The Science Journal of the American Association for Respiratory Care

2011 OPEN FORUM Abstracts

VOLUME DELIVERY AND MEASUREMENT CHARACTERISTICS OF THE TRILOGY 202 PORTABLE VENTILATOR.

Thomas J. Cahill, Cynthia C. White, Robert Campbell; Respiratory Care Division, Cincinnati Children's Hospital Medical Center, Cincinnati OH, OH

Introduction: The Trilogy 202 (Philips-Respironics, Murrysville, PA) allows ventilation with both active and passive circuit types. In Volume modes (VC), the Trilogy behaves differently with each circuit. We designed a bench study to evaluate volume delivery and measurement accuracy of the Trilogy 202 in VC at different lung mechanics and leaks. Methods: The Trilogy 202 was used to ventilate a TTL test lung (Michigan Instruments, MI) in A/C with both a passive and active circuit. Ventilator settings: rate- 12, FiO2 .21, PEEP 5 cmH2O, and a Ramp flow pattern. Resistance of 5 cmH2O/L/Sec was used in all test conditions. VT/Ti combinations of 250ml < 0.6s, and 500 ml < 0.9s were set with Compliance of 20, 40, and 60 ml/cmH2O. VT of 50ml < 0.3s was used with C of 20 only. Measurements were made at six leak rates created with a series of stopcocks. Delivered VT (Del-VT) was measured at the proximal airway with an NM3 Monitor (Philips, Carlsbad, CA). VTE and leak rate were recorded from the Trilogy display for 6 breaths. Del-VT was compared with set VT and the Trilogy VTE. Results: With the passive circuit, Del-VT was within 10% of set VT and the Trilogy VTE was within 10% of Del-VT at all zero leak conditions. At 50ml VT, Del-VT was < 85% of set VT at leak 1 and 5; and was < 30% of set VT at leak 2. VTE displayed on the Trilogy was within 10% of Del-VT at every leak. At 250ml VT, Del-VT was < 88% of set VT at leak 4 and 5 at each C. At leak 5 and C-60, the Trilogy VTE was < 88% of Del-VT and all other VTE measurements were within 10% of Del-VT . At 500ml VT, Del-VT was < 73% of set in all leak 5 conditions and the VTE display was < 90% of Del-VT in leak 5 at C-60 and C-40 and in leak 4 at C-60. With the active circuit, the Del-VT was within 10% of set VT for 50 and 250ml settings, as was the VTE display within 10% of Del-VT . At 500ml VT, Del-VT was < 88% of set and displayed VTE was < 14% of the Del-VT. Del-VT was < set VT by 27% at leak1, 54% at leak 2, and 66% at leak 3. Discussion: In VC, the Trilogy compensates for leaks < 30 L/min with passive circuit use and delivers increased VT compared to the active circuit. Measurement of VTE on the Trilogy accurately reflects Del-VT when leak is < 30 L/min.
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