Performance Comparison of Oxygen Delivery Devices in Patients with Varying Inspiratory Demands

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Student Presentation

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Faculty Sponsor

Thomas Wing


BACKGROUND Limited research on delivered FIO2 for oxygen delivery devices makes choosing the most effective device for our patients difficult. This is particularly true when caring for patients in high levels of respiratory distress. Hypothesis: When a patient’s level of distress increases, the actual FIO2 differs from the following published estimates: 0.28 - 0.36 on 2 - 4 LPM via nasal cannula, 0.40 - 0.60 on 6 - 10 LPM via simple mask, 0.60 - 0.80+ on 12 - 15 LPM via nonrebreather mask, 0.80 - 1.0 on 30 - 50 LPM via high flow nasal cannula and 0.24 - 0.90 on 1 - 15 LPM via OxyMaskTM.[1] METHODS A 2010 Hans Rudolph, Inc. Series 1101 Breathing Simulator was attached to a mannequin using large bore tubing and one way valves in order to simulate inhalation and exhalation. A new sensor was placed in a Hudson RCI galvanic fuel cell oxygen analyzer, calibrated to room air and 100% oxygen, and used to measure FIO2 in the trachea. The oxygen delivery devices were connected via small bore tubing to an H/K tank using a Thorpe tube to measure oxygen flow. The baseline values were as follows: RAW 3 cmH2O/L/sec, CST 60 mL/cmH2O, respiratory rate 20 br/min, percent inhale 20%, load effort SHORTIE, and effort slope of 20. The manipulated variables were oxygen flow rate and level of distress. The oxygen flow rates tested were between 2 and 50 LPM. The level of distress was represented by PIFR (peak inspiratory flow rate) which was established by increasing amplitude to result in PIFR of 40, 70 and 90 LPM. With each oxygen flow rate and level of distress, a measurement was taken after the FIO2 had stabilized for 60 seconds. RESULTS At a PIFR of 40 LPM, all devices performed at or above FIO2 expectations with the exception of the OxyMaskTM. At a PIFR of 40 LPM and oxygen flow rates of 10 LPM or greater, the OxyMaskTM performed below the published FIO2. Actual FIO2 delivery for all devices was lower than published estimates when the PIFR was 90 LPM. CONCLUSIONS We found that actual FIO2 delivery for all tested devices was lower than published estimates when the level of distress increased.

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