The Science Journal of the American Association for Respiratory Care

2010 OPEN FORUM Abstracts

EVALUATION OF PATIENT-VENTILATOR SYNCHRONY IN THE RESPIRONICS ST/D, VISION AND V60 WHEN VENTILATING A MANNEQUIN INTERFACED WITH AN ELECTRONIC BREATHING SIMULATOR

Britney L. Griffith, Dana Svancara, Lonny Ashworth; Respiratory Care, Boise State University, Boise, ID

Background: Respironics recently released the latest model in their line of BiPAP ventilators, the V60. To date, there has been little research conducted on its performance. Commonly, patients who are experiencing an exacerbation of COPD are placed on BiPAP to reduce their work of breathing (WOB); however, there are other factors, such as patient-ventilator dys-synchrony, that may actually increase WOB in these patients. The dys-synchrony can be exhibited as lengthened inspiratory time and/or trigger delay. The purpose of this project is to determine if the V60 enhances patient-ventilator synchrony when compared to the Respironics Vision and the ST/D when ventilating a mannequin interfaced with an electronic breathing simulator. Methods: The Laerdal SimMan mannequin was modified by connecting the left and right mainstems to the Hans Rudolph HR 1101 Electronic Lung simulator via corrugated tubing and 15 mm adaptors to simulate a spontaneously breathing patient. A Respironics ComfortGel full face mask was placed on the mannequin (with a measured leak of 45 L/min) to complete the circuit. The V60, Vision, and ST/D were connected to the mask via standard BiPAP tubing. Ventilator settings were: Mode Spontaneous Timed, Rate 4 breaths/minute, EPAP 5 cmH2O, IPAP 15 cmH2O, rise minimum allowed by the ventilator. HR 1101 settings: Resistance 25 cmH2O/L/sec, Compliance 60 ml/cmH2O, Rate 15 breaths/minute, Amplitude 8, Effort slope 15.0, % inhale 20, Target Volume 3000 ml, Load Effort Normal. Each ventilator ran for five minutes; the middle two minutes were used for analysis. Results: Data was measured by the HR 1101 at intervals of 0.05 seconds. Inspiratory time was measured as the amount of time from the beginning of inspiratory flow to the beginning of expiratory flow. The average inspiratory time was 0.93 seconds for the V60, compared to 1.0 second for the Vision and 1.75 seconds for the ST/D. Trigger delay was compared as the time from when patient effort began (measured by amplitude) to when inspiratory flow began. The average trigger delay was 0.10 seconds for the V60, compared to 0.14 seconds for the Vision and 0.20 seconds for the ST/D. Conclusion: The findings in this study have determined that the V60 is potentially more effective at reducing patient-ventilator dys-synchrony than the ST/D and the Vision, as measured by trigger delay and inspiratory time. This study could impact the clinicianÂ’s choice in ventilators for patients with COPD. Sponsored Research - None