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A Bench Model of Asynchrony in 6 Ventilators Equipped With Waveform-Guided Options
Isabella Maria Bianchi1, Eric Arisi2, Marco Pozzi2
1Dr Bianchi is affiliated with Department of Anesthesia and Intensive Care Medicine, Papa Giovanni XXXIII Hospital, Bergamo, Italy; and Department of Clinical-Surgical, Diagnostic and Paediatric Sciences, Unit of Anaesthesia and Intensive Care, University of Pavia, Pavia, Italy.
Respiratory Care
|February 19, 2025
Summary
New ventilator software using waveform analysis can improve patient-ventilator synchronization, especially for obstructive respiratory conditions. However, caution is advised for restrictive respiratory profiles, as some ventilators showed worsening synchronization.
Area of Science:
- Mechanical ventilation
- Respiratory mechanics
- Patient-ventilator interaction
Background:
- Patient-ventilator asynchrony is a common issue in pressure support ventilation.
- Waveform-guided algorithms aim to improve triggering and cycling by detecting respiratory activity.
- This study evaluates waveform-guided software on six mechanical ventilators.
Purpose of the Study:
- To assess the synchronization performance of six mechanical ventilators with waveform-guided software.
- To compare automated triggering and cycling against standard settings.
- To evaluate performance across different simulated respiratory mechanics and efforts.
Main Methods:
- Bench study comparing standard and waveform-guided settings on six ventilators (Hamilton G5, C6; IMT bellavista1000; Mindray SV300; Philips Respironics V200, V60).
- Simulated various respiratory mechanics, assistance levels, and patient efforts.
- Tested ventilators with default settings and waveform-guided automation (except V60).
Main Results:
- Automated settings improved triggering in obstructive profiles for B1000, G5, C6, V200.
- Automated settings reduced delayed cycling in obstructive profiles for B1000, G5, C6, V200.
- Asynchrony index (AI) decreased with automated settings in obstructive profiles for B1000, G5, C6, V200.
- Worsening cycling and increased AI were observed in restrictive profiles for some ventilators (B1000, V200).
Conclusions:
- Waveform-based algorithms show potential for enhancing patient-ventilator synchronization.
- Automation is most beneficial in simulated obstructive respiratory conditions.
- Careful consideration is needed for patients with restrictive respiratory profiles due to potential worsening of synchronization.
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