RT Journal Article
SR Electronic
T1 Evaluation of Ventilators for Mouthpiece Ventilation in Neuromuscular Disease
JF Respiratory Care
FD American Association for Respiratory Care
SP respcare.03031
DO 10.4187/respcare.03031
A1 Sonia Khirani
A1 Adriana Ramirez
A1 Vincent Delord
A1 Karl Leroux
A1 Frédéric Lofaso
A1 Solène Hautot
A1 Michel Toussaint
A1 David Orlikowski
A1 Bruno Louis
A1 Brigitte Fauroux
YR 2014
UL http://rc.rcjournal.com/content/early/2014/07/10/respcare.03031.abstract
AB BACKGROUND: Daytime mouthpiece ventilation is a useful adjunct to nocturnal noninvasive ventilation (NIV) in patients with neuromuscular disease. The aims of the study were to analyze the practice of mouthpiece ventilation and to evaluate the performance of ventilators for mouthpiece ventilation. METHODS: Practice of mouthpiece ventilation was assessed by a questionnaire, and the performance of 6 home ventilators with mouthpiece ventilation was assessed in a bench test using 24 different conditions per ventilator: 3 mouthpieces, a child and an adult patient profile, and 4 ventilatory modes. RESULTS: Questionnaires were obtained from 30 subjects (mean age 33 ± 11 y) using NIV for 12 ± 7 y. Fifteen subjects used NIV for > 20 h/day, and 11 were totally ventilator-dependent. The subject-reported benefits of mouthpiece ventilation were a reduction in dyspnea (73%) and fatigue (93%) and an improvement in speech (43%) and eating (27%). The bench study showed that none of the ventilators, even those with mouthpiece ventilation software, were able to deliver mouthpiece ventilation without alarms and/or autotriggering in each condition. Alarms and/or ineffective triggering or autotriggering were observed in 135 of the 198 conditions. The occurrence of alarms was more common with a large mouthpiece without a filter compared to a small mouthpiece with a filter (P < .001), but it was not related to the patient profile, the ventilatory mode, or the type of ventilator. CONCLUSIONS: Subjects are satisfied with mouthpiece ventilation. Alarms are common with home ventilators, although less common in those with mouthpiece ventilation software. Improvements in home ventilators are needed to facilitate the expansion of mouthpiece ventilation.