Irish researchers develop split ventilator for use on two Covid-19 patients at once

A team based in Galway has developed an adjustable split ventilator which can be used on two Covid-19 patients in intensive care at the one time.

As scaling up of ventilator production around the world in response to shortages caused by the pandemic is expected to take time, split ventilators are being developed in an attempt to ease acute pressures on ICU units treating the most seriously-ill patients.

The new device was developed by clinicians and members of the med tech sector in Galway. Based at NUIG, what became known as “The Inspire Team” designed a new system to support clinicians to safely split ventilation between two patients.

It is an important advance over others because it allows one to control key ventilatory parameters for each patient separately, “which is really important for a severe lung disease like Covid-19, and it monitors each patient separately”.

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The system is being made available to health services globally through www.galwayventshare.com and it has been designed so it can be replicated using medically-approved ventilator equipment that already exists in most hospitals.

It is more sophisticated than other prototypes as it allows for delivery of the correct lung volume based on each patient’s requirements, which can be adjusted as necessary.

"The amount delivered can be verified through a tablet connected to the ventilator, giving more confidence to the clinicians through individual patient monitoring," explained co-leader Tim Jones of SymPhysis Medical.

“The team has come together mindful of the need for speed in developing and sharing solutions that can treat the Covid-19 pandemic. We are making our findings available to colleagues worldwide to help alleviate some of the pressure on hospitals challenged by a shortage of ventilators,” he added.

With co-leaders Jack Connolly and Atif Shahzad they are now completing "sensor and interface prototypes" and rigorously testing the full system, "with all findings to be shared widely as soon as they're available".

The team is comprised of alumni of the BioInnovate medical device training programme at NUI Galway who work in Galway, a world-leading Med Tech hub, where approximately half of the world's ventilators are produced.

Anaesthetist Prof John Laffey NUIG School of Medicine, a specialist in intensive care at Galway University Hospitals, said the idea of using a ventilator to ventilate the lungs of two patients "is very much a last resort".

“Unfortunately, we have heard some reports of intensive care colleagues in other countries in the tragic situation of having to choose which one of two Covid-19 patients to offer ventilator support to,” he added.

Their innovation would change that decision from one of having to decide which patient to provide this life-supporting technology, to “allowing one to provide ventilatory support to both patients, buying time to allow one source additional ventilators”.

In the US pressure to use split ventilators has built up in recent weeks, especially in New York state because ICUs were over-whelmed. It led to federal health officials announcing hospitals may split one ventilator between two Covid-19 patients to keep up with demand for the life-saving technology though it said the practice should be used only “as an absolute last resort”.

The practice of ventilator splitting has been used very rarely and the safety of the practice remains undetermined though the US FDA has given approval for limited use of some prototypes. Some groups representing critical care providers in the US cautioned against the practice, saying “it cannot be done safely with current equipment.”

While companies like Ford and General Electric are ramping up production to the tune of 50,000 ventilators in the next 100 days, analysts say the production timeline lags current projections for Covid-19's peak. Even if there is a surge of ventilators ready for purchase, the US lacks a centralised "allocator" of critical supplies, forcing hospitals and state and federal governments to compete for available ventilators.

Meanwhile medical devices maker Medtronic is ramping up ventilator production at its plant in Galway to meet worldwide demand for the life-saving device with a view to producing more than 1,000 a week by the end of June.