A self-regulated expiratory flow device for mechanical ventilation: a bench study.

Energy dissipation Expiratory resistive load Flow-controlled expiration Mandatory ventilation

Journal

Intensive care medicine experimental
ISSN: 2197-425X
Titre abrégé: Intensive Care Med Exp
Pays: Germany
ID NLM: 101645149

Informations de publication

Date de publication:
16 Oct 2024
Historique:
received: 16 05 2024
accepted: 03 10 2024
medline: 17 10 2024
pubmed: 17 10 2024
entrez: 16 10 2024
Statut: epublish

Résumé

Unregulated expiratory flow may contribute to ventilator-induced lung injury. The amount of energy dissipated into the lungs with tidal mechanical ventilation may be used to quantify potentially injurious ventilation. Previously reported devices for variable expiratory flow regulation (FLEX) require, either computer-controlled feedback, or an initial expiratory flow trigger. In this bench study we present a novel passive expiratory flow regulation device. The device was tested using a commercially available mechanical ventilator with a range of settings (tidal volume 420 ml and 630 ml, max. inspiratory flow rate 30 L/min and 50 L/min, respiratory rate 10 min Maximal and minimal reduction in peak expiratory flow was from 97.18 ± 0.41 L/min to 25.82 ± 0.07 L/min (p < 0.001), and from 44.11 ± 0.42 L/min to 26.30 ± 0.06 L/min, respectively. Maximal prolongation in expiratory time was recorded from 1.53 ± 0.06 s to 3.64 ± 0.21 s (p < 0.001). As a result of the extended expiration, the maximal decrease in I:E ratio was from 1:1.15 ± 0.03 to 1:2.45 ± 0.01 (p < 0.001). The greatest increase in mean airway pressure was from 10.04 ± 0.03 cmH The device bench tested in this study demonstrated a significant reduction in peak expiratory flow rate and dissipated energy, compared to ventilation with unregulated expiratory flow. Application of the device warrants further experimental and clinical evaluation.

Identifiants

DOI: 10.1186/s40635-024-00681-0 PMID: 39414708
pubmed: 39414708
doi: 10.1186/s40635-024-00681-0
pii: 10.1186/s40635-024-00681-0
doi:

Types de publication

Journal Article

Langues

eng

Pagination

92

Informations de copyright

© 2024. The Author(s).

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Auteurs

Lianye Yang (L)

Biomedical Engineering Department, Flinders Medical Centre, South Adelaide Local Health Network, Adelaide, SA, Australia.

Ubbo F Wiersema (UF)

Intensive and Critical Care Unit, Flinders Medical Centre, South Adelaide Local Health Network, Flinders Lane, Bedford Park, Adelaide, SA, 5042, Australia.

Shailesh Bihari (S)

Intensive and Critical Care Unit, Flinders Medical Centre, South Adelaide Local Health Network, Flinders Lane, Bedford Park, Adelaide, SA, 5042, Australia. Shailesh.Bihari@sa.gov.au.
College of Medicine and Public Health, Flinders University, Adelaide, Australia. Shailesh.Bihari@sa.gov.au.
ORCID: 0000-0001-7553-8620

Roy Broughton (R)

Biomedical Engineering Department, Flinders Medical Centre, South Adelaide Local Health Network, Adelaide, SA, Australia.

Andy Roberts (A)

Biomedical Engineering Department, Flinders Medical Centre, South Adelaide Local Health Network, Adelaide, SA, Australia.

Nigel Kelley (N)

Biomedical Engineering Department, Flinders Medical Centre, South Adelaide Local Health Network, Adelaide, SA, Australia.

Mark McEwen (M)

Biomedical Engineering Department, Flinders Medical Centre, South Adelaide Local Health Network, Adelaide, SA, Australia.

Classifications MeSH