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The response of flow-triggered infant ventilators
M Nishimura1, D Hess, R M Kacmarek
1Respiratory Care Department Laboratory, Massachusetts General Hospital, Boston 02114, USA.
American Journal of Respiratory and Critical Care Medicine
|December 1, 1995
Summary
New infant ventilators with flow triggering may not be suitable for patient-triggered ventilation (PTV) in infants due to prolonged delay times and high trigger work, especially with smaller endotracheal tubes.
Area of Science:
- Pediatric critical care
- Respiratory physiology
- Mechanical ventilation
Background:
- Patient-triggered ventilation (PTV) has been limited in infants due to issues with pressure-triggered systems.
- Recent advancements include four infant ventilators utilizing flow triggering technology.
Purpose of the Study:
- To evaluate the feasibility of PTV in infants using new flow-triggered ventilators.
- To assess delay times, trigger pressures, and trigger work across various conditions.
Main Methods:
- Four infant ventilators with flow triggering were tested.
- Simulated infant lungs were connected via 3-, 4-, and 5-mm endotracheal tubes.
- Measurements included delay time, trigger pressure, and trigger work under varying ventilatory demands and PEEP levels.
Main Results:
- Significant differences in delay time, trigger pressure, and trigger work were observed based on endotracheal tube size, measurement site, ventilatory demand, and ventilator brand (p < 0.001).
- The 3-mm endotracheal tube showed the longest delay time (up to 138.2 ms) at high ventilatory drive.
- Trigger pressure and work increased with smaller tubes, higher demand, PEEP use, and measurement at the alveolus.
Conclusions:
- Flow-triggered PTV may be inappropriate for infants experiencing high ventilatory drive or requiring small endotracheal tubes.
- Further research is needed to optimize PTV settings for vulnerable infant populations.