25 ms·

Open-source “pandemic ventilator”

148 points by ericb 7y ago

Altjira 7y ago
I live in Vietnam. They do not have anywhere near the capacity needed to deal with ventilating. In HCM with a population of 9 million the largest hospital, Cho Ray, has 1000 beds ready but only 200 intensive, and 20 ventilators. Even fewer ECMO kits. Its one of the best equipped hospitals in the country. If things get bad, thousands will be sent home, thousands will die. Currently we are working on ways to repurpose industrial bottles and work with local gas and liquid oxygen manufacturers to come up with stop gap solutions to get oxygen to several thousand people at once, across the whole city, using existing propane gas distribution systems and grab app for monitoring and delivery. This is our ONLY option. For those pointing out how dangerous homemade ventilators and oxy kits can be, assume that WE KNOW that already, and that we wouldnt be looking at this unless it looked like there being no other option. We have under 700 large hospitals, but over 35,000 local clinics, many of which are run by local doctors with training and their own oxygen gear. We dont need them to be perfect, we dont need them to last forever, we just need them to work. If they save more than they harm, when people without them would die anyway, thats a meaningful impact. And yes, Viet doctors and government will use WHATEVER they need to get sh*t done and save lives.
jaekwon 7y ago
Thank you, creating a directory here: https://github.com/wikirona/wikirona/blob/master/oxygen/README.md https://github.com/wikirona/wikirona/blob/master/oxygen/READ...
popotamonga 7y ago
Can you actually buy a consumer ventilator? I would see myself paying up to 10k for a ventilator to have at home just in case...
- mjmdavis 7y ago
  Doing this could deprive hundreds of people of a life saving device.
  - Aeolun 7y ago
    If it’s on the open market it’s presumably not saving any lives. If it does get to the point where we have to pull everything off the open market, then maybe, but you can always go and offer it to a local hospital.
  - deleted 7y ago
    [deleted]
  - anonuser123456 7y ago
    Prices and consumption signal producers the relative importance of a good. Its better for people to drive prices up so suppliers can respond appropriately. Right now it makes sense for instance for defense companies (eg large manufacturing corps) to partner with med corps (who's supply chains are in shambles) to start cranking these our. But they won't unless the profit/market is there for it.
- TylerE 7y ago
  A cpap, or especially s bipap will come pretty close. Not the same in that isn’t true life support, but it does make breathing _much_ easier. I use a cpap at home for sleep apnea and was on a bipap for about 48 hours when hospitalized for pnuemonia. Machines cost about $500-1500 dollars. Do require a percription though.
  - JshWright 7y ago
    CPAP is a good way to prevent someone from getting intubated later on. It doesn't reduce the risk entirely, but early and aggressive CPAP usage can definitely reduce the likelihood of a pt needing intubation further down the line (more common w/ asthma/COPD, but there is some evidence supporting its use w/ ARDS pt's as well)
    - anonuser123456 7y ago
      In not sure this is true. CPAP/PEEP are used for first line mild ARDS. But it seems hard to find any conclusive evidence for efficacy. It definitely makes people more comfortable, but it's hard to say if the clinical efficacy is really there.
      - JshWright 7y ago
        The evidence is stronger in the case of mild ARDS (early NIVPP reduces intubation rates), by the time it has progressed to moderate/severe ARDS, it's too late and NIVPP isn't going to do any good. Apologies that I'm on my phone right now and don't have links at hand, but I have done some reading on this topic recently.
        JshWright 7y ago
        Outside the edit window, but this is one of the studies I was referring to: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4057073/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4057073/ From the conclusion: > Intubation rates did not exceed 35% in non-ARDS and mild ARDS and NIV may thus be used as the first-line ventilatory support ... By contrast, 84% of severe ARDS required intubation and NIV does not appear beneficial in this subset of patients ... In patients with moderate ARDS, NIV may be worth attempting in those having a PaO2/FiO2 ratio >150 in the absence of hemodynamic instability or altered consciousness ... There are definitely significant shortcoming to that study (single facility, etc), but it definitely points in the direction of CPAP being a viable treatment, especially if it's used aggressively (initiated early, high PEEP, etc)
- JshWright 7y ago
  Would you also hire a respiratory therapist on retainer to operate it for you?
  - Aeolun 7y ago
    Probably better to hire one to train you in it’s operation.
  - popotamonga 7y ago
    My wife is ICU medic
    - JshWright 7y ago
      Not sure what you mean by "medic" in this case, but does she have much experience running a vent? ARDS requires very careful management of ventilator settings (in addition to a whole host of other care), and is typically handled by specially trained respiratory therapists in a hospital setting.
- refurb 7y ago
  If you're so sick you need a ventilator, you're also going to need a ton of supportive care as well. The chances of a ventilator being the one missing link between life and death (outside of a hospital) is pretty small.
  - evv555 7y ago
    The chance of it being the missing link within a hospital seems large though. I imagine there are more beds then there are ventilators in any given hospital.
    - _jal 7y ago
      So the plan is to keep one around the house, maintained in good condition, to take with you to the hospital?
