Air Collective Forum

Q&A with Dr Bankov regarding basic ventilator design

NIV: Non-invasive ventilation

Q: Can manual ambu bag ventilation be used for ARDS caused by covid-19? And if it can, would you prefer that over a homemade ventilator?
A: According to the ARDSnet protocol, WHO recommendations and medical science it is not appropriate and effective. It can not be used.

Q: (Duplicate) Regarding manual ventilation with ambu bags, is it preferable to using homemade ventilators?
A: The two methods cannot be compared. Everyone can use Ambu after some instructions. There is a law frame for this but only doctors can use NIV.

Q: What are your biggest concerns regarding homemade ventilators? Any concerns regarding materials, construction, valves?
A: Of course it matters. I believe that with the public participation of many specialists, an effective and safe device can be made, but prioritizing the risks for me is first and foremost the way it is used. There is no need to comment on its use at all. This can only be done by medical specialists.

Q: In the discussed designs there are no intake filters, I guess it is very important that there are filters, because of probability of secondary bacterial infection?
A: Yes, and also warmifier and humidifier.

Q: Without filters, warmifier, humidifier, how many hours would you risk intubating a person for?
A: Hours. 1-2 as lifesaving measure.

Q: My understanding is that for PEEP you need intubation? And for ARDS you need PEEP?
A: Uou can apply NIV for ARDS.

Q: In which ventilator mode? PEEP or something else?
A: EPAP in NIV is equivalent to PEEP. The intubation is last step.

Q: What part of the ventilator is the most dangerous in case it breaks? pressure control?
A: Probably yes.

Q: I understand it can be deadly if pressure goes up suddenly, what if it drops suddenly?
A: It is dangerous too because of risk from lung colapse. The decrease can be pretty fast. It is important not to go under 3-5 cm H2O.

Q: Anything else?
A: For me the conrol of volume is important.