Titration of Parameters in Shared Ventilation With a Portable Ventilator

Area of Science:

• Mechanical Ventilation
• Critical Care Medicine
• Biomedical Engineering

Background:

• Dual-patient, single-ventilator protocols may be necessary during healthcare crises.
• Conventional ventilators can potentially support two patients simultaneously.

Purpose of the Study:

• To demonstrate a method for titrating mechanical ventilator settings for dual-patient ventilation.
• To assess the feasibility of adjusting peak inspiratory pressure (PIP), positive end-expiratory pressure (PEEP), and tidal volume ([Formula: see text]) in a dual-patient setup.

Main Methods:

• A prospective observational study using a ventilator connected to two test lungs.
• Titration of PIP using 3D-printed resistors in the inspiratory circuit.
• PEEP titration via an expiratory circuit with a manual PEEP valve.
• Tidal volume ([Formula: see text]) adjustment using a splitter in the ventilator tubing.

Main Results:

• Peak inspiratory pressure (PIP), PEEP, and tidal volume ([Formula: see text]) were reliably and incrementally adjustable in the experimental lung.
• Manageable, notable changes in pressure and tidal volume were observed in the control lung during adjustments.
• Consistent results were obtained with test lungs of identical and different compliances.

Conclusions:

• Simple, low-cost modifications enable reliable adjustment of pressures and tidal volume in dual-patient, single-ventilator circuits.
• This approach offers a potentially life-saving solution in resource-limited or crisis situations.
• Understanding circuit interactions is crucial for ensuring the safe application of dual-patient ventilation.