      - refurb 7y ago
        And if the staff is t trained on that particular model, there is no way they’ll use it.
      - evv555 7y ago
        No. The current survival stats involve 20% of those infected ending up in ICU. If this was to become a pandemic that would require millions of respirators to maintain that survival rate. Think about that and what "condition" you would accept for a respirator.
- jacquesm 7y ago
  10k for the ventilator is on the low side, but assuming you could buy one you still need an ICU or rough equivalent to take care of everything else and a massive autoclave for periodic sterilization or you're going to get a nice infection on top of your already very bad air supply situation. This is well outside of DIY territory, though there are people living in 'Iron lungs' for decades (but those are typically strong enough to survive for a while outside of them and can breathe independently if they have to, they use the iron lungs for relief).
mjmdavis 7y ago
This has genuinely given me hope. It would be great to see more ideas and work around this.
- ficklepickle 7y ago
  It reminds me of the baby incubator made from car parts. https://blogs.scientificamerican.com/news-blog/babys-hot-wheels-an-incubator-made-2008-12-16/ https://blogs.scientificamerican.com/news-blog/babys-hot-whe...
Confiks 7y ago
Here [1] is another interesting low-cost version of ventilator. It's an immersion two-phase continuous positive airway pressure (CPAP) device, of which all the parts are printable. The patient still needs to be able to initiate breaths themselves, but it will cost a lot less energy to breath. Combine it with a (admittedly lot harder to make) homemade pressure swing adsorbtion system that delivers high-oxygen air, using zeolite sieves and alternating pressure [2]. [1] https://www.youtube.com/watch?v=CHiRTMQCf1Y https://www.youtube.com/watch?v=CHiRTMQCf1Y [2] https://www.youtube.com/watch?v=ylj4oOnlIY0 https://www.youtube.com/watch?v=ylj4oOnlIY0
- mrtweetyhack 7y ago
  Oh shit! I forgot I have one of those sitting around!
- Gravityloss 7y ago
  Not a medical professional but the CPAP route sounds more promising to me. Simpler, less risk. What about just oxygen bottles or oxygen enrichment? They have their own dangers though.
  - kortex 7y ago
    I would imagine in a situation where you need ersatz CPAP, bottled oxygen is harder to come by and/or less affordable. PSA oxygen generators are simple to construct and provide continuous oxygen as long as you power them.
im3w1l 7y ago
Wow to think someone wrote this 12 years ago. I feel there is a lesson here but I don't know what.
- arcticbull 7y ago
  The lesson is diseases happen, and then they go away and we forget all about them. Bird flu, swine flu, SARS, MERS and soon nCoV-19. The number of active cases is approaching half of what it was at peak, and the mortality rate is now close to 0.7% - and largely weak/immunocompromised patients, the same order of magnitude as the normal flu. Further, a few groups claim a vaccine is only a few months away, and it responds to some existing antiviral medications.
  - ericb 7y ago
    > a few groups claim a vaccine is only a few months away That's just wrong as it would take months and months to test before you could deploy it. At least one of the vaccines for SARs actually made things worse, if memory serves. Not to mention the manufacturing ramp up time. The map is not the territory. For example, in the US, it is entirely unclear how many cases there are as only 400 tests have been done in total. Hopefully the antivirals will work out.
  - wbl 7y ago
    In Qoom nothing has been done. The Iraniam government refuses to take even the most basic control measures.
    - arcticbull 7y ago
      It also has a 0.7% case fatality rate in China (and 0.6% outside) on par with H1N1 at 0.45%. Nothing really needs to be done -- this time. The situation would be far, far worse with a disease that actually killed a lot of healthy individuals.
      - blagie 7y ago
        Worldwide, there were 2,979 deaths and 42,576 recovered. That math suggests you might have an extra decimal point there. There are many ways to do the math, but 0.7% is not really a sensible number to work from. General consensus hovers at 2-3%. Aside from that, a much larger (as of yet unknown) number have permanent lung scarring. That's not a joke. Read about SARS and MERS long-term prognosis from similar scarring.
sitkack 7y ago
The number one issue with ventilators is bacteria and second is if they fail you die. This absolutely the measure of last resort, but as the pandemic spreads there will be ventilator shortages and people that don’t have to die will die.
7a1c9427 7y ago
The naiveté being expressed in the comments here and as the premise behind the ventilator is astounding. I though I would share some information to put things in perspective: - If you are unwell enough to need a ventilator then the ventilator itself is going to the least of your worries. You will need the drugs and expertise to care for you. The current respiratory illnesses going around aren’t like polio and the iron lungs where all you need is help breathing. - If you can sort the above to have any hope of survival you need a “modern” ventilator that can operate in way that this simple homebrew device is physically not capable of offering. Most of the improvement in caring for people with ARDS is based upon careful and tight control of ventilatory parameters to prevent secondary lung injury. - Modern ventilators have a price tag of if you have to ask you can’t afford it. So in summary this is a nice build but serves no practical purpose.
- prostheticvamp 7y ago
