Literature DB >> 33456461

A New Medical Device to Provide Independent Ventilation to Two Subjects Using a Single Ventilator: Evaluation in Lung-Healthy Pigs.

Ignacio Lugones1, Roberto Orofino Giambastiani1, Oscar Robledo2, Martín Marcos2, Javier Mouly2, Agustín Gallo1, Verónica Laulhé1, María Fernanda Biancolini1.   

Abstract

BACKGROUND: The global crisis situation caused by SARS-CoV-2 has created an explosive demand for ventilators, which cannot be met even in developed countries. Designing a simple and inexpensive device with the ability to increase the number of patients that can be connected to existing ventilators would have a major impact on the number of lives that could be saved. We conducted a study to determine whether two pigs with significant differences in size and weight could be ventilated simultaneously using a single ventilator connected to a new medical device called DuplicARⓇ.
METHODS: Six pigs (median weight 12 kg, range 9-25 kg) were connected in pairs to a single ventilator using the new device for 6 hours. Both the ventilator and the device were manipulated throughout the experiment according to the needs of each animal. Tidal volume and positive end-expiratory pressure were individually controlled with the device. Primary and secondary outcome variables were defined to assess ventilation and hemodynamics in all animals throughout the experiment.
RESULTS: Median difference in weight between the animals of each pair was 67% (range: 11-108). All animals could be successfully oxygenated and ventilated for 6 hours through manipulation of the ventilator and the DuplicARⓇ device, despite significant discrepancies in body size and weight. Mean PaCO2 in arterial blood was 42.1 ± 4.4 mmHg, mean PaO2 was 162.8 ± 46.8 mmHg, and mean oxygen saturation was 98 ± 1.3%. End-tidal CO2 values showed no statistically significant difference among subjects of each pair. Mean difference in arterial PaCO2 measured at the same time in both animals of each pair was 4.8 ± 3 mmHg, reflecting the ability of the device to ventilate each animal according to its particular requirements. Independent management of PEEP was achieved by manipulation of the device controllers.
CONCLUSION: It is possible to ventilate two lung-healthy animals with a single ventilator according to each one's needs through manipulation of both the ventilator and the DuplicARⓇ device. This gives this device the potential to expand local ventilators surge capacity during disasters or pandemics until emergency supplies can be delivered from central stockpiles.
Copyright © 2020 Ignacio Lugones et al.

Entities:  

Year:  2020        PMID: 33456461      PMCID: PMC7774300          DOI: 10.1155/2020/8866806

Source DB:  PubMed          Journal:  Anesthesiol Res Pract        ISSN: 1687-6962


  15 in total

1.  Simultaneous ventilation of two healthy subjects with a single ventilator.

Authors:  R Smith; J M Brown
Journal:  Resuscitation       Date:  2009-07-02       Impact factor: 5.262

2.  Critical Supply Shortages - The Need for Ventilators and Personal Protective Equipment during the Covid-19 Pandemic.

Authors:  Megan L Ranney; Valerie Griffeth; Ashish K Jha
Journal:  N Engl J Med       Date:  2020-03-25       Impact factor: 91.245

3.  Potential Legal Liability for Withdrawing or Withholding Ventilators During COVID-19: Assessing the Risks and Identifying Needed Reforms.

Authors:  I Glenn Cohen; Andrew M Crespo; Douglas B White
Journal:  JAMA       Date:  2020-05-19       Impact factor: 56.272

4.  Fair Allocation of Scarce Medical Resources in the Time of Covid-19.

Authors:  Ezekiel J Emanuel; Govind Persad; Ross Upshur; Beatriz Thome; Michael Parker; Aaron Glickman; Cathy Zhang; Connor Boyle; Maxwell Smith; James P Phillips
Journal:  N Engl J Med       Date:  2020-03-23       Impact factor: 91.245

5.  Increasing ventilator surge capacity in disasters: ventilation of four adult-human-sized sheep on a single ventilator with a modified circuit.

Authors:  Lorenzo Paladino; Mark Silverberg; Jean G Charchaflieh; Julie K Eason; Brian J Wright; Nicholas Palamidessi; Bonnie Arquilla; Richard Sinert; Seth Manoach
Journal:  Resuscitation       Date:  2007-12-31       Impact factor: 5.262

6.  Shared Ventilation in the Era of COVID-19: A Theoretical Consideration of the Dangers and Potential Solutions.

Authors:  Jacob Herrmann; Andrea Fonseca da Cruz; Monica L Hawley; Richard D Branson; David W Kaczka
Journal:  Respir Care       Date:  2020-05-06       Impact factor: 2.258

7.  A single ventilator for multiple simulated patients to meet disaster surge.

Authors:  Greg Neyman; Charlene Babcock Irvin
Journal:  Acad Emerg Med       Date:  2006-08-02       Impact factor: 3.451

Review 8.  Introduction and executive summary: care of the critically ill and injured during pandemics and disasters: CHEST consensus statement.

Authors:  Michael D Christian; Asha V Devereaux; Jeffrey R Dichter; Lewis Rubinson; Niranjan Kissoon
Journal:  Chest       Date:  2014-10       Impact factor: 9.410

9.  Ventilator Sharing during an Acute Shortage Caused by the COVID-19 Pandemic.

Authors:  Jeremy R Beitler; Aaron M Mittel; Richard Kallet; Robert Kacmarek; Dean Hess; Richard Branson; Murray Olson; Ivan Garcia; Barbara Powell; David S Wang; Jonathan Hastie; Oliver Panzer; Daniel Brodie; Laureen L Hill; B Taylor Thompson
Journal:  Am J Respir Crit Care Med       Date:  2020-08-15       Impact factor: 21.405

Review 10.  Triage of Scarce Critical Care Resources in COVID-19 An Implementation Guide for Regional Allocation: An Expert Panel Report of the Task Force for Mass Critical Care and the American College of Chest Physicians.

Authors:  Ryan C Maves; James Downar; Jeffrey R Dichter; John L Hick; Asha Devereaux; James A Geiling; Niranjan Kissoon; Nathaniel Hupert; Alexander S Niven; Mary A King; Lewis L Rubinson; Dan Hanfling; James G Hodge; Mary Faith Marshall; Katherine Fischkoff; Laura E Evans; Mark R Tonelli; Randy S Wax; Gilbert Seda; John S Parrish; Robert D Truog; Charles L Sprung; Michael D Christian
Journal:  Chest       Date:  2020-04-11       Impact factor: 9.410

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  1 in total

1.  Combined Ventilation of Two Subjects with a Single Mechanical Ventilator Using a New Medical Device: An In Vitro Study.

Authors:  Ignacio Lugones; Matías Ramos; María Fernanda Biancolini; Roberto Orofino Giambastiani
Journal:  Anesthesiol Res Pract       Date:  2021-02-18
  1 in total

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