is a retired Army Nurse Corps officer and currently is a clinical professor teaching didactic instruction for the US Army Graduate Program in Anesthesia Nursing, Ft Sam Houston, Texas. Email:
is an Army Nurse Corps officer and currently serves as the director, US Army Graduate Program in Anesthesia Nursing, Ft Sam Houston, Texas.
AANA J. 2021 Apr;89(2):125-132.
For far-forward resuscitative care for combat trauma casualties, the field anesthesia machine best suited is the Universal Portable Anesthesia Complete (UPAC, Datex Ohmeda, GE Healthcare). However, no provision was made for mechanical ventilation. Historically the Impact Uni-Vent 754 ventilator (Impact Instrumentation, Zoll Medical Corp) was used to provide hands-free ventilation but has limitations. There are 3 other field-capable ventilators that could fill the gap, but no known published research studies exist that examine the compatibility of these ventilators with the UPAC. The research question of this experimental, crossover design study was: Are there operational differences in the Impact 754, Impact Uni-Vent 731, Hamilton-T1 (Hamilton Medical Inc), and second-generation Simplified Automated Ventilator (SAVe II, AutoMedx) ventilators' performance relative to tidal volumes, rates, and inhaled anesthetic concentrations when used with the UPAC? The Impact 754 was most accurate (P<.05), followed by the Impact 731, and Hamilton-T1, and the SAVe II was the least accurate related to minute ventilation comparisons. Each ventilator demonstrated effective inhaled anesthetic delivery (r=0.97-0.99). Data analysis results demonstrated statistical and clinical significance in the reliability of the tested ventilators to deliver set volumes and rates while delivering predictable and accurate amounts of volatile anesthetic.
对于战斗创伤伤员的远前救治,最合适的现场麻醉机是通用便携式麻醉机(UPAC,Datex Ohmeda,GE Healthcare)。然而,它没有提供机械通气的功能。历史上,Impact Uni-Vent 754 呼吸机(Impact Instrumentation,Zoll Medical Corp)曾用于提供免提通气,但有一定的局限性。还有 3 种其他可在现场使用的呼吸机可以填补这一空白,但目前尚无已知的研究对这些呼吸机与 UPAC 的兼容性进行研究。本实验性交叉设计研究的研究问题是:当与 UPAC 一起使用时,Impact 754、Impact Uni-Vent 731、Hamilton-T1(Hamilton Medical Inc)和第二代 Simplified Automated Ventilator(SAVe II,AutoMedx)呼吸机在潮气量、呼吸频率和吸入麻醉剂浓度方面的性能是否存在操作差异?Impact 754 最为准确(P<.05),其次是 Impact 731 和 Hamilton-T1,而 SAVe II 在分钟通气量比较方面最不准确。每个呼吸机都证明了有效的吸入麻醉剂输送(r=0.97-0.99)。数据分析结果表明,在提供设定的体积和频率的同时,测试呼吸机具有输送可预测和准确的挥发性麻醉剂的可靠性,这在统计学和临床方面都具有重要意义。