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As the number of COVID-19 cases across the globe keeps rising, there are concerns about the preparedness of India’s healthcare system to deal with a major outbreak in the country. A team of innovators including Zulqarnain, a student of the Industrial Design Centre of IIT Bombay, recently developed a low cost ventilator to help brace for such a scenario. 

Now, a team of IIT Bombay professors is developing another model of a low cost ventilator.

Before we discuss the intricacies of this ventilator, let us examine why the availability of inexpensive ventilators is so necessary.

In case COVID-19 patients develop acute respiratory distress syndrome, the only way to manage the symptoms effectively is to put the patient on ventilator assistance. As per Media Sources, there are around 40000 ventilators collectively in all Health facilities in India, whereas the number of cases already crossed 33000 mark on 30th April. Also, there is a question about the equivalent availability of ventilators in various regions of India.

Contributing to the resource scarcity is the prolonged incubation which many of these patients require as they recover – often 15 to 20 days of mechanical ventilation and then slow weaning. The average cost of a standard ventilator (₹ 1-1.5 lakh) and manufacturing time is the most critical hurdle in achieving the required capacity of ventilators. 

Source: MIT, semanticsscholar.org

Now that we have sufficient context about their need, we take a look at the ventilator that is being developed in IIT Bombay.

To tackle this problem, a group of professors from the Mechanical and Computer Science department – Prof. Ramesh Singh, Prof. Sohum Mujumdar Prof. Ashutosh Gupta, and Prof. Ankit Jain is developing a Low-Cost Ventilator with essential functionality specifically for COVID-19 patients, as mentioned by govt. of India. This is being done in collaboration with Technocraft Industries, founded by our alumni, for prototyping and instrumentation. 

This is an Ambu-bag based mechanical ventilator design. The ‘Ambu bag’ is a proprietary term for a hand-held bag valve mask (BVM) resuscitator that’s commonly used to provide positive pressure ventilation to patients who are not breathing or not breathing adequately. The Ambu bag is made of self-inflating, biocompatible plastic (E.g., Styrene Ethylene Butylene Styrene).

 

Ambu-bag is compressed by a flap and acts as a compressor. The flap is actuated by pulling a nylon belt wound on a stepper motor. The mixing of air and O2 occurs in the Ambu bag. This mixture is then delivered to the patient during the inspiration.

This ventilator provides assured tidal volume ( the volume of air moved into and out of the lungs during each ventilation cycle) by controlling the speed with which the Ambu bag compresses or decompresses determines the respiratory rate. While the amount of compression determines the tidal volume of air + O2 mixture delivered per breath. The operator selects the appropriate tidal volumes to the patient, usually 6-8 mL/kg of ideal body weight and a minimum respiratory rate.

In the case of COVID19 patients, it is also essential to have a continuous PEEP (positive end-expiratory pressure) of 2-10 cm H2O. At any time, the minimum pressure in the system should not drop below this level. An anti-asphyxiation valve and a pressure relief valve is present in the circuit to ensure the pressure doesn’t go below ambient or doesn’t exceed beyond what’s required. Auxiliary airflow is maintained at all times using a small air blower to provide continuous PEEP pressure. 

There are several modes of control for the ventilator. This ventilator design has Assisted and Mandatory mode. In the assisted mode, the ventilator detects the patient’s effort to inspire and then provides the inspiratory pressure. While in the mandatory mode, the breaths are given at a regular interval. The ventilator control system is based on a microcontroller with Bluetooth connection, which can be operated through a mobile app.

Source: MIT, semanticsscholar.org

The design also includes a pressure sensor just before the mask to continuously monitor the inspiratory pressure. The sensor provides vital information about a patient’s Lung compliance or any leakages in the system to the clinician. Currently, tests are being performed on this ventilator, and soon it will be released for open access. 

Innovators and Organizations across the globe are putting in all possible efforts to tackle this situation. Governments and Health care organizations are supporting and encouraging people to develop and come up with solutions to pandemic related problems. Insight applauds such innovations in the face of crisis and hopes for their successful and speedy implementation wherever required.

 

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