(Originally presented by Dr Andrew Inglis)

The COVID-19 pandemic has the potential to overwhelm intensive care capacity, including a severe shortage of ventilators. Is there potential to share ventilators between patients?

Our ICU capacity in Australia:
A recent study:
Surge Capacity of Australian Intensive Care Units Associated with COVID-19 Admissions, which surveyed 175 of these ICUs, produced the following relevant data:

  • Baseline ICU ventilator capacity is 2184 with a Surge Capacity of 4815 ventilators (includes: transport vents, anaesthetic machines, non-invasive machines and re-purposed veterinary ventilators)
  • Baseline ICU bed capacity is 2228 with a Surge Capacity of of 6531 beds
  • With the increase in ICU beds and expansion of ventilators, authors estimate 26% shortage of ventilators

So can we share ventilators?
There is research and very little real-world experience behind ventilator splitting therefore this should only be used as an absolute last resort

  • New York Presbyterian Hospital has developed a protocol:
    • Patients to be paralyzed
    • Pressure Control Ventilation
    • Matching patients with similar ventilatory requirements
    • Only patients with an anticipated ventilatory requirement > 72 hours
    • No severe baseline COPD/Asthma
    • Use of appropriate circuit filters

If you’re interested in exploring the idea of splitting ventilators further, check out these links:
The EMCrit Project –  Split Ventilators

The American Society of Anesthesiologists – Joint Statement on Multiple Patients per Ventilator 

Surge Capacity of Australian Intensive Care Units MJA, 2020