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Related Experiment Videos

Leak compensation in positive pressure ventilators: a lung model study.

S Mehta1, F D McCool, N S Hill

  • 1Mt Sinai Hospital, University of Toronto, Canada.

The European Respiratory Journal
|May 4, 2001
PubMed
Summary

Different ventilators show varied leak compensation during noninvasive ventilation. Pressure-targeted modes are better for leaks, but require careful settings to optimize performance and patient safety.

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Area of Science:

  • Respiratory Care
  • Biomedical Engineering
  • Medical Devices

Background:

  • Noninvasive positive pressure ventilation (NIPPV) is crucial for respiratory support.
  • Air leaks are common during NIPPV, potentially compromising ventilation efficacy.
  • Ventilator performance in compensating for leaks varies significantly.

Purpose of the Study:

  • To evaluate and compare the leak compensating abilities of six different positive pressure ventilators.
  • To assess how different ventilator modes and settings affect leak compensation.
  • To provide recommendations for optimizing NIPPV in the presence of air leaks.

Main Methods:

  • Six positive pressure ventilators were tested using a test lung model.
  • Simulated small and large air leaks were introduced.

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  • Ventilators were operated in assist/control or timed modes, with pressure-targeted ventilation.
  • Key parameters like delivered tidal volume, inspiratory duration, and cycling were monitored.

    • Main Results:

    • Significant differences in delivered tidal volume were observed between ventilators, even without leaks.
    • Pressure-targeted ventilation showed improved leak compensation compared to volume-targeted modes, especially for larger leaks.
    • Increasing inspiratory time (tI/ttot up to 0.5) improved compensation, while sensitive flow triggering caused autocycling.
    • Leaks negatively impacted cycling, I:E ratio, and tidal volume delivery in some ventilators.

    Conclusions:

    • Leak compensation capabilities vary substantially among positive pressure ventilators.
    • Pressure-targeted ventilators are generally preferred for NIPPV with significant air leaks.
    • Optimizing inspiratory flow, duration, triggering sensitivity, and inspiratory time limiting is essential for effective leak compensation.