Technique Articles

Establishing a Ventilator–Heart Lung Machine Communication Bridge to Mitigate Errors when Weaning from Bypass

^* Veterans Affairs Boston Healthcare System, Division of Cardiac Surgery, Boston, Massachusetts
^† Massachusetts General Hospital, Boston, Massachusetts; and
^‡ Harvard Medical School, Boston, Massachusetts

Address correspondence to: Geoffrey Rance, BS, CCP, Veterans Affairs Boston Healthcare System, Division of Cardiac Surgery, 1400 VFW Parkway, Mail Stop 112 West Roxbury, Boston, MA 02132. E-mail: geoffrey.rance@va.gov

Received: 19 September 2018
Accepted: 25 January 2019

Abstract

If a perfusionist weans a patient off the heart lung machine (HLM) and the anesthesiologist has not re-started the ventilator, the patient will become hypoxic. The objective of this project was to create a redundant safety system of verbal and electronic communication to prevent failure to ventilate errors after cardiopulmonary bypass. This objective could be realized by building an electronic communication bridge directly between the HLM and ventilator. A software application was created to retrieve and interpret data from the pump and ventilator and trigger a programmed smart alarm. The software is able to interpret data from the pump and ventilator. When both are off simultaneously (defined as a pump flow of 0 L/min with a respiratory rate of 0 breaths/min), the application will raies an alarm. Communication between a pump and ventilator is possible, enabling the deployment of a safety system that could exist in the operating room (OR) as a standalone alarm. A device dataset can be used to optimize clinical performance of the alarm. The application could also be integrated into smart checklists and computer-assisted OR process models that are currently in development.