The Science Journal of the American Association for Respiratory Care

2012 OPEN FORUM Abstracts


Cynthia C. White1, Matthew Venard2, Kevin Ferguson2; 1Respiratory Care Division, Cincinnati ChildrenÂ’s Hospital Medical Center, Cincinnati OH, OH; 2Clinical Engineering Department, Cincinnati ChildrenÂ’s Medical Center, Cincinnati, OH

Background: Noise pollution is a common problem in hospitals, and is caused both by medical equipment and baseline noises in the environment itself. Adverse effects of noise pollution include impact on physical health, pychological health, and cognition. The World Health Organization, (WHO) recommends noise levels in homes at 35dB with 30dB for bedrooms to decrease sleep disturbances. In hospitals, noise levels should not exceed 40dB during the day. Medical equipment that is inclusive of Respiratory Therapy equipment is a common source for elevation of noise levels. The objective of this bench study was to compare noise levels with 3 different exhalation valves used for both invasive and non-invasive ventilation with our single limb passive ventilator circuits. Methods: The Trilogy ventilator (Phillips Respironics, Carlsbad, CA) was used in all testing conditions and set up with a standard passive single limb circuit. The circuit was connected to a TTL lung model 560li (Michigan Instruments, Grand Rapids, MI). Three different Phillips Respironics ( Carlsbad, CA) exhalation ports were tested in the circuit for 5 minutes each during the study: 1) Whisper Swivel II 2) Disposable fixed exhalation port/multi hole 3) Disposable fixed exhalation port/single hole. The ventilator was placed in CPAP mode to maintain a consistent leak and peak noise level during the testing. Both a CPAP level of 15 cmH20 and 20 cmH20 were tested with each exhalation port. A Cirrus CR:812C Sound Level Meter was used to measure noise emitting from the exhalation port. Data was downloaded and analyzed in Deaf Defier 3.3 software. Noise data is reported in decibels (Db). Results: See chart below for mean noise levels of each exhalation valve and the low and high level Trilogy ventilator alam. Discussion: Noise levels for all three exhalation valves exceed WHO recommendations for noise levels in both the hospital and home environment. Noise levels increased with all three exhalation valves as pressure settings increased. The Whisper swivel II exhalation valve was the quietest exhalation port at both tested CPAP levels. The new Phillips Respironics multi hole DEP is10 decibels quieter at both CPAP settings compared to the old style fixed orifice single port exhalation port. Utilizing a quieter exhalation port may impact noise levels and patient/family satisfaction when using single limb passive circuit that requires insertion of an exhalation leak port. Sponsored Research - None