Pressure-Regulated Ventilator Splitting for Disaster Relief: Design, Testing, and Clinical Experience.

Area of Science:

• Critical Care Medicine
• Biomedical Engineering
• Respiratory Therapy

Background:

• The COVID-19 pandemic highlighted critical shortages in mechanical ventilator capacity during surge events.
• Existing hospital resources may be insufficient to meet patient demand in mass casualty or pandemic scenarios.
• Safe and scalable solutions are needed to expand ventilator availability rapidly.

Purpose of the Study:

• To define an approach for safe ventilator sharing prioritizing independent patient care.
• To design, test, and clinically evaluate a ventilator-splitting circuit for simultaneous ventilation of two patients.
• To share clinical insights and recommendations for implementing shared ventilation technology.

Main Methods:

• Development of a ventilator-splitting circuit enabling individualized positive end-expiratory pressure (PEEP).
• Testing of the circuit to ensure independent ventilatory support for each patient.
• Clinical application of the circuit in intensive care units during the COVID-19 pandemic.

Main Results:

• The developed circuit successfully provided individualized and titratable ventilatory support to two critically ill patients concurrently.
• Each patient received independent positive end-expiratory pressure (PEEP) settings.
• The system effectively insulated patients from physiological changes in the other, ensuring predictable care.

Conclusions:

• The described ventilator-sharing circuit offers a safe and effective method to expand ventilator capacity.
• This technology allows for individualized mechanical ventilation, crucial for critically ill patients.
• Clinical implementation provides valuable insights for future applications in critical care settings.