En Route Mechanical Ventilation Validation

Introduction

Additional validation was performed for the management of mechanically ventilated patients during transport, covering a range of clinical conditions and injuries.

Data Sources

Empirical data and published literature were used where available. When direct data were unavailable, expected patient outcomes were verified by clinical subject matter experts [304], [308].

Results

With Patient Effort

The following scenarios include spontaneous breathing (i.e., active respiratory muscle pressure) where appropriate.

• Scenario 1: Mild ARDS with Progressive Fall in Oxygenation
• Scenario 2: Moderate COPD with Subsequent Bronchospasm
• Scenario 3: Mild TBI with worsening ARDS
• Scenario 4: Moderate ARDS with Tension Pneumothorax
• Scenario 5: Mild ARDS with Right Mainstem Intubation
• Scenario 6: Hypoxemic Respiratory Failure - Pneumonia
• Scenario 7: Hypoxemic Respiratory Failure Plugged ETT

Without Patient Effort

The following scenarios were repeated without spontaneous breathing (i.e., no patient-generated respiratory effort) to support comparative validation. Scenario 4 features an apneic patient by design and is therefore unchanged in the no spontaneous effort set.

• Scenario 1 - NoSpontaneous: Mild ARDS with Progressive Fall in Oxygenation
• Scenario 2 - NoSpontaneous: Moderate COPD with Subsequent Bronchospasm
• Scenario 3 - NoSpontaneous: Mild TBI with worsening ARDS
• Scenario 5 - NoSpontaneous: Mild ARDS with Right Mainstem Intubation
• Scenario 6 - NoSpontaneous: Hypoxemic Respiratory Failure - Pneumonia
• Scenario 7 - NoSpontaneous: Hypoxemic Respiratory Failure Plugged ETT