Jouvet P, Hubert P, Jarreau P H, Lofaso F, Cloup M, Harf A
Paediatric Intensive Care Unit, Hospital Necker Enfants Malades, Paris, France.
Intensive Care Med. 1995 Sep;21(9):753-8. doi: 10.1007/BF01704743.
To analyze efficiency and reliability of 4 modern neonatal ventilators under difficult test conditions. The ventilators tested were: Babylog 8000 (Dräger Medical), BP 2001 (Bear Medical Systems), Sechrist IV 100 B (Sechrist Industries), Infant Star (Infrasonics INC).
Gas flow generation was tested by comparison of preset flow values with no resistance in the circuit to flow values obtained during interposition of a resistance in the inspiratory circuit. A decrease in gas flow was observed when interposition of a resistance in the inspiratory circuit increased peak inspiratory pressure to 60 cmH2O (gas flow decreased by 8% to 24% depending on the ventilator tested). The pressure limiting valve and the positive end-expiratory pressure valve were also evaluated in order to test their behaviour under different flow conditions. Flow-dependence of the pressure was noted for all ventilators except Babylog 8000. Assessment of the reliability of pressure monitoring revealed either 'under' or 'over' estimation of peak inspiratory pressure and positive end-expiratory pressure depending on the ventilator tested.
For the best clinical use of mechanical ventilators, neonatologists should be aware of these limitations. Therefore a regular assessment of ventilator performance and monitoring reliability is recommended.
分析4种现代新生儿呼吸机在困难测试条件下的效率和可靠性。所测试的呼吸机有:Babylog 8000(德尔格医疗公司)、BP 2001(熊牌医疗系统公司)、Sechrist IV 100 B(Sechrist工业公司)、Infant Star(英弗森尼克斯公司)。
通过比较回路无阻力时的预设流量值与吸气回路中插入阻力时获得的流量值来测试气流产生情况。当吸气回路中插入阻力使吸气峰压升至60 cmH₂O时,观察到气流下降(根据所测试的呼吸机不同,气流下降8%至24%)。还对压力限制阀和呼气末正压阀进行了评估,以测试它们在不同流量条件下的性能。除Babylog 8000外,所有呼吸机均观察到压力与流量的相关性。对压力监测可靠性的评估显示,根据所测试的呼吸机不同,吸气峰压和呼气末正压存在“低估”或“高估”情况。
为了机械呼吸机的最佳临床应用,新生儿科医生应了解这些局限性。因此,建议定期评估呼吸机性能和监测可靠性。