Patient–Ventilator Interaction Testing Using the Electromechanical Lung Simulator xPULM™ during V/A-C and PSV Ventilation Mode
During mechanical ventilation, a disparity between flow, pressure and volume demands of the patient and the assistance delivered by the mechanical ventilator often occurs. This paper introduces an alternative approach of simulating and evaluating patient–ventilator interactions with high fidelity us...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-04-01
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| Series: | Applied Sciences |
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| Online Access: | https://www.mdpi.com/2076-3417/11/9/3745 |
| _version_ | 1797536885513388032 |
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| author | Richard Pasteka Joao Pedro Santos da Costa Nelson Barros Radim Kolar Mathias Forjan |
| author_facet | Richard Pasteka Joao Pedro Santos da Costa Nelson Barros Radim Kolar Mathias Forjan |
| author_sort | Richard Pasteka |
| collection | DOAJ |
| description | During mechanical ventilation, a disparity between flow, pressure and volume demands of the patient and the assistance delivered by the mechanical ventilator often occurs. This paper introduces an alternative approach of simulating and evaluating patient–ventilator interactions with high fidelity using the electromechanical lung simulator xPULM™. The xPULM™ approximates respiratory activities of a patient during alternating phases of spontaneous breathing and apnea intervals while connected to a mechanical ventilator. Focusing on different triggering events, volume assist-control (V/A-C) and pressure support ventilation (PSV) modes were chosen to test patient–ventilator interactions. In V/A-C mode, a double-triggering was detected every third breathing cycle, leading to an asynchrony index of 16.67%, which is classified as severe. This asynchrony causes a significant increase of peak inspiratory pressure (7.96 ± 6.38 vs. 11.09 ± 0.49 cmH<sub>2</sub>O, <i>p</i> < 0.01)) and peak expiratory flow (−25.57 ± 8.93 vs. 32.90 ± 0.54 L/min, <i>p</i> < 0.01) when compared to synchronous phases of the breathing simulation. Additionally, events of premature cycling were observed during PSV mode. In this mode, the peak delivered volume during simulated spontaneous breathing phases increased significantly (917.09 ± 45.74 vs. 468.40 ± 31.79 mL, <i>p</i> < 0.01) compared to apnea phases. Various dynamic clinical situations can be approximated using this approach and thereby could help to identify undesired patient–ventilation interactions in the future. Rapidly manufactured ventilator systems could also be tested using this approach. |
| first_indexed | 2024-03-10T12:08:09Z |
| format | Article |
| id | doaj.art-ec45c71679a940789dc67f3ad7341655 |
| institution | Directory Open Access Journal |
| issn | 2076-3417 |
| language | English |
| last_indexed | 2024-03-10T12:08:09Z |
| publishDate | 2021-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Applied Sciences |
| spelling | doaj.art-ec45c71679a940789dc67f3ad73416552023-11-21T16:29:41ZengMDPI AGApplied Sciences2076-34172021-04-01119374510.3390/app11093745Patient–Ventilator Interaction Testing Using the Electromechanical Lung Simulator xPULM™ during V/A-C and PSV Ventilation ModeRichard Pasteka0Joao Pedro Santos da Costa1Nelson Barros2Radim Kolar3Mathias Forjan4Department of Life Science Engineering, University of Applied Sciences Technikum Wien, Hoechstaedtplatz 6, 1200 Vienna, AustriaDepartment of Life Science Engineering, University of Applied Sciences Technikum Wien, Hoechstaedtplatz 6, 1200 Vienna, AustriaCentro Hospitalar de Trás-os-Montes e Alto Douro, EPE Department of Intensive Care and Emergency Care, Lordelo, 5000-508 Vila Real, PortugalDepartment of Biomedical Engineering, Brno University of Technology, Technicka 3058, 61600 Brno, Czech RepublicDepartment of Life Science Engineering, University of Applied Sciences Technikum Wien, Hoechstaedtplatz 6, 1200 Vienna, AustriaDuring mechanical ventilation, a disparity between flow, pressure and volume demands of the patient and the assistance delivered by the mechanical ventilator often occurs. This paper introduces an alternative approach of simulating and evaluating patient–ventilator interactions with high fidelity using the electromechanical lung simulator xPULM™. The xPULM™ approximates respiratory activities of a patient during alternating phases of spontaneous breathing and apnea intervals while connected to a mechanical ventilator. Focusing on different triggering events, volume assist-control (V/A-C) and pressure support ventilation (PSV) modes were chosen to test patient–ventilator interactions. In V/A-C mode, a double-triggering was detected every third breathing cycle, leading to an asynchrony index of 16.67%, which is classified as severe. This asynchrony causes a significant increase of peak inspiratory pressure (7.96 ± 6.38 vs. 11.09 ± 0.49 cmH<sub>2</sub>O, <i>p</i> < 0.01)) and peak expiratory flow (−25.57 ± 8.93 vs. 32.90 ± 0.54 L/min, <i>p</i> < 0.01) when compared to synchronous phases of the breathing simulation. Additionally, events of premature cycling were observed during PSV mode. In this mode, the peak delivered volume during simulated spontaneous breathing phases increased significantly (917.09 ± 45.74 vs. 468.40 ± 31.79 mL, <i>p</i> < 0.01) compared to apnea phases. Various dynamic clinical situations can be approximated using this approach and thereby could help to identify undesired patient–ventilation interactions in the future. Rapidly manufactured ventilator systems could also be tested using this approach.https://www.mdpi.com/2076-3417/11/9/3745biomedical engineeringbreathing simulationelectromechanical lung simulatorpatient–ventilator interactionsrapidly manufactured ventilator systems testing |
| spellingShingle | Richard Pasteka Joao Pedro Santos da Costa Nelson Barros Radim Kolar Mathias Forjan Patient–Ventilator Interaction Testing Using the Electromechanical Lung Simulator xPULM™ during V/A-C and PSV Ventilation Mode Applied Sciences biomedical engineering breathing simulation electromechanical lung simulator patient–ventilator interactions rapidly manufactured ventilator systems testing |
| title | Patient–Ventilator Interaction Testing Using the Electromechanical Lung Simulator xPULM™ during V/A-C and PSV Ventilation Mode |
| title_full | Patient–Ventilator Interaction Testing Using the Electromechanical Lung Simulator xPULM™ during V/A-C and PSV Ventilation Mode |
| title_fullStr | Patient–Ventilator Interaction Testing Using the Electromechanical Lung Simulator xPULM™ during V/A-C and PSV Ventilation Mode |
| title_full_unstemmed | Patient–Ventilator Interaction Testing Using the Electromechanical Lung Simulator xPULM™ during V/A-C and PSV Ventilation Mode |
| title_short | Patient–Ventilator Interaction Testing Using the Electromechanical Lung Simulator xPULM™ during V/A-C and PSV Ventilation Mode |
| title_sort | patient ventilator interaction testing using the electromechanical lung simulator xpulm™ during v a c and psv ventilation mode |
| topic | biomedical engineering breathing simulation electromechanical lung simulator patient–ventilator interactions rapidly manufactured ventilator systems testing |
| url | https://www.mdpi.com/2076-3417/11/9/3745 |
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