RT Journal Article
SR Electronic
T1 Filters Alter the Performance of Noninvasive Ventilators
JF Respiratory Care
FD American Association for Respiratory Care
SP 795
OP 800
DO 10.4187/respcare.09365
VO 67
IS 7
A1 Tolson, Julie
A1 Hone, Rodney
A1 Bandiera, Christian
A1 Rautela, Linda
A1 Churchward, Thomas J
A1 Ridgers, Anna
A1 Howard, Mark E
A1 Worsnop, Christopher J
YR 2022
UL http://rc.rcjournal.com/content/67/7/795.abstract
AB BACKGROUND: Noninvasive ventilation is recommended in hypercapnic respiratory failure secondary to ventilatory failure. Noninvasive ventilation may contribute to aerosol dispersion, which may increase the risk of transmission of COVID 2019. The addition of filters to the ventilator circuit has been recommended to reduce this risk. The aim of this benchtop study was to investigate the impact of adding filters to a ventilator circuit.METHODS: In this benchtop study, a breathing simulator was used with 4 commonly used ventilators. Ventilators were set to approximate the typical settings that are used for patients on long-term noninvasive ventilation. Ventilator performance was then evaluated with 3 circuit configurations in place: circuit A: no filter in situ; circuit B: 1 filter at the simulator end of the circuit; and circuit C: 1 filter at the simulator end of the circuit and a second filter at the ventilator end of the circuit.RESULTS: Ventilator variables were impacted by the addition of filters. Measurements of peak pressure (P < .001), tidal volume (P < .001), and peak flow (P < .001) decreased between circuit A and circuit C in all ventilators that were tested. Ventilator triggering was less sensitive in 3 of the 4 ventilators and the fourth ventilator did not trigger under the same simulator settings.CONCLUSIONS: This study demonstrated that ventilator settings established with filters in situ are not applicable if the ventilator is used without the filters. This is an important clinical consideration for patients who are hospitalized and require noninvasive ventilation in the COVID 2019 era.