Abstract
Mechanical ventilators are increasingly evolving into computer-driven devices. These technical advancements have impact on clinical decisions in pediatric intensive care units (PICUs). A good understanding of the design of mechanical ventilators can improve clinical care. Tidal volume (TV) is one of the corner stones of ventilation: multiple technical factors influence the TV and, thus, influence clinical decision making. Ventilator manufacturers make various design choices regarding the phase, site and conditions of TV measurement as well as algorithmic processing choices. Such choice may impact the measurement and subsequent display of TV. A software change of the TV measuring algorithm of the SERVO-i® (Getinge, Solna, Sweden) at the PICU of the University Medical Centre Utrecht was studied in a prospective cohort. It showed, as example, a clinically significant impact of 8% difference in reported TV. Design choices in both the hardware and software of mechanical ventilators can have a clinically relevant impact on the measurement of tidal volume. In our search for the optimal TV for lung-protective ventilation, such choices should be taken into account.
Highlights
Mechanical ventilators are more and more frequently becoming computer-driven devices
As research regarding the clinical impact of different solutions is lacking, we performed a small prospective cohort study to illustrate whether a software change in the ventilators at our pediatric intensive care units (PICUs) affected the administered tidal volumes in our patients
When the volume expansion is included in the reference measurement for tidal volume, the target tidal volume will be reached at lower pressure levels
Summary
Mechanical ventilators are more and more frequently becoming computer-driven devices. The advances in ventilator technology raise the question whether we, as clinicians, still understand how we are ventilating our patients. : do we really know what tidal volume we are administering to the lungs our patients, especially in our neonatal and infant populations? We give an expert overview of the different approaches that are being used in ventilator devices to measure and control tidal volumes that are being administered. As research regarding the clinical impact of different solutions is lacking, we performed a small prospective cohort study to illustrate whether a software change in the ventilators at our PICU affected the administered tidal volumes in our patients
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
