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Research ArticleOriginal Research

A Comparison of Leak Compensation During Pediatric Noninvasive Ventilation: A Lung Model Study

Jun Oto, Christopher T Chenelle, Andrew D Marchese and Robert M Kacmarek
Respiratory Care February 2014, 59 (2) 241-251; DOI: https://doi.org/10.4187/respcare.02616
Jun Oto
Respiratory Care Services, Massachusetts General Hospital, Boston, Massachusetts.
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Christopher T Chenelle
Respiratory Care Services, Massachusetts General Hospital, Boston, Massachusetts.
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Andrew D Marchese
Respiratory Care Services, Massachusetts General Hospital, Boston, Massachusetts.
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Robert M Kacmarek
Respiratory Care Services, Massachusetts General Hospital, Boston, Massachusetts.
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  • For correspondence: [email protected]
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  • Fig. 1.
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    Fig. 1.

    Experimental setup for studying ventilator performance in pediatric noninvasive ventilation scenarios.

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    Fig. 2.

    Synchronization rates with 3 simulated body weights (10, 20, and 30 kg), 3 lung mechanics conditions (normal, obstructive, and restrictive), and 4 leak levels: baseline (BL) 2–3 L/min, L1 5–6 L/min, L2 9–10 L/min, and L3 19–20 L/min. Synchronization rate increased with body weight (P < .001). Synchronization rates were lower in the obstructive model than in the normal and the restrictive models (P < .001). As leak increased, synchronization rate decreased (P < .001). The bars show mean values.

  • Fig. 3.
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    Fig. 3.

    Types of asynchrony (auto-triggering, missed-triggering, and delayed cycling) as a percentage of the total simulated breaths. Premature cycling is not shown because it occurred only with the PB840 and in < 0.1% of simulated breaths. The bars show mean values.

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    Fig. 4.

    Percentage of simulated breaths that had auto-triggering, relative to body weight, lung mechanics scenario, and leak level (as in Fig. 3). Auto-triggering rate were not associated with body weight (P = .10). Auto-triggering was lower in the obstructive model than in the normal and restrictive models (P < .001). As leak increased, auto-triggering rate increased (P < .001). The bars show mean values.

  • Fig. 5.
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    Fig. 5.

    Percentage of simulated breaths that had miss-triggering, relative to body weight, lung mechanics scenario, and leak level (as in Fig. 3). Miss-triggering increased with decreased body weight (P < .001). Miss-triggering was higher in the obstructive model than in the normal and restrictive models (P < .001). Miss-triggering was not associated with leak level (P = .06). The bars show mean values.

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Respiratory Care: 59 (2)
Respiratory Care
Vol. 59, Issue 2
1 Feb 2014
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A Comparison of Leak Compensation During Pediatric Noninvasive Ventilation: A Lung Model Study
Jun Oto, Christopher T Chenelle, Andrew D Marchese, Robert M Kacmarek
Respiratory Care Feb 2014, 59 (2) 241-251; DOI: 10.4187/respcare.02616

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A Comparison of Leak Compensation During Pediatric Noninvasive Ventilation: A Lung Model Study
Jun Oto, Christopher T Chenelle, Andrew D Marchese, Robert M Kacmarek
Respiratory Care Feb 2014, 59 (2) 241-251; DOI: 10.4187/respcare.02616
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Keywords

  • leak compensation
  • pediatric noninvasive ventilation
  • acute care ventilator

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