Multifaceted bench comparative evaluation of latest intensive care unit ventilators

Area of Science:

• Mechanical Ventilation
• Respiratory Care
• Medical Device Performance Evaluation

Background:

• Bench studies are crucial for assessing ventilator performance in simulated clinical conditions.
• Understanding ventilator accuracy is vital for patient safety and effective treatment.

Purpose of the Study:

• To evaluate the accuracy of modern intensive care unit (ICU) ventilators in delivering set parameters.
• To assess ventilator performance under various typical and challenging conditions, including leakage.
• To provide clinicians with a detailed performance report of current ICU ventilators.

Main Methods:

• Thirteen ICU ventilators were tested using the ASL5000 test lung.
• Evaluations included accuracy of tidal volume (VT) and positive end-expiratory pressure (PEEP) in assist-control ventilation (ACV).
• Performance of trigger and pressurization in pressure support ventilation (PSV) and non-invasive ventilation (NIV) algorithms were assessed with and without leakage.

Main Results:

• Significant heterogeneity in ventilator performance was observed.
• In ACV, accuracy for VT and PEEP varied, with several devices failing to compensate for leakage.
• In PSV, inspiratory delays and pressurization efficiency differed significantly between devices, both invasively and non-invasively.

Conclusions:

• There is considerable variation in the performance of the latest generation of ICU ventilators.
• While NIV algorithms effectively manage leaks, core functions like VT delivery in ACV and pressurization in PSV may be less accurate than indicated.
• Clinicians should be aware of potential discrepancies between displayed values and actual ventilator performance.