Pressure-Regulated Ventilator Splitting (PReVentS): A COVID-19 Response Paradigm from Yale University

Micha Sam Brickman Raredon; Clark Fisher; Paul Heerdt; Ranjit Deshpande; Steven Nivison; Elaine Fajardo; Shamsuddin Akhtar; Thomas Raredon; Laura E. Niklason

Conversely, the pressure-gated valve on the expiratory limb of each patient's circuit provides a step-up in Positive End-Expiratory Pressure. So, the effective Positive End-Expiratory Pressure for a patient is equal to sum of the PEEP setting on the ventilator, and the setting on the pressure-gated valve in the expiratory limb of that patient's circuit. As an example of how the PReVentS ventilator splitting circuit might function for two patients, specific pressures are provided in Figure 9 . In this example, Patient #1 has very poor lung compliance and a high PEEP requirement: to maintain adequate minute ventilation and alveolar recruitment, this patient requires a PIP of 35 cmH2O and a PEEP of 20 cmH2O. In contrast, Patient #2 has less-severe lung disease, requiring less ventilatory support overall, and needs a PIP of only 25 cm H2O and a PEEP of 5 cm H2O (Figure 9 ). . CC-BY-NC-ND 4.0 International license It is made available under a author/funder, who has granted medRxiv a license to display the preprint in perpetuity.