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ULTIMATE MEDICAL HACKATHON: HOW FAST CAN WE DESIGN AND DEPLOY AN OPEN SOURCE VENTILATOR?

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MetalGear

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  1. How fast can we design and deploy an open source ventilator?
  2. There are so many brilliant minds on this forum
    1. Why not put the brainpower to good use?
  3. Possible to do it with an Arduino/Raspberry Pi controller for under $500?
 

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MetalGear

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A mechanical ventilator is an automatic machine designed to provide all or part of the work the body must do to move gas into and out of the lungs. The act of moving air into and out of the lungs is called breathing, or, more formally, ventilation.
The simplest mechanical device we could devise to assist a person’s breathing would be a hand-driven, syringe-type pump that is fitted to the person’s mouth and nose using a mask. A variation of this is the self-inflating, elastic resuscitation bag. Both of these require one-way valve arrangements to cause air to flow from the device into the lungs when the device is compressed, and out from the lungs to the atmosphere as the device is expanded. These arrangements are not automatic, requiring an operator to supply the energy to push the gas into the lungs through the mouth and nose. Thus, such devices are not considered mechanical ventilators.
Automating the ventilator so that continual operator intervention is not needed for safe, desired operation requires three basic components:
  1. A source of input energy to drive the device;
  2. A means of converting input energy into output energy in the form of pressure and flow to regulate the timing and size of breaths; and
  3. A means of monitoring the output performance of the device and the condition of the patient.
There was a time when you could take a handful of simple tools and do routine maintenance on your car engine. About that time the average clinician could also completely disassemble and reassemble a mechanical ventilator as a training exercise or to perform repairs. In those days (the late 1970s), textbooks1 describing ventilators understandably paid much attention to the individual mechanical components and pneumatic schematics. In fact, this philosophy was reflected to some extent in previous editions of this book. Today, both cars and ventilators are incredibly complex mechanical devices controlled by multiple microprocessors running sophisticated software (Fig. 3-1). Figure 3-2 shows the pneumatic schematic of a current intensive care ventilator. All but the most rudimentary maintenance of ventilators is now the responsibility of specially trained biomedical engineers. Our approach to describing ventilator design has thus changed from a focus on individual components to a more generalized model of a ventilator as a “black box,” that is, a device for which we supply an input and expect a certain output and whose internal operations are largely unknowable, indeed, irrelevant, to most clinical operators. What follows, then, is only a brief overview of the key design features of mechanical ventilators with an emphasis on input power requirements, transfer functions (pneumatic and electronic control systems), and outputs (pressure, volume, and flow waveforms). The rest of the chapter focuses on the interactions between the operator and the ventilator (the operator interface), and between the ventilator and the patient (the patient interface).
FIGURE 3-1
image
 

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A mechanical ventilator is an automatic machine designed to provide all or part of the work the body must do to move gas into and out of the lungs. The act of moving air into and out of the lungs is called breathing, or, more formally, ventilation.
The simplest mechanical device we could devise to assist a person’s breathing would be a hand-driven, syringe-type pump that is fitted to the person’s mouth and nose using a mask. A variation of this is the self-inflating, elastic resuscitation bag. Both of these require one-way valve arrangements to cause air to flow from the device into the lungs when the device is compressed, and out from the lungs to the atmosphere as the device is expanded. These arrangements are not automatic, requiring an operator to supply the energy to push the gas into the lungs through the mouth and nose. Thus, such devices are not considered mechanical ventilators.
Automating the ventilator so that continual operator intervention is not needed for safe, desired operation requires three basic components:
  1. A source of input energy to drive the device;
  2. A means of converting input energy into output energy in the form of pressure and flow to regulate the timing and size of breaths; and
  3. A means of monitoring the output performance of the device and the condition of the patient.
There was a time when you could take a handful of simple tools and do routine maintenance on your car engine. About that time the average clinician could also completely disassemble and reassemble a mechanical ventilator as a training exercise or to perform repairs. In those days (the late 1970s), textbooks1 describing ventilators understandably paid much attention to the individual mechanical components and pneumatic schematics. In fact, this philosophy was reflected to some extent in previous editions of this book. Today, both cars and ventilators are incredibly complex mechanical devices controlled by multiple microprocessors running sophisticated software (Fig. 3-1). Figure 3-2 shows the pneumatic schematic of a current intensive care ventilator. All but the most rudimentary maintenance of ventilators is now the responsibility of specially trained biomedical engineers. Our approach to describing ventilator design has thus changed from a focus on individual components to a more generalized model of a ventilator as a “black box,” that is, a device for which we supply an input and expect a certain output and whose internal operations are largely unknowable, indeed, irrelevant, to most clinical operators. What follows, then, is only a brief overview of the key design features of mechanical ventilators with an emphasis on input power requirements, transfer functions (pneumatic and electronic control systems), and outputs (pressure, volume, and flow waveforms). The rest of the chapter focuses on the interactions between the operator and the ventilator (the operator interface), and between the ventilator and the patient (the patient interface).
FIGURE 3-1
image
Sounds like a good starting place would be to round up some ventilator plans from the 1970s and some people from the 1970s who were familiar with how to disassemble and reassemble a ventilator.
 
