Titration Of Parameters In Shared Ventilation With A Portable Ventilator

BACKGROUND: Dual-patient, single-ventilator protocols (ie, protocols to ventilate 2 patients with a single conventional ventilator) may be required in times of crisis. This study demonstrates a means to titrate peak inspiratory pressure (PIP), PEEP, and F-IO2 for test lungs ventilated via a dual-patient, single-ventilator circuit. METHODS: This prospective observational study was conducted using a ventilator connected to 2 test lungs. Changes in PIP, PEEP, and F-IO2 were made to the experimental lung, while no changes were made to the control lung. Measurements were obtained simultaneously from each test lung. PIP was titrated using 3D-printed resistors added to the inspiratory circuit. PEEP was titrated using expiratory circuit tubing with an attached manual PEEP valve. F-IO2 was titrated by using a splitter added to the ventilator tubing. RESULTS: PIP, PEEP, and F-IO2 were reliably and incrementally titratable in the experimental lung, with some notable but manageable changes in pressure and F-IO2 documented in the control lung during these titrations. Similar results were measured in lungs with identical and different compliances. CONCLUSIONS: Pressures and F-IO2 can be reliably adjusted when utilizing a dual-patient, single-ventilator circuit with simple, low-cost modifications to the circuit. This innovation could potentially be lifesaving in a resource-limited or crisis setting. Understanding the interactions of these circuits is imperative for making their use safer.