2010 OPEN FORUM Abstracts
A LOW COST ALTERNATIVE FOR MECHANICAL VENTILATION IN LARGE SCALE DISASTERS.
Matthew Callaghan1, Dhruv Boddupalli2, Paul Yock1, Stephen Ruoss2, Thomas Krummel3; 1Biodesign, Stanford University, Stanford, CA; 2Medicine, Stanford University, Stanford, CA; 3Surgery, Stanford University, Stanford, CA
Introduction: Catastrophic disasters, particularly an influenza pandemic, force difficult allocation decisions for mechanical ventilation due to the high cost of these devices. Pandemic modeling suggests 750,000 additional ventilators may be required to meet demand in the US. This study compared a novel low-cost device with current ventilators using in-vivo and simulated ARDS models. Methods: A low-cost ventilator was constructed around a unique microprocessor and solenoid assembly to support adults and children in accordance with the ARDSnet protocol. An Oceanic/Magellan was used for comparison. ARDS was induced in swine with oleic acid injection (0.3mg/kg) and defined as PaO2/FiO2 < 200. Ventilation targets were a PaO2 >60mmHg and tidal volume ~15cc/kg. In simulation studies (Ingmar 4000 Servo Lung), ARDS was defined by 30ml/cmH2O compliance and 10cmH2O/l/s airway resistance. A Drager Evita was used for comparison. Results: In swine studies, there was no significant difference in performance between ventilators. Both maintained tidal volumes of 15cc/kg delivering inspiratory pressures to 50cmH2O with PEEP of 15cmH2O. Above 35cmH2O, the error in displayed pressure was 10%+/-2 on the Oceanic/Magellan and < 1% on the experimental device. In simulation studies, there was no significant difference in performance or display accuracy (< 1%) between ventilators. Trigger sensitivity and response times (+/- 0.5cmH2O and < 0.3sec) were similar in A/C modes. Conclusions: Here we describe a novel design for a low-cost ventilator. In-vivo and simulator performance in ARDS was comparable to existing devices. At approximately 1/10 the cost of current ventilators, this technology represents an alternative solution for pandemic stockpiling and emergency use. Sponsored Research - None