Ventilator

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Ventilator
Hamilton C6.jpg
Hamilton C6 Ventilator
Specialty Pulmonology

A ventilator is a type of breathing apparatus, a class of medical technology that provides mechanical ventilation by moving breathable air into and out of the lungs, to deliver breaths to a patient who is physically unable to breathe, or breathing insufficiently. Ventilators may be computerized microprocessor-controlled machines, but patients can also be ventilated with a simple, hand-operated bag valve mask. Ventilators are chiefly used in intensive-care medicine, home care, and emergency medicine (as standalone units) and in anesthesiology (as a component of an anesthesia machine).

Contents

Ventilators are sometimes called "respirators", a term commonly used for them in the 1950s (particularly the "Bird respirator"). However, contemporary medical terminology uses the word "respirator" to refer to a face-mask that protects wearers against hazardous airborne substances. [1]

Function

A standard setup for a ventilator in a hospital room. The ventilator pushes warm, moist air (or air with increased oxygen) to the patient. Exhaled air flows away from the patient. Ventilators.jpg
A standard setup for a ventilator in a hospital room. The ventilator pushes warm, moist air (or air with increased oxygen) to the patient. Exhaled air flows away from the patient.

In its simplest form, a modern positive pressure ventilator, consists of a compressible air reservoir or turbine, air and oxygen supplies, a set of valves and tubes, and a disposable or reusable "patient circuit". The air reservoir is pneumatically compressed several times a minute to deliver room-air, or in most cases, an air/oxygen mixture to the patient. If a turbine is used, the turbine pushes air through the ventilator, with a flow valve adjusting pressure to meet patient-specific parameters. When over pressure is released, the patient will exhale passively due to the lungs' elasticity, the exhaled air being released usually through a one-way valve within the patient circuit called the patient manifold.

Ventilators may also be equipped with monitoring and alarm systems for patient-related parameters (e.g., pressure, volume, and flow) and ventilator function (e.g., air leakage, power failure, mechanical failure), backup batteries, oxygen tanks, and remote control. The pneumatic system is nowadays often replaced by a computer-controlled turbopump.

Modern ventilators are electronically controlled by a small embedded system to allow exact adaptation of pressure and flow characteristics to an individual patient's needs. Fine-tuned ventilator settings also serve to make ventilation more tolerable and comfortable for the patient. In Canada and the United States, respiratory therapists are responsible for tuning these settings, while biomedical technologists are responsible for the maintenance. In the United Kingdom and Europe the management of the patient's interaction with the ventilator is done by critical care nurses.

The patient circuit usually consists of a set of three durable, yet lightweight plastic tubes, separated by function (e.g. inhaled air, patient pressure, exhaled air). Determined by the type of ventilation needed, the patient-end of the circuit may be either noninvasive or invasive.

Noninvasive methods, such as continuous positive airway pressure (CPAP) and non-invasive ventilation, which are adequate for patients who require a ventilator only while sleeping and resting, mainly employ a nasal mask. Invasive methods require intubation, which for long-term ventilator dependence will normally be a tracheotomy cannula, as this is much more comfortable and practical for long-term care than is larynx or nasal intubation.

Life-critical system

As failure may result in death, mechanical ventilation systems are classified as life-critical systems, and precautions must be taken to ensure that they are highly reliable, including their power supply. Ventilatory failure is the inability to sustain a sufficient rate of CO2 elimination to maintain a stable pH without mechanical assistance, muscle fatigue, or intolerable dyspnea. [2] Mechanical ventilators are therefore carefully designed so that no single point of failure can endanger the patient. They may have manual backup mechanisms to enable hand-driven respiration in the absence of power (such as the mechanical ventilator integrated into an anaesthetic machine). They may also have safety valves, which open to atmosphere in the absence of power to act as an anti-suffocation valve for spontaneous breathing of the patient. Some systems are also equipped with compressed-gas tanks, air compressors or backup batteries to provide ventilation in case of power failure or defective gas supplies, and methods to operate or call for help if their mechanisms or software fail. [3] Power failures, such as during a natural disaster, can create a life-threatening emergency for people using ventilators in a home care setting. [4] Battery power may be sufficient for a brief loss of electricity, but longer power outages may require going to a hospital. [4]

