Delgado Carlos, Romero Jose E, Puig Jaume, Izquierdo Ana, Ferrando Carlos, Belda F Javier, Soro Marina
Department of Anesthesia and Critical Care, Hospital Clínico Universitario, Valencia, Spain.
IBIME, ITACA Center, Universidad Politécnica de Valencia, Valencia, Spain.
Respir Care. 2017 Jan;62(1):34-41. doi: 10.4187/respcare.04938.
During recent years, ventilators using turbines as flow-generating systems have become increasingly more relevant. This bench study was designed to compare triggering and pressurization of 7 turbine mid-level ICU ventilators.
We used a dual-chamber lung model to test 7 mid-level ICU ventilators in pressure support mode with levels of 10, 15, and 20 cm HO with 2 PEEP levels of 5 cm HO and the minimum level allowed by the ventilator. A ventilator was connected to the master chamber to simulate 2 different effort levels. Pressure drop, trigger delay time, time to minimum pressure, and pressure time products (PTP) during trigger and the first 300 and 500 ms were analyzed.
In the trigger evaluation, the Savina had the highest delay time, whereas the C2, the V60, and the Trilogy had the lowest pressure drops and PTP values in both effort levels. In pressurization capacity assessment using ideal PTP300 and PTP500 percentages, the C2 and the V680 had the best results, and the Carina and the Savina had lower values, with no differences between both effort levels. Differences between PEEP levels did not seem to be relevant.
Pressure support mode for tested ventilators worked properly, but pressurization capacity and trigger function performance were clearly superior in the newest machines. The use of PEEP did not modify the results.
近年来，采用涡轮作为气流产生系统的呼吸机变得越来越重要。本实验台研究旨在比较7款涡轮中级重症监护病房呼吸机的触发和增压情况。
我们使用双腔肺模型，在压力支持模式下，以10、15和20 cmH₂O的水平，以及5 cmH₂O的两个呼气末正压（PEEP）水平和呼吸机允许的最低水平，测试7款中级重症监护病房呼吸机。将一台呼吸机连接到主腔室，以模拟两种不同的用力水平。分析触发期间以及最初300和500毫秒内的压力降、触发延迟时间、达到最小压力的时间和压力时间乘积（PTP）。
在触发评估中，Savina的延迟时间最长，而C2、V60和Trilogy在两种用力水平下的压力降和PTP值最低。在使用理想PTP300和PTP500百分比进行的增压能力评估中，C2和V680的结果最佳，Carina和Savina的值较低，两种用力水平之间没有差异。PEEP水平之间的差异似乎并不显著。
测试呼吸机的压力支持模式运行正常，但最新款机器的增压能力和触发功能性能明显更优。PEEP的使用并未改变结果。
