The Science Journal of the American Association for Respiratory Care

2007 OPEN FORUM Abstracts

TRIGGERING AND INITIAL GAS DELIVERY: THE BABYLOG VS. ICU VENTILATORS IN THE NEO-MODES

A. D. Marchese1, D. W. Chipman1, P. De La Oliva1, R. M. Kacmarek1


Background: Traditionally, specific ventilators have been manufactured to provide neonatal mechanical ventilation. However, the current generation of ICU ventilators now also provides a neonatal mode. We compared the triggering and initial gas delivery of four ICU ventilators to that of the Dräger Babylog.

Methods: Using the IngMar ALS 5000 we compared the Dräger Babylog to the Puritan Bennett 840, the Maquet Servo i, the Viasys AVEA, and the Drager Evita XL during simulated assisted ventilation in the pressure assist/control mode. The lung model was set with a compliance of 1 mL/cmH2O, a resistance of 100 cmH2O/L/sec, a spontaneous breath rate of 30 bpm. The muscular effort reached a maximum negative pressure of 7 cmH2O within 5% of the total breath cycle time followed by a hold period of 0.5% and a release period of 10% of the total breath cycle time. Each ventilator was evaluated with PEEP 5 cmH2O, peak pressure 20 cmH2O, inspiratory time 0.3 sec, and rate 20 bpm and with PEEP 10 cmH2O, peak pressure 30 cmH2O, inspiratory time 0.4 sec, and rate 20 bpm. Each ventilator setting was then repeated with a leak of 0.3 L/min at a constant pressure of 5 cmH2O. Sensitivity in all ventilators was set to the most sensitive level that did not result in auto-triggering and rise time was set at the highest level tolerated by the lung model without aborting operation.

Results: The following variables were evaluated: pressure to trigger, time to trigger, time to reestablish baseline post trigger, time to 90% of peak pressure, pressure time product of breath activation, and tidal volume. The table presents means and S.D. for 20 representative breaths, 5 from each of the 4 settings, selected after 2 minutes of stabilization.

Conclusion: All of the ICU ventilators performed as well as or better than the Babylog.

Ventilator Press. to
Trigg. (ms)
Time to
Trigg. (ms)
Time from Trigg. to Baseline (ms) Insp. T90 (ms) Press. Time Product (cmH2O × ms) Tidal Vol. (mL)
AVEA -0.42*
±0.04
61.04
±2.18
12.11
±1.50
125.00
±21.28
11.86
±1.65
24.09
±4.74
PB 840 -0.31
±0.03
58.30
±2.56
8.11
±0.72
59.96
±8.19
5.99
±1.13
29.05
±4.02
Servo i -0.59
±0.11
65.14
±4.84
10.94
±1.72
41.60
±2.70
14.20
±4.11
28.17
±4.39
Babylog -0.92
±0.14
89.75
±3.32
12.99
±1.82
141.02
±24.31
33.57
±8.53
22.51
±4.92
Evita XL -0.84
±0.08
91.41
±5.36
9.96
±1.08
46.58
±3.19
30.63
±8.25
29.13
±4.52

* All values are means ± S.D.


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