A Simulated Single Ventilator / Dual Patient Ventilation Strategy for Acute Respiratory Distress Syndrome During the COVID-19 Pandemic

Jose A. Solis-Lemus; Edward Costar; Denis Doorly; Eric C. Kerrigan; Caroline H. Kennedy; Frances Tait; Steven A Niederer; Peter E. Vincent; Steven E. Williams

In this simulation study we therefore develop, validate and make freely available a model of a mechanical ventilator supporting two patients using a simple T-junction splitter to supply air to both patients, based on the design proposed by Neyman et al. 7 We use the model to simulate ventilating two patients with different degrees of lung disease from a single ventilator and estimate the delivered volumes and pressures in each patient. This provides a quantitative estimate of the potential risks involved in this strategy. We then propose the addition of variable resistances and one-way valves to the ventilator tubing system and show that in our model these can be used to regulate tidal volumes in each patient independently in the presence of mismatched respiratory physiology.