updated May 7, 2020
Anesthesia machines are equipped with ventilators that in many cases are capable of providing life-sustaining mechanical ventilation to patients with respiratory failure. They are used for this purpose every day in the operating room. FDA approved labeling does not provide for using anesthesia ventilators for long term ventilatory support. Nevertheless, anesthesia ventilators are an obvious first-line backup during the COVID-19 pandemic when there are not sufficient ICU ventilators to meet the patient care needs. Local resources and constraints will impact how this solution can best be implemented. Anesthesia machines not currently being used may be located in your own hospital operating rooms, NORA locations, at nearby ambulatory surgery centers, nearby office-based surgery practices, and through your anesthesia equipment distributors. Guidance is available from the manufacturers regarding, but the guidance may not convey all of the clinical considerations. Anesthesia professionals will be needed to put these machines into service and to manage them while in use. Safe and effective use requires an understanding of the capabilities of the machines available, the differences between anesthesia machines and ICU ventilators, and how to set anesthesia machine controls to mimic ICU-type ventilation strategies.
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This document is intended to provide guidance on using anesthesia ventilators safely and effectively as ICU ventilators (PDF Updated May 7, 2020). Detailed information is provided and a quick reference guide (PDF Updated April 9, 2020) is available for downloading. The quick reference guide is intended to be a bedside tool and includes a suggested schedule for monitoring the effectiveness and safety of the anesthesia ventilator.
ASA is working with component societies to develop an inventory of local resources with the goal of moving machines to the locations where they are most needed.
(NOTE: Local conditions will likely dictate modifications to the recommendations provided. This document is intended to provide reference information that empowers caregivers at the bedside to make the best decisions possible to provide safe and effective care.)
Read the complete APSF/ASA Guidance on Purposing Anesthesia Machines as ICU Ventilators (PDF Updated May 7, 2020).
Download the Quick Reference: Setup and Monitoring Instructions – Anesthesia Machines as an ICU Ventilator (PDF Updated April 9, 2020).
Download the Guidance for Use of Volatile Anesthesic for Sedation of ICU Patients (PDF Updated April 7, 2020).
Download the Start Up Checklist: Procedure for Supporting Patients During the Anesthesia Machine Power Up Test (PDF Updated April 2, 2020).
For direct and customized advice, please send your questions about to [email protected]
Disclaimer: These guidelines were developed using the best judgement of clinicians with experience using anesthesia machines short-term in operating rooms. They are being frequently updated based on experience using anesthesia machines long-term for intensive care ventilation. The information and materials provided herein are provided only for information and educational purposes and do not establish a standard of care or constitute medical or legal advice. Readers are reminded to consult with their own institutions and medical/legal advisors.