Combined Ventilation of Two Subjects with a Single Mechanical Ventilator Using a New Medical Device: An In Vitro...

Area of Science:

• Critical Care Medicine
• Respiratory Therapy
• Biomedical Engineering

Background:

• The COVID-19 pandemic led to a critical shortage of ventilators.
• The DuplicAR device was developed to allow a single ventilator to support two patients simultaneously and independently.
• Assessing the efficacy and optimal use of the DuplicAR device is crucial for managing ventilator scarcity.

Purpose of the Study:

• To evaluate the DuplicAR device's ability to independently regulate peak inspiratory pressure (PIP) and positive-end expiratory pressure (PEEP) in two subjects.
• To compare the performance and safety of the DuplicAR device under both pressure-controlled ventilation (PCV) and volume-controlled ventilation (VCV) modes.
• To determine the most effective ventilation mode for utilizing the DuplicAR device.

Main Methods:

• Two test lungs were connected to a single ventilator using the DuplicAR device.
• Experiments were conducted in three stages simulating different patient conditions: identical subjects, subjects with different lung compliances, and subjects with different weights and compliances.
• Ventilation was assessed in both PCV and VCV modes, with PEEP requirements adjusted to achieve a target tidal volume of 7 mL/kg for each subject.

Main Results:

• The DuplicAR device successfully facilitated independent ventilation for subjects with varying weights, lung compliances, and PEEP requirements.
• Effective management of tidal volume (in VCV) or peak pressure (in PCV) and PEEP was achieved by manipulating ventilator settings and DuplicAR controllers.
• While functional in both modes, the DuplicAR device demonstrated superior performance in PCV, as adjustments for one subject did not impact the other.

Conclusions:

• The DuplicAR device is a viable tool for independently managing PIP and PEEP in two patients connected to one ventilator.
• The device allows for precise adjustment of driving pressure to meet diverse patient needs, including varying weights and lung compliances.
• Pressure-controlled ventilation is the recommended mode for using the DuplicAR device due to its enhanced performance and patient-specific control.