Maintaining a high inspired oxygen fraction with the Elisée 350 turbine transport ventilator connected to two portable oxygen concentrators in an austere environment.


Journal

The journal of trauma and acute care surgery
ISSN: 2163-0763
Titre abrégé: J Trauma Acute Care Surg
Pays: United States
ID NLM: 101570622

Informations de publication

Date de publication:
09 2020
Historique:
pubmed: 30 5 2020
medline: 6 1 2021
entrez: 30 5 2020
Statut: ppublish

Résumé

Management of critically ill patients requiring mechanical ventilation in austere environments or during disaster response is a logistic challenge. Availability of oxygen cylinders for mechanically ventilated patient may be difficult in such a context. A solution to ventilate patients requiring high fraction of inspired oxygen (FiO2) is to use a ventilator able to be supplied by a low-pressure oxygen source connected with two oxygen concentrators (OCs). We tested the Elisée 350 (ResMedBella Vista, Australia) ventilator paired with two Newlife Intensity 10 (Airsep, Ball Ground, Georgia) OCs and evaluated the delivered FiO2 across a range of minute volumes and combinations of ventilator settings. The ventilators were attached to a test lung, OC flow was adjusted with a Certifier FA ventilator test systems from 2 to 10 L/min and injected into the oxygen inlet port of the Elisée 350. The FiO2 was measured by the analyzer integrated in the ventilator, controlled by the ventilator test system. Several combinations of ventilator settings were evaluated to determine the factors affecting the delivered FiO2. The Elisée 350 ventilator is a turbine ventilator able to deliver high FiO2 when functioning with two OCs. However, modifications of the ventilator settings such as an increase in minute ventilation affect delivered FiO2 even if oxygen flow is constant on the OC. The ability of two OCs to deliver high FiO2 when used with a turbine ventilator makes this method of oxygen delivery a viable alternative to cylinders to ventilate patients requiring an FiO2 of ≥80% in austere place or during disaster response. Feasibility study on test bench, level V.

Sections du résumé

BACKGROUND
Management of critically ill patients requiring mechanical ventilation in austere environments or during disaster response is a logistic challenge. Availability of oxygen cylinders for mechanically ventilated patient may be difficult in such a context. A solution to ventilate patients requiring high fraction of inspired oxygen (FiO2) is to use a ventilator able to be supplied by a low-pressure oxygen source connected with two oxygen concentrators (OCs). We tested the Elisée 350 (ResMedBella Vista, Australia) ventilator paired with two Newlife Intensity 10 (Airsep, Ball Ground, Georgia) OCs and evaluated the delivered FiO2 across a range of minute volumes and combinations of ventilator settings.
METHODS
The ventilators were attached to a test lung, OC flow was adjusted with a Certifier FA ventilator test systems from 2 to 10 L/min and injected into the oxygen inlet port of the Elisée 350. The FiO2 was measured by the analyzer integrated in the ventilator, controlled by the ventilator test system. Several combinations of ventilator settings were evaluated to determine the factors affecting the delivered FiO2.
RESULTS
The Elisée 350 ventilator is a turbine ventilator able to deliver high FiO2 when functioning with two OCs. However, modifications of the ventilator settings such as an increase in minute ventilation affect delivered FiO2 even if oxygen flow is constant on the OC.
CONCLUSION
The ability of two OCs to deliver high FiO2 when used with a turbine ventilator makes this method of oxygen delivery a viable alternative to cylinders to ventilate patients requiring an FiO2 of ≥80% in austere place or during disaster response.
LEVEL OF EVIDENCE
Feasibility study on test bench, level V.

Identifiants

pubmed: 32467466
doi: 10.1097/TA.0000000000002792
pii: 01586154-202009000-00032
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e59-e63

Références

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d'Aranda E, Bordes J, Bourgeois B, Clay J, Esnault P, Cungi P-J, Goutorbe P, Kaiser E, Meaudre E. Fraction of inspired oxygen delivered by Elisée™ 350 turbine transport ventilator with a portable oxygen concentrator in an austere environment. J Spec Oper Med. 2016;16(3):30–35.
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Auteurs

Michaël Cardinale (M)

From the Intensive Care and Anesthesia Federation (M.C., P-J.C., J.B., S.S., E.M., G.L.), Sainte Anne Military Teaching Hospital, Toulon; Central Establishment of Equipment of the Military Health Service (F.C.), Orléans; and Anesthesia Service (A.L.), Laveran Military Teaching Hospital, Marseille, France.

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