Improved Non-Invasive Ventilation Triggering and Synchronization System Targeting Infants and Neonates

Project Summary AbstractMinnesota HealthSolutions Corporation and Children s Hospital Los Angeles propose the development and validation of a novel methodology for effective triggering and synchronization of non invasive ventilationNIVfor infants and children in the intensive care unitICUTechnology advancements in NIV have improved outcomes for critically ill patientsbut unfortunatelymost neonates and children do not achieve the full benefits of NIVparticularly bi level ventilationbecause they are unable to effectively synchronize breaths with the noninvasive ventilatorThis is because pediatric NIV patient interface appliances often have significant air leakagewhichwhen combined with the fact that children generate smaller changes in airway flowprevents the ventilator from reliably sensing patient effortThe resulting ventilator timed breaths are asynchronous with patient effortleading to ineffective ventilationhigher patient effort of breathingand worsening lung injuryThe lack of effective NIV leads to higher rates of intubation in neonates and young childrenwith unnecessary exposure to medications which harm the developing mindlonger ICU lengths of stayand iatrogenic complications such as infectionventilator induced diaphragm dysfunctionand post ICU impairment in quality of lifeVentilator manufacturers are searching for solutions to this problem because many previously developed products have not gained wide scale commercial use since they are invasive or have substantial technical limitations when applied to the infant or neonateThe proposed project will developrefine and initially validate a novel hierarchical ventilator trigger algorithm and test this trigger system in a newly collectedreal world ICU dataset involving neonatesinfantsand children in the neonatal and pediatric ICU at Children s Hospital Los Angeles Project Narrative Minnesota HealthSolutions Corporation and Children s Hospital Los Angeles propose the development and validation of a novel methodology for effective triggering and synchronization of non invasive ventilationNIVfor infants and children in the intensive care unitICUThis method will overcome major limitations of currently available noninvasive ventilators when they are used on small infants and children and will lead to higher success rates of NIV for infants and childrenImproved NIV success rates will result in reduced intubation in neonates and young childrenwith reduced exposure to medications which harm the developing mindshorter ICU lengths of stayand fewer iatrogenic complications such as infectionventilator induced diaphragm dysfunctionand post ICU impairment in quality of life