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Giraldo-Cadavid LF, Echeverry J, Varón-Vega F, Bastidas A, Ramírez-Jaime A, Cardona AF, Lopez Vega CJ, Serrano-Mayorca CC, Garay D, Rincón DN, Oliveros H, Ramírez IA, Garcia-Gallo E, Enciso-Prieto VA, Ibáñez-Prada ED, Camelo JC, Cucunubo L, Buitrago L, Paipa LA, Longas LC, Agudelo-Otálora LM, Porras Diaz NF, Rachid RR, Henao I RD, Pedraza S, Reyes LF. The development and implementation of a low-cost mechanical ventilator in a low-middle-income country during the COVID-19 pandemic: The Unisabana-HERONS. Heliyon 2024; 10:e30671. [PMID: 38756610 PMCID: PMC11096896 DOI: 10.1016/j.heliyon.2024.e30671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 04/02/2024] [Accepted: 05/01/2024] [Indexed: 05/18/2024] Open
Abstract
Background The COVID-19 pandemic in Latin America generated the need to develop low-cost, fast-manufacturing mechanical ventilators. The Universidad de La Sabana and the Fundacion Neumologica Colombiana designed and manufactured the Unisabana-HERONS (USH) ventilator. Here, we present the preclinical and clinical study results to evaluate its effectiveness and safety characteristics in an animal model (Yorkshire Sow) and five patients with acute respiratory failure receiving mechanical ventilatory support for 24 h. Methods The effectiveness and safety outcomes included maintaining arterial blood gases and pulse oximetry saturation (SpO2), respiratory pressures and volumes (during continuous monitoring) in the range of ARDS and lung-protective strategy goals, and the occurrence of barotrauma. A significance level of 0.05 was used for statistical tests. This clinical trial was registered on Clinicaltrials.gov (NCT04497623) and approved by the ethics committee. Results Among patients treated with the Unisabana-HERONS, the most frequent causes of acute respiratory failure were pneumonia in 3/5 (60 %) and ARDS in 2/5 (40 %). During the treatment, the ventilatory parameters related to lung protection protocols were kept within the safety range, and vital signs and blood gas were stable. The percentage of time that the respiratory pressures or volumes were out of safety range were plateau pressure >30 cm H2O: 0.00 %; driving pressure >15 cm H2O: 0.06 %; mechanical power >15 J/min: 0.00 %; and Tidal volume >8 mL/kg: 0.00 %. There were no adverse events related to the ventilator. The usability questionnaire retrieved a median score for all items between 9 and 10 (best score: 10), indicating great ease of use. Conclusion The Unisabana-HERONS ventilator effectively provided adequate gas exchange and maintained the ventilatory parameters in the range of lung protection strategies in humans and an animal model. Furthermore, it is straightforward to use and is a low-cost medical device.
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Affiliation(s)
| | | | - Fabio Varón-Vega
- Fundación Neumológica Colombiana, Bogotá, Colombia
- Universidad de Navarra, Pamplona, Spain
| | | | - Andrés Ramírez-Jaime
- Universidad de La Sabana, Chía, Colombia
- Universidad de Los Andes, Bogotá, Colombia
| | | | - Cristian Joao Lopez Vega
- Fundación Clínica Shaio, Bogotá, Colombia
- Fundación Cardioinfantil Instituto de Cardiología, Bogotá, Colombia
- Universidad Nacional de Colombia, Bogotá, Colombia
| | | | - Diana Garay
- Universidad de La Sabana, Chía, Colombia
- Clínica Universidad de La Sabana, Chía, Colombia
| | | | | | | | | | | | - Elsa D. Ibáñez-Prada
- Universidad de La Sabana, Chía, Colombia
- Clínica Universidad de La Sabana, Chía, Colombia
| | | | | | | | | | | | | | | | | | | | - Santiago Pedraza
