The Effect Of Jet Nebulization On Mechanical Ventilation Under Different Modes

Background: The effect of jet nebulization on mechanical ventilation(MV)under different ventilator modes has not been determined.Objectives: This study was designed to investigate the impact of jet nebulization applied in six ventilators on mechanical ventilation under different modes in vitro.Methods : Jet nebulizer and six kinds of ventilators(three of which are equipped with nebulization function)were connected with simulated lung(ASL5000)to simulate aerosol therapy.The ventilator mode was set to volume control mode(VC)and pressure control mode(PC),and the driving flow was4L/min and 8L/min respectively.The jet nebulizer was placed both at the Y-tube and at 15 cm distance from the Y-tube inspiratory limb distal to the patient for the intensive care unit(ICU)ventilators.Compare the effects of jet nebulization on the basis of triggering performance,control performance and tidal volume under different conditions.Results: Ventilator-integrated jet nebulizers had no effect on ventilator performance in different ventilation patterns.However,performance varied widely among external oxygen-driven jet nebulization.TPmin(time from the beginning of the lung simulator’s inspiratory effort to the lowest value of airway pressure needed to trigger the ventilator),Ttrig(time to trigger),and Ptrig(the magnitude of airway pressure drop needed to trigger)were significantly increased under different modes and position.The greater the driving flow,the stronger the impact on PIP(peak inspiratory pressure)and PIF(peak inspiratory flow)under VC mode,however,there was no significant change under PC mode.The tidal volume(equal to the patient’s actual tidal volume)and expiratory tidal volume VTe were significantly increased by jet nebulization,while inspiratory tidal volume VTi remained stable in VC mode;In PC mode,as the driving flow increased,inspiratory tidal volume VTi was on the decrease and expiratory tidal volume VTe was increased.The tidal volume was not significantly altered by jet nebulization.Conclusion: Triggering performance was decreased under various modes when using external oxygen-driven jet nebulization.While the effect of nebulization on control performance and tidal volume varied under different ventilator modes.The greater the driving flow,the stronger the impact on mechanical ventilation.