Abstract
BackgroundLong term oxygen therapy improves survival in hypoxemic patients with chronic obstructive pulmonary disease (COPD). Because pressure support ventilation with a home care ventilator is largely unsupervised, there is considerable risk of leakage occurring, which could affect delivered FiO2. We have therefore conducted a bench study in order to measure the effect of different levels of O2 supply and degrees of leakage on delivered FiO2. Ventilator tested: Legendair® (Airox™, Pau, France). Thirty-six measures were performed in each four ventilators with zero, 5 and 10 l.min-1 leakage and 1,2,4 and 8 l O2 flow.FindingsFiO2 decreased significantly with 5 l.min-1 leakage for all O2 flow rates, and with 10 l.min-1 at 4 and 8 l.min-1 O2.ConclusionDuring application of NIV on home ventilators, leakage can dramatically decrease inspired FiO2 making it less effective. It is important to know the FiO2 dispensed when NIV is used for COPD at home. We would encourage industry to develop methods for FiO2 regulation Chronic use of NIV for COPD with controlled FiO2 or SpO2 requires further studys.
Highlights
Long term oxygen therapy improves survival in hypoxemic patients with chronic obstructive pulmonary disease (COPD)
It is important to know the Inspired fraction of oxygen (FiO2) dispensed when Non-invasive ventilation (NIV) is used for COPD at home
The bench study confirms our hypothesis in six cases of eight; FiO2 decreases with all O2 flows with 5 liters per minute leaks and with 4 and 8 liters O2 supply with 10 liters per minute of leaks
Summary
Long term oxygen therapy improves survival in hypoxemic patients with chronic obstructive pulmonary disease (COPD). Because pressure support ventilation with a home care ventilator is largely unsupervised, there is considerable risk of leakage occurring, which could affect delivered FiO2. Long-term oxygen therapy (LTOT) improves survival in hypoxemic patients with chronic obstructive pulmonary disease (COPD) [1,2]. Nocturnal non-invasive ventilation (NIV) improves quality of life and blood gas status, with fewer intensive care admissions, survival is not affected [5,6]. Most home care ventilators deliver pressure support via a turbine and a constant normobaric O2 supply [7,8]. Whereas ICU ventilators deliver the set Fi02 (hyperbaric 02 witch permits variable O2 supply), with pressure support NIV, leakage around the mask could influence the received FiO2.
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