Our innovative stainless-steel splitter
In the MultiVentY project, we approached the problem of ventilator shortage capacity by doubling the capacity of available ventilators through the use of a splitter (a Y-shaped piece). This choice is motivated by the reliability of the functionality and the familiarity of the doctors with the existing respirators. Adding splitters to the breathing circuits is the simplest way to increase the capacity of existing ventilators and is a technique of crisis medicine that has already been studied in theory (1-2) and in practice (3).
The MultiVentY project involve the design and the launch in mass production a Y multiplier (splitters) allowing two patients to be connected to the same ventilator.
Splitters can be manufactured in mechanical fabrics or bought from our Belgian manufacture
This multiplier is designed in surgical stainless steel (316L) in order to allow its sterilization and its reuse between two pairs of patients and thus to cope with the shortages of medical equipment presented by hospitals and suppliers.
The splitter in stainless steel is manufactured on mechanic machinery. Tests on commercial ventilators have successfully been performed at CHC Saint-Elisabeth Heusy (Verviers, Belgium).
The mass production phase is launched. The international community (university, hospital as well as private companies, see below) has all shown great interest in the inox design of the splitter. The stainless-steel splitter is integrated to the databases of the international workforce “Differential Multiventilation International Working Group”.
Being an open-source solution, the design files can be freely downloaded here.
Specifications of the MultiVentY splitter
Surgical grade stainless steel (316L) allowing for sterilization;
Universal fitting 22 and 25mm connections, making it compatible with all the splitted ventilation components (Figure 1);
Reusable between two uses by standard sterilization, keeping this critical component out of shortage risk.
Although the use of a simple splitter doubles the invasive respiratory assistance capacity of intensive care units, this simple technique poses certain issues. First, the setup does not allow to monitor and control the parameters for each different patient in the circuit. This is however critical to assure the survival of the patients. Moreover, as stated by the Joint Statement, “sharing mechanical ventilators should not be attempted because it cannot be done safely with current equipment”. Finally, when performing dual ventilation by means of a splitter only, technical constraints arise such as the need for the patients to be sedated, and the choice of patients with very similar morphology and respiratory characteristics. In simple dual-ventilation, the ventilator circuits connected to different patients are in parallel. In the pressure-controled mode, the pressure in each circuit remains the same and this could be the cause of lung injuries. See [2,5] for more information about the modes of control and related injuries.
However, using a single ventilator between multiple patients can be done safer by adding different modules to the splitter to allow for individualized respiratory cares. This is called “differential multiventilation” and recommended procedures are described in detail on the “Complete solution” section.
1. Neyman G, Irvin, C. A single ventilator for multiple simulated patients to meet disaster surge. Academic Emergency Medicine, 2006, 13(11), 1246–1249.
2. Farkas J. Splitting ventilators to provide titrated support to a large group of patients. PulmCrit. 2020/03/15.
3. Babcock C. COVID-19 How to Use One Ventilator to Save Multiple Lives. Youtube Video. 2020/03/14.
.4. SCCM/ AARC/ ASA/ APSF/AACN/ ACCP. Consensus Statement on Multiple Patients Per Ventilator. Joint Statement. 2020/03/29.
5. Matta S. Shared ventilation: how to do it if you have to. Life in the fast Line. 2020/03/08.