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Identifying Potential Ventilator Auto-Triggering Among Organ Procurement Organization Referrals.
Nicholas R Henry1, Christopher J Russian2, Joseph Nespral3
1Department of Respiratory Care, Texas State University, San Marcos, TX, USA NH14@txstate.edu.
Progress in Transplantation (Aliso Viejo, Calif.)
|May 22, 2016
Summary
An algorithm to detect ventilator auto-triggering could have assisted organ recovery coordinators 63 times in 2013. This tool helps identify inappropriate ventilator breaths, improving organ donor referrals and brain death testing.
Area of Science:
- Critical Care Medicine
- Organ Donation and Transplantation
- Respiratory Therapy
Background:
- Ventilator auto-trigger, an unintended mechanical breath, can stem from improper sensitivity settings.
- This can delay critical brain death testing and cause confusion for healthcare teams and families.
Purpose of the Study:
- To assess the frequency of organ donor referrals benefiting from an algorithm to identify and correct ventilator auto-triggering.
- Evaluate the need for such a tool in organ recovery coordination.
Main Methods:
- Retrospective analysis of organ donor referrals from a single Organ Procurement Organization (OPO) in central Texas during 2013.
- Examined referrals involving withdrawal of care or organ recovery.
- Determined the incidence of absent brain stem reflexes with spontaneous respirations on mechanical ventilation.
Main Results:
- 672 OPO referrals were reviewed.
- 63 referrals (42 with withdrawal of care, 21 with organ recovery) showed absent brain stem reflexes except for ventilator-supported respirations.
- An algorithm for ventilator auto-trigger detection could have been applied 63 times.
Conclusions:
- A significant number of organ donor referrals presented with conditions potentially indicating ventilator auto-triggering.
- An algorithm to identify and correct ventilator auto-triggering could provide substantial support to organ recovery coordinators.
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