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Noordergraaf GJ, Froklage R. The Bag-valve-device: Its many production types and models are not clinically equal. Resuscitation 2024; 194:110061. [PMID: 38030116 DOI: 10.1016/j.resuscitation.2023.110061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Revised: 11/16/2023] [Accepted: 11/20/2023] [Indexed: 12/01/2023]
Affiliation(s)
- Gerrit J Noordergraaf
- Department of Anesthesiology, Resuscitation & Pain Management, Elisabeth-TweeSteden Hospital, Hilvarenbeekseweg 60, 5022GC Tilburg, the Netherlands.
| | - Roger Froklage
- Department of Anesthesiology, Resuscitation & Pain Management, Elisabeth-TweeSteden Hospital, Hilvarenbeekseweg 60, 5022GC Tilburg, the Netherlands
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Design and Analysis of a Low-Cost Electronically Controlled Mobile Ventilator, Incorporating Mechanized AMBU Bag, for Patients during COVID-19 Pandemic. JOURNAL OF HEALTHCARE ENGINEERING 2022; 2022:6436818. [PMID: 35368917 PMCID: PMC8968386 DOI: 10.1155/2022/6436818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Revised: 02/05/2022] [Accepted: 02/23/2022] [Indexed: 11/18/2022]
Abstract
The outbreak of novel COVID-19 has severely and unprecedentedly affected millions of people across the globe. The painful respiratory distress caused during this disease calls for external assistance to the victims in the form of ventilation. The most common types of artificial ventilating units available at the healthcare facilities and hospitals are exorbitantly expensive to manufacture, and their number is fairly inadequate even in the so-called developed countries to cater to the burning needs of an ever-increasing number of ailing human subjects. According to available reports, without the provision of ventilation, the novel COVID-19 patients are succumbing to their ailments in a huge number of cases. This colossal problem of the availability of ventilator units can be addressed to a great extent by readily producible and cost-effective ventilating units that can be used on those suffering patients during an acute emergency and in the absence of conventional expensive ventilators at hospitals and medical care units. This paper has made an attempt to design and simulate a simple, yet effective, mechanized ventilator unit, which can be conveniently assembled without a profuse skillset and operated to resuscitate an ailing human patient. The stepper motor-controlled kinematic linkage is designed to deliver the patient with a necessitated discharge of air at optimum oxygen saturation through the AMBU bag connected in a ventilation circuit. With the associated code on MATLAB, the motor control parameters such as angular displacement and speed are deduced according to the input patient conditions (age group, tidal volume, breathing rate, etc.) and thereafter fed to the controller that drives the stepper motor. With a proposed feedback loop, the real-time static and dynamic compliance, airway resistance values can be approximately determined from the pressure variation cycle and fed to the controller unit to adjust the tidal volume as and when necessary. The simplistic yet robust design not only renders easy manufacturability by conventional and rapid prototyping techniques like 3D printing at different scales but also makes the product easily portable with minimal handling difficulty. Keeping the motto of Health for All as envisioned by the WHO, this low-cost indigenously engineered ventilator will definitely help the poor and afflicted towards their right to health and will help the medical professionals buy some time to manage the patient with acute respiratory distress syndrome (ARDS) towards recovery. Moreover, this instrument mostly includes readily available functional units having standard specifications and can be considered as standard bought-out items.
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Mathanlal T, Israel Nazarious M, Mantas-Nakhai R, Zorzano MP, Martin-Torres J. ATMO-vent: An adapted breathing atmosphere for COVID-19 patients. HARDWAREX 2020; 8:e00145. [PMID: 33015423 PMCID: PMC7518965 DOI: 10.1016/j.ohx.2020.e00145] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 09/16/2020] [Accepted: 09/16/2020] [Indexed: 06/11/2023]
Abstract
The ongoing worldwide pandemic of coronavirus disease 2019 (COVID-19), has been one of the most significant challenges to humankind in centuries. The extremely contagious nature of the SARS-CoV-2 virus has put forth an immense pressure on the health sector. In order to mitigate the stress on the healthcare systems especially to battle the crisis of mechanical ventilators, we have designed a modular, and robust DIY ventilator, ATMO-Vent (Atmospheric Mixture Optimization Ventilator) which can be fully mounted within two days by two operators. The ATMO-Vent has been designed using low-cost, robust, Commercial Off The Shelf (COTS) components, with many features comparable to a full-fledged ventilator. ATMO-Vent has been designed based on the United Kingdom Medicines & Healthcare products Regulatory Agency (UK-MHRA) guidelines for Rapidly Manufactured Ventilator System (RMVS), yet is scalable to the specific requirements of different countries. ATMO-Vent is capable of adjusting the Fraction of Inspiratory Oxygen (FiO2) levels, Tidal Volume (TV), frequency of breaths, Inspiratory/Expiratory ratio (I/E), Peak Inspiratory Pressure (PIP) and Positive End-Expiratory Pressure (PEEP). ATMO-Vent can operate in two modes - Continuous Mandatory Ventilation (CMV) using Volume-Controlled Ventilation (VCV) and in Assisted Control (AC) mode with pressure triggered by the patient. ATMO-Vent has undergone rigorous testing and qualifies under Class B Electric and Magnetic Compatibility (EMC) requirements of EN 55,011 CISPR 11 standards.
