Chest
Original ResearchRespiratory CareMonitoring of Noninvasive Ventilation by Built-in Software of Home Bilevel Ventilators: A Bench Study
Section snippets
Materials and Methods
A panel of home ventilators distributed in Western Europe and equipped with built-in software providing at least monitoring of leaks, RR, and Vt were tested. Seven ventilators were included: Monnal T30 (Airox), Synchrony and Trilogy (Philips Respironics), Ventimotion (Weinmann), Vivo 40 (Breas), and VPAP III ST and VPAP IV ST-A (ResMed). Software brands and the modes of estimation of leaks are summarized in Table 1. Tests were performed between July and September 2009.
Leaks
Figure 2 and Table 2 summarize results regarding leaks. For ventilators F and G, intentional leaks (ie, of mask exhalation valve) are not included in data reported by the ventilator software, and therefore were subtracted from total leaks measured by the bench test to allow comparison between the bench test and software values. With this kept in mind, the threshold of clinical relevance for leaks suggested, arbitrarily, by manufacturers is 24 L/min for devices F and G.8, 21 For other devices,
Discussion
The present study is, to our knowledge, the first to assess the reliability of two important parameters, leaks and Vt, provided by the software of recent home bilevel ventilators by comparing results with objective assessment on a bench test. Results show the following: (1) different devices do not estimate leaks in the same way, that among seven ventilators tested, results provided were calculated in three different ways; (2) the precision of estimation of leaks varied very significantly
Acknowledgments
Author contributions: Mr Contal: contributed to the study design and protocol, recording and analysis of data, and writing and revision of the manuscript.
Ms Vignaux: contributed to the recording and analysis of data and revision of the manuscript.
Dr Combescure: contributed to the analysis of data, statistical analysis, and revision of the manuscript.
Dr Pepin: contributed to the study design and protocol, analysis of data, and writing and revision of the manuscript.
Dr Jolliet: contributed to the
References (31)
- et al.
Changing patterns in long-term noninvasive ventilation: a 7-year prospective study in the Geneva Lake area
Chest
(2003) - et al.
Effect of sleep on patient/ventilator asynchrony in patients undergoing chronic non-invasive mechanical ventilation
Respir Med
(2007) - et al.
Respiratory patterns during sleep in obesity-hypoventilation patients treated with nocturnal pressure support: a preliminary report
Chest
(2007) - et al.
Performance characteristics of 10 home mechanical ventilators in pressure-support mode: a comparative bench study
Chest
(2005) - et al.
Performance characteristics of bilevel pressure ventilators: a lung model study
Chest
(1997) - et al.
Intentional leaks in industrial masks have a significant impact on efficacy of bilevel noninvasive ventilation: a bench test study
Chest
(2009) - et al.
Leak monitoring in noninvasive ventilation [in Spanish]
Arch Bronconeumol
(2004) - et al.
Clinical impact of leak compensation during non-invasive ventilation
Respir Med
(2009) - et al.
Patterns of home mechanical ventilation use in Europe: results from the Eurovent survey
Eur Respir J
(2005) - et al.
SomnoNIV Group. Nocturnal monitoring of home non-invasive ventilation: the contribution of simple tools such as pulse oximetry, capnography, built-in ventilator software and autonomic markers of sleep fragmentation
Thorax
(2011)
NPPV Titration Task Force of the American Academy of Sleep Medicine. Best clinical practices for the sleep center adjustment of noninvasive positive pressure ventilation (NPPV) in stable chronic alveolar hypoventilation syndromes
J Clin Sleep Med
Evaluating noninvasive ventilation using a monitoring system coupled to a ventilator: a bench-to-bedside study
Eur Respir J
Performance of mechanical ventilators at the patient's home: a multicentre quality control study
Thorax
Performance of ventilators for noninvasive positive-pressure ventilation in children
Eur Respir J
Cited by (0)
Funding/Support: The authors have reported to CHEST that no funding was received for this study.
Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).