Medicine Intensive-Réanimation Hôpital Edouard Herriot, Lyon, France; Université de Lyon, Lyon, France; and Institut Mondor de Recherches Biomédicales, INSERM 955, CNRS ERL 7000, Créteil, France.
Medicine Intensive-Réanimation Hôpital Edouard Herriot, Lyon, France; and Université de Lyon, Lyon, France.
Respir Care. 2022 Sep;67(9):1129-1137. doi: 10.4187/respcare.09889. Epub 2022 Jul 5.
Oxygen therapy via high-flow nasal cannula (HFNC) has been extensively used during the COVID-19 pandemic. The number of devices has also increased. We conducted this study to answer the following questions: Do HFNC devices differ from the original device for work of breathing (WOB) and generated PEEP?
Seven devices were tested on ASL 5000 lung model. Compliance was set to 40 mL/cm HO and resistance to 10 cm HO/L/s. The devices were connected to a manikin head via a nasal cannula with F set at 0.21. The measurements were performed at baseline (manikin head free of nasal cannula) and then with the cannula and the device attached with oxygen flow set at 20, 40, and 60 L/min. WOB and PEEP were assessed at 3 simulated inspiratory efforts (-5, -10, -15 cm HO muscular pressure) and at 2 breathing frequencies (20 and 30 breaths/min). Data were expressed as median (first-third quartiles) and compared with nonparametric tests to the Optiflow device taken as reference.
Baseline WOB and PEEP were comparable between devices. Over all the conditions tested, WOB was 4.2 (1.0-9.4) J/min with the reference device, and the relative variations from it were 0, -3 (2-4), 1 (0-1), -2 (1-2), -1 (1-2), and -1 (1-2)% with Airvo 2, G5, HM80, T60, V500, and V60 Plus devices, respectively, ( < .05 Kruskal-Wallis test). PEEP was 0.9 (0.3-1.5) cm HO with Optiflow, and the relative differences were -28 (22-33), -41 (38-46), -30 (26-36), -31 (28-34), -37 (32-42), and -24 (21-34)% with Airvo 2, G5, HM80, T60, V500, and V60 Plus devices, respectively, ( < .05 Kruskal-Wallis test).
WOB was marginally higher and PEEP marginally lower with devices as compared to the reference device.
高流量鼻导管（HFNC）氧疗在 COVID-19 大流行期间得到了广泛应用。设备数量也有所增加。我们进行这项研究是为了回答以下问题：HFNC 设备在呼吸功（WOB）和产生的 PEEP 方面与原始设备是否存在差异？
在 ASL 5000 肺模型上测试了 7 种设备。顺应性设置为 40mL/cmHO，阻力设置为 10cmHO/L/s。设备通过带有 F 设定值为 0.21 的鼻导管连接到模拟人头。在基线（模拟人头无鼻导管）时以及将导管和设备连接并将氧气流量设置为 20、40 和 60L/min 时进行测量。在 3 种模拟吸气努力（-5、-10、-15cmHO 肌肉压力）和 2 种呼吸频率（20 和 30 次/分钟）下评估 WOB 和 PEEP。数据以中位数（第一至第三四分位数）表示，并与作为参考的 Optiflow 设备进行了非参数检验比较。
所有设备的基线 WOB 和 PEEP 均无差异。在所有测试条件下，参考设备的 WOB 为 4.2（1.0-9.4）J/min，而与之相对的变异率分别为 0、-3（2-4）、1（0-1）、-2（1-2）、-1（1-2）和-1（1-2）%的设备分别为 Airvo 2、G5、HM80、T60、V500 和 V60 Plus （<.05 Kruskal-Wallis 检验）。Optiflow 的 PEEP 为 0.9（0.3-1.5）cmHO，Airvo 2、G5、HM80、T60、V500 和 V60 Plus 设备的相对差异分别为-28（22-33）、-41（38-46）、-30（26-36）、-31（28-34）、-37（32-42）和-24（21-34）%（<.05 Kruskal-Wallis 检验）。
与参考设备相比，WOB 略高，PEEP 略低。
