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Related Experiment Videos

A comparison of intermittent mandatory ventilation systems.

K Hillman, J Friedlos, A Davey

    Critical Care Medicine
    |May 1, 1986
    PubMed
    Summary

    Demand valves in ICU ventilators, used for intermittent gas flow, show variable patient-triggering performance. Mechanical testing revealed significant differences in sensitivity and delay times among common models, impacting patient tolerance.

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    Area of Science:

    • Biomedical Engineering
    • Respiratory Care
    • Medical Device Technology

    Background:

    • Intensive Care Unit (ICU) ventilators often employ demand valves for intermittent gas flow to conserve oxygen.
    • Patient tolerance for demand valve systems appears lower compared to continuous flow systems.
    • Spontaneous breathing efforts by patients require precise ventilator response for comfort and efficacy.

    Purpose of the Study:

    • To evaluate the performance of common ICU ventilators with demand valves during simulated spontaneous breathing.
    • To quantify key parameters like sensitivity, delay time, and inspiratory resistance in intermittent flow mode.
    • To compare ventilator performance against manufacturer specifications.

    Main Methods:

    • A mechanical model simulating patient spontaneous breathing efforts was utilized.

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  • Nine different ICU ventilators were tested in their intermittent flow (demand valve) mode.
  • Measurements included trigger sensitivity, total delay time, initial inspiratory resistance, and initial flow.

    • Main Results:

    • Ventilator sensitivity ranged from -0.2 to -2.0 cm H2O.
    • Total delay time varied significantly, from 19 to 92 milliseconds.
    • Initial inspiratory resistance and flow showed considerable variation between devices.
    • Observed performance values frequently deviated from manufacturer specifications.

    Conclusions:

    • Significant variability exists in the performance of demand valves across different ICU ventilators.
    • These performance discrepancies, particularly in sensitivity and delay, may contribute to poor patient tolerance.
    • Accurate reporting and adherence to specifications for ventilator performance parameters are crucial for clinical application.