Scoring System to Evaluate the Performance of ICU Ventilators in the Pandemic of COVID-19: A Lung Model Study
| Autor: | Fei Xie, Ying Zhao, Xingshuo Hu, Lixin Xie, Hongjun Gu, Qingyun Yang, Ruo-Xuan Wen, Kaifei Wang, Zhanqi Zhao, Guoxin Mo, Knut Möller |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
performance of triggering
medicine.medical_specialty Medicine (General) Scoring system Coronavirus disease 2019 (COVID-19) Respiratory rate Context (language use) law.invention 03 medical and health sciences 0302 clinical medicine R5-920 stability of pressurization law Intensive care accuracy in volume delivery Medicine leakage correction analytic hierarchy process Original Research Lung business.industry Model study scoring system 030208 emergency & critical care medicine General Medicine medicine.anatomical_structure 030228 respiratory system Ventilation (architecture) Emergency medicine ventilator performance business |
| Zdroj: | Frontiers in Medicine Frontiers in Medicine, Vol 8 (2021) |
| ISSN: | 2296-858X |
| Popis: | Ventilators in the intensive care units (ICU) are life-support devices that help physicians to gain additional time to cure the patients. The aim of the study was to establish a scoring system to evaluate the ventilator performance in the context of COVID-19. The scoring system was established by weighting the ventilator performance on five different aspects: the stability of pressurization, response to leaks alteration, performance of reaction, volume delivery, and accuracy in oxygen delivery. The weighting factors were determined with analytic hierarchy process (AHP). Survey was sent out to 66 clinical and mechanical experts. The scoring system was built based on 54 valid replies. A total of 12 commercially available ICU ventilators providing non-invasive ventilation were evaluated using the novel scoring system. A total of eight ICU ventilators with non-invasive ventilation mode and four dedicated non-invasive ventilators were tested according to the scoring system. Four COVID-19 phenotypes were simulated using the ASL5000 lung simulator, namely (1) increased airway resistance (IR) (10 cm H2O/L/s), (2) low compliance (LC) (compliance of 20 ml/cmH2O), (3) low compliance plus increased respiratory effort (LCIE) (respiratory rate of 40 and inspiratory effort of 10 cmH2O), (4) high compliance (HC) (compliance of 50 ml/cmH2O). All of the ventilators were set to three combinations of pressure support and positive end-expiratory pressure levels. The data were collected at baseline and at three customized leak levels. Significant inaccuracies and variations in performance between different non-invasive ventilators were observed, especially in the aspect of leaks alteration, oxygen and volume delivery. Some ventilators have stable performance in different simulated phenotypes whereas the others have over 10% scoring differences. It is feasible to use the proposed scoring system to evaluate the ventilator performance. In the COVID-19 pandemic, clinicians should be aware of possible strengths and weaknesses of ventilators. |
| Databáze: | OpenAIRE |
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