Emergency mechanical ventilation at moderate altitude.

Portable emergency ventilators are commonly used in the prehospital setting in the transport of critically ill patients in hypobaric environments. The aim of our trial was to evaluate the influence on minute ventilation and blood gas analysis of moderate altitude (3000 m) compared to 171 m in healthy volunteers during mechanical ventilation with the Draeger Oxylog ventilator. At 3000 m, the delivered minute volume increased by 9.8% in the air mix mode and by 14.6% in the no air mix mode. PaO2 at 3000 m altitude decreased by 33.3% in the air mix mode, and no statistical change was observed in the no air mix mode. PaCO2 at 3000 m altitude decreased by 9.0% in the air mix mode and by 12.8% in the no air mix mode. These changes are of sufficient magnitude and importance to require monitoring of minute volume to prevent barotrauma or volume-related trauma and to monitor oxygenation by pulse oximetry during emergency mechanical ventilation at moderate altitude.