Remote Control and Monitoring of GE Aisys Anesthesia Machines Repurposed as Intensive Care Unit Ventilators

Connor, Chris; Palmer, Louisa J.; Pentakota, Sujatha

doi:10.1097/aln.0000000000003371

Cited by 5 publications

(5 citation statements)

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“…Each of these practices has been used individually at other centers during the COVID-19 pandemic. [12][13][14][15] Because tubing extensions can prevent doors from closing completely and maintaining negative pressure in the patient's room, pressure gradients may need to be tested by the hospital's biomedical engineering team before this practice is implemented.…”

Section: Preparation For Cardiac Arrestmentioning

confidence: 99%

Cardiopulmonary Resuscitation in Intensive Care Unit Patients With Coronavirus Disease 2019

Cheruku

Dave

Goff

et al. 2020

Journal of Cardiothoracic and Vascular Anesthesia

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Cardiopulmonary resuscitation (CPR) in patients with severe acute respiratory syndrome coronavirus-2Àassociated disease (coronavirus disease 2019) poses a unique challenge to health-care providers due to the risk of viral aerosolization and disease transmission. This has caused some centers to modify existing CPR procedures, limit the duration of CPR, or consider avoiding CPR altogether. In this review, the authors propose a procedure for CPR in the intensive care unit that minimizes the number of personnel in the immediate vicinity of the patient and conserves the use of scarce personal protective equipment. Highlighting the low likelihood of successful resuscitation in high-risk patients may prompt patients to decline CPR. The authors recommend the preemptive placement of central venous lines in high-risk patients with intravenous tubing extensions that allow for medication delivery from outside the patients' rooms. During CPR, this practice can be used to deliver critical medications without delay. The use of a mechanical compression system for CPR further reduces the risk of infectious exposure to health-care providers. Extracorporeal membrane oxygenation should be reserved for patients with few comorbidities and a single failing organ system. Reliable teleconferencing tools are essential to facilitate communication between providers inside and outside the patients' rooms. General principles regarding the ethics and peri-resuscitative management of coronavirus 2019 patients also are discussed.

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Section: Preparation For Cardiac Arrestmentioning

confidence: 99%

Cardiopulmonary Resuscitation in Intensive Care Unit Patients With Coronavirus Disease 2019

Cheruku

Dave

Goff

et al. 2020

Journal of Cardiothoracic and Vascular Anesthesia

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“…A "domino switch" technique [22] is introduced, in which an anesthesia machine is replaced with a new machine every day for use as a ventilator. As an example of the effective use of the special functions of individual anesthesia machines, Connor et al also reported an experience of remotely controlling GE Aisys from a separate room to reduce the risk of infection for medical staff [23]. Although a technique to share an ICU ventilator between two patients was reported [24], no such cases for the anesthesia machine have been reported.…”

Section: Use Of Anesthesia Machines Versus Icu Ventilatorsmentioning

confidence: 99%

Anesthesiologist behavior and anesthesia machine use in the operating room during the COVID-19 pandemic: awareness and changes to cope with the risk of infection transmission

Obara

2020

J Anesth

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The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) disease [coronavirus disease 2019 (COVID-19) infection] first appeared in December 2019 in China and is now spreading worldwide. Because SARS-CoV-2 can be transmitted via aerosols and surface contaminations of the environment, appropriate use of anesthesia machines and appropriate behavior in the operation room (OR) are required specifically in relation to this disease. The use of high-performance hydrophobic filters with a high rate of virus rejection is recommended as the type of viral filter, and surgical team behaviors that result in aerosol splashes should be avoided. Appropriate hand hygiene by the anesthesiologist is crucial to prevent unexpected environmental contamination. When the anesthesia machine is used instead of an intensive care unit ventilator, it is important to keep the fresh gas flow at least equal to the minute ventilation to prevent excessive humidity in the circuit and to monitor condensation in the circuit and inspiratory carbon dioxide pressure. In addition, both the surgical smoke inherent in thermal tissue destruction and the surgical team's shoe soles may be factors for the presence of SARS-CoV-2 in the operating room. Ensuring social distancing-even with a mask in the OR-may be beneficial because healthcare providers may be asymptomatic carriers. After the acute crisis period of COVID-19, the number of cases of essential but nonurgent surgeries for waiting patients is likely to increase; therefore, optimization of OR scheduling will be an important topic. Anesthesiologists will benefit from new standard practices focusing on the prevention of COVID-19 infection.

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Section: Introductionmentioning

confidence: 99%

“…5 When possible, the ventilator control panel was disconnected from the ventilator body and extended outside the patient room on an umbilical electrical cable. 6 Other ICUs placed the entire ventilator outside of patient rooms by orienting the head of the bed near a bidirectional wall conduit for the ventilator circuit to pass through. 5 Biomedical engineering and RT groups also explored, but, to our knowledge, never deployed, novel solutions for remote ventilator management that were designed to be used with existing ventilators.…”

Section: Introductionmentioning

confidence: 99%

Novel Technology Deployed for Remote Ventilator Management by Respiratory Therapists During the COVID-19 Pandemic: Lessons Learned

Rausen

Nahass

Halpern

2022

J Intensive Care Med

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A novel remote ventilator management (control) technology (Omnitool) was implemented for use with ICU patients during the COVID-19 pandemic to mitigate in-person respiratory therapist interactions and preserve personal protective equipment. In the latter half of 2020, eight mechanical ventilators were purchased and enabled for Omnitool deployment through the application of a vendor software option. Subsequently, these ventilators were outfitted with commercially available informatics hardware that permitted remote communication and management via the existing hospital network. In total, 17 patients with COVID-19 respiratory failure were placed on Omnitool enabled ventilators between January 1, 2021-April 30, 2021. The median Omnitool use days was 10. Deployment of a novel remote ventilator management technology is feasible; however, further study is needed to simplify the set up and utilization of the system. Future demands for remote ventilator management are predictable, whether in rural areas, military scenarios without adequate RT staffing, or in circumstances with new and easily transmissible toxic infections, and will continue to encourage the development of relatively easy to apply informatics-based solutions. Herein we share five lessons learned from our Omnitool deployment.

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Remote Control and Monitoring of GE Aisys Anesthesia Machines Repurposed as Intensive Care Unit Ventilators

Cited by 5 publications

References 0 publications

Cardiopulmonary Resuscitation in Intensive Care Unit Patients With Coronavirus Disease 2019

Cardiopulmonary Resuscitation in Intensive Care Unit Patients With Coronavirus Disease 2019

Anesthesiologist behavior and anesthesia machine use in the operating room during the COVID-19 pandemic: awareness and changes to cope with the risk of infection transmission

Novel Technology Deployed for Remote Ventilator Management by Respiratory Therapists During the COVID-19 Pandemic: Lessons Learned

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