title: Accuracy of tidal volume delivered by home mechanical ventilation during mouthpiece ventilation: A bench evaluation.
abstract: The aim of our study was to evaluate efficacy and reliability of currently available ventilators for mouthpiece ventilation (MPV). Five life-support home ventilators were assessed in a bench test using different settings simulating the specificities of MPV, such as intermittent circuit disconnection and presence of continuous leaks. The intermittent disconnection of the circuit caused relevant swings in the delivered tidal volume ( VT), showing a VTovershoot during the disconnection periods and a VTdecrease when the interface was reconnected to the test lung. The five ventilators showed substantial differences in the number of respiratory cycles necessary to reach a stable VTin the volume-controlled setting, ranging from 1.3 ± 0.6 to 7.3 ± 1.2 cycles. These differences were less accentuated in the volume-assisted setting (MPV-dedicated mode, when available). Our data show large differences in the capacity of the different ventilators to deal with the rapidly changing respiratory load features that characterize MPV, which can be further accentuated according to the used ventilator setting. The dedicated MPV modes allow improvement in the performance of ventilators only in some defined situations. This has practical consequences for the choice of the ventilator to be used for MPV in a specific patient.
authors.affiliation: 1 AP-HP, Hôpital Raymond Poincaré, Service de Réanimation médicale et unité de ventilation à domicile, Garches, France.
authors.forename: Adam
authors.initials: A
authors.lastname: Ogna
authors.affiliation: 2 AP-HP, Hôpital Raymond Poincaré, Service de Physiologie-Explorations Fonctionnelles, Garches, France.
authors.forename: Helene
authors.initials: H
authors.lastname: Prigent
authors.affiliation: 2 AP-HP, Hôpital Raymond Poincaré, Service de Physiologie-Explorations Fonctionnelles, Garches, France.|3 AP-HP, Hôpital Raymond Poincaré INSERM CIC 14.29, Garches, France.
authors.forename: Line
authors.initials: L
authors.lastname: Falaize
authors.affiliation: 4 ASV Santé, Gennevilliers, France.
authors.forename: Karl
authors.initials: K
authors.lastname: Leroux
authors.affiliation: 2 AP-HP, Hôpital Raymond Poincaré, Service de Physiologie-Explorations Fonctionnelles, Garches, France.
authors.forename: Dante
authors.initials: D
authors.lastname: Santos
authors.affiliation: 3 AP-HP, Hôpital Raymond Poincaré INSERM CIC 14.29, Garches, France.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Vaugier
authors.affiliation: 1 AP-HP, Hôpital Raymond Poincaré, Service de Réanimation médicale et unité de ventilation à domicile, Garches, France.|3 AP-HP, Hôpital Raymond Poincaré INSERM CIC 14.29, Garches, France.
authors.forename: David
authors.initials: D
authors.lastname: Orlikowski
authors.affiliation: 2 AP-HP, Hôpital Raymond Poincaré, Service de Physiologie-Explorations Fonctionnelles, Garches, France.
authors.forename: Frederic
authors.initials: F
authors.lastname: Lofaso
keywords: Non-invasive ventilation; bench evaluation; home ventilators; mouthpiece ventilation; neuromuscular disease