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Effects of jet nebulization on ventilator performance with different invasive ventilation modes: A bench study
Xinyu Li1, Wei Tan1, Hongwen Zhao1
1Department of Respiratory and Critical Care Medicine, The First Hospital of China Medical University, Shenyang, China.
Frontiers in Medicine
|November 7, 2022
Summary
External jet nebulizers significantly impact ventilator triggering performance in both volume control (VC) and pressure control (PC) modes. Ventilator-integrated nebulizers showed no effect, highlighting the importance of nebulizer type in mechanical ventilation.
Area of Science:
- Mechanical Ventilation
- Respiratory Therapy
- Medical Device Engineering
Background:
- The impact of jet nebulization on mechanical ventilator performance, specifically in volume control (VC) and pressure control (PC) modes, remains largely undetermined.
- Aerosol therapy delivery during mechanical ventilation is crucial for patient treatment.
Purpose of the Study:
- To investigate the in vitro effects of different jet nebulizer types on ventilator performance during mechanical ventilation.
- To compare the impact of ventilator-integrated versus external jet nebulizers on triggering, control, and tidal volume delivery in VC and PC modes.
Main Methods:
- Two jet nebulizer types (ventilator-integrated and external) were tested with six ventilators using a lung simulator.
- Mechanical ventilation was set to VC and PC modes, with external nebulizer driving flows at 4 L/min and 8 L/min.
- Nebulizer placement varied (between patient airway and Y-piece, or 15 cm proximal to Y-piece). Triggering, control performance, and tidal volume were assessed against baseline.
Main Results:
- Ventilator-integrated jet nebulizers did not affect ventilator performance (P > 0.05).
- External jet nebulizers significantly altered triggering performance (TPmin, Ttrig, Ptrig; P < 0.05) in both VC and PC modes.
- External nebulizers increased peak inspiratory pressure (Ppeak) and flow (Pflow) in VC mode, affected tidal volume differently across modes (VTi, VT, VTe), and showed increased impact with higher driving flows (P < 0.05).
Conclusions:
- External jet nebulizers significantly impair triggering performance in both VC and PC modes.
- The effects of external jet nebulizers on control performance and tidal volume delivery are variable and depend on the ventilation mode and nebulizer settings.
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