Telerobotic Operation of Intensive Care Unit Ventilators

Abstract

Since the first reports of a novel coronavirus (SARS-CoV-2) in December 2019, over 33 million people have been infected worldwide and approximately 1 million people worldwide have died from the disease caused by this virus, COVID-19. In the United States alone, there have been approximately 7 million cases and over 200,000 deaths. This outbreak has placed an enormous strain on healthcare systems and workers. Severe cases require hospital care, and 8.5% of patients require mechanical ventilation in an intensive care unit (ICU). One major challenge is the necessity for clinical care personnel to don and doff cumbersome personal protective equipment (PPE) in order to enter an ICU unit to make simple adjustments to ventilator settings. Although future ventilators and other ICU equipment may be controllable remotely through computer networks, the enormous installed base of existing ventilators do not have this capability. This paper reports the development of a simple, low cost telerobotic system that permits adjustment of ventilator settings from outside the ICU. The system consists of a small Cartesian robot capable of operating a ventilator touch screen with camera vision control via a wirelessly connected tablet master device located outside the room. Engineering system tests demonstrated that the open-loop mechanical repeatability of the device was 7.5 mm, and that the average positioning error of the robotic finger under visual servoing control was 5.94 mm. Successful usability tests in a simulated ICU environment were carried out and are reported. In addition to enabling a significant reduction in PPE consumption, the prototype system has been shown in a preliminary evaluation to significantly reduce the total time required for a respiratory therapist to perform typical setting adjustments on a commercial ventilator, including donning and doffing PPE, from 271 to 109 s.

Advances in the Application of AI Robots in Critical Care: Scoping Review

“…The application of robotics in the medical field is extensive, encompassing myriad functions and scenarios, rendering their precise classification a formidable task. Multimedia Appendix 2 [ 6 , 18 - 90 ], which is neither exclusive nor exhaustive, summarizes the representative research groups and commercial suppliers to provide readers with a panoramic view of the field.…”

“…Computer vision tasks that enable an intuitive user interface and accurate robot control are executed on the master console. The system was initially developed and deployed for the most popular touch screen–controlled ventilator at Johns Hopkins Hospital, the Maquet Servo-u (Getinge AB) [ 18 ]. Different from the traditional ventilators in most ICUs, the robot performs remote control and monitoring outside the ICU room through the network.…”

“…This approach not only minimizes the installation burden but also ensures that the robot’s operation remains closely aligned with conventional manual procedures. Such a configuration facilitates ease of use and integration into existing medical workflows, thereby enhancing efficiency without compromising the quality of patient care [ 18 ]. In a simulated ICU environment, a Cartesian robot reduced the total time required for a respiratory therapist to make typical setup adjustments to a traditional ventilator from 271 to 109 seconds, which was 2.49 times faster [ 18 ].…”

Use of Robots in Critical Care: Systematic Review

“…Sawyer (Rethink Robotics GmbH) [ 43 ], a 7-axis robot with flexible joints and a camera, could successfully perform a variety of COVID-19 health care tasks: intravenous pump device continuation, ventilator knob adjustment, ICU monitor silencing, oxygen knob adjustment, and call button deactivation. Vagvolgyi et al [ 44 ] demonstrated the use of a telerobotic cartesian system to allow the adjustment of ventilator settings from outside the ICU. Similarly, this was feasible in a simulated ICU environment and specifically saved 59.8% of the time (a decrease from 271 seconds to 109seconds).…”

A human-machine interaction method and process based on the intelligent medical robot

“…"According to the physiological structure of the human body, doctors have great limitations in terms of the accuracy, stability, fatigue resistance and radiation resistance of the operation, which are the advantages of robots" [5]. The so-called service robots are mostly simple, low-cost and controlled by touch screens [6,7]. It also has unique advantages in medical treatment, such as identification and avoidance ability and intelligent human-computer interaction interface, so as to be safe and radiation-free and adapt to the human spirit [5].…”