Performance of ventilators for noninvasive positive pressure ventilation in children

¹ AP-HP, Hôpital Armand Trousseau, Paediatric Pulmonary Dept, Paris, France; and Université Pierre et Marie Curie-Paris6, INSERM UMR S-719, Paris, France
² ADEP Assistance, Puteaux, Paris
³ INSERM U 841, Créteil, France; and Paris XII University, Créteil France
⁴ AP-HP, Hôpital Raymond Poincaré, Université de Versailles Saint Quentin en Yvelines, Dept of Clinical Physiology, Garches, France; and INSERM U 841, Créteil, France

^* To whom correspondence should be addressed. E-mail: brigitte.fauroux{at}trs.aphp.fr.

	Abstract

The aim of the study was to evaluate the performance characteristics of all the ventilators proposed for home noninvasive positive pressure ventilation in children in France.

Seventeen ventilators, (volume-targeted, n=1, pressure-targeted, n=12, and dual ventilators, n=4) were evaluated on a bench which simulated 6 different paediatric ventilatory patterns. For each ventilator, the quality of the inspiratory and expiratory trigger, and the ability to reach and maintain the preset pressures and volumes were evaluated with the 6 patient profiles.

The performance of the ventilators showed a great variability and depended on the type of trigger (flow or pressure), the type of circuit, and the patient profile. Differences between the preset and measured airway pressure and between the tidal volume measured by the ventilator and on the bench were observed. Leaks were associated with the inability to detect the patient's inspiratory effort or autotriggering. No single ventilator was able to adequately ventilate the 6 paediatric profiles. Only few ventilators were able to ventilate the profiles simulating the youngest patients.

A systematic paediatric bench evaluation is recommended for every ventilator proposed for home ventilation in order to detect any dysfunction and to guide the choice of the appropriate ventilator for a specific patient.

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