  This is correct. Particularly the “if you are unwell enough to need the vent, the vent is the least of Your worries.” The vent keeps you oxygenating while we address the (usually multiple, overlapping and interacting) severe issues that led to you needing the vent. This is ICU-level care. A vent without an ICU doc and appropriate medications (and ideally a resp tech and a nurse) might as well be an origami crane. Hospitals will run out of one those other things, on average, before they run out of vents.
  - jfim 7y ago
    Thanks for chiming in. If I understand what you're saying correctly, you're saying that in the case where one would be so sick as to require a ventilator, they'd be in a situation where the ventilator only buys more time before the condition worsens, but doesn't actually address the root cause of the problem. As such, even if someone were to find a hospital-grade ventilator that fell off the back of a truck and managed to properly use it, the non-ventilator care is what makes the difference in outcome, not the ventilator itself. Is that correct?
    - catblast 7y ago
greesil 7y ago
I was thinking that with the shortage of antiviral masks in the consumer space, if there was a way to diy one. Extra points if it involves a 3d printer.
- JshWright 7y ago
  Masks are not for keeping healthy people safe from pathogens. They are for keeping sick people from spreading virus laden droplets when they cough/sneeze. A mask that's capable of keeping a virus out is a a) much more expensive than a typical surgical mask, b) easy to wear improperly, negating its usefulness, and c) only good for a limited time before needing to be thrown out.
  - Johnny555 7y ago
    And inhalation isn't the only way to get infected -- any mucous membrane (including the eyes) is a possible infection route. The only real protection is a full hazmat suit with a full face shield. And you need to know how to take it off without infecting yourself. The best way to protect yourself from the illness is to stay away from other infected people, not wear some home made protective gear that you're probably not going to replace often enough or handle and dispose of properly after you take it off.
  - mike_d 7y ago
    > Masks are not for keeping healthy people safe from pathogens All the doctors and nurses having to wear masks will be so relieved to hear this. But seriously the advice of not wearing N95 masks when you are healthy is not because they are ineffective, but because they are trying to discourage hoarding. Even current CDC recommendations for healthcare workers suggest N95 masks for only patient intake and direct care, with all others wearing surgical masks to help protect the supply of N95s.
    - maccard 7y ago
      Health workers are likely aware that those protections are for the safety of the people they're treating, not for themselved
arcticbull 7y ago
Very cool project, and a fun article, though I can't help feel like this thing is more likely to kill you than nCoV-19. It's got a mortality rate of 0.7% (same order of magnitude as the garden variety flu) and I'm betting there's a much more than 0.7% chance this thing blows your lungs clean out haha.
- divbzero 7y ago
  0.7% mortality rate for 2019-nCoV is inaccurate. We do not know the mortality rate with any precision at this point and early estimates place it far higher than 0.7%. Let’s be neither alarmist nor complacent, but above all get our facts right and avoid spreading misleading information.
  - arcticbull 7y ago
    The WHO pins it at 0.7% and falling as understanding thereof and treatment improves [1 - page 12, graph on page 13]. This makes a lot of sense as the earliest numbers were based only on people presenting severe symptoms, and huge quantities of people with nCoV are completely and totally asymptomatic. As with the flu, mortality is highest in older people, and the immunocompromised. [1] https://www.who.int/docs/default-source/coronaviruse/who-china-joint-mission-on-covid-19-final-report.pdf https://www.who.int/docs/default-source/coronaviruse/who-chi...
    - cjbprime 7y ago
      Like you say, if you are over 70 and get it, your mortality rate would be more like 10%, even with these lower numbers. > This makes a lot of sense as the earliest numbers were based only on people presenting severe symptoms, and huge quantities of people with nCoV are completely and totally asymptomatic. Isn't another possible explanation that it simply takes very sick people a few weeks to die from it, so if you start counting a week farther back then the confirmed-then-died rate will be higher? (Due to undercounting of people who are going to die from it but haven't yet.)
      - 7y ago
lukevp 7y ago
This is maybe unrelated, but is there a diy version of a mask for filtering air? What I want is a full face mask with filtered air for working on cars, around solvents and paints, and such, but the masks usually require the force of your own lungs to pull the air through the filter and through a 1 way valve when you exhale. I want something battery powered that does the air filtering. What am I looking for and how much does this cost? And would something like this be usable for what I had envisioned when I read “pandemic ventilator” which would be like something you could wear while you were out and about and it would filter everything you’re breathing.
- viklove 7y ago
  What would the battery be for?
  - lukevp 7y ago
    To power some type of air pressurization system so that it’s not my lungs that are pressurizing the air, this is because filtering the air requires additional pressure to force the air through the filter.
- fao_ 7y ago
  Is the battery for some kind of fan that pulls in air? Presumably any kind of fan would make it difficult to extract the air output properly. You should focus on HEPA compliant masks that make it easier to filter out things, like the Respro series -- however those are not confirmed for use to extract solvents and paints, so that might be worse than no option at all because you could believe that you are protected and actually the mask does not protect you.
