Michelle Rausen, BS, MS, RRT, RRT-NPS
Technical Director, Respiratory Therapy
Memorial Sloan Kettering Cancer Center
New York, NY
Disclosure information not submitted.
Thomas Nahass, MD
Fellow
Memorial Sloan Kettering Cancer Center
New York, NY
Disclosure information not submitted.
Neil Halpern, MD, MCCM
Director, Critical Care Center
Memorial Sloan Kettering Cancer Center
Teaneck, New Jersey, United States
Disclosure information not submitted.
Title: Utility of Remote-Controlled Ventilator Software (Omnitool) During the COVID-19 Pandemic
Introduction/Hypothesis: The goal of this study is to assess the utility of remote-controlled ventilator software for routine management that mitigates the need for in-room ventilator interactions with COVID-19 patients. The Omnitool (Medtronic, Minneapolis, MN) software was granted emergency use authorization (EUA) by the Food and Drug Administration for COVID-19 patients only for the duration of the pandemic. Via a standard computer on the hospital network, located outside of the patient’s room, a respiratory therapist can remotely log into the patient’s ventilator. The therapist can then both monitor and control the ventilator.
Methods: This is a retrospective observational study of all COVID-19 positive, intubated and mechanically ventilated patients with documented use of the Omnitool software, in a 20-bed medical-surgical ICU from January 1, 2021-April 30, 2021. Three datasets (demographics, ventilator flowsheets, and remote ventilator access logs) were used to compile a master database of total ventilator interactions. These were categorized into parameter changes, alarm changes, observations, and miscellaneous. These categories were tallied and compared by patient for in-room vs. remote management.
Results: 17 patients (F=11, M=6), average age of 62 years, with a median hospital LOS of 37 days, ICU LOS of 30 days, and ventilator days of 25. 11,157 total ventilator interactions (average 656 interactions per patient) were analyzed and categorized. 10,082 (90%) were in-room and 1,075 (10%) were remote. Of the 1,613 parameter changes, 1,389 (86%) were in-room vs. 224 (14%) remote. Of the 680 alarm changes, 618 (91%) were in-room vs. 62 (9%) remote. Of the 8,750 observations, 8,075 (92%) were in-room vs. 675 (8%) remote. Of the 114 miscellaneous interactions, 100% were remote.
Conclusions: Only 10% of total ventilator interactions were performed remotely. This limited dataset suggests that remote ventilator management is feasible; however, further study is needed to identify the barriers to its broader use and utility in COVID-19 and other types of infectious ICU patients.