University of Cincinnati, Department of Surgery, Cincinnati, OH, USA.
Prehosp Disaster Med. 2011 Oct;26(5):330-4. doi: 10.1017/S1049023X1100656X.
Disasters and mass-casualty scenarios may overwhelm medical resources regardless of the level of preparation. Disaster response requires medical equipment, such as ventilators, that can be operated under adverse circumstances and should be able to provide respiratory support for a variety of patient populations.
The objective of this study was to evaluate the performance of three portable ventilators designed to provide ventilatory support outside the hospital setting and in mass-casualty incidents, and their adherence to the Task Force for Mass Critical Care recommendations for mass-casualty care ventilators.
Each device was evaluated at minimum and maximum respiratory rate and tidal volume settings to determine the accuracy of set versus delivered VT at lung compliance settings of 0.02, 0.08 and 0.1 L/cm H20 with corresponding resistance settings of 10, 25, and 5 cm H2O/L/sec, to simulate patients with ARDS, severe asthma, and normal lungs. Additionally, different FIO2 settings with each device (if applicable) were evaluated to determine accuracy of FIO2 delivery and evaluate the effect on delivered VT. Ventilators also were tested for duration of battery life.
VT decreased with all three devices as compliance decreased. The decrease was more pronounced when the internal compressor was activated. At the 0.65 FIO2 setting on the MCV 200, the measured FIO2 varied widely depending on the set VT. Battery life range was 311-582 minutes with the 73X having the longest battery life. Delivered VT decreased toward the end of battery life with the SAVe having the largest decrease. The respiratory rate on the SAVe also decreased approaching the end of battery life.
The 73X and MCV 200 were the closest to satisfying the Task Force for Mass Critical Care requirements for mass casualty ventilators, although neither had the capability to provide PEEP. The 73X provided the most consistent tidal volume delivery across all compliances, had the longest battery duration and the least decline in VT at the end of battery life.
无论准备程度如何，灾难和大规模伤亡场景都可能使医疗资源不堪重负。灾难应对需要医疗设备，例如呼吸机，可以在不利情况下运行，并且应该能够为各种患者人群提供呼吸支持。
本研究的目的是评估三种设计用于在医院环境之外和大规模伤亡事件中提供通气支持的便携式呼吸机的性能，并评估它们对大规模重症监护呼吸机的任务组推荐的符合程度。
在最小和最大呼吸频率和潮气量设置下评估每个设备，以确定在肺顺应性设置为 0.02、0.08 和 0.1 L/cm H20 时，设定与输送 VT 的准确性，以及相应的阻力设置为 10、25 和 5 cm H2O/L/sec，模拟患有 ARDS、严重哮喘和正常肺的患者。此外，评估了每种设备（如果适用）的不同 FIO2 设置，以确定 FIO2 输送的准确性并评估其对输送 VT 的影响。还测试了呼吸机的电池寿命。
随着顺应性的降低，所有三种设备的 VT 均降低。当内部压缩机激活时，降低更为明显。在 MCV 200 的 0.65 FIO2 设置下，测量的 FIO2 变化很大，具体取决于设定的 VT。电池寿命范围为 311-582 分钟，73X 的电池寿命最长。随着 SAVe 的电池寿命接近尾声，输送的 VT 下降。SAVe 的呼吸频率也在接近电池寿命结束时下降。
73X 和 MCV 200 最接近满足任务组对大规模伤亡呼吸机的要求，尽管两者都没有提供 PEEP 的能力。73X 在所有顺应性下提供了最一致的潮气量输送，电池寿命最长，在电池寿命结束时 VT 下降最小。
