A preliminary clinical evaluation of a new portable life support ventilator with invasively ventilated home users

Background: Trilogy Evo (Philips Respironics, Murrysville PA) is a new life support ventilator that provides invasive and non-invasive ventilation to adult and pediatric patients with a minimum weight of 2.5kg. Aims: To evaluate the performance of the Trilogy Evo ventilator compared to parameters from user’s current ventilator. Methods: Patients treated with invasive mechanical ventilation via tracheostomy tube (IPAP 15.9 ± 3.2cmH2O, EPAP 5.3 ± 1.6cmH2O, and tidal volume 263 ± 166ml) were enrolled. At baseline, users were monitored on their current ventilator (LTV or Trilogy) for 15 minutes then were set-up on the Trilogy Evo for at least 15 minutes with one or more of the following circuits: Passive, ActivePAP, Active Flow and Dual Limb. Pulse oximetry (SpO2) and End Tidal CO2 (EtCO2) were recorded. Results: Thirteen participants (7 males, age 11.3 ± 10.1) completed the study. Modes utilized were SIMV-VC (n=9), S/T (n=3), and A/C-PC (n=1). Trilogy Evo passive circuit settings were IPAP 15.4 ± 3.7 cmH2O, EPAP 5.2 ± 1.5 cmH2O, and tidal volume 236 ± 166 ml. No clinical difference in EtCO2 mmHg (baseline 31.6 ± 6.3 vs Trilogy Evo 29.7 ± 6.9) or SpO2% (baseline 97.3 ± 1.8 vs Trilogy Evo 97.6 ± 1.2) were detected. In users with significant leaks around their trach tubes, the tidal volume and/or pressure settings needed to be decreased to match baseline therapy due to leak compensation algorithms with the passive circuit on Trilogy Evo. Conclusion: In this group of patients, Trilogy Evo provided effective ventilation based on SpO2 and EtCO2 values. The leak compensation capabilities may offer benefits to patients with airway leak issues.