BACKGROUND Portable ventilators continue to decrease in size while increasing in performance. We bench-tested the triggering, battery duration, and tidal volume (V(T)) of 7 portable ventilators: LTV 1000, LTV 1200, Puritan Bennett 540, Trilogy, Vela, iVent 101, and HT50. METHODS We tested triggering with a modified dual-chamber test lung to simulate spontaneous breathing with weak, normal, an...

The aim of the present study was to evaluate the performance characteristics of all the ventilators proposed for home noninvasive positive-pressure ventilation in children in France. The ventilators (one volume-targeted, 12 pressure-targeted and four dual) were evaluated on a bench which simulated six different paediatric ventilatory patterns. For each ventilator, the quality of the inspiratory...

Is there a distinction between withholding and withdrawing medical treatment at the end of life? In the past two decades, courts and bioethicists in most Western countries have rejected this distinction. However, some doctors, patients, and families still find the distinction to have important ethical implications. A proposed Israeli law offers a unique approach that attempts to respect the cul...

In the previous issue of Critical Care, Rose and colleagues report the results of a survey on the frequency with which ICU nurses are involved in decision-making in ventilator management. About 63 to 88% of the decisions were made by nurses in collaboration with physicians, and as much as 68% of ventilator adjustments were performed by nurses independent of physicians. Nurse involvement in deci...

Problem statement: Rotating turbine ventilators were generally found in most countries. They were simple in structure, light in weight and cheap to install. It was quite surprising that, the aerodynamics of this common device had not been numerically examined and the design process of most of these ventilators had developed progressively through trial and error methods. Approach: This study was...

BACKGROUND Open-circuit mouthpiece ventilation (MPV) is a form of noninvasive ventilation that can be used to provide portable daytime ventilatory support for neuromuscular patients with chronic respiratory failure. MPV has been reported to reduce the risk of respiratory infection due to tracheostomy, and to improve cough and voice function and patient quality of life. Despite these potential b...

The principles and practice ofmanaging mechanical ventilation are often daunting to chest physicians. It is easy to see why this should be. Firstly, the physician's experience of ventilators is usually in intensive care units where the responsibility rests largely, but often to a loosely defined degree, with anaesthetists. The complex and rapidly changing medical problems of patients require fr...

Evidence that noninvasive intermittent positive-pressure ventilation (NiIPPV) improves exercise capacity in chronic obstructive pulmonary disease (COPD) is limited. The effectiveness of different ventilators in this setting has not been studied. Three bilevel pressure support ventilators (Bipap S/T 30, Nippy2 and Vpap II ST), applied via a mouthpiece, were compared during submaximal treadmill e...

BACKGROUND Closed endotracheal suctioning during mechanical ventilation is increasingly used, but its impact on ventilator function has not been fully studied. METHODS We evaluated the impact of closed suctioning with 11 critical-care ventilators, during assisted ventilation in pressure-support mode, pressure-assist/control mode, volume-assist/control mode, and during continuous positive airw...