History

The history of mechanical ventilation begins with various versions of what was eventually called the iron lung, a form of noninvasive negative-pressure ventilator widely used during the polio epidemics of the twentieth century after the introduction of the "Drinker respirator" in 1928, improvements introduced by John Haven Emerson in 1931, [5] and the Both respirator in 1937. Other forms of noninvasive ventilators, also used widely for polio patients, include Biphasic Cuirass Ventilation, the rocking bed, and rather primitive positive pressure machines. [5]

In 1949, John Haven Emerson developed a mechanical assister for anaesthesia with the cooperation of the anaesthesia department at Harvard University. Mechanical ventilators began to be used increasingly in anaesthesia and intensive care during the 1950s. Their development was stimulated both by the need to treat polio patients and the increasing use of muscle relaxants during anaesthesia. Relaxant drugs paralyse the patient and improve operating conditions for the surgeon but also paralyse the respiratory muscles. In 1953 Bjørn Aage Ibsen set up what became the world's first Medical/Surgical ICU utilizing muscle relaxants and controlled ventilation. [6]

An East-Radcliffe respirator model from the mid-twentieth century East-Radcliffe Respirator Wellcome L0001305.jpg
An East-Radcliffe respirator model from the mid-twentieth century

In the United Kingdom, the East Radcliffe and Beaver models were early examples. The former used a Sturmey-Archer bicycle hub gear to provide a range of speeds, and the latter an automotive windscreen wiper motor to drive the bellows used to inflate the lungs. [7] Electric motors were, however, a problem in the operating theatres of that time, as their use caused an explosion hazard in the presence of flammable anaesthetics such as ether and cyclopropane. In 1952, Roger Manley of the Westminster Hospital, London, developed a ventilator which was entirely gas-driven and became the most popular model used in Europe. It was an elegant design, and became a great favourite with European anaesthetists for four decades, prior to the introduction of models controlled by electronics. It was independent of electrical power and caused no explosion hazard. The original Mark I unit was developed to become the Manley Mark II in collaboration with the Blease company, which manufactured many thousands of these units. Its principle of operation was very simple, an incoming gas flow was used to lift a weighted bellows unit, which fell intermittently under gravity, forcing breathing gases into the patient's lungs. The inflation pressure could be varied by sliding the movable weight on top of the bellows. The volume of gas delivered was adjustable using a curved slider, which restricted bellows excursion. Residual pressure after the completion of expiration was also configurable, using a small weighted arm visible to the lower right of the front panel. This was a robust unit and its availability encouraged the introduction of positive pressure ventilation techniques into mainstream European anesthetic practice.

The 1955 release of Forrest Bird's "Bird Universal Medical Respirator" in the United States changed the way mechanical ventilation was performed, with the small green box becoming a familiar piece of medical equipment. [8] The unit was sold as the Bird Mark 7 Respirator and informally called the "Bird". It was a pneumatic device and therefore required no electrical power source to operate.

In 1965, the Army Emergency Respirator was developed in collaboration with the Harry Diamond Laboratories (now part of the U.S. Army Research Laboratory) and Walter Reed Army Institute of Research. Its design incorporated the principle of fluid amplification in order to govern pneumatic functions. Fluid amplification allowed the respirator to be manufactured entirely without moving parts, yet capable of complex resuscitative functions. [9] Elimination of moving parts increased performance reliability and minimized maintenance. [10] The mask is composed of a poly(methyl methacrylate) (commercially known as Lucite) block, about the size of a pack of cards, with machined channels and a cemented or screwed-in cover plate. [11] The reduction of moving parts cut manufacturing costs and increased durability. [10]

The bistable fluid amplifier design allowed the respirator to function as both a respiratory assistor and controller. It could functionally transition between assistor and controller automatically, based on the patient's needs. [11] [10] The dynamic pressure and turbulent jet flow of gas from inhalation to exhalation allowed the respirator to synchronize with the breathing of the patient. [12]

Intensive care environments around the world revolutionized in 1971 by the introduction of the first SERVO 900 ventilator (Elema-Schönander), constructed by Björn Jonson. It was a small, silent and effective electronic ventilator, with the famous SERVO feedback system controlling what had been set and regulating delivery. For the first time, the machine could deliver the set volume in volume control ventilation.

