2003 OPEN FORUM Abstracts
Bench testing the Viasys Corpak Pulmanex Pulmonary Assist
Mark Rose RRT, Anne Schaer RRT, Mike Trevino RRT, Gary L. Weinstein MD FCCP, Presbyterian Hospital of Dallas.
Background: In an effort to reduce expenditures, our facility opted to better utilize a piece of equipment that had already been in use as part of the anesthesia circuit. This device, (Pulmanex Sideport Kit #BLD-83167) consists of an adjustable sideport relief valve, that when attached to a 3L non self-inflating bag, enables the user to provide manual ventilation. The bag's intended use was to ventilate post-operative patients during transport from the operating room to the ICU. Additionally, the bag was intended to replace the standard self-inflating bag for this patient population while they remained intubated. We encountered several patients that were transported to the ICU with this bag/valve/ETT combination that presented with apparent problems relating to ventilation. In an effort to better understand the properties of this bag, we constructed the following test.
METHODOLOGY: Using a bench model (Michigan Instruments 5600i), we evaluated the Corpak Pulmanex Pulmonary Assist Circuit. Vt and PEEP were assessed at varying compliance and resistance settings utilizing inlet flow rates of 4, 8 and 12 LPM. Four scenarios are presented on the table below using a single-handed technique at a frequency of 10 bpm for all three liter flows. We ran these tests for 3 minutes each, as this represents the average time involved transporting a pt from the operating room to the ICU. Additionally, a static test at all three liter flows was performed with the bag attached for 30 seconds to evaluate PEEP rise.
|Flowrate lpm||#1 open/closed||#2 open/closed||#3 open/closed||#4 open/closed|
|4 lpm||Vt ml.||502||954||274||304||292||388||280||390|
|8 lpm||Vt ml.||1108||718||1108||718||1106||1016||272||672|
|12 lpm||Vt ml.||1140||534||284||1192||916||534||328||502|
Test 1: C=0.05L/cmH2O, R=5.0L/sec/cmH2O. Test 2: C= 0.05L/cmH2O, R=50.0L/sec/cmH2O.
Test 3: C= 0.02L/cmH2O, R=5.0L/sec/cmH2O. Test 4: C= 0.02L/cmH2O, R=50.0L/sec/cmH2O.
Open: sideport valve turned all the way open.
Closed: sideport valve turned all the way closed.
CONCLUSION: We concluded that; when used according to manufacturers recommendations, this bag functions as designed as a rebreathing device while attached directly to an endotracheal tube. However, due to the nature of the sideport valve and patient lung dynamics, this bag may not be adequate for some patient populations. Our study illustrates the importance of proper and thorough education with respect to this non-self inflating, rebreathing bag.