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RESEARCH PRODUCT

Comparative bench study evaluation of different infant interfaces for non-invasive ventilation

Giorgio ContiL TortoroloGiorgia SpinazzolaCesare GregorettiOlimpia FestaAndrea CortegianiMarco PiastraGiuliano FerroneRoberta Costa

subject

Pulmonary and Respiratory Medicinemedicine.medical_specialtyAcute respiratory failure; Bench test; Infant mask; Mechanical ventilation; Non invasive ventilation; Patient-ventilator interactionRespiratory ratemedicine.medical_treatmentPressure support ventilationAcute respiratory failureManikinsBench test03 medical and health sciences0302 clinical medicineMechanical ventilationRespiratory Rate030225 pediatricsInternal medicineSettore MED/41 - ANESTESIOLOGIAIntubation IntratrachealTidal VolumeMedicineNon-invasive ventilationHumansTidal volumePatient-ventilator interactionMonitoring PhysiologicWork of BreathingMechanical ventilationlcsh:RC705-779LungNoninvasive Ventilationbusiness.industryMasksInfantNon invasive ventilationlcsh:Diseases of the respiratory systemAcute respiratory failure; Bench test; Infant mask; Mechanical ventilation; Non invasive ventilation; Patient-ventilator interaction; Pulmonary and Respiratory Medicinemedicine.anatomical_structure030228 respiratory systemVolume (thermodynamics)ItalyAcute DiseaseBreathingCardiologyInfant maskbusinessRespiratory InsufficiencyResearch Article

description

Abstract Background To compare, in terms of patient-ventilator interaction and performance, a new nasal mask (Respireo, AirLiquide, FR) with the Endotracheal tube (ET) and a commonly used nasal mask (FPM, Fisher and Paykel, NZ) for delivering Pressure Support Ventilation (PSV) in an infant model of Acute Respiratory Failure (ARF). Methods An active test lung (ASL 5000) connected to an infant mannequin through 3 different interfaces (Respireo, ET and FPM), was ventilated with a standard ICU ventilator set in PSV. The test lung was set to simulate a 5.5 kg infant with ARF, breathing at 50 and 60 breaths/min). Non-invasive ventilation (NIV) mode was not used and the leaks were nearly zero. Results The ET showed the shortest inspiratory trigger delay and pressurization time compared to FPM and Respireo (p < 0.01). At each respiratory rate tested, the FPM showed the shortest Expiratory trigger delay compared to ET and Respireo (p < 0.01). The Respireo presented a lower value of Inspiratory pressure–time product and trigger pressure drop than ET (p < 0.01), while no significant difference was found in terms of pressure-time product at 300 and 500 ms. During all tests, compared with the FPM, ET showed a significantly higher tidal volume (VT) delivered (p < 0.01), while Respireo showed a trend toward an increase of tidal volume delivered compared with FPM. Conclusions The ET showed a better patient-ventilator interaction and performance compared to both the nasal masks. Despite the higher internal volume, Respireo showed a trend toward an increase of the delivered tidal volume; globally, its efficiency in terms of patient-ventilator interaction was comparable to the FPM, which is the infant NIV mask characterized by the smaller internal volume among the (few) models on the market.

10.1186/s12890-018-0620-xhttp://europepmc.org/articles/PMC5889592