A simulated single ventilator/ dual patient ventilation strategy for acute respiratory distress syndrome during the COVID-19 pandemic

TY - JOUR

T1 - A simulated single ventilator/ dual patient ventilation strategy for acute respiratory distress syndrome during the COVID-19 pandemic

AU - Solís-Lemus, José A.

AU - Costar, Edward

AU - Doorly, Denis

AU - Kerrigan, Eric C.

AU - Kennedy, Caroline H.

AU - Tait, Frances

AU - Niederer, Steven

AU - Vincent, Peter E.

AU - Williams, Steven E.

PY - 2020/8/1

Y1 - 2020/8/1

N2 - The potential for acute shortages of ventilators at the peak of the COVID-19 pandemic has raised the possibility of needing to support two patients from a single ventilator. To provide a system for understanding and prototyping designs, we have developed a mathematical model of two patients supported by a mechanical ventilator. We propose a standard set-up where we simulate the introduction of T-splitters to supply air to two patients and a modified set-up where we introduce a variable resistance in each inhalation pathway and one-way valves in each exhalation pathway. Using the standard set-up, we demonstrate that ventilating two patients with mismatched lung compliances from a single ventilator will lead to clinically significant reductions in tidal volume in the patient with the lowest respiratory compliance. Using the modified set-up, we demonstrate that it could be possible to achieve the same tidal volumes in two patients with mismatched lung compliances, and we show that the tidal volume of one patient can be manipulated independently of the other. The results indicate that, with appropriate modifications, two patients could be supported from a single ventilator with independent control of tidal volumes.

AB - The potential for acute shortages of ventilators at the peak of the COVID-19 pandemic has raised the possibility of needing to support two patients from a single ventilator. To provide a system for understanding and prototyping designs, we have developed a mathematical model of two patients supported by a mechanical ventilator. We propose a standard set-up where we simulate the introduction of T-splitters to supply air to two patients and a modified set-up where we introduce a variable resistance in each inhalation pathway and one-way valves in each exhalation pathway. Using the standard set-up, we demonstrate that ventilating two patients with mismatched lung compliances from a single ventilator will lead to clinically significant reductions in tidal volume in the patient with the lowest respiratory compliance. Using the modified set-up, we demonstrate that it could be possible to achieve the same tidal volumes in two patients with mismatched lung compliances, and we show that the tidal volume of one patient can be manipulated independently of the other. The results indicate that, with appropriate modifications, two patients could be supported from a single ventilator with independent control of tidal volumes.

KW - Acute respiratory distress syndrome

KW - ARDS

KW - Coronavirus

KW - COVID-19

KW - Ventilator sharing

KW - Ventilator splitting

UR - http://www.scopus.com/inward/record.url?scp=85091848607&partnerID=8YFLogxK

U2 - 10.1098/rsos.200585

DO - 10.1098/rsos.200585

M3 - Article

AN - SCOPUS:85091848607

SN - 2054-5703

VL - 7

JO - Royal Society open science

JF - Royal Society open science

IS - 8

M1 - e200585

ER -