title: Performance of portable ventilators for mass-casualty care.
abstract: BACKGROUND
  Disasters and mass-casualty scenarios may overwhelm medical resources regardless of the level of preparation. Disaster response requires medical equipment, such as ventilators, that can be operated under adverse circumstances and should be able to provide respiratory support for a variety of patient populations.
  
  
  OBJECTIVE
  The objective of this study was to evaluate the performance of three portable ventilators designed to provide ventilatory support outside the hospital setting and in mass-casualty incidents, and their adherence to the Task Force for Mass Critical Care recommendations for mass-casualty care ventilators.
  
  
  METHODS
  Each device was evaluated at minimum and maximum respiratory rate and tidal volume settings to determine the accuracy of set versus delivered VT at lung compliance settings of 0.02, 0.08 and 0.1 L/cm H20 with corresponding resistance settings of 10, 25, and 5 cm H2O/L/sec, to simulate patients with ARDS, severe asthma, and normal lungs. Additionally, different FIO2 settings with each device (if applicable) were evaluated to determine accuracy of FIO2 delivery and evaluate the effect on delivered VT. Ventilators also were tested for duration of battery life.
  
  
  RESULTS
  VT decreased with all three devices as compliance decreased. The decrease was more pronounced when the internal compressor was activated. At the 0.65 FIO2 setting on the MCV 200, the measured FIO2 varied widely depending on the set VT. Battery life range was 311-582 minutes with the 73X having the longest battery life. Delivered VT decreased toward the end of battery life with the SAVe having the largest decrease. The respiratory rate on the SAVe also decreased approaching the end of battery life.
  
  
  CONCLUSIONS
  The 73X and MCV 200 were the closest to satisfying the Task Force for Mass Critical Care requirements for mass casualty ventilators, although neither had the capability to provide PEEP. The 73X provided the most consistent tidal volume delivery across all compliances, had the longest battery duration and the least decline in VT at the end of battery life.
authors.affiliation: University of Cincinnati, Department of Surgery, Cincinnati, OH, USA. thomas.blakeman@hotmail.com
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Blakeman
authors.forename: Dario
authors.initials: D
authors.lastname: Rodriquez
authors.forename: Warren C
authors.initials: WC
authors.lastname: Dorlac
authors.forename: Dennis J
authors.initials: DJ
authors.lastname: Hanseman
authors.forename: Ellie
authors.initials: E
authors.lastname: Hattery
authors.forename: Richard D
authors.initials: RD
authors.lastname: Branson
mesh_terms: D004189:Disaster Planning; D006801:Humans; D054527:Mass Casualty Incidents; D019095:Point-of-Care Systems; D012122:Ventilators, Mechanical