A Comparison of the Puritan-Bennett 7200a Ventilator's Flow-By Mode to the T-Piece Mode prior to Extubation in Postsurgical Patients

Abstract

We compared flow-by ventilation (FB) via the Puritan-Bennett 7200a ventilator with T-piece ventilation (TP) during weaning from mechanical ventilation (MV). METHODS: We placed 22 consecutive postsurgical patients being weaned from MV on FB at base flows of 10 L/min and 20 L/min and then on TP. Blood pressure, pulse rate, respiratory rate, blood gases, tidal volume, and peak inspiratory flow were measured after at least 20 min in each mode. Statistical analysis of clinical status used a three-level, one-way analysis of variance with technique as a within-subjects factor. Setup costs of the three ventilatory modes were evaluated using relative value units for labor plus actual costs of added equipment and supplies. RESULTS: Although there was a statistically significant difference in $P_{ac{o}_2}$ among the ventilatory modes, this was not clinically important. No other differences were found. Each FB mode cost $2.55 to set up, whereas TP cost $11.90. CONCLUSIONS: FB and TP were clinically equivalent. However, the alarm and monitoring capabilities during FB are useful and may be worth the one-time cost ($1,000) of adding the optional flow-by software to the 7200a ventilator.