- Universidad de La Sabana, Chía, Colombia
- Clínica Universidad de La Sabana, Chía, Colombia
| | - Luis Felipe Reyes
- Universidad de La Sabana, Chía, Colombia
- Clínica Universidad de La Sabana, Chía, Colombia
- Pandemic Sciences Institute, University of Oxford, Oxford, United Kingdom
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Buytaert J, Collins P, Abed Abud A, Allport P, Pazos Álvarez A, Akiba K, de Aguiar Francisco OA, Bay A, Bernard F, Baron S, Bertella C, Brunner JX, Bowcock T, Buytaert-De Jode M, Byczynski W, De Carvalho R, Coco V, Collins R, Dikic N, Dousse N, Dowd B, Dreimanis K, Dumps R, Durante P, Fadel W, Farry S, Fernàndez Prieto A, Fernàndez Tèllez A, Flynn G, Franco Lima V, Frei R, Gallas Torreira A, García Chàvez T, Gazis E, Guida R, Hennessy K, Henriques A, Hutchcroft D, Ilic S, Ivanovs A, Jevtic A, Jimenez Dominguez E, Joram C, Kapusniak K, Lemos Cid E, Lindner J, Lindner R, Ivàn Martínez Hernàndez M, Meboldt M, Milovanovic M, Mico S, Morant J, Morel M, Männel G, Murray D, Nasteva I, Neufeld N, Neuhold I, Pardo-Sobrino López F, Pèrez Trigo E, Pichel Jallas G, Pilorz E, Piquilloud L, Pons X, Reiner D, Règules Medel HD, Rodríguez Ramírez S, Rodíguez Cahuantzi M, Roosens C, Rostalski P, Sanders F, Saucet E, Schmid Daners M, Schmidt B, Schoettker P, Schwemmer R, Schindler H, Sharma A, Sivakumaran D, Sigaud C, Spitas V, Steffen N, Svihra P, Tejeda Muñoz G, Tachatos N, Tsolakis E, van Leemput J, Vignaux L, Vasey F, Woonton H, Wyllie K. The HEV Ventilator: at the interface between particle physics and biomedical engineering. ROYAL SOCIETY OPEN SCIENCE 2022; 9:211519. [PMID: 35308626 PMCID: PMC8924767 DOI: 10.1098/rsos.211519] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 02/17/2022] [Indexed: 05/03/2023]
Abstract
A high-quality, low-cost ventilator, dubbed HEV, has been developed by the particle physics community working together with biomedical engineers and physicians around the world. The HEV design is suitable for use both in and out of hospital intensive care units, provides a variety of modes and is capable of supporting spontaneous breathing and supplying oxygen-enriched air. An external air supply can be combined with the unit for use in situations where compressed air is not readily available. HEV supports remote training and post market surveillance via a Web interface and data logging to complement standard touch screen operation, making it suitable for a wide range of geographical deployment. The HEV design places emphasis on the ventilation performance, especially the quality and accuracy of the pressure curves, reactivity of the trigger, measurement of delivered volume and control of oxygen mixing, delivering a global performance which will be applicable to ventilator needs beyond the COVID-19 pandemic. This article describes the conceptual design and presents the prototype units together with a performance evaluation.
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Affiliation(s)
- Jan Buytaert
- European Organization for Nuclear Research, Espl. des Particules 1, 1211 Meyrin, Geneva, Switzerland
| | - Paula Collins
- European Organization for Nuclear Research, Espl. des Particules 1, 1211 Meyrin, Geneva, Switzerland
- Oliver Lodge Laboratory, University of Liverpool, Liverpool L69 7ZE, UK
| | - Adam Abed Abud
- European Organization for Nuclear Research, Espl. des Particules 1, 1211 Meyrin, Geneva, Switzerland
- Oliver Lodge Laboratory, University of Liverpool, Liverpool L69 7ZE, UK
| | - Phil Allport
- Particle Physics Group, School of Physics and Astronomy, University of Birmingham, Birmingham B15 2TT, UK
