Background: The purpose of this study was to evaluate the occurrence of Auto-PEEP in Volume A/C when ventilating normal, ARDS and COPD lung conditions on multiple ventilators.
Method: This study was completed using an electronic lung simulator configured to simulate normal, ARDS and COPD conditions. A 70 kg predicted PBW, with a tidal volume of 6 ml/kg, was used in Volume A/C. Settings were adjusted to achieve a minute ventilation of 90 ml/min/kg, 120 ml/min/kg and 150 ml/min/kg PBW. Respiratory rates used were 15, 20 and 25 BPM. PEEP was set at 5 cm H2O. Under normal, ARDS and COPD lung conditions, each ventilator had a decelerating flow waveform.
Results: As respiratory rate increased, an increase in Auto-PEEP was observed in each ventilator. The CareFusion Avea ended the COPD simulation with the highest amount of Auto-PEEP at 2.10 cm H 2 O at 150 ml/min/kg.
Conclusion: In Volume A/C, a reduction in expiratory time causes an increase in mean airway pressure, Auto-PEEP, and Total PEEP in all conditions with all ventilators. Further research is needed to evaluate the presence of Auto-PEEP and elevated mean airway pressures in the clinical setting with mechanically ventilated patients.
References: Arnal, J.-M., Garnero, A., Saoli, M., & Chatburn, R. L. (2018). Parameters for Simulation of Adult Subjects During Mechanical Ventilation. Respiratory Care, 63(2), 158–168. doi: 10.4187/respcare.05775
Davis, Kathleen A.; Peterson, Heather P.; Sanders, Alex R.; and Ashworth, Lonny, "A Bench Study Evaluation of the Amount of Auto-PEEP When Ventilating an Electronic Lung Model Simulated to Represent Normal, ARDS and COPD Lung Conditions" (2020). 2020 Undergraduate Research Showcase. 40.