Bench evaluation of commercially available and newly developed interfaces for mouthpiece ventilation

Clin Respir J. 2018 Mar;12(3):890-894. doi: 10.1111/crj.12601. Epub 2017 Jan 9.

Abstract

Introduction: Mouthpiece ventilation represents a valuable treatment for patients needing daytime non-invasive ventilation. This modality is however underused, in part because of limitations in the available equipment.

Objective: To develop a new flexible and moldable mouthpiece, aiming to address some of the issues of the currently available interfaces.

Methods: We compared two commercially available and the newly developed mouthpieces in a bench test using four life-support home ventilators and three settings per ventilator.

Results: The three interfaces showed marked differences in their resistive characteristics. In the volume-controlled setting (VC-CMV) with 500 mL tidal volume (VT ), the delivered VT , ranged between 459 ± 7 mL (-8%) and 501 ± 4 mL (+0.2%), according to the used ventilator. In the VC-CMV setting with VT 1000 mL, one of the ventilators did not assure the set VT with the new mouthpiece, because of the high-pressure limitation. In the pressure-controlled setting (PC-CMV at 20 cmH2 O), the effective pressure differed between the tested interfaces according to their resistance, resulting in a decrease in the delivered VT .

Conclusions: They found measurable differences in the ventilation's performances comparing the interfaces for mouthpiece ventilation, which seem to have a minor clinical relevance in the most settings, but should be systematically checked. They validated in-vitro the newly developed mouthpiece with respect to the ventilation performances; a clinical study is needed to investigate the potential advantages we expect from the new mouthpiece.

Keywords: bench evaluation; home ventilators; interfaces; mouthpiece ventilation; neuromuscular disease; non-invasive ventilation.

Publication types

  • Comparative Study

MeSH terms

  • Air Pressure
  • Equipment Design
  • Humans
  • Lung / physiology*
  • Neuromuscular Diseases / complications*
  • Noninvasive Ventilation / instrumentation*
  • Quality of Life
  • Respiratory Insufficiency / mortality*
  • Respiratory Insufficiency / psychology
  • Respiratory Insufficiency / therapy
  • Tidal Volume / physiology
  • Ventilators, Mechanical / standards