Does anyone know of any safety issues preventing the use of the Eagle Uni-ventilator in the multiplace chamber?
Date posted: 1/2/2020
Thank you for your question. The UHMS HBO2 safety committee can provide information to assist you in answering your question, but the ultimate responsibility for these types of questions rests with the medical director and safety director of your facility.
It is known to many of the Committee Members that the impact Uni-Vent® Eagle™ Model 754 Ventilator has been used successfully in the multiplace hyperbaric environment at treatment pressures up to and including 3ATA.
Notably, the U.S. Navy has tested and used this ventilator since February of 2007. However, parts for this ventilator are known to be in short supply as the current manufacturer, ZOLL (formerly IMPACT) has discontinued the sale of this ventilator as of April 23rd, 2015. The ZOLL Company will continue to provide support, to the best of their ability, until 2022. Due to these concerns, the UHMS Safety Committee recommends that these factors are considered when deciding how best to support your equipment and provide safe care to your most critical of patients.
In this Committee’s opinion, choosing a ventilator to use in the hyperbaric environment is a critical decision that should be made jointly by the Hyperbaric Safety Director, Medical Director, Nursing Leadership, Hospital Biomedical, Respiratory Care support, and Hospital Administration.
While the UHMS Hyperbaric Safety Committee cannot endorse a specific device, many Safety Committee Members have shared their experience with this ventilator. It is specifically noted that since it is gas driven, a sufficient supply of gas is necessary to use this ventilator under hyperbaric conditions. Other comments include:
- Inaccurate readout of supply tidal volume (Vt) when operating on pneumatic power (with air and oxygen connected). When operating on DC power and with the internal air pump operating, the Vt is correct. Suggest not relying on the digital supply readout, but always confirm Vt by measuring exhaled Vt with a mechanical spirometer.
- Use a simple test lung to initially set up Vt, RR, FiO2 and PEEP and verify all settings with a spirometer, timer, O2 analyzer, and external manometer.
- Inert purge battery and electronics compartments to prevent oxygen ingress, causing a fire hazard.
- Battery power is short lived. Suggest running on pneumatic power (air and oxygen connected) without the air pump running.
- If powered using 110 VAC, it is important to keep the AC/DC adapter outside the chamber.
- It will need adjustments for Vt during compression and decompression.
- In general terms, be mindful of Boyle’s law when preparing to mechanically ventilate a patient in the hyperbaric environment. Ensure that the ET tube cuff is switched from air to saline or sterile water.
It is our recommendation that each ventilator should be individually tested to measure changes in tidal volume at varying treatment pressures. We suggest that a detailed record of the evaluation be completed and signed by the Safety Director, Medical Director, and Biomedical support specialist. Finally, it is important that all end-users receive proper training in the use of this ventilator before placing the device into service.
We would also like to provide the following references for your consideration:
Popa DA, Waterhouse L, Duchnick JJ, Witucki PJ, “Performance of the Uni-Vent Eagle™ Model 754 ventilator under hyperbaric conditions,” 2017, UHMS Annual Scientific Meeting, UHM 2017, Vol 44, No.5, pg. 470-471
Hennessey PJ, “EVALUATION OF THE UNI-VENT™ EAGLE™ MODEL 754 VENTILATOR FOR USE IN THE SURFACE RECOMPRESSION CHAMBERS (SRC) OF THE SUBMARINE RESCUE DIVING AND RECOMPRESSION SYSTEM (SRDRS),” Navy Experimental Diving Unit Publication TR 07-03, February 2007
Stanga DF, Beck G, Chimiak JM, “EVALUATION OF RESPIRATORY SUPPORT DEVICES FOR USE IN THE HYPERBARIC CHAMBER,” Navy Experimental Diving Unit Publication TR 03-18, November 2003
ZOLL Mechanical Ventilation and Airway Management Group, “754 Commercial EOL Letter,” ZOLL Medical Corporation, April 23rd, 2015
The UHMS Safety Committee
Neither the Undersea and Hyperbaric Medical Society (UHMS) staff nor its members are able to provide medical diagnosis or recommend equipment over the internet. If you have medical concerns about hyperbaric medicine you need to be evaluated by a doctor licensed to practice medicine in your locale, which can provide you professional recommendations for hyperbaric medicine based upon your condition. The responsibility of approving the use of equipment resides with the physician and safety director of the facility. Information provided on this forum is for general educational purposes only. It is not intended to replace the advice of your own health care practitioner and you should not rely upon it as though it were specific medical advice given to you personally.