Mechanical ventilation is a very effective therapy, but with many complications. Simulators are used in many fields, including medicine, to enhance safety issues. In the intensive care unit, they are used for teaching cardiorespiratory physiology and ventilation, for testing ventilator performance, for forecasting the effect of ventilatory support, and to determine optimal ventilatory management. They are also used in research and development of clinical decision support systems (CDSSs) and explicit computerized protocols in closed loop. For all those reasons, cardiorespiratory simulators are one of the tools that help to decrease mechanical ventilation duration and complications. This paper describes the different types of simulators described in the literature for physiologic simulation and modeling of the respiratory system, including a new simulator (SimulResp), and proposes a validation process for these simulators.

Mechanical ventilation can be perceived as a treatment with a very narrow therapeutic window, i.e., highly efficient but with considerable side effects if not used properly and in a timely manner. Protocols and guidelines have been designed to make mechanical ventilation safer and protective for the lung. However, variable effects and low compliance with use of written protocols have been reported repeatedly. Use of explicit computerized protocols for mechanical ventilation might very soon become a "must." Several closed loop systems are already on the market, and preliminary studies are showing promising results in providing patients with good quality ventilation and eventually weaning them faster from the ventilator. The present paper defines explicit computerized protocols for mechanical ventilation, describes how these protocols are designed, and reports the ones that are available on the market for children.

AbstractsBiPAP mode was used among all patients. After the second hour of NPPV we observe reduction of respiratory rate (43.72±13.46 b/min vs 34.25±13.47, p<0.01), heart rate (138.66 b/min vs 129.27±24.21, p<0.01) and improvement of the SPO 2 (86.17±13.33 vs 94.85±6.9, p<0.01). We listed only 36 (33%) failures which had recourse to the intubation. Conclusion The NPPV is an interesting technique in PICU and the results are promising. The post-extubation ARF is probably a better indication for NPPV in paediatrics. Objective This study was performed to determine faisability and efficacy of Noninvasive postive pressure ventilation (NPPV) for infant and children with acute respiratory failure (ARF). Materials and Methods During March 2006 to December 2011, we include in this prospective observational study infants and children ≤ 16 years of age hospitalized at the multidisciplinary PICU of the university teaching hospital of Oran with hypoxemic or hypercarbic acute respiratory distress. The patients were eligible to receive in first intention mask ventilation by means of a conventional volumetric ventilators as an alternative means of respiratory support in association with conventional medical treatment. Patients were evaluated regarding physiologic variables prospectively before NIV and at 2 hrs of NPPV. Results A total of 109 patients were included. The average of age been of 57.07±57.95 months, we use NPPV for 22 (20%) children with hypercarbic acute respiratory failure (ARF), for 87 (80%) with hypoxemic ARF. 44 (40%) patients had ARF after extubation. The VALIDATION OF PEDIATRIC CARDIORESPIRATORY A287Abstracts ability to provide PEEP despite repeated autoclavation. Some valves showed tears or displacement of the rubber seal.

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