Microprocessor ventilators

Microprocessor control led to the third generation of intensive care unit (ICU) ventilators, starting with the Dräger EV-A [13] in 1982 in Germany which allowed monitoring the patient's breathing curve on an LCD monitor. One year later followed Puritan Bennett 7200 and Bear 1000, SERVO 300 and Hamilton Veolar over the next decade. Microprocessors enable customized gas delivery and monitoring, and mechanisms for gas delivery that are much more responsive to patient needs than previous generations of mechanical ventilators. [14]

Open-source ventilators

An open-source ventilator is a disaster-situation ventilator made using a freely-licensed design, and ideally, freely-available components and parts. Designs, components, and parts may be anywhere from completely reverse-engineered to completely new creations, components may be adaptations of various inexpensive existing products, and special hard-to-find and/or expensive parts may be 3D printed instead of sourced. [15] [16]

During the 2019–2020 COVID-19 pandemic, various kinds of ventilators have been considered. Deaths caused by COVID-19 have occurred when the most severely infected experience acute respiratory distress syndrome, a widespread inflammation in the lungs that impairs the lungs' ability to absorb oxygen and expel carbon dioxide. These patients require a capable ventilator to continue breathing.

Among ventilators that might be brought into use for treating people with COVID-19, there have been many concerns. These include current availability, [17] [18] the challenge of making more and lower cost ventilators, effectiveness, [19] functional design, safety, [20] [21] portability, [22] suitability for infants, [23] assignment to treat other illnesses, and operator training. [24] Deploying the best possible mix of ventilators can save the most lives.

Although not formally open-sourced, the Ventec V+ Pro ventilator was developed in April 2020 as a shared effort between Ventec Life Systems and General Motors, to provide a rapid supply of 30,000 ventilators capable of treating COVID-19 patients. [25] [26]

A major worldwide design effort began during the 2019-2020 coronavirus pandemic after a Hackaday project was started, [27] [ non-primary source needed ] in order to respond to expected ventilator shortages causing higher mortality rate among severe patients.

On March 20, 2020, the Irish Health Service [28] began reviewing designs. [29] A prototype is being designed and tested in Colombia. [30]

The Polish company Urbicum reports successful testing [31] of a 3D-printed open-source prototype device called VentilAid. The makers describe it as a last resort device when professional equipment is missing. The design is publicly available. [32] The first Ventilaid prototype requires compressed air to run.

On March 21, 2020, the New England Complex Systems Institute (NECSI) began maintaining a strategic list of open source designs being worked on. [33] [34] The NECSI project considers manufacturing capability, medical safety and need for treating patients in various conditions, speed dealing with legal and political issues, logistics and supply. [35] NECSI is staffed with scientists from Harvard and MIT and others who have an understanding of pandemics, medicine, systems, risk, and data collection. [35]

The University of Minnesota Bakken Medical Device Center initiated a collaboration with various companies to bring a ventilator alternative to the market that works as a one-armed robot and replaces the need for manual ventilation in emergency situations. The Coventor device was developed in a very short time and approved on April 15, 2020, by the FDA, only 30 days after conception. The mechanical ventilator is designed for use by trained medical professionals in intensive care units and easy to operate. It has a compact design and is relatively inexpensive to manufacture and distribute. The cost is only about 4% of a normal ventilator. In addition, this device does not require pressurized oxygen or air supply, as is normally the case. A first series is manufactured by Boston Scientific. The plans are to be freely available online to the general public without royalties. [36] [37]

COVID-19 pandemic

The COVID-19 pandemic has led to shortages of essential goods and services - from hand sanitizers to masks to beds to ventilators.[ citation needed ] Countries around the world have experienced shortages of ventilators. [38] Furthermore, fifty-four governments, including many in Europe and Asia, imposed restrictions on medical supply exports in response to the coronavirus pandemic. [39]

The capacities to produce and distribute invasive and non-invasive ventilators vary by country. In the initial phase of the pandemic, China ramped up its production of ventilators, secured large amounts of donations from private firms, and dramatically increased imports of medical devices worldwide. As a result, the country accumulated a reservoir of ventilators throughout the pandemic in Wuhan. Western Europe and the United States, which outrank China in their production capacities, suffered a shortage of supplies due to the sudden and scattered outbreaks throughout the North American and European continents. Finally, Central Asia, Africa, and Latin America, which depend almost entirely on importing ventilators, suffered severe shortages of supplies.[ citation needed ]

Healthcare policy-makers have met serious challenges to estimate the number of ventilators needed and used during the pandemic. When data is often not available for ventilators specifically, estimates are sometimes made based on the number of intensive care unit beds available, which often contain ventilators. [40]

