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1.
J Int Med Res ; 50(11): 3000605221138487, 2022 Nov.
Article in English | MEDLINE | ID: covidwho-2138613

ABSTRACT

OBJECTIVE: During March 2020 in the United States, demand for sedatives increased by 91%, that for analgesics rose by 79%, and demand for neuromuscular blockers increased by 105%, all owing to the number of COVID-19 cases requiring invasive mechanical ventilation (MV). We hypothesize that analgesic and sedative requirements decrease following tracheotomy in this patient population. METHODS: In this cross-sectional study, we conducted a retrospective chart review to identify patients with COVID-19 who underwent tracheotomy (T) at an academic medical center between March 2020 and January 2021. We used a paired Student t-test to compare total oral morphine equivalents (OMEs), total lorazepam equivalents, 24-hour average dexmedetomidine dosage in µg/kg/hour, and 24-hour average propofol dosage in µg/kg/minute on days T-1 and T+2 for each patient. RESULTS: Of 50 patients, 46 required opioids before and after tracheotomy (mean decrease of 49.4 mg OMEs). Eight patients required benzodiazepine infusion (mean decrease of 45.1 mg lorazepam equivalents. Fifteen patients required dexmedetomidine infusion (mean decrease 0.34 µg/kg/hour). Seventeen patients required propofol (mean decrease 20.5 µg/kg/minute). CONCLUSIONS: When appropriate personal protective equipment is available, use of tracheotomy in patients with COVID-19 who require MV may help to conserve medication supplies in times of extreme shortages.


Subject(s)
Analgesia , COVID-19 , Dexmedetomidine , Propofol , Humans , Hypnotics and Sedatives/therapeutic use , Tracheotomy , Cross-Sectional Studies , Dexmedetomidine/therapeutic use , Lorazepam , Retrospective Studies , Pain/drug therapy , Ventilators, Mechanical , Analgesics/therapeutic use , Morphine
2.
BMJ Open ; 12(11): e062561, 2022 11 21.
Article in English | MEDLINE | ID: covidwho-2137738

ABSTRACT

OBJECTIVE: This study aimed to assess US/UK adults' attitudes towards COVID-19 ventilator and vaccine allocation. DESIGN: Online survey including US and UK adults, sampled to be representative for sex, age, race, household income and employment. A total of 2580 participated (women=1289, age range=18 to 85 years, Black American=114, BAME=138). INTERVENTIONS: Participants were asked to allocate ventilators or vaccines in scenarios involving individuals or groups with different medical risk and additional risk factors. RESULTS: Participant race did not impact vaccine or ventilator allocation decisions in the USA, but did impact ventilator allocation attitudes in the UK (F(4,602)=6.95, p<0.001). When a racial minority or white patient had identical chances of survival, 14.8% allocated a ventilator to the minority patient (UK BAME participants: 24.4%) and 68.9% chose to toss a coin. When the racial minority patient had a 10% lower chance of survival, 12.4% participants allocated them the ventilator (UK BAME participants: 22.1%). For patients with identical risk of severe COVID-19, 43.6% allocated a vaccine to a minority patient, 7.2% chose a white patient and 49.2% chose a coin toss. When the racial minority patient had a 10% lower risk of severe COVID-19, 23.7% participants allocated the vaccine to the minority patient. Similar results were seen for obesity or male sex as additional risk factors. In both countries, responses on the Modern Racism Scale were strongly associated with attitudes toward race-based ventilator and vaccine allocations (p<0.0001). CONCLUSIONS: Although living in countries with high racial inequality during a pandemic, most US and UK adults in our survey allocated ventilators and vaccines preferentially to those with the highest chance of survival or highest chance of severe illness. Race of recipient led to vaccine prioritisation in cases where risk of illness was similar.


Subject(s)
COVID-19 , Vaccines , Adult , Humans , Male , Female , Adolescent , Young Adult , Middle Aged , Aged , Aged, 80 and over , COVID-19/epidemiology , COVID-19/prevention & control , African Americans , Ventilators, Mechanical , United Kingdom/epidemiology
3.
PLoS One ; 17(11): e0277570, 2022.
Article in English | MEDLINE | ID: covidwho-2116520

ABSTRACT

N95/FFP3 respirators have been critical to protect healthcare workers and their patients from the transmission of COVID-19. However, these respirators are characterised by a limited range of size and geometry, which are often associated with fitting issues in particular sub-groups of gender and ethnicities. This study describes a novel methodology which combines magnetic resonance imaging (MRI) of a cohort of individuals (n = 8), with and without a respirator in-situ, and 3D registration algorithm which predicted the goodness of fit of the respirator. Sensitivity analysis was used to optimise a deformation value for the respirator-face interactions and corroborate with the soft tissue displacements estimated from the MRI images. An association between predicted respirator fitting and facial anthropometrics was then assessed for the cohort.


