Pressure-controlled ventilation for the long-range aeromedical transport of patients with burns

Pressure-controlled ventilation is used to treat smoke inhalation injury to achieve adequate oxygenation and ventilation at lower peak inspiratory pressures. A portable pressure controlled time-cycled transport ventilator permits this modality to be used in the field. We have examined the safety and efficacy of this ventilator for aeromedical transfer of thermally injured patients. Burn flight teams transported 146 intubated patients with thermal injury to the U.S. Army Burn Center with this system. The average extent of burn injury was 40.45% total body surface area with an average full thickness injury of 25.29% total body surface area. The transport ventilator was used for 57 rotary wing and 89 fixed wing missions. The study group was transported a total of 86,889 miles without in-flight morbidity, mortality, or failure of ventilation. Arterial blood gas analysis at conclusion of flight demonstrated all arterial pH ≤7.35 in 85% of the patients, an arterial partial pressure of carbon dioxide ≤45 tort in 97%, and an arterial partial pressure of oxygen ≤70 torr in 99%. Pressure-controlled ventilation performed by an experienced transport team with this ventilator is safe and effective for the long-range aeromedical transfer of intubated patients with burns.