Abstract:
BACKGROUND:It is difficult to apply noninvasive ventilation (NIV) simultaneously with pulsed-dose oxygen delivery. We evaluated the feasibility and efficacy of pulsed-dose oxygen delivery during NIV. METHODS:A bench study was conducted using a simulated lung during NIV, with a breathing frequency of 10 or 20 breaths/min and 3 oxygen injection sites (site A on face mask, site B proximal to face mask, and site C at the ventilator outlet) with continuous flow oxygen delivery of 1, 3, or 5 L/min) or pulsed-dose oxygen delivery (numerical settings of 1, 3, or 5 representing the oxygen pulse characteristics). [Formula: see text] under different experimental conditions and the influence of mode of oxygen delivery on NIV (compared to baseline and continuous flow oxygen delivery vs pulsed-dose oxygen delivery) were compared. In the clinical study, we enrolled 10 subjects with COPD exacerbation who received NIV with either continuous flow oxygen delivery or pulsed-dose oxygen delivery. Under the same targeted pulse oxygen saturation (88-92%), the numerical settings of different modes of oxygen delivery were titrated, and the clinical parameters during the different modes of oxygen delivery were compared. RESULTS:In the bench study, the ratio of the [Formula: see text] with pulsed-dose oxygen delivery to the [Formula: see text] with continuous flow oxygen delivery at the same numerical setting was 0.94 ± 0.15. The oxygen injection site had a significant influence on [Formula: see text] in pulsed-dose oxygen delivery or continuous flow oxygen delivery mode (P < .05). Pulsed-dose oxygen delivery worked effectively with the ventilator, as demonstrated by the fine synchronization in the breathing cycle of the ventilator, the simulated lung, and the pulsed-dose oxygen delivery. When compared with each other or compared to the baseline individually, pulsed-dose oxygen delivery and continuous flow oxygen delivery showed no clinically important effects on NIV (all P > .05 or changes < 10%). In the clinical study, the mean numerical settings for pulsed-dose oxygen delivery and continuous flow oxygen delivery modes after titration were 2.68 ± 0.32 and 2.31 ± 0.56 L/min, respectively. There was no significant difference between continuous flow oxygen delivery and pulsed-dose oxygen delivery (P > .05). CONCLUSIONS:Integration of pulsed-dose oxygen delivery into NIV could achieve efficacy similar to that achieved with continuous flow oxygen delivery.
journal_name
Respir Carejournal_title
Respiratory careauthors
Li LL,Yang HY,Jin H,Dai B,Peng Y,Tan Wdoi
10.4187/respcare.06922subject
Has Abstractpub_date
2020-09-01 00:00:00pages
1323-1332issue
9eissn
0020-1324issn
1943-3654pii
respcare.06922journal_volume
65pub_type
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