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Trigger performance of five pediatric home ventilators and one ICU ventilator depending on circuit type and system

Jana Baumgartner1, Johanna Schmidt2, Daniel Klotz1

  • 1Division of Neonatology and Pediatric Intensive Care Medicine, Center for Pediatrics and Adolescent Medicine, Faculty of Medicine, Medical Center, University of Freiburg, Freiburg, Germany.

Pediatric Pulmonology
|December 15, 2021
PubMed

Insights

Choosing the right home ventilator for children with chronic respiratory failure is challenging. This study found significant differences in ventilator trigger performance based on circuit type and system leak size.

Area of Science:

  • Pediatric respiratory care
  • Biomedical engineering
  • Mechanical ventilation

Background:

  • The number of children requiring home mechanical ventilation for chronic respiratory failure is increasing globally.
  • Selecting appropriate home ventilators for pediatric patients presents a challenge for clinicians.
  • This study addresses the need for comparative data on pediatric home ventilator performance.

Purpose of the Study:

  • To compare the trigger performance of various pediatric bilevel home ventilators and an intensive care unit ventilator.
  • To evaluate the impact of different circuit types and system leak on ventilator trigger function.

Main Methods:

  • A physical lung model was used to test five pediatric bilevel home ventilators and one ICU ventilator.
  • Ventilators were evaluated with compatible circuits under varying system leak conditions.
  • Simulated patient breathing effort was applied with specific flow rates and respiratory frequency.

Main Results:

  • Significant variations in trigger performance were observed among the evaluated ventilators.
  • Trigger thresholds, pressure rise times, and trigger work differed notably between devices.
  • Leak compensation effectiveness was dependent on the circuit type, not the circuit's internal diameter.

Conclusions:

  • The triggering performance of home ventilators for pediatric patients varies considerably.
  • Optimal ventilator-circuit selection should account for patient-specific factors like age, condition, and potential for system leaks.
  • Clinicians need to consider these performance differences when choosing home ventilation equipment.
Abstract

Keywords:
chronic respiratory failurehome mechanical ventilationlong-term mechanical ventilationlong-term noninvasive ventilationnoninvasive positive-pressure ventilation

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