Skip to Main content Skip to Navigation
Journal articles

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, *
* Corresponding author
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 [CHU Raymond-Poincaré], 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.
Document type :
Journal articles
Complete list of metadatas

Cited literature [19 references]  Display  Hide  Download

https://www.hal.inserm.fr/inserm-00854227
Contributor : Georges Guellaen <>
Submitted on : Monday, August 26, 2013 - 3:41:03 PM
Last modification on : Wednesday, October 14, 2020 - 4:12:19 AM
Long-term archiving on: : Wednesday, November 27, 2013 - 4:22:13 AM

Files

Khirani_Harms_unintentional_le...
Files produced by the author(s)

Identifiers

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⟩

Share

Metrics

Record views

441

Files downloads

771