| | - Antonio Pazos Álvarez
- Instituto Galego de Física de Altas Enerxías (IGFAE), Universidade de Santiago de Compostela, Santiago de Compostela, 15782 Galicia, Spain
| | - Kazuyoshi Akiba
- Nikhef National Institute for Subatomic Physics, Amsterdam 1098 XG, The Netherlands
| | - Oscar Augusto de Aguiar Francisco
- European Organization for Nuclear Research, Espl. des Particules 1, 1211 Meyrin, Geneva, Switzerland
- Department of Physics and Astronomy, University of Manchester, Manchester M13 9PL, UK
| | - Aurelio Bay
- Institute of Physics, Ecole Polytechnique Fédérale de Lausanne (EPFL), CH-1015 Lausanne, Switzerland
| | - Florian Bernard
- Institute of Physics, Ecole Polytechnique Fédérale de Lausanne (EPFL), CH-1015 Lausanne, Switzerland
| | - Sophie Baron
- European Organization for Nuclear Research, Espl. des Particules 1, 1211 Meyrin, Geneva, Switzerland
| | - Claudia Bertella
- European Organization for Nuclear Research, Espl. des Particules 1, 1211 Meyrin, Geneva, Switzerland
| | | | - Themis Bowcock
- Oliver Lodge Laboratory, University of Liverpool, Liverpool L69 7ZE, UK
| | - Martine Buytaert-De Jode
- European Organization for Nuclear Research, Espl. des Particules 1, 1211 Meyrin, Geneva, Switzerland
| | - Wiktor Byczynski
- European Organization for Nuclear Research, Espl. des Particules 1, 1211 Meyrin, Geneva, Switzerland
- Tadeusz Kosciuszko Cracow University of Technology, 31-155 Cracow, Poland
| | | | - Victor Coco
- European Organization for Nuclear Research, Espl. des Particules 1, 1211 Meyrin, Geneva, Switzerland
| | - Ruth Collins
- Department of Molecular Medicine, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA
| | - Nikola Dikic
- Applied Physics Laboratory, Faculty of Electronic Engineering, University of Nis˘, Aleksandra Medvedeva 14, Nis˘ 18000, Serbia
| | - Nicolas Dousse
- Hôpitaux Universitaires de Genève, 1205 Genève, Switzerland
| | - Bruce Dowd
- Prince of Wales Hospital, Randwick, New South Wales 2052, Australia
| | - Kārlis Dreimanis
- Centre of High-Energy Physics and Accelerator Technologies and Faculty of Computer Science and Information Technology, Riga Technical University, 1 Kalku Street, Riga LV-1658, Latvia
| | - Raphael Dumps
- European Organization for Nuclear Research, Espl. des Particules 1, 1211 Meyrin, Geneva, Switzerland
| | - Paolo Durante
- European Organization for Nuclear Research, Espl. des Particules 1, 1211 Meyrin, Geneva, Switzerland
| | - Walid Fadel
- European Organization for Nuclear Research, Espl. des Particules 1, 1211 Meyrin, Geneva, Switzerland
| | - Stephen Farry
- Oliver Lodge Laboratory, University of Liverpool, Liverpool L69 7ZE, UK
| | - Antonio Fernàndez Prieto
- Instituto Galego de Física de Altas Enerxías (IGFAE), Universidade de Santiago de Compostela, Santiago de Compostela, 15782 Galicia, Spain
| | - Arturo Fernàndez Tèllez
- Facultad de Ciencias Físico Matemàticas, Benèmerita Universidad Autónoma de Puebla, Apartado Postal 165, 72000 Puebla, Pue., Mèxico
| | - Gordon Flynn
- Prince of Wales Hospital, Randwick, New South Wales 2052, Australia
- University of New South Wales, Sydney, New South Wales 2052, Australia
| | | | - Raymond Frei
- Institute of Physics, Ecole Polytechnique Fédérale de Lausanne (EPFL), CH-1015 Lausanne, Switzerland
| | - Abraham Gallas Torreira
- Instituto Galego de Física de Altas Enerxías (IGFAE), Universidade de Santiago de Compostela, Santiago de Compostela, 15782 Galicia, Spain
| | - Tonatiuh García Chàvez
- Facultad de Ciencias Físico Matemàticas, Benèmerita Universidad Autónoma de Puebla, Apartado Postal 165, 72000 Puebla, Pue., Mèxico
