Development and Evaluation of an Automated Manual Resuscitator-Based Emergency Ventilator-Alternative

Area of Science:

• Biomedical Engineering
• Critical Care Medicine
• Respiratory Therapy

Background:

• Mass casualty incidents, exemplified by the COVID-19 pandemic, can overwhelm healthcare systems and strain ventilator supplies.
• Manual resuscitator devices like bag-valve masks (BVMs) require constant professional operation, limiting their utility during shortages.

Purpose of the Study:

• To develop an automated manual resuscitator-based emergency ventilator-alternative (AMREV) to address ventilator shortages.
• To provide a hands-free, automated BVM solution that supports adjustable ventilation parameters.

Main Methods:

• Developed the AMREV device for automated BVM compressions, compatible with standard 5-inch diameter BVMs.
• Assessed AMREV performance using simulated lung models with varying resistance and compliance.
• Evaluated device functionality over extended periods (7 days) and compatibility with multiple commercial BVMs.

Main Results:

• AMREV achieved adjustable tidal volumes (110-700 ml) and delivered consistent positive end-expiratory pressure (PEEP) (10-40 cmH2O).
• Device operated continuously for seven days with <3.2% variation in delivered volume and pressure.
• AMREV demonstrated consistent performance (<10% variation) across seven different commercial BVM setups.

Conclusions:

• The AMREV provides a reliable, automated, volume-controlled ventilation alternative for extended use during ventilator shortages.
• This device can serve as a critical resource for healthcare systems facing unprecedented demand for respiratory support.