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MetalGear

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Sounds like a good starting place would be to round up some ventilator plans from the 1970s and some people from the 1970s who were familiar with how to disassemble and reassemble a ventilator.
I am reading up about iron lung machines and am MacGuyvering some stuff on paper as we speak.
 

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Disclaimer: this is not medical advice, see your MD, call 911 for any emergency etc etc.

there's a way to make multiple branches off of a single vent to ventilate multiple pts. The civilian world has some very basic vents that can be operated with a minimum of training, but that is less than optimal (read: near useless) treatment for any severe pulmonary pathology. The tech is already developed and on the market, I think the real issue is getting them into service and whether or not they will be adequate for the conditions. There's also the logistics of providing supplemental O2 to drive the vents, as most vents require a driving gas and all these pts who are critically ill have increased O2 requirements.
 
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MetalGear

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Ventilators are so expensive

I am betting that most of the costs are regulatory/testing and software driven
 

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Ventilators are so expensive

I am betting that most of the costs are regulatory/testing and software driven
exactly. You can’t just make a ventilator and sell it. It has to go through FDA approval and clearance. Which is time consuming and expensive.

the cost to manufacture I’m sure isn’t high. the cost is related to regulation, maintenance requirements, etc.

this is not something you can use at home. It requires expertise to place a breathing tube, it requires expertise, and labs to make sure you are managing the vent correctly.

in theory this sounds good. In practice impossible
 
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MetalGear

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exactly. You can’t just make a ventilator and sell it. It has to go through FDA approval and clearance. Which is time consuming and expensive.

the cost to manufacture I’m sure isn’t high. the cost is related to regulation, maintenance requirements, etc.

this is not something you can use at home. It requires expertise to place a breathing tube, it requires expertise, and labs to make sure you are managing the vent correctly.

in theory this sounds good. In practice impossible
  • The aim is to give away the design, not to sell it
  • My dad is high-risk and I guess this is my way of coping, build stuff
  • Mom has been in the medical field for 30+ years and can intubate
    • Education would have to be a big component especially on the intubation end
  • I understand there are regulatory hurdles
    • If you had no choice though, what would you do and would you care about FDA regulations?
 
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MetalGear

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theres also the old school way of making lungs stronger, just blow up balloons.
The idea is to make a mechanical ventilator, not so much to strengthen lungs
 

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3D Printed Valves - Success in Italy


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Massimo Temporelli, founder of The FabLab in Milan and a very active and popular promoter of Industry 4.0 and 3D printing in Italy, reported early on Friday 13th that he was contacted by Nunzia Vallini, editor of the Giornale di Brescia, with whom he has been collaborating for several years for the dissemination of Industry 4.0 culture in schools.

She explained that the hospital in Brescia (near one of the hardest-hit regions for coronavirus infections) urgently needed valves (in the photo) for an intensive care device and that the supplier could not provide them in a short time. Running out of the valves would have been dramatic and some people might have lost their lives. So she asked if it would be possible to 3D print them.
 
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Bekit

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How's this going @MetalGear ?

I ran across these videos on YouTube ... looks like other people are thinking along the same lines. Are you teaming up with any of these people by any chance?

View: https://www.youtube.com/watch?v=n57u1NvXBgw


By the way, a guy named Michael McPeck commented 3 days ago on this video and said this. Might also be worth looking to see if he could help.

"Hi Johnny - I'm a respiratory therapist, with 50+ years of experience under my belt, who could answer a lot of the questions I know you have. In addition to my respiratory therapy clinical, management, teaching, research and publication experience, I managed to work for a couple medical device companies for about 10 years and have some experience with the development, manufacturing, regulatory, marketing and sales aspects of medical device creation. Like many of the others who expressed themselves here, I am also amazed and grateful that there are creative and caring people like you who are willing to attempt to solve challenging problems that have the potential to save many lives. However, and I mean this kindly, you don't know what you don't know. Yet. And you were honest and humble enough to point that out during your video. Please let me know how to contact you to set up an opportunity to discuss your technical issues by telephone. I can tell that you have the know-how to problem solve and get things done and I think I might be able to sharpen your aim a bit in the realm of mechanical ventilation. Thanks."

Another iteration of this guy's work:
View: https://www.youtube.com/watch?v=oS6GA83nbds


And a few more options...

View: https://www.youtube.com/watch?v=JnpnS2w_O6U


View: https://www.youtube.com/watch?v=KN8WwNotGP8


View: https://www.youtube.com/watch?v=Y_92mDYfRGs
 
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MetalGear

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Sounds like a good starting place would be to round up some ventilator plans from the 1970s and some people from the 1970s who were familiar with how to disassemble and reassemble a ventilator.
There are quite a few existing and tested designs like you said:


 

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