United States

In 2006, president George W. Bush signed the Pandemic and All-Hazards Preparedness Act, which created the Biomedical Advanced Research and Development Authority (BARDA) within the United States Department of Health and Human Services. In preparation for a possible epidemic of respiratory disease, the newly created office awarded a $6 million contract to Newport Medical Instruments, a small company in California, to make 40,000 ventilators for under $3,000 apiece. In 2011, Newport sent three prototypes to the Centers for Disease Control. In 2012, Covidien, a $12 billion/year medical device manufacturer, which manufactured more expensive competing ventilators, bought Newport for $100 million. Covidien delayed and in 2014 cancelled the contract.

BARDA started over again with a new company, Philips, and in July 2019, the FDA approved the Philips ventilator, and the government ordered 10,000 ventilators for delivery in mid-2020. [41]

On April 23, 2020, NASA reported building, in 37 days, a successful COVID-19 ventilator, named VITAL ("Ventilator Intervention Technology Accessible Locally"). On April 30, NASA reported receiving fast-track approval for emergency use by the United States Food and Drug Administration for the new ventilator. [42] [43] [44] On May 29, NASA reported that eight manufacturers were selected to manufacture the new ventilator. [45]

Canada

On April 7, 2020, Prime Minister Justin Trudeau announced that the Canadian Federal Government would be sourcing thousands of 'Made in Canada' ventilators. A number of organisations responded from across the country. [46] They delivered a large quantity of ventilators to the National Emergency Strategic Stockpile. From west to east, the companies include Canadian Emergency Ventilators Inc, Bayliss Medical Inc, Thornhill Medical, Vexos Inc, and CAE Inc.

See also

Related Research Articles

<span class="mw-page-title-main">Mechanical ventilation</span> Method to mechanically assist or replace spontaneous breathing

Mechanical ventilation or assisted ventilation is the medical term for using a machine called a ventilator to fully or partially provide artificial ventilation. Mechanical ventilation helps move air into and out of the lungs, with the main goal of helping the delivery of oxygen and removal of carbon dioxide. Mechanical ventilation is used for many reasons, including to protect the airway due to mechanical or neurologic cause, to ensure adequate oxygenation, or to remove excess carbon dioxide from the lungs. Various healthcare providers are involved with the use of mechanical ventilation and people who require ventilators are typically monitored in an intensive care unit.

<span class="mw-page-title-main">Intensive care medicine</span> Medical care subspecialty, treating critically ill

Intensive care medicine, also called critical care medicine, is a medical specialty that deals with seriously or critically ill patients who have, are at risk of, or are recovering from conditions that may be life-threatening. It includes providing life support, invasive monitoring techniques, resuscitation, and end-of-life care. Doctors in this specialty are often called intensive care physicians, critical care physicians, or intensivists.

<span class="mw-page-title-main">Iron lung</span> Negative-pressure mechanically functioning respirator

An iron lung is a type of negative pressure ventilator (NPV), a mechanical respirator which encloses most of a person's body and varies the air pressure in the enclosed space to stimulate breathing. It assists breathing when muscle control is lost, or the work of breathing exceeds the person's ability. Need for this treatment may result from diseases including polio and botulism and certain poisons.

<span class="mw-page-title-main">Respiratory arrest</span> Medical condition

Respiratory arrest is a serious medical condition caused by apnea or respiratory dysfunction severe enough that it will not sustain the body. Prolonged apnea refers to a patient who has stopped breathing for a long period of time. If the heart muscle contraction is intact, the condition is known as respiratory arrest. An abrupt stop of pulmonary gas exchange lasting for more than five minutes may permanently damage vital organs, especially the brain. Lack of oxygen to the brain causes loss of consciousness. Brain injury is likely if respiratory arrest goes untreated for more than three minutes, and death is almost certain if more than five minutes.

<span class="mw-page-title-main">Artificial ventilation</span> Assisted breathing to support life

Artificial ventilation or respiration is when a machine assists in a metabolic process to exchange gases in the body by pulmonary ventilation, external respiration, and internal respiration. A machine called ventilator provides the person air manually by moving air in and out of the lungs when an individual is unable to breathe on their own. The ventilator prevents the accumulation of carbon dioxide so that the lungs don't collapse due to the low pressure. The use of artificial ventilation can be traced back to the seventeenth century. There are three ways of exchanging gases in the body: manual methods, mechanical ventilation, and neurostimulation.

