Performance of ventilators at simulated altitude: study of FiO2

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Performance of ventilators at simulated
altitude study of FiO2
Jean-Pierre Tourtier , Thomas Leclerc, Marc
Borne Military hospital Val-de-Grâce, Paris,
France
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Introduction (1)

• Aero medical evacuation ventilatory support
• Ventilators turbine technology
• Hypobaric
• FiO2 preset / assessed / delivered

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Introduction (2)

• 2 ventilators
• T-bird VS02
  LTV-1000

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Methods (1)

• ?
• Cabin altitude simulation

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Methods (2)

• ?
• Altitude simulated
• 1500 m (4000 feet)
• 2500 m (6700 feet)
• 3000 m (3000 feet)

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Methods (3)

• ?
• Lung simulation VT1 Bioteck
• Normal lung
• (resistance  5.6 cm H2O/L/min  compliance  50
  ml/cm H2O)
• Acute Respiratory Distress Syndrom
• (resistance  3.9 cm H2O/L/min  compliance  20
  ml/cm H2O)

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Methods (4)

• ?
• Ventilation parameters

Lung model Normal lung ARDS
Vt set (ml) 700, 400 400, 250
Respiratory rate 12 20
I/E 1/2 1/1
Fi02 () 21,50,90 21, 50, 90
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Methods (5)

• ?
• Measurements
• Actual FiO2
• paramagnetic analysis

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Methods (6)paramagnetic analysis

• focused magnetic field
• Oxygen is attracted
• electric potential
•  gold standard 

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Results (1) Normal lung, ARDS T-bird VS02
Cabin Altitude (m) 90 1500 2500 3000
FiO2 set 50 50 50 50
Fi02 assessed 48 43 55 50
FiO2 delivered 49 53 57 61
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Results (2) Normal lung, ARDS T-bird VS02
Cabin Altitude (m) 90 1500 2500 3000
FiO2 set 90 90 90 90
Fi02 assessed 87 76 94 84
FiO2 delivered 88 96 99 99
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Results (3) Normal lung, ARDS LTV-1000
Cabin Altitude (m) 90 1500 2500 3000 3000 ARDS Vt 450 ml
FiO2 set 50 50 50 50 50
Fi02 assessed 49 49 50 50 53
FiO2 delivered 50 51 53 54 50
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Results (4) Normal lung, ARDS LTV-1000
Cabin Altitude (m) 90 1500 2500 3000 3000 ARDS Vt 450 ml
FiO2 set 90 90 90 90 90
Fi02 assessed 87 76 88 92 92
FiO2 delivered 88 96 94 95 90
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Results (5) exampleNormal lung, FiO2 set50
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Conclusion (1) T-bird VS02

• ?
• Variations between FiO2 set and delivered high
• Variations between FiO2 delivered and assessed
  high
• Inefficacity of ventilators Fi02 analysis

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Conclusion (2) LTV-1000

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• Variations between FiO2 set and delivered
  moderate
• Variations between FiO2 delivered and assessed
  high
• Inefficacity of ventilators Fi02 analysis

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Conclusion (3) OXYMAN

• ?