Effect of Anesthesia Machine Ventilator and ICU Ventilator on Intraoperative Oxygenation and Ventilation

Abstract

Mechanical ventilation is required in patients under general anesthesia. Intraoperatively, mechanical ventilation is usually performed using an anesthesia machine because of its combined capacity to deliver anesthetic agents, but anesthesiologists frequently encounter situations in which an anesthesia machine ventilator alone does not achieve optimal oxygenation or ventilation and requires switching to the intensive care unit (ICU) ventilator for better performance. Sometimes that decision is made after a discussion with the surgical and intensive care teams. Previous studies have compared respiratory parameters in different ventilators in artificial model lung simulation, 1 Katz JA Kallet RH Alonso JA et al. Improved flow and pressure capabilities of the Datex-Ohmeda SmartVent anesthesia ventilator. J Clin Anesth. 2000; 12: 40-47 Crossref PubMed Scopus (10) Google Scholar , 2 Marjanovic NS De Simone A Jegou G et al. A new global and comprehensive model for ICU ventilator performances evaluation. Ann Intensive Care. 2017; 7: 68 Crossref PubMed Scopus (13) Google Scholar , 3 Wallon G Bonnet A Guérin C. Delivery of tidal volume from four anaesthesia ventilators during volume-controlled ventilation: a bench study. Br J Anaesth. 2013; 110: 1045-1051 Abstract Full Text Full Text PDF PubMed Scopus (25) Google Scholar , 4 Hallbäck M Wallin MK. Correction to the paper 'Delivery of tidal volume from four anaesthesia ventilators during volume-controlled ventilation: a bench study'. Br J Anaesth. 2016; 116: 720-721 Abstract Full Text Full Text PDF PubMed Scopus (2) Google Scholar , 5 Ball L Dameri M Pelosi P. Modes of mechanical ventilation for the operating room. Best Pract Res Clin Anaesthesiol. 2015; 29: 285-299 Crossref PubMed Scopus (35) Google Scholar but their clinical implications have not been thoroughly investigated. The authors present 13 cases that required switching from an anesthesia machine ventilator to an ICU ventilator for clinical reasons, and discuss the effects on patients’ parameters and outcomes, as well as the rationale behind these effects using the authors’ artificial model lung and literature review.