We performed a bench (BS) and human (HS) study to test the hypothesis that estimation of tidal volume (VT) during noninvasive helmet pressure support ventilation (nHPSV) would be possible using a turbine driven ventilator (TDV) coupled with an intentional leak single-limb vented circuit. During the BS a mannequin was connected to a lung simulator (LS) and at different conditions of respiratory mechanics, positive end expiratory pressure (PEEP) levels and leaks (30, 50 and 80 L/min). All differences were within the 95% limits of agreement (LoA) in all conditions in the Bland-Altman plot. The overall bias (difference between VT measured by TDV and LS) was 35 ml (95% LoA 10 to 57 ml), 15 ml (95% LoA -40 to 70 ml), 141 ml (95% LoA 109 to 173 ml) in the normal, restrictive and obstructive conditions. The bias at different leaks flow in normal condition was 29 ml (95% LoA 19 to 38 ml). In the HS four healthy volunteers using nHPSV had a pneumotachograph (P) inserted through a mouthpiece to measure subject's VT.The bias showed a scarce clinical relevance. In conclusions, VT estimation seems to be feasible and accurate in all conditions but the obstructive one. Additional leaks seem not to affect VT reliability.

Cortegiani A., Navalesi P., Accurso G., Sabella I., Misseri G., Ippolito M., et al. (2019). Tidal Volume Estimation during Helmet Noninvasive Ventilation: an Experimental Feasibility Study. SCIENTIFIC REPORTS, 9, 1-8 [10.1038/s41598-019-54020-5].

Tidal Volume Estimation during Helmet Noninvasive Ventilation: an Experimental Feasibility Study

Cortegiani A.
;
Accurso G.;Sabella I.;Misseri G.;Ippolito M.;Palmeri C.;Gregoretti C.
2019-01-01

Abstract

We performed a bench (BS) and human (HS) study to test the hypothesis that estimation of tidal volume (VT) during noninvasive helmet pressure support ventilation (nHPSV) would be possible using a turbine driven ventilator (TDV) coupled with an intentional leak single-limb vented circuit. During the BS a mannequin was connected to a lung simulator (LS) and at different conditions of respiratory mechanics, positive end expiratory pressure (PEEP) levels and leaks (30, 50 and 80 L/min). All differences were within the 95% limits of agreement (LoA) in all conditions in the Bland-Altman plot. The overall bias (difference between VT measured by TDV and LS) was 35 ml (95% LoA 10 to 57 ml), 15 ml (95% LoA -40 to 70 ml), 141 ml (95% LoA 109 to 173 ml) in the normal, restrictive and obstructive conditions. The bias at different leaks flow in normal condition was 29 ml (95% LoA 19 to 38 ml). In the HS four healthy volunteers using nHPSV had a pneumotachograph (P) inserted through a mouthpiece to measure subject's VT.The bias showed a scarce clinical relevance. In conclusions, VT estimation seems to be feasible and accurate in all conditions but the obstructive one. Additional leaks seem not to affect VT reliability.
Settore MED/41 - Anestesiologia
Cortegiani A., Navalesi P., Accurso G., Sabella I., Misseri G., Ippolito M., et al. (2019). Tidal Volume Estimation during Helmet Noninvasive Ventilation: an Experimental Feasibility Study. SCIENTIFIC REPORTS, 9, 1-8 [10.1038/s41598-019-54020-5].
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10447/386117
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