Table_2_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COVID-19疫情爆发期间，重症患者住院人数激增，全球对呼吸机的需求量剧增，因此探索了设备共享的替代策略。本研究开发并评估了一种利用临床可用组件，在多种临床相关条件下实现潮气量个体化的共享通气系统。同时，对呼吸机的远程监控可行性也进行了评估。方法：通过利用现有资源和现成组件，开发了一种可同时为两名患者提供通气的呼吸机共享系统（VSS）以及一种远程监控肺机械学的呼吸机监控系统（VMS）。VSS和VMS的可行性和有效性通过在单一呼吸机上使用两只测试肺的台式测试进行了评估，随后在正常和受损肺功能的大鼠模型中对其性能进行了评估。结果：在台式测试中，VSS和VMS在压力和容量调节的通气模式下，在测试肺中实现了设定的个体化参数，误差百分比最小，表明了最高的精确度和准确性。在动物研究中，VSS和VMS成功地在临床可接受的范围内提供了个体化的机械通气参数。此外，我们发现在目标值和测量值之间没有统计学上的显著差异。结论：VSS能够为具有不同肺条件的两只测试肺或动物提供充分的通气。VMS能够准确显示机械通气设置、参数和警报。通过利用现成和定制3D打印组件，这两个系统均可迅速组装，以在疫情或大规模伤亡灾难情况下扩大通气，为多名重症患者提供救治。