Maintaining a high inspired Oxygen Fraction with the Elisée® 350 turbine transport ventilator connected to two portable oxygen concentrators in an austere environment.

BACKGROUND Management of critically ill patients requiring mechanical ventilation in austere environments or during disaster response is a logistic challenge. Availability of oxygen cylinders for mechanically ventilated patient may be difficult in such a context. A solution to ventilate patients requiring high FiO2 is to use a ventilator able to be supplied by a low-pressure oxygen source connected with 2 oxygen concentrators. We tested the Resmed Elisee®350 ventilator paired with two Newlife® Intensity 10 (Airsep) oxygen concentrator and evaluated the delivered fraction of inspired oxygen (FiO2) across a range of minute volumes and combinations of ventilator settings. METHODS The ventilators were attached to a test lung, OC flow was adjusted with a Certifier®FA ventilator test systems from 2L/min to 10L/min and injected into the oxygen inlet port of the Elisee®350. FiO2 was measured by the analyzer integrated in the ventilator, controlled by the ventilator test system. Several combinations of ventilator settings were evaluated to determine the factors affecting the delivered FiO2. RESULTS The Elisee®350 ventilator is a turbine ventilator able to deliver high FiO2 when functioning with two oxygen concentrators. However, modifications of the ventilator settings such as an increase in minute ventilation affect delivered FiO2 even if oxygen flow is constant on the oxygen concentrator. CONCLUSIONS The ability of two oxygen concentrator to deliver high FiO2 when used with a turbine ventilator makes this method of oxygen delivery a viable alternative to cylinders to ventilate patients requiring FiO2≥80% in austere place or during disaster response LEVEL OF EVIDENCE: V, feasibility study on test bench.