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Sprint Day 0: An Open Source ventilator project you can believe in.
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trophosphere:

--- Quote from: helius on April 02, 2020, 11:45:19 pm ---Thanks for the reply. I wasn't actually talking about aspirating the chest wall as in pneumothorax etc, but of non-invasive airway clearance techniques like the ones taught to cystic fibrosis patients.

I mention this because all reports I have heard from doctors facing this pandemic is that mechanical ventilation is particularly hard on the body, takes weeks to recover from, and is often associated with comorbidities in older or weaker patients.

--- End quote ---

In cystic fibrosis, the problem is more so with mucus plugging in the airways whereas in pneumonia the main problem is that the alveoli (the tiny air sacs at the end of the respiratory tree) get filled with fluid (pus/exudate). Sure there is increased mucus production in pneumonia but the main contributor to the decrease in oxygenation is the decrease in area available for effective gas exchange.

The main purpose of using a ventilator in a patient with pneumonia is to (1) provide sufficient respiratory support such that they do not tire out by decreasing the work of breathing with the added bonus of decreasing total metabolic demand, (2) increase effective gas exchange by keeping the alveoli open or opening of the alveoli through something called recruitment, and (3) ensure that their respiratory status is not compromised even if the patient is exhibiting a severe enough altered mental status that they are either unable to maintain their airway or are at high risk of aspiration.

Being placed on a ventilator is hard on the body because often they are on the ventilator for a large number of days such that their respiratory muscles weaken. In addition, skeletal muscle elsewhere in the body weaken as well because they are essentially bed-bound due to often needing to be sedated as (I'm sure everyone agrees) having a tube down the trachea is quite unpleasant. That being said, there are people that are tied to ventilators for many years without the need for sedation because they have had a tracheostomy and a connection is made that way.


--- Quote from: filssavi on April 02, 2020, 07:29:34 am ---Nobody here, (and in other projects as well) has any clue of the human anatomy, physiology and pathology to even start coming up with requirements that should stop you right there and then, you can’t just google for 5 minutes, copy some stuff from around the web and call it a day.

--- End quote ---

I don't know about that. A few of us on the forum are actually practicing physicians. It's just that we don't see any convincing arguments yet to embark on creating something from scratch when the main problem (as far as I can see) is mainly manufacturing output. This would be the same train of thought as the current need for personal protective equipment and toilet paper(in the US at least). To put it in another way, the demand became so high in such a short amount of time that the current manufacturing setup is unable to keep up. Thus one would believe it would be more valuable and quicker to ramp up production vs creating something new, having to go through regulatory approval, and then having to address the aspect of mass production anyway.
SilverSolder:

--- Quote from: trophosphere on April 03, 2020, 03:53:21 am ---
[...] Thus one would believe it would be more valuable and quicker to ramp up production vs creating something new, having to go through regulatory approval, and then having to address the aspect of mass production anyway.


--- End quote ---

This, in spades, as pretty much anyone with industrial/manufacturing experience would tell you.
Siwastaja:

--- Quote from: trophosphere on April 03, 2020, 03:53:21 am ---It's just that we don't see any convincing arguments yet to embark on creating something from scratch when the main problem (as far as I can see) is mainly manufacturing output.

--- End quote ---

Yes.

The train of thought for them is not a complete fallacy, though. It has a few realistic, even remotely possible elements to hold the otherwise unrealistic story.

There apparently are some short periods when there is a lack of ventilator equipment in some hardly hit areas, because it takes time to increase ventilator manufacturing. This is true. Now, the story goes like this: some super bright team of science nerds in their garage hack together an iffy-looking, but good-enough thing, build a dozen of them, bring them to a hospital, and save a few dozen lives. (Add some dramatic music here.)

This is like any fantasy, it has remote chances of happening, but the fallacy part is that every "open hardware" idiot is writing themselves in the lead role of that story. What they don't realize at all is that starting to build a bureaucratic community, from scratch, with all the broken telephone play with people they don't know on the interwebz, has already failed before it even started.

They almost always realize they can't do it, or even a meaningful part of it. They don't realize that due to this, they are not needed, and that no one who could do it, is unwilling to participate to their ego projects.

If this fantasy were going to happen, it would be with a few actually bright guys and gals, who already freaking know what to do, to just start doing it, like immediately. No "project planning" needed.

Open source or not, is a completely irrelevant aspect, as are the details whether the design uses Arduino or 3D printing, or not. Anyone who gets fixated to such details are automatically proven morons who can't understand much beyond buzzword and popularity contests. While important to some, they don't get the job done.
Corporate666:
Entertaining thread :)

We don't have a ventilator design problem, i.e. we lack well-performing ventilator designs.  We have a manufacturing output problem, i.e. we need more of these things.  Who in their right mind thought the solution to the production problem was to design an entirely new unit?  I know, it's largely about making a simpler design that can be cranked out, but all of the brain power being used on these projects would be better utilized solving the manufacturing problem, including alternate solutions at the component or subassembly level where availability constraints limit how many of an existing/proven design can be manufactured.

There is massive, massive untapped (and currently un/under utilized) manufacturing capacity in this world that we could leverage to make ventilators, but we're going with the best ROI at the moment, using big manufacturers like the car companies to make proven designs.

tszaboo:
OP, honestly, if you want to help, join an open source project, dont start a new one.

Some people think that engineers are pessimistic, and downers. They bring negative energy, with sentences like " cant be done", "unrealistic expectations". The reality is, any engineer who has some experience, on each project see a thousand way a project can go wrong.

And say, you want to design an open source ventilator. What are you going to do, start ordering all the parts for it? Like realistically, electronics parts have some 12 weeks leadtime. Say, you have the same leadtime for medical valves, pumps and so on.
Are you going to order these parts? There are companies who actually know how to make this, waiting in line to assemble as many units as possible (and make as much profit as possible).
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