Pressure Sensor Stability Analysis of Positive End Expiratory Pressure Parameters in Flow Analyzer Design
Abstract
The Positive End Expiratory Pressure (PEEP) parameter is a parameter that must be considered in the process of determining the patient's condition, a safe threshold, and must be in accordance with the settings. However, often the PEEP value on the ventilator does not match the settings so that the measuring instrument capable of detecting PEEP on the ventilator is the Flow Analyzer. The purpose of this study was to design a Flow Analyzer using the MPX2010 sensor to analyze the stability of the PEEP parameters on the ventilator. This study used PEEP settings of 0, 5, 8, 11, 14, 17, 20, 23, 26, and 29 cmH2O. Data were collected using a ventilator with VCV (Volume Control Ventilation) and PCV (Pressure Control Ventilation) modes. The tool used for reference from standard measurements uses the Standard Flow Analyzer tool. The results of this study indicate that the measurement accuracy of PEEP parameters with the Flow Analyzer module at each PEEP setting has the smallest error of ±0% at 0 cmH2O setting so that it also has the smallest value of 0 by standard. deviation and uncertainty (UA) value 0 at each setting. The Flow Analyzer measurement module has the largest error in the 5 cmH2O setting, which is ±13.2% with the largest correction value of 0.77. From the data obtained, it can be said that the monitoring of the PEEP parameter is quite stable even though the value is still out of tolerance. Monitoring of PEEP stability parameters can be implemented during the ventilator calibration process which needs to be carried out to analyze damage and reduce the time of damage to the ventilator.
Downloads
References
The Intensive Care Foundation, Handbook of Mechanical Ventilation: A User’s Guide Ventilation. 2015.
S. Shunker, “Mechanical Ventilation Learning Package,” Intensive Care Unit, pp. 1–75, 2016.
B. Kumar, Handbook of Mechanical Ventilation. 2011. doi: 10.5005/jp/books/11466.
L. Gattinoni et al., “Positive end-expiratory pressure: How to set it at the individual level,” Ann. Transl. Med., vol. 5, no. 14, pp. 1–10, 2017, doi: 10.21037/atm.2017.06.64.
A. Das, P. P. Menon, J. G. Hardman, and D. G. Bates, “Optimization of mechanical ventilator settings for pulmonary disease states,” IEEE Trans. Biomed. Eng., vol. 60, no. 6, pp. 1599–1607, 2013, doi: 10.1109/TBME.2013.2239645.
M. C. Sklar, B. K. Patel, J. R. Beitler, T. Piraino, and E. C. Goligher, “Optimal Ventilator Strategies in Acute Respiratory Distress Syndrome,” Semin. Respir. Crit. Care Med., vol. 40, no. 1, pp. 81–93, 2019, doi: 10.1055/s-0039-1683896.
T. Bluth et al., “Effect of Intraoperative High Positive End-Expiratory Pressure (PEEP) with Recruitment Maneuvers vs Low PEEP on Postoperative Pulmonary Complications in Obese Patients: A Randomized Clinical Trial,” JAMA - J. Am. Med. Assoc., vol. 321, no. 23, pp. 2292–2305, 2019, doi: 10.1001/jama.2019.7505.
F. Gordo and I. Conejo, “What PEEP level should I use in my patient?,” Med. Intensiva, vol. 41, no. 5, pp. 267–269, 2017, doi: 10.1016/j.medin.2016.10.010.
E. Fan et al., “An official American Thoracic Society/European Society of intensive care medicine/society of critical care medicine clinical practice guideline: Mechanical ventilation in adult patients with acute respiratory distress syndrome,” Am. J. Respir. Crit. Care Med., vol. 195, no. 9, pp. 1253–1263, 2017, doi: 10.1164/rccm.201703-0548ST.
R. Carrasco Loza, G. Villamizar Rodríguez, and N. Medel Fernández, “Ventilator-Induced Lung Injury (VILI) in Acute Respiratory Distress Syndrome (ARDS): Volutrauma and Molecular Effects,” Open Respir. Med. J., vol. 9, no. 1, pp. 112–119, 2015, doi: 10.2174/1874306401509010112.
