Research at Samaritan on repurposing operating room anesthesia machines for ventilators was published in the winter edition of the Journal of Special Operations Medicine.
Brian Delmonaco, MD, Tomer Pelleg, DO, and clinical engineer Charles D. Wickens teamed up on the project after the U.S. Food and Drug Administration issued guidance for hospitals facing shortages of mechanical ventilators. The FDA asked the facilities to consider alternative devices capable of delivering breaths or pressure support including anesthesia machines.
The three Samaritan employees co-authored the article which provided technical information and practical guidance for the safe use of the anesthesia machines on critically ill patients outside the operating room.
“Since operating rooms have ventilators and patients severely ill with COVID-19 need ventilators, it is tempting to repurpose an anesthesia gas machine to meet the high demand during this pandemic,” said Delmonaco. “It is tricky to do so but not impossible. We wrote a “how-to” article.”
The Journal, which was originally started under the auspices of the United States Special Operations Command Surgeons office, is the only peer-reviewed journal devoted to Special Operations medicine.
“We felt it important to conduct and publish this research by bringing forth practical, sensible ideas and techniques to providers that are currently considering unconventional methods to care for their patients,” said Wickens. “Prior to our publication, there was limited published information describing their use and the technological as well as practical limitations.”
In their article the trio points out that adjustments in alarm settings, increasing fresh gas flow rates and daily self-tests of the anesthesia machines are needed to ensure continued safety of ongoing ventilation.
“The article dives into the details of day-to-day anesthesia ventilator maintenance as well as how to safely use these machines outside the OR,” said Delmonaco. “We detail trouble-shooting and the limitations of repurposing these machines for ICU patients.”
The three spent more than a year working on the research project.
“We are truly blessed to have Drs. Delmonaco and Pelleg on the SHS team,” said Wickens. “Their uncompromising and compassionate approach to patient care is infectious and having the opportunity to work closely together will always be with me.”