1 / 1

Results and Discussions Pressure and alarms of aestiva5

Are ventilators with an American or a European breathing bag safe to prevent accidental volutrauma? Steven M. Cnudde, M.D 1 ., Jan Paul J Mulier, M.D 1 ., Ph.D., Thomas Deckmyn, M.D 2 . 1 Dep of Anaesthesiology, AZ St Jan AV Brugge, Belgium 2 Dep of Anaesthesiology, AZ St Lucas Brugge, Belgium.

hector
Download Presentation

Results and Discussions Pressure and alarms of aestiva5

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Are ventilators with an American or a European breathing bag safe to prevent accidental volutrauma?Steven M. Cnudde, M.D1., Jan Paul J Mulier, M.D1., Ph.D., Thomas Deckmyn, M.D2. 1Dep of Anaesthesiology, AZ St Jan AV Brugge, Belgium2Dep of Anaesthesiology, AZ St Lucas Brugge, Belgium • Results and Discussions • Pressure and alarms of aestiva5 • The USA breathing bag has a maximum pressure of 34 cmH20. • The EUR breathing bag has a maximum pressure of 46 cmH20. • Airway pressure stayed above 20 cm H20 for more then 10 seconds in all three ventilators. • Discussion: • Healthy ASA I patients and children with a high total lung compliance might have hyperinflation at a continous airway pressure of 20 cmH20. • APL valve and alarms below 20 cmH20 makes manual ventilation impossible. • Correct alarm and APL setting could not prevent hyperinflation in case of human error. • Conclusion: • 1. The tested ventilators are dangerous to very dangerous. • 2. Correct alarm and APL setting are important but only vigilance remains the cornerstone of safety. • 3. Technical improvement is possible to prevent hyperinflation and would be ideal to protect every ventilator with a manual ventilation mode. • Background: • The APL valve protects against high airway pressures. • At induction: Fresh gas flow high. • The APL valve at maximum (facilitating face mask ventilation). • Dangerous: if ventilation mode remains manual. • Airway pressure rises very fast and causes volutrauma if no immediate reaction occurs. • Goal of the study: • Evaluation of 3 ventilators: • Aestiva 5 from Datex-Ohmeda • Julian from Draeger • Neptune from Medec • in the manual ventilation mode, without manual compression • Materials and methods: • The airway pressure is measured and the time when an alarm went off. • Two types of breathing bags (2l.) are connected for manual ventilation: • An European type (Ch Medical, Ltd) latex free balloon • An USA type (Vital signs, Inc) latex free balloon • Fresh gas flow at 12 l/min. Airway pressure alarm at maximum level. • The artificial lung (Pulmo-Sim apparatus from Blease) with a compliance of 23 ml/cm H20. • At T0 the ventilator is switched to a manual ventilation mode without compression of the breathing bag. • The airway pressure is monitored. • The time when the alarms went off are noted by a high frequency pulse given on the pressure transducer. • A ventilator is considered • dangerous if the airway pressure stayed above 20 cm H20 for more than 10 seconds and • very dangerous if no alarm did go off in that time. Anesthesiology 2006; 105: A932 ,Annual Meeting ASA October 14-18, 2006 McCormick Place-Chicago, Illinois

More Related