Improved Systems for Respiratory Support

项目摘要/摘要 明尼苏达医疗解决方案公司(MHS)和洛杉矶儿童医院(CHLA)提出 开发和验证一种新的系统，用于创建定制的呼吸接口器具 目的改进重症监护病房(ICU)婴幼儿的无创呼吸机(NIV)。 NIV的技术进步改善了危重患者的预后，但不幸的是，大多数 新生儿和儿童不能获得NIV的全部好处，特别是双水平呼吸，因为他们 无法有效地使呼吸与非侵入性呼吸机同步。这是因为儿科NIV患者 接口电器经常有明显的漏气现象，再加上儿童 在呼吸道流量中产生较小的变化，防止呼吸机可靠地感知患者的努力。这个 由此产生的呼吸机呼吸与患者的努力不同步，导致换气无效，患者较高 呼吸困难，肺损伤加重。为了克服过多的泄漏和不足的触发， 临床医生经常收紧界面，导致皮肤破裂和压疮。[和合]相关性压疮 正在成为重症监护病房最常见的并发症之一。缺乏有效的NIV线索 新生儿和幼儿插管率较高，不必要地暴露于 损害发育中的智力，延长重症监护室的住院时间，以及感染、呼吸机等医源性并发症 诱发的横隔膜功能障碍和ICU后生活质量的损害。呼吸机制造商 正在寻找这个问题的解决方案，因为许多以前开发的产品都没有获得 大规模商业用途，因为它们是侵入性的，或者在应用于 婴儿或新生儿。拟议的项目将开发和评估快速住院的创新系统。 生产定制的NIV呼吸接口。

Project Summary/Abstract Minnesota HealthSolutions Corporation (MHS) and Children’s Hospital Los Angeles (CHLA) propose the development and validation of a novel system for creating custom-fit respiratory interface appliances for the purpose of improving non-invasive ventilation (NIV) for infants and children in the intensive care unit (ICU). Technology advancements in NIV have improved outcomes for critically ill patients, but unfortunately, most neonates and children do not achieve the full benefits of NIV, particularly bi-level ventilation, because they are unable to effectively synchronize breaths with the non-invasive ventilator. This is because pediatric NIV patient interface appliances often have significant air leakage, which, when combined with the fact that children generate smaller changes in airway flow, prevents the ventilator from reliably sensing patient effort. The resulting ventilator breaths are asynchronous with patient effort, leading to ineffective ventilation, higher patient effort of breathing, and worsening lung injury. To overcome excessive leakage and inadequate triggering, clinicians often tighten interfaces, resulting in skin breakdown and pressure ulcers. NIV related pressure ulcers are becoming amongst the most common complications in intensive care units. The lack of effective NIV leads to higher rates of intubation in neonates and young children, with unnecessary exposure to medications which harm the developing mind, longer ICU lengths of stay, and iatrogenic complications such as infection, ventilator induced diaphragm dysfunction, and post-ICU impairment in quality of life. Ventilator manufacturers are searching for solutions to this problem because many previously developed products have not gained widescale commercial use since they are invasive or have substantial technical limitations when applied to the infant or neonate. The proposed project will develop and evaluate an innovative system for rapid in-hospital production of custom-fit NIV respiratory interfaces.