Can ‘co-venting’ solve New Jersey’s ventilator shortage problem?

Allowing patients to share ventilators, or "co-venting,” could help New Jersey hospitals deal with a potential surge in COVID-19 cases.

News 12 Staff

Apr 3, 2020, 12:45 AM

Updated 1,564 days ago

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Allowing patients to share ventilators, or "co-venting,” could help New Jersey hospitals deal with a potential surge in COVID-19 cases. But a Kane in Your Corner investigation finds the method could also bring added risk. And even one of the researchers who helped develop the technique is not convinced it would be successful against the coronavirus,
This week, Gov. Phil Murphy brought public attention to co-venting, saying his administration had asked FEMA to allow New Jersey hospitals to use the technique. He called it "a necessary step to buy us precious time."
Co-venting was first proposed in 2006, when two researchers concluded, "A single ventilator can be quickly modified to ventilate four simulated adults for a limited time." One of those researchers, Dr. Charlene Babcock, recently produced a YouTube video, to demonstrate how she believes one ventilator can be modified to serve two or even four patients simultaneously.
The concept is simple in theory. By setting the ventilator to double the pressure, it can be hooked up to two patients at once. Co-venting was even used successfully, albeit briefly, after the 2017 shootings at the Mandalay Bay casino in Las Vegas.
Proponents contend that when lives are at stake, the choice is simple.
In her YouTube video, Dr. Babcock, now with Ascension St. John Hospital in Detroit, says: "If it was me, and I had four patients who needed intubation, and I only had one ventilator, I would simply have a shared discussion meeting with all four families, and say 'I could pick one to live, or I could try to have all four lives'.”
Kane In Your Corner requested an interview with Dr. Babcock, but she did not return messages.
Another pioneer in co-venting research is urging a more cautious approach, however.
Richard Branson, of the University of Cincinnati, says to be able to share a ventilator successfully, patients have to require nearly the same amount of oxygen. He says with a disease like COVID-19, which attacks the lungs, that's not always possible.
"Over the course of a day, if one starts to better and the other starts to get worse, then the distribution of the volume is going to change," Branson says.
Constant monitoring can help. But Branson says ultimately, if patients' oxygen needs diverge too much and spare ventilators are not available, the only option may be to remove one patient from ventilation altogether.
"I’ve seen quotes from other people who say, 'If the choice is the person dies or I put two on the same ventilator (that's an easy call)'," Branson says. “Well there’s also the possibility that you could have saved one of them with the ventilator, but now you can’t save either."
Despite the risks, Branson agrees that in a pandemic co-venting is an option hospitals should consider. However, he says they should do as a last resort, fully aware of the risks involved.
Health officials, of course, hope co-venting doesn't become necessary. It's one of the many reasons they continue to urge New Jersey residents to observe social distancing requirements so the state can "flatten the curve."


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