一种新型医疗器械在单台机械呼吸机下对两名受试者联合通气的体外研究

IF 1.6 Q2 ANESTHESIOLOGY
Anesthesiology Research and Practice Pub Date : 2021-02-18 eCollection Date: 2021-01-01 DOI:10.1155/2021/6691591
Ignacio Lugones, Matías Ramos, María Fernanda Biancolini, Roberto Orofino Giambastiani
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引用次数: 2

摘要

SARS-CoV-2大流行导致呼吸机突然短缺。DuplicARⓇ是一种新颖的设备,可以使用单个呼吸机同时独立地对两名受试者进行通气。本研究的目的是(a)确定DuplicARⓇ在压力控制通气和容积控制通气条件下独立调节每位受试者呼气峰压和呼气正端压的效果;(b)确定DuplicARⓇ表现出最佳性能和安全性的通气模式。材料和方法:使用DuplicARⓇ将两个测试肺连接到单个呼吸机上。建立了三个实验阶段:(1)两个相同的被试,(2)两个体重相同但肺顺应性不同的被试,(3)两个体重不同但肺顺应性不同的被试。在每个阶段,试验肺以两种通气模式通气。其中一名受试者呼气末正压要求依次升高。目标是通过操纵呼吸机和DuplicARⓇ控制器,使每个受试者在所有不同阶段的潮气量达到7 ml/kg。结果:DuplicARⓇ允许两名体重和/或肺顺应性和/或PEEP要求不同的受试者进行充分的通气。这是通过调节两名受试者的总潮气量(在容积控制通气中)或所需的最高峰值压力(在压力控制通气中)以及呼吸机的基本呼气正端压力来实现的,同时操纵DuplicARⓇ控制器来降低需要较少的受试者的潮气量或峰值压力和/或增加需要较多的受试者的呼气正端压力。虽然通风目标可以在任何通风模式下实现,但DuplicARⓇ在压力控制通风中表现更好,因为一个受试者变量的变化不会改变另一个受试者。结论:DuplicARⓇ是一种有效的工具,可以独立管理两名连接一台呼吸机的受试者的峰值吸气压力和呼气正端压力。驱动压力可调节,以满足不同体重和肺顺应性受试者的要求。压力控制通风比容积控制通风有优点,因此是推荐的通风方式。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Combined Ventilation of Two Subjects with a Single Mechanical Ventilator Using a New Medical Device: An In Vitro Study.

Combined Ventilation of Two Subjects with a Single Mechanical Ventilator Using a New Medical Device: An In Vitro Study.

Combined Ventilation of Two Subjects with a Single Mechanical Ventilator Using a New Medical Device: An In Vitro Study.

Introduction: The SARS-CoV-2 pandemic has created a sudden lack of ventilators. DuplicAR is a novel device that allows simultaneous and independent ventilation of two subjects with a single ventilator. The aims of this study are (a) to determine the efficacy of DuplicAR to independently regulate the peak and positive-end expiratory pressures in each subject, both under pressure-controlled ventilation and volume-controlled ventilation and (b) to determine the ventilation mode in which DuplicAR presents the best performance and safety.

Materials and methods: Two test lungs are connected to a single ventilator using DuplicAR. Three experimental stages are established: (1) two identical subjects, (2) two subjects with the same weight but different lung compliance, and (3) two subjects with different weights and lung compliances. In each stage, the test lungs are ventilated in two ventilation modes. The positive-end expiratory pressure requirements are increased successively in one of the subjects. The goal is to achieve a tidal volume of 7 ml/kg for each subject in all different stages through manipulation of the ventilator and the DuplicAR controllers.

Results: DuplicAR allows adequate ventilation of two subjects with different weights and/or lung compliances and/or PEEP requirements. This is achieved by adjusting the total tidal volume for both subjects (in volume-controlled ventilation) or the highest peak pressure needed (in pressure-controlled ventilation) along with the basal positive-end expiratory pressure on the ventilator and simultaneously manipulating the DuplicAR controllers to decrease the tidal volume or the peak pressure in the subject that needs less and/or to increase the positive-end expiratory pressure in the subject that needs more. While ventilatory goals can be achieved in any of the ventilation modes, DuplicAR performs better in pressure-controlled ventilation, as changes experienced in the variables of one subject do not modify the other one.

Conclusions: DuplicAR is an effective tool to manage the peak inspiratory pressure and the positive-end expiratory pressure independently in two subjects connected to a single ventilator. The driving pressure can be adjusted to meet the requirements of subjects with different weights and lung compliances. Pressure-controlled ventilation has advantages over volume-controlled ventilation and is therefore the recommended ventilation mode.

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