P. L. Silva and P. R. M. Rocco, “The basics of respiratory mechanics: ventilator-derived parameters,” Ann. Transl. Med., vol. 6, no. 19, pp. 376–376, 2018, doi: 10.21037/atm.2018.06.06.
M. Vargas, Y. Sutherasan, C. Gregoretti, and P. Pelosi, “PEEP role in ICU and operating room: From pathophysiology to clinical practice,” Sci. World J., vol. 2014, 2014, doi: 10.1155/2014/852356.
A. M. Mercat and J. C. M. Richard, “Positive End-Expiratory Pressure Setting in Adults With Acute Lung Injury and Acute Respiratory Distress Syndrome,” Surv. Anesthesiol., vol. 52, no. 6, pp. 272–273, 2008, doi: 10.1097/01.sa.0000318641.66249.02.
P. Marchionni, A. Galli, V. P. Carnielli, and L. Scalise, “A novel measurement technique for the assessment of best positive end-expiratory pressure in newborn patient,” IEEE Med. Meas. Appl. MeMeA 2020 - Conf. Proc., 2020, doi: 10.1109/MeMeA49120.2020.9137151.
T. Sujeeth, “Low Cost Mechanical Ventilator with Controlled PEEP,” Int. J. Res. Appl. Sci. Eng. Technol., vol. 9, no. VI, pp. 2273–2278, 2021, doi: 10.22214/ijraset.2021.34662.
G. Cewers, “Expiratory Pressure Regulation in a Ventilator,” Patent, vol. i, no. 12, 2012.
P. Zhang, J. Sun, G. Wan, and W. Liu, “Development of Ventilator Tester Calibration Equipment,” IET Conf. Publ., vol. 2015, no. CP680, 2015, doi: 10.1049/cp.2015.0790.
S. Zulfiqar, H. Nadeem, Z. Tahir, M. Mazhar, and K. M. Hasan, “Portable, Low Cost, Closed-Loop Mechanical Ventilation Using Feedback from Optically Isolated Analog Sensors,” IEEE Reg. 10 Annu. Int. Conf. Proceedings/TENCON, vol. 2018-Octob, no. October, pp. 1913–1916, 2019, doi: 10.1109/TENCON.2018.8650277.
I. Freescale Semiconductor, Tehnical Data MPX4250 Series. 2009.
A. C. McKown, M. W. Semler, and T. W. Rice, “Best PEEP trials are dependent on tidal volume,” Crit. Care, vol. 22, no. 1, pp. 21–23, 2018, doi: 10.1186/s13054-018-2047-4.
R. Nadeem, K. Ahmed, L. Salama, and A. M. Elhoufi, “Tolerable Maximum Positive End Expiratory Pressure in Mechanically Ventilated Patients and Its Impact on Blood Flow across Cardiac Valves: Index Case Report of a Physiology Study,” Dubai Med. J., vol. 2, no. 4, pp. 163–167, 2019, doi: 10.1159/000504045.
H. Kaykisizli and V. Ciftci, “Reference standard design for flow calibration of mechanical ventilator and lung simulator calibrators,” TÜBİTAK UME J., vol. 10, pp. 1–4, 2010, doi: 10.1109/biyomut.2010.5479874.
F. I. Semiconductor, “Freescale Semiconductor 200 kPa On-Chip Temperature Compensated Silicon Pressure Sensors,” NPX Datasheet, pp. 2006–2008, 2008.
C. Rajan, B. Megala, A. Nandhini, and C. R. Priya, “A Review : Comparative Analysis of Arduino Micro Controllers in Robotic Car,” Int. J. Mech. Aerospace, Ind. Mechatronics Eng., vol. 9, no. 2, pp. 371–380, 2015.
A. C. Bento, “An Experiment with Arduino Uno and Tft Nextion for Internet of Things,” 2018 Int. Conf. Recent Innov. Electr. Electron. Commun. Eng. ICRIEECE 2018, no. July 2018, pp. 1238–1242, 2018, doi: 10.1109/ICRIEECE44171.2018.9008416.
Copyright (c) 2023 Levana Forra Wakidi, Abd Kholiq, Eko Dedi Prasetyo, Chandrasekaran P
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution-ShareAlikel 4.0 International (CC BY-SA 4.0) that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).
