• Sakina H Sojar, Austin M Quinn, William H Bortcosh, Paul C Decerbo, Esther Chung, Carolyn J La Vita, and Gregory D Jay.
• Division of Pediatric Emergency Medicine, Department of Emergency Medicine, Alpert Medical School, Brown University, Rhode Island Hospital, Providence, Rhode Island. sakina_sojar@brown.edu.
• Respir Care. 2021 May 1; 66 (5): 758768758-768.

BackgroundDual-patient, single-ventilator protocols (ie, protocols to ventilate 2 patients with a single conventional ventilator) may be required in times of crisis. This study demonstrates a means to titrate peak inspiratory pressure (PIP), PEEP, and [Formula: see text] for test lungs ventilated via a dual-patient, single-ventilator circuit.MethodsThis prospective observational study was conducted using a ventilator connected to 2 test lungs. Changes in PIP, PEEP, and [Formula: see text] were made to the experimental lung, while no changes were made to the control lung. Measurements were obtained simultaneously from each test lung. PIP was titrated using 3D-printed resistors added to the inspiratory circuit. PEEP was titrated using expiratory circuit tubing with an attached manual PEEP valve. [Formula: see text] was titrated by using a splitter added to the ventilator tubing.ResultsPIP, PEEP, and [Formula: see text] were reliably and incrementally titratable in the experimental lung, with some notable but manageable changes in pressure and [Formula: see text] documented in the control lung during these titrations. Similar results were measured in lungs with identical and different compliances.ConclusionsPressures and [Formula: see text] can be reliably adjusted when utilizing a dual-patient, single-ventilator circuit with simple, low-cost modifications to the circuit. This innovation could potentially be lifesaving in a resource-limited or crisis setting. Understanding the interactions of these circuits is imperative for making their use safer.Copyright © 2021 by Daedalus Enterprises.

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