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 1329
OP 1337
DO 10.4187/respcare.03031
VO 59
IS 9
A1 Khirani, Sonia
A1 Ramirez, Adriana
A1 Delord, Vincent
A1 Leroux, Karl
A1 Lofaso, Frédéric
A1 Hautot, Solène
A1 Toussaint, Michel
A1 Orlikowski, David
A1 Louis, Bruno
A1 Fauroux, Brigitte
YR 2014
UL http://rc.rcjournal.com/content/59/9/1329.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.