The US Strategic National Stockpile (SNS) Ventilators in COVID-19: A Comparison of Functionality and Analysis regarding the Emergency Purchase of 200,000 devices.

Branson, Rich; Dichter, Jeffrey R.; Feldman, Henry; Devereaux, Asha; Dries, David; Perry, John F.; Benditt, Joshua; Hossain, Tanzib; Ghazipura, Marya; King, Mary; Baldisseri, Marie; Christian, Michael D.; Domingiuez-Cherit, Guillermo; Henry, Kiersten; Martland, Anne Marie O.; Huffines, Meredith; Ornoff, Doug; Persoff, Jason; Rodriquez, Dario; Maves, Ryan C.; Kissoon, Niranjan Tex; Rubinson, Lewis

Background Early in the COVID-19 pandemic, there was serious concern that the United States (US) would encounter a short fall of mechanical ventilators. In response, the US government, utilizing the Defense Production Act ordered the development of 200,000 ventilators from 11 different manufacturers. These ventilators have different capabilities and it is not evident whether all are able to support COVID-19 patients. Research Question Evaluate ventilator requirements for affected COVID-19 patients, assess the clinical performance of current SNS ventilators employed during the pandemic, and finally compare ordered ventilators functionality based on COVID-19 patient needs. Study Design and Methods Current published literature, publicly available documents, and lay press articles were reviewed by a diverse team of disaster experts. Data was assembled into tabular format which formed the basis for analysis and future recommendations. Results COVID-19 patients often develop severe hypoxemic acute respiratory failure and ARDS requiring high levels of ventilator support. Current SNS ventilators were unable to fully support all COVID-19 patients, and only about half of newly ordered ventilators have the capacity to support the most severely affected patients; ventilators with less capacity for providing high level support are still of significant value in caring for many patients. Interpretation Current SNS ventilators and those on order are capable of supporting most but not all COVID-19 patients. Technologic, logistic, and educational challenges encountered from current SNS ventilators are summarized, with potential next generation SNS ventilator updates offered. Clinical Trial Registration N/A