Are home ventilators able to guarantee a minimal tidal volume?
OBJECTIVE
The aim of the study was to evaluate the ability of home ventilators to maintain a minimal tidal volume during different conditions associated with alveolar hypoventilation.


METHODS
Bench evaluation coupled with an in vivo study on two healthy subjects.


METHODS
Tertiary university hospital and research unit.


METHODS
Six ventilators having a "volume guarantee" module (Synchrony II, Philips Respironics; Vivo 40, Breas; Legendair, Airox; Elisee 150, Philips Respironics; Ventimotion, Weinmann; and VS III, Resmed) were tested on a lung bench in a baseline condition and in three conditions associated with alveolar hypoventilation: increase in airway resistance, decrease in lung compliance, and non-intentional leaks. An in vivo study completed the bench study for the non-intentional leak condition.


RESULTS
The six ventilators were able to maintain a minimal tidal volume during an increase in airway resistance and a decrease in lung compliance. The maintenance of a minimal tidal volume during a non-intentional leak was more difficult and was associated with large variations in tidal volume, a default of pressure support delivery for some devices, and patient-ventilator dyssynchrony, both during the bench and the in vivo study.


CONCLUSIONS
The six home ventilators tested in the study were able to maintain a minimal tidal volume during an increase in airway resistance and a decrease in lung compliance, but not during a non-intentional leak.
Fauroux
Brigitte
B
Pediatric Pulmonary Department, Research Unit, National Reference Center for Rare Lung Diseases, INSERM, UMR S-938, AP-HP, Hôpital Armand-Trousseau, Université Pierre et Marie Curie-Paris 6, 75012, Paris, France. brigitte.fauroux@trs.aphp.fr
Leroux
Karl
K
Pépin
Jean-Louis
JL
Lofaso
Frédéric
F
Louis
Bruno
B
D000403:Airway Resistance / Q000502:physiology; D019544:Equipment Failure Analysis; D006699:Home Care Services; D006801:Humans; D008170:Lung Compliance / Q000502:physiology; D011175:Positive-Pressure Respiration / Q000295:instrumentation*; D012129:Respiratory Function Tests; D020182:Sleep Apnea, Central / Q000628:therapy; D013990:Tidal Volume / Q000502:physiology*