The Science Journal of the American Association for Respiratory Care

1997 OPEN FORUM Abstracts


Robert Campbell RRT, Jay Johannigman MD, Kenneth Davis Jr., MD, Richard D. Branson RRT. Department of Surgery, University of Cincinnati, Cincinnati, OH.

Background: Transport of the mechanically ventilated patient can be aided by use of a transport ventilator. We evaluated the Impact 754 in the laboratory and during transport of mechanically ventilated patients from the ICU. The 754 has an integral compressor, blender, and PEEP control. Method: Tidal volume (V_{T}) delivery and FIO_{2} stability were measured during simulated ventilatory support of a lung model at V_{T}'s of 250, 500, 750, and 1000 mL, PEEP of 0-10 cm H_{2}O, FIO_{2} of 0.21, 0.5 and 1.0, respiratory frequency of 10-20 b/min, and varying compliance and resistance settings (compliance 0.02-0.1 L/cm H_{2}O, resistance 5-20 cm H_{2}O/L/s). Volume measurements were made using integral test lung software (PneuView, Michigan Instruments). Airway pressures were measured with standard physiologic transducers and FIO_{2} was measured with a precision analyzer (OM-11, Sensormedics, Inc). Twelve patients requiring transport from the ICU had ABG's measured prior to transport (PB 7200ae) and after transport (Impact 754). Ventilator settings were matched for V_{T}, FIO_{2}, PEEP, and f. Results: Tables 1 and 2 show laboratory and clinical findings respectively. Data were analyzed using a t-test, (*p < 0.05).

Table 1 C_{L} =0.1, Raw=5 C_{L}=0.02, Raw=5 C_{L}=0.02, Raw=20

Set V_{T}/FIO_{2}

V_{T}(mL) FIO_{2}(%) V_{T}(mL) FIO_{2}(%) V_{T}(mL) FIO_{2}(%)

250 mL/0.5 247(12) 47(3) 230(10) 48(3) 213(16)* 47(2)

500 mL/0.5 509(21) 46(4) 471(32) 53(2) 440(16)* 52(4)

1000mL/0.5 1056(40) 48(4) 945(34) 50(3) 815(15)* 54(3)

Table 2 Nellcor PB 7200ae Impact 754

pH 7.37(0.08) 7.35(0.1)

PaCO_{2} 45(4) 44(5)

PaO_{2} 84(17) 88(13)

Average duration of transport was 75 (22)mins. Mean PEEP was 9(3) cm H_{2}O and mean FIO_{2} was 48(8). Conclusions: Delivered V_{T} diminished as peak pressure increased and compressible volume of the circuit increased. The decrement in V_{T} was significant at C_{L} =0.02, Raw =20. FIO_{2} was stable at all settings tested. Patients tolerated transport and there were no adverse events. There were no significant differences in blood gases between the ICU ventilator (7200ae) and Impact 754. The Impact 754 provides adequate ventilation and oxygenation during transport of ICU patients and provides an adjustable FIO_{2}.


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