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The Influence of Condensate in the Piezometric Tube on Patient Ventilator Interaction During Noninvasive Positive Pressure Ventilation FREE TO VIEW

Hu Jieying; Zheng Zeguang
Author and Funding Information

State Key Laboratory of Respiratory Disease, Guangzhou, China

Copyright 2016, American College of Chest Physicians. All Rights Reserved.

Chest. 2016;149(4_S):A532. doi:10.1016/j.chest.2016.02.555
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SESSION TITLE: Respiratory Care

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Saturday, April 16, 2016 at 11:45 AM - 12:45 PM

PURPOSE: To study The effects of condensate in the piezometric tube on Patient ventilator interaction during Noninvasive positive pressure ventilation.

METHODS: Six healthy adults received non-invasive positive pressure ventilation. Different capacity of physiological saline was injected gradually into the piezometric tube. The dynamic changes of the pressure of mask (Pmask), piezometric tube near mask (Ppro), piezometric tube near breathing machine (Pdis), and the flow were observed.

RESULTS: With increasing saline: (1) The trigger time: TItri (Pmask), TItri (Ppro) and TItri (Pdis) increased (from 0.093±0.053 to 0.278±0.120s, from 0.108±0.056 to 0.255±0.129s, and from 0.094±0.048 to 0.212±0.117s respectively). The trigger pressure TPtri (Pmask), TPtri (Pro) and TPtri (Pdis) increased (from 0.269±0.216 to 2.730±1.548cm H2O, from 0.284±0.227 to 2.679±1.529cm H2O and from 0.274±0.214 to 2.573±1.994 cm H2O respectively). The pressure-time product (PTP) increased (from 0.031±0.038 to 0.717±0.842 cm H2O*S, from 0.038±0.045 to 0.747±0.908cm H2O*S, and from 0.031±0.039 to 0.467±0.262cm H2O*S respectively). (2) Ineffective triggering rate increased from 0to8 times/min; Spurious triggering rate from 0 to 33 times/min. (3) The plateau pressure of Pmask and Ppro is exceed preset parameter, increased significantly compare with 0ml, from 10.108±0.207 to 17.744±1.915cm H2O and from 10.115±0.220 to 17.72±1.947cm H2O. The chang of plateau pressure of Pdis is not significantly (from 10.169±0.193 to 10.858±0.351cm H2O). The baseline pressure of Pmask, Ppro and Pdis changed from 3.902±0.299 to 10.454±1.893cm H2O, from 3.897±0.307 to 10.465±1.866 cm H2O and from 3.919±0.146 to 4.475±1.063cm H2O respectively. (4) The pressure fluctuation of platform and baseline indicated the pressure support is instability. (5) The time when the pressure of the Pdis began to change was delayed to Pmask and Ppro, delayed 0.099±0.087S comparaed with 0 ml.

CONCLUSIONS: It will influence patient-ventilator synchrony when there are condensate in the piezometric tube during Noninvasive positive pressure ventilation. To improve the Patient ventilator interaction of noninvasive positive pressure ventilation, should be avoided condensate in the piezometric tube.

CLINICAL IMPLICATIONS: It will reduce the patient-ventilator synchrony when there are condensate in the piezometric tube during Noninvasive positive pressure ventilation. So we should Strengthen the management of the piezometric tube and avoid or reduce the generation of condensate.

DISCLOSURE: The following authors have nothing to disclose: Hu Jieying, Zheng Zeguang

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