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Research ArticleOriginal Research

Filters Alter the Performance of Noninvasive Ventilators

Julie Tolson, Rodney Hone, Christian Bandiera, Linda Rautela, Thomas J Churchward, Anna Ridgers, Mark E Howard and Christopher J Worsnop
Respiratory Care July 2022, 67 (7) 795-800; DOI: https://doi.org/10.4187/respcare.09365
Julie Tolson
Department of Respiratory and Sleep Medicine, Austin Health, Heidelberg, Victoria, Australia.
Institute for Breathing and Sleep, Heidelberg, Victoria, Australia.
The University of Melbourne, Melbourne, Victoria, Australia.
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  • For correspondence: [email protected]
Rodney Hone
Department of Respiratory and Sleep Medicine, Austin Health, Heidelberg, Victoria, Australia.
Institute for Breathing and Sleep, Heidelberg, Victoria, Australia.
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Christian Bandiera
Swinburne University of Technology, Hawthorn, Victoria, Australia.
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Linda Rautela
Department of Respiratory and Sleep Medicine, Austin Health, Heidelberg, Victoria, Australia.
Institute for Breathing and Sleep, Heidelberg, Victoria, Australia.
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Thomas J Churchward
Department of Respiratory and Sleep Medicine, Austin Health, Heidelberg, Victoria, Australia.
Institute for Breathing and Sleep, Heidelberg, Victoria, Australia.
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Anna Ridgers
Department of Respiratory and Sleep Medicine, Austin Health, Heidelberg, Victoria, Australia.
Institute for Breathing and Sleep, Heidelberg, Victoria, Australia.
The University of Melbourne, Melbourne, Victoria, Australia.
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Mark E Howard
Department of Respiratory and Sleep Medicine, Austin Health, Heidelberg, Victoria, Australia.
Institute for Breathing and Sleep, Heidelberg, Victoria, Australia.
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Christopher J Worsnop
Department of Respiratory and Sleep Medicine, Austin Health, Heidelberg, Victoria, Australia.
Institute for Breathing and Sleep, Heidelberg, Victoria, Australia.
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Abstract

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.

  • COVID-19
  • infectious diseases
  • noninvasive ventilation
  • respiratory failure
  • benchtop study

Footnotes

  • Correspondence: Julie Tolson BAppSc Hons, Department of Respiratory and Sleep Medicine, Austin Health, PO Box 5555, Heidelberg, Victoria, Australia, 3084. E-mail: julie.tolson{at}austin.org.au
  • Dr Howard reports provision of equipment from ResMed and Philips Respironics. The other authors have disclosed no conflicts of interest.

  • Copyright © 2022 by Daedalus Enterprises
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Respiratory Care: 67 (7)
Respiratory Care
Vol. 67, Issue 7
1 Jul 2022
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Filters Alter the Performance of Noninvasive Ventilators
Julie Tolson, Rodney Hone, Christian Bandiera, Linda Rautela, Thomas J Churchward, Anna Ridgers, Mark E Howard, Christopher J Worsnop
Respiratory Care Jul 2022, 67 (7) 795-800; DOI: 10.4187/respcare.09365

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Filters Alter the Performance of Noninvasive Ventilators
Julie Tolson, Rodney Hone, Christian Bandiera, Linda Rautela, Thomas J Churchward, Anna Ridgers, Mark E Howard, Christopher J Worsnop
Respiratory Care Jul 2022, 67 (7) 795-800; DOI: 10.4187/respcare.09365
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Keywords

  • COVID-19
  • infectious diseases
  • noninvasive ventilation
  • respiratory failure
  • benchtop study

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