Bench Evaluation of Gas Duration in a Disaster for Two Frequently Used Portable Ventilators for Neonates

Background: Blended medical gas is required for premature infants in the NICU, a high resource-utilization area during a disaster. Portable ventilators are powered by battery or plugged into generator- supported emergency electrical outlets. Oxygen is bled in, or attached to a 50 PSI gas source, while air is provided by compressed gas cylinder, a turbine driven source, or compressor. Portable ventilators are often needed when a disaster resulting in a power outage or gas failure occurs. The purpose of this bench study is to compare the duration of gas consumption on two frequently used portable ventilators for neonates. Methods: A pNeuton mini pneumatic portable ventilator (Airon, Melbourne, FL) was attached to a pNeuton Mini Patient Circuit (Airon). A Hamilton T1 ventilator (Hamilton Medical, Reno, NV) was connected to a RT 265 neonatal ventilator circuit (Fisher & Paykel, Irvine, CA). The circuit was attached to an Infant Ingmar Neo Lung (Ingmar, Pittsburgh, PA) for the individual gas duration tests at differing oxygenation percentages on both ventilators. We compared the duration of oxygen gas at a FIO2 of 21%, 40%, 60% and 100% when attached to 2200 PSI e-cylinder oxygen. The settings used for both ventilators tested were pressure control PIP 25, PEEP +5, rate 30, and inspiratory time 0.5 s. The pNeuton was set to a constant flow of 6 L/min. The Hamilton T1 flow was calculated by the ventilator for the given settings. Duration of gas was determined as compressed oxygen gas from an E cylinder transitioned from full to empty cylinder at each of the specified oxygen percentages. Results: The results of oxygen gas duration in minutes were displayed in the accompanying table. The Hamilton T1 ventilator consumed oxygen three times less than the pNeuton Mini ventilator. Conclusions: At neonatal settings, an electrically powered and turbine-driven powered portable ventilators are good options for mechanical ventilation when a blended gas is needed in the presence of a gas failure. The Hamilton T1’s turbine driven mechanism is gas conserving and preferred over pneumatic driven ventilators as long as a power source is available. However, understanding your gas and ventilator resources and choosing the correct ventilator to support these emergencies is critical.Oxygen Duration In MinutesFiO2Hamilton T1pNeuton Mini21%Internal compressor no tank needed11940%89123560%522148100%27096