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Monitoring of non-invasive ventilation by built-in software of home bi-level ventilators: a bench study.
MedLine Citation:
PMID:  21778253     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
ABSTRACT BACKGROUND: Recent bi-level positive pressure ventilators for home non-invasive ventilation (NIV) provide clinicians with softwares which record items important for patient monitoring such as compliance, tidal volume (V(T)), leaks. However, validity of this information has not yet been independently assessed. METHODS: Testing of seven home ventilators on a bench model, adapted to simulate NIV and generate unintentional leaks (i.e other than mask exhalation valve). Five levels of leaks were simulated with a computer driven solenoid valve (0 - 60L/min.) at different levels of inspiratory pressure (15 and 25 cmH(2)O), and at a fixed expiratory pressure (5 cmH(2)O), i.e. a total of 10 conditions. Bench data was compared to results retrieved from ventilator software for leaks and V(T). RESULTS: For assessing leaks, three of the devices tested were highly reliable, with a small bias (0.3 - 0.9L/min), narrow limits of agreement (LA) and high correlations (R(2): 0.993-0.997) when comparing ventilator software and bench results; conversely, for 4 ventilators, bias ranged from -6.0 to -25.9 L/min, exceeding -10L /min for 2 devices, with wide LA, and lower correlations (R(2): 0.70 - 0.98). Bias for leaks increased markedly with importance of leaks in three devices. V(T) was underestimated by all devices and bias (range: 66 - 236 ml) increased with higher insufflation pressures. Only 2 devices had a bias < 100 ml, all testing conditions considered. CONCLUSION: Clinicians monitoring patients with home ventilation must be aware of differences in estimation of leaks and V(T) by ventilator softwares, and of different ways in reporting leaks according to device used.
Authors:
Olivier Contal; Laurence Vignaux; Christophe Combescure; Jean-Louis Pepin; Philippe Jolliet; Jean-Paul Janssens
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-7-21
Journal Detail:
Title:  Chest     Volume:  -     ISSN:  1931-3543     ISO Abbreviation:  -     Publication Date:  2011 Jul 
Date Detail:
Created Date:  2011-7-22     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
1Division of Pulmonary Diseases, Geneva University Hospital, E-mail: Jean-Paul.Janssens@hcuge.ch.
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