2012 OPEN FORUM Abstracts
A BENCH EVALUATION OF MINUTE VOLUME DELIVERY THROUGH INTRAPULMONARY PERCUSSIVE VENTILATION USED IN CONJUNCTION WITH THE DRAEGER EVITA.
Christopher J. Benitez, Kevin Crezee; Respiratory Care, Primary Childrens Medical Center, Salt Lake City, UT
Abstract Background: In the summer of 2011 Primary Childrens Medical Center began using the Percussionaire IPV 1C (Sandpointe, Idaho) in conjunction with the Draeger Evita XL (Luebeck, Germany) with the Cone head adapter. Questions soon arose about the Minute Volume and the Tidal Volume being delivered. Little research was available. The goal was to discover how much minute ventilation increased with the introduction of the IPV to the current ventilator in a pediatric lung model. Method: The IPV1C with Phasitron and Cone Head were placed in line with the Draeger Evita XL. A TSI Certifier FA plus Ventilator Test System (Shoreview, Minnesota) was attached to a SmartLung Adult (Imtmedical Ag, Switzerland). The lung was set to Compliance of 15 mL/mbar and Resistance of 20 mbar/L/second. The ventilator was set to pressure control. Settings were PCV + mode (Pressure Control SIMV) Pips of 21, 25, and 29, I-times .7, .8, and .9 seconds, Peep 5, Breath Rate 20 Pressure Support off. The IPV 1C was set to driving pressures of 25 and 30 PSI with Percussive knob settings at full left (FL), 9 oclock, 12 oclock, 3 oclock, and full right (FR). TheTSI Certifier measured VT, VE, Peak Flow, Pip, PEEP, Mean, and Rate. Each cycle was run for approximately one minute. Results: At Ventilator Pip of 21 and driving pressure of 25 VE increased from 2.04 l/min to 9 and 10 l/min, at a Driving pressure of 30 VE increased to 9.6 and 10.9 L/min. The VE decreased as the percussion knob was rotated from far left to far right. With Ventilator Pip 25 Driving Pressure 25 VE increased from 2.8 L/min to 9.2-9.7 L/min and at Driving pressure 30, VE Increased to 9.6-10.3 LPM. With a Ventilator Pip of 29, and driving pressure of 25 VE Increased from 4.0 to 8.9-9.7, at a driving pressure of 30 VE increased to 9.8 to 10. The VE decreased as the percussion knob was rotated from far left to far right with all combination. Conclusion: Minute Ventilation significantly increases with the introduction of the IPV 1C in conjunction with mechanical ventilation. The Increase in VE at PIP of 21 was average 414%-448%.The Increase in VE at PIP of 25 was average 304%-323%. The Increase in VE at PIP of 29 was average 209%-227%. Increasing Driving pressure subsequently shows to increase VE. Further studies need to involve use of CO2 monitoring devices when the IPV is placed on a patient. Bench studies looking at Varying peep levels also need to be researched. Sponsored Research - None IPV Study Results