• Rich Branson, Jeffrey R Dichter, Henry Feldman, Asha Devereaux, David Dries, Joshua Benditt, Tanzib Hossain, Marya Ghazipura, Mary King, Marie Baldisseri, Michael D Christian, Guillermo Domingiuez-Cherit, Kiersten Henry, Anne Marie O Martland, Meredith Huffines, Doug Ornoff, Jason Persoff, Dario Rodriquez, Ryan C Maves, Niranjan Tex Kissoon, and Lewis Rubinson.
• Department of Surgery, Division of Trauma & Critical Care, University of Cincinnati, Cincinnati, OH.
• Chest. 2021 Feb 1; 159 (2): 634652634-652.

BackgroundEarly in the coronavirus disease 2019 (COVID-19) pandemic, there was serious concern that the United States would encounter a shortfall of mechanical ventilators. In response, the US government, using the Defense Production Act, ordered the development of 200,000 ventilators from 11 different manufacturers. These ventilators have different capabilities, and whether all are able to support COVID-19 patients is not evident.Research QuestionEvaluate ventilator requirements for affected COVID-19 patients, assess the clinical performance of current US Strategic National Stockpile (SNS) ventilators employed during the pandemic, and finally, compare ordered ventilators' functionality based on COVID-19 patient needs.Study Design And MethodsCurrent published literature, publicly available documents, and lay press articles were reviewed by a diverse team of disaster experts. Data were assembled into tabular format, which formed the basis for analysis and future recommendations.ResultsCOVID-19 patients often develop severe hypoxemic acute respiratory failure and adult respiratory defense syndrome (ARDS), requiring high levels of ventilator support. Current SNS ventilators were unable to fully support all COVID-19 patients, and only approximately half of newly ordered ventilators have the capacity to support the most severely affected patients; ventilators with less capacity for providing high-level support are still of significant value in caring for many patients.InterpretationCurrent SNS ventilators and those on order are capable of supporting most but not all COVID-19 patients. Technologic, logistic, and educational challenges encountered from current SNS ventilators are summarized, with potential next-generation SNS ventilator updates offered.Copyright © 2020 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

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