- amluto 7y ago
  What you want is called PAPR. edit: Avoiding the extra breathing effort is only part of the benefit. Respirators generally let a lot more pollutants in through leakage than through actual failure to capture them because it’s very hard to make a good seal around your face. A powered respirator can keep the internal pressure neutral or slightly positive, reducing the tendency for anything to leak in around the mask.
DoreenMichele 7y ago
I get that people are scared and trying to reassure themselves. This is really not the way to go. I don't know how to foster some kind of constructive discussion of preventive best practices or whatever, but medical devices that aren't cleaned properly and kept sterile cause horrifying and deadly infections regularly. This even happens in hospital settings. This article doesn't even seem to be bothering to address the need to disinfect everything. With lung issues, that's a not unimportant detail.
Cass 7y ago
If it comes to that, you can also share a conventional ventilator between two people. It's an ugly hack, because you have to use the same settings on both patients, so it doesn't allow for the sort of precise control you want if you're managing ARDS, but probably still a better solution than using a home-made ventilator. It was successfully used when the ER ran out of ventilators in the wake of the Vegas shooting[1], but is probably better used in the sort of emergency where you just need to win a few hours' time than a sustained crisis. 1: https://epmonthly.com/article/not-heroes-wear-capes-one-las-vegas-ed-saved-hundreds-lives-worst-mass-shooting-u-s-history/ https://epmonthly.com/article/not-heroes-wear-capes-one-las-...
kortex 7y ago
Wow, some of the comments/downvotes here are astounding, especially for a group of people priding themselves on problem solving and FOSS. Obviously, a plywood vent isn't hygenic. But R&D isn't a zero to one jump, you gotta start somewhere. Often it's that first spark of "wait this is something that needn't be only the domain of hospital gear companies" to inspire others to work on the problem. Sure, a vent alone is probably not gonna improve your chance of living without the right care, but if there was a set of condensed instructions and WHO essential meds, yeah, maybe you have a shot. This is also more about developing countries / rolling pandemics / CME-Carrington event than cov19 alone. Tell me, when was the last time you saw a panic in a trace/log to the effect of, "This should never occur." ? No one wants to be in the situation to need backups. This is part of a backup plan. The defeatism in this thread already makes me want to go and improve the design. For one, you can get pneumatic valves which take the place of 2 or maybe even 3 of the valves on the machine.
Delariva 7y ago
While well intentioned, I really don’t think this should be built by anyone for use on an actual patient. As mentioned in other posts, mechanical ventilation is only part of “life support” with a typical ICU admission for ARDS requiring: establishing peripheral IVs, central venous line (giant IV in neck to heart placed under sterile conditions), intubation (Which requires expertise and advanced equipment), oxygen (lots in terms of liters), medications (inotropes, sedatives, paralytics, nutritional support, bronchodilators, etc.) urine/foley catheter, the ability to suction the airway, nasogastric tube, bedside monitoring (arterial line, capnography, etc) potentially chest tube, dedicated bedside staff and access to X-rays and CT, blood work (particularly Arterial blood gas analysis for mech vent) to guide process, specialists for consults and this doesn’t include what else is needed when other systems fails (as is this case in ARDS: kidneys can fail which needs dialysis). Also, mechanical ventilation needs heat and humidification (requiring about 1L or sterile water every 12-24 hours) so you don’t jam up the airways with a mucus plug; so you need a temperature probe on the vent circuit as well. Also, mechanical ventilation is an aerosol generating medical procedure and even with the proper filters can still expose people in the surrounding meter or so to a virus. There’s also a great little unit that was used in Vietnam war called the Bird after the inventor - simple and clever and should be able to be cheaply manufactured or even potentially DIY but I think it required a high pressure gas source to drive the tidal volume.
- Diederich 7y ago
  Thanks for a detailed, well considered response. > intubation Do you think a laryngeal mask airway would useful in these kinds of situations?
zelienople 7y ago
In the initial studies out of Wuhan, about 15% of Covid-19 patients required critical care. These patients were treated with a ventilator, antiviral medications, and the support of an ICU. The mortality rate was about 2-3%. This scenario does not scale very well in a pandemic because there are simply not enough resources to provide this level of care to those who need it. There are about 5000 ventilators in Canada, for example, meaning that the country can effectively treat, at most, about 33,000 cases, assuming that the 15% ratio of total sick patients to those requiring critical care holds true. The mortality figures that we have so far are based upon everyone who needs it receiving critical care. As the pandemic scales, the mortality figures could easily reach 15% as the number of sick greatly exceeds the capacity to treat them. This project shows, therefore, that someone understands the real problem of Covid-19 and is attempting to solve it. I'll take a plywood ventilator over no ventilator any day of the week, even without the other resources of an ICU. I suspect a jet ventilator would be easier to build and more effective under the circumstances, so maybe that should be version 2.

