Bench Tests of Simple, Handy Ventilators for Pandemics: Performance, Autonomy, and Ergonomy

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Abstract:

BACKGROUND: It has been pointed out that in the wake of a virulent flu strain, patients with survivable illness will die from lack of resources unless more ventilators are made available. Numerous disaster-type ventilators are available, but few evaluations have been performed. OBJECTIVE: To compare simple, lightweight, and handy ventilators that could be used in the initial care of patients with respiratory distress. METHODS: We bench-tested 4 volume-cycled ventilators (Carevent ALS, EPV100, Pneupac VR1, and Medumat Easy) and 2 pressure-cycled ventilators (Oxylator EMX and VAR-Plus). We studied their general physical characteristics, sonometry, gas consumption, technical performance, ergonomy, and user-friendliness. With a test lung we assessed performance at FIO2 of 0.50 and 1.0, set compliance of 30, 70, and 120 mL/cm H2O, and set resistance of 5, 10, and 20 cm H2O/L/s. To study user-friendliness and ergonomy we conducted, in randomized order, 7 or 8 objective, quantitative tests and 2 subjective tests. RESULTS: Compliance and resistance strongly affected tidal volume with the pressure-cycled ventilators (from 418 ± 49 mL to 1,377 ± 444 mL with the VAR-Plus, at the lowest pressure level), whereas the volume-cycled ventilators provided a consistent tidal volume in the face of changing test lung characteristics. CONCLUSIONS: We are concerned that the pressure-cycled ventilators did not provide a consistent tidal volume, and under certain conditions the volume delivered would be unsafe (too large or too small). Most of the volume-cycled ventilators proved to be technically efficient and reliable. Their reliability, portability, and ease of use could make them valuable in natural disasters and mass-casualty events.

Keywords: disaster; emergency; influenza; mass-casualty event; mechanical ventilator; pandemic

Document Type: Research Article

DOI: http://dx.doi.org/10.4187/respcare.00841

Affiliations: Département de Médecine Familiale et Médecine d’Urgence, Université Laval, Québec, Canada; Centre de Recherche du Centre Hospitalier Affilié Universitaire Hôtel-Dieu de Lévis et Centre Hospitalier Affilié l’Hôpital de l’Enfant-Jésus, Québec, Canada; Pôle Urgences-Service d’Aide Médicale Urgente, Centre Hospitalier Universitaire de la Cavale Blanche, Brest, France

Publication date: June 1, 2011

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