Dipartimento di Fisiopatologia Medico-Chirurgica e dei Trapianti, Università degli Studi di Milano, Polo Universitario San Paolo, Milan, Italy.
Respir Care. 2013 Feb;58(2):305-12. doi: 10.4187/respcare.01598.
The performances of 2 noninvasive CPAP systems (high flow and low flow air-entrainment masks) were compared to the Boussignac valve in 3 different scenarios.
Scenario 1: pneumatic lung simulator with a tachypnea pattern (tidal volume 800 mL at 40 breaths/min). Scenario 2: Ten healthy subjects studied during tidal breaths and tachypnea. Scenario 3: Twenty ICU subjects enrolled for a noninvasive CPAP session. Differences between set and effective CPAP level and F(IO(2)), as well as the lowest airway pressure and the pressure swing around the imposed CPAP level, were analyzed. The lowest airway pressure and swing were correlated to the pressure-time product (area of the airway pressure curve below the CPAP level) measured with the simulator. P(aO(2)) was a subject's further performance index.
Lung simulator: Boussignac F(IO(2)) was 0.54, even if supplied with pure oxygen. The air-entrainment masks had higher swing than the Boussignac (P = .007). Pressure-time product correlated better with pressure swing (Spearman correlation coefficient [ρ] = 0.97) than with lowest airway pressure (ρ = 0.92). In healthy subjects, the high-flow air-entrainment mask showed lower difference between set and effective F(IO(2)) (P < .001), and lowest airway pressure (P < .001), compared to the Boussignac valve. In all measurements the Boussignac valve showed higher than imposed CPAP level (P < .001). In ICU subjects the high-flow mask had lower swing than the Boussignac valve (P = .03) with similar P(aO(2)) increase.
High-flow air-entrainment mask showed the best performance in human subjects. During high flow demand, the Boussignac valve delivered lower than expected F(IO(2)) and showed higher dynamic hyper-pressurization than the air-entrainment masks.
在三种不同情况下，比较了两种非侵入性 CPAP 系统（高流量和低流量空气夹带面罩）与 Boussignac 阀的性能。
方案 1：带有呼吸急促模式的气动肺模拟器（潮气量 800mL，呼吸频率 40 次/分）。方案 2：10 名健康受试者在潮气量呼吸和呼吸急促时进行研究。方案 3：20 名 ICU 患者接受无创 CPAP 治疗。分析设定和有效 CPAP 水平以及 F(IO(2))之间的差异，以及最低气道压力和围绕设定 CPAP 水平的压力波动。最低气道压力和波动与模拟器测量的气道压力曲线下方的压力时间乘积（CPAP 水平以下的气道压力曲线的面积）相关。P(aO(2))是受试者的进一步性能指标。
肺模拟器：即使供应纯氧，Boussignac 的 F(IO(2))也为 0.54。空气夹带面罩的波动高于 Boussignac（P =.007）。压力时间乘积与压力波动的相关性（Spearman 相关系数 [ρ] = 0.97）优于与最低气道压力（ρ = 0.92）的相关性。在健康受试者中，与 Boussignac 阀相比，高流量空气夹带面罩显示出较低的设定与有效 F(IO(2))（P <.001）和最低气道压力（P <.001）之间的差异。在所有测量中，Boussignac 阀显示出高于设定 CPAP 水平（P <.001）。在 ICU 患者中，高流量面罩的波动低于 Boussignac 阀（P =.03），同时 P(aO(2))增加。
高流量空气夹带面罩在人体受试者中表现最佳。在高流量需求期间，Boussignac 阀提供的 F(IO(2))低于预期，并显示出比空气夹带面罩更高的动态超压。