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Affiliation(s)
- Thasshwin Mathanlal
- Group of Atmospheric Science, Department of Computer Science, Electrical and Space Engineering, Luleå, University of Technology, Luleå 97 187, Sweden
| | - Miracle Israel Nazarious
- Group of Atmospheric Science, Department of Computer Science, Electrical and Space Engineering, Luleå, University of Technology, Luleå 97 187, Sweden
| | - Roberto Mantas-Nakhai
- Group of Atmospheric Science, Department of Computer Science, Electrical and Space Engineering, Luleå, University of Technology, Luleå 97 187, Sweden
| | - Maria-Paz Zorzano
- Group of Atmospheric Science, Department of Computer Science, Electrical and Space Engineering, Luleå, University of Technology, Luleå 97 187, Sweden
- Centro de Astrobiología (CSIC-INTA), Torrejon de Ardoz, 28850 Madrid, Spain
- School of Geosciences, University of Aberdeen, Meston Building, King's College, Aberdeen AB24 3UE, UK
| | - Javier Martin-Torres
- Group of Atmospheric Science, Department of Computer Science, Electrical and Space Engineering, Luleå, University of Technology, Luleå 97 187, Sweden
- Instituto Andaluz de Ciencias de la Tierra (CSIC-UGR), 18100 Granada, Spain
- School of Geosciences, University of Aberdeen, Meston Building, King's College, Aberdeen AB24 3UE, UK
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de Beer DAH, Nesbitt FD, Bell GT, Rapuleng A. The Universal Anaesthesia Machine (UAM): assessment of a new anaesthesia workstation built with global health in mind. Anaesthesia 2016; 72:444-451. [DOI: 10.1111/anae.13752] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/17/2016] [Indexed: 11/29/2022]
Affiliation(s)
- D. A. H. de Beer
- Department of Anaesthesia; Great Ormond Street Hospital for Children NHS Foundation Trust; London UK
| | - F. D. Nesbitt
- Department of Anaesthesia; Homerton Hospital; London UK
| | - G. T. Bell
- Department of Anaesthesia; Royal Hospital for Children; Glasgow UK
| | - A. Rapuleng
- Department of Biomedical Engineering; Great Ormond Street Hospital for Children NHS Foundation Trust; London UK
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From mouth-to-mouth to bag-valve-mask ventilation: evolution and characteristics of actual devices--a review of the literature. BIOMED RESEARCH INTERNATIONAL 2014; 2014:762053. [PMID: 24971346 PMCID: PMC4058195 DOI: 10.1155/2014/762053] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/25/2014] [Accepted: 03/19/2014] [Indexed: 12/03/2022]
Abstract
Manual ventilation is a vital procedure, which remains difficult to achieve for patients who require ventilatory support. It has to be performed by experienced healthcare providers that are regularly trained for the use of bag-valve-mask (BVM) in emergency situations. We will give in this paper, a historical view on manual ventilation's evolution throughout the last decades and describe the technical characteristics, advantages, and hazards of the main devices currently found in the market. Artificial ventilation has developed progressively and research is still going on to improve the actual devices used. Throughout the past years, a brand-new generation of ventilators was developed, but little was done for manual ventilation. Many adverse outcomes due to faulty valve or misassembly were reported in the literature, as well as some difficulties to ensure efficient insufflation according to usual respiratory parameters. These serious incidents underline the importance of BVM system routine check and especially the unidirectional valve reassembly after sterilization, by only experienced and trained personnel. Single use built-in devices may prevent disassembly problems and are safer than the reusable ones. Through new devices and technical improvements, the safety of BVM might be increased.
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