Linear regression model and least square method for experimental identification of AMBU bag in simple ventilator

Purpose In the COVID-19 outbreak periods, people's life has been deranged, leading to disrupt the world. Firstly, the number of deaths is growing and has the potential to surpass the highest level at any time. Secondly, the pandemic broke many countries' fortified lines of epidemic prevention and gave people a more honest view of its seriousness. Finally, the pandemic has an impact on life, and the economy led to a shortage in medical, including a lack of clinicians, facilities and medical equipment. One of those, a simple ventilator is a necessary piece of medical equipment since it might be useful for a COVID-19 patient's treatment. In some cases, the COVID-19 patients require to be treated by modern ventilators to reduce lung damage. Therefore, the addition of simple ventilators is a necessity to relieve high work pressure on medical bureaucracies. Some low-income countries aim to build a simple ventilator for primary care and palliative care using locally accessible and low-cost components. One of the simple principles for producing airflow is to squeeze an artificial manual breathing unit (AMBU) iterative with grippers, which imitates the motion of human fingers. Unfortunately, the squeezing angle of grippers is not proportional to the exhaust air volume from the AMBU bag. This paper aims to model the AMBU bag by a mathematical equation that enables to implement on a simple controller to operate a bag-valve-mask (BVM) ventilator with high accuracy performance. Design/methodology/approach This paper provides a curvature function to estimate the air volume exhausting from the AMBU bag. Since the determination of the curvature function is sophisticated, the coefficients of the curvature function are approximated by a quadratic function through the experimental identification method. To obtain the high accuracy performance, a linear regression model and a least square method are employed to investigate the characteristic of the BVM ventilator's grippers angle with respect to the airflow volume produced by the AMBU bag. Findings This paper investigates the correlation between the exhausting airflow of the AMBU bag and the grippers angle of the BVM ventilator. Originality/value The experimental results validated that the regression model of the characteristic of the exhausting airflow of the AMBU bag with respect to the grippers' angle has been fitted with a coefficient over 98% within the range of 350-750 ml.

Intrahospital Transport of a Critically Ill Patient on Extracorporeal Membrane Oxygenation Support with Severe Acute Respiratory Distress Syndrome due to COVID-19

Patients who do not respond to conventional mechanical ventilation (MV) support for respiratory failure due to the Coronavirus disease-19 may require the support of extracorporeal membrane oxygenation (ECMO). Intrahospital transportation of critically ill patients under MV and ECMO support carries potential risks that could be life-threatening. A structured process performed by a professional team plays a vital role in improving patient safety during transportation of the patient. In this presentation, we aim to share our experiences during the intrahospital transportation of a patient on ECMO support with appropriate equipment and a team of experienced personel. (English) [ FROM AUTHOR] Konvansiyonel mekanik ventilasyon (MV) desteğine yanıt vermeyen, Koronavirüs hastalığı-2019'a bağlı solunum yetmezliği olan hastalar, ekstrakorporeal membran oksijenasyonu (ECMO) desteğine ihtiyaç duyabilir. MV ve ECMO desteği altındaki kritik hastaların hastane içi nakli yaşamı tehdit eden birçok potansiyel riske sahiptir. Uygun ekipman ve deneyimli personelden oluşan bir ekip tarafından gerçekleştirilen yapılandırılmış bir süreç, hastanın nakli sırasında hasta güvenliğinin artırılmasında hayati bir rol oynar. Bu sunumda, ECMO desteğinde olan bir hastamızın hastane içi transportunda sırasındaki deneyimlerimizi paylaşmayı amaçladık. (Turkish) [ FROM AUTHOR] Copyright of Medical Journal of Bakirkoy is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

The Effects of ICU Crisis Reorganization on Outcomes in Patients Not Infected With Coronavirus Disease 2019 During the Initial Surge of the Coronavirus Disease 2019 Pandemic.

To determine if ICU reorganization due to the coronavirus disease 2019 pandemic affected outcomes in critically ill patients who were not infected with coronavirus disease 2019. DESIGN: This was a Before-After study, with coronavirus disease 2019-induced ICU reorganization as the intervention. A retrospective chart review of adult patients admitted to a reorganized ICU during the coronavirus disease 2019 surge (from March 23, 2020, to May 06, 2020: intervention group) was compared with patients admitted to the ICU prior to coronavirus disease 2019 surge (from January 10, 2020, to February 23, 2020: before group). SETTING: High-intensity cardiac, medical, and surgical ICUs of a community hospital in metropolitan Missouri. PATIENTS: All patients admitted to the ICU during the before and intervention period were included. Patients younger than 18 years old and those admitted after an elective procedure or surgery were excluded. Patients with coronavirus disease 2019 were excluded. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: We identified a total of 524 eligible patients: 342 patients in the before group and 182 in the intervention group. The 28-day mortality was 25.1% (86/342) and 28.6% (52/182), respectively (p = 0.40). The ICU length of stay, ventilator length of stay, and ventilator-free days were similar in both groups. Rates of patient adverse events including falls, inadvertent endotracheal tube removal, reintubation within 48 hours of extubation, and hospital acquired pressure ulcers occurred more frequently in the study group (20 events, 11%) versus control group (12 events, 3.5%) (p = 0.001). CONCLUSIONS: Twenty-eight-day mortality, in patients who required ICU care and were not infected with coronavirus disease 2019, was not significantly affected by ICU reorganization during a pandemic.