148 points by ericb 7y ago

I live in Vietnam. They do not have anywhere near the capacity needed to deal with ventilating. In HCM with a population of 9 million the largest hospital, Cho Ray, has 1000 beds ready but only 200 intensive, and 20 ventilators. Even fewer ECMO kits. Its one of the best equipped hospitals in the country. If things get bad, thousands will be sent home, thousands will die. Currently we are working on ways to repurpose industrial bottles and work with local gas and liquid oxygen manufacturers to come up with stop gap solutions to get oxygen to several thousand people at once, across the whole city, using existing propane gas distribution systems and grab app for monitoring and delivery. This is our ONLY option. For those pointing out how dangerous homemade ventilators and oxy kits can be, assume that WE KNOW that already, and that we wouldnt be looking at this unless it looked like there being no other option. We have under 700 large hospitals, but over 35,000 local clinics, many of which are run by local doctors with training and their own oxygen gear. We dont need them to be perfect, we dont need them to last forever, we just need them to work. If they save more than they harm, when people without them would die anyway, thats a meaningful impact. And yes, Viet doctors and government will use WHATEVER they need to get sh*t done and save lives.

jaekwon 7y ago

Thank you, creating a directory here: https://github.com/wikirona/wikirona/blob/master/oxygen/README.md https://github.com/wikirona/wikirona/blob/master/oxygen/READ...

popotamonga 7y ago

Can you actually buy a consumer ventilator? I would see myself paying up to 10k for a ventilator to have at home just in case...

mjmdavis 7y ago
Doing this could deprive hundreds of people of a life saving device.
- Aeolun 7y ago
  If it’s on the open market it’s presumably not saving any lives. If it does get to the point where we have to pull everything off the open market, then maybe, but you can always go and offer it to a local hospital.
- deleted 7y ago
  [deleted]
- anonuser123456 7y ago
  Prices and consumption signal producers the relative importance of a good. Its better for people to drive prices up so suppliers can respond appropriately. Right now it makes sense for instance for defense companies (eg large manufacturing corps) to partner with med corps (who's supply chains are in shambles) to start cranking these our. But they won't unless the profit/market is there for it.
TylerE 7y ago
A cpap, or especially s bipap will come pretty close. Not the same in that isn’t true life support, but it does make breathing _much_ easier. I use a cpap at home for sleep apnea and was on a bipap for about 48 hours when hospitalized for pnuemonia. Machines cost about $500-1500 dollars. Do require a percription though.
- JshWright 7y ago
  CPAP is a good way to prevent someone from getting intubated later on. It doesn't reduce the risk entirely, but early and aggressive CPAP usage can definitely reduce the likelihood of a pt needing intubation further down the line (more common w/ asthma/COPD, but there is some evidence supporting its use w/ ARDS pt's as well)
  - anonuser123456 7y ago
    In not sure this is true. CPAP/PEEP are used for first line mild ARDS. But it seems hard to find any conclusive evidence for efficacy. It definitely makes people more comfortable, but it's hard to say if the clinical efficacy is really there.
    - JshWright 7y ago
      The evidence is stronger in the case of mild ARDS (early NIVPP reduces intubation rates), by the time it has progressed to moderate/severe ARDS, it's too late and NIVPP isn't going to do any good. Apologies that I'm on my phone right now and don't have links at hand, but I have done some reading on this topic recently.
      - JshWright 7y ago
        Outside the edit window, but this is one of the studies I was referring to: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4057073/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4057073/ From the conclusion: > Intubation rates did not exceed 35% in non-ARDS and mild ARDS and NIV may thus be used as the first-line ventilatory support ... By contrast, 84% of severe ARDS required intubation and NIV does not appear beneficial in this subset of patients ... In patients with moderate ARDS, NIV may be worth attempting in those having a PaO2/FiO2 ratio >150 in the absence of hemodynamic instability or altered consciousness ... There are definitely significant shortcoming to that study (single facility, etc), but it definitely points in the direction of CPAP being a viable treatment, especially if it's used aggressively (initiated early, high PEEP, etc)
JshWright 7y ago
Would you also hire a respiratory therapist on retainer to operate it for you?
- Aeolun 7y ago
  Probably better to hire one to train you in it’s operation.
- popotamonga 7y ago
  My wife is ICU medic
  - JshWright 7y ago
    Not sure what you mean by "medic" in this case, but does she have much experience running a vent? ARDS requires very careful management of ventilator settings (in addition to a whole host of other care), and is typically handled by specially trained respiratory therapists in a hospital setting.
refurb 7y ago
If you're so sick you need a ventilator, you're also going to need a ton of supportive care as well. The chances of a ventilator being the one missing link between life and death (outside of a hospital) is pretty small.
- evv555 7y ago
  The chance of it being the missing link within a hospital seems large though. I imagine there are more beds then there are ventilators in any given hospital.
  - _jal 7y ago
    So the plan is to keep one around the house, maintained in good condition, to take with you to the hospital?
    - refurb 7y ago
      And if the staff is t trained on that particular model, there is no way they’ll use it.
    - evv555 7y ago
      No. The current survival stats involve 20% of those infected ending up in ICU. If this was to become a pandemic that would require millions of respirators to maintain that survival rate. Think about that and what "condition" you would accept for a respirator.
jacquesm 7y ago
10k for the ventilator is on the low side, but assuming you could buy one you still need an ICU or rough equivalent to take care of everything else and a massive autoclave for periodic sterilization or you're going to get a nice infection on top of your already very bad air supply situation. This is well outside of DIY territory, though there are people living in 'Iron lungs' for decades (but those are typically strong enough to survive for a while outside of them and can breathe independently if they have to, they use the iron lungs for relief).

