The Science Journal of the American Association for Respiratory Care

1999 OPEN FORUM Abstracts


Robert Campbell RRT, Richard Branson RRT, Jay Johannigman MD, Fred Luchette MD, Kenneth Davis JR. MD, Scott Frame MD. University of Cincinnati, Cincinnati, OH.

INTRODUCTION: The Achieva ventilator (Mallinkrodt/NPB, Minneapolis) is a new subacute care vent that is piston-based and is equipped with pressure control, pressure support, and flow triggering. We evaluated the Achieva clinically in terms of gas exchange, ventilatory parameters, and patient comfort.

Methods: Ten stable, mechanically ventilated ICU pts were placed on the Achieva after obtaining informed consent. Settings were identical to those provided with a standard ICU ventilator. Pts were monitored continuously for 4 hrs and an ABG was drawn for comparison with values obtained while on the ICU ventilator. Ventilatory variables (f, VT, VE, PIP) were measured, recorded and compared between ventilators. Each pt was asked to rate ?ease of breathing? (EOB) as: 1) very difficult, 2) difficult, 3) easy, or 4) very easy.

Results: Mean ventilator settings were SIMV rate of 3.8, VT of 755, PEEP of 6.0, PSV of 13.1, Ti of 1.1, and FiO2 of 0.41. Table 1 shows the results (mean ± SD) for ABGs, ventilatory variables, and EOB for both ventilation periods.

Table 1. Achieva ICU Vent.
PaCO2 (mmHg) 41.3 ± 9.7 39.9 ± 9.3
PaO2 (mmHg) 98.6 ± 32.3 99.4 ± 19.6
PIP (cmH2O) 34 ± 3.5 34 ± 5.2
Spont VT (ml) 422 ± 71 417 ± 101
Spont f (bpm) 17 ± 5.5 18 ± 5.7
VE (L/min) 10.5 ± 3.7 10.4 ± 3.1
EOB 3.1 ± 0.7 3.1 ± 0.9

Three pts experienced dyssnychrony with the Achieva during the trial. These periods were usually associated with a ?volume alarm? and were generally resolved after suctioning of the airway. CONCLUSION: The Achieva provides ventilation, oxygenation, and ease of breathing comparable to standard ICU ventilators in this sample of stable ICU pts.


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