Transcatheter ventilation with a modified Rapid-O2 oxygen insufflation device

Area of Science:

• Medical Devices
• Respiratory Physiology
• Emergency Medicine

Background:

• The Rapid-O2 oxygen insufflation device was developed for rescue oxygenation during cannot intubate, cannot oxygenate (CICO) events.
• Hypercapnia is an expected consequence in CICO scenarios.
• The device was modified to improve ventilation via the Venturi effect during exhalation.

Purpose of the Study:

• To identify the most effective combination of inner and insufflation catheters for optimal ventilation.
• To measure insufflating and expiratory flows and pressures with the modified device.
• To assess the impact of modifications on minute volumes in a simulated CICO event.

Main Methods:

• Various inner catheters (20-14 G, 2-mm ID TTC) and insufflation catheters (16 G, 14 G, 2-mm ID TTC) were tested.
• Insufflating and expiratory flows were measured at 15 L/min oxygen flow.
• Pressures were measured at 6-15 L/min, and minute volumes were determined using a trachea-lung model and the modified Rapid-O2 device.

Main Results:

• An 18 G inner catheter was found to be most effective.
• Insufflating pressures varied from 97 to 377 cmH2O at 15 L/min.
• Negative expiratory pressures of approximately 50 cmH2O were achieved.
• Minute volumes of 7.0 L/min and 5.37 L/min were recorded with 2-mm ID and 14 G insufflation catheters, respectively.
• The modified Rapid-O2 demonstrated significantly greater minute volumes.

Conclusions:

• The modified Rapid-O2 device can provide adequate minute volumes for adult ventilation in CICO events.
• Using a 14 G or 2-mm ID insufflation catheter at 15 L/min is recommended.
• The modified device shows significant potential for ventilation during CICO emergencies.