Skip to main content
 

Main menu

  • Home
  • Content
    • Current Issue
    • Editor's Commentary
    • Archives
    • Most-Read Papers of 2022
  • Authors
    • Author Guidelines
    • Submit a Manuscript
  • Reviewers
    • Reviewer Information
    • Create Reviewer Account
    • Reviewer Guidelines: Original Research
    • Reviewer Guidelines: Reviews
    • Appreciation of Reviewers
  • CRCE
    • Through the Journal
    • JournalCasts
    • AARC University
    • PowerPoint Template
  • Open Forum
    • 2023 Call for Abstracts
    • 2022 Abstracts
    • Previous Open Forums
  • Podcast
    • English
    • Español
    • Portugûes
    • 国语
  • Videos
    • Video Abstracts
    • Author Interviews
    • Highlighted Articles
    • The Journal

User menu

  • Subscribe
  • My alerts
  • Log in

Search

  • Advanced search
American Association for Respiratory Care
  • Subscribe
  • My alerts
  • Log in
American Association for Respiratory Care

Advanced Search

  • Home
  • Content
    • Current Issue
    • Editor's Commentary
    • Archives
    • Most-Read Papers of 2022
  • Authors
    • Author Guidelines
    • Submit a Manuscript
  • Reviewers
    • Reviewer Information
    • Create Reviewer Account
    • Reviewer Guidelines: Original Research
    • Reviewer Guidelines: Reviews
    • Appreciation of Reviewers
  • CRCE
    • Through the Journal
    • JournalCasts
    • AARC University
    • PowerPoint Template
  • Open Forum
    • 2023 Call for Abstracts
    • 2022 Abstracts
    • Previous Open Forums
  • Podcast
    • English
    • Español
    • Portugûes
    • 国语
  • Videos
    • Video Abstracts
    • Author Interviews
    • Highlighted Articles
    • The Journal
  • Twitter
  • Facebook
  • YouTube
Research ArticleOriginal Research

Multiplex Ventilation: Solutions for Four Main Safety Problems

Morgan E Sorg, Richard D Branson, Umur Hatipoğlu and Robert L Chatburn
Respiratory Care July 2021, 66 (7) 1074-1086; DOI: https://doi.org/10.4187/respcare.08749
Morgan E Sorg
Cleveland Clinic, Cleveland, Ohio. Mr Branson is affiliated with the University of Cincinnati, Cincinnati, Ohio and is Editor-in-Chief of R C.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • For correspondence: [email protected]
Richard D Branson
Cleveland Clinic, Cleveland, Ohio. Mr Branson is affiliated with the University of Cincinnati, Cincinnati, Ohio and is Editor-in-Chief of R C.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Umur Hatipoğlu
Cleveland Clinic, Cleveland, Ohio. Mr Branson is affiliated with the University of Cincinnati, Cincinnati, Ohio and is Editor-in-Chief of R C.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Robert L Chatburn
Cleveland Clinic, Cleveland, Ohio. Mr Branson is affiliated with the University of Cincinnati, Cincinnati, Ohio and is Editor-in-Chief of R C.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Data
  • Supplemental
  • References
  • Info & Metrics
  • PDF
Loading

This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.

Abstract

BACKGROUND: The COVID-19 pandemic has led to an increased demand for mechanical ventilators and concerns of a ventilator shortage. Several groups have advocated for 1 ventilator to ventilate 2 or more patients in the event of such a shortage. However, differences in patient lung mechanics could make sharing a ventilator detrimental to both patients. Our previous study indicated failure to ventilate in 67% of simulations. The safety problems that must be solved include individual control of tidal volume (VT), individual measurement of VT, individualization of PEEP settings, and individual PEEP measurement. The purpose of this study was to evaluate potential solutions developed at our institution.

METHODS: Two separate lung simulators were ventilated with a modified multiplex circuit using pressure control ventilation. Parameters of the lung models used for simulations (resistance and compliance) were evidence-based from published studies. Individual circuit-modification devices were first evaluated for accuracy. Devices were an adjustable flow diverter valve, a prototype dual volume display, a PEEP valve, and a disposable PEEP display. Then the full modified multiplex circuit was assessed by ventilating 6 pairs of simulated patients with different lung models and attempting to equalize ventilation. Ventilation was considered equalized when VT and end-expiratory lung volume were within 10% for each simulation.

