Return to Main Menu

VDR is standard care for MUSC burn patients by Chris West Public Relations During the summer of 1999, the MUSC Burn Unit began using a new respirator that has David Barillo, M.D., head of plastic surgery, excited, primarily because of what it brings to the unit: better care for his patients. Dr. David Barillo “The Volume Diffusive Respirator (VDR) ventilator is about the only thing in the last 20 or so years that has had any significant effect on smoke inhalation injury,”  Barillo said. This is especially important in that “smoke inhalation is the single most important factor in predicting survival of burn patients.” Barillo began working with the VDR in the early 1990s at Brooke Army Medical Center in San Antonio, Texas. It evolved through several models and is now in its fourth incarnation, the VDR-4, the very model being used by MUSC now.  In 1991, the respirator received FDA approval and has become the standard of care in burn medicine at many of the larger burn units in the country including the University of North Carolina at Chapel Hill, the four Shrine-sponsored burn hospitals in Sacramento, Boston, Cincinnati and Galveston and the Brooke Army Medical Center Burn Unit.  The VDR was created by Forrest Bird, M.D., Ph.D., and  president of Bird Space Technologies and Percussionaire Corp. in Sandpoint, Ind., in the 1980s. Bird, who is known for his pioneering work with respirators, is regarded by many as the father of mechanical ventilation.  His first invention was appropriately called the Bird Ventilator, which he updated and improved to keep up with a chronic respiratory illness his wife had acquired. He is still involved in the field and makes the ventilators available through his new company, Percussionaire.  What makes this respirator unique is that it is two respirators  that serve different features of burn care.  One is a low-frequency, pressure-control ventilator and the other is a high-frequency jet ventilator. “This allows for the ventilation of patients at much lower pressures which reduces the amount of pressure-caused injuries,” Barillo said. “The jet ventilator aids in preventing pneumonia by clearing secretions.” This is important because the mortality rate for victims of smoke inhalation is “increased from 20 percent by inhalation alone to 60 percent with the onset of pneumonia,” according to Barillo. When used as salvage therapy after the failure of conventional respiration, the VDR was able to sustain life in five cases, according to the findings by the Brooke Army Burn Unit. The unit also found that “the number of pneumonia cases was cut in half for what you would predict for that population and survival was twice as much as what was  expected for that population.” Barillo also praises the VDR’s versatility saying  “the ventilator can also be used to treat other very sick people with other problems such as head trauma, lung diseases with air leaks, surgical ICU, neurosurgery patients and thoracic surgery patients.” MUSC now rents a unit from Percussionaire, but Barillo hopes the university will purchase it in the near future. “It is cutting edge technology at the major burn centers in the country,” he said, “and it’s exciting that we are able to provide it here.”