COVent – Improve Ventilation Safety by Means of Intra-tracheal Pressure Monitoring – A Short-term Solution
Mechanical ventilation support is part of the therapeutic strategy for critically ill COVID-19 patients. However, ventilators are in short supply in many parts of the world and there are safety concerns related to low-cost, do-it-yourself ventilators, in particular ventilator-induced lung injury from excessive pressure. This consortium will critically evaluate a range of available ventilators, as well as integrate innovative pressure sensors in low-cost ventilators, aiming to improve patient care and to help improve outcomes of patients in need of mechanical ventilation.
Acute respiratory distress syndrome (ARDS) is a frequent cause of critical illness and mortality in the current COVID-19 pandemic. Supportive therapeutic strategies for ARDS very often include the use of mechanical ventilation. However, patients are subject to ventilator-induced lung injury.
The overall objectives and aims of this research project are to develop and provide practical solutions aiming to reduce the risk associated with the use of mechanical ventilation. In response to the existing shortage of mechanical ventilators, especially in low-income countries, instructions for a large number of low cost/do-it-yourself ventilators and off-label use are currently available, but these instructions do not necessarily include information on safety standards. A short-term solution will assess currently described low cost open-source ventilators with regards to their characteristics, mechanisms and regulations to prevent ventilation associated lung injury. To reduce the risk of ventilator-induced lung injury, monitoring and ultimately controlling the pressures applied to lung tissue are of critical relevance. An evaluation of commercially available pressure sensors and their technology will be performed. The final aim is the integration of a pressure sensor, which will be attached as an add-on system to the tip of endotracheal tubes. This would enable intra-tracheal pressure measurements providing information on actually exerted pressures aiming at guiding regulation of ventilators, directing decisions for safe mechanical ventilation and would apply to low-cost, open-source ventilators and potentially as well as to technologically sophisticated ventilators.
Above banner: Lack of medical equipment and capacity to accommodate patients are particularly pronounced in critical situations such as the COVID-19 pandemic.
Researchers measure pathophysiological lung parameters in a lung simulator ventilated by a low-cost ventilator. Pressure measurements, visualised on the computer screen, enable safety assessment of the low-cost ventilator. Image: Kiran Kuruvithadam
Patient on mechanical ventilation. The tube is placed in the trachea with the tip above the bifurcation, allowing ventilation of both lungs. Inflated cuff seals out fluid. Endotracheal tube is secured with strap and connected to the ventilator. Figure: CoVent
- The consortium is led by investigator Prof Thomas Erb.
- Additional investigators and collaborators include Prof Mirko Meboldt, Prof Jürg Hammer, Dr Marianne Schmid Daners and Dr Sören Fricke.