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

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

some of those institutions are

  • university of Columbia University College of Physicians & Surgeons

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

 

 

 

 

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

 

 

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

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

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

  • 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:

  • FetCO2 and FeCO2 measurements

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

  • VO2 and VCO2 measurements 

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

  • 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

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

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

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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