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Accuracy of Ventilator-Reported Triggering and Cycling Mechanisms in Home-Use Ventilators
Marte Skogstad Allgot1,2, Ove Fondenes3, Manel Luján4
1Ms. Allgot, Prof. Skjønsberg, and Dr. Aarrestad are affiliated with the Department of Pulmonary Medicine, Oslo University Hospital, Oslo, Norway.
Background:
Accurate monitoring of triggering and cycling mechanisms and ventilator respiratory rate is essential for analyzing patient-ventilator interaction in long-term noninvasive ventilation (NIV). Many home-use ventilators provide breath-by-breath and summarized data about triggering and cycling mechanisms and ventilator breathing frequencies. The aim of this study was to explore the reporting and assess the accuracy of the available data on the triggering and cycling mechanisms and the ventilator respiratory rate provided by 3 commonly used ventilators intended for home use. In addition, we aimed to discuss the clinical usefulness of the information provided by the various ventilators.
Methods:
To assess the accuracy of the reporting on the triggering and cycling mechanisms and ventilator respiratory rate, we established a bench model using a lung simulator, a research-grade data acquisition system, and 3 different ventilators (Lumis 150, Vivo 3, and Prisma VENT 40). The bench model was used to control the mechanisms for triggering and cycling and provided an external validation method compared with data simultaneously obtained by the built-in sensors of the ventilators. The ventilators were tested for breath-by-breath and summarized information regarding triggering and cycling mechanisms, and for summarized data regarding ventilator respiratory rate estimation.
Results:
The breath-by-breath and summarized data on the triggering and cycling mechanisms and ventilator respiratory rate showed excellent agreement between the externally verified mechanism and the reported mechanism in all the ventilators tested.
Conclusions:
Given the degree of diagnostic accuracy in identifying the triggering and cycling mechanisms and the ventilator respiratory rate in the home-use ventilators tested, this study supports the use of these tools in the monitoring of patients using long-term NIV. The establishment of the reliability of these tools is also a necessary step when correlating ventilator data with clinically relevant, patient-related outcomes in future studies.
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