Performance evaluation of an internet of medical things digital flowmeter in a mechanical ventilator: A bench study

Background: Oxygen therapy is a fundamental medical intervention with a narrow therapeutic index. Despite robust evidence supporting conservative approaches, adherence to protocols remains below 40%, partly due to technological limitations of traditional analog flowmeters that can exhibit deviations up to 30% at high flows. Digital IoMT flowmeters like ATAS O2 VM emerge as accurate alternatives, but their integration with mechanical ventilators requires demonstration of safety and efficacy, particularly in pressure-controlled modes and low-flow scenarios. Objective: To evaluate ATAS O2 VM performance when integrated with mechanical ventilators in PCV mode, analyzing its impact on ventilatory parameters and oxygen consumption detection capability at different FiO₂ levels. Methods: Two complementary bench trials were conducted using a mechanical ventilator and reference flowmeter. Trial 1 compared four conditions (without ATAS, with ATAS at 21% and 100% O₂ under different pressures), measuring inspired volume, inspiratory time, and peak flow. Trial 2 tested detection capability at five FiO₂ levels (100%, 50%, 30%, 25%, 21%) in adult and neonatal scenarios, comparing algorithm versions 1.0 and 2.0. Results: ATAS O2 VM preserved ventilatory parameters with variations