A resuscitator is a device using positive pressure to inflate the lungs of an unconscious person who is not breathing, in order to keep them oxygenated and alive. There are three basic types: a manual version consisting of a mask and a large hand-squeezed plastic bulb using ambient air, or with supplemental oxygen from a high-pressure tank. The second type is the expired air or breath powered resuscitator. The third type is an oxygen powered resuscitator. These are driven by pressurized gas delivered by a regulator, and can either be automatic or manually controlled. The most popular type of gas powered resuscitator are time cycled, volume constant ventilators. In the early days of pre-hospital emergency services, pressure cycled devices like the Pulmotor were popular but yielded less than satisfactory results. Most modern resuscitators are designed to allow the patient to breathe on his own should he recover the ability to do so. All resuscitation devices should be able to deliver more than 85% oxygen when a gas source is available.

<span class="mw-page-title-main">Breathing apparatus</span> Equipment allowing or assisting the user to breath in a hostile environment

A breathing apparatus or breathing set is equipment which allows a person to breathe in a hostile environment where breathing would otherwise be impossible, difficult, harmful, or hazardous, or assists a person to breathe. A respirator, medical ventilator, or resuscitator may also be considered to be breathing apparatus. Equipment that supplies or recycles breathing gas other than ambient air in a space used by several people is usually referred to as being part of a life-support system, and a life-support system for one person may include breathing apparatus, when the breathing gas is specifically supplied to the user rather than to the enclosure in which the user is the occupant.

<span class="mw-page-title-main">Bag valve mask</span> Hand-held device to provide positive pressure ventilation

A bag valve mask (BVM), sometimes known by the proprietary name Ambu bag or generically as a manual resuscitator or "self-inflating bag", is a hand-held device commonly used to provide positive pressure ventilation to patients who are not breathing or not breathing adequately. The device is a required part of resuscitation kits for trained professionals in out-of-hospital settings (such as ambulance crews) and is also frequently used in hospitals as part of standard equipment found on a crash cart, in emergency rooms or other critical care settings. Underscoring the frequency and prominence of BVM use in the United States, the American Heart Association (AHA) Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiac Care recommend that "all healthcare providers should be familiar with the use of the bag-mask device." Manual resuscitators are also used within the hospital for temporary ventilation of patients dependent on mechanical ventilators when the mechanical ventilator needs to be examined for possible malfunction or when ventilator-dependent patients are transported within the hospital. Two principal types of manual resuscitators exist; one version is self-filling with air, although additional oxygen (O2) can be added but is not necessary for the device to function. The other principal type of manual resuscitator (flow-inflation) is heavily used in non-emergency applications in the operating room to ventilate patients during anesthesia induction and recovery.

<span class="mw-page-title-main">Continuous positive airway pressure</span> Form of ventilator which applies mild air pressure continuously to keep airways open

Continuous positive airway pressure (CPAP) is a form of positive airway pressure (PAP) ventilation in which a constant level of pressure greater than atmospheric pressure is continuously applied to the upper respiratory tract of a person. The application of positive pressure may be intended to prevent upper airway collapse, as occurs in obstructive sleep apnea, or to reduce the work of breathing in conditions such as acute decompensated heart failure. CPAP therapy is highly effective for managing obstructive sleep apnea. Compliance and acceptance of use of CPAP therapy can be a limiting factor, with 8% of people stopping use after the first night and 50% within the first year.

<span class="mw-page-title-main">Orinasal mask</span> Breathing mask that covers the mouth and the nose only.

An orinasal mask, oro-nasal mask or oral-nasal mask is a breathing mask that covers the mouth and the nose only. It may be a complete independent item, as an oxygen mask, or on some anaesthetic apparatuses, or it may be fitted as a component inside a fullface mask on underwater breathing apparatus, a gas mask or an industrial respirator to reduce the amount of dead space. It may be designed for its lower edge to seal on the front of the lower jaw or to go under the chin.