Subject(s)
COVID-19 , Respiratory Protective Devices , Humans , COVID-19/prevention & control , N95 Respirators , Ventilators, Mechanical , Health Personnel
4.
Int J Environ Res Public Health ; 19(22)2022 Nov 21.
Article in English | MEDLINE | ID: covidwho-2116036

ABSTRACT

As a result of the COVID-19 pandemic, many new materials and masks came onto the market. To determine their suitability, several standards specify which properties to test, including bacterial filtration efficiency (BFE), while none describe how to determine viral filtration efficiency (VFE), a property that is particularly important in times of pandemic. Therefore, we focused our research on evaluating the suitability and efficiency of different systems for determining VFE. Here, we evaluated the VFE of 6 mask types (e.g., a surgical mask, a respirator, material for mask production, and cloth masks) with different filtration efficiencies in four experimental setups and compared the results with BFE results. The study included 17 BFE and 22 VFE experiments with 73 and 81 mask samples tested, respectively. We have shown that the masks tested had high VFE (>99% for surgical masks and respirators, ≥98% for material, and 87-97% for cloth masks) and that all experimental setups provided highly reproducible and reliable VFE results (coefficient of variation < 6%). Therefore, the VFE tests described in this study can be integrated into existing standards for mask testing.


Subject(s)
COVID-19 , Masks , Humans , Pandemics/prevention & control , COVID-19/prevention & control , Filtration , Ventilators, Mechanical
6.
J Intensive Care Med ; 37(12): 1662-1666, 2022 Dec.
Article in English | MEDLINE | ID: covidwho-2113158

ABSTRACT

A novel remote ventilator management (control) technology (Omnitool) was implemented for use with ICU patients during the COVID-19 pandemic to mitigate in-person respiratory therapist interactions and preserve personal protective equipment. In the latter half of 2020, eight mechanical ventilators were purchased and enabled for Omnitool deployment through the application of a vendor software option. Subsequently, these ventilators were outfitted with commercially available informatics hardware that permitted remote communication and management via the existing hospital network. In total, 17 patients with COVID-19 respiratory failure were placed on Omnitool enabled ventilators between January 1, 2021-April 30, 2021. The median Omnitool use days was 10. Deployment of a novel remote ventilator management technology is feasible; however, further study is needed to simplify the set up and utilization of the system. Future demands for remote ventilator management are predictable, whether in rural areas, military scenarios without adequate RT staffing, or in circumstances with new and easily transmissible toxic infections, and will continue to encourage the development of relatively easy to apply informatics-based solutions. Herein we share five lessons learned from our Omnitool deployment.


Subject(s)
COVID-19 , Respiratory Insufficiency , Humans , Pandemics , Ventilators, Mechanical , Respiratory Insufficiency/therapy , Technology
8.
J Int Med Res ; 50(11): 3000605221135446, 2022 Nov.
Article in English | MEDLINE | ID: covidwho-2098199

ABSTRACT

OBJECTIVE: To determine the incidence and significance of ventilator avoidance in patients with critical coronavirus disease 2019 (COVID-19). METHODS: This prospective observational cohort study evaluated hospital mortality and 1-year functional outcome among critically ill patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-associated acute respiratory distress syndrome (ARDS). The explanatory variable was ventilator avoidance, modeled as 'initial refusal' of intubation (yes/no). Modified Rankin Scale (mRS) scores were obtained from surviving patients (or their surrogates) via phone or email questionnaire. RESULTS: Among patients for whom intubation was recommended (n = 102), 40 (39%) initially refused (95% confidence interval [CI] 30%, 49%). The risk of death was 79.3% (49/62) in those who did not initially refuse intubation compared with 77.5% (31/40) in those who initially refused, with an adjusted odds ratio for death of 1.27 (95% CI 0.47, 3.48). The distribution of 1-year mRS scores was not significantly different between groups. CONCLUSION: Among critically ill patients with COVID-19-associated ARDS, ventilator avoidance was common, but was not associated with increased in-hospital mortality or 1-year functional outcome.


