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Title: Filters Alter the Performance of Noninvasive Ventilators.
Austin Authors: Tolson, Julie ;Hone, Rodney;Bandiera, Christian;Rautela, Linda ;Churchward, Thomas J ;Ridgers, Anna;Howard, Mark E ;Worsnop, Christopher J 
Affiliation: Respiratory and Sleep Medicine
Institute for Breathing and Sleep
Swinburne University of Technology, Hawthorn, Victoria, Australia..
The University of Melbourne, Melbourne, Victoria, Australia..
Issue Date: Jul-2022
Date: 2022
Publication information: Respiratory Care 2022; 67(7): 795-800
Abstract: Noninvasive ventilation is recommended in hypercapnic respiratory failure secondary to ventilatory failure. Noninvasive ventilation may contribute to aerosol dispersion, which may increase the risk of transmission of COVID 2019. The addition of filters to the ventilator circuit has been recommended to reduce this risk. The aim of this benchtop study was to investigate the impact of adding filters to a ventilator circuit. In this benchtop study, a breathing simulator was used with 4 commonly used ventilators. Ventilators were set to approximate the typical settings that are used for patients on long-term noninvasive ventilation. Ventilator performance was then evaluated with 3 circuit configurations in place: circuit A: no filter in situ; circuit B: 1 filter at the simulator end of the circuit; and circuit C: 1 filter at the simulator end of the circuit and a second filter at the ventilator end of the circuit. Ventilator variables were impacted by the addition of filters. Measurements of peak pressure (P < .001), tidal volume (P < .001), and peak flow (P < .001) decreased between circuit A and circuit C in all ventilators that were tested. Ventilator triggering was less sensitive in 3 of the 4 ventilators and the fourth ventilator did not trigger under the same simulator settings. This study demonstrated that ventilator settings established with filters in situ are not applicable if the ventilator is used without the filters. This is an important clinical consideration for patients who are hospitalized and require noninvasive ventilation in the COVID 2019 era.
DOI: 10.4187/respcare.09365
ORCID: 0000-0002-7002-2657
Journal: Respiratory care
PubMed URL: 35610028
PubMed URL:
Type: Journal Article
Subjects: COVID-19
benchtop study
infectious diseases
noninvasive ventilation
respiratory failure
Appears in Collections:Journal articles

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