New York will allow two patients to share a single ventilator

New York state has approved technology that allows two patients to share a single ventilator, in an effort to address a desperate need as the number of coronavirus patients in the state rocketed past 37,000.

Gov. Andrew Cuomo on Thursday referred to the method as “splitting” and said it involves adding a second set of tubes to a ventilator.

“It’s not ideal,” Cuomo said, “but we believe it’s workable.”

The governor has repeatedly said the state needs at least 30,000 ventilators to treat coronavirus patients, but it has only a fraction of that. Cuomo said Wednesday that New York has 4,000 ventilators in the hospital system and the federal government has sent another 4,000. The state has purchased an additional 7,000 and is looking for more.

He explained Thursday that the demand for ventilators is so high, in part, because some Covid-19 patients need them for an extended period of time. Patients in other situations are typically on ventilators for three to four days, Cuomo said, while Covid-19 patients are on them anywhere from 11 to 21 days.

The governor previewed the “experimental” splitting strategy on Tuesday, saying, “We have no alternative.”

At least one hospital is already using the method. Dr. Emile Bacha, chief of the division of cardiac, thoracic and vascular surgery at Columbia University Irving Medical Center in New York City, said Thursday that operating rooms had been turned into intensive care units, “with one ventilator serving for two patients.”

The state is exploring converting anesthesia machines to works as ventilators, the governor said. But New York officials continue to search for more ventilators to add to their supply.

“We’re still shopping for ventilators all across the country,” Cuomo said. “We need more.”

Sharing ventilators presents ‘myriad issues,’ expert says

Asked whether splitting ventilators between patients could work, Dr. Mary Dale Peterson, president of the American Society of Anesthesiologists, told CNN, “The short answer is no.”

Sharing ventilators, she said, would present “myriad issues you would have to contend with.”

It’s not difficult to hook more than one patient up to a ventilator, Peterson said, and if there were two patients who were in the same situation, with “exactly the same size and lung compliance and disease process, it could maybe work.”

But many patients will have different requirements, and the settings on each ventilator need to be tailored to each patient’s needs. Some patients will need different levels of oxygen, for example.

“So you can imagine, one patient who has one requirement, another patient has the opposite requirement,” Peterson said. “So you actually may do a disservice — you will do disservice to both patients.”

Peterson favors the idea of repurposing anesthesia machines, of which there are more than 70,000 in the country, she said.

“We have ventilators on all of our anesthesia machines in every single operating room and ambulatory care center in the nation,” she told CNN.

“Before resorting to something that we believe would probably harm more patients,” she added, “we need to fully utilize the resources that area already there that can actually save lives.”