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Due to the recent coronavirus outbreak, many efforts and innovative solutionshave surfaced to deal with the possible shortage of ventilators uponcatastrophic surges of patients. One solution involves splitting one ventilatorto treat multiple patients and is in principle easy to implement, but there areobvious risks, and little is known on how the technique would work on patientswith ARDS from Covid-19. Previous studies have shown that multiple test lungsof equal characteristics can be successfully ventilated from one machine, butthat large variations in tidal volume delivery occurs when lungs with differentcompliance are connected. In contribution to the discussion of the feasibilityof the technique, a technical assessment was done including experimentsexpanding on the previous studies using two types of test lungs, differentventilator settings and test lung characteristics. Using two test lungsconnected to a ventilator, the tidal volumes and pressures into both lungs weremeasured for different combinations of lung compliance, airway resistances,modes of ventilation, inspiratory and end-expiratory pressure levels. We founddiscrepancies in delivered tidal volumes for paired test lungs proportionalwith compliance differences, little influence from differences in airwayresistances, and that changes in compliance of only one test lung would alsochange the tidal volume delivered to the other test lung when in volumecontrolled mode. For one of the test lung types, we also found that higher PEEPsettings could strongly influence the tidal volume balance between the testlungs. From this study and from a technical point of view, we were not able toidentify reliable settings, adjustments or any simple measures to overcome thehazards of this simple technique, and a more advanced solution is indicated formitigating risks.

Splitting one ventilator for multiple patients -- a technical assessment