Protective Recommendations for Non-invasive Ventilation During COVID-19 Pandemic: A Bench Evaluation of the Effects of Instrumental Dead Space on Alveolar Ventilation

Delorme, Mathieu; Leroux, Karl; Boussaïd, Ghilas; Lebret, Marius; Prigent, Hélène; Léotard, Antoine; Louis, Bruno; Lofaso, Frédéric

doi:10.1016/j.arbres.2021.01.012

Cited by 7 publications

(6 citation statements)

References 25 publications

(23 reference statements)

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“…In line with previous bench studies [ 3 , 11 ], our results highlight that PAP and NIV devices should be used as per their user manual without any alteration on their regular setup. Indeed, any change may impair their efficacy.…”

supporting

confidence: 90%

Addition of bacterial filter alters positive airway pressure and non-invasive ventilation performances

Rabec

Fresnel²,

Retory

et al. 2022

Eur Respir J

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Recently, one manufacturer of home ventilators issued an alert regarding the potential risk of serious injury related to the use of some of their positive airway pressure (PAP) and non-invasive ventilation (NIV) devices [1]. The risk is caused by the polyurethane foam used in their ventilators. In some cases, the foam broke into the blower and could have been inhaled by patients. The manufacturer and some healthcare regulatory agencies advocated, as a temporary solution, to modify PAP and NIV circuits by adding an inline bacterial filter in order to reduce the risk of inhalation [2]. However, changing ventilator circuits can alter ventilator performances during PAP and NIV [3].

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supporting

confidence: 90%

Addition of bacterial filter alters positive airway pressure and non-invasive ventilation performances

Rabec

Fresnel²,

Retory

et al. 2022

Eur Respir J

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“…Furthermore, the instrumental dead space effect on alveolar ventilation should be pondered. In a bench study, Delorme et al , demonstrated that when the dual-limb circuit was connected to a non-vented mask with two filters placed both at the inspiratory and expiratory port of the ventilator, the dead space effect was low [ 71 ]. The disadvantages and advantages of different tubing systems equipped with BVF, HME and HMEF are shown in figure 1 .…”

Section: Prudently Applying Non-invasive Respiratory Support (Nirs)mentioning

confidence: 99%

“…Delorme et al , compared the effects on dead space and P ETCO2 in differently deployed NIPPV. In methods b and c, pressure support levels had to be increased to 6 and 1cmH2O respectively to compensate for the equipment dead space [ 71 ]. A dual-limb circuit connected to a non-vented mask (e) is the best recommendation and (c) and (d) are recommended if a single-limb circuit was applying.…”

Section: Prudently Applying Non-invasive Respiratory Support (Nirs)mentioning

confidence: 99%

Respiratory care for the critical patients with 2019 novel coronavirus

Wang¹,

Lu²,

Yang³

et al. 2021

Respiratory Medicine

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Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is transmitted through respiratory droplets, aerosols and close contact. Cross infections occur because viruses spread rapidly among humans. Nineteen percent (19%) of the infected patients developed severe pneumonia and acute respiratory distress syndrome (ARDS). Hypoxemia usually occurs and patients may require oxygen therapy or mechanical ventilation (MV) support. In this article, recently published clinical experience and observational studies were reviewed. Corresponding respiratory therapy regarding different stages of infection is proposed. Infection control principles and respiratory strategies including oxygen therapy, non-invasive respiratory support (NIRS), intubation evaluation, equipment preparation, ventilator settings, special maneuvers comprise of the prone position (PP), recruitment maneuver (RM), extracorporeal membrane oxygenation (ECMO), weaning and extubation are summarized. Respiratory equipment and device disinfection recommendations are worked up. We expect this review article could be used as a reference by health care workers in patient care while minimizing the risk of environmental contamination.

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“… 12 , 13 , 14 , 15 , 16 Finally, many treatments both pharmacological (especially antivirals, immunomodulators and anti-inflammatories) and non-pharmacological treatments has been used during this pandemic era at different moments and severities of the disease, sometimes with controversial results. 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 …”

Section: Introductionmentioning

confidence: 99%

Short and Long-Term Impact of COVID-19 Infection on Previous Respiratory Diseases

Chiner-Vives

Cordovilla-Pérez

Rosa-Carrillo

et al. 2022

Archivos de Bronconeumología

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Protective Recommendations for Non-invasive Ventilation During COVID-19 Pandemic: A Bench Evaluation of the Effects of Instrumental Dead Space on Alveolar Ventilation

Abstract: Graphical abstract

Cited by 7 publications

References 25 publications

Addition of bacterial filter alters positive airway pressure and non-invasive ventilation performances

Addition of bacterial filter alters positive airway pressure and non-invasive ventilation performances

Respiratory care for the critical patients with 2019 novel coronavirus

Short and Long-Term Impact of COVID-19 Infection on Previous Respiratory Diseases

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