1998 OPEN FORUM Abstracts
WHAT ASPECTS OF VENTILATOR PERFORMANCE SHOULD BE MEASURED?
Dean Hess, PhD, RRT Assistant Professor of Anaesthesia Harvard Medical School Assistant Director of Respiratory Care Massachusetts General Hospital Boston, MA
Ventilator performance is an issue that is addressed by clinicians, managers, and manufacturers. There are currently few standards for the evaluation of many aspects of ventilator performance. Many of us have done a quick-and-dirty evaluation of ventilator performance by breathing on the ventilator ourselves or by attaching the ventilator to a simple rubber test lung. However, a systematic and precise evaluation requires sophisticated test lungs and measurement methodology. A variety of such equipment is commercially available. It is important that these systems evaluate aspects of ventilator performance during both full and partial ventilatory support. When evaluating new features on ventilators, I think that six important questions need to be asked:
* Does it make physiologic sense?
* Does it address an important clinical problem?
* Is there evidence to support its use?
* Does it add value?
* Is it easy to use clinically, with a low likelihood of misapplication?
* What happens when it fails?
The costs of introducing ventilator technology must be carefully considered and include issues such as hardware and software costs, training costs, liability costs, and costs of reusable supplies. In a managed care environment, it is important to appreciate that increased costs of a new technology cannot be recovered with increased patient changes. Accordingly, benefit must be achieved through improved patient comfort and/or compliance, decreased morbidity, increased survival, or decreased ventilator days, ICU days, or hospital days.
The 44th International Respiratory Congress Abstracts-On-Disk®, November 7 - 10, 1998, Atlanta, Georgia.