mjmdavis 7y ago

This has genuinely given me hope. It would be great to see more ideas and work around this.

ficklepickle 7y ago
It reminds me of the baby incubator made from car parts. https://blogs.scientificamerican.com/news-blog/babys-hot-wheels-an-incubator-made-2008-12-16/ https://blogs.scientificamerican.com/news-blog/babys-hot-whe...

Confiks 7y ago

Here [1] is another interesting low-cost version of ventilator. It's an immersion two-phase continuous positive airway pressure (CPAP) device, of which all the parts are printable. The patient still needs to be able to initiate breaths themselves, but it will cost a lot less energy to breath. Combine it with a (admittedly lot harder to make) homemade pressure swing adsorbtion system that delivers high-oxygen air, using zeolite sieves and alternating pressure [2]. [1] https://www.youtube.com/watch?v=CHiRTMQCf1Y https://www.youtube.com/watch?v=CHiRTMQCf1Y [2] https://www.youtube.com/watch?v=ylj4oOnlIY0 https://www.youtube.com/watch?v=ylj4oOnlIY0

mrtweetyhack 7y ago
Oh shit! I forgot I have one of those sitting around!
Gravityloss 7y ago
Not a medical professional but the CPAP route sounds more promising to me. Simpler, less risk. What about just oxygen bottles or oxygen enrichment? They have their own dangers though.
- kortex 7y ago
  I would imagine in a situation where you need ersatz CPAP, bottled oxygen is harder to come by and/or less affordable. PSA oxygen generators are simple to construct and provide continuous oxygen as long as you power them.

im3w1l 7y ago

Wow to think someone wrote this 12 years ago. I feel there is a lesson here but I don't know what.

arcticbull 7y ago
The lesson is diseases happen, and then they go away and we forget all about them. Bird flu, swine flu, SARS, MERS and soon nCoV-19. The number of active cases is approaching half of what it was at peak, and the mortality rate is now close to 0.7% - and largely weak/immunocompromised patients, the same order of magnitude as the normal flu. Further, a few groups claim a vaccine is only a few months away, and it responds to some existing antiviral medications.
- ericb 7y ago
  > a few groups claim a vaccine is only a few months away That's just wrong as it would take months and months to test before you could deploy it. At least one of the vaccines for SARs actually made things worse, if memory serves. Not to mention the manufacturing ramp up time. The map is not the territory. For example, in the US, it is entirely unclear how many cases there are as only 400 tests have been done in total. Hopefully the antivirals will work out.
- wbl 7y ago
  In Qoom nothing has been done. The Iraniam government refuses to take even the most basic control measures.
  - arcticbull 7y ago
    It also has a 0.7% case fatality rate in China (and 0.6% outside) on par with H1N1 at 0.45%. Nothing really needs to be done -- this time. The situation would be far, far worse with a disease that actually killed a lot of healthy individuals.
    - blagie 7y ago
      Worldwide, there were 2,979 deaths and 42,576 recovered. That math suggests you might have an extra decimal point there. There are many ways to do the math, but 0.7% is not really a sensible number to work from. General consensus hovers at 2-3%. Aside from that, a much larger (as of yet unknown) number have permanent lung scarring. That's not a joke. Read about SARS and MERS long-term prognosis from similar scarring.

sitkack 7y ago

The number one issue with ventilators is bacteria and second is if they fail you die. This absolutely the measure of last resort, but as the pandemic spreads there will be ventilator shortages and people that don’t have to die will die.