RESULTS: The adjustable flow diverter valve allowed volume adjustment to 1 patient without affecting the other. The average error of the dual volume display was –17%. The PEEP valves individualized PEEP, but the PEEP gauge error ranged from 17% to 41%. Using the multiplex circuit, ventilation was equalized regardless of differences in resistance or compliance, reversing the “failure modes” of our previous study.

CONCLUSIONS: The results of this simulation-based study indicate that devices for individual control and display of VT and PEEP are effective in extending the usability and potential patient safety of multiplex ventilation.

  • mechanical ventilation
  • emergency ventilation
  • COVID-19
  • lung simulator
  • split ventilation
  • surge ventilation
  • national stockpile
  • differential ventilation
  • ventilator sharing
  • ventilator shortage
  • simultaneous ventilation
  • dual ventilation

Footnotes

  • Correspondence: Morgan E Sorg RRT, Cleveland Clinic, 9500 Euclid Ave, Cleveland, Ohio 44195–5243. E-mail: morgan.sorg15{at}gmail.com
  • Supplementary material related to this paper is available at http://www.rcjournal.com.

  • Mr Branson has disclosed relationships with Mallinckrodt, Pfizer, Vyaire, Ventec Life Systems, and Zoll Medical. Mr Chatburn has disclosed relationships with IngMar Medical, Vyaire, and Promedic Consulting. The other authors have disclosed no conflicts of interest.

  • Copyright © 2021 by Daedalus Enterprises
View Full Text

Pay Per Article - You may access this article (from the computer you are currently using) for 1 day for US$30.00

Regain Access - You can regain access to a recent Pay per Article purchase if your access period has not yet expired.

Log in using your username and password

Forgot your user name or password?
PreviousNext
Back to top

In this issue

Respiratory Care: 66 (7)
Respiratory Care
Vol. 66, Issue 7
1 Jul 2021
  • Table of Contents
  • Table of Contents (PDF)
  • Cover (PDF)
  • Index by author

 

Print
Download PDF
Article Alerts
Sign In to Email Alerts with your Email Address
Email Article

Thank you for your interest in spreading the word on American Association for Respiratory Care.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Multiplex Ventilation: Solutions for Four Main Safety Problems
(Your Name) has sent you a message from American Association for Respiratory Care
(Your Name) thought you would like to see the American Association for Respiratory Care web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Citation Tools
Multiplex Ventilation: Solutions for Four Main Safety Problems
Morgan E Sorg, Richard D Branson, Umur Hatipoğlu, Robert L Chatburn
Respiratory Care Jul 2021, 66 (7) 1074-1086; DOI: 10.4187/respcare.08749

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero

Share
Multiplex Ventilation: Solutions for Four Main Safety Problems
Morgan E Sorg, Richard D Branson, Umur Hatipoğlu, Robert L Chatburn
Respiratory Care Jul 2021, 66 (7) 1074-1086; DOI: 10.4187/respcare.08749
del.icio.us logo Digg logo Reddit logo Twitter logo CiteULike logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Jump to section

  • Article
    • Abstract
    • Introduction
    • Methods
    • Results
    • Discussion
    • Limitations
    • Conclusions
    • Footnotes
    • References
  • Figures & Data
  • Supplemental
  • Info & Metrics
  • References
  • PDF

Related Articles

Cited By...

Keywords

  • mechanical ventilation
  • emergency ventilation
  • COVID-19
  • lung simulator
  • split ventilation
  • surge ventilation
  • national stockpile
  • differential ventilation
  • ventilator sharing
  • ventilator shortage
  • simultaneous ventilation
  • dual ventilation

Info For

  • Subscribers
  • Institutions
  • Advertisers

About Us

  • About the Journal
  • Editorial Board

AARC

  • Membership
  • Meetings
  • Clinical Practice Guidelines

More

  • Contact Us
  • RSS
American Association for Respiratory Care

Print ISSN: 0020-1324        Online ISSN: 1943-3654

© Daedalus Enterprises, Inc.

Powered by HighWire