We are all too familiar with the rapid spread and expansion of the novel coronavirus severe acute respiratory syndrome coronavirus 2 beginning in late fall 2019 (i.e., COVID-19) to its being named a worldwide pandemic by the World Health Organization on March 11, 2020.1 Nation after nation followed with declaring national emergencies and due to overwhelming burden of acute respiratory distress syndrome (ARDS) leading to respiratory failure needing invasive mechanical ventilation health systems worldwide were overrun. The shear number of critically ill patients with ARDS needing ventilators leads to hospitals being left with few to no bed availability with patients being houses worldwide in makeshift wards. Beyond the need for beds, the need for ventilators to support patients during their (often protracted) critical illness was in short supply leading to heartbreaking rationing of resources.2,3

Across the world, makeshift ventilator apparati were constructed, with varying degrees of success. One novel approach of splitting ventilators emerged and obtained Food and Drug Administration (FDA) Emergency Use Authorization.4 The ventilator sharing and monitoring system, which is a mechanical device that can split one ventilator among four patients with electronic monitoring. This mechanical system with electronic monitoring in technology enables titration of peak inspiratory pressure, tidal volume and positive end-expiratory pressure for up, VT, and PEEP for (up to 4) individual, simultaneously ventilated patients.

This technology and bioengineering team approach is a wonderful example of engineering and medicine coming together to solve daunting physiologic problems. This consortia with expertise from Stanford’s Departments of Cardiothoracic Surgery, Bioengineering, Mechanical Engineering and Comparative Medicine teamed with Bloom Energy to rapidly characterize the problem, identify a potential solution, model and develop prototype devices and controllers, test and refine in vivo and then in vitro. Ultimately, they were able to bring the concept and results to the FDA to attain Emergency Use Authorization and provide the technology, which has unique advantages in resource-limited times and areas.

This merging of engineering and medicine expertise to quickly and efficiently combine strengths of academia and industry is to be commended in this time of worldwide unrest. This serves as a model of how multidisciplinary collaborations result in effective bioengineering solutions addressing pressing real-world medical challenges.

1. Centers for Disease Control and Prevention. (2022, August 16). CDC Museum Covid-19 timeline. Centers for Disease Control and Prevention. Retrieved August 28, 2022, from https://www.cdc.gov/museum/timeline/covid19.html. 2. Ranney ML, Griffeth V, Jha AK: Critical supply shortages - The need for ventilators and personal protective equipment during the Covid-19 pandemic. N Engl J Med 382: e41, 2020. 3. White DB, Lo B: A framework for rationing ventilators and critical care beds during the COVID-19 pandemic. JAMA 323: 1773–1774, 2020. 4. Paulsen MJ, Zhu Y, Park M, et al.: FDA EUA approved novel COVID-19, pressure-regulated, mechanical ventilator splitter that enables differential compliance multiplexing. ASAIO J 68: 1228–1231,2022.