Hostname: page-component-848d4c4894-ttngx Total loading time: 0 Render date: 2024-05-08T17:09:49.126Z Has data issue: false hasContentIssue false
  • English
  • Français

Gas-Powered and Portable Ventilators: An Evaluation of Six Models

Published online by Cambridge University Press:  28 June 2012

Jerry P. Nolan  and
Peter J.F. Baskett
Jerry P. Nolan
Affiliation:
Senior Registrar in Anaesthesia, Royal United Hospital, Bath, United Kingdom
Peter J.F. Baskett
Affiliation:
Consultant Anaesthetist, Frenchay Hospital, Bristol, United Kingdom
Get access Rights & Permissions [Opens in a new window]

Abstract

Introduction:

Gas-powered resuscitators (ventilators) designed to be used primarily for resuscitation should be basic and simple to use. They offer many advantages over manual methods of ventilation during in-hospital cardiopulmonary resuscitation. Portable ventilators intended for critical care transport require additional, more sophisticated features such as: adjustable pressure limiting valves, air-mixing, airway pressure gauge, independent tidal volume and rate controls, and a Positive End-Expiratory Pressure (PEEP) valve. The performance of six gas-powered resuscitators/portable ventilators (TransPAC, Oxylog, Ambu Matic, ERA 2000, Uni-Vent, and MARS) was evaluated.

Methods:

The accuracy of volumes delivered to a test lung at three different compliance and resistance settings, was assessed for each ventilator prior to clinical evaluation during cardio-pulmonary resuscitation (CPR) and patient transport.

Results:

In each circumstance, measured tidal volumes and levels of minute ventilation decreased as resistance was increased and compliance reduced. Much of this loss of measured tidal volume occurred through inspiratory pressure relief valves that tended to start leaking at pressures below the preset level. Increasing levels of back-pressure resulted in further reductions in tidal volume when the ventilators were tested using the air-mix mode (available on three of the devices). In general, each resuscitator functioned well when used during CPR within the hospital.

Conclusions:

Each resuscitator tested failed to deliver the preset volumes and this must be considered during their use. Inspiratory pressure relief valves for all but one of the ventilators tested would not permit the delivery of adequate levels of ventilation in patients with low pulmonary compliance and/or high airway resistance.

Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 7 , Issue 1 , March 1992 , pp. 25 - 34
Copyright
Copyright © World Association for Disaster and Emergency Medicine 1992

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Branson, RD, McGough, EK: Transport ventilators. Problems in Critical Care 1990;4:254–274.Google Scholar
2. Gray, AJG: Portable lung ventilators. Brit J Hosp Med 1981;173–178.Google Scholar
3. Resuscitators intended for use with humans ISO 8382:1988, International Organization for Standardization, 1988.Google Scholar
4. British Standard Specification for ventilatory resuscitators BS 6850:1987, British Standards Institution, 1987.Google Scholar
5. Eaton, JM: Adult manual resuscitators. Brit J Hosp Med 1984;67–70.Google Scholar
6. Melker, RJ, Banner, MJ: Ventilation during CPR: Two-rescuer standards reappraised. Ann Emerg Med 1985;14:397–402.CrossRefGoogle ScholarPubMed
7. Phillips, GD, Skowronski, GA: Manual resuscitators and portable ventilators. Anaesthesia and Intensive Care 1986;14:306–313.CrossRefGoogle ScholarPubMed
8. Park, GR, Johnson, S: A ventilator for use during mobile intensive care and total intravenous anaesthesia. The Drager Oxylog. Anaesthesia 1982;37:1204–1208.CrossRefGoogle ScholarPubMed
9. Park, GR, Manara, AR, Bodenham, AR, Moss, CJ: The pneuPAC ventilator with new patient valve and air compressors. Anaesthesia 1989;44:419–424.CrossRefGoogle ScholarPubMed
10. Nichols, PKT, Sedwards, BJ: Higher pressure ventilation and the Bain coaxial breathing system. Anaesthesia 1991;46:994.Google ScholarPubMed
11. Resuscitators, resuscitates containers and resusdtator kits. AS 2488:1981, Standards Association of Australia, 1981.Google Scholar
12. Hess, D, Baran, C: Ventilatory volumes using mouth-to-mouth, mouth-to-mask, and bag-valve-mask techniques. Am J Emerg Med 1985;3:292–296.CrossRefGoogle ScholarPubMed
13. Harrison, RR, Maull, KI, Keenan, RL: Mouth-to-mask ventilation: A superior method of rescue breathing. Ann Emerg Med 1982;11:74–76.CrossRefGoogle ScholarPubMed
14. Harber, T, Lucas, BGB: An evaluation of some mechanical resuscitators for use in the ambulance service: Annals of the Royal College of Surgeons of England 1980;62:291–293.Google ScholarPubMed
15. Grande, CM, Williams, D, McCauley, M: Critical care transport: Mobile management of the trauma patient inside and outside the trauma center. In Stene, JK, Grande, CM (eds): Trauma Anesthesia. 1990, Williams & Wilkins, Baltimore, pp 407.Google ScholarPubMed
16. Heinrichs, W, Mertzlufft, F, Dick, W: Accuracy of delivered versus preset minute ventilation of portable emergency ventilators. Crit Care Med 1989;17:682–685.CrossRefGoogle ScholarPubMed