7a1c9427 7y ago

The naiveté being expressed in the comments here and as the premise behind the ventilator is astounding. I though I would share some information to put things in perspective: - If you are unwell enough to need a ventilator then the ventilator itself is going to the least of your worries. You will need the drugs and expertise to care for you. The current respiratory illnesses going around aren’t like polio and the iron lungs where all you need is help breathing. - If you can sort the above to have any hope of survival you need a “modern” ventilator that can operate in way that this simple homebrew device is physically not capable of offering. Most of the improvement in caring for people with ARDS is based upon careful and tight control of ventilatory parameters to prevent secondary lung injury. - Modern ventilators have a price tag of if you have to ask you can’t afford it. So in summary this is a nice build but serves no practical purpose.

prostheticvamp 7y ago
This is correct. Particularly the “if you are unwell enough to need the vent, the vent is the least of Your worries.” The vent keeps you oxygenating while we address the (usually multiple, overlapping and interacting) severe issues that led to you needing the vent. This is ICU-level care. A vent without an ICU doc and appropriate medications (and ideally a resp tech and a nurse) might as well be an origami crane. Hospitals will run out of one those other things, on average, before they run out of vents.
- jfim 7y ago
  Thanks for chiming in. If I understand what you're saying correctly, you're saying that in the case where one would be so sick as to require a ventilator, they'd be in a situation where the ventilator only buys more time before the condition worsens, but doesn't actually address the root cause of the problem. As such, even if someone were to find a hospital-grade ventilator that fell off the back of a truck and managed to properly use it, the non-ventilator care is what makes the difference in outcome, not the ventilator itself. Is that correct?
  - catblast 7y ago

greesil 7y ago

I was thinking that with the shortage of antiviral masks in the consumer space, if there was a way to diy one. Extra points if it involves a 3d printer.

JshWright 7y ago
Masks are not for keeping healthy people safe from pathogens. They are for keeping sick people from spreading virus laden droplets when they cough/sneeze. A mask that's capable of keeping a virus out is a a) much more expensive than a typical surgical mask, b) easy to wear improperly, negating its usefulness, and c) only good for a limited time before needing to be thrown out.
- Johnny555 7y ago
  And inhalation isn't the only way to get infected -- any mucous membrane (including the eyes) is a possible infection route. The only real protection is a full hazmat suit with a full face shield. And you need to know how to take it off without infecting yourself. The best way to protect yourself from the illness is to stay away from other infected people, not wear some home made protective gear that you're probably not going to replace often enough or handle and dispose of properly after you take it off.
- mike_d 7y ago
  > Masks are not for keeping healthy people safe from pathogens All the doctors and nurses having to wear masks will be so relieved to hear this. But seriously the advice of not wearing N95 masks when you are healthy is not because they are ineffective, but because they are trying to discourage hoarding. Even current CDC recommendations for healthcare workers suggest N95 masks for only patient intake and direct care, with all others wearing surgical masks to help protect the supply of N95s.
  - maccard 7y ago
    Health workers are likely aware that those protections are for the safety of the people they're treating, not for themselved

arcticbull 7y ago

Very cool project, and a fun article, though I can't help feel like this thing is more likely to kill you than nCoV-19. It's got a mortality rate of 0.7% (same order of magnitude as the garden variety flu) and I'm betting there's a much more than 0.7% chance this thing blows your lungs clean out haha.

divbzero 7y ago
0.7% mortality rate for 2019-nCoV is inaccurate. We do not know the mortality rate with any precision at this point and early estimates place it far higher than 0.7%. Let’s be neither alarmist nor complacent, but above all get our facts right and avoid spreading misleading information.
- arcticbull 7y ago
  The WHO pins it at 0.7% and falling as understanding thereof and treatment improves [1 - page 12, graph on page 13]. This makes a lot of sense as the earliest numbers were based only on people presenting severe symptoms, and huge quantities of people with nCoV are completely and totally asymptomatic. As with the flu, mortality is highest in older people, and the immunocompromised. [1] https://www.who.int/docs/default-source/coronaviruse/who-china-joint-mission-on-covid-19-final-report.pdf https://www.who.int/docs/default-source/coronaviruse/who-chi...
  - cjbprime 7y ago
    Like you say, if you are over 70 and get it, your mortality rate would be more like 10%, even with these lower numbers. > This makes a lot of sense as the earliest numbers were based only on people presenting severe symptoms, and huge quantities of people with nCoV are completely and totally asymptomatic. Isn't another possible explanation that it simply takes very sick people a few weeks to die from it, so if you start counting a week farther back then the confirmed-then-died rate will be higher? (Due to undercounting of people who are going to die from it but haven't yet.)
    - 7y ago

lukevp 7y ago

This is maybe unrelated, but is there a diy version of a mask for filtering air? What I want is a full face mask with filtered air for working on cars, around solvents and paints, and such, but the masks usually require the force of your own lungs to pull the air through the filter and through a 1 way valve when you exhale. I want something battery powered that does the air filtering. What am I looking for and how much does this cost? And would something like this be usable for what I had envisioned when I read “pandemic ventilator” which would be like something you could wear while you were out and about and it would filter everything you’re breathing.

viklove 7y ago
What would the battery be for?
- lukevp 7y ago
  To power some type of air pressurization system so that it’s not my lungs that are pressurizing the air, this is because filtering the air requires additional pressure to force the air through the filter.
fao_ 7y ago
Is the battery for some kind of fan that pulls in air? Presumably any kind of fan would make it difficult to extract the air output properly. You should focus on HEPA compliant masks that make it easier to filter out things, like the Respro series -- however those are not confirmed for use to extract solvents and paints, so that might be worse than no option at all because you could believe that you are protected and actually the mask does not protect you.
amluto 7y ago
What you want is called PAPR. edit: Avoiding the extra breathing effort is only part of the benefit. Respirators generally let a lot more pollutants in through leakage than through actual failure to capture them because it’s very hard to make a good seal around your face. A powered respirator can keep the internal pressure neutral or slightly positive, reducing the tendency for anything to leak in around the mask.

