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A rapidly deployable individualized system for augmenting ventilator capacity.
Science Translational Medicine ( IF 15.8 ) Pub Date : 2020-06-24 , DOI: 10.1126/scitranslmed.abb9401
Shriya S Srinivasan 1, 2, 3 , Khalil B Ramadi 1, 2, 3 , Francesco Vicario 4 , Declan Gwynne 1, 2, 3 , Alison Hayward 2, 3, 5 , David Lagier 6 , Robert Langer 1, 3, 7, 8 , Joseph J Frassica 4, 8 , Rebecca M Baron 9 , Giovanni Traverso 1, 2, 3
Affiliation  

Strategies to split ventilators to support multiple patients requiring ventilatory support have been proposed and used in emergency cases in which shortages of ventilators cannot otherwise be remedied by production or procurement strategies. However, the current approaches to ventilator sharing lack the ability to individualize ventilation to each patient, measure pulmonary mechanics, and accommodate rebalancing of the airflow when one patient improves or deteriorates, posing safety concerns to patients. Potential cross-contamination, lack of alarms, insufficient monitoring, and inability to adapt to sudden changes in patient status have prevented widespread acceptance of ventilator sharing. We have developed an individualized system for augmenting ventilator efficacy (iSAVE) as a rapidly deployable platform that uses a single ventilator to simultaneously and more safely support two individuals. The iSAVE enables individual-specific volume and pressure control and the rebalancing of ventilation in response to improvement or deterioration in an individual’s respiratory status. The iSAVE incorporates mechanisms to measure pulmonary mechanics, mitigate cross-contamination and backflow, and accommodate sudden flow changes due to individual interdependencies within the respiratory circuit. We demonstrate these capacities through validation using closed- and open-circuit ventilators on linear test lungs. We show that the iSAVE can temporarily ventilate two pigs on one ventilator as efficaciously as each pig on its own ventilator. By leveraging off-the-shelf medical components, the iSAVE could rapidly expand the ventilation capacity of health care facilities during emergency situations such as pandemics.



中文翻译:

可快速部署的个性化系统,用于增强呼吸机容量。

已经提出了将呼吸机分割以支持多名需要呼吸机支持的患者的策略,并在紧急情况下使用了这些策略,在紧急情况下,生产或采购策略无法弥补呼吸机的短缺。然而,当前共享呼吸机的方法缺乏使每个患者个体通气,测量肺力学以及在一名患者好转或恶化时适应气流再平衡的能力,这给患者带来了安全隐患。潜在的交叉污染,缺乏警报,监测不足以及无法适应患者状况的突然变化,已导致呼吸机共享被广泛接受。我们已经开发了一个个性化的系统来增强呼吸机功效(iSAVE),这是一个可快速部署的平台,该平台使用单个呼吸机同时并更安全地支持两个人。iSAVE可以根据个人呼吸状况的改善或恶化,进行个人特定的音量和压力控制以及通气的重新平衡。iSAVE结合了多种机制,可测量肺部力学,减轻交叉污染和回流,并适应由于呼吸回路内各个相互依存关系而引起的流量突然变化。我们通过在线性测试肺上使用闭式和开式呼吸机进行验证来证明这些能力。我们显示,iSAVE可以像使用每只猪在自己的呼吸机上一样有效地使一台呼吸机上的两只猪暂时通风。

更新日期:2020-06-25
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