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Compensation for large leaks during NIV

Article

Author: Matthias Himmelstoss

Date of first publication: 02.10.2020

Last change: 14.04.2023

Moved to Public website

Hamilton Medical ventilators provide high leakage compensation during inspiration by assessing the remaining flow at the end of exhalation as an offset for the trigger setting, while maintaining the set PEEP.

Compensation for large leaks during NIV

We carried out in-house testing to evaluate maximum airway leakage (simulated mask leak) as the leakage amount where both patient inspiratory and expiratory efforts can still be detected and synchronized to our ventilators without causing auto-triggering or prolonged exhalation. We made a distinction between the inspiratory leak (leakage present at peak inspiratory flow), where the patient’s expiratory effort is correctly detected by the ventilator, and the expiratory leak (leakage at the end of exhalation), where the patient’s inspiratory effort is still correctly detected by the ventilator and a breath is triggered.

Graph showing compensation values
Pressure compensation and volume compensation in HAMILTON-C2/C3
Graph showing compensation values
Pressure compensation and volume compensation in HAMILTON-C2/C3

Leak compensation according to ventilator model

Our results showed that noninvasive ventilation synchronized with spontaneous patient breathing efforts is possible up to the rates shown below.

Relevant devices: HAMILTON-G5/S1 (SW v2.8x and later); HAMILTON-C2/C3/C6 (SW v2.2.x and later / SW v2.0.x and later / SW v1.1.x and later; with option IntelliSync+ active); HAMILTON-C1/T1/MR1 (SW v2.2.x and later) 

HAMILTON-C6

HAMILTON-G5/S1

HAMILTON-C2/C3

HAMILTON-C1/T1/MR1

Inspiratory leak compensation

Up to 150 l/min

Up to 75 l/min

Up to 85 l/min

Up to 85 l/min

Expiratory leak compensation

Up to 30 l/min

Up to 30 l/min

Up to 30 l/min

Up to 30 l/min