Abstract
AbstractThe COVID-19 crisis has revealed and exacerbated a shortage of mechanical ventilators in hospitals around the world, regardless of their government’s resources. Where some countries can respond to the situation by ordering more high-end ventilators, the price is often too high for low- and middle-income countries (LMICs) and securing them can be difficult. The goal of this work is to design, prototype, and test a low-cost ventilator, called ETH breathe, based on the automated compression of a resuscitator bag. A holistic and systematic design approach is taken to create a compact and adaptable device that can safely meet the current requirements. This is achieved by using 72% standard parts out of 33 (72%) and prioritizing compactness in the mechanical design. The control system is developed to provide both continuous mandatory ventilation (CMV) and spontaneous breathing support or assist control (AC), which significantly extends the potential use cases beyond patient sedation. The prototype is tested for accuracy, modularity, and oxygen response using a full physiological artificial lung. The results show for the first time in literature that the design operates within the defined requirements, based on emergency government regulations, and can be used with different sizes of resuscitator bags and different positions of the flow sensor. This provides a sound basis for further development of a low-cost, portable mechanical ventilator for potential use in LMICs.
Highlights
Introduction and BackgroundThe COVID-19 crisis is overwhelming healthcare systems around the world
It is measured according to four main parameters: the tidal volume, the breathing rate, the Positive end-expiratory pressure (PEEP), and the I:E ratio
The Medicines and Healthcare products Regulatory Agency (MHRA) guideline requires “±(4.0 +(15% of the actual volume expired through the patient-connection port)) mL” [18] accuracy for the tidal volume, which is the main parameter in a volume-controlled system
Summary
The COVID-19 crisis is overwhelming healthcare systems around the world. In part, to keep up with the increasing demand for medical equipment and supplies to combat the pandemic. One particular challenge has been to provide mechanical ventilation to patients suffering from acute respiratory distress syndrome (ARDS). Universities, medical facilities, and companies have been under pressure to design and produce alternatives to the established medical devices as their countries are put under increasing demand. Many of the proposed solutions are tailored to first world markets, where an average intensive care unit (ICU) ventilator can cost between US $25,000 and US$50,000 [1,2]. Due to the prohibitive cost, lowand middle-income countries (LMICs) were already in shortage of mechanical ventilators before the COVID-19 crisis started [3,4]. Some LMICs do not even have a single ventilator [3]
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