Accuracy of volume measurements in mechanically ventilated newborns: a comparative study of commercial devices.

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Ventilatory measurements in ventilated newborns are increasingly used to monitor and to optimize mechanical ventilation. The aim of this study was to compare the accuracy of volume measurements by different instruments using standardized laboratory conditions. The accuracy of displayed volume values of different commercial devices (Bicore CP-100, Ventrak 1500, Ventrak 1550, Babylog 8000, PEDS IV and SensorMedics 2600) was investigated using adjustable calibration syringes (volume range 2-60 ml, breathing rates 30/min-60/min) and humidified (>95%), heated (35 degrees C) breathing gas with adjustable FIO2 (0.21-1.0). The pneumotach and also the tubes were placed within an incubator (37 degrees C). The relative volume error of all devices was in conformity with clinically allowed tolerances (Bicore CP-100 6.4+/-0.5% (mean +/- SD), Ventrak 1500 3.6+/-4.2%, Ventrak 1550 6.5+/-2.7%, Babylog 8000 -5.5+/-1.5%, PEDS IV -4.0+/-1.4%, SensorMedics 2600 3.5+/-1.75%) for the measuring range studied (10 ml < V < 60 ml, rate 30-60/min, FIO2 = 0.21). Unacceptable errors were obtained for volumes lower than 10 ml with Bicore CP-100 (-28.5+/-26%) and PEDS IV (-10.3+/-3.4%). Changes in FIO2 had an important influence on volume measurements and only the SensorMedics 2600 and the PEDS IV corrected properly for FIO2 changes. Most of the currently available neonatal spirometry devices allow sufficiently accurate volume measurements in the range of 10-60 ml and at frequencies between 30-60/min provided that an increased FIO2 is taken into account.