Ogna Adam, Prigent Helene, Falaize Line, Leroux Karl, Santos Dante, Vaugier Isabelle, Orlikowski David, Lofaso Frederic
Hôpital Raymond Poincaré, Service de Réanimation médicale et unité de ventilation à domicile, AP-HP, Garches, 92380, France.
Hôpital Raymond Poincaré, Service de Physiologie-Explorations Fonctionnelles, AP-HP, Garches, 92380, France.
Clin Respir J. 2018 Mar;12(3):890-894. doi: 10.1111/crj.12601. Epub 2017 Jan 9.
Mouthpiece ventilation represents a valuable treatment for patients needing daytime non-invasive ventilation. This modality is however underused, in part because of limitations in the available equipment.
To develop a new flexible and moldable mouthpiece, aiming to address some of the issues of the currently available interfaces.
We compared two commercially available and the newly developed mouthpieces in a bench test using four life-support home ventilators and three settings per ventilator.
The three interfaces showed marked differences in their resistive characteristics. In the volume-controlled setting (VC-CMV) with 500 mL tidal volume (V ), the delivered V , ranged between 459 ± 7 mL (-8%) and 501 ± 4 mL (+0.2%), according to the used ventilator. In the VC-CMV setting with V 1000 mL, one of the ventilators did not assure the set V with the new mouthpiece, because of the high-pressure limitation. In the pressure-controlled setting (PC-CMV at 20 cmH O), the effective pressure differed between the tested interfaces according to their resistance, resulting in a decrease in the delivered V .
They found measurable differences in the ventilation's performances comparing the interfaces for mouthpiece ventilation, which seem to have a minor clinical relevance in the most settings, but should be systematically checked. They validated in-vitro the newly developed mouthpiece with respect to the ventilation performances; a clinical study is needed to investigate the potential advantages we expect from the new mouthpiece.
口含器通气是日间需要无创通气患者的一种重要治疗方法。然而，这种方式未得到充分利用，部分原因是现有设备存在局限性。
研发一种新型的可弯曲且可塑形的口含器，旨在解决当前可用接口存在的一些问题。
我们在台架试验中使用四台家用生命支持呼吸机，每台呼吸机设置三种参数，对两种市售口含器和新研发的口含器进行了比较。
三种接口在阻力特性方面存在显著差异。在潮气量（V）为500 mL的容量控制通气模式（VC-CMV）下，根据所使用的呼吸机不同，输送的V在459±7 mL（-8%）至501±4 mL（+0.2%）之间。在V为1000 mL的VC-CMV模式下，由于高压限制，其中一台呼吸机使用新口含器时无法保证设定的V。在压力控制通气模式（20 cmH₂O的PC-CMV）下，根据测试接口的阻力不同，有效压力也有所不同，导致输送的V减少。
他们发现，比较口含器通气接口时，通气性能存在可测量的差异，在大多数情况下，这些差异似乎临床相关性较小，但应进行系统检查。他们在体外验证了新研发口含器的通气性能；需要进行一项临床研究来调查我们期望从新口含器中获得的潜在优势。
