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

Adjusting PEEP: Assuming the ventilator PEEP is set at 0 cmH2O, each patient's PEEP is set independently by the expiratory limb pressure gated valve. To adjust this PEEP, make the desired adjustment on the expiratory limb pressure gated valve (decrease valve setting to decrease PEEP, increase valve setting to increase PEEP). After this change, consider if you need to adjust the same patient's PIP to maintain a constant driving pressure or tidal volume. Measure this patient's airway pressures to make sure they reflect the desired change. Measure this patient's VTe to make sure it is appropriate. View flow tracings on the ventilator or pressure tracings on the patient monitor to alert you to breath stacking. Adjust alarms to reflect the new settings.