title: Bench evaluation of commercially available and newly developed interfaces for mouthpiece ventilation.
abstract: BACKGROUND
  Mouthpiece ventilation represents a valuable treatment for patients needing daytime non-invasive ventilation. This modality is however underused, in part because of limitations in the available equipment.
  
  
  OBJECTIVE
  To develop a new flexible and moldable mouthpiece, aiming to address some of the issues of the currently available interfaces.
  
  
  METHODS
  We compared two commercially available and the newly developed mouthpieces in a bench test using four life-support home ventilators and three settings per ventilator.
  
  
  RESULTS
  The three interfaces showed marked differences in their resistive characteristics. In the volume-controlled setting (VC-CMV) with 500 mL tidal volume (VT), the delivered VT, ranged between 459 ± 7 mL (-8%) and 501 ± 4 mL (+0.2%), according to the used ventilator. In the VC-CMV setting with VT1000 mL, one of the ventilators did not assure the set VTwith the new mouthpiece, because of the high-pressure limitation. In the pressure-controlled setting (PC-CMV at 20 cmH2O), the effective pressure differed between the tested interfaces according to their resistance, resulting in a decrease in the delivered VT.
  
  
  CONCLUSIONS
  They found measurable differences in the ventilation's performances comparing the interfaces for mouthpiece ventilation, which seem to have a minor clinical relevance in the most settings, but should be systematically checked. They validated in-vitro the newly developed mouthpiece with respect to the ventilation performances; a clinical study is needed to investigate the potential advantages we expect from the new mouthpiece.
authors.affiliation: Hôpital Raymond Poincaré, Service de Réanimation médicale et unité de ventilation à domicile, AP-HP, Garches, 92380, France.
authors.forename: Adam
authors.initials: A
authors.lastname: Ogna
authors.affiliation: Hôpital Raymond Poincaré, Service de Physiologie-Explorations Fonctionnelles, AP-HP, Garches, 92380, France.
authors.forename: Helene
authors.initials: H
authors.lastname: Prigent
authors.affiliation: Hôpital Raymond Poincaré, Service de Physiologie-Explorations Fonctionnelles, AP-HP, Garches, 92380, France.|AP-HP, Hôpital Raymond Poincaré, INSERM CIC 14.29, Garches, 92380, France.
authors.forename: Line
authors.initials: L
authors.lastname: Falaize
authors.affiliation: ASV Sante, Gennevilliers, 92230, France.
authors.forename: Karl
authors.initials: K
authors.lastname: Leroux
authors.affiliation: Hôpital Raymond Poincaré, Service de Physiologie-Explorations Fonctionnelles, AP-HP, Garches, 92380, France.
authors.forename: Dante
authors.initials: D
authors.lastname: Santos
authors.affiliation: AP-HP, Hôpital Raymond Poincaré, INSERM CIC 14.29, Garches, 92380, France.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Vaugier
authors.affiliation: Hôpital Raymond Poincaré, Service de Réanimation médicale et unité de ventilation à domicile, AP-HP, Garches, 92380, France.|AP-HP, Hôpital Raymond Poincaré, INSERM CIC 14.29, Garches, 92380, France.
authors.forename: David
authors.initials: D
authors.lastname: Orlikowski
authors.affiliation: Hôpital Raymond Poincaré, Service de Physiologie-Explorations Fonctionnelles, AP-HP, Garches, 92380, France.
authors.forename: Frederic
authors.initials: F
authors.lastname: Lofaso
mesh_terms: D000399:Air Pressure; D004867:Equipment Design; D006801:Humans; D008168:Lung / Q000502:physiology*; D009468:Neuromuscular Diseases / Q000150:complications*; D063087:Noninvasive Ventilation / Q000295:instrumentation*; D011788:Quality of Life; D012131:Respiratory Insufficiency / Q000401:mortality* / Q000523:psychology / Q000628:therapy; D013990:Tidal Volume / Q000502:physiology; D012122:Ventilators, Mechanical / Q000592:standards
keywords: bench evaluation; home ventilators; interfaces; mouthpiece ventilation; neuromuscular disease; non-invasive ventilation