Harms of unintentional leaks during volume targeted pressure support ventilation.: Efficiency of Targeted Volume Mode

Sonia Khirani 1 Bruno Louis 2 Karl Leroux 3 Vincent Delord 4 Brigitte Fauroux 5 Frédéric Lofaso 6, *
* Auteur correspondant
1 INSERM U955, équipe 13
S2A Santé, Service de pneumologie pédiatrique, IMRB - Institut Mondor de Recherche Biomédicale, BCR - Biomécanique cellulaire et respiratoire
2 INSERM U955, équipe 13
IMRB - Institut Mondor de Recherche Biomédicale, BCR - Biomécanique cellulaire et respiratoire
5 INSERM U955, équipe 13
Service de pneumologie pédiatrique, IMRB - Institut Mondor de Recherche Biomédicale, BCR - Biomécanique cellulaire et respiratoire
6 INSERM U955, équipe 13
Role des Cellules Dendritiques Dans la Regulation des Effecteurs de l'Immunite Antitumorale, Service de physiologie et d'explorations fonctionnelles, IMRB - Institut Mondor de Recherche Biomédicale, BCR - Biomécanique cellulaire et respiratoire
Abstract : BACKGROUND: Volume targeted pressure support ventilation (VT-PSV) is a hybrid mode increasingly used to maintain a minimal tidal volume (VT) by automatically adjusting the level of inspiratory pressure. The objective of the study was to determine the ability of home ventilators to maintain the preset minimal VT during unintentional leaks in a VT-PSV mode. METHODS: Seven ventilators were tested on a lung bench with different circuit configurations and with different levels of unintentional leaks. Unintentional leaks were generated using calibrated holes. RESULTS: All the studied ventilators with a single-limb circuit with intentional leak (n = 5) were able to maintain the minimal preset VT during unintentional leaks. One ventilator overcompensated VT during unintentional leaks of high intensity. In contrast, all studied ventilators with a single circuit with an expiratory valve (n = 2) or a double-circuit (n = 3) but one failed to maintain the minimal VT during unintentional leaks. Unintentional leaks generated a decrease in inspiratory pressure, which was responsible for the fall in VT. CONCLUSIONS: Most of the studied ventilators with a single-limb circuit with intentional leak correctly estimate the expiratory VT and therefore successfully maintain the preset minimal VT during unintentional leaks, in contrast to most of the studied ventilators with a double-circuit, which paradoxically are not able to directly measure expiratory VT. Importantly, the VT-PSV mode, when used with most ventilators with expiratory valve or double-circuit, can paradoxically exacerbate the VT drop during unintentional leaks.
Type de document :
Article dans une revue
Respiratory Medicine, Elsevier, 2013, 107 (7), pp.1021-9. 〈10.1016/j.rmed.2013.03.013〉
Liste complète des métadonnées

Littérature citée [19 références]  Voir  Masquer  Télécharger

http://www.hal.inserm.fr/inserm-00854227
Contributeur : Georges Guellaen <>
Soumis le : lundi 26 août 2013 - 15:41:03
Dernière modification le : lundi 30 avril 2018 - 12:22:03
Document(s) archivé(s) le : mercredi 27 novembre 2013 - 04:22:13

Fichiers

Khirani_Harms_unintentional_le...
Fichiers produits par l'(les) auteur(s)

Identifiants

Collections

Citation

Sonia Khirani, Bruno Louis, Karl Leroux, Vincent Delord, Brigitte Fauroux, et al.. Harms of unintentional leaks during volume targeted pressure support ventilation.: Efficiency of Targeted Volume Mode. Respiratory Medicine, Elsevier, 2013, 107 (7), pp.1021-9. 〈10.1016/j.rmed.2013.03.013〉. 〈inserm-00854227〉

Partager

Métriques

Consultations de la notice

325

Téléchargements de fichiers

448