Authors: Jean Dellamonica Bruno Louis Aissam Lyazidi Frédéric Vargas Laurent Brochard
Publish Date: 2008/07/01
Volume: 34, Issue: 11, Pages: 2035-2043
Abstract
Intrapulmonary percussive ventilation IPV is a form of highfrequency ventilation that can be superimposed on spontaneous breathing or conventional ventilation Drawbacks include difficulties achieving adequate airway humidification and an inability to monitor delivered volumes and pressures which may vary with patient characteristics The objectives of this study were to assess various humidification setups to measure intrapulmonary pressures and volumes resulting from IPV superimposed on a conventional driving ventilator DV and to test several ventilators regarding their ability to accept added IPVBench study in a testlung setup was used to measure humidification and the effects of adding IPV to a DV under various conditions of compliance resistance plateau and positive endexpiratory pressures Then five ventilators were tested in combination with IPVAdequate humidification required a heated humidifier on the inspiratory line downstream of the IPV device IPV increased endinspiratory intrapulmonary pressures up to 10 cmH2O increased delivered volumes up to 237 ml and generated intrinsic PEEP from 17 to 43 cmH2O when no PEEP was set on the DV Intrinsic PEEP was lower or absent when PEEP was set on the DV With most tested ventilators IPV prevented reliable flow monitoring Autotriggering and missing cycles were common and the PEEP effect varied across DVsAchieving adequate humidification with IPV requires a specific setup Superimposing IPV on standard ventilation can increase intrapulmonary pressures and tidal volumes importantly and interfere with the triggering sensors of the ventilator These factors must be taken into account before clinical use
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