Split ventilation with pressure regulators for patient-specific tidal volumes (preprint)

ABSTRACT

As a measure of last resort during the COVID-19 pandemic, single mechanical ventilators have been repurposed to support multiple patients. In existing split-ventilator configurations using FDA-approved tubing adaptors, each patient receives the same inspiratory pressure, requiring careful matching of patients to avoid barotrauma. Progression of disease may cause tidal volumes to diverge from desired targets, and routine interventions (eg. suctioning) in one patient may adversely affect other patients. To overcome these limitations, we demonstrate a split-ventilator configuration that enables individualized patient management by incorporating a commonly available pressure regulator used for gas appliances. We validate this method by achieving various combinations of tidal volume in each of two synthetic lungs using a standard ventilator machine in combination with two gas flow analyzers. With further safety testing and instrumentation, pressure regulators may represent a viable path to substantially augment the capacity for ventilation in resource-constrained settings.