Doctors everywhere are forced to make difficult decisions about who lives and who dies!
Shortage of equipment, especially ventilators should not be a reason for that. Doctors did not sign up for this!!
Even at this unprecedented time for our generation!
This must be avoided and we have a solution. It can be used NOW and everywhere, while we flatten the curve!
The shortage of proper ventilators might force health-care professionals to either improperly use Non Invasive Ventilation (NIV) in patients that needed Invasive Mechanical Ventilation (IMV) or exclude patients that otherwise would have their respiratory therapy escalated.
Single-limb NIV are widely available and relatively cheap equipment that, if convertible to IMV (that could be connected to an invasive airway: patient intubated with a tracheal tube or with a tracheostomy), would increase significantly the ventilatory capacity of healthcare services.
Authorities mandated the use of antiviral filters on the expiratory branch, that blocked the use of single limb NIV with commercially available circuits.
What it does
It's a ventilator assembly ready to be used and save lives.
Converts a single-limb NIV ventilator to an IMV ventilator using off-the-shelf medical equipment to modify the respiratory circuit assembly and its function.
How we built it
- Using already available NIV ventilators and circuits, together with Ruben's and CPAP valves, and only acquiring flexible and autoclavable silicon connectors.
- Hospitals can use spare circuit parts to increase their invasive ventilation capabilities at a very low cost (less than 5 € each).
Why is it different from other solutions
- Hospitals worldwide can build it in-house, today and for less than 5€.
- Already scientifically reviewed and validated.
- Does not imply future overstocking of mechanical ventilators.
- Does not require healthcare professionals any additional training.
Challenges we ran into
- Collection of scientific evidence to support this innovative approach.
- Making it possible for any doctor to set up and use it on a very easy and straightforward way.
- Find an autoclavable silicon that was flexible enough and had an adequate size to allow the connection between different diameter parts.
- Spreading the information to those health-care professionals facing shortages.
Accomplishments that we're proud of
- It can be done now, by any physician with ventilation skills, using commercially available devices approved for medical use.
- Our solution assembles them in an innovative manner, making it easier to license. Though we need help for licensing.
- We've tested the efficacy and reliability of the assembly in the lab for 24H continuous operation.
- Pressures delivered to the airway were within 2cmH2O range of the ventilator settings with standard deviation close to zero.
- The scientific report concerning this project was peer-reviewed and accepted for publication in the European Journal of Anaesthesiology.
What we learned
It's difficult to spread the information.
What's next for NIV to IMV Conversion
- Reach health teams around the world and provide them with the step by step Assembly Manual.
- Get formal support from health regulatory agencies in order to license its widespread use.
- We intend to legally declare we do not want to make a profit out of it.
- Paulo-Roberto Ferreira, Department of Anaesthesiology, Centro Hospitalar de Vila Nova de Gaia / Espinho, Portugal. Department of Medical Sciences, Univerity of Aveiro, Portugal.
Project role: Concept design, clinical application.
- Tiago Oliveira-e-Sá, Pulmonology Department, Hospital de Santa Marta, Centro Hospitalar Universitário de Lisboa Central, Portugal; NOVA Medical School, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Portugal.
Project role: Concept design, clinical application.
- Duarte Almeida, Process Development and I4.0 engineering, Bosch Thermotechnology, Portugal.
Project role: Testing equipment development, automation, instrumentation and Engineering coordination.
- Vitor Silva, R&D Laboratory Management, Bosch Thermotechnology, Portugal.
Project role: Measuring equipment development, mechanics, instrumentation and post-processing data algorithms.
- Filipe Rego, Manufacturing Engineering, Bosch Thermotechnology, Portugal.
Project role: Labview sw development and intrumentation advisory.
- Nuno Mateus, Quality Process, Quality and Safety, Bosch Thermotechnology, Portugal.
Project role: Sensor calibration and statistical analysis.
- André Cunha, Metallurgical and Materials Engineer, Fernando Pinto Catão & Irmão Lda., Portugal
Project role: Connectors design and industrialization.
Partnerships and Aknowledgements
- Department of Anaesthesiology, Centro Hospitalar de Vila Nova de Gaia/Espinho - Portugal.
- Department of Medical Sciences, Universidade de Aveiro, Portugal.
- Pulmonology Department, Hospital de Santa Marta, Centro Hospitalar Universitário de Lisboa Central, Portugal.
- NOVA Medical School, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Portugal.
- Bosch Thermotechnology Portugal: laboratorial equipment and facilities.
- Rita Meireles (Intensive Care Unit, CHTS, Portugal), Ana Bernardino (Anaesthesiology Department, CHUC, Portugal) and Francisco Soares (Cardiology Department, HSA/HDL, Portugal): conceptual development, clinical validation and scientific reviewing.
- Francisco Pitschieller (freelancer technical designer): diagrams and "User's Manual" design.
- Pedro Menezes (FEUP, Portugal); Daniel Vasconcelos (IESCTEC/FEUP, Portugal), Rui Oliveira (Trativi, Portugal): silicon connector development.
- Helpful Engineering: platform for network creation.
- Breas Portugal and Linde Portugal: for borrowing ventilators, circuits and valves.
- Giammarco Casanova, Caroline Mindus, Andrius Zhilenas, Yahya Mohamed Mao among others for mentoring our project during EUvsVirus.org Hackathon.
- Ricardo Castro (freelancer): for his help creating the video.
- Tiago Moura (I4.0 Engineer, Bosch Thermotechnology, Portugal): for helping in the testing equipment assembly.