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Surge Capacity Mechanical Ventilation

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Abstract:

Mechanical ventilation in a situation of mass casualty respiratory failure will require a substantial increase in the capacity for mechanical ventilation, to prevent unnecessary mortality. Concern over the difficulties of treating large numbers of patients with respiratory failure is exceeded only by our lack of experience on which to base decisions. This review evaluates the likely scenarios that could lead to mass casualty respiratory failure and the types of respiratory failure anticipated. A literature review was conducted, using the National Library of Medicine Medical Subject Headings terms "mass casualty respiratory failure," "pandemic flu," "disaster preparedness," and "mass casualty care." Papers were reviewed for relevance to the topic. There is little historical or empirical evidence upon which to base decisions regarding mass casualty respiratory failure and augmenting positive-pressure ventilation capacity. Matching the degree of respiratory impairment anticipated from the most likely mass casualty scenarios allows conclusions to be drawn regarding the performance characteristics of ventilators required for these situations. Little is known about the success of mechanical-ventilator stockpiling for mass casualty respiratory failure. Careful planning with an emphasis on matching ventilator performance to patient need and caregiver skill is critical to appropriate stockpile choices.

Keywords: MASS CASUALTY; MECHANICAL VENTILATION; PANDEMIC

Document Type: Research Article

Affiliations: 1: Department of Surgery, Division of Trauma/Critical Care, University of Cincinnati, Cincinnati, Ohio 2: Division of Pulmonary and Critical Care Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland 3: Division of Pulmonary and Critical Care Medicine, Harborview Medical Center, University of Washington, Seattle, Washington; United States Centers for Disease Control and Prevention; Seattle and King County Public Health, Seattle, Washington

Publication date: January 1, 2008

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