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[Effect on inspiratory cycling-off synchronization with different expiratory trigger sensitivity level during
Yuqing Chen1, Xingyi Zhang, Kewen Cheng
1Department of Respiratory Medicine, Shanghai First People's Hospital, Shanghai Jiaotong University, Shanghai 200080, China.
Zhonghua Yi Xue Za Zhi
|December 31, 2014
Summary
This study compared expiratory trigger sensitivity settings on bilevel ventilators during system leaks. The Auto-Trak system demonstrated better patient-ventilator synchrony, especially in obstructive conditions.
Area of Science:
- Respiratory Mechanics
- Mechanical Ventilation
- Biomedical Engineering
Background:
- Noninvasive ventilation is crucial for respiratory support.
- System leaks can impair ventilator performance and patient synchrony.
- Expiratory trigger sensitivity (ETS) is a key setting affecting cycling-off.
Purpose of the Study:
- To compare inspiratory cycling-off synchronization with different expiratory trigger sensitivity (ETS) settings during noninvasive pressure support ventilation (PSV).
- To evaluate ventilator performance under conditions of system leak.
- To assess the impact of ETS adjustments on patient-ventilator synchrony.
Main Methods:
- Two bilevel ventilators were tested using a lung model simulating obstructive and restrictive ventilatory dysfunction.
- Ventilators were set at 15 cmH2O pressure support and 5 cmH2O PEEP.
- Tests were conducted with system air leaks (24-28 L/min), collecting data on cycling delay, tidal volume, and airflow.
Main Results:
- The Auto-Trak system showed significantly less delay cycling in obstructive conditions compared to the Curative Flexo ST 30.
- Adjusting ETS levels influenced tidal volume, inspiratory time, and peak expiratory flow.
- Premature cycling occurred in restrictive conditions with both ventilators; delay cycling was noted with Flexo ST 30 at insensitive ETS settings.
Conclusions:
- Bilevel ventilator performance and cycling-off differ significantly between obstructive and restrictive conditions, likely due to algorithm software.
- Modifying ETS settings can improve ventilatory parameters and patient-ventilator synchrony during air leaks.
- The Auto-Trak system offers comparable results and improved synchronization during PSV compared to conventional ETS adjustments.
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