DoreenMichele 7y ago

I get that people are scared and trying to reassure themselves. This is really not the way to go. I don't know how to foster some kind of constructive discussion of preventive best practices or whatever, but medical devices that aren't cleaned properly and kept sterile cause horrifying and deadly infections regularly. This even happens in hospital settings. This article doesn't even seem to be bothering to address the need to disinfect everything. With lung issues, that's a not unimportant detail.

Cass 7y ago

If it comes to that, you can also share a conventional ventilator between two people. It's an ugly hack, because you have to use the same settings on both patients, so it doesn't allow for the sort of precise control you want if you're managing ARDS, but probably still a better solution than using a home-made ventilator. It was successfully used when the ER ran out of ventilators in the wake of the Vegas shooting[1], but is probably better used in the sort of emergency where you just need to win a few hours' time than a sustained crisis. 1: https://epmonthly.com/article/not-heroes-wear-capes-one-las-vegas-ed-saved-hundreds-lives-worst-mass-shooting-u-s-history/ https://epmonthly.com/article/not-heroes-wear-capes-one-las-...

kortex 7y ago

Wow, some of the comments/downvotes here are astounding, especially for a group of people priding themselves on problem solving and FOSS. Obviously, a plywood vent isn't hygenic. But R&D isn't a zero to one jump, you gotta start somewhere. Often it's that first spark of "wait this is something that needn't be only the domain of hospital gear companies" to inspire others to work on the problem. Sure, a vent alone is probably not gonna improve your chance of living without the right care, but if there was a set of condensed instructions and WHO essential meds, yeah, maybe you have a shot. This is also more about developing countries / rolling pandemics / CME-Carrington event than cov19 alone. Tell me, when was the last time you saw a panic in a trace/log to the effect of, "This should never occur." ? No one wants to be in the situation to need backups. This is part of a backup plan. The defeatism in this thread already makes me want to go and improve the design. For one, you can get pneumatic valves which take the place of 2 or maybe even 3 of the valves on the machine.

Delariva 7y ago

While well intentioned, I really don’t think this should be built by anyone for use on an actual patient. As mentioned in other posts, mechanical ventilation is only part of “life support” with a typical ICU admission for ARDS requiring: establishing peripheral IVs, central venous line (giant IV in neck to heart placed under sterile conditions), intubation (Which requires expertise and advanced equipment), oxygen (lots in terms of liters), medications (inotropes, sedatives, paralytics, nutritional support, bronchodilators, etc.) urine/foley catheter, the ability to suction the airway, nasogastric tube, bedside monitoring (arterial line, capnography, etc) potentially chest tube, dedicated bedside staff and access to X-rays and CT, blood work (particularly Arterial blood gas analysis for mech vent) to guide process, specialists for consults and this doesn’t include what else is needed when other systems fails (as is this case in ARDS: kidneys can fail which needs dialysis). Also, mechanical ventilation needs heat and humidification (requiring about 1L or sterile water every 12-24 hours) so you don’t jam up the airways with a mucus plug; so you need a temperature probe on the vent circuit as well. Also, mechanical ventilation is an aerosol generating medical procedure and even with the proper filters can still expose people in the surrounding meter or so to a virus. There’s also a great little unit that was used in Vietnam war called the Bird after the inventor - simple and clever and should be able to be cheaply manufactured or even potentially DIY but I think it required a high pressure gas source to drive the tidal volume.

Diederich 7y ago
Thanks for a detailed, well considered response. > intubation Do you think a laryngeal mask airway would useful in these kinds of situations?

zelienople 7y ago

In the initial studies out of Wuhan, about 15% of Covid-19 patients required critical care. These patients were treated with a ventilator, antiviral medications, and the support of an ICU. The mortality rate was about 2-3%. This scenario does not scale very well in a pandemic because there are simply not enough resources to provide this level of care to those who need it. There are about 5000 ventilators in Canada, for example, meaning that the country can effectively treat, at most, about 33,000 cases, assuming that the 15% ratio of total sick patients to those requiring critical care holds true. The mortality figures that we have so far are based upon everyone who needs it receiving critical care. As the pandemic scales, the mortality figures could easily reach 15% as the number of sick greatly exceeds the capacity to treat them. This project shows, therefore, that someone understands the real problem of Covid-19 and is attempting to solve it. I'll take a plywood ventilator over no ventilator any day of the week, even without the other resources of an ICU. I suspect a jet ventilator would be easier to build and more effective under the circumstances, so maybe that should be version 2.