Simultaneous mechanical ventilation of several patients with a single ventilator.

INTRODUCTION: Simultaneous mechanical ventilation of several patients with a single ventilator might reduce the deficit of these devices for the care of patients with acute respiratory failure due to Covid-19. OBJECTIVE: To communicate the results of a mechanical ventilation exercise with a ventilator in a lung simulator, and simultaneously in two and four. RESULTS: No statistically significant differences were observed between programmed, recorded and measured positive end-expiratory pressure, mean airway pressure and peak pressure, except when simultaneously ventilating four lung simulators. CONCLUSIONS: Simultaneous mechanical ventilation should be implemented by medical personnel with experience in the procedure, be restricted to two patients and carried out in the intensive care unit.

INTRODUCCIÓN: La ventilación mecánica simultánea a varios pacientes con un solo ventilador podría disminuir el déficit de esos dispositivos para atender a los enfermos con insuficiencia respiratoria aguda por Covid-19. OBJETIVO: Comunicar los resultados de un ejercicio de ventilación mecánica con un ventilador en un simulador de pulmón, y simultáneamente en dos y cuatro. RESULTADOS: No se observaron diferencias estadísticamente significativas entre la presión positiva al final de la espiración, presión media de la vía aérea y presión pico programadas, registradas y medidas, excepto al ventilar simultáneamente cuatro simuladores de pulmón. CONCLUSIONES: La ventilación mecánica simultánea debe ser instaurada por personal médico con experiencia en el procedimiento, restringirse a dos pacientes y ser realizada en la unidad de cuidados intensivos.

Ventilación mecánica simultánea con un solo ventilador a varios pacientes / Simultaneous mechanical ventilation of several patients with a single ventilator

Resumen Introducción: La ventilación mecánica simultánea a varios pacientes con un solo ventilador podría disminuir el déficit de esos dispositivos para atender a los enfermos con insuficiencia respiratoria aguda por Covid-19. Objetivo: Comunicar los resultados de un ejercicio de ventilación mecánica con un ventilador en un simulador de pulmón, y simultáneamente en dos y cuatro simuladores. Resultados: No se observaron diferencias estadísticamente significativas entre la presión positiva al final de la espiración, presión media de la vía aérea y presión pico programadas, registradas y medidas, excepto al ventilar simultáneamente cuatro simuladores de pulmón. Conclusiones: La ventilación mecánica simultánea debe ser instaurada por personal médico con experiencia en el procedimiento, restringirse a dos pacientes y ser realizada en la unidad de cuidados intensivos.

Abstract Introduction: Simultaneous mechanical ventilation of several patients with a single ventilator might reduce the deficit of these devices for the care of patients with acute respiratory failure due to Covid-19. Objective: To communicate the results of a mechanical ventilation exercise with a ventilator in a lung simulator, and simultaneously in two and four. Results: No statistically significant differences were observed between positive end-expiratory pressure, mean airway pressure, and programmed, recorded and measured peak pressure, except when simultaneously ventilating four lung simulators. Conclusions: Simultaneous mechanical ventilation should be implemented by medical personnel with experience in the procedure, be restricted to two patients and carried out in the intensive care unit.

[New device and technique to measure intra-abdominal pressure]. / Nueva técnica y dispositivo para medir la presión intraabdominal.

INTRODUCTION: sequential measurement of intra-abdominal pressure is of paramount importance for an early detection and appropriate therapeutic management of intra-abdominal hypertension and abdominal compartment syndrome. OBJECTIVE: to validate a device and technique developed to measure intra-abdominal pressure (an innovation of the Foley urinary catheter named intra-abdominal pressure catheter). METHODS: three different sets of measurements where done to test the intra-abdominal pressure catheter device: I. 50 measurements were done with the intra-abdominal pressure catheter device and compared against those measurements done using a manometer graded in cm H(2)O; II. Direct measurement of intra-abdominal pressure in five patients during elective laparoscopy vs the intraabdominal pressure catheter device; and III. Measurement of intra-abdominal pressure by the Kron method (Gold standard) vs intra-abdominal pressure catheter device in three patents with intra-abdominal hypertension/abdominal compartment syndrome. Measurements where compared with Pearson correlation test and Bland Altman statistics. RESULTS: I.Intra-abdominal pressure catheter vs graded manometer: r = 0.99, with a mean pressure difference of 0.27 ± 0.23 mmHg, CI (0.039 to 0.092 mmHg). II. Direct measurement of intra-abdominal pressure during laparoscopy vs intra-abdominal pressure catheter device: r = 0.93, with a mean pressure difference of 0.18 ± 0.84 mmHg, CI (-1.46 to 1.83 mmHg) and III. Measurement of intra-abdominal pressure by the Kron Method vs intra-abdominal pressure catheter device: r = 0.81, with a mean pressure difference of -0.41 ± 0.87, CI (-2.12 mmHg to 1.30 mmHg). CONCLUSIONS: the intra-abdominal pressure catheter device is a safe and reliable instrument for measuring intra-abdominal pressure.