Samuel Hellman, PhD
Memorial Sloan Kettering Cancer Center
Grant Chen, MD
Anesthesiology & Critical Care Medicine
Memorial Sloan Kettering Cancer Center
A group of anesthesiologists and biomedical engineers at MSK have developed a novel system that will allow two intubated COVID-19 patients to be simultaneously supported by one mechanical ventilator.
Crucially, the system includes an adjustable pressure regulator added at the inspiratory limb of each patient’s breathing circuit and provides the clinician the ability to independently set the tidal volume for each patient. Additionally, a third flow circuit with a breathing bag is added to the system to allow pressure-equalization and maintain total system flow. The extra circuit allows the ventilator to maintain sufficient flow using elevated pressure while independently down-regulating each patient’s pressure.
One of the critical problems with utilizing a single ventilator for multiple patients during prolonged ventilation has been the inability to compensate for variability in the patients’ size, weight and pulmonary compliances.
Prolonged periods of mechanical ventilation are required when dealing with the COVID-19 population, and our inability to individualize each patient’s tidal volume will eventually lead to ventilator induced lung injury (VILI) and thus jeopardize the survival of both patients. For this reason, numerous national societies have warned against the use of splitting one ventilator for multiple patients.
But this innovative set-up can potentially double the number of ventilators available by superseding the imprecise science used to overcome these variations.
Since we have not yet experienced a ventilator shortage at MSK we have only used the MSK Octopus on test-lungs.
Our invention is intended to be a short-term fix to address the serious lack of ventilators currently being faced as a consequence of the COVID-19 pandemic. It is only for use after hospital administration has approved and acknowledged the unique ethical considerations in a crisis situation such as this.
Samuel Hellman, PhD – MSK Medical Physics
Gregory W. Fischer, MD, FASA, Chairman, Anesthesiology and Critical Care Medicine
Robert J Downey, MD – MSK Thoracic Service, Department of Surgery
Grant Chen, MD, Anesthesiology and Critical Care Medicine
Takeshi Irie, MD, PhD, Anesthesiology and Critical Care Medicine
Paul Booth, MS – MSK Biomedical Engineering
Jud Ramaker, MD – MSK Volunteer Retired Technical Supervisor - Respiratory Care Service
MSKCC COVID-19 Innovations Team
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