Simultaneous ventilation in the Covid-19 pandemic. A bench study

Guérin, Claude; Cour, Martin; Stevic, Neven; Degivry, Florian; L’Her, Erwan; Louis, Bruno; Argaud, Laurent

doi:10.1371/journal.pone.0245578

Cited by 5 publications

(1 citation statement)

References 31 publications

(52 reference statements)

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“…The huge flow rate of patients with a severe acute respiratory failure admitted to ICUs worldwide during the first wave of the COVID-19 pandemic created a risk of ventilators shortage and urged the healthcare system to quickly implement different strategies to match the demand [ 1 , 10 ]. Strategies of note included splitting ventilators between two patients [ 11 , 12 ], developing easy-to-build, open-source, cheap ventilators [ 13 , 14 ] and using an intermediate ventilator dedicated to emergency rooms and patient transport with an enhanced production at a large scale with the help of non-medical industry. Using the same ventilator for two patients is still an experimental and non-recommended strategy [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

The eSpiro Ventilator: An Open-Source Response to a Worldwide Pandemic

Terzi

Rastello

Déhan

et al. 2021

JCM

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Objective: To address the issue of ventilator shortages, our group (eSpiro Network) developed a freely replicable, open-source hardware ventilator. Design: We performed a bench study. Setting: Dedicated research room as part of an ICU affiliated to a university hospital. Subjects: We set the lung model with three conditions of resistance and linear compliance for mimicking different respiratory mechanics of representative intensive care unit (ICU) patients. Interventions: The performance of the device was tested using the ASL5000 lung model. Measurements and Main Results: Twenty-seven conditions were tested. All the measurements fell within the ±10% limits for the tidal volume (VT). The volume error was influenced by the mechanical condition (p = 5.9 × 10−15) and the PEEP level (P = 1.1 × 10−12) but the clinical significance of this finding is likely meaningless (maximum −34 mL in the error). The PEEP error was not influenced by the mechanical condition (p = 0.25). Our experimental results demonstrate that the eSpiro ventilator is reliable to deliver VT and PEEP accurately in various respiratory mechanics conditions. Conclusions: We report a low-cost, easy-to-build ventilator, which is reliable to deliver VT and PEEP in passive invasive mechanical ventilation.

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Section: Discussionmentioning

confidence: 99%

The eSpiro Ventilator: An Open-Source Response to a Worldwide Pandemic

Terzi

Rastello

Déhan

et al. 2021

JCM

Self Cite

View full text Add to dashboard Cite

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The Transport of Respiratory Distress Syndrome Twin Newborns: The 27-Year-Long Experience of Gaslini Neonatal Emergency Transport Service Using Both Single and Double Ventilators

Bellini

Battaglini

Pianta

et al. 2023

Air Medical Journal

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A time-multiplexing approach to shared ventilation

Yarinsky,

Blocker,

Alves Pinto

et al. 2024

Preprint

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Ventilator shortages during the COVID-19 pandemic forced some hospitals to practice and many to consider shared ventilation, where a single ventilator is used to ventilate multiple patients simultaneously. However, the high risk of harm to co-ventilated patients secondary to the inability to treat anatomically different patients or safely adapt to dynamic ventilation requirements has prevented full adoption of multi-patient coventilation. Here, a time-multiplexing approach to shared ventilation is introduced to overcome these safety concerns. A proof-of-concept device consisting of electromechanically coupled ball valves to induce customized resistances and facilitate the delivery of alternating breaths from the ventilator to each patient is presented. The approach successfully ventilated two test lungs, and individualized tidal volume combinations of various magnitudes were produced. Over five hours of co-ventilation, consistency in tidal volume delivery was comparable to independent ventilation. Time-multiplexing was able to facilitate delivery of statistically unique tidal volumes to two test lungs and maintain the consistency of tidal volumes within each test lung while independently ventilated with identical parameters. The ability to adjust each test lung’s inspiratory pressures dynamically and independently was also demonstrated. The time-multiplexing approach has the potential to increase the viability of co-ventilation for ongoing and future ventilator shortages.

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Simultaneous ventilation in the Covid-19 pandemic. A bench study

Cited by 5 publications

References 31 publications

The eSpiro Ventilator: An Open-Source Response to a Worldwide Pandemic

The eSpiro Ventilator: An Open-Source Response to a Worldwide Pandemic

The Transport of Respiratory Distress Syndrome Twin Newborns: The 27-Year-Long Experience of Gaslini Neonatal Emergency Transport Service Using Both Single and Double Ventilators

A time-multiplexing approach to shared ventilation

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