Oxygen Consumption with Mechanical Ventilation in a Field Anesthesia Machine

Field anesthesia machines (FAM) with gas-powered ventilators have been developed for remote locations that may not have a central supply of oxygen. These ventilators may rapidly deplete oxygen cylinders, especially in patients with decreased pulmonary compliance. Our goal in this study was to determine oxygen consumption rates with a contemporary FAM in models of high (HC) and low (LC) pulmonary compliance. Oxygen consumption rates were tested using D cylinders (initial pressure 1700 psig) and the Narkomed® M FAM, which uses an air injector to decrease compressed gas consumption by entraining room air as part of the drive gas. Three different tidal volumes (Vt) were tested (500, 750, and 1000 mL) with HC and LC lung models, and the fresh gas flow rate was 1 L/min. Respiratory rate was constant at 10 breaths/min. Oxygen consumption varied directly with Vt and inversely with compliance, increasing from 4.8 ± 0.07 L/min with the HC-500 mL Vt model to 6.2 ± 0.05 L/min with the LC-1000 mL Vt model. D cylinder duration ranged from 56.8 ± 0.4 to 73.6 ± 1.0 minutes. Assuming oxygen fresh gas flow of 1 L/min, calculating tank duration with the fastest consumption rate underestimated the tank duration for more compliant and smaller Vt models but provided a greater margin of patient safety.