Ventilator integrated polygraphy for patients using non-invasive ventilation; Case report

Abstract

The COVID-19 pandemic has meant that home respiratory services have needed to be reviewed. As a result, new solutions have been developed and implemented. The Vivo 45™ (Breas, Mölnlycke, Sweden) is a ventilator that offers clinicians the ability to attach effort belts to the device. This allows the clinician to review ventilator traces with the addition of thoracic and abdominal activity. This allows more flexibility for the monitoring of patients at home and in the hospital, with detection of patient ventilator asynchrony (PVA). Decreasing PVA may improve ventilator adherence and increased ventilator usage improves survival. We report three cases of patients undergoing overnight monitoring with the Vivo 45™, highlighting the benefit of ventilator integrated polygraphy. In our three cases we demonstrate a simple safe tool to optimize NIV treatment over one or two-night recordings using ventilator downloaded software with the addition of effort belts and pulse oximetry without involving more than one machine and without hospitalization in a sleep unit.

Monitoring Systems in Home Ventilation

“…Modern ventilators are available with modules to connect the belt and SpO 2 directly to the ventilator. This solution makes recording easier, and the clinician can see the airway pressure and flow measured by the ventilator, the effort belts, and SpO 2 all displayed on the same page [ 33 ] ( Figure 9 ).…”

International Survey of the Tools Used for Assessment, Monitoring and Management of Home Mechanical Ventilation Patients

“…It is surprising that clinicians rely more on the ventilator download data for unintentional leaks rather than directly questioning the patient during a clinical review (88%, n = 80). Finally, most of the respondents were neutral concerning the use of ventilator integrated polygraphy, which is likely due to the lack of data detailing its clinical role outside of case series [27].…”