现代便携式呼吸器在不同肺模型中的体外性能和作为重症监护呼吸器的替代:一项基于模拟的队列研究。

Celine Josianne Schneider, Christian Peter Both, Daniel Fries, Pedro David Wendel-Garcia, Philipp Karl Buehler, Beate Grass, Vincenzo Cannizzaro, Christian Escher, Achim Schmitz, Jörg Thomas
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引用次数: 0

摘要

背景:安全运输通气患者且不丧失疗效是一个挑战。便携式呼吸机通常用于运送危重病人,但其性能往往有限。目的:本研究旨在比较现代便携式呼吸器与现代重症监护呼吸器在不同肺环境下的体外性能。设计:便携式和重症监护呼吸器的体外测试。工作地点:苏黎世大学儿童医院麻醉科。主要观察指标:将便携式呼吸器Hamilton T1与重症监护呼吸器bellavista1000 (BV)进行比较,并与ASL 5000 (ASL)装置进行不同设置。ASL可以模拟新生儿、儿童和成人肺功能正常或受损的肺环境。评估输送潮气量、近端和远端气道压力和肺力学特性的准确性。结果:Bland-Altman分析显示,与重症监护呼吸器的15.9% (95% CI -18.5 - 50.3)相比,便携式呼吸器提供的应用潮汐量准确性更高,为12.6%[95%置信区间(CI) -8.9至34.2]。特别是在新生儿和婴儿肺模型中,便携式呼吸器提供的潮汐容量的准确性为13.2% (95%CI -8.9至35.3)优于重症监护呼吸器提供的20.9% (95%CI -15.9至57.7)。重症监护呼吸器对肺顺应性的评估更准确,而便携式呼吸器对气道阻力的评估更准确。然而,两种呼吸器在评估肺力学时仅显示出中等的总体准确性。结论:所研制的便携式呼吸机是一种实用的危重病人有创通气设备。总体性能不逊色于传统的重症监护呼吸器。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The in-vitro performance of a modern portable respirator in different lung models and as an alternative intensive care respirator: A simulation based cohort study.

Background: Transporting ventilated patients safely and without loss of efficacy is a challenge. Portable ventilators are generally used to transport critically ill patients, but their performance is often limited.

Objective: This study aimed to compare the in-vitro performance of a modern portable respirator with a modern intensive care respirator for different lung settings.

Design: An in-vitro testing of a portable and an intensive care respirator.

Settings: Anaesthesia Department at the University Children's Hospital Zurich.

Main outcome measures: The portable respirator Hamilton T1 was compared with the established intensive care respirator bellavista1000 (BV) while applying different settings with the ASL 5000 (ASL) device. The ASL can simulate neonatal, paediatric, and adult lung settings with normal or impaired lung function. Accuracy of delivered tidal volumes, proximal and distal airway pressures and mechanical lung properties were assessed.

Results: Bland-Altman analyses showed higher accuracy for applied tidal volumes delivered by the portable respirator, 12.6% [95% confidence interval (CI) -8.9 to 34.2], compared with the intensive care respirator, 15.9% (95% CI -18.5 to 50.3). In neonatal and infant lung models particularly, the accuracy of delivered tidal volumes by the portable respirator, 13.2% (95% CI -8.9 to 35.3) was superior to those delivered by the intensive care respirator, 20.9% (95%CI -15.9 to 57.7). Lung compliance estimation was performed more accurately by the intensive care respirator, whereas the portable respirator measured airway resistance more accurately. However, both respirators showed only moderate overall accuracy when assessing lung mechanics.

Conclusion: The tested portable respirator proved to be a useful device for invasive ventilation of critically ill patients. The overall performance is non-inferior to a conventional intensive care respirator.

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