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.
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