"Split" ventilation in bench and porcine models of Acute Respiratory Distress Syndrome.

Abstract

Introduction: Split ventilation (using a single ventilator to ventilate multiple patients) is technically feasible. However, connecting two patients with acute respiratory distress syndrome (ARDS) and differing lung mechanics to a single ventilator is concerning. This study aimed to, 1) determine functionality of a split ventilation system in benchtop tests 2) determine whether split ventilation would allow lung protective ventilation similar to conventional ventilation in a porcine model of ARDS and 3) assess usability of a split ventilation system with minimal specific training. 

Methods: The functionality of a split ventilation system was assessed using test lungs. The usability of the system was assessed in simulated clinical scenarios. The feasibility of the system to provide modified lung protective ventilation was assessed in a porcine model of ARDS (n=30). 

Results: In bench testing a split ventilation system independently ventilated two test lungs under conditions of varying compliance and resistance. In usability tests, a high proportion of naïve operators could assemble and use the system. In the porcine model, modified lung protective ventilation was feasible with split ventilation and produced similar respiratory mechanics, gas exchange and biomarkers of lung injury when compared to conventional ventilation.

Conclusions: Split ventilation can provide lung protective ventilation and is feasible in bench testing and an in vivo model of ARDS.