|
?:abstract
|
-
BACKGROUND During the COVID-19 pandemic, a need for innovative, inexpensive, and simple ventilator devices for mass use has emerged. The Oxylator is an FDA approved, fist-size, ultra-light, portable ventilation device developed for out-of-hospital emergency ventilation. It has not been tested in conditions of severe lung injury or with added PEEP. OBJECTIVES 1) To assess the performance and reliability of the device in simulated and experimental conditions of severe lung injury, and 2) to derive monitoring methods allowing the delivery of a safe individualized ventilation during situations of surge. METHODS Functioning of the device with added PEEP valve was extensively tested on a bench, mimicking adult patients with various respiratory mechanics during controlled ventilation, spontaneous breathing, and prolonged unstable conditions where mechanics and/or breathing effort was changed at every breath. The device was further tested on a porcine model (n=4) with normal lungs and after inducing lung injury and was compared with conventional ventilation modes. RESULTS The device was stable and predictable: it delivered a constant flow (30 L/min) and cycled automatically at the inspiratory pressure set (minimum of 20 cmH2O) above auto-PEEP. Changes in respiratory mechanics manifested as changes in respiratory timing, allowing prediction of tidal volumes from respiratory rate. Simulating lung injury resulted in relatively low tidal volumes (330 mL with compliance of 20 mL/cmH2O). In the porcine model, arterial oxygenation, CO2 and pH were comparable to conventional modes of ventilation. CONCLUSION The Oxylator is a simple device that delivers stable ventilation with tidal volumes within a clinically acceptable range in bench and porcine lung models with low compliance. External monitoring of respiratory timing is advisable, allowing tidal volume estimation and recognition of changes in respiratory mechanics. The device can be an efficient, low-cost practical rescue solution for providing ventilatory support as a temporary bridge but requires a caregiver at bedside.
|
![[This page as RDF]](https://research.tib.eu/covid-19/static/rdf-icon.gif){kind=icon}