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Ventilator output splitting interface ‘ACRA’: Description and evaluation in lung simulators and in an experimental ARDS animal model

The current COVID-19 pandemic has led the world to an unprecedented global shortage of ventilators, and its sharing has been proposed as an alternative to meet the surge. This study outlines the performance of a preformed novel interface called ’ACRA’, designed to split ventilator outflow into two b...

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Autores principales: Otero, Pablo E., Tarragona, Lisa, Zaccagnini, Andrea S., Verdier, Natali, Ceballos, Martin R., Gogniat, Emiliano, Cabaleiro, Juan M., D’Adamo, Juan, Duriez, Thomas, Eijo, Pedro Garcia, Artana, Guillermo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8386869/
https://www.ncbi.nlm.nih.gov/pubmed/34432821
http://dx.doi.org/10.1371/journal.pone.0256469
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author Otero, Pablo E.
Tarragona, Lisa
Zaccagnini, Andrea S.
Verdier, Natali
Ceballos, Martin R.
Gogniat, Emiliano
Cabaleiro, Juan M.
D’Adamo, Juan
Duriez, Thomas
Eijo, Pedro Garcia
Artana, Guillermo
author_facet Otero, Pablo E.
Tarragona, Lisa
Zaccagnini, Andrea S.
Verdier, Natali
Ceballos, Martin R.
Gogniat, Emiliano
Cabaleiro, Juan M.
D’Adamo, Juan
Duriez, Thomas
Eijo, Pedro Garcia
Artana, Guillermo
author_sort Otero, Pablo E.
collection PubMed
description The current COVID-19 pandemic has led the world to an unprecedented global shortage of ventilators, and its sharing has been proposed as an alternative to meet the surge. This study outlines the performance of a preformed novel interface called ’ACRA’, designed to split ventilator outflow into two breathing systems. The ’ACRA’ interface was built using medical use approved components. It consists of four unidirectional valves, two adjustable flow-restrictor valves placed on the inspiratory limbs of each unit, and one adjustable PEEP valve placed on the expiratory limb of the unit that would require a greater PEEP. The interface was interposed between a ventilator and two lung units (phase I), two breathing simulators (phase II) and two live pigs with heterogeneous lung conditions (phase III). The interface and ventilator adjustments tested the ability to regulate individual pressures and the resulting tidal volumes. Data were analyzed using Friedman and Wilcoxon tests test (p < 0.05). Ventilator outflow splitting, independent pressure adjustments and individual tidal volume monitoring were feasible in all phases. In all experimental measurements, dual ventilation allowed for individual and tight adjustments of the pressure, and thus volume delivered to each paired lung unit without affecting the other unit’s ventilation—all the modifications performed on the ventilator equally affected both paired lung units. Although only suggested during a dire crisis, this experiment supports dual ventilation as an alternative worth to be considered.
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spelling pubmed-83868692021-08-26 Ventilator output splitting interface ‘ACRA’: Description and evaluation in lung simulators and in an experimental ARDS animal model Otero, Pablo E. Tarragona, Lisa Zaccagnini, Andrea S. Verdier, Natali Ceballos, Martin R. Gogniat, Emiliano Cabaleiro, Juan M. D’Adamo, Juan Duriez, Thomas Eijo, Pedro Garcia Artana, Guillermo PLoS One Research Article The current COVID-19 pandemic has led the world to an unprecedented global shortage of ventilators, and its sharing has been proposed as an alternative to meet the surge. This study outlines the performance of a preformed novel interface called ’ACRA’, designed to split ventilator outflow into two breathing systems. The ’ACRA’ interface was built using medical use approved components. It consists of four unidirectional valves, two adjustable flow-restrictor valves placed on the inspiratory limbs of each unit, and one adjustable PEEP valve placed on the expiratory limb of the unit that would require a greater PEEP. The interface was interposed between a ventilator and two lung units (phase I), two breathing simulators (phase II) and two live pigs with heterogeneous lung conditions (phase III). The interface and ventilator adjustments tested the ability to regulate individual pressures and the resulting tidal volumes. Data were analyzed using Friedman and Wilcoxon tests test (p < 0.05). Ventilator outflow splitting, independent pressure adjustments and individual tidal volume monitoring were feasible in all phases. In all experimental measurements, dual ventilation allowed for individual and tight adjustments of the pressure, and thus volume delivered to each paired lung unit without affecting the other unit’s ventilation—all the modifications performed on the ventilator equally affected both paired lung units. Although only suggested during a dire crisis, this experiment supports dual ventilation as an alternative worth to be considered. Public Library of Science 2021-08-25 /pmc/articles/PMC8386869/ /pubmed/34432821 http://dx.doi.org/10.1371/journal.pone.0256469 Text en © 2021 Otero et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Otero, Pablo E.
Tarragona, Lisa
Zaccagnini, Andrea S.
Verdier, Natali
Ceballos, Martin R.
Gogniat, Emiliano
Cabaleiro, Juan M.
D’Adamo, Juan
Duriez, Thomas
Eijo, Pedro Garcia
Artana, Guillermo
Ventilator output splitting interface ‘ACRA’: Description and evaluation in lung simulators and in an experimental ARDS animal model
title Ventilator output splitting interface ‘ACRA’: Description and evaluation in lung simulators and in an experimental ARDS animal model
title_full Ventilator output splitting interface ‘ACRA’: Description and evaluation in lung simulators and in an experimental ARDS animal model
title_fullStr Ventilator output splitting interface ‘ACRA’: Description and evaluation in lung simulators and in an experimental ARDS animal model
title_full_unstemmed Ventilator output splitting interface ‘ACRA’: Description and evaluation in lung simulators and in an experimental ARDS animal model
title_short Ventilator output splitting interface ‘ACRA’: Description and evaluation in lung simulators and in an experimental ARDS animal model
title_sort ventilator output splitting interface ‘acra’: description and evaluation in lung simulators and in an experimental ards animal model
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8386869/
https://www.ncbi.nlm.nih.gov/pubmed/34432821
http://dx.doi.org/10.1371/journal.pone.0256469
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