The Multisplit Ventilator System: Performance Testing of Respiratory Support Shared by Multiple Patients

Ventilator sharing has been proposed as a method of increasing ventilator capacity during instances of critical shortage. We sought to assess the ability of a regulated, shared ventilator system, the multisplit ventilator system, to individualize support to multiple simulated patients using one ventilator. We employed simulated patients of varying size, compliance, minute ventilation requirement, and positive end-expiratory pressure (PEEP) requirement. Performance tests were performed to assess the ability of the system, versus control, to achieve individualized respiratory goals to clinically disparate patients sharing a single ventilator following ARDSNet guidelines (Acute Respiratory Distress Syndrome). Resilience tests measured the effects of simulated adverse events occurring to one patient on another patient sharing a single ventilator. The multisplit ventilator system met individual oxygenation and ventilation requirements for multiple simulated patients with a tolerance similar to that of a single ventilator. Abrupt endotracheal tube occlusion or extubation occurring to one patient resulted in modest, clinically tolerable changes in ventilation parameters for the remaining patients. The proof-of-concept ventilator system presented in this paper is a regulated, shared ventilator system capable of individualizing ventilatory support to clinically dissimilar simulated patients. It is resilient to common adverse events and represents a feasible option to ventilate multiple patients during a severe ventilator shortage.