TY - JOUR T1 - Feasibility and Efficacy of Pulsed-Dose Oxygen Delivery During Noninvasive Ventilation JF - Respiratory Care SP - 1323 LP - 1332 DO - 10.4187/respcare.06922 VL - 65 IS - 9 AU - Li-Li Li AU - Hai-Yin Yang AU - Hong Jin AU - Bing Dai AU - Yun Peng AU - Wei Tan Y1 - 2020/09/01 UR - http://rc.rcjournal.com/content/65/9/1323.abstract N2 - BACKGROUND: It is difficult to apply noninvasive ventilation (NIV) simultaneously with pulsed-dose oxygen delivery. We evaluated the feasibility and efficacy of pulsed-dose oxygen delivery during NIV.METHODS: A bench study was conducted using a simulated lung during NIV, with a breathing frequency of 10 or 20 breaths/min and 3 oxygen injection sites (site A on face mask, site B proximal to face mask, and site C at the ventilator outlet) with continuous flow oxygen delivery of 1, 3, or 5 L/min) or pulsed-dose oxygen delivery (numerical settings of 1, 3, or 5 representing the oxygen pulse characteristics). under different experimental conditions and the influence of mode of oxygen delivery on NIV (compared to baseline and continuous flow oxygen delivery vs pulsed-dose oxygen delivery) were compared. In the clinical study, we enrolled 10 subjects with COPD exacerbation who received NIV with either continuous flow oxygen delivery or pulsed-dose oxygen delivery. Under the same targeted pulse oxygen saturation (88–92%), the numerical settings of different modes of oxygen delivery were titrated, and the clinical parameters during the different modes of oxygen delivery were compared.RESULTS: In the bench study, the ratio of the with pulsed-dose oxygen delivery to the with continuous flow oxygen delivery at the same numerical setting was 0.94 ± 0.15. The oxygen injection site had a significant influence on in pulsed-dose oxygen delivery or continuous flow oxygen delivery mode (P < .05). Pulsed-dose oxygen delivery worked effectively with the ventilator, as demonstrated by the fine synchronization in the breathing cycle of the ventilator, the simulated lung, and the pulsed-dose oxygen delivery. When compared with each other or compared to the baseline individually, pulsed-dose oxygen delivery and continuous flow oxygen delivery showed no clinically important effects on NIV (all P > .05 or changes < 10%). In the clinical study, the mean numerical settings for pulsed-dose oxygen delivery and continuous flow oxygen delivery modes after titration were 2.68 ± 0.32 and 2.31 ± 0.56 L/min, respectively. There was no significant difference between continuous flow oxygen delivery and pulsed-dose oxygen delivery (P > .05).CONCLUSIONS: Integration of pulsed-dose oxygen delivery into NIV could achieve efficacy similar to that achieved with continuous flow oxygen delivery. ER -