Wayne State University, Detroit, MI, United States of America; Department of Emergency Medicine, Ascension Providence, Southfield, MI, United States of America.
Department of Critical Care Medicine, University of Calgary, Calgary, AB, Canada.
Am J Emerg Med. 2020 Oct;38(10):2045-2048. doi: 10.1016/j.ajem.2020.06.089. Epub 2020 Jul 10.
Ventilator sharing is one option to emergently increase ventilator capacity during a crisis but has been criticized for its inability to adjust for individual patient needs. Newer ventilator sharing designs use valves and restrictors to control pressures for each patient. A key component of these designs is an inline Positive End Expiratory Pressure (PEEP) Valve but these are not readily available. Creating an inline PEEP valve by converting a standard bag-valve-mask PEEP valve is possible with the addition of a 3D printed collar.
This was a feasibility study assessing the performance and safety of a method for converting a standard PEEP valve into an inline PEEP valve. A collar was designed and printed that covers the exhaust ports of the valve and returns exhaled gases to the ventilator.
The collar piece was simple to print and easily assembled with the standard PEEP valve. In bench testing it successfully created differential pressures in 2 simulated expiratory limbs without leaking to the atmosphere at pressures greater than 60 cm of H2O.
Our novel inline PEEP valve design shows promise as an option for building a safer ventilator sharing system.
在危机期间，呼吸机共享是紧急增加呼吸机容量的一种选择，但因其无法针对个体患者的需求进行调整而受到批评。新型呼吸机共享设计使用阀门和限流器来控制每个患者的压力。这些设计的一个关键组件是内置式呼气末正压（PEEP）阀，但这些阀不易获得。通过在标准的球囊-面罩 PEEP 阀上增加一个 3D 打印的套管，可以将内置式 PEEP 阀转换为内置式 PEEP 阀。
这是一项可行性研究，评估了将标准 PEEP 阀转换为内置式 PEEP 阀的方法的性能和安全性。设计并打印了一个套管，覆盖阀的排气口，并将呼出的气体送回呼吸机。
套管很容易打印，并且可以轻松地与标准的 PEEP 阀组装在一起。在台架测试中，它成功地在 2 个模拟呼气分支中产生了压差，在压力大于 60cmH2O 时不会向大气泄漏。
我们的新型内置式 PEEP 阀设计作为构建更安全的呼吸机共享系统的一种选择具有很大的潜力。
