12 research outputs found
Comparative evaluation of three total full-face masks for delivering Non-Invasive Positive Pressure Ventilation (NPPV): a bench study
Abstract Historically, the oro-nasal mask has been the preferred interface to deliver Non-Invasive Positive Pressure Ventilation (NPPV) in critically ill patients. To overcome the problems related to air leaks and discomfort, Total Full-face masks have been designed. No study has comparatively evaluated the performance of the total Full-face masks available.The aim of this bench study was to evaluate the influence of three largely diffuse models of total Full -face masks on patient-ventilator synchrony and performance during pressure support ventilation. NPPV was applied to a mannequin, connected to an active test lung through three largely diffuse Full-face masks: Dimar Full-face mask (DFFM), Performax Full-face mask (RFFM) and Pulmodyne Full-face mask (PFFM).The performance analysis showed that the ΔPtrigger was significantly lower with PFFM (p < 0.05) at 20 breaths/min (RRsim) at both pressure support (iPS) levels applied, while, at RRsim 30, DFFM had the longest ΔPtrigger compared to the other 2 total full face masks (p < 0.05). At all ventilator settings, the PTP200 was significantly shorter with DFFM than with the other two total full-face masks (p < 0.05). In terms of PTP500 ideal index (%), we did not observe significant differences between the interfaces tested. The PFFM demonstrated the best performance and synchrony at low respiratory rates, but when the respiratory rate increased, no difference between all tested total full-face masks was reported
Remifentanil effects on respiratory drive and timing during pressure support ventilation and neurally adjusted ventilatory assist
We assessed the effects of varying doses of remifentanil on respiratory drive and timing in patients receiving Pressure Support Ventilation (PSV) and Neurally Adjusted Ventilatory Assist (NAVA). Four incrementing remifentanil doses were randomly administered to thirteen intubated patients (0.03, 0.05, 0.08, and 0.1\u3bcg\ub7Kg 121\ub7min 121) during both PSV and NAVA. We measured the patient's (Ti/Ttotneu) and ventilator (Ti/Ttotmec) duty cycle, the Electrical Activity of the Diaphragm (EAdi), the inspiratory (Delaytrinsp) and expiratory (Delaytrexp) trigger delays and the Asynchrony Index (AI). Increasing doses of remifentanil did not modify EAdi, regardless the ventilatory mode. In comparison to baseline, remifentanil infusion >0.05\u3bcg/Kg 121/min 121produced a significant reduction of Ti/Ttotneuand Ti/Ttotmecby prolonging the expiratory time. Delaytrinspand Delaytrexpwere significantly shorter in NAVA, respect to PSV. AI was not influenced by the different doses of remifentanil, but it was significantly lower during NAVA, compared to PSV. In conclusion remifentanil did not affect the respiratory drive, but only respiratory timing, without differences between modes
A bench study of 2 ventilator circuits during helmet noninvasive ventilation
OBJECTIVE: To compare helmet noninvasive ventilation (NIV), in terms of
patient-ventilator interaction and performance, using 2 different circuits for
connection: a double tube circuit (with one inspiratory and one expiratory line)
and a standard circuit (a Y-piece connected only to one side of the helmet,
closing the other side).
METHODS: A manikin, connected to a test lung set at 2 breathing frequencies (20
and 30 breaths/min), was ventilated in pressure support ventilation (PSV) mode
with 2 different settings, randomly applied, of the ratio of pressurization time
to expiratory trigger time (T(press)/T(exp-trigger)) 50%/25%, default setting,
and T(press)/T(exp-trigger) 80%/60%, fast setting, through a helmet. The helmet
was connected to the ventilator randomly with the double and the standard
circuit. We measured inspiratory trigger delay (T(insp-delay)), expiratory
trigger delay (T(exp-delay)), T(press)), time of synchrony (T(synch)), trigger
pressure drop, inspiratory pressure-time product (PTP), PTP at 300 ms and 500 ms,
and PTP at 500 ms expressed as percentage of an ideal PTP500 (PTP500 index).
RESULTS: At both breathing frequencies and ventilator settings, helmet NIV with
the double tube circuit showed better patient-ventilator interaction, with
shorter T(insp-delay), T(exp-delay), and T(press); longer T(synch); and higher
PTP300, PTP500, and PTP500 index (all P < .01).
CONCLUSIONS: The double tube circuit had significantly better patient-ventilator
interaction and a lower rate of wasted effort at 30 breaths/min
Riviste di teatro e ricerca accademica. Un colloquio e un inventario
Il volume riporta gli esiti d'un processo di ricerca sulle riviste teatrali che la Consulta Universitaria di Teatro ha svolto ad ampio spettro, in diverse fasi e con diversi strumenti cognitivi: il reperimento dato, l'indagine statistica, il confronto pubblico e l'approfondimento analitico. Si tratta, innanzi tutto, degli Atti del Convegno internazionale "Le riviste teatrali fra globalizzazione, storia e innovazione tecnologica" (Bologna, 2013). In secondo luogo, si consegnano al lettore le risultanze del lavoro svolto negli anni 2013-2015 dalla Commissione riviste e internazionalizzazione della CUT: Roberta Carpani, Sandra Pietrini, Gerardo Guccini, Paolo Quazzolo, Armando Petrini, Daniele Vianello