Subject(s)
COVID-19 , Respiratory Distress Syndrome , Humans , SARS-CoV-2 , Critical Illness , Prospective Studies , Respiratory Distress Syndrome/therapy , Ventilators, Mechanical
11.
Biomed Eng Online ; 21(1): 77, 2022 Oct 14.
Article in English | MEDLINE | ID: covidwho-2079424

ABSTRACT

OBJECTIVES: To use deep learning of serial portable chest X-ray (pCXR) and clinical variables to predict mortality and duration on invasive mechanical ventilation (IMV) for Coronavirus disease 2019 (COVID-19) patients. METHODS: This is a retrospective study. Serial pCXR and serial clinical variables were analyzed for data from day 1, day 5, day 1-3, day 3-5, or day 1-5 on IMV (110 IMV survivors and 76 IMV non-survivors). The outcome variables were duration on IMV and mortality. With fivefold cross-validation, the performance of the proposed deep learning system was evaluated by receiver operating characteristic (ROC) analysis and correlation analysis. RESULTS: Predictive models using 5-consecutive-day data outperformed those using 3-consecutive-day and 1-day data. Prediction using data closer to the outcome was generally better (i.e., day 5 data performed better than day 1 data, and day 3-5 data performed better than day 1-3 data). Prediction performance was generally better for the combined pCXR and non-imaging clinical data than either alone. The combined pCXR and non-imaging data of 5 consecutive days predicted mortality with an accuracy of 85 ± 3.5% (95% confidence interval (CI)) and an area under the curve (AUC) of 0.87 ± 0.05 (95% CI) and predicted the duration needed to be on IMV to within 2.56 ± 0.21 (95% CI) days on the validation dataset. CONCLUSIONS: Deep learning of longitudinal pCXR and clinical data have the potential to accurately predict mortality and duration on IMV in COVID-19 patients. Longitudinal pCXR could have prognostic value if these findings can be validated in a large, multi-institutional cohort.


Subject(s)
COVID-19 , Deep Learning , Respiration Disorders , COVID-19/diagnostic imaging , COVID-19/therapy , Humans , Retrospective Studies , Ventilators, Mechanical , X-Rays
12.
Rev Esp Anestesiol Reanim (Engl Ed) ; 69(9): 544-555, 2022 11.
Article in English | MEDLINE | ID: covidwho-2069621

ABSTRACT

BACKGROUND: The Severe Acute Respiratory Syndrome (SARS)-Coronavirus 2 (CoV-2) pandemic pressure on healthcare systems can exhaust ventilator resources, especially where resources are restricted. Our objective was a rapid preclinical evaluation of a newly developed turbine-based ventilator, named the ACUTE-19, for invasive ventilation. METHODS: Validation consisted of (a) testing tidal volume (VT) delivery in 11 simulated models, with various resistances and compliances; (b) comparison with a commercial ventilator (VIVO-50) adapting the United Kingdom Medicines and Healthcare products Regulatory Agency-recommendations for rapidly manufactured ventilators; and (c) in vivo testing in a sheep before and after inducing acute respiratory distress syndrome (ARDS) by saline lavage. RESULTS: Differences in VT in the simulated models were marginally different (largest difference 33ml [95%-confidence interval (CI) 31-36]; P<.001ml). Plateau pressure (Pplat) was not different (-0.3cmH2O [95%-CI -0.9 to 0.3]; P=.409), and positive end-expiratory pressure (PEEP) was marginally different (0.3 cmH2O [95%-CI 0.2 to 0.3]; P<.001) between the ACUTE-19 and the commercial ventilator. Bland-Altman analyses showed good agreement (mean bias, -0.29, [limits of agreement, 0.82 to -1.42], and mean bias 0.56 [limits of agreement, 1.94 to -0.81], at a Pplat of 15 and 30cmH2O, respectively). The ACUTE-19 achieved optimal oxygenation and ventilation before and after ARDS induction. CONCLUSIONS: The ACUTE-19 performed accurately in simulated and animal models yielding a comparable performance with a VIVO-50 commercial device. The acute 19 can provide the basis for the development of a future affordable commercial ventilator.


