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PMC:7176269 JSONTXT 19 Projects

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Id Subject Object Predicate Lexical cue
T1 0-125 Sentence denotes Emergency Open-source Three-dimensional Printable Ventilator Circuit Splitter and Flow Regulator during the COVID-19 Pandemic
T2 127-141 Sentence denotes To the Editor:
T3 142-328 Sentence denotes We present a novel addition to a previously described solution to address ventilator shortages from severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) pandemic infection surges.
T4 329-534 Sentence denotes Using access to open-source data for three-dimensional printing, ventilator splitters can be rapidly produced at any location to allow multiple patients to share a single ventilator in disaster situations.
T5 535-678 Sentence denotes The original ventilator circuit splitting solution has been previously described1 and was implemented during the 2017 Las Vegas mass shooting.2
T6 679-954 Sentence denotes A three-dimensional printable Y-piece (Y-splitter), with an optional inspiratory limb flow limiter to account for differential lung compliance, can function to divide the ventilator’s inspiratory and expiratory limbs among patients, based on Neyman and Irvin’s concept (figs.
T7 955-968 Sentence denotes 1, 2, and 3).
T8 969-1039 Sentence denotes Ideally, patients with comparable lung compliance are paired together.
T9 1040-1129 Sentence denotes More than two patients may be theoretically possible with nesting additional Y-splitters.
T10 1130-1188 Sentence denotes However, the required flow may exceed ventilator capacity.
T11 1189-1368 Sentence denotes With advances in additive manufacturing and the widespread accessibility of three-dimensional printers, local production bypasses global travel barriers or supply chain breakdown.
T12 1369-1376 Sentence denotes Fig. 1.
T13 1378-1463 Sentence denotes Three-dimensional printable Y-splitter (*) and optional flow limiter (**) attachment.
T14 1464-1525 Sentence denotes Fig. 2. (Left) Three-dimensional rendition of flow limiters.
T15 1526-1631 Sentence denotes Longitudinal and cross sectional views shown above. (Right) Commercially available one-way circuit valve.
T16 1632-1639 Sentence denotes Fig. 3.
T17 1641-1766 Sentence denotes Two Y-splitters (*) with in-line flow limiter (**) and dual expiratory limb one-way valves (***) for two-patient ventilation.
T18 1767-1901 Sentence denotes A single piece is readily printed in approximately 1 h without additional support material using a consumer three-dimensional printer.
T19 1902-2036 Sentence denotes Production can be scaled to produce 12 Y-splitters at a time on a typical consumer 200 mm × 200 mm × 200 mm three-dimensional printer.
T20 2037-2124 Sentence denotes We used polylactic acid filament, although other filaments are likely to be applicable.
T21 2125-2202 Sentence denotes There are limitations to these devices and the concept of ventilator sharing.
T22 2203-2345 Sentence denotes First, there is a risk of cross-contamination between patients connected to the same ventilator; this can be mitigated with inline filtration.
T23 2346-2497 Sentence denotes Second, the patients sharing the ventilator must be in close proximity to the machine, which will be restricted to the length of the ventilator tubing.
T24 2498-2575 Sentence denotes This is a concern where positive cases require airborne or contact isolation.
T25 2576-2661 Sentence denotes Third, the patients must be paralyzed to facilitate a controlled mode of ventilation.
T26 2662-2855 Sentence denotes Additionally, to ventilate multiple patients with the same settings, several parameters need to be considered such as patient size, ideal body weight, lung compliance, mode of ventilation, etc.
T27 2856-2943 Sentence denotes Individualized adjustments are possible with flow limiters but also possibly imprecise.
T28 2944-3071 Sentence denotes An application for Food and Drug Administration emergency use authorization has been submitted at the time of this publication.
T29 3072-3464 Sentence denotes The Food and Drug Administration has prioritized ventilators, ventilator tubing connectors, and ventilator accessories similar to this device for the emergency use authorization pathway because of the SARS-CoV2 pandemic.3,4 We urge that clinicians use their best judgement and adhere to local regulations in the utilization of these three-dimensional printable tools for ventilator splitting.
T30 3465-3615 Sentence denotes The three-dimensional print files are free and immediately available for open-source download, production, and emergency utilization around the globe.
T31 3616-3692 Sentence denotes The files can be found at https://ventsplitter.org (accessed April 7, 2020).
T32 3694-3710 Sentence denotes Research Support
T33 3711-3786 Sentence denotes Support was provided solely from institutional and/or departmental sources.
T34 3788-3807 Sentence denotes Competing Interests
T35 3808-3901 Sentence denotes The authors have no competing interests in the production of this work in the last 36 months.
T36 3902-4011 Sentence denotes Dr. Eckmann has a financial relationship with AVANOS Medical (Alpharetta, Georgia) as a technical consultant.
T37 4012-4282 Sentence denotes Dr. Eckmann has been the applicant for education grants received by the institution (University of Texas Health Science Center, San Antonio, Texas) from Medtronic (Minneapolis, Minnesota), Boston Scientific (Marlborough, Massachusetts), and Abbot (Abbot Park, Illinois).
T38 4283-4453 Sentence denotes None of the above mentioned companies produce equipment related to the work presented here nor are any specific commercial products in this article discussed or promoted.