Pediatric Chronic Mechanical Ventilation Device Choice During a Recall and Pandemic

Abstract

Background:

Mechanical ventilation is the staple of respiratory services provided by any respiratory department. Having the appropriate model, stock and clinical expertise is crucial. When one of those elements is lacking, the others cannot function. Amidst the shortage in ventilators because of the pandemic and in addition to one of the largest ventilator recall nationwide ever experienced, our organization had to mitigate patient impact by removing the units recalled from service, while building resiliency for our pediatric Ventilator Care Program.

Methods:

A multidisciplinary team was brought together to collaboratively assess, analyze, and manage the ventilator recall and help determine the pathway forward for our patients with noninvasive and invasive chronic ventilation. A technical performance comparison table of equivalent ventilators was created virtually as a baseline for analysis. A risk-benefit analysis was completed over several meetings and two ventilators were brought in for evaluation. DME partners were consulted to help determine device availability.

Results:

Seven ventilators (3 noninvasive and 4 invasive ventilators) were evaluated. The Philips EV300 and Ventec VOCSN ventilators were chosen for clinical evaluation. The EV300 was found to be acceptable for our BPD/neonatal population and had the added benefit of being approved for infants weighing greater than 2.5 kg to adults. The VOCSN ventilator was found to be acceptable for our neuromuscular population and had the added benefit of containing integrated ventilation, oxygen concentrator, cough assist, and nebulizer features. Both devices were used immediately to replace the recalled units. Additionally, a plan was created to stock, educate, and upgrade the entire fleet of Philips 100 and 202 devices within 4 years.

Conclusions:

Considering the medical complexity and specific requirements to provide safe and effective ventilation to the pediatric chronic ventilation population, two devices were chosen from two different manufacturers.