Ventilator Shortage
In the U.S, in the worst case scenario there could be a shortage of 700k ventilators. There is interest in using 1 ventilator to support multiple patients in order to deal with the possible shortage.
But this is difficult to do because there is the concept of ventilator-patient independence. The ventilator should be configured to fit the patient's needs, not the other way around. If a patient has a high respiration rate (tachypnea), they shouldn't cause the other patients connected to the ventilator to hyperventilate.
continuous mandatory ventilation (CMV)
Patients can normally trigger a breath. However this isn't possible when 1 ventilator is being used to support multiple patients, because that could hyperventilate other patients. And so the ventilator must be set to an antiquated mode, where the patient has no control over the rate of the ventilation and the ventilator fires on a set rate. This mode is generally uncomfortable for the patient and so modern ventilators may be lacking this mode. This mode can be simulated by:
- Set the trigger threshold as high as possible so that triggering is prohibitively difficult to do.
- If that doesn't work, respirolytic sedation via opioids or propofol may be an option.
- Paralysis could be used as the last resort.
Due to the inability to precisely control the tidal volume, hypercapnia will likely be an issue and would have to be anticipated and accounted for.