Document Detail

Autonomous control of inspired oxygen concentration during mechanical ventilation of the critically injured trauma patient.
MedLine Citation:
PMID:  19204511     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Transport of mechanically ventilated patients in a combat zone presents challenges including conservation of resources. In the battlefield setting, the provision of adequate oxygen supplies remains a significant issue. Autonomous control of oxygen concentration may allow a reduction in mission load. METHODS: Trauma patients requiring ventilation and inspired oxygen concentration (FIO2) greater than 0.35 were evaluated for study. Patients were randomized to consecutive 4-hour periods of autonomous control or standard care. The system for autonomous control consisted of a ventilator, oximeter, and a portable computer. The portable computer housed the control algorithm and collected ventilator and oxygen saturation (SpO2) data every 5 seconds. The controller goal was to maintain SpO2 at 94% +/- 2% via discrete changes of 1% to 5%. Ventilator settings and SpO2 were recorded every 5 seconds for analysis. RESULTS: Fifteen patients were enrolled in this study. Oxygen saturation was maintained in the 92% to 96% saturation range 33% +/- 36% of the time during clinician control versus 83% +/- 21% during autonomous control. Oxygen usage was reduced by 44% during autonomous control. There was a slight difference in the total duration of SpO2 episodes less than 88% between groups (6.02 +/- 0.83 vs. 6.87 +/- 0.46 minutes, p < 0.05). There were no differences in the number of episodes of SpO2 <88%. CONCLUSION: Autonomous control of FIO2 offers the opportunity for a reduction in oxygen usage, allowing a weight and resource reduction, without increasing risk of hypoxemia in ventilated trauma patients.
Jay A Johannigman; Richard Branson; Dorian Lecroy; George Beck
Publication Detail:
Type:  Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  The Journal of trauma     Volume:  66     ISSN:  1529-8809     ISO Abbreviation:  J Trauma     Publication Date:  2009 Feb 
Date Detail:
Created Date:  2009-02-10     Completed Date:  2009-04-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376373     Medline TA:  J Trauma     Country:  United States    
Other Details:
Languages:  eng     Pagination:  386-92     Citation Subset:  AIM; IM    
Division of Trauma and Critical Care, Department of Surgery, University of Cincinnati, Cincinnati, Ohio, USA.
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MeSH Terms
Blood Gas Analysis
Critical Illness*
Glasgow Coma Scale
Injury Severity Score
Military Medicine
Oximetry / instrumentation*
Oxygen Inhalation Therapy / instrumentation*
Respiration, Artificial*
Transportation of Patients*

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