Zobrazit v EDS

Volume-targeted ventilation with a Fabian ventilator: maintenance of tidal volumes and blood CO2.

Uloženo v:
Podrobná bibliografie
Název: Volume-targeted ventilation with a Fabian ventilator: maintenance of tidal volumes and blood CO2.
Autoři: Belteki, Gusztav, Széll, András, Lantos, Lajos, Kovács, Gabor, Szántó, Gyula, Berényi, Aniko, Szilágyi, Mónika, Liszkay, Gábor, Kőhalmi, Ferenc, Morley, Colin J., Somogyvári, Zsolt
Zdroj: Archives of Disease in Childhood -- Fetal & Neonatal Edition; May2020, Vol. 105 Issue 3, pF253-F258, 6p, 1 Chart, 4 Graphs
Témata: BLOOD volume, PYTHON programming language, POSITIVE end-expiratory pressure, PARTIAL pressure, INVERSE relationships (Mathematics), ENDOTRACHEAL suctioning
Abstrakt: Objective: To analyse the performance of the Fabian +NCPAP evolution ventilator during volume guarantee (VG) ventilation in neonates at maintaining the target tidal volume and what tidal and minute volumes are required to maintain normocapnia.Methods: Clinical and ventilator data were collected and analysed from 83 infants receiving VG ventilation during interhospital transfer. Sedation was used in 26 cases. Ventilator data were downloaded with a sampling rate of 0.5 Hz. Data were analysed using the Python computer language and its data analysis packages.Results: ~107 hours of ventilator data were analysed, consisting of ~194 000 data points. The median absolute difference between the actual expiratory tidal volume (VTe) of the ventilator inflations and the target tidal volume (VTset) was 0.29 mL/kg (IQR: 0.11-0.79 mL/kg). Overall, VTe was within 1 mL/kg of VTset in 80% of inflations. VTe decreased progressively below the target when the endotracheal tube leak exceeded 50%. When leak was below 50%, VTe was below VTset by >1 mL/kg in less than 12% of inflations even in babies weighing less than 1000 g. Both VTe (r=-0.34, p=0.0022) and minute volume (r=-0.22, p=0.0567) showed a weak inverse correlation with capillary partial pressure of carbon dioxide (Pco2) values. Only 50% of normocapnic blood gases were associated with tidal volumes between 4 and 6 mL/kg.Conclusions: The Fabian ventilator delivers volume-targeted ventilation with high accuracy if endotracheal tube leakage is not excessive and the maximum allowed inflating pressure does not limit inflations. There is only weak inverse correlation between tidal or minute volumes and Pco2. [ABSTRACT FROM AUTHOR]
Copyright of Archives of Disease in Childhood -- Fetal & Neonatal Edition is the property of BMJ Publishing Group and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Databáze: Complementary Index
Popis
Abstrakt:<bold>Objective: </bold>To analyse the performance of the Fabian +NCPAP evolution ventilator during volume guarantee (VG) ventilation in neonates at maintaining the target tidal volume and what tidal and minute volumes are required to maintain normocapnia.<bold>Methods: </bold>Clinical and ventilator data were collected and analysed from 83 infants receiving VG ventilation during interhospital transfer. Sedation was used in 26 cases. Ventilator data were downloaded with a sampling rate of 0.5 Hz. Data were analysed using the Python computer language and its data analysis packages.<bold>Results: </bold>~107 hours of ventilator data were analysed, consisting of ~194 000 data points. The median absolute difference between the actual expiratory tidal volume (VTe) of the ventilator inflations and the target tidal volume (VTset) was 0.29 mL/kg (IQR: 0.11-0.79 mL/kg). Overall, VTe was within 1 mL/kg of VTset in 80% of inflations. VTe decreased progressively below the target when the endotracheal tube leak exceeded 50%. When leak was below 50%, VTe was below VTset by >1 mL/kg in less than 12% of inflations even in babies weighing less than 1000 g. Both VTe (r=-0.34, p=0.0022) and minute volume (r=-0.22, p=0.0567) showed a weak inverse correlation with capillary partial pressure of carbon dioxide (Pco2) values. Only 50% of normocapnic blood gases were associated with tidal volumes between 4 and 6 mL/kg.<bold>Conclusions: </bold>The Fabian ventilator delivers volume-targeted ventilation with high accuracy if endotracheal tube leakage is not excessive and the maximum allowed inflating pressure does not limit inflations. There is only weak inverse correlation between tidal or minute volumes and Pco2. [ABSTRACT FROM AUTHOR]
ISSN:13592998
DOI:10.1136/archdischild-2019-317152