Simple low-cost construction and calibration of accurate pneumotachographs for monitoring mechanical ventilation in low-resource settings.
calibration
flow measurement
low- and middle-income countries
mechanical ventilation
pneumotachograph
tidal volume
Journal
Frontiers in medicine
ISSN: 2296-858X
Titre abrégé: Front Med (Lausanne)
Pays: Switzerland
ID NLM: 101648047
Informations de publication
Date de publication:
2022
2022
Historique:
received:
08
05
2022
accepted:
11
07
2022
entrez:
18
8
2022
pubmed:
19
8
2022
medline:
19
8
2022
Statut:
epublish
Résumé
Assessing tidal volume during mechanical ventilation is critical to improving gas exchange while avoiding ventilator-induced lung injury. Conventional flow and volume measurements are usually carried out by built-in pneumotachographs in the ventilator or by stand-alone flowmeters. Such flow/volume measurement devices are expensive and thus usually unaffordable in low-resource settings. Here, we aimed to design and test low-cost and technically-simple calibration and assembly pneumotachographs. The proposed pneumotachographs are made by manual perforation of a plate with a domestic drill. Their pressure-volume relationship is characterized by a quadratic equation with parameters that can be tailored by the number and diameter of the perforations. We show that the calibration parameters of the pneumotachographs can be measured through two maneuvers with a conventional resuscitation bag and by assessing the maneuver volumes with a cheap and straightforward water displacement setting. We assessed the performance of the simplified low-cost pneumotachographs to measure flow/volume during mechanical ventilation as carried out under typical conditions in low-resource settings, i.e., lacking gold standard expensive devices. Under realistic mechanical ventilation settings (pressure- and volume-control; 200-600 mL), inspiratory tidal volume was accurately measured (errors of 2.1% on average and <4% in the worst case). In conclusion, a simple, low-cost procedure facilitates the construction of affordable and accurate pneumotachographs for monitoring mechanical ventilation in low- and middle-income countries.
Identifiants
pubmed: 35979205
doi: 10.3389/fmed.2022.938949
pmc: PMC9376320
doi:
Types de publication
Journal Article
Langues
eng
Pagination
938949Informations de copyright
Copyright © 2022 Farré, Rodríguez-Lázaro, Gozal, Trias, Solana, Navajas and Otero.
Déclaration de conflit d'intérêts
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Références
Flow Meas Instrum. 2021 Dec;82:102058
pubmed: 34611384
Intensive Care Med. 2010 Dec;36(12):2074-80
pubmed: 20862452
Med Devices (Auckl). 2012;5:111-9
pubmed: 23293543
J Appl Physiol (1985). 2019 Oct 1;127(4):1150-1162
pubmed: 31487222
J Appl Physiol (1985). 2003 Aug;95(2):571-6
pubmed: 12704091
Am J Respir Crit Care Med. 2017 Feb 15;195(4):438-442
pubmed: 27626833
Bull World Health Organ. 2008 Jan;86(1):52-6
pubmed: 18235890
PLoS One. 2015 Jan 24;10(1):e0116949
pubmed: 25617837
F1000Res. 2020 Mar 30;9:218
pubmed: 32411358
Am J Respir Crit Care Med. 2020 Nov 1;202(9):1244-1252
pubmed: 32805143
Chest. 2016 Nov;150(5):1109-1117
pubmed: 27477213
Technol Health Care. 2017;25(2):237-250
pubmed: 28387686
N Engl J Med. 2020 May 21;382(21):1973-1975
pubmed: 32202721
Paediatr Anaesth. 2015 Apr;25(4):413-20
pubmed: 25491944
Anaesth Intensive Care. 2011 May;39(3):410-7
pubmed: 21675060
J Appl Physiol (1985). 1999 Jul;87(1):36-46
pubmed: 10409556
Crit Care Med. 2015 Oct;43(10):2263-4
pubmed: 26376257
Med Eng Phys. 2015 Mar;37(3):257-64
pubmed: 25659299
Am J Respir Crit Care Med. 2019 Jan 1;199(1):118-120
pubmed: 30265582
Cochrane Database Syst Rev. 2013 Feb 28;(2):CD003844
pubmed: 23450544
J Appl Physiol Respir Environ Exerc Physiol. 1982 Jul;53(1):280-5
pubmed: 7118642
Eur Respir J. 2020 Jun 4;55(6):
pubmed: 32312862