Modes of mechanical ventilation are one of the most important aspects of the usage of mechanical ventilation. The mode refers to the method of inspiratory support. In general, mode selection is based on clinician familiarity and institutional preferences, since there is a paucity of evidence indicating that the mode affects clinical outcome. The most frequently used forms of volume-limited mechanical ventilation are intermittent mandatory ventilation (IMV) and continuous mandatory ventilation (CMV). There have been substantial changes in the nomenclature of mechanical ventilation over the years, but more recently it has become standardized by many respirology and pulmonology groups. Writing a mode is most proper in all capital letters with a dash between the control variable and the strategy.

Continuous mandatory ventilation (CMV) is a mode of mechanical ventilation in which breaths are delivered based on set variables. Still used in the operating room, in previous nomenclature, CMV referred to "controlled mechanical ventilation", a mode of ventilation characterized by a ventilator that makes no effort to sense patient breathing effort. In continuous mandatory ventilation, the ventilator can be triggered either by the patient or mechanically by the ventilator. The ventilator is set to deliver a breath according to parameters selected by the operator. "Controlled mechanical ventilation" is an outdated expansion for "CMV"; "continuous mandatory ventilation" is now accepted standard nomenclature for mechanical ventilation. CMV today can assist or control itself dynamically, depending on the transient presence or absence of spontaneous breathing effort. Thus, today's CMV would have been called ACV in older nomenclature, and the original form of CMV is a thing of the past. But despite continual technological improvement over the past half century, CMV may still be uncomfortable for the patient.

Intermittent Mandatory Ventilation (IMV) refers to any mode of mechanical ventilation where a regular series of breaths are scheduled but the ventilator senses patient effort and reschedules mandatory breaths based on the calculated need of the patient. Similar to continuous mandatory ventilation in parameters set for the patients pressures and volumes but distinct in its ability to support a patient by either supporting their own effort or providing support when patient effort is not sensed. IMV is frequently paired with additional strategies to improve weaning from ventilator support or to improve cardiovascular stability in patients who may need full life support.

A negative pressure ventilator (NPV) is a type of mechanical ventilator that stimulates an ill person's breathing by periodically applying negative air pressure to their body to expand and contract the chest cavity.

<span class="mw-page-title-main">Bragg-Paul Pulsator</span> Medical ventilator

The Bragg-Paul Pulsator, also known as the Bragg-Paul respirator, was a non-invasive medical ventilator invented by William Henry Bragg and designed by Robert W. Paul in 1933 for patients unable to breathe for themselves due to illness.

<span class="mw-page-title-main">N95 respirator</span> Particulate respirator meeting the N95 standard

An N95 respirator is a particulate-filtering facepiece respirator or elastomeric filter that meets the U.S. National Institute for Occupational Safety and Health (NIOSH) N95 classification of air filtration, meaning that it filters at least 95% of airborne particles that have a mass median aerodynamic diameter of 0.3 micrometers under 42 CFR Part 84. This standard does not require that the respirator be resistant to oil; two other standards, R95 and P95, add that requirement. The N95 type is the most common particulate-filtering facepiece respirator. It is an example of a mechanical filter respirator, which provides protection against particulates but not against gases or vapors. An authentic N95 respirator is marked with the text "NIOSH" or the NIOSH logo, the filter class ("N95"), and, for filtering facepiece respirators, a "TC" approval number of the form XXX-XXXX, the approval number. All N95 respirators, regardless of type, must be listed on the NIOSH Certified Equipment List (CEL) or the NIOSH Trusted-Source page, and it must have headbands instead of ear loops.

<span class="mw-page-title-main">Open-source ventilator</span> Ventilator of freely-licensed design

An open-source ventilator is a disaster-situation ventilator made using a freely licensed (open-source) design, and ideally, freely available components and parts. Designs, components, and parts may be anywhere from completely reverse-engineered or completely new creations, components may be adaptations of various inexpensive existing products, and special hard-to-find and/or expensive parts may be 3D-printed instead of purchased. As of early 2020, the levels of documentation and testing of open-source ventilators was well below scientific and medical-grade standards.

<span class="mw-page-title-main">Proning</span> Nursing technique

Proning or prone positioning is the placement of patients into a prone position so that they are lying on their front. This is used in the treatment of patients in intensive care with acute respiratory distress syndrome (ARDS). It has been especially tried and studied for patients on ventilators but, during the COVID-19 pandemic, it is being used for patients with oxygen masks and CPAP as an alternative to ventilation.

