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 patients with similar lung compliance, but different tidal volume requirements, it can still be necessary to achieve different tidal volumes. To show how this can be achieved when two patients are supported by one ventilator using our proposed modified splitter (Figure 2) we simulated two moderately severe ARDS patients (Lung Model C). We then adjusted the inhalation pathway resistors for each patient and the PIP to achieve i.) equivalent tidal volume between Patient 1 and Patient 2 (C-C); ii.) a 30% decreased tidal volume in patient 2 (C-C(-)); or iii.) a 30% increase in tidal volume in patient 2 (C-C(+)). We show that, by elevating the resistance in the inhalation pathway in Patient 2, we can reduce tidal volume for Patient 2, whilst maintaining tidal volume for Patient 1. Similarly, we show that, by increasing the resistance for Patient 1 and elevating PIP, we can maintain the tidal volume for patient 1 and increase the tidal volume for Patient 2 (Figure 6 and Table 5 ). This shows that it is possible to independently adjust the tidal volume in Patient 2 from the tidal volume in Patient 1.