Sharing Mechanical Ventilator: In Vitro Evaluation of Circuit Cross-Flows and Patient Interactions

Author:

Colombo Sebastiano MariaORCID,Battistin MicheleORCID,Carlesso Eleonora,Vivona Luigi,Carfagna FabioORCID,Valsecchi Carlo,Florio Gaetano,Carenzo LucaORCID,Tonetti Tommaso,Ranieri Vito Marco,Cecconi Maurizio,Pesenti Antonio,Grasselli GiacomoORCID,Zanella AlbertoORCID

Abstract

During the COVID-19 pandemic, a shortage of mechanical ventilators was reported and ventilator sharing between patients was proposed as an ultimate solution. Two lung simulators were ventilated by one anesthesia machine connected through two respiratory circuits and T-pieces. Five different combinations of compliances (30–50 mL × cmH2O−1) and resistances (5–20 cmH2O × L−1 × s−1) were tested. The ventilation setting was: pressure-controlled ventilation, positive end-expiratory pressure 15 cmH2O, inspiratory pressure 10 cmH2O, respiratory rate 20 bpm. Pressures and flows from all the circuit sections have been recorded and analyzed. Simulated patients with equal compliance and resistance received similar ventilation. Compliance reduction from 50 to 30 mL × cmH2O−1 decreased the tidal volume (VT) by 32% (418 ± 49 vs. 285 ± 17 mL). The resistance increase from 5 to 20 cmH2O × L−1 × s−1 decreased VT by 22% (425 ± 69 vs. 331 ± 51 mL). The maximal alveolar pressure was lower at higher compliance and resistance values and decreased linearly with the time constant (r² = 0.80, p < 0.001). The minimum alveolar pressure ranged from 15.5 ± 0.04 to 16.57 ± 0.04 cmH2O. Cross-flows between the simulated patients have been recorded in all the tested combinations, during both the inspiratory and expiratory phases. The simultaneous ventilation of two patients with one ventilator may be unable to match individual patient’s needs and has a high risk of cross-interference.

Publisher

MDPI AG

Subject

Filtration and Separation,Chemical Engineering (miscellaneous),Process Chemistry and Technology

Reference40 articles.

1. Managing ICU surge during the COVID-19 crisis: rapid guidelines

2. The Toughest Triage — Allocating Ventilators in a Pandemic

3. Manual ventilation and risk of barotrauma: Primum non nocere;Ricard;Respir. Care,2005

4. One ventilator for two patients: feasibility and considerations of a last resort solution in case of equipment shortage

5. Peak pressures during manual ventilation;Turki;Respir. Care,2005

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