1997 OPEN FORUM Abstracts
CASE STUDY OF VENTILATOR GRAPHICS AS AN ADJUNCT TO LIQUID VENTILATION IN PREMATURES.
Raymond Malloy BS RRT, William Bucher RRT, John Emberger BS RRT, Herbert Patrick MD, Jay Greenspan MD, Departments of Pulmonary Care and Neonatology, Thomas Jefferson University Hospital, Inc, Philadelphia PA.
Background: Prematures with severe RDS have been studied on liquid ventilation as a national study. When liquid ventilation has been used, frequent refilling is required (up to Q hour). Filling has been based on chest x-rays, endotracheal tube meniscus, and intermittent pulmonary function testing. Hypothesis: We wanted to determine if real-time ventilator graphics of pulmonary function change before and after refilling the liquid for ventilation of the lungs of a premature. Methods: In this case study, the premie was ventilated with the Bear Cub 750 including the real-time graphics package. We monitored the premie before refilling and after refilling. Pressure/Volume Loops (graphical representation of PFT values) were printed out as shown below. Results: The figures represent Pressure/Volume Loops of a premie on liquid ventilation just before refilling the lungs (Pre-Fill) and then just after refilling the lungs (Post-Fill). For these two separate fills, 5 cc was used in the first and 8 cc was used in the second.
(See original for figures)
Conclusions: In this case, change can be appreciated in the Pressure/Volume Loops with refilling during liquid ventilation. Changes include both change in the area of the curve and slope of the curve. We have not yet done quantitative measures, but graphics alone will help bedside clinicians determine when refilling is necessary. The application of graphics may also play an important role in surfactant or bronchodilator delivery, endotracheal tube placement, and endotracheal tube leak management.