A bench evaluation of fraction of oxygen in air delivery and tidal volume accuracy in home care ventilators available for hospital use.
BACKGROUND
Turbine-powered ventilators are not only designed for long-term ventilation at home but also for hospital use. It is important to verify their capabilities in delivering fraction of oxygen in air (FIO2) and tidal volume (VT).


METHODS
We assessed the FIO2accuracy and the VTdelivery in four home care ventilators (HCV) on the bench. The four HCV were Astral 150, Elisée 150, Monnal T50 and Trilogy 200 HCV, which were connected to a lung model (ASL 5000). For assessing FIO2accuracy, lung model was set to mimic an obstructive lung and HCV were set in volume controlled mode (VC). They supplied with air, 3 or 15 L/min oxygen and FIO2was measured by using a ventilator tester (Citrex H4TM). For the VTaccuracy, the lung model was set in a way to mimic three adult configurations (normal, obstructive, or restrictive respiratory disorder) and one pediatric configuration. Each HCV was set in VC. Two VT(300 and 500 mL) in adult lung configuration and one 50 mL VTin pediatric lung configuration, at two positive end expiratory pressures 5 and 10 cmH2O, were tested. VTaccuracy was measured as volume error (the relative difference between set and measured VT). Statistical analysis was performed by suing one-factor ANOVA with a Bonferroni correction for multiple tests.


RESULTS
For Astral 150, Elisée 150, Monnal T50 and Trilogy 200, FIO2averaged 99.2%, 93.7%, 86.3%, and 62.1%, respectively, at 15 L/min oxygen supplementation rate (P<0.001). Volume error was 0.5%±0%, -38%±0%, -9%±0%, -29%±0% and -36%±0% for pediatric lung condition (P<0.001). In adult lung configurations, Monnal T50 systematically over delivered VTand Trilogy 150 was sensitive to lung configuration when VTwas set to 300 mL at either positive end-expiratory pressure (PEEP).


CONCLUSIONS
HCV are different in terms of FIO2efficiency and VTdelivery.
Medical ICU, Lyon University Hospital, Lyon, France.
Loredana
L
Baboi
Biostatistic Department, Lyon University Hospital, Lyon, France;; University of Lyon, Lyon, France;; Biometry and Evolutionary Biology Laboratory, CNRS 5558, Villeurbanne, France.
Fabien
F
Subtil
Medical ICU, Lyon University Hospital, Lyon, France;; University of Lyon, Lyon, France;; INSERM 955, 94010 Créteil cedex, France.
Claude
C
Guérin
Home care ventilators (HCV); fraction of oxygen in air (FIO2); intermediate care; life support; tidal volume (VT)