A Novel Multi-ventilation Technique to Split Ventilators
This article has been Reviewed by the following groups
Listed in
- Evaluated articles (ScreenIT)
Abstract
Background
Despite efforts to initially contain Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV-2), it has spread worldwide and has strained international healthcare systems to the point where advanced respiratory resources and ventilators are depleted. This study aims to explore splitting ventilators, or “multi-ventilation,” as a viable alternative in these demanding times. We investigated whether individualized tidal volume and positive end expiratory pressure (PEEP) delivery is possible to lungs of different compliances that are being simultaneously ventilated from one anesthesia ventilator.
Methods
We performed a controlled experiment in an operating room environment without animal or human participants. Two “test lungs” were connected to distinct modified Y-pieces that were ventilated in parallel from a single anesthesia ventilator.
Results
Ventilation can be manipulated to qualitatively deliver individually tailored tidal volumes in the setting of varying PEEP and compliance requirements in pressure control mode.
Conclusions
Splitting ventilators, or “multi-ventilation,” is a viable alternative to acute ventilator shortage during a pandemic. Ventilators can be split for individualized tidal volume and positive end-expiratory pressure delivery in multiple subjects of differing compliances and demographics.
Article activity feed
-
SciScore for 10.1101/2020.04.28.20083741: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement not detected. Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable not detected. Table 2: Resources
No key resources detected.
Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:Our study is subject to several limitations. First, we performed the experiment using a modern anesthesia machine ventilator rather than an intensive care unit (ICU) ventilator. However, many such machines stand idle or are …
SciScore for 10.1101/2020.04.28.20083741: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement not detected. Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable not detected. Table 2: Resources
No key resources detected.
Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:Our study is subject to several limitations. First, we performed the experiment using a modern anesthesia machine ventilator rather than an intensive care unit (ICU) ventilator. However, many such machines stand idle or are underutilized, allowing our intervention to be a major force multiplier. Second, lacking a flowmeter (given supply shortfalls), our design set-up could not accurately report split tidal volumes in real time. However, such flowmeters are generally accessible and will likely be available again soon for clinical use. Third, certain ventilation parameters could not be split, namely, Fraction of inspired oxygen (FiO2), respiratory rate, and inspiratory time. Future improvements of our proposed design will likely overcome some of these shortfalls. Lastly, some equipment (e.g. ball-valve) was utilized in a manner for which they were not originally designed. However, such parts are commonly used in other industries (e.g. plumbing) and are engineered to withstand fluid pressures far greater than those encountered in human ventilation. In all, these results support the careful administration of multi-ventilation as a viable last-resort alternative in a controlled and supervised environment.
Results from TrialIdentifier: No clinical trial numbers were referenced.
Results from Barzooka: We did not find any issues relating to the usage of bar graphs.
Results from JetFighter: We did not find any issues relating to colormaps.
Results from rtransparent:- Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
- Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
- No protocol registration statement was detected.
-
-