Subject(s)
COVID-19 , Noninvasive Ventilation , Respiratory Distress Syndrome , Sheep , Animals , COVID-19/therapy , Ventilators, Mechanical , Tidal Volume , Respiratory Distress Syndrome/therapy , SARS-CoV-2
13.
Sci Transl Med ; 14(666): eabm8351, 2022 10 12.
Article in English | MEDLINE | ID: covidwho-2063973

ABSTRACT

The COVID-19 pandemic demonstrated the need for inexpensive, easy-to-use, rapidly mass-produced resuscitation devices that could be quickly distributed in areas of critical need. In-line miniature ventilators based on principles of fluidics ventilate patients by automatically oscillating between forced inspiration and assisted expiration as airway pressure changes, requiring only a continuous supply of pressurized oxygen. Here, we designed three miniature ventilator models to operate in specific pressure ranges along a continuum of clinical lung injury (mild, moderate, and severe injury). Three-dimensional (3D)-printed prototype devices evaluated in a lung simulator generated airway pressures, tidal volumes, and minute ventilation within the targeted range for the state of lung disease each was designed to support. In testing in domestic swine before and after induction of pulmonary injury, the ventilators for mild and moderate injury met the design criteria when matched with the appropriate degree of lung injury. Although the ventilator for severe injury provided the specified design pressures, respiratory rate was elevated with reduced minute ventilation, a result of lung compliance below design parameters. Respiratory rate reflected how well each ventilator matched the injury state of the lungs and could guide selection of ventilator models in clinical use. This simple device could help mitigate shortages of conventional ventilators during pandemics and other disasters requiring rapid access to advanced airway management, or in transport applications for hands-free ventilation.


Subject(s)
Acute Lung Injury , COVID-19 , Animals , Homeostasis , Humans , Oxygen , Pandemics , Printing, Three-Dimensional , Respiratory Rate , Swine , Ventilators, Mechanical
14.
Curr Opin Crit Care ; 28(6): 652-659, 2022 Dec 01.
Article in English | MEDLINE | ID: covidwho-2063071

ABSTRACT

PURPOSE OF REVIEW: To describe different strategies adopted during coronavirus disease 2019 pandemic to cope with the shortage of mechanical ventilators. RECENT FINDINGS: Short-term interventions aimed to increase ventilator supply and decrease demand. They included: redistributing and centralizing patients, repurposing operating rooms into intensive care units (ICUs) and boosting ventilator production and using stocks and back-ups; support by the critical care outreach team to optimize treatment of patients in the ward and permit early discharge from the ICU, ethical allocation of mechanical ventilators to patients who could benefit more from intensive treatment and short term ICU trials for selected patients with uncertain prognosis, respectively. Long-term strategies included education and training of non-ICU physicians and nurses to the care of critically-ill patients and measures to decrease viral spread among the population and the progression from mild to severe disease. SUMMARY: The experience and evidence gained during the current pandemic is of paramount importance for physicians and law-makers to plan in advance an appropriate response to any future similar crisis. Intensive care unit, hospital, national and international policies can all be improved to build systems capable of treating an unexpectedly large number of patients, while keeping a high standard of safety.


Subject(s)
COVID-19 , Humans , COVID-19/therapy , Ventilators, Mechanical , Pandemics , Intensive Care Units , Critical Care
15.
Health Aff (Millwood) ; 41(10): 1513-1522, 2022 10.
Article in English | MEDLINE | ID: covidwho-2054398

ABSTRACT

The COVID-19 pandemic offers an opportunity to examine public opinion regarding the allocation of scarce medical resources. In this conjoint experiment on a nationally representative sample of US adults, we examined how a range of patient characteristics affect respondents' willingness to allocate a ventilator between two patients with equal likelihood of short-term survival and how this differs by respondents' attributes. Respondents were 5.5 percentage points less likely to allocate a ventilator to a patient with a disability than to a nondisabled patient. Disability bias was correlated with older age cohorts and higher education levels of respondents. Liberal and moderate respondents were more likely to give a ventilator to Black and Asian patients than to White patients. Conservatives were much less likely to allocate a ventilator to transgender patients than to cisgender patients. These findings demonstrate the importance of bias mitigation and civil rights enforcement in health policy making, especially under conditions of scarcity.


