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Filters Alter the Performance of Noninvasive Ventilators
Julie Tolson1,2,3, Rodney Hone4,2, Christian Bandiera5
1Department of Respiratory and Sleep Medicine, Austin Health, Heidelberg, Victoria, Australia. julie.tolson@austin.org.au.
Respiratory Care
|May 24, 2022
Summary
Adding filters to noninvasive ventilation circuits significantly alters ventilator performance, impacting pressure, tidal volume, and triggering. Settings must be re-evaluated when using filters to ensure patient safety during the COVID-19 pandemic.
Area of Science:
- Respiratory care
- Biomedical engineering
- Infectious disease control
Background:
- Noninvasive ventilation (NIV) is crucial for hypercapnic respiratory failure.
- NIV may increase COVID-19 transmission risk due to aerosol dispersion.
- Filters are recommended for NIV circuits to mitigate transmission risks.
Purpose of the Study:
- To evaluate the impact of adding filters to ventilator circuits.
- To assess changes in ventilator performance with filter integration.
Main Methods:
- Benchtop study using a breathing simulator and four common ventilators.
- Tested three circuit configurations: no filter, one filter, and two filters.
- Simulated typical long-term NIV settings.
Main Results:
- Peak pressure, tidal volume, and peak flow significantly decreased with filters (Circuit C vs. A).
- Ventilator triggering sensitivity was reduced in 3 of 4 ventilators.
- One ventilator failed to trigger with filters under tested settings.
Conclusions:
- Ventilator settings require adjustment when filters are used.
- Current settings are not transferable between filtered and unfiltered circuits.
- This finding is critical for safe NIV use in hospitalized COVID-19 patients.
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