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Gaceta médica de México

versión On-line ISSN 2696-1288versión impresa ISSN 0016-3813

Gac. Méd. Méx vol.156 no.4 Ciudad de México jul./ago. 2020  Epub 27-Mayo-2021 

Carta al editor

Feasibility of shared mechanical ventilation

Factibilidad de la ventilación mecánica compartida

Jorge Alberto Castañón-González*  1 

Sergio Camacho-Juárez1 

Luis Antonio Gorordo-Delsol1 

Jessica Garduño-López1 

Orlando Pérez-Nieto1 

Marco Antonio Amezcua-Gutiérrez1 

Germán Fernández-de Alba Vejar1 

1Secretaría de Salud, Hospital Juárez de México, Intensive Care Unit, Mexico City, Mexico

We read with interest the letter to the editor sent by Dr. José Luis Sandoval Gutiérrez, where he comments our publication on simultaneous mechanical ventilation for several patients with a single ventilator.1 Therein, he points out that, due to the variability of lung mechanics and the state of severity of patients with acute respiratory distress syndrome, there would be treatment complications; he concludes that it is not yet possible claiming that “where one can be ventilated, two can be ventilated as well.”

In this regard, we specifically answer:

  • 1. In our article, we clearly mention that candidates must have similar pathophysiological processes, for example, COVID-19 pneumonia, and similar conduction pressure, to achieve acceptable tidal volumes and avoid ergotrauma.

  • 2. Recently, at New York Presbyterian Hospital, Dr. Jeremy R. Beitler and his team successfully carried out shared ventilation for 48 hours in three pairs of patients. The publication is in press.2

  • 3. There are variations to this technique whereby two oxygen blenders and positive end-expiratory pressure (PEEP) valves are installed on each branch of the ventilator inspiratory and expiratory circuits, respectively, to dose the fraction of inspired oxygen and PEEP to each patient.3 Although, as Dr. Beitler himself points out in his article, “these biomedical engineering solutions in the presence of a shortage of ventilators and equipment, due to the urgency of circumstances, are not the best clinical solution in this context “.

  • 4. Fortunately, we have not had the need to apply this technique in Mexico, but we can conclude that “where one patient can be ventilated, two can be (safely) ventilated as well”.


1. Castañón-González JA, Camacho-Juárez S, Gorordo-Delsol LA, Garduño-López J, Pérez Nieto O, Amezcua-Gutiérrez MA, Fernández-de Alba Vejar G. Ventilación mecánica simultánea con un solo ventilador a varios pacientes. Gac Med Mex 2020;156:250-253. [ Links ]

2. Beitler JR, Mittel AM, Kallet R, Kacmarek R, Hess D, et al. Ventilator sharing during an acute shortage caused by COVID-19 pandemic. Am J Respir Crit Care Med. 2020 Jun 9. DOI:10.1164/rccm.202005-1586LE [ Links ]

3. Han JS, Mashari A, Singh D, Dianti J, Goliher E, Long M, et al. Personalized ventilation to multiple patients using a single ventilator:Description and proof of concept. Crit Care Explor 2020:2(5);e0118. DOI:10.1097/CCE.0000000000000118 [ Links ]

Received: June 24, 2020; Accepted: June 26, 2020

* Correspondence: Jorge Alberto Castañón-González E-mail:

Creative Commons License Instituto Nacional de Cardiología Ignacio Chávez. Published by Permanyer. This is an open ccess article under the CC BY-NC-ND license