COVID-19-19 Relation of Driving Pressure in the Acute Respiratory Distress Syndrome (ARDS) and Local Lung Tissue Damage under the COVID-19 Pandemic through Cyber Physical Emergency Lung Ventilators
Abstract
A lung ventilator, mechanical artificial lung ventilator, respirator, or simply ventilator is a machine thatsupports the patient s breathing. These machines are used mainly in hospitals. A ventilator is usuallyused for short periods (hours or days), such as during surgery, when the patient is anesthetized andthe drugs used to induce anesthesia may interrupt normal breathing. Thus, a ventilator helps toensure the patient s breathing during surgery. A ventilator can also be used when treating a seriouslung disease or other condition that affects normal breathing, which is the case of the COVID-19Pandemic situation. The high mortality rate of COVID-19 pandemic is associated to a secondarycondition, ARDS - Acute Respiratory Distress Syndrome, that demands precise protective pulmonarymaneuvers promoted through lung ventilators. Particularly in this proposal we had designed an opensource low cost emergency lung ventilator named INSPIRE. INSPIRE is a low cost, built from off-theshelf components widely available, including high end microcomputers based on the Single BoardComputer (SBC) approach. A cyber physical system (CPS) is a system in which a mechanism iscontrolled or monitored by computer-based algorithms. In cyber-physical systems, physical andsoftware components are deeply intertwined, able to operate on different spatial and temporal scales ,exhibit multiple and distinct behavioral modalities, and interact with each other in ways that changewith context. Marcelo Amato et al. [1] have shown through the statistical analysis of more than 6.000human patient treatments that the driving pressure, defined by de (Tidal Volume)/Compliance (P=VT/CRS), when the Tidal volume is normalized by body weight, is the most significant factor to predictthe survival at the patient. This result must be understood in terms of the local lung tissue damage.Electrical Impedance Tomography (EIT) [2] allows the estimation of the local ventilation and localpulsatility. We propose a study to check the hypothesis that large driving pressure causes spatiallyclose regions of overdistation and collapse of alveoli. The study should use EIT in some centers and alarge amount of clinical data that will be captured during the treatment of the COVID-19 epidemic bythe use of a cyber-physical emergency lung ventilators. Particularly in our approach we would like toembed long distance transmission and GPS ( Geographic Positioning System ) Technologies to recordpatient conditions and location. Our research is on an experimental phase, with first Inspire ventilatorsbeing introduced in Covid-19 patients first week of May 2020. INSPIRE is under coordination ofUniversidade de So Paulo, USP is a public and non-profit organization from State of So PauloBrazil. USP is tasked to research and develop a low cost and rapid production of INSPIRE ventilatorswithout jeopardizing the required quality. These ventilators will be freely distributed to needed publichospitals in Brazil. In the next 6 weeks, USP estimates to produce a total of 1.000 ventilators with thedonated equipment and will estimate to support 5.000 COVID-19 patients with ARDS. USP isreceiving request to get ventilators from several states in Brazil, and the current total estimation is theneed of 40.000 ventilators for the next coming months in Brazil.
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Jul 20, 2020
- Source ID
- N629092012041
Entities
People
- Marcelo K. Zuffo
Organizations
- Office of Naval Research
- United States Navy