The Science Journal of the American Association for Respiratory Care

2008 OPEN FORUM Abstracts

THE OSCILLATRON® SERVO IN A PATIENT WITH SEVERE HYPOXEMIC RESPIRATORY FAILURE IMPROVES OXYGENATION

Felix Khusid1, Emma Fisher1, Gerard Lombardo1, Sagar Naik1



Introduction: The Oscillatron® Servo is a Bi-Phasic active push and pull diaphragm with an active exhalation phase. It is attached to the primary ventilator in order to provide High Frequency Oscillations that are running through the convective breath of the ventilator.

Case Description:
A 21 year old man with a history of epilepsy and mild retardation, was admitted to the ICU with aspiration pneumonia, unspecified septicemia, and respiratory failure. CT of the chest revealed bilateral consolidation extending from the posterior lower lobes to the posterior upper lobes associated with sub segmental atelectasis . There was difficulty stabilizing oxygenation and ventilation on conventional mechanical ventilation settings prompting addition of an Oscillatron to the conventional ventilator . Improvement was dramatic and resulted in rapid stabilization of respiratory gases. After four (4) weeks of prolonged ventilatory support patient was weaned off mechanical ventilation and discharged home.

Discussion: Patient was on the ventilator with the following settings:

CMV-14, VT-450 ml, FIO2 - 1.0, Peep + 11 cm H2O
ABG revealed PH-7.41, PaCO2-51, PaO2-82.

The Oscillatron® Servo was added to the Dräger Evita XL Ventilator at a frequency of 530 oscillations per minute and amplitude of 5cm H2O

One hour later ABG revealed PH-7.50, PaCo2-40, PaO2-205

Within twenty-four (24) hours on the Oscillatron® Servo, the FIO2 was successfully decreased to 40% and PEEP decreased to 8cmH2O.

Conclusion: The Oscillatron® Servo is capable of delivering from 400 - 900 oscillations per minute as well as controlling the I:E ratio of those oscillations. The Oscillatron® Servo enables improvement of oxygenation through enhanced diffusion, creating oscillatory FRC that results in improved intrapulmonary gas mixing within the lungs.