Subject(s)
COVID-19 , Adult , Humans , Pandemics , Public Opinion , Resource Allocation , Ventilators, Mechanical
16.
Skelet Muscle ; 12(1): 21, 2022 09 09.
Article in English | MEDLINE | ID: covidwho-2038880

ABSTRACT

BACKGROUND: In intensive care units (ICU), mechanical ventilation (MV) is commonly applied to save patients' lives. However, ventilator-induced diaphragm dysfunction (VIDD) can complicate treatment by hindering weaning in critically ill patients and worsening outcomes. The goal of this study was to identify potential genes involved in the endogenous protective mechanism against VIDD. METHODS: Twelve adult male rabbits were assigned to either an MV group or a control group under the same anesthetic conditions. Immunostaining and quantitative morphometry were used to assess diaphragm atrophy, while RNA-seq was used to investigate molecular differences between the groups. Additionally, core module and hub genes were analyzed using WGCNA, and co-differentially expressed hub genes were subsequently discovered by overlapping the differentially expressed genes (DEGs) with the hub genes from WGCNA. The identified genes were validated by western blotting (WB) and quantitative real-time polymerase chain reaction (qRT-PCR). RESULTS: After a VIDD model was successfully built, 1276 DEGs were found between the MV and control groups. The turquoise and yellow modules were identified as the core modules, and Trim63, Fbxo32, Uchl1, Tmprss13, and Cst3 were identified as the five co-differentially expressed hub genes. After the two atrophy-related genes (Trim63 and Fbxo32) were excluded, the levels of the remaining three genes/proteins (Uchl1/UCHL1, Tmprss13/TMPRSS13, and Cst3/CST3) were found to be significantly elevated in the MV group (P < 0.05), suggesting the existence of a potential antiproteasomal, antiapoptotic, and antiautophagic mechanism against diaphragm dysfunction. CONCLUSION: The current research helps to reveal a potentially important endogenous protective mechanism that could serve as a novel therapeutic target against VIDD.


Subject(s)
Diaphragm , Ventilators, Mechanical , Animals , Atrophy , Intensive Care Units , Male , Rabbits , Respiration, Artificial/adverse effects
17.
Appl Environ Microbiol ; 88(19): e0122122, 2022 Oct 11.
Article in English | MEDLINE | ID: covidwho-2038232

ABSTRACT

The objective of this study was to evaluate the effectiveness of UV technology for virus disinfection to allow FFR reuse. UV is a proven decontamination tool for microbial pathogens, including the SARS-CoV-2 virus. Research findings suggest that the impacts of UV-C treatment on FFR material degradation should be confirmed using microbial surrogates in addition to the commonly performed abiotic particle testing. This study used the surrogates, E. coli and MS-2 bacteriophage, as they bracket the UV response of SARS-CoV-2. Lower log inactivation was observed on FFRs than predicted by aqueous-based UV dose-response data for MS-2 bacteriophage and E. coli. In addition, the dose-response curves did not follow the trends commonly observed with aqueous data for E. coli and MS-2. The dose-response curves for the respirators in this study had a semicircle shape, where the inactivation reached a peak and then decreased. This decrease in UV inactivation is thought to be due to the degradation of the fibers of the FFR and allows for more viral and bacterial cells to wash through the layers of the respirator. This degradation phenomenon was observed at UV doses at and above 2,000 mJ/cm2. Results have demonstrated that FFR materials yield various results in terms of effective disinfection in experiments conducted on KN95 and N95 face respirators. The highest inactivation for both surrogates was observed with the KN95 respirator made by Purism, yielding 3 and 2.75 log inactivation for E. coli and MS-2 at UV doses of 1,500 mJ/cm2. The KN95 made by Anboruo yielded the lowest inactivation for MS-2 at 0.75 log when exposed to 1,000 mJ/cm2. To further test the degradation theory, experiments used a collimated beam device to test the hypothesis further that degradation is occurring at and above UV doses of 1,500 mJ/cm2. The experiment aimed to determine the effect of "predosing" a respirator with UV before inoculating the respirator with MS-2. In this test, quantification of the penetrated irradiance value and the ability of each layer to retain MS-2 were quantified. The results of the experiments varied from the intact FFR degradation experiments but displayed some data to support the degradation theory. IMPORTANCE Research suggests degradation of FFR materials at high UV doses is important. There appears to be a peak inactivation dose at approximately 1,500 mJ/cm2. The subsequent dose increases appear to have the reverse effect on inactivation values; these trends have shown true with both the N95 and KN95-Purism respirators.


