title: Bench test evaluation of volume delivered by modern ICU ventilators during volume-controlled ventilation.
abstract: OBJECTIVE
  During volume-controlled ventilation, part of the volume delivered is compressed into the circuit. To correct for this phenomenon, modern ventilators use compensation algorithms. Humidity and temperature also influence the delivered volume.
  
  
  METHODS
  In a bench study at a research laboratory in a university hospital, we compared nine ICU ventilators equipped with compensation algorithms, one with a proximal pneumotachograph and one without compensation. Each ventilator was evaluated under normal, obstructive, and restrictive conditions of respiratory mechanics. For each condition, three tidal volumes (V (T)) were set (300, 500, and 800 ml), with and without an inspiratory pause. The insufflated volume and the volume delivered at the Y-piece were measured independently, without a humidification device, under ambient temperature and pressure and dry gas conditions. We computed the actually delivered V (T) to the lung under body temperature and pressure and saturated water vapour conditions (BTPS).
  
  
  RESULTS
  For target V (T) values of 300, 500, and 800 ml, actually delivered V (T) under BTPS conditions ranged from 261 to 396 ml (-13 to +32%), from 437 to 622 ml (-13 to +24%), and from 681 to 953 ml (-15 to +19%), respectively (p < 0.01). Respiratory system mechanics and application of an inspiratory pause significantly affected actually delivered V (T). Assuming a set V (T) of 6 ml/kg of predicted body weight, a difference of 1-2 ml/kg with actually delivered V (T) would be commonly observed.
  
  
  CONCLUSIONS
  The difference between preset V (T) and actually delivered V (T) is clinically meaningful and differs across modern ICU ventilators.
authors.affiliation: Medical Intensive Care Unit, AP-HP, Centre Hospitalier Albert Chenevier, Henri Mondor, Créteil, France.
authors.forename: Aissam
authors.initials: A
authors.lastname: Lyazidi
authors.forename: Arnaud W
authors.initials: AW
authors.lastname: Thille
authors.forename: Guillaume
authors.initials: G
authors.lastname: Carteaux
authors.forename: Fabrice
authors.initials: F
authors.lastname: Galia
authors.forename: Laurent
authors.initials: L
authors.lastname: Brochard
authors.forename: Jean-Christophe M
authors.initials: JC
authors.lastname: Richard
mesh_terms: D007362:Intensive Care Units; D012121:Respiration, Artificial / Q000379:methods*; D013990:Tidal Volume; D012122:Ventilators, Mechanical