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A regulator for pressure-controlled total-liquid ventilation.

Raymond Robert1, Philippe Micheau, Olivier Avoine

  • 1Mechanical Engineering Department, Université de Sherbrooke, Sherbrooke, QC J1K2R1, Canada.

IEEE Transactions on Bio-Medical Engineering
|September 12, 2009
PubMed
Summary
This summary is machine-generated.

Total-liquid ventilation (TLV) uses perfluorochemical liquid for mechanical breathing. A new controller ensures safe expiratory flow, maintaining gas exchange and simplifying clinical use in intensive care.

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Area of Science:

  • Biomedical Engineering
  • Respiratory Physiology
  • Critical Care Medicine

Background:

  • Total-liquid ventilation (TLV) is an experimental mechanical ventilation method using perfluorochemical liquid.
  • Conventional ventilators require pressure-controlled ventilation, a feature needed for liquid ventilators.
  • The Inolivent-4 prototype requires a controller for pressure-regulated expiratory flow.

Purpose of the Study:

  • To design a robust controller for pressure-regulated expiratory flow.
  • To implement this controller on the Inolivent-4 liquid ventilator prototype.
  • To evaluate the controller's efficiency in simulations, in vitro, and in vivo.

Main Methods:

  • Numerical simulations were performed.
  • In vitro experiments were conducted.
  • In vivo experiments were performed on five healthy term newborn lambs.

Main Results:

  • The controller efficiently generated expiratory flows, preventing lung collapse.
  • Adequate gas exchange and normal acid-base equilibrium were maintained in vivo.
  • Improved minute ventilation, oxygenation, and CO2 extraction were observed, nearing flow limits.

Conclusions:

  • Pressure-controlled ventilation during expiration is effective for total-liquid ventilation.
  • A minute ventilation of 140 mL x min(-1) x kg(-1) or higher ensures adequate CO2 removal (PaCO2 < 55 mmHg).
  • This approach simplifies liquid ventilator use, facilitating clinical adoption in intensive care units.