Inspiration
(1) Medical ventilators currently in use are capable of supplying only one person, and each patient must be provided with a separate ventilator, ARDS patients are using the medical ventilators more than one week long in average, so the available quantity runs out fast.
(2) Exhaled infectious air exits into the common hospital airspace by the respiratory equipment currently in use, whereby doctors and nurses are at increased risk due to working in air contaminated with high concentrations of viruses.
(3) An important factor to consider when setting up mass health camps is, which equipment can be used without hospital infrastructure in places where there are no drainage pipes in the wall and power distribution is limited to each camp bed.
(4) Medical ventilators are expensive devices, people in developing countries (such as some African, or Asian countries) cannot afford proper medical equipment.
The solution
MassVentil concept brings a revolutionary solution to patient ventilation. In short: we are designing and realizing a mass patient ventilation system, that can ventilate up to 50 or even more people at once, protect healthcare workers, and can be operated outside of hospitals, in temporary emergency camps.
The MassVentil solution can be realized using medical grade components or from sterilized non-medical budget materials (water pipelines, cheap air ventilators, stepper motors, microcontrollers, etc.) too.
With such devices, hundreds of people could be ventilated (individually) at the same time in an ad-hoc hospital or in an emergency camp environment. This solution can be used as emergency solution for thousands of people around the world and vast amount of patients, doctors, nurses could be saved.
What it does
(1) Our MassVentil solution consists of a central duct system and personal ventilator modules for the individual patients. The central inhalation and exhalation duct system supplies air to and collects gases from all the personal ventilator modules for ventilating more patients at the same time, thereby saving more lives.
(2) In our MassVentil concept, the medical ventilator removes (and filters) exhaled infectious air from the common airspace, significantly reducing the risk of infection for nursing staff, to provide safer working conditions.
(3) The mass ventilator system, is to be employed ad-hoc in an out-of-hospital environment without the need for advanced hospital infrastructure. (For the ventilation only electricity, medical professionals, and portable oxygen tanks are needed).
(4) According to the evaluations/feedbacks received from medical professionals about our already created prototypes, even the low-budget version ventilates easily 5 persons in a reliable way. The system supports both non-invasive ventilation modes (using face ventilation masks) and invasive ventilation modes (using endotracheal tubes). The treatment process of acute respiratory distress (ARDS) problems involves continuous patient ventilation. Each MassVentil patient ventilation unit can do pressure and volume control as the treatment requires. All generic ARDS ventilation modes are supported by the system such as: CMV, CPAP, BiPAP, CIMV, APRV, IPPV, PCV.
How we built it
We have assembled the very first machine using a home vacuum cleaner to validate the concept some weeks ago. Afterwards an improved prototype was built, which has a real engine in the engine room and sensors are designed into the system. We have consulted medical professionals, and according to their advices, we have started to include important medical ventilation modes and parameters (such as PEEP). In the new prototype version, we have successfully achieved patient ventilation for 3 patients. All “patients” were lung phantoms and each ventilated individually. We have started drawing the CADs, and we are writing the code for the Dashboard of the MassVentil system, too. Later on in a new prototype version we have successfully achieved patient ventilation for 5 simulated patients with the 3rd generation patient ventilation valve. We are now realizing the 4th generation patient ventilation valve, which enables increased patient safety (during power failure).
The solution’s impact to the crisis
MassVentil system can save life of patients, and furthermore protects doctors and nurses from virus infections. The MassVentil solution brings viable solution for poor countries, where access to medical ventilators is not feasible. Our centralized patient monitoring system supports effective patient monitoring with limited number of medical professionals. The MassVentil system can be deployed in remote areas, where hospitals are not available and within hospitals as an additional medical patient ventilation facility.
The necessities in order to continue the project
(1) More test facilities/setups needed to increase the MassVentil systems adaptability. Deployment in foreign countries assumes different environmental conditions, such as temperature, power supply, etc. We are looking for universities, maker communities, device developers worldwide to build up local MassVentil systems according to the open blueprints. (2) More time needed to increase patient safety. As the MassVentil system is doing both volume and pressure-controlled ventilation, we are working on the safe implementation of the vast amount of ARDS ventilation modes. (3) Financial support needed to scale up the system to 50 or even more patients.
