Disaster Medicine and Public Health Preparedness

Research Article

Mechanical Ventilators in US Acute Care Hospitals

Lewis Rubinson c1, Frances Vaughn, Steve Nelson, Sam Giordano, Tom Kallstrom, Tim Buckley, Tabinda Burney, Nathaniel Hupert, Ryan Mutter, Michael Handrigan, Kevin Yeskey, Nicole Lurie and Richard Branson

ABSTRACT

Objective: The supply and distribution of mechanical ventilation capacity is of profound importance for planning for severe public health emergencies. However, the capability of US health systems to provide mechanical ventilation for children and adults remains poorly quantified. The objective of this study was to determine the quantity of adult and pediatric mechanical ventilators at US acute care hospitals.

Methods: A total of 5752 US acute care hospitals included in the 2007 American Hospital Association database were surveyed. We measured the quantities of mechanical ventilators and their features.

Results: Responding to the survey were 4305 (74.8%) hospitals, which accounted for 83.8% of US intensive care unit beds. Of the 52 118 full-feature mechanical ventilators owned by respondent hospitals, 24 204 (46.4%) are pediatric/neonatal capable. Accounting for nonrespondents, we estimate that there are 62 188 full-feature mechanical ventilators owned by US acute care hospitals. The median number of full-feature mechanical ventilators per 100 000 population for individual states is 19.7 (interquartile ratio 17.2–23.1), ranging from 11.9 to 77.6. The median number of pediatric-capable device full-feature mechanical ventilators per 100 000 population younger than 14 years old is 52.3 (interquartile ratio 43.1–63.9) and the range across states is 22.1 to 206.2. In addition, respondent hospitals reported owning 82 755 ventilators other than full-feature mechanical ventilators; we estimate that there are 98 738 devices other than full-feature ventilators at all of the US acute care hospitals.

Conclusions: The number of mechanical ventilators per US population exceeds those reported by other developed countries, but there is wide variation across states in the population-adjusted supply. There are considerably more pediatric-capable ventilators than there are for adults only on a population-adjusted basis.

(Disaster Med Public Health Preparedness. 2010;4:199-206)

(Received July 26 2010)

(Accepted August 30 2010)

Key Words:

  • surge mechanical ventilation;
  • disaster respiratory care;
  • mass respiratory failure;
  • surge capacity

Correspondence

c1 Address correspondence and reprint requests to Dr Lewis Rubinson, National Disaster Medical System, 409 C Street, Suite 330, Washington, DC 20224 (e-mail: lewis.rubinson@hhs.gov).

Author Affiliations: Drs Rubinson, Vaughn, Handrigan, Yeskey, and Lurie and Ms Burney are with the Office of the Assistant Secretary for Preparedness and Response, US Department of Health and Human Services; Messers Nelson, Giordano, Kallstrom, and Buckley are with the American Association for Respiratory Care; Dr Hupert is with the Department of Public Health, Weill Medical College; Dr Mutter is with the Agency for Healthcare Research and Quality, US Department of Health and Human Services; and Mr Branson is with the Department of Surgery, University of Cincinnati.