title: Volume-Targeted Ventilation in the Neonate: Benchmarking Ventilators on an Active Lung Model.
abstract: OBJECTIVE
  Mechanically ventilated neonates have been observed to receive substantially different ventilation after switching ventilator models, despite identical ventilator settings. This study aims at establishing the range of output variability among 10 neonatal ventilators under various breathing conditions.
  
  
  METHODS
  Relative benchmarking test of 10 neonatal ventilators on an active neonatal lung model.
  
  
  METHODS
  Neonatal ICU.
  
  
  METHODS
  Ten current neonatal ventilators.
  
  
  METHODS
  Ventilators were set identically to flow-triggered, synchronized, volume-targeted, pressure-controlled, continuous mandatory ventilation and connected to a neonatal lung model. The latter was configured to simulate three patients (500, 1,500, and 3,500 g) in three breathing modes each (passive breathing, constant active breathing, and variable active breathing).
  
  
  RESULTS
  Averaged across all weight conditions, the included ventilators delivered between 86% and 110% of the target tidal volume in the passive mode, between 88% and 126% during constant active breathing, and between 86% and 120% under variable active breathing. The largest relative deviation occurred during the 500 g constant active condition, where the highest output machine produced 147% of the tidal volume of the lowest output machine.
  
  
  CONCLUSIONS
  All machines deviate significantly in volume output and ventilation regulation. These differences depend on ventilation type, respiratory force, and patient behavior, preventing the creation of a simple conversion table between ventilator models. Universal neonatal tidal volume targets for mechanical ventilation cannot be transferred from one ventilator to another without considering necessary adjustments.
authors.affiliation: All authors: Division of Neonatology, Department of Pediatrics and Adolescent Medicine, Paracelsus Medical University, Salzburg, Austria.
authors.forename: Tobias J
authors.initials: TJ
authors.lastname: Krieger
authors.forename: Martin
authors.initials: M
authors.lastname: Wald
mesh_terms: D019985:Benchmarking; D006801:Humans; D007231:Infant, Newborn; D015931:Intensive Care, Neonatal / Q000592:standards*; D008168:Lung / Q000502:physiology*; D008953:Models, Anatomic; D012121:Respiration, Artificial / Q000295:instrumentation* / Q000592:standards / Q000706:statistics & numerical data; D013990:Tidal Volume; D055397:Ventilator-Induced Lung Injury / Q000517:prevention & control; D012122:Ventilators, Mechanical / Q000592:standards* / Q000706:statistics & numerical data