RT Journal Article
SR Electronic
T1 Low-cost, easy-to-build non-invasive pressure support ventilator for under-resourced regions: open source hardware description, performance and feasibility testing
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 2000846
DO 10.1183/13993003.00846-2020
A1 Onintza Garmendia
A1 Miguel A. Rodríguez-Lazaro
A1 Jorge Otero
A1 Phuong Phan
A1 Alexandrina Stoyanova
A1 Anh Tuan Dinh-Xuan
A1 David Gozal
A1 Daniel Navajas
A1 Josep M. Montserrat
A1 Ramon Farré
YR 2020
UL http://erj.ersjournals.com/content/early/2020/04/16/13993003.00846-2020.abstract
AB Aim Current pricing of commercial mechanical ventilators in low/middle-income countries (LMICs) markedly restricts their availability, and consequently a considerable number of patients with acute/chronic respiratory failure cannot be adequately treated. Our aim was to design and test an affordable and easy-to-build non-invasive bilevel pressure ventilator to allow reducing the serious shortage of ventilators in LMICs.Methods The ventilator was built using off-the-shelf materials available via e-commerce and was based on a high-pressure blower, two pressure transducers and an Arduino Nano controller with a digital display (total retail cost <75 US$), with construction details open source provided for free replication. The ventilator was evaluated (and compared with a commercially available device (Lumis-150, Resmed): a) in the bench using an actively breathing patient simulator mimicking a range of obstructive/restrictive disease and b) in 12 healthy volunteers wearing a high airway resistance and thoracic/abdominal bands to mimic obstructive/restrictive patients.Results The designed ventilator provided inspiratory/expiratory pressures up to 20/10 cmH2O, respectively, with no faulty triggering or cycling both in the bench test and in volunteers. Breathing difficulty score rated (1–10 scale) by the loaded breathing subjects was significantly (p<0.005) decreased from 5.45±1.68 without support to 2.83±1.66 when using the prototype ventilator, which showed no difference with the commercial device (2.80±1.48; p=1.000).Conclusion The low-cost, easy-to-build non-invasive ventilator performs similarly as a high-quality commercial device, with its open-source hardware description, will allow for free replication and use in LMICs, facilitating application of this life-saving therapy to patients who otherwise could not be treated.FootnotesThis manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.Conflict of interest: Dr. Garmendia has nothing to disclose.Conflict of interest: Dr. Otero has nothing to disclose.Conflict of interest: Dr. Phan has nothing to disclose.Conflict of interest: Dr. Stoyanova has nothing to disclose.Conflict of interest: Dr. Dinh-Xuan has nothing to disclose.Conflict of interest: Dr. Gozal has nothing to disclose.Conflict of interest: Dr. Navajas has nothing to disclose.Conflict of interest: Dr. Montserrat has nothing to disclose.Conflict of interest: Dr. Farré reports other from ResMed, other from ANTADIR, outside the submitted work.Conflict of interest: Dr. Rodríguez-Lazaro has nothing to disclose.