<span class="mw-page-title-main">Carl Gunnar Engström</span> Swedish physician and inventor

Carl Gunnar David Engström was a Swedish physician and innovator. He is the inventor of the first intermittent positive pressure mechanical ventilator that could deliver breaths of controllable volume and frequency and also deliver inhalation anesthetics.

<span class="mw-page-title-main">Glossary of breathing apparatus terminology</span> Definitions of technical terms used in connection with breathing apparatus

A breathing apparatus or breathing set is equipment which allows a person to breathe in a hostile environment where breathing would otherwise be impossible, difficult, harmful, or hazardous, or assists a person to breathe. A respirator, medical ventilator, or resuscitator may also be considered to be breathing apparatus. Equipment that supplies or recycles breathing gas other than ambient air in a space used by several people is usually referred to as being part of a life-support system, and a life-support system for one person may include breathing apparatus, when the breathing gas is specifically supplied to the user rather than to the enclosure in which the user is the occupant.

References

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  28. ↑ Sternlicht, Alexandra. "There's A Shortage Of Ventilators For Coronavirus Patients, So This International Group Invented An Open Source Alternative That's Being Tested Next Week". Forbes . Retrieved 2020-03-21.
  29. ↑ Rodrigo, Chris Mills (2020-03-20). "Irish health officials to review 3D-printed ventilator". The Hill . Retrieved 2020-03-21.
  30. ↑ colombiareports (2020-03-21). "Colombia close to having world's first open source and low-cost ventilator to 'beat Covid-19'". Colombia News | Colombia Reports. Retrieved 2020-03-21.
  31. ↑ urbicum (2020-03-23). "VentilAid -open-source ventilator, that can be made anywhere locally". VentilAid. Retrieved 2020-03-23.
  32. ↑ urbicum (2020-03-23). "GitLab - VentilAid / VentilAid". VentilAid. Retrieved 2020-03-23.
  33. ↑ Fenton, Bruce (March 21, 2020). "Ventilator Project Update: March 21th, 2020". Medium. Retrieved March 27, 2020.
  34. ↑ "A list projects to make emergency ventilators in response to COVID-19, focusing on free-libre open source". GitHub. Retrieved March 27, 2020.
  35. 1 2 Fenton, Bruce (March 14, 2020). "We need Ventilators - We Need You to Help Get Them Built". Medium. Retrieved March 27, 2020.
  36. ↑ Joe Carlson (2020-04-16). "FDA approves production of device designed at University of Minnesota to help COVID-19 patients breathe". startribune.com. Star Tribune.
  37. ↑ Darrell Etherington (2020-04-16). "FDA authorizes production of a new ventilator that costs up to 25x less than existing devices". techcrunch.com. Verizon Media.
  38. ↑ "Allocating Ventilators in a Pandemic". healthmanagement.org. 2020-03-24. Retrieved 2020-03-25.
  39. ↑ "Export restrictions threaten ventilator availability". politico.com. 2020-03-24. Retrieved 2020-03-25.
  40. ↑ Prachi Singh; Shamika Ravi; Sikim Chakraborty (2020-03-24). "COVID-19 | Is India's health infrastructure equipped to handle an epidemic?". Brookings Institution. Retrieved 2020-06-07.
  41. ↑ Nicholas Kulish, Sarah Kliff and Jessica Silver-Greenberg (March 29, 2020). "The U.S. Tried to Build a New Fleet of Ventilators. The Mission Failed. As the coronavirus spreads, the collapse of the project helps explain America's acute shortage". New York Times.
  42. ↑ Inclán, Bettina; Rydin, Matthew; Northon, Karen; Good, Andrew (30 April 2020). "NASA-Developed Ventilator Authorized by FDA for Emergency Use". NASA . Retrieved 1 May 2020.
  43. ↑ Good, Andrew; Greicius, Tony (April 23, 2020). "NASA Develops COVID-19 Prototype Ventilator in 37 Days". NASA . Retrieved April 24, 2020.
  44. ↑ Wall, Mike (April 24, 2020). "NASA engineers build new COVID-19 ventilator in 37 days". Space.com . Retrieved April 24, 2020.
  45. ↑ Inclán, Bettina; Rydin, Matthew; Northon, Karen; Good, Andrew (May 29, 2020). "Eight US Manufacturers Selected to Make NASA COVID-19 Ventilator". NASA . Retrieved May 29, 2020.
  46. ↑ "Made in Canada ventilators". Government of Canada. 26 November 2020.
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