Vent Lock: A 3D Printed Ventilator Multiplexer to Enhance the Capacity of Treating Patients with COVID 19

Mechanical ventilators are essential to patients who become critically ill from acute respiratory distress syndrome (ARDS), and shortages have been reported due to the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We utilized cost-effective, on-demand 3D printing (3DP) technology to produce critical components for a novel ventilator multiplexer system, Vent-Lock, to split one ventilator or anesthesia gas machine between two patients. FloRest, a novel 3DP flow restrictor, provides clinicians control of tidal volumes and positive end expiratory pressure (PEEP), using the 3DP manometer adaptor to monitor pressures. We tested the ventilator splitter circuit in simulation centers between artificial lungs and used an anesthesia gas machine to successfully ventilate two swines. As one of the first studies to demonstrate splitting one anesthesia gas machine between two swines, we present proof-of-concept of a de novo , closed, multiplexing system, with flow restriction for individualized patient therapy. Our studies underscore that while possible, ventilator multiplexing is a complicated synergy between machine settings, circuit modification, and patient monitoring. Consequently, ventilator multiplexing is reserved only as a last emergency resource, by trained clinicians and respiratory therapists with ventilator operative experience. ### Competing Interest Statement Authors Xun, Shallal, Unger, Tao, Torres, Vladimirov, Frye, Singhala, Horne, Yesantharao, Kim, Talcott, Montana, Winters, Frisella, Kushner, Guest, Kang, and Caffrey have no relevant disclosures. Dr. Burke receives research funding from the International Anesthesiology Research Society Mentored Research Award. Dr. Sacks receives unrestricted research funding from ViOptix Inc., and is co-founder of LifeSprout Inc. ### Funding Statement The authors acknowledge financial support from the Johns Hopkins University President's Response to COVID-19 Fund, the Start-Up Fund from the Whiting School of Engineering at Johns Hopkins University, support from the Department of Civil and Systems Engineering and Johns Hopkins Center for Additive Manufacturing and Architected Materials, and the National Science Foundation (DMREF-1628974). JU acknowledges financial support from the U.S. Army Research Office (ARO) sponsored NDSEG Fellowship program and AT acknowledges support by a NASA Space Technology Research Fellowship. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Institutional Animal Care and Use Committee of Washington University School of Medicine All necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Yes Data is available upon request