A mass-casualty respiratory failure event where patients exceed available ventilators has spurred several proposed solutions. One proposal is use of a single ventilator to support 4 patients.A was modified allow attachment circuits. Each circuit connected one chamber 2 dual-chambered, test lungs. The set at tidal volume (V(T)) 2.0 L, frequency 10 breaths/min, and PEEP 5 cm H(2)O. Tests were repeated with pressure targeted breaths 15 Airway pressure, volume, flow measured each chamber. lungs...

ABSTRACT Introduction Secondary injury following traumatic brain (TBI) commonly results from hypoxia. Cabin Altitude Restriction (CAR) is used in postinjury aeromedical evacuation (AE) to reduce the hypobaric effects of flight on wounded warriors. Previous work has shown increased inflammation after high altitude exposure TBI. The aim this study determine level systemic induced by conditions CAR Methods Forty-eight female pigs were utilized test TBI vs. sham, hypobaria and standard cabin...

Mechanical ventilation requires frequent reassessment from providers to ensure delivery of lung protective ventilation. However, in resource-limited settings, the time and attention are not always feasible. This study aimed compare a physiologic closed-loop control (PCLC) ventilator capable self-adjusting based on patient parameters against standard care (SOC) ventilatory management porcine model. The compared SOC (n = 15) with PCLC for three injury models: hemorrhage, injury, hemorrhage...

Portable ventilators are increasingly utilized in the intra- and inter-hospital transport of patients. We evaluated 4 portable ventilators, Impact EMV, CareFusion LTV 1200, Newport HT70, Hamilton T1, terms triggering, delivered tidal volume (V(T)) accuracy, battery duration, F(IO(2)) gas consumption.Triggering was tested using a microprocessor controlled breathing simulator that simulated weak, normal, aggressive inspiratory effort muscle pressures -2, -4, -8 cm H2O respectively. Delivered...

Hypobaric hypoxemia is a well-known risk of aeromedical evacuation (AE). Validating patients as safe to fly includes assessment oxygenation status well oxygen-carrying capability (hemoglobin). The incidence and severity during AE noncritically injured casualties have not been studied.Subjects deemed by the validating flight surgeon were monitored with pulse oximetry from line until arrival at definitive care. All subjects US military personnel or contractors following traumatic injuries....

BACKGROUND Monitoring for acute blood loss is critical in surgical patients, and delays identifying hemorrhage can result poor outcomes. The current standard of care monitoring patients at risk bleeding serial measurement hemoglobin (Hgb) by laboratory complete count (CBC). Point-of-care testing (i.e., iSTAT) be a rapid method evaluating Hgb, spectrophotometry-based devices Radical-7) offer the advantages being continuous noninvasive. We sought to evaluate accuracy Radical-7 iSTAT measuring...

<h3>BACKGROUND:</h3> Portable ventilators continue to decrease in size while increasing performance. We bench-tested the triggering, battery duration, and tidal volume (V_T) of 7 portable ventilators: LTV 1000, 1200, Puritan Bennett 540, Trilogy, Vela, iVent 101, HT50. <h3>METHODS:</h3> tested triggering with a modified dual-chamber test lung simulate spontaneous breathing weak, normal, strong inspiratory effort. measured duration by fully charging operating ventilator...

Background: Transportation of the critically ill or injured war fighter requires coordinated care and judicious use resources. Availability oxygen (O2) supplies for mechanically ventilated patient is crucial. Size weight cylinders makes transport difficult presents an increased risk fire. A proposed solution to a portable concentrator (POC) mechanical ventilation. We tested SeQual Eclipse II POC paired with Impact 754 Pulmonetics LTV-1200 ventilators in laboratory evaluated fraction inspired...

To determine the alterations in intracranial pressure (ICP) during U. S. Air Force Critical Care Transport Team transport of critically injured warriors with ICP monitoring by intraventricular catheter (IVC).Patients an IVC following traumatic brain injury requiring aeromedical evacuation from Bagram to Landstuhl Regional Medical Center were studied A data logger monitored both and arterial blood was equipped integral XYZ accelerometer monitor movement.Eleven patients full collection takeoff...

BACKGROUND Aeromedical transport of critically ill patients requires continued, accurate performance equipment at altitude. Changes in barometric pressure can affect the mechanical ventilators calibrated for operation sea level. Deploying that maintain a consistent tidal volume (VT) delivery various altitudes is imperative lung protection when transporting wounded war fighters to each echelon care. METHODS Three (Impact 731, Hamilton T1, and CareFusion Revel) were tested pediatric (50 100...

Ascent to altitude results in the expansion of gases closed spaces. The management overinflation endotracheal tube (ETT) cuff at is critical prevent mucosal injury.We continuously measured ETT pressures during a Critical Care Air Transport Team training flight 8,000-ft cabin pressure using four methods management. ETTs were placed tracheal model, and mechanical ventilation was performed. In control ETT, inflated 20 mm Hg 22 not manipulated. manual method used manometer adjust cruising after...

Oxygen cylinders are heavy and present a number of hazards, liquid oxygen is too cumbersome to be used in far forward environments. Portable concentrators (POCs) chemical generators (COGs) have been proposed as solution. We evaluated 3 commercially available POCs COGs laboratory setting. Altitude testing was done at sea level 8,000, 16,000, 22,000 ft. Temperature extreme performed after storing devices 60°C −35°C for 24 hours. Mean FIO2 decreased storage with Eclipse iGo also the higher...

Acute lung injury (ALI) is a condition that leads to impaired oxygen delivery. We demonstrated previously using portable concentrator (POC) with pulsed dose delivery of an alternative option conserve while still maintaining adequate in mechanical model. hypothesized modified POC, can provide oxygenation animal model.In crossover study, we induced ALI 15 pigs oleic acid ventilated the equipment used by Critical Care Air Transport Teams US Force. compared POC both continuous flow and modes,...

BACKGROUND Successful mechanical ventilation requires that the airway be controlled by an endotracheal tube (ETT) with inflatable cuff to seal airway. Aeromedical evacuation represents a unique challenge in which manage ETT cuffs. We evaluated three methods of automatic pressure adjustment during changes altitude chamber. METHODS Size 7.5 and 8.0 mm ETTs are currently included Critical Care Air Transport Team allowance standard were used for evaluation. Three controllers—Intellicuff,...

Closed-loop controllers (CLCs) embedded within portable mechanical ventilators may allow for autonomous weaning. The ability of CLCs to maintain adequate oxygenation in the setting hemorrhage and lung injury is unknown. We hypothesized that a ventilator with CLC inspired fraction oxygen (FIO2) could provide porcine model injury.