FDA recommends limiting use of ventilator splitters for COVID patients

The early-pandemic ventilator shortage prompted researchers to design ventilator splitters like this one. (Image courtesy of Johns Hopkins University)

The FDA is urging healthcare providers to use ventilator splitters for COVID-19 patients only when there is no alternative.

The agency released a letter to providers asking them to consider non-invasive ventilation such as high-flow nasal oxygen or non-invasive positive pressure ventilation before resorting to a ventilator splitter. If a ventilator splitter is the only option, the agency said clinicians should limit sharing of ventilation to two patients with similar ventilatory requirements and only for up to 48 hours.

The recommendations are based on clinicians’ experience and research conducted since the pandemic began. “These activities greatly increased the understanding of the known and potential risks and benefits of ventilator splitters in a very short time,” the agency said.

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What is a medical ventilator and how does it work?

Image from Ventec Life Systems

The ventilator has come to the fore as a vital piece of equipment during the COVID-19 pandemic.

Put simply, ventilators exist to help patients who can’t breathe, breathe. The novel coronavirus’ attack on the respiratory system brought ventilators into the spotlight, forcing the U.S. to turn to its strategic national stockpile as manufacturers scrambled to scale-up production in short order.

While some of the major manufacturers pump out machines and fulfill recently awarded government contracts, researchers at universities and laboratories have entered the ring with alternative ventilators falling under FDA emergency use authorization (EUA) guidelines. However, while useful in a time of need, the alternative machines that cover mechanical ventilation struggle to scratch the surface of capabilities attributable to the in-demand ICU ventilators.


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MIT researchers may have invented a safer way of splitting ventilators

[Image courtesy of MIT]

MIT and Brigham and Women’s Hospital researchers say they have a way of splitting ventilators which could address many of the safety concerns — potentially boosting the supply of ventilators amid the COVID-19 pandemic.

They have demonstrated their concept’s effectiveness in the lab — but they still caution it should be used only as a last resort during an emergency when a patient’s life is at stake.

Ventilators should only be shared as a last resort. One problem: Patients sharing the ventilator must all have the same lung capacity. If one patient’s lung function improves or another’s deteriorates, one patient may receive the right amount of air but other may be out of luck.

Basically the MIT team incorporated flow valves, one for each patient’s branch, that allow them to control the amount of air that each receives. “These flow valves allow you to personalize the flow…

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