits with an expiratory valve or ventilators using a double circuit. Additionally, Carlucci et al 162 reported that vented circuits are able to better compensate for leaks compared with nonvented circuits with an active valve.…”

Section: Niv Modes: Recent and Future Developmentsmentioning

confidence: 99%

Hot Topics in Noninvasive Ventilation: Report of a Working Group at the International Symposium on Sleep-Disordered Breathing in Leuven, Belgium

et al. 2015

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During the last few decades, attention has increasingly focused on noninvasive ventilation (NIV) in the treatment of chronic respiratory failure. The University of Leuven and the University Hospitals Leuven therefore chose this topic for a 2-day working group session during their International Symposium on Sleep-Disordered Breathing. Numerous European experts took part in this session and discussed (1) NIV in amyotrophic lateral sclerosis (when to start NIV, NIV and sleep, secretion management, and what to do when NIV fails), (2) recent insights in NIV and COPD (high-intensity NIV, NIV in addition to exercise training, and NIV during exercise training), (3) monitoring of NIV (monitoring devices, built-in ventilator software, leaks, and asynchronies) and identifying events during NIV; and (4) recent and future developments in NIV (target-volume NIV, electromyography-triggered NIV, and autoregulating algorithms)

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“…In contrast, when the tidal volume is estimated by the expired volume, the tidal volume can be overestimated. 14,15 Finally, the majority of the PRVC ventilation devices are currently not reliable during unintentional leak, underlining the need to check these modes during unintentional leak.…”

Section: Evaluation Of the Patients' Equipment Versus The Prescribersmentioning

confidence: 99%

Long-Term Mechanical Ventilation Equipment for Neuromuscular Patients: Meeting the Expectations of Patients and Prescribers

Lofaso¹,

Prigent²,

Tiffreau³

et al. 2013

Respir Care

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BACKGROUND:To maximize the likelihood of successful long-term mechanical ventilation (MV) in patients with neuromuscular diseases, ventilator characteristics and settings must be chosen carefully, taking into account both medical requisites and the patient's preference and comfort. OBJECTIVES: To evaluate patients' knowledge about and comfort with their long-term MV; to compare patients' and prescribers' opinions and expectations regarding long-term MV; and to compare the equipment used by the patients to the prescribers' current MV prescription. METHODS: Neuromuscular patients receiving long-term MV, and home MV prescribers in Belgium and France were asked to respond to a questionnaire survey specifically developed for the study. RESULTS: Completed questionnaires were collected from 209 patients (mean age 35.4 ؎ 15.9 y, range 3-86 y), ventilated since 11 ؎ 17 year, and 45 MV prescribers. One hundred sixty-three (78%) patients correctly designated their MV mode as a volume or pressure controlled mode. When an inspiratory trigger was available, 92% of the patients were able to use it, but only 69% were satisfied. Prescribers were more prone than patients to use new technologies such as an emergency-release system for the noninvasive interface (1-10 visual analog scale score 9.2 ؎ 1.5 vs 6.8 ؎ 3.3, P < .001), a humidification system (8.6 ؎ 1.4 vs 7.8 ؎ 2.6, P ‫؍‬ .02), a contactor for providing larger inspiratory volumes (8.4 ؎ 1.7 vs 6.0 ؎ 3.0, P ‫؍‬ .009), a built-in cough assistance mode (9.2 ؎ 1.4 vs 5.5 ؎ 3.5, P < .001), new options to improve speech, or new MV modes such as a volume-targeted pressure control. CONCLUSIONS: The opinions of patients and prescribers differed about the ideal home ventilator. Patients were less prone to use new technologies, mainly because of a lack of information, underlining the need for regular MV update in patients receiving long-term MV.

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Harms of unintentional leaks during volume targeted pressure support ventilation

Cited by 37 publications

References 20 publications

Long-Term Ventilation in Neuromuscular Patients: Review of Concerns, Beliefs, and Ethical Dilemmas

Long-Term Ventilation in Neuromuscular Patients: Review of Concerns, Beliefs, and Ethical Dilemmas

Hot Topics in Noninvasive Ventilation: Report of a Working Group at the International Symposium on Sleep-Disordered Breathing in Leuven, Belgium

Long-Term Mechanical Ventilation Equipment for Neuromuscular Patients: Meeting the Expectations of Patients and Prescribers

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