| | - Evangelos Gazis
- National Technical University of Athens - NTUA, Zografou Campus, 15780 Athens, Greece
| | - Roberto Guida
- European Organization for Nuclear Research, Espl. des Particules 1, 1211 Meyrin, Geneva, Switzerland
| | - Karol Hennessy
- Oliver Lodge Laboratory, University of Liverpool, Liverpool L69 7ZE, UK
| | - Andre Henriques
- European Organization for Nuclear Research, Espl. des Particules 1, 1211 Meyrin, Geneva, Switzerland
| | - David Hutchcroft
- Oliver Lodge Laboratory, University of Liverpool, Liverpool L69 7ZE, UK
| | - Stefan Ilic
- Applied Physics Laboratory, Faculty of Electronic Engineering, University of Nis˘, Aleksandra Medvedeva 14, Nis˘ 18000, Serbia
| | - Artūrs Ivanovs
- Centre of High-Energy Physics and Accelerator Technologies and Faculty of Computer Science and Information Technology, Riga Technical University, 1 Kalku Street, Riga LV-1658, Latvia
| | | | - Emigdio Jimenez Dominguez
- Facultad de Ciencias Físico Matemàticas, Benèmerita Universidad Autónoma de Puebla, Apartado Postal 165, 72000 Puebla, Pue., Mèxico
| | - Christian Joram
- European Organization for Nuclear Research, Espl. des Particules 1, 1211 Meyrin, Geneva, Switzerland
| | - Kacper Kapusniak
- European Organization for Nuclear Research, Espl. des Particules 1, 1211 Meyrin, Geneva, Switzerland
| | - Edgar Lemos Cid
- Instituto Galego de Física de Altas Enerxías (IGFAE), Universidade de Santiago de Compostela, Santiago de Compostela, 15782 Galicia, Spain
| | - Jana Lindner
- University of Applied Sciences Offenburg, 77652 Offenburg, Baden-Wuerttemberg, Germany
| | - Rolf Lindner
- European Organization for Nuclear Research, Espl. des Particules 1, 1211 Meyrin, Geneva, Switzerland
| | - M. Ivàn Martínez Hernàndez
- Facultad de Ciencias Físico Matemàticas, Benèmerita Universidad Autónoma de Puebla, Apartado Postal 165, 72000 Puebla, Pue., Mèxico
| | - Mirko Meboldt
- Product Development Group Zurich, Department of Mechanical and Process Engineering, ETH Zurich, 8092 Zurich, Switzerland
| | - Marko Milovanovic
- European Organization for Nuclear Research, Espl. des Particules 1, 1211 Meyrin, Geneva, Switzerland
- Deutsches Elektronen-Synchrotron (DESY), Platanenallee 6, 15738 Zeuthen, Germany
| | - Sylvain Mico
- European Organization for Nuclear Research, Espl. des Particules 1, 1211 Meyrin, Geneva, Switzerland
| | - Johan Morant
- European Organization for Nuclear Research, Espl. des Particules 1, 1211 Meyrin, Geneva, Switzerland
| | - Michel Morel
- European Organization for Nuclear Research, Espl. des Particules 1, 1211 Meyrin, Geneva, Switzerland
| | - Georg Männel
- Fraunhofer Research Institution for Individualized and Cell-based Medical Engineering (IMTE), 23562 Lübeck, Germany
| | - Dónal Murray
- Department of Physics and Astronomy, University of Manchester, Manchester M13 9PL, UK
| | - Irina Nasteva
- Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro 21941-972, Brazil
| | - Niko Neufeld
- European Organization for Nuclear Research, Espl. des Particules 1, 1211 Meyrin, Geneva, Switzerland
| | - Igor Neuhold
- European Organization for Nuclear Research, Espl. des Particules 1, 1211 Meyrin, Geneva, Switzerland
| | | | - Eliseo Pèrez Trigo
- Instituto Galego de Física de Altas Enerxías (IGFAE), Universidade de Santiago de Compostela, Santiago de Compostela, 15782 Galicia, Spain
| | - Gonzalo Pichel Jallas
- Instituto Galego de Física de Altas Enerxías (IGFAE), Universidade de Santiago de Compostela, Santiago de Compostela, 15782 Galicia, Spain
| | - Edyta Pilorz