Subject(s)
COVID-19 , Disinfection , COVID-19/prevention & control , Decontamination/methods , Disinfection/methods , Escherichia coli , Humans , N95 Respirators , SARS-CoV-2 , Ultraviolet Rays , Ventilators, Mechanical
18.
J Occup Environ Hyg ; 19(10-11): 663-675, 2022.
Article in English | MEDLINE | ID: covidwho-2028921

ABSTRACT

The COVID-19 pandemic has affected the world and caused a supply shortage of personal protection equipment, especially filtering facepiece respirators (FFP). This has increased the risk of many healthcare workers contracting SARS-CoV-2. Various strategies have been assessed to tackle these supply issues. In critical shortage scenarios, reusing single-use-designed respirators may be required. Thus, an easily applicable and reliable FFP2 (or alike) respirator decontamination method, allowing safe re-use of FFP2 respirators by healthcare personnel, has been developed and is presented in this study. A potent and gentle aerosolized hydrogen peroxide (12% wt) method was applied over 4 hr to decontaminate various brands of FFP2 respirators within a small common room, followed by adequate aeration and storage overnight. The microbial efficacy was tested on unused respirator pieces using spores of Geobacillus stearothermophilus. Further, decontamination effectiveness was tested on used respirators after one 12-hr shift by swabbing before and after the decontamination. The effects of up to ten decontamination cycles on the respirators' functionality were evaluated using material properties, the structural integrity of the respirators, and fit tests with subjects. The suggested H2O2 decontamination procedure was proven to be (a) sufficiently potent (no microbial recovery, total inactivation of biological indicators as well as spore inoculum on critical respirator surfaces), (b) gentle as no significant damage to the respirator structural integrity and acceptable fit factors were observed, and (c) safe as no H2O2 residue were detected after the defined aeration and storage. Thus, this easy-to-implement and scalable method could overcome another severe respirator shortage, providing enough flexibility to draft safe, effective, and logistically simple crisis plans. However, as highlighted in this study, due to the wealth of design and material used in different models and brands of respirators, the decontamination process should be validated for each FFP respirator model before its field implementation.


Subject(s)
COVID-19 , SARS-CoV-2 , Humans , Pandemics/prevention & control , COVID-19/prevention & control , Decontamination/methods , Equipment Reuse , Ventilators, Mechanical
19.
Annu Int Conf IEEE Eng Med Biol Soc ; 2022: 957-961, 2022 07.
Article in English | MEDLINE | ID: covidwho-2018756

ABSTRACT

The MASI mechanical ventilator was developed in a state of emergency to meet the demand for ventilators caused by COVID-19. Although it has obtained positive results in its use with patients in intensive care units, not having an optimal quality non-invasive ventilation (NIV) modality prevents it from being used in the early treatment of patients, which has been shown to prevent admission to the ICU and reduce mortality. Therefore, the following study focuses on evaluating MASI's ability to provide NIV using different accessories in order to compare their performance and determine which one would work best with MASI, and under which conditions. To do this, the high-flow nasal cannula, facial mask, and ventilation helmet accessories were tested under different pressure parameter settings. The data was collected using a gas flow analyzer. After that, a statistical analysis of the results was carried out, which showed that the face mask is the best accessory to use for NIV with MASI, and that it performs with optimal accuracy and precision when the peak inspiratory pressure is set at a value lower than 25 cmH20. Clinical Relevance- This study presents an optimization of the non-invasive ventilation (NIV) modality of the MASI me-chanical ventilator by evaluating its performance with different accessories.


Subject(s)
COVID-19 , Noninvasive Ventilation , Humans , Masks , Respiration, Artificial , Ventilators, Mechanical
20.
Annu Int Conf IEEE Eng Med Biol Soc ; 2022: 986-990, 2022 07.
Article in English | MEDLINE | ID: covidwho-2018741

ABSTRACT

More than 500 millions of people were affected by the COVID-19 pandemic and in Peru there is an increasing the high numbers of cumulative cases; as well as the hospitalized people, where more than 20 % require mechanical ventilation. This condition with other respiratory diseases cause patients to remain connected to a mechanical ventilator until they regain the ability to perform this vital function on their own. Some prototypes with characteristics equivalent to a high-end mechanical ventilator have been developed. And therefore, this paper presents the design and simulation of an algorithm for the pressure-controlled pulmonary ventilation mode of the mechanical ventilator. The functional design of the algorithm uses the linear multi compartment mathematical model to simulate the respiratory system. Finally the results respond adequately under multiple scenarios, including variations of the ventilator and pulmonary parameters, where the algorithm presents encouraging results in the mechanical ventilator simulation. Clinical relevance - The algorithm presented in this study will allow to have better knowledge for a treatment and eventual clinical diagnosis in health centers, especially in eventual variants and outbreaks of COVID-19.


Subject(s)
COVID-19 , Algorithms , COVID-19/therapy , Humans , Pandemics , Software , Ventilators, Mechanical
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