The Science Journal of the American Association for Respiratory Care

2010 OPEN FORUM Abstracts

BREATH TYPE DELIVERY DURING A LUNG MODEL-VENTILATOR INTERACTION OF NON-INVASIVE VENTILATION IN THE PRESENCE OF A LEAK: COMPARING THE RESPIRONICS BIPAP® VISION, RESPIRONICS V60®, AND THE HAMILTON C2®

Robert L. Joyner, Sidney R. Schneider, Donald D’Aquila, Maribeth Cohey; Health Sciences, Salisbury University, Salisbury, MD

Background: Ideally, mechanical ventilators providing NPPV would automatically compensate for circuit and interface leaks to ensure patient-ventilator synchrony. Manufacturers of ventilators offering NPPV attempt to improve patient-ventilator interaction by incorporating features that detect and compensate for leaks while maintaining proper triggering and cycling. Methods: A lung model-ventilator performance comparison was constructed to compare the Respironics BiPAP Vision, the Respironics V60 and the Hamilton C2 during conditions of sequenced system leak. Each ventilator evaluated in this study was exposed to a protocol that incorporated increasing and decreasing system leaks, during which time breath type delivery (i.e., triggered, missed, and auto-triggered) was recorded. For each leak condition, Repeated Measured Analysis of Variance (SPSS 17 for Windows) was used to compare within and between ventilator differences among leak conditions for each breath type delivered. Results: The C2 ventilator delivered fewer triggered breaths than either the Vision or the V60 at a leak condition of 50 L/min (p < 0.05). No differences (p > 0.05) were identified in the number of missed breaths delivered. At conditions of higher leak (i.e., 25 L/min and 50 L/min), there were a greater number of auto-triggered breaths delivered by the C2 (p < 0.05) as compared to either the Vision or the V60. Conclusion: Taken together, missed breaths and auto-triggered breaths interfere with patient-ventilator interaction, and any increase in the delivery of auto-triggered or missed breaths result in a decrease in patient-ventilator synchrony. In our study, the presence of system leaks resulted in more lung model-ventilator dyssynchrony by the C2 ventilator when compared to either the Respironics BiPAP Vision or the Respironics V60. This study is limited by its bench design and should be repeated in a clinical setting. Sponsored Research - Philips/Respironics