NHS could let TWO coronavirus patients use the same ventilator to boost intensive care capacity

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The NHS could allow doctors to hook two patients up to one ventilator if the coronavirus crisis overwhelms hospitals in the UK.

Currently the intensive care machines are limited to a one-to-one ratio but if critical care units become stacked with patients this could have to be reconsidered.

The risk of infection becomes higher if more than one person is connected to the same machine but one expert in the UK said there was ‘no debate’.

Medics in New York have already been permitted to try the technique by the state’s governor, Andrew Cuomo.

The UK is not known to have allowed it yet, but the country is facing a severe shortage of ventilators and has had to draft in vacuum cleaner and plane engine manufacturers to make more to plug a shortfall. 

The Government is in a race to get capacity up from 8,000 to 30,000 but has admitted that many of them won’t be available for months, by which time it could be too late. 

Ventilators are crucial to helping severely ill coronavirus patients to recover – they are machines which pump oxygen in someone’s lungs when they become unable to breathe on their own (Pictured, an intensive care doctor in Germany stands beside a ventilator)

Ventilators are used to help a person breathe if they have lung disease or another condition that makes breathing difficult. They work by pumping air into people's lungs if they don't work properly

Ventilators are used to help a person breathe if they have lung disease or another condition that makes breathing difficult. They work by pumping air into people’s lungs if they don’t work properly

NHS planners are considering relaxing the rules on using ventilators in a bid to instantly expand the UK’s intensive care capacity, The Guardian reports. 

Thousands of people are already being hospitalised by the coronavirus and many need intensive care if they develop serious infections. 

The survival rate in intensive care is said to be around 50/50 so it’s vital that patients have the right equipment – for those with lung infections this includes a ventilator.

An NHS chief yesterday warned that extra capacity being created for the NHS is being used up ‘very quickly’.

Allowing ventilators to be used for two patients at a time could double capacity in one fell swoop in some areas. 

The biggest drawback is a risk of bacterial infection which can be triggered by inserting tubes directly into people’s airways, which are sensitive and usually protected by the nose and throat.

UK IN SCRAMBLE TO BOOST VENTILATOR CAPACITY 

The UK Government has admitted it might take ‘months’ to bring in thousands of ventilators for the NHS – despite fears that the coronavirus outbreak could peak at Easter.

The Prime Minister’s spokesman said 8,000 of the vital machines had been sourced, as part of efforts to bolster the health service’s capacity to 16,000.

However, while many of those should be in use ‘in the coming weeks’, a spokesman for the Prime Minister suggested ‘thousands’ would take much longer.

Experts believe the NHS will need at least 30,000 of the devices to avoid huge numbers of deaths when the outbreak is at its height.

The comments came as separate efforts to get manufacturers to produce ventilators took a step forward with the Government ordering 10,000 from Dyson – despite the engineering giant never making them before. 

The British firm, most famous for its vacuum cleaners, says it has a prototype tested on humans and could start delivering them from mid-April, pending ‘regulatory approval’.

The Prime Minister’s official spokesman thanked businesses for an ‘overwhelming response’ to the drive to build the vital machines for those who are critically ill.

‘Safety of those who need this vital equipment is our absolute priority. We are now testing proof of concepts from a number of suppliers in the coming days with the support of expert clinicians and health regulators,’ he said.

‘New orders are all dependent on machines passing regulatory tests; this is the case with Dyson. Their machines must meet the necessary safety and regulatory standards – if they do not they will not be brought or rolled out to hospitals.’

Professor Paul Hunter, an infectious diseases expert at the University of East Anglia, told MailOnline: ‘Normally I would worry about possible cross infection between the patients using the same device.

‘But if it is a choice between certain death for half the patients and the possibility of a subsequent bacterial chest infection. I do not think there is any debate.’

Professor Mark Tooley, from the Royal Academy of Engineering, was sceptical and added: ‘I have never heard of ventilators being shared between multiple patients as the process of ventilation is very personal – the controls and sensors are set to satisfy an individual patient needs and wellbeing.

‘The risk of infection would also be high if used for seriously ill patients. In theory it could be possible, but it would be a very complex procedure, fraught with issues.

‘As far I as I can tell, it has only been done as a simulation, many years ago, and never on real-life patients.’

A study in 2006 tested splitting a ventilator as many as four ways on artificial lungs and found that it could be done in a way which benefited all the ‘patients’.  

Researchers used a single ventilator to help four fake patients breathe at the same time for 12 hours by connecting a series of plastic tubes to the device.

They were able to split the flow of oxygen four ways and redirect it into lung simulators using cheap tubes that are readily available in all hospitals.

The method could be used as a last resort by frontline medics if health services are overrun by patients whose lungs have failed, researchers said. 

Dr Charlene Babcock, a doctor at St John’s Hospital and Medical Center in Detroit, did the study 14 years ago but the results were based on adults weighing 11 stone (70kg) and who were otherwise healthy.

A 2006 study used a single ventilator to help four artificial sets of lungs breathe at the same time for 12 hours by connecting a series of plastic tubes to the device

A 2006 study used a single ventilator to help four artificial sets of lungs breathe at the same time for 12 hours by connecting a series of plastic tubes to the device

Dr Charlene Babcock, from St John's Hospital and Medical Center in Detroit, has posted a video on YouTube demonstrating how to modify ventilators

Dr Charlene Babcock, from St John’s Hospital and Medical Center in Detroit, has posted a video on YouTube demonstrating how to modify ventilators 

In reality, severely ill coronavirus patients are likely to be overweight and to have other health conditions such as asthma or chronic lung disease.  

Dr Babcock last week created a YouTube video showing how modern ventilators could be repurposed.

In it, she shows how to connect tubes normally used for tracheotomies to modify the ventilators.

But the doctor admits the study was limited because it did not look at humans and instead used lung simulators.

Writing in the study, she says: ‘The chief limitation of this study is that it is a simulator study. Therefore, only successful physical ventilation could be demonstrated. 

‘The presumption of equal ventilation to all four lung simulators presumed equal lung physiology. 

‘A patient with asthma with greater resistance to ventilations may not receive equal ventilation with this system.’