2015 Comparative study of home ventilator performances and analysis of patient-ventilator interactions in noninvasive ventilation

Defended on November 24, 2015
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Emeline Fresnel

- Abstract Noninvasive ventilation can be defined as a modality of treatment for chronic respiratory failure. Nowadays, it is sufficiently often prescribed to motivate test bench studies whose objectives are to evaluate and compare ventilator performances. To provide reliable and reproducible assessments, we revisited many aspects of test bench studies and developed a parametric procedure for testing ventilators. We initially focused our attention on the modeling of a physiological inspiratory effort which, when driving three pathophysiological lung models, allows to simulate a realistic cohort of patients. The development of this procedure required to introduce a clear and motivated terminology, as well as to unify the parameter setting of the ventilators. It was then possible to characterize the ventilator synchronizability, defined as the ability of the device to synchronize with the different pulmonary models they were connected to. These performances depend on the mechanics and dynamics of the lung model. Providing to practitioners reports and tools for comparing ventilators on a dedicated website should facilitate the choice of a ventilatory assistance device adapted to each patient. This works also were also devoted to the use of a dynamical model for the patient-ventilator system which allowed us not only to review most of the asynchrony events observed in clinics but also to explain their underlying mechanisms. Linking theoretical and experimental results offers us a perspective for identifying the ventilator operating strategies, a required step to improve patient-ventilator interactions.

- Guide for testing ventilator performances
During her Ph.D. thesis, Emeline Fresnel completed a guide for confrontating the ventilator performances using the parametric procedure she developed. By French law, this website is only accessible by professional working in healthcare but the methodology is posted with an open access.

- References

  • E. Fresnel, J.-F. Muir & C. Letellier, Realistic human muscle pressure for driving a mechanical lung, EPJ Nonlinear Biomedical Physics, 2, 7, 2014, Online
  • E. Fresnel, E. Yacoub, U. Freitas, A. Kerfourn, V. Messager, E. Mallet, J.-F. Muir & C. Letellier, An easy-to-use technique to characterize cardiodynamics from first-return maps on ΔRR-intervals, Chaos, 25 (8), 083111, 2015. Online

This thesis was supported by ADIR Association

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