A Comprehensive Bench Assessment of Automatic Tube Compensation in ICU Ventilators for Better Clinical Management.

airflow resistance automatic tube compensation endotracheal tube mechanical ventilation weaning

Journal

Respiratory care
ISSN: 1943-3654
Titre abrégé: Respir Care
Pays: United States
ID NLM: 7510357

Informations de publication

Date de publication:
Dec 2020
Historique:
pubmed: 2 7 2020
medline: 23 2 2021
entrez: 2 7 2020
Statut: ppublish

Résumé

Automatic tube compensation (ATC) unloads endotracheal tube (ETT) resistance. We conducted a bench assessment of ATC functionality in ICU ventilators to improve clinical management. This study had 2 phases. First, we performed an international survey on the use of ATC in clinical practice, hypothesizing a rate of ATC use of 25%. Second, we tested 7 modern ICU ventilators in a lung model mimicking a normal subject (Normal), a subject with ARDS, and a subject with COPD. Inspiratory effort consisted of esophageal pressure over 30 consecutive breaths obtained in a real patient under weaning. A brand new 8-mm inner diameter ETT was attached to the lung model, and ATC was set at 100% compensation for the ETT. The 30 breaths were first run with ATC off and no ETT (ie, reference period), and then with ATC on and ETT (ie, active period). The primary end point was the difference in tidal volume (V The clinical use of ATC was 64% according to 644 individuals who responded to the international survey. The V ATC is used more frequently in clinical practice than expected. In addition, V

Sections du résumé

BACKGROUND BACKGROUND
Automatic tube compensation (ATC) unloads endotracheal tube (ETT) resistance. We conducted a bench assessment of ATC functionality in ICU ventilators to improve clinical management.
METHODS METHODS
This study had 2 phases. First, we performed an international survey on the use of ATC in clinical practice, hypothesizing a rate of ATC use of 25%. Second, we tested 7 modern ICU ventilators in a lung model mimicking a normal subject (Normal), a subject with ARDS, and a subject with COPD. Inspiratory effort consisted of esophageal pressure over 30 consecutive breaths obtained in a real patient under weaning. A brand new 8-mm inner diameter ETT was attached to the lung model, and ATC was set at 100% compensation for the ETT. The 30 breaths were first run with ATC off and no ETT (ie, reference period), and then with ATC on and ETT (ie, active period). The primary end point was the difference in tidal volume (V
RESULTS RESULTS
The clinical use of ATC was 64% according to 644 individuals who responded to the international survey. The V
CONCLUSIONS CONCLUSIONS
ATC is used more frequently in clinical practice than expected. In addition, V

Identifiants

pubmed: 32606077
pii: respcare.07608
doi: 10.4187/respcare.07608
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1864-1873

Informations de copyright

Copyright © 2020 by Daedalus Enterprises.

Déclaration de conflit d'intérêts

The authors have disclosed no conflicts of interest.

Auteurs

Louis-Marie Galerneau (LM)

Médecine Intensive Réanimation, Université de Grenoble-Alpes, Grenoble, France.
INSERM 1042, Grenoble, France.

Nicolas Terzi (N)

Médecine Intensive Réanimation, Université de Grenoble-Alpes, Grenoble, France.
INSERM 1042, Grenoble, France.

Emanuele Turbil (E)

Anesthesiology and Critical Care Department, Università degli studi di Sassari, Sassari,Italy.

Zakaria Riad (Z)

Anesthesiology Department, Groupement Hospitalier Est, Lyon, France.

Carole Schwebel (C)

Médecine Intensive Réanimation, Université de Grenoble-Alpes, Grenoble, France.
INSERM 1042, Grenoble, France.

Martin Cour (M)

Médecine Intensive Réanimation, Groupement Hospitalier Centre, Hopital Edouard Herriot, Université de Lyon, Lyon, France.

Laurent Argaud (L)

Médecine Intensive Réanimation, Groupement Hospitalier Centre, Hopital Edouard Herriot, Université de Lyon, Lyon, France.

Claude Guérin (C)

Médecine Intensive Réanimation, Groupement Hospitalier Centre, Hopital Edouard Herriot, Université de Lyon, Lyon, France. claude.guerin@chu-lyon.fr.
INSERM 955, Créteil, France.

Bruno Louis (B)

Institut Mondor de Recherche Biomédicale, Université Paris Est Créteil, INSERM 955, Créteil, France.

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Classifications MeSH