PERFORMANCE COMPARISON OF 15 TRANSPORT VENTILATORS
Fig. 1. PaCO2, arterial pH, and ratio of PaO2 to fraction of inspired oxygen (FIO2) in healthy (no lung injury) sheep during ventilation with 14 transport ventilator models. Each set of values represents data from a single sheep. Assessment was performed on 2 sheep with each ventilator. The large variability in the ratio of PaO2 to fraction of inspired oxygen (PaO2/FIO2) is because some of the ventilators only offer only 1 or 2 FIO2 settings, and because of the level of gas exchange in each sheep. The Vortran RespirTech Pro could not be used on the animals we tested. The Percussionaire TXP and the Vortran RespirTech Pro could not be set to the specifications required by the lung model. U Univent Eagle 754. P Pulmonetic Systems LTV 1000. V VersaMed iVent. B Bird Avian. M Oceanic Medical Products Magellan. N Newport HT50. PT Pneupac Parapac Transport 200D. PM Pneupac Parapac Medic. C Pneupac Compac 200. BI Bio-Med Devices IC2A. BC Bio-Med Devices Crossvent 3. CV Carevent ATV. A Life Support Products AutoVent 2000. PC Percussionaire TXP.
ation target under all conditions with the lung-injured sheep. As with the uninjured sheep, with all the ventilators the hemodynamics were stable throughout the tests.
Use of Transport Ventilators
The major findings of this study are: 1. All the evaluated ventilators were able to maintain normal ventilation and hemodynamics in healthy sheep.
2. In the lung-injured sheep, few of the ventilators could be set to meet the PaCO2 or pH targets. The ventilators unable to meet these targets were limited by the RR set- ting.
3. In the bench study, only 6 of the ventilators met the VT and RR settings under all the test conditions.
4. Only 5 of the ventilators (Univent Eagle 754, Ver- saMed iVent, Newport HT50, Pulmonetic Systems LTV 1000, and Pneupac Compac 200) can operate without a compressed gas source, and their battery life differed con- siderably.
5. A full E-size cylinder of oxygen allowed ventilation with 100% oxygen for only 30–77 min.
6. The 2 ventilators most suitable for use in front-line rescue situations, where oxygen may not be available, are the Newport HT50 and the Univent Eagle 754.
Transport ventilators are required in various settings: intra-hospital, inter-hospital, pre-hospital, and in the field by military or civilian authorities.3 Each of these settings has different priorities regarding ventilator design. In for- ward military or field use by civilian groups, the ideal ventilator would be simple to operate, battery powered, compact, lightweight, and would operate without com- pressed gas. In that setting it is unlikely that the patient will be breathing spontaneously, so versatility of available modes is unnecessary. Similar issues exist during pre-hos- pital transport, but compressed gas is readily available in most ambulances, so a pneumatically operated ventilator is as acceptable as a battery operated unit. During inter-hos- pital transport the patient may be breathing spontaneously, which necessitates patient-triggered ventilation, and fre- quently these patients require high FIO2.
The most common use of transport ventilators is in in- tra-hospital transport. At Massachusetts General Hospital, the respiratory care department performs about 30 one- way patient transports per day and another 10–15 are per- formed by the anesthesia department, all of which require continuous mechanical ventilation. Most of these trans-
RESPIRATORY CARE JUNE 2007 VOL 52 NO 6