- European Organization for Nuclear Research, Espl. des Particules 1, 1211 Meyrin, Geneva, Switzerland
| | - Lise Piquilloud
- Adult Intensive Care Unit, University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Xavier Pons
- European Organization for Nuclear Research, Espl. des Particules 1, 1211 Meyrin, Geneva, Switzerland
| | - David Reiner
- John Curtin School of Medical Research, Canberra, Australian Capital Territory 2600, Australia
| | - Hector David Règules Medel
- Facultad de Ciencias Físico Matemàticas, Benèmerita Universidad Autónoma de Puebla, Apartado Postal 165, 72000 Puebla, Pue., Mèxico
| | - Saul Rodríguez Ramírez
- Facultad de Ciencias Físico Matemàticas, Benèmerita Universidad Autónoma de Puebla, Apartado Postal 165, 72000 Puebla, Pue., Mèxico
| | - Mario Rodíguez Cahuantzi
- Facultad de Ciencias Físico Matemàticas, Benèmerita Universidad Autónoma de Puebla, Apartado Postal 165, 72000 Puebla, Pue., Mèxico
| | | | - Philipp Rostalski
- Institute for Electrical Engineering in Medicine, University of Lübeck, 23562 Lübeck, Germany
- Fraunhofer Research Institution for Individualized and Cell-based Medical Engineering (IMTE), 23562 Lübeck, Germany
| | - Freek Sanders
- European Organization for Nuclear Research, Espl. des Particules 1, 1211 Meyrin, Geneva, Switzerland
| | - Eric Saucet
- Hôpitaux Universitaires de Genève, 1205 Genève, Switzerland
| | - Marianne Schmid Daners
- Product Development Group Zurich, Department of Mechanical and Process Engineering, ETH Zurich, 8092 Zurich, Switzerland
| | - Burkhard Schmidt
- European Organization for Nuclear Research, Espl. des Particules 1, 1211 Meyrin, Geneva, Switzerland
| | | | - Rainer Schwemmer
- European Organization for Nuclear Research, Espl. des Particules 1, 1211 Meyrin, Geneva, Switzerland
| | - Heinrich Schindler
- European Organization for Nuclear Research, Espl. des Particules 1, 1211 Meyrin, Geneva, Switzerland
| | - Archana Sharma
- European Organization for Nuclear Research, Espl. des Particules 1, 1211 Meyrin, Geneva, Switzerland
| | - Derick Sivakumaran
- Product Development Group Zurich, Department of Mechanical and Process Engineering, ETH Zurich, 8092 Zurich, Switzerland
| | - Christophe Sigaud
- European Organization for Nuclear Research, Espl. des Particules 1, 1211 Meyrin, Geneva, Switzerland
| | - Vasilios Spitas
- National Technical University of Athens - NTUA, Zografou Campus, 15780 Athens, Greece
| | - Nicola Steffen
- Product Development Group Zurich, Department of Mechanical and Process Engineering, ETH Zurich, 8092 Zurich, Switzerland
| | - Peter Svihra
- Department of Physics and Astronomy, University of Manchester, Manchester M13 9PL, UK
| | - Guillermo Tejeda Muñoz
- Facultad de Ciencias Físico Matemàticas, Benèmerita Universidad Autónoma de Puebla, Apartado Postal 165, 72000 Puebla, Pue., Mèxico
| | - Nikolaos Tachatos
- Product Development Group Zurich, Department of Mechanical and Process Engineering, ETH Zurich, 8092 Zurich, Switzerland
| | - Efstratios Tsolakis
- National Technical University of Athens - NTUA, Zografou Campus, 15780 Athens, Greece
| | | | - Laurence Vignaux
- Cardio-Respiratory Units, Hôpital de La Tour, 1217 Meyrin, Switzerland
| | - Francois Vasey
- European Organization for Nuclear Research, Espl. des Particules 1, 1211 Meyrin, Geneva, Switzerland
| | - Hamish Woonton
- Monash Health, Melbourne, Victoria 3168, Australia
- Dandenong Hospital, Melbourne, Victoria 3175, Australia
| | - Ken Wyllie
- European Organization for Nuclear Research, Espl. des Particules 1, 1211 Meyrin, Geneva, Switzerland
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