[abstract] OMNI-VENT: ANOTHER OPTION FOR MECHANICAL VENTILATION IN THE MONOPLACE HYPERBARIC CHAMBER

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[abstract] OMNI-VENT: ANOTHER OPTION FOR MECHANICAL VENTILATION IN THE MONOPLACE HYPERBARIC CHAMBER

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Title: [abstract] OMNI-VENT: ANOTHER OPTION FOR MECHANICAL VENTILATION IN THE MONOPLACE HYPERBARIC CHAMBER
Author: Churchill, S; Weaver, LK; Haberstock, D
Abstract: BACKGROUND: Some critically ill patients needing hyperbaric oxygen therapy (HBO2) may have significant lung injury (e.g. ARDS) that creates a clinical decision making dilemma regarding the ability to adequately ventilate the patient while compressed in the hyperbaric chamber. To our knowledge, the 500A ventilator (Sechrist Industries, Anaheim, CA) is currently the only ventilator used in monoplace HBO2. It is limited regarding the delivery of high minute ventilations, particularly with test lungs of low compliance (CL)1. In looking for a ventilator that could deliver the tidal volume (VT) and ventilatory rate (VR), with concomitant high positive end-expiratory pressures (PEEP) at chamber pressures of 3 atm abs, the Omni-Vent (Omni-Tech, Topeka, KS) was chosen because of its performance in air and in-hospital transports. The performance of the 500 A and the Omni-Vent (O-V) ventilators were tested, simulating a patient with low CL = 8 cm H20, airway resistance = 0, and PEEP = 20 cm H20. Both ventilators were evaluated to a goal VR = 37/min and VT = 500 ml, flows set to maximum, at chamber pressures from 0.85-3.0 atm abs. The ventilators supply pressures were adjusted to maximum. RESULTS: Ppk+ Peak Airway pressure, I/E = Inspiratory/Expiratory Time Ratio. See aqua box for RESULTS. CONCLUSION: The Omni-Vent performance was superior to the Sechrist 500A in this extreme testing circumstance by delivering a higher VT and VR with lower I/E ratio. The 500A performs well in patients with CL greater than 50 ml/cm H2O, VR less than 18/min, VT less than 600/ml, PEEP less than 10 cm H2O. Outside of these parameters there are risks for inverted I/E ratio, stacking of breaths, hypotension, and pulmonary barotrauma which may be reduced with the O-V. The technical ability to ventilate a patient does not necessarily support that it should be done. The evaluation of the potential risk and benefit of HBO2 for critically ill patients is essential.1 Weaver, L. et al., Hyperbaric Medicine Practice 1994.
Description: Undersea and Hyperbaric Medical Society, Inc. (http://www.uhms.org )
URI: http://archive.rubicon-foundation.org/636
Date: 1998

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  • UHMS Meeting Abstracts
    This is a collection of the published abstracts from the Undersea and Hyperbaric Medical Society (UHMS) annual meetings.

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