Table 1

Connecting two patients to one ventilator.

Prerequisites:	Emergency situation, no available ventilators Mechanical ventilator with internal flow sensor Double ventilation circuit Passed leakage test Double patient ventilation successfully simulated with two test lungs/balloons in the desired ventilatory settings range Deeply sedated or paralysed patients with similar PBW
Settings:	Set PCV and PEEP with driving pressure ≤15 cmH₂O Switch off inspiratory trigger
Starting procedures:	Connect first patient. Assess Vt and lung mechanics (plateau pressure, static compliance, total PEEP), maintaining the second wye occluded Connect second patient Clamp first patient’s ET during an expiratory hold and perform lung mechanics assessment on second patient (plateau pressure, static compliance, total PEEP) Set longer inspiratory ramp time if desired FiO₂ cannot be reached
Monitoring and alarms:	Set alarm on Vt and FiO₂ at least Monitor SpO₂ at least Monitor EtCO₂ whenever possible Perform ABG regularly
Provide another ventilator as soon as possible

ABG, arterial blood gas test; ET, endotracheal tube; EtCO₂, end-tidal carbon dioxide; FiO₂, fraction of inspired oxygen ; PBW, predicted body weight; PCV, pressure-controlled ventilation; PEEP, positive end-expiratory pressure; SpO₂, peripheral capillary oxygen saturation; Vt, tidal volume.