• Leonard Bunting, Steven Roy, Hannah Pinson, Tobin Greensweig, and International Differential Multi-Ventilation Working Group.
• Wayne State University, Detroit, MI, United States of America; Department of Emergency Medicine, Ascension Providence, Southfield, MI, United States of America. Electronic address: Leonard.Bunting@ascension.org.
• Am J Emerg Med. 2020 Oct 1; 38 (10): 2045-2048.

BackgroundVentilator sharing is one option to emergently increase ventilator capacity during a crisis but has been criticized for its inability to adjust for individual patient needs. Newer ventilator sharing designs use valves and restrictors to control pressures for each patient. A key component of these designs is an inline Positive End Expiratory Pressure (PEEP) Valve but these are not readily available. Creating an inline PEEP valve by converting a standard bag-valve-mask PEEP valve is possible with the addition of a 3D printed collar.MethodsThis was a feasibility study assessing the performance and safety of a method for converting a standard PEEP valve into an inline PEEP valve. A collar was designed and printed that covers the exhaust ports of the valve and returns exhaled gases to the ventilator.ResultsThe collar piece was simple to print and easily assembled with the standard PEEP valve. In bench testing it successfully created differential pressures in 2 simulated expiratory limbs without leaking to the atmosphere at pressures greater than 60 cm of H2O.ConclusionOur novel inline PEEP valve design shows promise as an option for building a safer ventilator sharing system.Copyright © 2020 Elsevier Inc. All rights reserved.

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