The concept of ventilator sharing

1. TABLE OF CONTENTS
Abstract............................................................................................................................................ 3
introduction ..................................................................................................................................... 4
Literature Review............................................................................................................................. 5
Description....................................................................................................................................... 6
Manufacturingprocess...................................................................................................................... 8
Input Data Analysis......................................................................................................................... 10
material canbe used ................................................................................................................... 11
Resultsand Discussion.................................................................................................................... 12
DISCUSSION................................................................................................................................ 13
Conclusion.................................................................................................................................. 13
References..................................................................................................................................... 14

2. ABSTRACT
Objectives: To know if a ventilator available in an emergency dpartment
could quickly adjust to supply ventilation for four adult’s lungs
simultaneously.
Methods: Using lung simulators, easily available plastic tubing, and
ventilators, human lung simulators were added in equivalent the ventilator
was ventilating the equivalent of four adult’s lung.
Data collected: inclusive pressure, positive end-expiratory pressure, total
end volume, and total minute ventilation. Any obvious asymmetry in the
delivery of gas to the adult lung simulators was also recorded. The ventilator
was run for almost 12 consecutive hours
Results: Using easily available plastic tubing set up to minimize space
volume, the four adult lung simulators were simply ventilated for 12 hours
using one ventilator. In pressure control (set at 25 mm H2O), the mean tidal
volume was 1,884 mL (approximately 471 mL/lung simulator) with average
minute ventilation of 30.2 L/min (or 7.5 L/min/lung simulator). In volume
control (set at 2 L), the mean pressure was 28 cm H2O and the minute
ventilation were 32.5 L/min total (8.1 L/min/lung simulator). [1]
Conclusions: A single ventilator can be quickly adjusted to ventilate four
lung simulated adults for a limited time. this pilot study recommended
significant potential for the expanded use of a single ventilator during cases
of disastersurge involving multiple casualties with respiratory failure.
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3. INTRODUCTION
The rapid spreadof COVID-19throughouttheworldhas putan unimaginablestrain
on the healthcare system. Patients are at risk of facing the effect of don't have
enough ventilators, who deals with fatal respiratory failure. This is the last resort,
an emergency device for use earlier severeshortageof ventilators.
Ithas been demonstratedthat usingT tubes and adapters,the ventilator circuit can
be divided so that four simulated patients can share a single emergency ventilator
Some hospitals do not have T-tubes or other parts readily available to set up a
ventilator for multiple patients. This 3D printed partcan be used in such situations.
the goal is to have an easily printed 3D part so that anyonein Iraq or world who
may need it in dire circumstances, can use it to savelives.

4. LITERATURE REVIEW
The concept of ventilator sharing was first written to our knowledge by Dr.
Niemann and Dr.Irvinein 2006(AcEmergency Medicine 2006).Theydemonstrated
that by using T tubes and adapters, the ventilator circuit could be divided so that
four simulated patients could sharea single emergency ventilator.
The technique was successfully used by Dr. Minis in the 2017 Las Vegas mass
shooting incident. This technique saved patients' lives and buy time until more
breathing machines arrive.
St. John's Medical Center (Detroit, MI) and Dr. Peter Hoffman
(Departmentof Physics, WayneState University, Detroit, MI)
and don’t forgetBryan and Jennifer THE VENTILATORCIRCUITSPLITTER, TEAM
BRYAN LAI, MD
Anesthesiologist, Pain Medicine Physician
San Antonio, Texas, USA
University of Texas Health Science Center at San Antonio
JENNIFER ERIAN, MD
Anesthesiologist, Pain Medicine Physician
San Antonio, Texas, USA
Consultants in Pain Medicine
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5. DESCRIPTION
This device enables ventilation of many patients using an anesthesia device or
ventilator for intensive care, and this device takes this concept a step forward by
enabling the selective application of resistance to flow on one end of the patient's
inhalation, allowing ventilation of two or more patients depending on the
inhalation. Pressure... Designed to be in compliance with international standards
for 22mm breathing circuits. We can use 4-way splitter but not tested yet, but
published by popular request. You can show method four and two-way separator
in the following figure.
TWO PATIENTS
To ventilate two patients on one ventilator, place one splitter on the inspiratory limb and
one on the expiratory limb as show
FOUR PATIENTS
To ventilate four patients, you need a total of 6 splitters arranged such that each of the
splitters in the “Two Patient” scenario has an additional splitter on each limb.[2]

