PulmCrit – Splitting 1 ventilator to provide support to 4 patients
“COVID-19 might out-strip the number of mechanical ventilators available to us. This has led to interest in using a single ventilator to support multiple patients. This post will review the theory and evidence regarding this (Download). “
Bedrock principle: Patient-Ventilator Independence.Normally, we adjust the ventilator so that the ventilator is adapted well to suit an individual patient’s needs. The adage is “fit the ventilator to the patient, don’t fit the patient to the ventilator” – in other words, adjust the ventilator to keep the patient comfortable, rather than over-sedating the patient to tolerate an uncomfortable ventilator mode.
We cannot do this when splitting the ventilator. In fact, any interaction where the patient drives the ventilator is problematic (because this allows one patient to affect another patient’s ventilation). For example, we wouldn’t want one patient’s tachypnea to cause other patients attached to the same ventilator to be hyperventilated.
Thus, a bedrock principle of multiple-patient ventilation is that each patient should have no effect on the ventilation of other patients attached to the ventilator. This is achievable, as described in this EMCrit post (Link).
Courtesy: EMCrit Site: EMCrit is devoted to Maximally Aggressive Care: Maximally Aggressive Curative Care and Maximally Aggressive Palliative Care
Use of a Single Ventilator to Support 4 Patients: Laboratory Evaluation of a Limited Concept