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首页> 外文期刊>Intensive care medicine >A bench study of intensive-care-unit ventilators: new versus old and turbine-based versus compressed gas-based ventilators.
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A bench study of intensive-care-unit ventilators: new versus old and turbine-based versus compressed gas-based ventilators.

机译：重症监护室呼吸机的基准研究：新式呼吸机与旧式呼吸机，涡轮式呼吸机与压缩式气体呼吸机。

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OBJECTIVE: To compare 13 commercially available, new-generation, intensive-care-unit (ICU) ventilators in terms of trigger function, pressurization capacity during pressure-support ventilation (PSV), accuracy of pressure measurements, and expiratory resistance. DESIGN AND SETTING: Bench study at a research laboratory in a university hospital. METHODS: Four turbine-based ventilators and nine conventional servo-valve compressed-gas ventilators were tested using a two-compartment lung model. Three levels of effort were simulated. Each ventilator was evaluated at four PSV levels (5, 10, 15, and 20 cm H2O), with and without positive end-expiratory pressure (5 cm H2O). Trigger function was assessed as the time from effort onset to detectable pressurization. Pressurization capacity was evaluated using the airway pressure-time product computed as the net area under the pressure-time curve over the first 0.3 s after inspiratory effort onset. Expiratory resistance was evaluated by measuring trapped volume in controlled ventilation. RESULTS: Significant differences were found across the ventilators, with a range of triggering delays from 42 to 88 ms for all conditions averaged (P < 0.001). Under difficult conditions, the triggering delay was longer than 100 ms and the pressurization was poor for five ventilators at PSV5 and three at PSV10, suggesting an inability to unload patient's effort. On average, turbine-based ventilators performed better than conventional ventilators, which showed no improvement compared to a bench comparison in 2000. CONCLUSION: Technical performance of trigger function, pressurization capacity, and expiratory resistance differs considerably across new-generation ICU ventilators. ICU ventilators seem to have reached a technical ceiling in recent years, and some ventilators still perform inadequately.
机译：目的：比较13种市售的新一代重症监护病房（ICU）呼吸机的触发功能，压力支持通气（PSV）期间的加压能力，压力测量的准确性和呼气阻力。设计与设置：在大学医院的研究实验室进行基准研究。方法：使用两室肺模型测试了四台基于涡轮的呼吸机和九台常规的伺服阀压缩气体呼吸机。模拟了三个级别的努力。在有和没有正呼气末压（5 cm H2O）的情况下，在四个PSV水平（5、10、15和20 cm H2O）下评估每个呼吸机。触发功能被评估为从努力发作到可检测到的加压时间。使用吸气开始后最初0.3 s内的气道压力时间乘积，以压力时间曲线下的净面积计算得出的加压能力。通过测量受控通气中的滞留量来评估呼气阻力。结果：发现各呼吸机之间存在显着差异，所有条件下的平均触发延迟范围为42到88 ms（P <0.001）。在困难的条件下，触发延迟时间超过100毫秒，并且PSV5处的5台呼吸机和PSV10处的3台呼吸机的加压不佳，表明无法减轻患者的负担。平均而言，基于涡轮的呼吸机的性能优于传统的呼吸机，与2000年的台式试验相比没有任何改善。结论：触发功能，增压能力和呼气阻力的技术性能在新一代ICU呼吸机上差异很大。近年来，ICU呼吸机似乎已达到技术上限，有些呼吸机仍表现不佳。

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