6. MORE THAN FOUR
Itmay be possibleto ventilate morepeople, but the limitation of the ventilator is the
total volume that can be transferred. , since this is a modular design, you can ventilate
3,4,5,6,7+patients.
But in somecases, there is a difference in the ages and portability of the lungs, so we
use a piece to reduce the air. And it also made by 3d printer
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7. MANUFACTURING PROCESS
3D printing, or additive manufacturing, is the construction of a three-dimensional
object froma CAD model or a digital 3D model.[3]
The term "3D printing" can refer to a variety of processes in which material is
joined or solidified under computer control to create a three-dimensional object,
with material being added together typically layer by layer.[4]
200micron QUALITYpreset
Brim
Raft
To prevent air lea
 100% infill
 25 perimeters (which actually means that there is no infill!) PLA seems to
work better than PETG best option MED-AMB10
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8. printer type my Prusa i3 MK3S Everything was modelled on 0.4mm
nozzles material used PLA (Polylactic acid)
But the material has to be biocompatible as MED-AMB 10 is solid and
transparent for a range of medical and industrial applications, including
when biocompatibility, sterilization and/or thermal resistance are
required. (5)
100% infill for strength and leak reduction
0.2-0.3mm layer height. Smaller layer heights may be associated with
reduced leakage around splices
No supports are needed for any print
the print time it was 6h 10m
total weight about 65g
The circuit divider should be printed upside-down 'Y'
The delimiters must be printed in portrait position Consider the edge of
the divider. (6)
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9. INPUT DATA ANALYSIS
designthe part and convert the file intostl. extensiontolet the 3dprinter read
the shape and slice it
in Formware 3D program.
• the object sizes the single port shouldhave an inside diameter >22.1mm
& <22.75mmmeasuredat the outermost point
• The dual ports shouldhave an outside diameter of >21.5mm& <22.0mm
measuredat the outermost point
• Of course, the standardwouldbe to have your prints test fittedon
the actual machines intendedfor use.
• If your print does not meet these specifications, scale your prints so
that they are in specification.
•
•
volume o.89ml and the part don’t need support.
number of faces 1566 andvertices 9281.
10

10. material can be used
MED-AMB 10 is a rigid, translucent material for a range of medical and industrial
applications, including when biocompatibility, sterilization and/or thermal
resistance is required Capable of meeting ISO 10993-5 and -10 standards for
biocompatibility, this material can also be sterilized by autoclave. Itdelivers highly
accurate parts with excellent feature resolution and high definition.[5]
• Features
• Biocompatible*
• Sterilizable by autoclave
• Thermal resistanceover 100 °C
• Excellent humidity/moistureresistance
• Rigid and translucent
SG is a biocompatible Class I material, developed for the printing of SurgicalGuides
for implantsurgeryuse.the material can also besterilized using standardautoclave
protocols. The use of an autoclave does not affect the dimensional stability;
therefore, Next Dent SG can be used in every operating theatre. [7]
Features
• high precision
• easy to insertdrill sleeves, directly after printing.
• Enabling even greater precision during surgery.
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11. RESULTS AND DISCUSSION
RESULTS After the configuration was sealed, the ventilator system did not
alarm. Visual inspection showed roughly equivalent excursion of all lung
models. No respiratory stacking was seen. Averages of ventilator display
readout samplings over the course of the study are presented in Table 1.
Table 1 Pressureand Flow Characteristicsof Lung Simulators in Multiple Patient
VentilationConfigurationas an Average of Random Collections.
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12. DISCUSSION
A four-patientconfiguration operated successfully on a single ventilator for almost
12 hours. Pressures did not exceed 35 cm H2O. Airway pressures beyond 35 mm
H2O are associated with ventilator-induced lung injury.[8]
Individual tidal volumes reached 471–507 mL, which approximates 7 mL/kg for a
70-kg individual. Studies have shown that ventilation with 6–8 mL/kg is associated
with improved outcome in injured lungs.[9]
No evidence of respiratory stacking or preferential filling of individual lung
simulators was observed.
Conclusion
This pilot study suggests that the physics of a ventilator/ patient circuit could
accommodate more than one patient. In a catastrophic situation, when there are
more patients who require ventilators than there are ventilators available, simple
modification of the ventilator circuit could help absorb the extra burden.
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13. REFERENCES
1-Hick JL, O’Laughlin DT. Concept of operations for triage of mechanical ventilation in
an epidemic. Acad Emerg Med. 2006; 13:223–9.
2- web sit https://ventsplitter.org/
3- "3D printing scales up". The Economist. 5 September 2013.
4- Excell, Jon (23 May 2010). "The rise of additive manufacturing". The
Engineer. Retrieved 30 October 2013.
5-Figure 4 Standalone: http://infocenter.3dsystems.com/figure4standalone/node/1546
6-Figure 4 Modular: http://infocenter.3dsystems.com/figure4modular/node/1741
7-NextDent” © 2016 Vertex-Dental B.V. http://www.nextdent.com
8-MacIntyre NR. Principles of mechanical ventilation. In: Mason RJ, Murray JF,
Broaddus VC, Nadel JA, eds. Murray & Nadel’s Textbook of Respiratory Medicine. 4th
ed. Philadelphia, PA: Harcourt Health Sciences Group, 2005, p. 2342.
9-Michaels AJ. Management of post traumatic respiratory failure. Crit Care Clin. 2004;
20:83–99.

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