کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
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4211259 | 1280632 | 2009 | 7 صفحه PDF | دانلود رایگان |

SummaryAir leaks often result in alveolar hypoventilation in mechanically ventilated patients with neuromuscular disease. The primary objective of this study was to assess the feasibility, efficacy and tolerance of a ventilator equipped with an automated air-leak compensation system in a clinical situation. Fourteen neuromuscular patients with nocturnal air leaks during home ventilation were included in a prospective randomised crossover study. A modified VS Ultra ventilator was studied during two consecutive nights and patients were randomly ventilated with and without a leak-compensation system, respectively. Tolerance, minute ventilation, blood gas values, sleep parameters, and nocturnal oxygen saturation were assessed. Leak compensation significantly increased the mean inspiratory and expiratory tidal volumes (731 ± 312 vs. 1094 ± 432 ml [p = 0.002] and 329 ± 130 vs. 496 ± 388 ml [p = 0.006], respectively) and inspiratory and expiratory flows (51.7 ± 8.2 vs. 61.8 ± 12.4 l/min [p = 0.016] and 63.3 ± 26.2 vs. 83.3 ± 37.8 l/min [p = 0.013], respectively). The system acted by increasing both inspiratory time (from 1355 ± 230 to 1527 ± 159 ms, p = 0.038) and inspiratory pressure (from 14.0 ± 2.8 to 18.3 ± 3.4 cm H2O, p = 0.002). Leak compensation improved arterial PCO2 (6.18 ± 0.9 vs. 5.21 ± 1.0 kPa, p = 0.004), slow-wave-sleep latency (119 ± 69 vs. 87 ± 35 min, p = 0.04), and tolerance. Air-leak compensation is feasible and may produce beneficial effects in neuromuscular patients. The automatic air-leak compensation system tested here should be evaluated in long-term efficacy and tolerance studies and compared to other ventilation modes capable of compensating for leaks, such as pressure support.
Journal: Respiratory Medicine - Volume 103, Issue 2, February 2009, Pages 173–179