Characterization and Optimization of the Subsalve Helmet Ventilation Circuit in a High-Fidelity Acute Respiratory Distress Syndrome (ARDS) Lung Model.

IF 1.3 Q4 ENGINEERING, BIOMEDICAL

Medical Devices-Evidence and Research Pub Date : 2025-04-16 eCollection Date: 2025-01-01 DOI:10.2147/MDER.S487868

John Donahue, Clinton O Chichester Iii, Alex Hornstein, Michael Lombardi, Amanda M Chichester

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Abstract

Purpose: The Subsalve helmet continuous positive airway pressure (CPAP) circuit is a low-cost, easy to implement non-invasive ventilation option for treatment of acute respiratory failure. The circuit is simple to set up and operate, and is designed to be used with any commonly available continuous positive airway pressure device.

Model materials and methods: Simulation of an acute respiratory distress syndrome (ARDS) patient allows optimization of treatment parameters without risk. The boundaries of safe and effective helmet CPAP treatment were measured in the TestChest^® lung simulator with AQAI SIS software. The capabilities of the TestChest allow for representation of complex breathing patterns, simulation of muscular fatigue, and the ability to model patients with worsening ARDS. Treatment settings were tested by varying CPAP pressure and oxygen flow rate in a simulated ARDS patient.

Results: Moderate CPAP pressure led to significant increases in SpO₂ (oxygen saturation) (10% increase at 14 cmH₂O pressure) and maintained improvements compared to the control even at the latest stage of the disease. When oxygen was introduced, patient SpO₂ increased proportional to the oxygen flow rate. 5 liters per minute (LPM) oxygen increased patient SpO₂ by 3% in the severe ARDS model and 30 LPM oxygen increased SpO₂ by 7%. Moderate pressure led to significant increases in SpO₂ comparable to high concentrations of oxygen. CO₂ does not accumulate in the helmet as long as the minimal flow rate (60 LPM of air) is maintained during treatment.

Conclusion: Our data demonstrate that the Subsalve helmet CPAP circuit, with limited oxygen availability, is an effective treatment strategy for ARDS patients in low-resource settings. Moderate positive end expiratory pressure (PEEP) is recommended to improve blood oxygenation. Subsalve has the potential to conserve critical resources in future epidemics.

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高保真急性呼吸窘迫综合征（ARDS）肺模型中面罩下通气回路的表征与优化

目的：面罩下持续气道正压通气（CPAP）回路是治疗急性呼吸衰竭的一种低成本、易于实施的无创通气选择。该电路设置和操作简单，设计用于任何常用的持续气道正压装置。模型材料和方法：模拟急性呼吸窘迫综合征（ARDS）患者，可以在无风险的情况下优化治疗参数。在使用aai SIS软件的TestChest®肺模拟器中测量安全有效的头盔CPAP治疗边界。TestChest的功能允许表示复杂的呼吸模式，模拟肌肉疲劳，并能够模拟恶化的ARDS患者。在模拟ARDS患者中，通过改变CPAP压力和氧流量来测试治疗设置。结果：适度的CPAP压力导致SpO2（氧饱和度）显著增加（在14 cmH2O压力下增加10%），即使在疾病的最后阶段，与对照组相比仍保持改善。当氧气引入时，患者SpO2与氧气流速成正比增加。在严重ARDS模型中，5升/分钟（LPM）的氧气使患者SpO2升高3%，30升/分钟的氧气使SpO2升高7%。中等压力导致SpO2显著增加，与高浓度氧气相当。在处理过程中，只要保持最小的空气流量（60 LPM），二氧化碳就不会在头盔中积累。结论：我们的数据表明，在氧气可用性有限的情况下，面罩下CPAP循环是低资源环境下ARDS患者的有效治疗策略。建议适度呼气末正压（PEEP）以改善血液氧合。亚药膏具有在未来流行病中保存关键资源的潜力。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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