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Pandemic Ventilator Project

panvent.blogspot.com

21–30 of 111 posts

Re: Pandemic Ventilator Project

#21
post #16

Some related submissions: https://news.ycombinator.com/item?id=22573926 "Low-cost portable ventilator (2010)" https://news.ycombinator.com/item?id=22573656 "Low-cost ventilator wins Sloan health care prize (2019)"

Is there some way HN can bend to support the pandemic? A flag or something?

Re: Pandemic Ventilator Project

#22
post #3

Any thoughts about using a regular sleep apnea CPAP device for this type of situation, where one has access to the pressure settings?

- COVID-19 seems to be mainly hypoxic respiratory failure, not hypercapnic respiratory failure - NIV (Non invasive ventilation, CPAP is essentially a form of this) doesn't typically perform well (on a patient outcomes, mortality basis) for pneumonia with hypoxia compared with invasive ventilation. However, this is thought to partly be because NIV delays the decision to proceed with intubation and ventilation. If ther…

Ok, so what is the best way, in your opinion, for a still healthy hacker/maker geek to contribute something (anything?) to helping our local ICUs from being overwhelmed with patients?

Edited to add: Spoken as the Dad of a 28 week premie who spent 8 weeks on a ventilator in a NICU.

Re: Pandemic Ventilator Project

#23
4x resources delay a crisis by 2 doublings.

If a doubling takes 7 days, that’s just 2 weeks.

R0 (reproduction rate) overwhelms everything. The only way out safely is to greatly reduce R0:

- social distancing: 6-9 feet away from everyone

- avoiding crowds

- Never share utensils; no buffets

- hygienic routines: wash hands, use wipes, close toilet lid before flushing (see Amoy Gardens), etc.

And convince others to do the same.

Italy closed schools when they had just 150 confirmed cases but still in a tragic crisis because people kept socializing.

See a timeline & analysis here: https://www.luca-dellanna.com/how-bad/

Re: Pandemic Ventilator Project

#24
post #20
post #3

Any thoughts about using a regular sleep apnea CPAP device for this type of situation, where one has access to the pressure settings?

Someone dear to me needs a ventilator per tracheostomy (Trilogy 100). Her Consultant Aenesthesist who was in Italy four weeks ago and works on an Intensive Care Unit told me that 6 out 10 Covid-19 affected ITU patients require an ECMO ( https://en.m.wikipedia.org/wiki/Extracorporeal_membrane_oxyg... ). This is very bad. I could sense his unease, these are machines you don't come by easily. His ITU is preparing for wa…

Well that's very not good, I hope it's much lower than that:

https://www.theguardian.com/society/2020/feb/27/coronavirus-...

Re: Pandemic Ventilator Project

#25
post #22

Earlier quoted context omitted.

- COVID-19 seems to be mainly hypoxic respiratory failure, not hypercapnic respiratory failure - NIV (Non invasive ventilation, CPAP is essentially a form of this) doesn't typically perform well (on a patient outcomes, mortality basis) for pneumonia with hypoxia compared with invasive ventilation. However, this is thought to partly be because NIV delays the decision to proceed with intubation and ventilation. If ther…

Ok, so what is the best way, in your opinion, for a still healthy hacker/maker geek to contribute something (anything?) to helping our local ICUs from being overwhelmed with patients? Edited to add: Spoken as the Dad of a 28 week premie who spent 8 weeks on a ventilator in a NICU.

As others have commented above, reducing the rate of spread (social distancing and hygiene, and convincing others to do likewise) so that this is a more smeared out event with a lower peak need for equipment and staff is the most important intervention. It's also very hard to do; not sure if there is a technological lever that will move the needle on this (advertising?)

Re: Pandemic Ventilator Project

#26
post #22

Earlier quoted context omitted.

Ok, so what is the best way, in your opinion, for a still healthy hacker/maker geek to contribute something (anything?) to helping our local ICUs from being overwhelmed with patients? Edited to add: Spoken as the Dad of a 28 week premie who spent 8 weeks on a ventilator in a NICU.

As others have commented above, reducing the rate of spread (social distancing and hygiene, and convincing others to do likewise) so that this is a more smeared out event with a lower peak need for equipment and staff is the most important intervention. It's also very hard to do; not sure if there is a technological lever that will move the needle on this (advertising?)

I'm a semi-retired Ph.D. scientist, and have already been doing Social Distancing for some time. My (frequently washed ;-) ) idle hands want to contribute something more!

Since you are a professional in the field, I am asking your help for brainstorming useful, contributory things for people like me (and others) who are feeling the need to DO something.

If hacking up ventilators (like in the OP) is not a great idea from your perspective, can you suggest anything else?

And, THANK YOU for doing the job you do, from someone whose life was affected by people like you!

Re: Pandemic Ventilator Project

#27
post #14

I've been looking over the designs being put forward in the various places now, and I cannot understand why people aren't just planning to copy the Manley ventilator. This was the standard ventilator in Europe for decades. It is simple to design, does not even require electricity (mechanical solution driven by air from central compressed air system) so all parts can be sourced locally, and the design has a clinically…

The issue is that with the kind of ventilation required you need to sedate the patient with gasses and you need to recycle those gasses and unused oxygen. With the length of time patients have to be on this you don't want to lose those gasses and also pump it out into the atmosphere. The Manley design could be a good starting point I suppose, you just have to replace the weight system with controllers and add a carbo…

Physician here; this isn't true for the ventilation of COVID patients, or ICU patients in general.

There's a difference between simple ventilator [1], and an anesthesia machine [2] that adds gas mixing, scavenging, etc.

ICU patients are anesthetized using IV sedation (a common regimen in the US is fentanyl/propofol), not inhalational anesthetics. Most vents only have simple inline filters to reduce contamination.

[1] A classic vent in the US is the Puritan Bennett 840. Here's its manual showing filters: https://www.medtronic.com/content/dam/covidien/library/us/en...

[2] https://en.wikipedia.org/wiki/Anaesthetic_machine

Re: Pandemic Ventilator Project

#28

4x resources delay a crisis by 2 doublings. If a doubling takes 7 days, that’s just 2 weeks. R0 (reproduction rate) overwhelms everything. The only way out safely is to greatly reduce R0: - social distancing: 6-9 feet away from everyone - avoiding crowds - Never share utensils; no buffets - hygienic routines: wash hands, use wipes, close toilet lid before flushing (see Amoy Gardens), etc. And convince others to do th…

Every ad network and every social media platform need to be saying as much world wide to everyone, 10 times a day.
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