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Published in: Journal of Anesthesia 4/2021

01-08-2021 | Acute Respiratory Distress-Syndrome | Original Article

Development of a multi-patient ventilator circuit with validation in an ARDS porcine model

Authors: Benjamin P. Wankum, Riley E. Reynolds, Andrea R. McCain, Nathaniel T. Zollinger, Keely L. Buesing, Russel D. Sindelar, Frank M. Freihaut, Tariku Fekadu, Benjamin S. Terry

Published in: Journal of Anesthesia | Issue 4/2021

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Abstract

Purpose

The COVID-19 pandemic threatens our current ICU capabilities nationwide. As the number of COVID-19 positive patients across the nation continues to increase, the need for options to address ventilator shortages is inevitable. Multi-patient ventilation (MPV), in which more than one patient can use a single ventilator base unit, has been proposed as a potential solution to this problem. To our knowledge, this option has been discussed but remains untested in live patients with differing severity of lung pathology.

Methods

The objective of this study was to address ventilator shortages and patient stacking limitations by developing and validating a modified breathing circuit for two patients with differing lung compliances using simple, off-the-shelf components. A multi-patient ventilator circuit (MPVC) was simulated with a mathematical model and validated with four animal studies. Each animal study had two human-sized pigs: one healthy and one with lipopolysaccharide (LPS) induced ARDS. LPS was chosen because it lowers lung compliance similar to COVID-19. In a previous study, a control group of four pigs was given ARDS and placed on a single patient ventilation circuit (SPVC). The oxygenation of the MPVC ARDS animals was then compared to the oxygenation of the SPVC animals.

Results

Based on the comparisons, similar oxygenation and morbidity rates were observed between the MPVC ARDS animals and the SPVC animals.

Conclusion

As healthcare systems worldwide deal with inundated ICUs and hospitals from pandemics, they could potentially benefit from this approach by providing more patients with respiratory care.
Appendix
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Metadata
Title
Development of a multi-patient ventilator circuit with validation in an ARDS porcine model
Authors
Benjamin P. Wankum
Riley E. Reynolds
Andrea R. McCain
Nathaniel T. Zollinger
Keely L. Buesing
Russel D. Sindelar
Frank M. Freihaut
Tariku Fekadu
Benjamin S. Terry
Publication date
01-08-2021
Publisher
Springer Singapore
Published in
Journal of Anesthesia / Issue 4/2021
Print ISSN: 0913-8668
Electronic ISSN: 1438-8359
DOI
https://doi.org/10.1007/s00540-021-02948-2

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