Portable Patient Ventilator: Improving ICU Sedation

Physicians working in the intensive care unit (ICU) frequently face an unsettling dilemma: how to sedate patients deeply enough so they're unaware of pain, but not so deeply that they experience withdrawal symptoms once they’re no longer sedated.

UB researchers helped solve this quandary by designing a portable patient ventilator that delivers small amounts of powerful inhalation anesthetic agents as patients breathe or are mechanically ventilated.

The aim is to duplicate at each ICU bedside the same powerful and effective method of anesthetizing patients that works so well in the operating room, but without the expensive equipment and monitoring requirements.

The ventilator was invented by Bradley Fuhrman, MD, professor of pediatrics and anesthesiology and chief of critical care at Women and Children’s Hospital of Buffalo, and Mark Dowhy, director of the Pediatric Critical Care laboratory in the Department of Pediatrics.

A key advantage of inhaled anesthetics over intravenous sedation—the current approach in the ICU—is that inhaled anesthesia delivers and clears sedatives by way of the metabolic and excretory systems. That’s a critical factor for patients who have sustained damage to their kidneys or livers as a result of their illness.

When anesthesia is delivered through the lung, there is a much more rapid onset of effect and much quicker reversal once it’s removed. This is an especially important consideration in patients who need to be frequently or abruptly awakened, such as children who have suffered trauma to the skull.

“With our ventilator, the patient is continually rebreathing the same anesthetic and oxygen mixture, so the amount of anesthetic that is used can be reduced by about 80 percent,” Fuhrman explains.

The device also has promising applications in treating large numbers of patients during pandemics or other events with mass casualties because it can safely enable multiple patients to share a single ventilator.