Maxwell Witt, MD
Internal Medicine Resident, Department of Internal Medicine
University of New Mexico, Albuquerque, NM, United States
Disclosure information not submitted.
Julia Cartwright, MD
Pediatrics Resident, Department of Pediatrics
University of Michigan, Ann Arbor, MI, United States
Disclosure information not submitted.
Zoey Chopra, BA
University of Michigan Medical School and Department of Economics
University of Michigan, MCIRCC, United States
Disclosure information not submitted.
Kathryn Quanstrom, BA
Medical Student, University of Michigan Medical School
University of Michigan, United States
Disclosure information not submitted.
Andrew Shute, BS
Medical Student, University of Michigan Medical School
University of Michigan, MCIRCC, United States
Disclosure information not submitted.
Rodney Daniels, MD
Assistant Professor, Pediatric Critical Care Medicine and Biomedical Engineering
Univ of Michigan Health System
Ann Arbor, MI
Disclosure information not submitted.
Title: An Open-Source Ventilation Device for Critical Access and Low Resource Settings
Introduction: In critical access and resource limited settings worldwide, there is a need for increased access to ventilators. This study’s objective was to create a locally sourced and inexpensive device capable of independently controlling ventilation parameters for multiple patients simultaneously.
Methods: Ventilation devices were constructed with a common manifold, rotary valves, and patient-specific respiratory circuits. To assess the independence of respiratory parameters, sensitivity testing was performed using an AIO1256 Michigan Instruments Adult Artificial lung with PneuView software. The relationship between intended and experimental positive end expiratory pressure (PEEP), respiratory rate (RR), and peak inspiratory pressure (PIP) was determined using linear regression analysis. Students t-test with Bonferroni correction was used to compare parameters between vents. Wear testing was completed for 168 hours, and multiple devices (n=4) were tested while connected to a source producing up to 40 cm H2O air pressure. Tidal volumes were estimated using an anemometer.
Results: Wear testing demonstrated ventilator function was preserved after 168 hours. The inspiratory to expiratory ratio was 1:1.4, and the relationship between desired and experimental RR was: RRe = 0.97 * RRd + 0.5 (R2 = 0.99). RR variation had an effect on PIP (p < 0.01), but with no significance on t-testing between vents. The relationship between desired and experimental PEEP was: PEEPe = 0.77 * PEEPd + 3.3 (R2 = 0.92). The relationship between desired and experimental PIP was: PIPe = 0.60 * PIPd + 16.7 (R2 = 0.89). There was a 7.7% decrease in PIP when PEEP was increased from 5 to 10 cm H2O (p < 0.01), but changes in PIP did not have an impact on PEEP or RR. Changes in each parameter did affect tidal volume as expected. There was no difference in respiratory parameters comparing single and duo ventilation device configurations. The final design of the ventilation system was portable and compact, with a single ventilator costing $394.
Conclusions: We present a low-cost, open-source ventilation device that could be utilized in critical access and/or low resource settings. This portable ventilator can be used as a single unit or as multiple combined units to independently control respiratory parameters for multiple patients simultaneously