A translational study evaluating a ruggedized portable oxygen concentrator versus an oxygen cylinder in simulated polytrauma intubation of swine

Objectives

Portable oxygen concentrators (POCs) are medical devices that use filters to selectively remove nitrogen from ambient air to produce concentrated, medical-grade oxygen. This is the first study to evaluate a ruggedized POC's performance during simulated polytrauma intubation.

Methods

Twenty-seven swine were intubated and anesthetized with ketamine. At T = 0, animals were extubated, received a chest wall injury, a tibia fracture, and 20% total blood volume controlled hemorrhage was initiated. At T = 10 min, the swine were pre-oxygenated using a bag-valve mask connected to one of three randomized oxygen sources: (1) a ruggedized POC, (2) a M-15 oxygen cylinder, or (3) room air (control). At T = 12 min, animals were re-intubated to simulate polytrauma intubation and connected to the test oxygen source for the remainder of the experiment. Surviving animals entered a 2-h period where partial pressure of oxygen (PaO₂), oxygen saturation (SpO₂), and regional oxygen saturation (rSO₂) were monitored. Groups were compared using analysis of variance (ANOVA), Fisher's exact, log-rank analysis, or mixed-effects model as appropriate.

Results

All animals survived except one in the POC group. Mixed-effects models revealed differences between groups with regards to PaO₂ (p < 0.0001) and SpO₂ (p = 0.006). Based on post hoc analysis, oxygen cylinder PaO₂ was superior to both POC and control, but there were no differences between POC and control PaO₂. There were statistically and clinically significant differences in SpO₂ during periods of pre-oxygenation (T = 10‒12 min), intubation (T = 12‒14 min), and immediately after intubation (T = 14‒20 min). The POC battery was consumed in 43 ± 13 min.

Conclusion

In our swine model, a single, ruggedized POC provided inferior amounts of oxygen supplementation compared to an oxygen cylinder and performed no better than room air.