Performance Characteristics of 10 Home Mechanical Ventilators in

Anne Battisti; Didier Tassaux, MD; Jean-Paul Janssens, MD; Jean-Bernard Michotte; Samir Jaber, MD; and Philippe Jolliet, MD

During the last decade, major changes have occurred in the field of home noninvasive ventilation (NIV). First, the number of patients with obesity-hypoventilation syndrome and COPD whose homes are equipped with long-term home NIV devices has been steadily increasing. Second, there has been a progressive shift from volume-controlled ventilation to pressure-controlled ventilation, mainly because the latter allows the use of ventilators that are smaller, quieter, easier to use, and cheaper. Third, pressure-support ventilation applied with a bilevel pressure generator has become the ventilalaboratory mode of choice when pressure control is used inthe home setting.Fourth, considerable progress has been made in the design, function, and performance of bilevel devices, such that these machines can perform as well as some ICU ventilators. Therefore, an increasing number of machines has become available on the market, and the physician is often faced with the difficult task of choosing the optimal device for a given patient. Making the right choice is important, since performance and patient comfort vary among devices. Furthermore, optimizing patient-ventilator interactions, an increasingly recognized issue especially in the presence of restrictive or obstructive respiratory mechanics, depends on how a given device can be adjusted to meet the challenge. These issues are key to the success of long-term home NIV, patient-ventilator dyssynchrony being one of the documented causes of patient intolerance to the technique.The purpose of the present study was to compare the performance and adaptability to abnormal respiratory mechanics of 10 recently developed bilevel devices that are available in the United States and/or Europe.

Performance Characteristics of 10 Home Mechanical Ventilators in Pressure-Support Mode