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

The PReVentS protocol is designed for the care of such patients, as a last resort when suitable numbers of contemporary ICU ventilators are not available to ventilate each patient individually. The system described herein is novel in its level of individualized control of both Peak Inspiratory Pressure (PIP) and Positive End-Expiratory Pressure (PEEP), allowing for adaptation to differences in lung compliance and body habitus. Importantly, the system allows for adjustment of PIP and PEEP as support requirements change over time, although respiratory rates will remain the same for each patient. For this setup, is it assumed that patients are sedated and paralyzed to a degree such that they do not trigger breaths delivered from the ventilator. Ventilation triggers can also be set sufficiently high to prevent inadvertent triggering of breaths.