The Covid-19 pandemic triggered ventilator shortages in hospitals around the world as clinicians rushed to treat symptoms of acute respiratory distress syndrome.

Many ventilators can support more than one patient at a time, but doing so comes with complications that have made this practice inadvisable. For instance, air supply cannot be suited to each patient’s unique needs.

The dire situations that many hospitals have faced during the pandemic inspired a team of researchers and doctors at Massachusetts Institute of Technology and Brigham and Women’s Hospital to create a new system to customize air pressure and volume to more safely support two people on one ventilator. 

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The iSAVE, or the individualized system for augmenting ventilator efficiency, is a circuit made out of medical-grade, readily available materials. A study on the system was recently published in Science Translational Medicine. 

This machine is not the standard of care, but can be a tool in the extraordinary circumstances of the current pandemic, said Giovanni Traverso, the study’s senior author and an assistant professor at MIT. “These kinds of solutions are ones that one might contemplate when there are no other options. … The way that we see it, [this] is a tool that at least adds to that conversation and consideration.”

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Richard Branson, editor-in-chief of the journal Respiratory Care and professor at the department of surgery at the University of Cincinnati, said that while the scientists did “a reasonable job” of making the idea of sharing ventilators safer, it still should be the last resort. 

There are problems that could arise with a system like this. For example, creating more connections increases the risk of one of them getting disconnected. Patients also need to be monitored more carefully, which increases the complexity of care at a time when clinicians are already overwhelmed. 

“Everybody who does it really sits back and goes, ‘Boy, I hope we never really have to do this,'” said Branson, who co-authored two recent studies exploring the idea of ventilator sharing. 

Shriya Srinivasan, lead author of the study and an MIT postdoctoral fellow, recognizes that iSAVE does have its limitations — patients still have to share some properties of the ventilator, and clinicians have to monitor them more closely. 

The group is now trying to get emergency use authorization from the Food and Drug Administration. It’s also working with nonprofits in other countries to see if the system could help with their patients. The researchers sent these partners kits with all the needed components, so they can test the system at their hospitals. 

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