Marjanovic Nicolas S, De Simone Agathe, Jegou Guillaume, L'Her Erwan
Urgences Adultes/SAMU 86, CHU de Poitiers, 86000, Poitiers Cedex, France.
ABS-Lab, Laboratoire d'Anatomie, Biomécanique et Simulation, Université de Poitiers, Rue de la Milétrie, 86000, Poitiers Cedex, France.
Ann Intensive Care. 2017 Dec;7(1):68. doi: 10.1186/s13613-017-0285-2. Epub 2017 Jun 17.
This study aimed to provide a new global and comprehensive evaluation of recent ICU ventilators taking into account both technical performances and ergonomics.
Six recent ICU ventilators were evaluated. Technical performances were assessed under two FIO levels (100%, 50%), three respiratory mechanics combinations (Normal: compliance [C] = 70 mL cmHO/resistance [R] = 5 cmHO L s; Restrictive: C = 30/R = 10; Obstructive: C = 120/R = 20), four exponential levels of leaks (from 0 to 12.5 L min) and three levels of inspiratory effort (P0.1 = 2, 4 and 8 cmHO), using an automated test lung. Ergonomics were evaluated by 20 ICU physicians using a global and comprehensive model involving physiological response to stress measurements (heart rate, respiratory rate, tidal volume variability and eye tracking), psycho-cognitive scales (SUS and NASA-TLX) and objective tasks completion.
Few differences in terms of technical performance were observed between devices. Non-invasive ventilation modes had a huge influence on asynchrony occurrence. Using our global model, either objective tasks completion, psycho-cognitive scales and/or physiological measurements were able to depict significant differences in terms of devices' usability. The level of failure that was observed with some devices depicted the lack of adaptation of device's development to end users' requests.
Despite similar technical performance, some ICU ventilators exhibit low ergonomics performance and a high risk of misusage.
本研究旨在对近期的重症监护病房（ICU）呼吸机进行全面的全球评估，综合考虑技术性能和人体工程学因素。
对六台近期的ICU呼吸机进行评估。使用自动测试肺，在两种吸入氧浓度（FIO）水平（100%、50%）、三种呼吸力学组合（正常：顺应性[C]=70mL/cmH₂O/阻力[R]=5cmH₂O/L/s；限制性：C=30/R=10；阻塞性：C=120/R=20）、四种指数级别的漏气水平（从0至12.5L/min）以及三种吸气努力水平（P0.1=2、4和8cmH₂O）下评估技术性能。由20名ICU医生使用一个全面的整体模型评估人体工程学，该模型涉及对应激的生理反应测量（心率、呼吸频率、潮气量变异性和眼动追踪）、心理认知量表（系统可用性量表[SUS]和美国国家航空航天局任务负荷指数[NASA-TLX]）以及客观任务完成情况。
各设备之间在技术性能方面观察到的差异较少。无创通气模式对不同步的发生有巨大影响。使用我们的整体模型，客观任务完成情况、心理认知量表和/或生理测量能够描述设备在可用性方面的显著差异。一些设备观察到的故障水平表明设备开发未能适应最终用户的需求。
尽管技术性能相似，但一些ICU呼吸机的人体工程学性能较低且存在误用的高风险。
