Effect of dynamic random leaks on the monitoring accuracy of home mechanical ventilators: a bench study

BMC Pulmonary Medicine

Manel Lujàn²  Xavier Pomares³  Lluís Blanch¹  Eduard Monsó²  Jaume Montanyà⁴  Ana Sogo³ 

[1] Department of Critical Care, Corporació Sanitària Parc Taulí, Institut Universitari Parc Taulí, Universitat Autònoma de Barcelona, Sabadell, Spain;CIBERES, Ciber de Enfermedades Respiratorias. Carretera Soller Km 12, Bunyola, Spain;Department of Pneumology, Corporació Sanitària Parc Taulí, Institut Universitari Parc Taulí, Universitat Autònoma de Barcelona, Sabadell, Spain;Bettercare S.L., Sabadell, Spain

关键词: Bench;    Unintentional leaks;    Tidal volume;    Non-invasive ventilation;   

Others  :  865463
DOI  :  10.1186/1471-2466-13-75

 received in 2013-04-15, accepted in 2013-12-04,  发布年份 2013

【 摘 要 】

Background

So far, the accuracy of tidal volume (VT) and leak measures provided by the built-in software of commercial home ventilators has only been tested using bench linear models with fixed calibrated and continuous leaks. The objective was to assess the reliability of the estimation of tidal volume (VT) and unintentional leaks in a single tubing bench model which introduces random dynamic leaks during inspiratory or expiratory phases.

Methods

The built-in software of four commercial home ventilators and a fifth ventilator-independent ad hoc designed external software tool were tested with two levels of leaks and two different models with excess leaks (inspiration or expiration). The external software analyzed separately the inspiratory and expiratory unintentional leaks.

Results

In basal condition, all ventilators but one underestimated tidal volume with values ranging between -1.5 ± 3.3% to -8.7% ± 3.27%. In the model with excess of inspiratory leaks, VT was overestimated by all four commercial software tools, with values ranging from 18.27 ± 7.05% to 35.92 ± 17.7%, whereas the ventilator independent-software gave a smaller difference (3.03 ± 2.6%). Leaks were underestimated by two applications with values of -11.47 ± 6.32 and -5.9 ± 0.52 L/min. With expiratory leaks, VT was overestimated by the software of one ventilator and the ventilator-independent software and significantly underestimated by the other three, with deviations ranging from +10.94 ± 7.1 to -48 ± 23.08%. The four commercial tools tested overestimated unintentional leaks, with values between 2.19 ± 0.85 to 3.08 ± 0.43 L/min.

Conclusions

In a bench model, the presence of unintentional random leaks may be a source of error in the measurement of VT and leaks provided by the software of home ventilators. Analyzing leaks during inspiration and expiration separately may reduce this source of error.

【 授权许可】

   
2013 Sogo et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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