Bench-test comparison of 26 emergency and transport ventilators

INTRODUCTION: Numerous emergency and transport ventilators are commercialized and new generations arise constantly. The aim of this study was to evaluate a large panel of ventilators to allow clinicians to choose a device, taking into account their specificities of use. METHODS: This experimental bench-test took into account general characteristics and technical performances. Performances were assessed under different levels of FIO(2) (100%, 50% or Air-Mix), respiratory mechanics (compliance 30,70,120 mL/cmH(2)O; resistance 5,10,20 cmH(2)O/mL/s), and levels of leaks (3.5 to 12.5 L/min), using a test lung. RESULTS: In total 26 emergency and transport ventilators were analyzed and classified into four categories (ICU-like, n = 5; Sophisticated, n = 10; Simple, n = 9; Mass-casualty and military, n = 2). Oxygen consumption (7.1 to 15.8 L/min at F(I)O(2) 100%) and the Air-Mix mode (F(I)O(2) 45 to 86%) differed from one device to the other. Triggering performance was heterogeneous, but several sophisticated ventilators depicted triggering capabilities as efficient as ICU-like ventilators. Pressurization was not adequate for all devices. At baseline, all the ventilators were able to synchronize, but with variations among respiratory conditions. Leak compensation in most ICU-like and 4/10 sophisticated devices was able to correct at least partially for system leaks, but with variations among ventilators. CONCLUSION: Major differences were observed between devices and categories, either in terms of general characteristics or technical reliability, across the spectrum of operation. Huge variability of tidal volume delivery with some devices in response to modifications in respiratory mechanics and F(I)O(2) should make clinicians question their use in the clinical setting. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s13054-014-0506-0) contains supplementary material, which is available to authorized users.