Intensive Care Medicine

, Volume 34, Issue 9, pp 1669–1675 | Cite as

Trigger performance of mid-level ICU mechanical ventilators during assisted ventilation: a bench study

  • Juliana C. Ferreira
  • Daniel W. Chipman
  • Robert M. Kacmarek
Original

Abstract

Objective

To compare the triggering performance of mid-level ICU mechanical ventilators with a standard ICU mechanical ventilator.

Design

Experimental bench study.

Setting

The respiratory care laboratory of a university-affiliated teaching hospital.

Subject

A computerized mechanical lung model, the IngMar ASL5000.

Interventions

Ten mid-level ICU ventilators were compared to an ICU ventilator at two levels of lung model effort, three combinations of respiratory mechanics (normal, COPD and ARDS) and two modes of ventilation, volume and pressure assist/control. A total of 12 conditions were compared.

Measurements and main results

Performance varied widely among ventilators. Mean inspiratory trigger time was <100 ms for only half of the tested ventilators. The mean inspiratory delay time (time from initiation of the breath to return of airway pressure to baseline) was longer than that for the ICU ventilator for all tested ventilators except one. The pressure drop during triggering (Ptrig) was comparable with that of the ICU ventilator for only two ventilators. Expiratory Settling Time (time for pressure to return to baseline) had the greatest variability among ventilators.

Conclusions

Triggering differences among these mid-level ICU ventilators and with the ICU ventilator were identified. Some of these ventilators had a much poorer triggering response with high inspiratory effort than the ICU ventilator. These ventilators do not perform as well as ICU ventilators in patients with high ventilatory demand.

Keywords

Ventilators Mechanical Respiratory mechanics Respiration Artificial Intensive care units Equipment safety Models Biological 

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Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • Juliana C. Ferreira
    • 1
    • 2
  • Daniel W. Chipman
    • 3
  • Robert M. Kacmarek
    • 3
    • 4
  1. 1.Departments of Respiratory Care and Anesthesia and Critical CareMassachusetts General HospitalBostonUSA
  2. 2.Pulmonary Division, Respiratory ICUHospital das Clinicas, University of Sao PauloSao PauloBrazil
  3. 3.Respiratory Care Services—Ellison 401Massachusetts General HospitalBostonUSA
  4. 4.Department of AnesthesiaHarvard Medical SchoolBostonUSA

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