Author: Volsko Teresa A Hoffman Justin Conger Alecia Chatburn Robert L
Publisher: The Journal Respiratory Care Company
ISSN: 0020-1324
Source: Respiratory Care, Vol.57, Iss.8, 2012-08, pp. : 1297-1304
Disclaimer: Any content in publications that violate the sovereignty, the constitution or regulations of the PRC is not accepted or approved by CNPIEC.
Abstract
BACKGROUND: Technological advances have increased ventilator mode complexity and risk of operator error. OBJECTIVE: To compare differences in volume control (VC) ventilation with set-point and dual targeting. Two hypotheses were tested: tidal volume (VT) delivery is different with VC using set-point versus dual targeting during active versus passive breathing; VC with dual targeting delivers VT similar to pressure support ventilation (PS) with active breathing. METHODS: The Ingmar Medical ASL 5000 lung model simulated pulmonary mechanics of an adult patient with ARDS during active and passive ventilation. Resistance was standardized at 10 cm H2O/L/s and compliance at 32 mL/cm H2O. Active breathing was simulated by setting the frequency (f) = 26 breaths/min, and adjusting the muscle pressure (Pmus) to produce a VT of 384 mL. VC was initiated with the Puritan Bennett 840 (set-point targeting) and the Servo-i (dual targeting) at VT = 430 mL, mandatory f = 15 breaths/min, and PEEP = 10 cm H2O. During PS, cycle threshold was set to 30% and peak inspiratory pressure adjusted to produce a VT similar to that delivered during VC. Expiratory VT was collected on 10 consecutive breaths during active and passive breathing with VC and PS. Mean VT differences (active vs passive model) were compared using analysis of variance. Statistical significance was established at
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