Individualized mechanical ventilation in a shared ventilator setting: limits, safety and technical details.

Area of Science:

• Critical Care Medicine
• Respiratory Therapy
• Biomedical Engineering

Background:

• The COVID-19 pandemic increased demand for mechanical ventilators.
• Split ventilator setups offer an emergency solution for ventilating multiple patients with one machine.
• Individualized ventilation parameters are crucial for patient safety and clinical efficacy.

Purpose of the Study:

• To test the hypothesis that ventilation can be individualized in a split ventilator setup.
• To identify limitations of split ventilation using bench testing.
• To assess the feasibility of optimizing tidal volumes, PEEP, and FiO2.

Main Methods:

• Bench testing was conducted using two test lungs.
• Lung compliance, volume, plateau pressure, and PEEP were determined.
• Individualization of airway pressures, tidal volume, PEEP, and FiO2 was assessed using flow restrictors.

Main Results:

• Lung compliance ranged from 13 to 27 mL/cmH2O.
• Extrinsic PEEP was applicable, with volume and pressure regulation achieved via flow restrictor valve adjustments.
• Individualized FiO2 modulation was possible with minimal impact on the other circuit.

Conclusions:

• Split ventilator systems allow for individualization and monitoring of tidal volumes, PEEP, and FiO2.
• Bench testing demonstrated the potential for optimizing patient safety and clinical applicability.
• In vivo research is required to validate clinical outcomes and limitations for potential use as a last resort strategy.