RESUMO
IntroductionThe increased demand for mechanical ventilation caused by the SARS-CoV-2 pandemic could generate a critical situation where patients may lose access to mechanical ventilators. Combined ventilation, in which two patients are ventilated simultaneously but independently with a single ventilator has been proposed as a life-saving bridge while waiting for new ventilators availability. New devices have emerged to facilitate this task and allow individualization of ventilatory parameters in combined ventilation. In this work we run computer-based electrical simulations of combined ventilation. We introduce an electrical model of a proposed mechanical device which is designed to individualize ventilatory parameters, and tested it under different circumstances. Materials and MethodsWith an electronic circuit simulator applet, an electrical model of combined ventilation is created using resistor-capacitor circuits. A device is added to the electrical model which is capable of individualizing the ventilatory parameters of two patients connected to the same ventilator. Through computational simulation, the model is tested in different scenarios with the aim of achieving adequate ventilation of two subjects under different circumstances: 1) two identical subjects; 2) two subjects wiIth the same size but different lung compliance; and 3) two subjects with different sizes and compliances. The goal is to achieve the established charge per unit of size on each capacitor under different levels of end-expiratory voltage (as an end-expiratory pressure analog). Data collected included capacitor charge, voltage, and charge normalized to the weight of the simulated patient. ResultsSimulations show that it is possible to provide the proper charge to each capacitor under different circumstances using an array of electrical components as equivalents to a proposed mechanical device for combined ventilation. If the pair of connected capacitors have different capacitances, adjustments must be made to the source voltage and/or the resistance of the device to provide the appropriate charge for each capacitor under initial conditions. In pressure control simulation, increasing the end-expiratory voltage on one capacitor requires increasing the source voltage and the device resistance associated with the other simulated patient. On the other hand, in the volume control simulation, it is only required to intervene in the device resistance. ConclusionsUnder simulated conditions, this electrical model allows individualization of combined mechanical ventilation.
