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Open Access 01-09-2008 | Original

Subject–ventilator synchrony during neural versus pneumatically triggered non-invasive helmet ventilation

Authors: Onnen Moerer, Jennifer Beck, Lukas Brander, Roberta Costa, Michael Quintel, Arthur S. Slutsky, Fabrice Brunet, Christer Sinderby

Published in: Intensive Care Medicine | Issue 9/2008

Abstract

Objective

Patient–ventilator synchrony during non-invasive pressure support ventilation with the helmet device is often compromised when conventional pneumatic triggering and cycling-off were used. A possible solution to this shortcoming is to replace the pneumatic triggering with neural triggering and cycling-off—using the diaphragm electrical activity (EA_di). This signal is insensitive to leaks and to the compliance of the ventilator circuit.

Design

Randomized, single-blinded, experimental study.

Setting

University Hospital.

Participants and subjects

Seven healthy human volunteers.

Interventions

Pneumatic triggering and cycling-off were compared to neural triggering and cycling-off during NIV delivered with the helmet.

Measurements and results

Triggering and cycling-off delays, wasted efforts, and breathing comfort were determined during restricted breathing efforts (<20% of voluntary maximum EA_di) with various combinations of pressure support (PSV) (5, 10, 20 cm H₂O) and respiratory rates (10, 20, 30 breath/min). During pneumatic triggering and cycling-off, the subject–ventilator synchrony was progressively more impaired with increasing respiratory rate and levels of PSV (p < 0.001). During neural triggering and cycling-off, effect of increasing respiratory rate and levels of PSV on subject–ventilator synchrony was minimal. Breathing comfort was higher during neural triggering than during pneumatic triggering (p < 0.001).

Conclusions

The present study demonstrates in healthy subjects that subject–ventilator synchrony, trigger effort, and breathing comfort with a helmet interface are considerably less impaired during increasing levels of PSV and respiratory rates with neural triggering and cycling-off, compared to conventional pneumatic triggering and cycling-off.

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Title: Subject–ventilator synchrony during neural versus pneumatically triggered non-invasive helmet ventilation
Authors: Onnen Moerer
Jennifer Beck
Lukas Brander
Roberta Costa
Michael Quintel
Arthur S. Slutsky
Fabrice Brunet
Christer Sinderby
Publication date: 01-09-2008
Publisher: Springer-Verlag
Published in: Intensive Care Medicine / Issue 9/2008
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-008-1163-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Subject–ventilator synchrony during neural versus pneumatically triggered non-invasive helmet ventilation

Abstract

Objective

Design

Setting

Participants and subjects

Interventions

Measurements and results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Design

Setting

Participants and subjects

Interventions

Measurements and results

Conclusions

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