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Venkatachari M, Arun Babu T. Comparison of Efficacy of Pressure Controlled vs. Traditional Manual Mask Ventilation for Newborn Resuscitation - A Simulation-Based Pilot Randomized Control Trial: Correspondence. Indian J Pediatr 2024:10.1007/s12098-024-05053-w. [PMID: 38270752 DOI: 10.1007/s12098-024-05053-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 01/18/2024] [Indexed: 01/26/2024]
Affiliation(s)
- Mahesh Venkatachari
- Department of Pediatrics, All India Institute of Medical Sciences (AIIMS), Mangalagiri, Andhra Pradesh, 522 503, India
| | - Thirunavukkarasu Arun Babu
- Department of Pediatrics, All India Institute of Medical Sciences (AIIMS), Mangalagiri, Andhra Pradesh, 522 503, India.
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Farré R, Rodríguez-Lázaro MA, Gonzalez-Martin J, Castro P, Hospital T, Compta Y, Solana G, Gozal D, Otero J. Device for Negative Pressure Wound Therapy in Low-Resource Regions: Open-Source Description and Bench Test Evaluation. J Clin Med 2022; 11:jcm11185417. [PMID: 36143070 PMCID: PMC9503864 DOI: 10.3390/jcm11185417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 09/10/2022] [Accepted: 09/13/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Negative (vacuum) pressure therapy promotes wound healing. However, commercially available devices are unaffordable to most potential users in low- and middle-income countries (LMICs), limiting access to many patients who could benefit from this treatment. This study aimed to design and test a cheap and easy-to-build negative pressure device and provide its detailed open-source description, thereby enabling free replication. Methods: the negative pressure device was built using off-the-shelf materials available via e-commerce and was based on a small pump, a pressure transducer, and the simplest Arduino controller with a digital display (total retail cost ≤ 75 US$). The device allows the user to set any therapeutic range of intermittent negative pressure and has two independent safety mechanisms. The performance of the low-cost device was carefully tested on the bench using a phantom wound, producing a realistic exudate flow rate. Results: the device generates the pressure patterns set by the user (25–175 mmHg of vacuum pressure, 0–60 min periods) and can drain exudate flows within the clinical range (up to 1 L/h). Conclusions: a novel, low-cost, easy-to-build negative pressure device for wound healing displays excellent technical performance. The open-source hardware description provided here, which allows for free replication and use in LMICs, will facilitate the application and wider utilization of this therapy to patients.
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Affiliation(s)
- Ramon Farré
- Unitat de Biofísica i Bioenginyeria, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, 08036 Barcelona, Spain
- CIBER de Enfermedades Respiratorias, 28029 Madrid, Spain
- Institut Investigacions Biomèdiques August Pi Sunyer, 08036 Barcelona, Spain
- Correspondence:
| | - Miguel A. Rodríguez-Lázaro
- Unitat de Biofísica i Bioenginyeria, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, 08036 Barcelona, Spain
| | - Julian Gonzalez-Martin
- Microbiology Department-CDB, Hospital Clinic-ISGlobal-University of Barcelona, 08036 Barcelona, Spain
- CIBER of Infectiuos Diseases (CIBERINFEC), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Pedro Castro
- Institut Investigacions Biomèdiques August Pi Sunyer, 08036 Barcelona, Spain
- Intensive Care Unit, Internal Medicine Department, Hospital Clínic, 08036 Barcelona, Spain
| | - Teresa Hospital
- Intensive Care Unit, Internal Medicine Department, Hospital Clínic, 08036 Barcelona, Spain
| | - Yaroslau Compta
- Institut Investigacions Biomèdiques August Pi Sunyer, 08036 Barcelona, Spain
- Institut de Neurociències, Service of Neurology, Parkinson’s Disease and Movement Disorders Unit, Hospital Clinic de Barcelona, 08036 Barcelona, Spain
- Institut de Neurociències, Maeztu Center, Universitat de Barcelona, 08036 Barcelona, Spain
| | - Gorka Solana
- Faculdade de Engenharias e Tecnologias, Universidade Save, Maxixe, Mozambique
| | - David Gozal
- Department of Child Health, The University of Missouri School of Medicine, Columbia, MO 65212, USA
| | - Jorge Otero
- Unitat de Biofísica i Bioenginyeria, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, 08036 Barcelona, Spain
- CIBER de Enfermedades Respiratorias, 28029 Madrid, Spain
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Farré R, Gozal D, Nguyen VN, Pearce JM, Dinh-Xuan AT. Open-Source Hardware May Address the Shortage in Medical Devices for Patients with Low-Income and Chronic Respiratory Diseases in Low-Resource Countries. J Pers Med 2022; 12:jpm12091498. [PMID: 36143283 PMCID: PMC9502622 DOI: 10.3390/jpm12091498] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Revised: 09/04/2022] [Accepted: 09/10/2022] [Indexed: 01/09/2023] Open
Abstract
Respiratory diseases pose an increasing socio-economic burden worldwide given their high prevalence and their elevated morbidity and mortality. Medical devices play an important role in managing acute and chronic respiratory failure, including diagnosis, monitoring, and providing artificial ventilation. Current commercially available respiratory devices are very effective but, given their cost, are unaffordable for most patients in low- and middle-income countries (LMICs). Herein, we focus on a relatively new design option—the open-source hardware approach—that, if implemented, will contribute to providing low-cost respiratory medical devices for many patients in LMICs, particularly those without full medical insurance coverage. Open source reflects a set of approaches to conceive and distribute the comprehensive technical information required for building devices. The open-source approach enables free and unrestricted use of the know-how to replicate and manufacture the device or modify its design for improvements or adaptation to different clinical settings or personalized treatments. We describe recent examples of open-source devices for diagnosis/monitoring (measuring inspiratory/expiratory pressures or flow and volume in mechanical ventilators) and for therapy (non-invasive ventilators for adults and continuous positive airway pressure support for infants) that enable building simple, low-cost (hence, affordable), and high-performance solutions for patients in LMICs. Finally, we argue that the common practice of approving clinical trials by the local hospital ethics board can be expanded to ensure patient safety by reviewing, inspecting, and approving open hardware for medical application to maximize the innovation and deployment rate of medical technologies.
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Affiliation(s)
- Ramon Farré
- Unitat de Biofísica i Bioenginyeria, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, 08036 Barcelona, Spain
- CIBER de Enfermedades Respiratorias, 28029 Madrid, Spain
- Institut Investigacions Biomèdiques August Pi Sunyer, 08036 Barcelona, Spain
- Correspondence:
| | - David Gozal
- Department of Child Health, The University of Missouri School of Medicine, Columbia, MO 65201, USA
| | - Viet-Nhung Nguyen
- National Tuberculosis Program, 463 Hoang Hoa Tham, Vinh Phu, Ba Dinh, Hanoi 118000, Vietnam
| | - Joshua M. Pearce
- Department of Electrical & Computer Engineering, Ivey Business School, Western University, London, ON N6A 5B9, Canada
| | - Anh Tuan Dinh-Xuan
- Service de Physiologie-Explorations Fonctionnelles, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris (AP-HP), 75014 Paris, France
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