Personalized Ventilation to Multiple Patients Using a Single Ventilator: Description and Proof of Concept

Area of Science:

• Biomedical Engineering
• Respiratory Therapy
• Critical Care Medicine

Background:

• Single-ventilator multi-patient (SVMP) ventilation presents challenges in individualizing patient respiratory parameters.
• Existing methods for SVMP may compromise patient safety and treatment efficacy.
• There is a need for adaptable circuits that allow precise control for each patient.

Purpose of the Study:

• To design and validate a novel ventilator circuit for simultaneous ventilation of two or more patients using a single mechanical ventilator.
• To enable independent adjustment of tidal volume, oxygen concentration, and positive end-expiratory pressure for each patient.
• To ensure that adjustments for one patient do not adversely affect the ventilation of another, regardless of respiratory system mechanics.

Main Methods:

• A "bag-in-a-box" breathing circuit design was implemented using readily available hospital components.
• Two such circuits were assembled, each connecting a flexible bag within a rigid container to a test lung via a one-way valve.
• The system was tested by ventilating mechanical test lungs, varying parameters like tidal volume, compliance, and positive end-expiratory pressure, and observing effects on co-ventilated lungs.

Main Results:

• The "bag-in-a-box" system successfully achieved distinct tidal volumes, dynamic driving pressures, and positive end-expiratory pressures in two test lungs with differing compliances.
• Complete airway obstruction or disconnection in one circuit had a minimal impact (<5% average) on ventilation delivered to the other co-ventilated lung.
• The proof-of-concept studies demonstrated the feasibility of the designed circuit.

Conclusions:

• The developed secondary "bag-in-a-box" circuit provides a viable solution for individualized ventilation of multiple patients with a single ventilator.
• This system effectively addresses key concerns associated with multi-patient ventilation, enhancing safety and therapeutic control.
• The design offers a practical approach to resource optimization in critical care settings.