2007 OPEN FORUM Abstracts
EVALUATION OF THE BRONCHOTRON®-I ON A 2.8 KILOGRAM PIGLET LUNG MODEL
P. E. Fish1, W. Ware2, A. Prince2
Background: Start up or continuation of High frequency ventilation (HFV) during critical care transport poses difficulties because of power requirements and size of the most commonly used devices. The Bronchotron-I (Percussionaire®, Sandpoint, ID) is a lightweight, pneumatic powered, combination HFV/time-cycled conventional ventilator, packaged for this purpose. We evaluated the performance of the Bronchotron-I in the HFV mode on a 2.8 kg. piglet lung model.
Method: One 2.8 kg. Piglet with normal lungs was sedated, intubated with a 3.5 ETT and ventilated in the time cycled mode of the Bronchotron-I with the following settings: FIO2-21%, RR-10 breaths per minute (bpm), It-.35 seconds, PIP-12 cmH2O, PEEP-3 cmH2O MAP-6 cmH2O. Arterial and venous lines were inserted. Continuous blood pressure monitoring was obtained as well as arterial blood gas (ABG) measurements using the Via® low volume blood gas monitor (International Biomedical, Austin, TX). Baseline values were pH 7.41, PCO2 38.7, PO2 140, HCO3- 25, SPO2 100, BP 56/42, and HR 69. The piglet was then switched to the HFV mode at 480 bpm. Amplitude was set for a good chest wiggle and recorded from the analog manometer. MAP was set to match that of the conventional setting. FIO2 remained at 21%; ABGâs were recorded after stabilization. Lung injury was then induced by repeated saline lavage. The piglet was placed back on the Bronchotron-I at a rate of 480 bpm. FIO2 was maintained at 21%; Amplitude was set for a good chest wiggle and MAP adjusted to +2 cmH2O of the conventional ventilation setting while assessing for lung overinflation and compromised cardiac output. ABGâs and vitals were recorded. (Table 1)
Results: TABLE 1
Conclusion: Many infants with unanticipated problems are delivered in community hospitals. For infants referred to larger facilities that have failed to respond to conventional ventilator treatment or already initiated on HFV, the Bronchotron-I provides a lightweight, low power alternative. No adverse conditions were noted. The Bronchotron-I was capable of ventilating and oxygenating under the evaluation conditions. Improved monitoring especially for amplitude and MAP would be a suggestion. A tendency to over ventilate the normal piglet lungs in the HFV mode should be noted. Additional studies are recommended.