2011 OPEN FORUM Abstracts
EVALUATION OF A VOLUME TARGETED NIV DEVICE:BENCH EVALUATION OF THE BREATHE TECHNOLOGIES NON-INVASIVE OPEN VENTILATION SYSTEM (NIOV TM).
Richard D. Branson1, Chris Blakeman1, Joe Cipollone2; 1Surgery, University of Cincinnati, Cincinnati, OH; 2Engineering, Breathe Technologies, San Ramon, CA
Introduction: Early ambulation in the ventilated patient is gaining wider acceptance. We evaluated a new portable (1 lb), gas powered, volume ventilator designed for NIV via a proprietary nasal pillows interface (Breathe Technologies, CA). Description: The Breathe system uses gas power from a high pressure oxygen source to deliver patient triggered tidal volumes (VT) and supplemental oxygen through a low profile non-invasive interface using nasal pillows. The interface contains two high velocity nozzles and air-entrainment ports to augment the patient's inspired tidal volume and fraction of inspired oxygen (FIO2). Methods: We developed a model to approximate a patient's nose, upper airway and trachea. The model was connected to a test lung (ASL5000, Ingmar Medical, Pittsburgh, PA) via 22 mm ID corrugated tubing. The nasal pillows were adjusted in the nares using a lanyard. cannula. No strap or external pressure was used to attach the appliance to the model. The ASL was set to represent a normal patient, a patient with COPD and a patient with interstitial lung disease (ILD). This was accomplished by varying compliance (100 ml/cmH20, 125 ml/cmH2O, and 50 ml/cmH2O), resistance (5 cmH2O/L/s, 10 cmH2O/L/s, and 5 cmH2O/L/s), respiratory rate and VT (15 bpm x 364 ml, 15 bpm x 387 ml, and 20 bpm x 282 ml), and effort (muscle pressures of -5 cmH2O, -9 cmH2O, and -8 cmH2O). The Breathe ventilator was set at delivered volumes of 100 ml, 150 ml, 200 ml, and 250 ml. Baseline data was also collected without the appliance connected. Data was collected at 512 Hz for 15 breaths at each condition. Delivered VT, inspired oxygen concentration (FIO2), inspiratory flow (V), and peak inspiratory pressure (PIP) were recorded for each breath. Data for a minimum of 10 breaths were used to calculate mean +/- SD. Results: The table demonstrates the data at baseline, set VT of 100 ml, and 250 ml. Conclusions: The Breathe volume ventilator delivered an augmented simulated patient tidal volume of 362 to 823 ml, augmenting the simulated patient's spontaneous tidal volume by up to 459 ml, depending on ventilator settings and ASL lung conditions. Delivered FIO2 ranged from 0.36 to 0.45 and was also dependent on ventilator settings and ASL lung conditions. The PIP, delivered VT's, and measured FIO2 support the hypothesis that this system can augment minute ventilation and supply supplemental oxygen in spontaneously breathing patients with a simple, non-invasive interface.
Sponsored Research - Breathe Technologies sponosred this research.
VT= tidal volume in ml, FIO2= inspired oxygen, PIP=peak inspiratory pressure in cmH2O, Flow = peak flow in L/min