The value of our solution after the crisis
Recent strong MassVentil prototypes are built from non-medical grade materials, and we are now focusing on the budget level implementation of the MassVentil concept targeting developing countries in Africa and Asia. After the crisis, a highly effective, medical-grade product will emerge from the mass patient ventilation concept, which can be a useful component of any national disaster/emergency response teams later.
Challenges we ran into
(1) Sensor components are hard to purchase recently (2) Medical ventilators are similar to critical infrastructures. Patient safety is crucial. Testing such systems requires a lot of time. (3) Pressure and volume based ventilation control requires solid medical knowledge, knowledge transfer from doctors is difficult as they are hard to reach during their fight against the virus.
Accomplishments that we are proud of
We have realized proof-of-concept and strong prototype versions of the MassVentil concept. The realized MassVentil system is working and provides ventilation for ARDS patients (tested on lung phantoms). We have realized an online, real-time, easy-to-use patient monitoring dashboard to manage patient ventilation at large scale. We are now designing a transportable container version of the MassVentil system, which can increase the mobility and deployment capabilities of the system.
What we have done during the weekend
We have reorganized the existing blueprints of the project, we have started the box design of the patient ventilation unit, have redesigned the Dashboard UI of the system. Furthermore, we have started building the next test environment, which will do patient ventilation for 10 patients. We have started to design a transportable MassVentil container version.
What we learned
Team work is crucial in such rapid development. We have started the system design just some weeks ago. Recently the MassVentil Team has about 1000 developers and another 1000 contributors from different countries. EUvsVirus was an excellent occasion and it provided an effective communication platform to receive inputs from large audience.
What's next
We are finishing the next prototype system which will ventilate 10 patients (29.04.2020). We are recently finalizing the design of the 3D boxes/houses for the patient ventilation unit and for the patient ventilation valve. Transportable "Container version" of the MassVentil system is planned to be ready in 2 weeks with capability of 20 patients. All realized blueprints, CADs, circuit designs, and software are provided for public access by default.
MassVentil System Specification overview
The system is suitable for non-invasive and invasive ventilation (for each single person).
Both volume control and pressure control are available for each patient.
PEEP till 25 mbar available (with fine grain adjustment) for each patient.
Maximum continuous flow 150 L/min.
Free breathing support for each patient.
Patient triggered breathing support (inhale and exhale) for each patient.
Possible to cough into the system for each patient.
O2 -tank or O2 concentrator can be connected if it is able to provide at least 80 mbar.
FiO2 (oxygen level) adjustment from 21%-100% (with fine grain adjustment) for each patient.
Humidity and temperature are controlled by HME (HME booster is optional, it can be used); optionally, temperature can be controlled in the inhale bus too.
Exhaled air is always carried out from the patient area and filtered 2x with HEPA (ULPA is optional) air filters before releasing into the air.
Patient interface: patient ventilation unit can be connected to standard patient ventilation masks (for non-invasive ventilation), using endotracheal tubes (for invasive ventilation) or to special Covid-19 masks with tube type connectors, or to nasal prongs. We are about to carry away the infectious air from the patient in order to protect medical professionals, thus patient interfaces with direct exhale valves are not preferred.
Patient safety
Oxygen concentration high and low threshold alarms available.
25 mbar mechanical fail-safe value to limit maximum airway pressure is available.
If the patient ventilation unit losts its power supply (from 3rd gen. patient ventilation valve) free breathing is supported to/from local air allowed by an additional mechanical valve.
In case of invasive ventilation during power outage at the patient ventilation unit: medical professional should maintain the ventilation manually.
Online full dashboard has been created for the whole system, and for each patient. The patient dashboard is very similar to a normal medical ventilator dashboard to ease the usage/learning curve for the doctors and nurses.
All active devices (main motor control and patient ventilation units) are connected via a secured, common wireless network.
Dashboard is available on all kind of online browsers, can be used on a vast amount of equipment (including tabs, smart phones, laptops and PCs).
All active units have unique IDs in the system. System maintenance, and patient treatment/ventilation control is logged non-stop.
Patient parameter monitoring is available online via the patient dashboard in real-time (100 ms scale), where last minute data and historical patient data visualization is available too.
Built With
- arduino
- c/c++
- duct
- exhale/inhale
- javascript
- motors
- mqtt
- scada
- system
- thingsboard