Bench test evaluation of volume delivered by modern ICU ventilators during volume-controlled ventilation
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During volume-controlled ventilation, part of the volume delivered is compressed into the circuit. To correct for this phenomenon, modern ventilators use compensation algorithms. Humidity and temperature also influence the delivered volume.
In a bench study at a research laboratory in a university hospital, we compared nine ICU ventilators equipped with compensation algorithms, one with a proximal pneumotachograph and one without compensation. Each ventilator was evaluated under normal, obstructive, and restrictive conditions of respiratory mechanics. For each condition, three tidal volumes (VT) were set (300, 500, and 800 ml), with and without an inspiratory pause. The insufflated volume and the volume delivered at the Y-piece were measured independently, without a humidification device, under ambient temperature and pressure and dry gas conditions. We computed the actually delivered VT to the lung under body temperature and pressure and saturated water vapour conditions (BTPS).
For target VT values of 300, 500, and 800 ml, actually delivered VT under BTPS conditions ranged from 261 to 396 ml (−13 to +32%), from 437 to 622 ml (−13 to +24%), and from 681 to 953 ml (−15 to +19%), respectively (p < 0.01). Respiratory system mechanics and application of an inspiratory pause significantly affected actually delivered VT. Assuming a set VT of 6 ml/kg of predicted body weight, a difference of 1–2 ml/kg with actually delivered VT would be commonly observed.
The difference between preset VT and actually delivered VT is clinically meaningful and differs across modern ICU ventilators.
KeywordsMechanical ventilation Volume-controlled ventilation Bench test ventilator Protective ventilation
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