Bench Evaluation of Three Critical Care Ventilators During Pressure Targeted Modes Ventilation

Abstract

Background: The BellaVista 1000 is a relatively new ventilator. The purpose of this bench study was to determine whether this device performs similar to two commonly used critical care ventilators (Puritan Bennett 980 and Avea CVS) while ventilating in PC AC and CPAP with PSV, in a normal lung model.

Methods: To evaluate each ventilator, the Ingmar Medical ASL 5000 Electronic Breathing Simulator (ASL 5000) was used. The ASL 5000 was used to trigger breaths and simulate patient lung mechanics for a normal lung model: resistance inspiratory 13 cm H₂O/L/s, resistance expiratory 12 cm H₂O/L/s, static compliance 54 mL/cm H₂O, respiratory rate 10 breaths/min, and P_mus 20 cm H₂O. Ventilators evaluated: BellaVista 1000 (Bellavista), Puritan Bennett 980 (PB980), and Avea CVS (Avea). Modes: PC A/C and CPAP with PSV. Ventilator settings: PC A/C: respiratory rate 10 breaths/min, inspiratory pressure 5 cm H₂O, inspiratory time 1 s, PEEP 5 cm H₂O, flow trigger 2 L/min, FIO₂ 0.21. CPAP with PSV: PSV 0 cm H₂O, PEEP 5 cm H₂O, flow trigger 2 L/min, FIO₂ 0.21. Test runs were 4 min long; only the data collected in the middle 2 min was utilized. The recorded values, calculated via the ASL 5000, during each mode of ventilation, during each patient scenario, were analyzed.

Results: Statistical findings concluded that in PC AC, the Bellavista and PB980 have similar values with only a small difference in Ppeak (12 ± .01), PEEP (5 ± .02) and max pressure drop during trigger (-1 ± .01). However, the Avea has a much longer time to trigger (216 ± 3), a much greater max pressure drop during trigger (-3 ± .01), as well as a larger difference in the time between Pmin and PEEP (216 ± 2). In CPAP-PSV, the Bellavista, PB 980 and Avea showed similar trends as when they were in PC-AC.

Conclusions: Not all ventilators respond similarly under similar conditions. It is important to ensure that the ventilator adequately meets the patient’s needs. The information gathered in this study demonstrated that the Bellavista 1000 is similar to the PB 980 with respect to the Ppeak, PEEP, max pressure drop during trigger, inspiratory volume, time to Pmin after start of effort, time to Pmin, and PEEP. Further testing, under additional conditions, is necessary to verify the results.

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