The in-vitro performance of a modern portable respirator in different lung models and as an alternative intensive care respirator

BACKGROUND Transporting ventilated patients safely and without loss of efficacy is a challenge. Portable ventilators are generally used to transport critically ill patients, but their performance is often limited. OBJECTIVE This study aimed to compare the in-vitro performance of a modern portable respirator with a modern intensive care respirator for different lung settings. DESIGN An in-vitro testing of a portable and an intensive care respirator. SETTINGS Anaesthesia Department at the University Children's Hospital Zurich. MAIN OUTCOME MEASURES The portable respirator Hamilton T1 was compared with the established intensive care respirator bellavista1000 (BV) while applying different settings with the ASL 5000 (ASL) device. The ASL can simulate neonatal, paediatric, and adult lung settings with normal or impaired lung function. Accuracy of delivered tidal volumes, proximal and distal airway pressures and mechanical lung properties were assessed. RESULTS Bland-Altman analyses showed higher accuracy for applied tidal volumes delivered by the portable respirator, 12.6% [95% confidence interval (CI) −8.9 to 34.2], compared with the intensive care respirator, 15.9% (95% CI −18.5 to 50.3). In neonatal and infant lung models particularly, the accuracy of delivered tidal volumes by the portable respirator, 13.2% (95% CI −8.9 to 35.3) was superior to those delivered by the intensive care respirator, 20.9% (95%CI −15.9 to 57.7). Lung compliance estimation was performed more accurately by the intensive care respirator, whereas the portable respirator measured airway resistance more accurately. However, both respirators showed only moderate overall accuracy when assessing lung mechanics. CONCLUSION The tested portable respirator proved to be a useful device for invasive ventilation of critically ill patients. The overall performance is non-inferior to a conventional intensive care respirator.