Table_1_Development and evaluation of a mechanical ventilator-sharing system.xlsx

BackgroundDuring the COVID-19 pandemic surge in the hospitalization of critically ill patients and the global demand for mechanical ventilators, alternative strategies for device sharing were explored. We developed and assessed the performance of a system for shared ventilation that uses clinically available components to individualize tidal volumes under a variety of clinically relevant conditions. The feasibility of remote monitoring of ventilators was also assessed.
MethodsBy using existing resources and off-the-shelf components, a ventilator-sharing system (VSS) that ventilates 2 patients simultaneously with a single device, and a ventilator monitoring system (VMS) that remotely monitors pulmonary mechanics were developed. The feasibility and effectiveness of VSS and VMS were evaluated in benchtop testing using 2 test lungs on a single ventilator, and then performance was assessed in translational swine models of normal and impaired lung function.
ResultsIn benchtop testing, VSS and VMS delivered the set individualized parameters with minimal % errors in test lungs under pressure- and volume-regulated ventilation modes, suggesting the highest precision and accuracy. In animal studies, the VSS and VMS successfully delivered the individualized mechanical ventilation parameters within clinically acceptable limits. Further, we found no statistically significant difference between the target and measured values.
ConclusionThe VSS adequately ventilated 2 test lungs or animals with variable lung conditions. The VMS accurately displayed mechanical ventilation settings, parameters, and alarms. Both of these systems could be rapidly assembled for scaling up to ventilate several critically ill patients in a pandemic or mass casualty disaster situations by leveraging off-the-shelf and custom 3D printed components.

【背景】在新型冠状病毒肺炎（COVID-19）大流行期间，重症患者住院人数大幅攀升，全球对机械呼吸机的需求暴涨，研究人员探索了设备共享的替代救治策略。本研究开发并评估了一套共享通气系统的性能：该系统采用临床可用组件，可在多种临床相关工况下实现潮气量的个体化调节；同时还对呼吸机远程监测的可行性进行了评估。
【方法】本研究依托现有资源与市售现成组件（off-the-shelf components），开发了两套系统：一是单台设备可同时为2名患者实施通气的呼吸机共享系统（ventilator-sharing system, VSS），二是可远程监测肺力学参数的呼吸机监测系统（ventilator monitoring system, VMS）。研究首先采用单台呼吸机搭配2台测试肺，通过台架实验评估VSS与VMS的可行性与有效性；随后在正常肺功能与肺功能受损的转译猪模型中，对两套系统的性能进行了测评。
【结果】台架实验结果显示，在压力调控与容量调控通气模式下，VSS与VMS可向测试肺输送预设的个体化通气参数，百分比误差极低，表明系统具备极高的精准度与准确性。动物实验中，VSS与VMS可将个体化机械通气参数控制在临床可接受的范围内并成功输送；进一步分析显示，目标参数与实测参数之间无统计学显著性差异。
【结论】VSS可对2台测试肺或不同肺功能状态的实验动物实施充分通气。VMS可精准显示机械通气的设置参数、实时监测指标与报警信息。借助市售现成组件与定制3D打印部件，这两套系统均可快速组装，从而在大流行或大规模伤亡灾害场景下，快速扩容以满足多名重症患者的通气需求。