Is the use of automated artificial manual breathing unit resuscitators justified during a pandemic mechanical ventilator crisis?

Kakkar, Kamna; Gupta, Bhavna

doi:10.4266/acc.2020.00311

Cited by 5 publications

(3 citation statements)

References 3 publications

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“…It is important to understand that automated resuscitators, including ABBU, have significant limitations compared to fully functional ICU ventilators [ 9 , 20 , 27 , 28 ]. Due to the use of a fixed low flow oxygen source, delivered FiO 2 decreases with increases in V T or RR and may be a significant factor contributing to oxygen desaturation in patients.…”

Section: Discussionmentioning

confidence: 99%

Data automated bag breathing unit for COVID-19 ventilator shortages

Gruslova

Katta

Cabe

et al. 2021

ICMx

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Background The COVID-19 pandemic has caused a global mechanical ventilator shortage for treatment of severe acute respiratory failure. Development of novel breathing devices has been proposed as a low cost, rapid solution when full-featured ventilators are unavailable. Here we report the design, bench testing and preclinical results for an 'Automated Bag Breathing Unit' (ABBU). Output parameters were validated with mechanical test lungs followed by animal model testing. Results The ABBU design uses a programmable motor-driven wheel assembled for adult resuscitation bag-valve compression. ABBU can control tidal volume (200–800 ml), respiratory rate (10–40 bpm), inspiratory time (0.5–1.5 s), assist pressure sensing (− 1 to − 20 cm H2O), manual PEEP valve (0–20 cm H2O). All set values are displayed on an LCD screen. Bench testing with lung simulators (Michigan 1600, SmartLung 2000) yielded consistent tidal volume delivery at compliances of 20, 40 and 70 (mL/cm H2O). The delivered fraction of inspired oxygen (FiO2) decreased with increasing minute ventilation (VE), from 98 to 47% when VE was increased from 4 to 16 L/min using a fixed oxygen flow source of 5 L/min. ABBU was tested in Berkshire pigs (n = 6, weight of 50.8 ± 2.6 kg) utilizing normal lung model and saline lavage induced lung injury. Arterial blood gases were measured following changes in tidal volume (200–800 ml), respiratory rate (10–40 bpm), and PEEP (5–20 cm H2O) at baseline and after lung lavage. Physiological levels of PaCO2 (≤ 40 mm Hg [5.3 kPa]) were achieved in all animals at baseline and following lavage injury. PaO2 increased in lavage injured lungs in response to incremental PEEP (5–20 cm H2O) (p < 0.01). At fixed low oxygen flow rates (5 L/min), delivered FiO2 decreased with increased VE. Conclusions ABBU provides oxygenation and ventilation across a range of parameter settings that may potentially provide a low-cost solution to ventilator shortages. A clinical trial is necessary to establish safety and efficacy in adult patients with diverse etiologies of respiratory failure.

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Section: Discussionmentioning

confidence: 99%

Data automated bag breathing unit for COVID-19 ventilator shortages

Gruslova

Katta

Cabe

et al. 2021

ICMx

View full text Add to dashboard Cite

show abstract

“…It is important to understand that automated resuscitators, including ABBU, have signi cant limitations compared to fully functional ICU ventilators (10,22,(29)(30). Due to the use of a xed low ow oxygen source, delivered FiO 2 decreases with increases in V T or RR and may be a signi cant factor contributing to oxygen desaturation in patients.…”

Section: Discussionmentioning

confidence: 99%

295: Automated Bag Breathing Unit for COVID-19 Ventilator Shortages

Gruslova

Cabe

Katta

et al. 2020

Critical Care Medicine

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Background: The COVID-19 pandemic has caused a global mechanical ventilator shortage for treatment of severe acute respiratory failure. Development of novel breathing devices has been proposed as a low cost, rapid solution when full-featured ventilators are unavailable. Here we report the design, bench testing and preclinical results for an 'Automated Bag Breathing Unit' (ABBU). Output parameters were

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“…Many of these control systems are purely mechanical (i.e., with no control electronics), so any modification of the breathing cycle parameters entails changing mechanical components such as cams or gears. All of this makes them rough and sometimes unreliable since the minimal resistance requirements and safety regulations are not always met [24].…”

Section: Introductionmentioning

confidence: 99%

Design for the Automation of an AMBU Spur II Manual Respirator

et al. 2021

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This article shows the design of a device to automatize an Ambu Spur II manual respirator. The aim of this compassionate medicine device is to provide an emergency alternative to conventional electric respirators—which are in much shortage—during the present COVID-19 pandemic. To develop the device, the classical method of product design based on concurrent engineering has been employed. First, the specifications of the machine have been determined, including the function determining the air volume provided at every moment of the breathing cycle; second, an adequate compression mechanism has been designed; third, the control circuit of the motor has been determined, which can be operated via a touchscreen and which includes sensor feedback; fourth, the device has been materialized with readily available materials and market components, mostly of low cost; and fifth, the machine has been successfully tested, complying with sanitary regulations and operating within desirable ranges. The device has been already manufactured to supply respirators to several hospitals around the Catalan Autonomous Community in Spain, but can also be replicated in developing countries such as Ecuador.

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Is the use of automated artificial manual breathing unit resuscitators justified during a pandemic mechanical ventilator crisis?

Cited by 5 publications

References 3 publications

Data automated bag breathing unit for COVID-19 ventilator shortages

Data automated bag breathing unit for COVID-19 ventilator shortages

295: Automated Bag Breathing Unit for COVID-19 Ventilator Shortages

Design for the Automation of an AMBU Spur II Manual Respirator

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