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在 ICU 条件下,对转运和急救呼吸机中的 PC-CMVs 模式进行台架评估。

Bench assessment of PC-CMVs modes in transport and emergency ventilators under ICU conditions.

机构信息

Biomedical Engineering Laboratory, Escola Politécnica, University of Sao Paulo, Sao Paulo, Brazil.

Laboratory of Final Uses and Energy Management, Energy Center, Institute for Technological Research, Sao Paulo, Brazil.

出版信息

Sci Rep. 2024 Sep 29;14(1):22570. doi: 10.1038/s41598-024-73056-w.

DOI:10.1038/s41598-024-73056-w
PMID:39343813
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11439908/
Abstract

Although there has been an increase in bench test evaluation of mechanical ventilators in recent years, a publication gap remains in assessing Pressure Control Continuous Mandatory Ventilation Modes with a set point targeting scheme PC-CMVs. This study evaluates the operational variability in PC-CMVs of eleven transport and emergency ventilators used in ICU units in Brazil during the COVID-19 pandemic. The assessment involved a comprehensive set of test scenarios derived from existing literature and the NBR ISO 80601-2-12:2014 standard. Nine parameters were computed for five consecutive breaths, offering a comprehensive characterization of pressure and flow waveforms. Most ventilators had Inspiratory pressure and PEEP values that fell outside of the tolerance ranges. Notably, three mechanical ventilators failed to reach the target pressures within the specified inspiratory times during test scenarios with a higher time constant (τ). We observed significant differences among emergency and transport ventilators in all assessed parameters, indicating a performance difference in PC-CMVs modes. The current results might help clinicians determine which ventilator models are suitable for specific clinical situations, particularly when unfavorable circumstances compel doctors to use ventilators that may not provide adequate support for patients in intensive care units.

摘要

尽管近年来对机械通气机的台架测试评估有所增加,但在评估设定点为目标方案的压力控制持续强制通气模式(PC-CMV)方面,仍存在发表差距。本研究评估了在 COVID-19 大流行期间巴西 ICU 病房使用的 11 种转运和急救通气机的 PC-CMV 的操作变异性。评估涉及从现有文献和 NBR ISO 80601-2-12:2014 标准中得出的一套全面的测试方案。为五个连续的呼吸计算了九个参数,全面描述了压力和流量波形。大多数通气机的吸气压力和 PEEP 值超出了公差范围。值得注意的是,在具有更高时间常数(τ)的测试方案中,有三台机械通气机未能在规定的吸气时间内达到目标压力。我们观察到所有评估参数在急救和转运通气机之间存在显著差异,表明 PC-CMV 模式的性能存在差异。目前的结果可能有助于临床医生确定哪些通气机型号适用于特定的临床情况,特别是在不利情况下,医生不得不使用可能无法为 ICU 患者提供足够支持的通气机时。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9e77/11439908/4ab68094aefd/41598_2024_73056_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9e77/11439908/71ce0c37f751/41598_2024_73056_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9e77/11439908/00b632beaa55/41598_2024_73056_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9e77/11439908/4ab68094aefd/41598_2024_73056_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9e77/11439908/71ce0c37f751/41598_2024_73056_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9e77/11439908/00b632beaa55/41598_2024_73056_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9e77/11439908/4ab68094aefd/41598_2024_73056_Fig3_HTML.jpg

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本文引用的文献

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Bench Assessment of Expiratory Valve Resistance of Current ICU Ventilators in Dynamic Conditions.
在动态条件下评估当前 ICU 呼吸机呼气阀阻力的台架研究。
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