The eSpiro Ventilator: An Open-Source Response to a Worldwide Pandemic

Abstract

Objective: To address the issue of ventilator shortages, our group (eSpiro Network) developed a freely replicable, open-source hardware ventilator. Design: We performed a bench study. Setting: Dedicated research room as part of an ICU affiliated to a university hospital. Subjects: We set the lung model with three conditions of resistance and linear compliance for mimicking different respiratory mechanics of representative intensive care unit (ICU) patients. Interventions: The performance of the device was tested using the ASL5000 lung model. Measurements and Main Results: Twenty-seven conditions were tested. All the measurements fell within the ±10% limits for the tidal volume (VT). The volume error was influenced by the mechanical condition (p = 5.9 × 10−15) and the PEEP level (P = 1.1 × 10−12) but the clinical significance of this finding is likely meaningless (maximum −34 mL in the error). The PEEP error was not influenced by the mechanical condition (p = 0.25). Our experimental results demonstrate that the eSpiro ventilator is reliable to deliver VT and PEEP accurately in various respiratory mechanics conditions. Conclusions: We report a low-cost, easy-to-build ventilator, which is reliable to deliver VT and PEEP in passive invasive mechanical ventilation.

Assessment of open-source, intermediate and ICU ventilators to face the COVID-19 pandemic

“…The COVID-19 pandemic triggered many strategies to challenge the risk of ventilators shortage. [1][2][3] One was the development of new low-cost ventilators 4 as recently proposed. A second strategy was a large-scale production of intermediate ventilators dedicated to emergency room and patient transport with the help of nonmedical industry, as was the case in France where the government asked car manufacturer Peugeot SA to build 1500 Osiris 3 (Air Liquide Medical System, Antony, France), and in the United States where government ordered the purchase of 200 000 ventilators from 11 companies in the country.…”

“…3 It seems unlikely that we are doing an excellent job: half a century has passed since the work of Turco et al and today's package insert recommendations are far from clear: key details are still not included and 2019 WHO guidelines are falling short. 4 In the literature we can find that the first report of coring dates to 1994 when rubber particles were found inside lidocaine syringes used for retrobulbar anaesthesia. 5 Since then only case reports or a few articles with small sample sizes have tried to assess the incidence of this phenomenon.…”