Splitting ventilators to provide titrated support to a large group of COVID-19 patients

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Several institutions have developed protocols for using one ventilator for multiple patients (split ventilator protocols)

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some of those institutions are

  • university of Columbia University College of Physicians & Surgeons

  • Pulmonary and Critical Care Medicine at the University of Vermont (PulmCrit)

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The Company Vent Multiplexor lcc has developed a split-device which can be used to adjust the tidal volume for each patient

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More or less all institutions point out the need for monitoring of each patient, as this is critical to understand how well the ventilation efficacy for each patient is managed

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For this you can use BEACON to track ventilation efficacy for each patient:

  • Measure actual Vt delivered to patient

  • VO2/VCO2 measurement 

  • Gas exchange impairment (SHUNT, Low V/Q & High V/Q etc) in order to set optimal PEEP

  • Etc

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Waveform screen

Connect BEACON and monitor the waveforms of what is delivered to the patient. This will give you a "ventilator monitor" per patient

The waveform screen shows the following information

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  • Ppeak, Pplat, VO2 and VCO2 as values

  • Pressure (cmH2O) and Flow (l/min) as waveforms - automatically adjusted

  • The current ventilator settings 

Monitoring

BEACON has build-in physiological monitoring. Connect BEACON and monitor the physiological progression of the patient

With the physiological monitoring screen you can monitor the physiological variables of the patient:

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  • FetCO2 and FeCO2 measurements

  • Anatomical (Vd-ana) and Alveolar (Vd-alv) deadspace measurements

  • VO2 and VCO2 measurements 

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The Gas Exchange information screen displays the estimated (measured) SHUNT, Low V/Q and High V/Q for the patient

Optimizing Nutrition for the Covid-19 patient

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  • VO2 - is the measured Oxygen Consumption of the patient

  • VCO2 - is the produced Carbon Dioxide production of the patient

  • REE - is the calculated Resting Energy Expenditure of the patient, based on the VO2 and VCO2 measurements

  • RQ - is the calculated difference between VO2 and VCO2

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For VO2 and VCO2, the average Variable in % is shown over a time window of 30 minutes

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For REE, the current REE is shown and average REE is shown over a time window of 30 minutes

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Disclaimer 

Mermaid Care does not recommend the use of one mechanical ventilator for more than one patient. To ensure appropriate and lung-protective ventilation and monitoring awe recommend using our BEACON Caresystem 

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