Coronavirus pandemic: Since the world is grappling with a lack of ventilators which could make a crucial difference in the treatment of COVID-19 patients, a team of volunteers, including physicians, engineers, computer scientists and others, which has been centred at the Massachusetts Institute of Technology (MIT), has started working on developing a safe and inexpensive alternative to the technology, which can be built quickly anywhere in the world, the institute has said in a statement.
The team, which has been called MIT E-Vent (MIT emergency ventilator), had been constituted on March 12, the statement said, in response to the rapidly spreading pandemic. The idea came together after doctors urged the institute to do something and they received an influx of mail referring to a paper published by some MIT students in 2010. The students had consulted local physicians and designed a simple ventilator which could be built using parts worth $100, as against the actual ventilators which cost $30,000. The paper published then only included the ventilator’s design and testing.
However, looking at the need of the hour, the new team, which is linked to the course for which the students had published the project, has resumed the project on an urgent basis.
Speciality of the ventilator
The ventilator designed by the students included a key component called bag-valve resuscitator or the Ambu bag, which is an inexpensive alternative to ventilator and is a manually-operated hand-held pouch. As it is a component used by professionals in cases where a ventilator is not immediately available, hospitals have Ambu bags available in large quantities.
How do Ambu bags work?
An Ambu bag is designed to be used by medical professionals in cases like cardiac arrests, in order to support the patients’ breathing until a ventilator becomes available. In the case of an Ambu bag, like for a ventilator, a tube is inserted in the airway of the patient, and air is pumped into the lungs by squeezing and relaxing the pouch. It is done by trained medical professionals who know how to evaluate the patient and adjust the time and the pressure of the squeeze accordingly.
How will the ventilator work?
As designed by the students, the ventilator would devise a mechanical system to squeeze and relax the Ambu bag. This is needed as the task cannot be carried out by a person over an extended period of time. However, the statement noted, it is very important that the system does not damage the bag and that it is controllable so that the pressure and the time can be tailored according to the need of the particular patient. Moreover, the device should be very reliable since any malfunction could be fatal, but the students had taken this into account and designed it in a way to allow for the bag to be immediately operated manually.
What is the new team focusing on?
The team now constituted is mainly concerned with the potential of the device to be used by people who have no clinical knowledge or expertise in the hardware which is meant to run for days as the design needs one million cycles to support a patient on ventilator over a period of two weeks. Moreover, the codes in the design should be fault tolerant as the device is a crucial one which would perform life-saving functions. In order to tackle any misinformation or bad advice, the team has on its website (e-vent [dot] mit [dot] edu) uploaded verified information on the clinical use of ventilators and the training and monitoring which is needed to use such a system.
A team member stated that they are releasing guidance continuously as it is developed and they are urging clinical engineering teams to work with local resources while following the main specifications and safety guidance. Moreover, the researchers, while welcome any inputs, emphasised that the project is not meant for typical do-it-yourselfers, since some basic understanding of clinical-technical interference is required and also needs special understanding of and adherence to the strict specifications and guidelines of the US Food and Drug Administration (FDA).
The team, which consists of only volunteers, has been working without any funding and is working anonymously so that people do not call them with inquiries about the project. They feel that such calls might overwhelm them and interfere with their work on the project. A team member said that they would like to focus on their work and this is one of the main reasons why the team’s website is crucial. Anyone who is interested can check the website to see what the team is doing and also communicate with them using it.
A team member also said that since their primary concern is patient safety, they had to figure out what would be the minimum set of functions that the device would have to perform to be both safe and useful.
According to the statement, new versions of the ventilator design have already been constructed and are being prepared for additional functional tests. The team has also said that they have already put up enough information on their website to allow other teams to work parallel to them and has also included the links to some of these teams on the website.