Biological evaluation of a mechanical ventilator that operates by controlling an automated manual resuscitator. A descriptive study in swine

• Published in: PloS one Vol. 17; no. 3; p. e0264774
• Main Authors: Gonzales Carazas, Maryanne Melanie, Gavidia, Cesar Miguel, Davila Fernandez, Roberto, Vargas Zuñiga, Juan Alberto, Crespo Paiva, Alberto, Bocanegra, William, Calderon, Joan, Sanchez, Evelyn, Perales, Rosa, Zeña, Brandon, Calcina Isique, Juan Fernando, Reategui, Jaime, Castañeda, Benjamin, Casado, Fanny L
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 03-03-2022; Public Library of Science (PLoS)
• Subjects: Acid base equilibrium; Acute respiratory distress syndrome; Anesthesia; Animal experimentation; Animals; Automation; Biochemistry; Biology and Life Sciences; Blood Gas Analysis; Brain damage; Carbonates; Cardiopulmonary Resuscitation - instrumentation; Care and treatment; COVID-19; COVID-19 - complications; COVID-19 - pathology; COVID-19 - physiopathology; Diagnosis; Echocardiography; EKG; Electrocardiography; Engineering and Technology; Female; Gas analyzers; Health aspects; Hemodynamic monitoring; Hemodynamics; Hogs; Kidneys; Lactic acid; Lungs; Machinery condition monitoring; Male; Mechanical properties; Mechanical ventilation; Medicine and Health Sciences; Methods; Necropsy; Organs; Oxygenation; Parameters; Perfusion; pH effects; Physical Sciences; Physiological aspects; Physiological responses; Physiology; Respiration; Respiration, Artificial - instrumentation; Resuscitation; Risk factors; SARS-CoV-2 - physiology; Swine; System effectiveness; Ventilation; Ventilators; Ventilators, Mechanical; Veterinary colleges; Peru
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0264774

The Covid-19 outbreak challenged health systems around the world to design and implement cost-effective devices produced locally to meet the increased demand of mechanical ventilators worldwide. This study evaluates the physiological responses of healthy swine maintained under volume- or pressure-controlled mechanical ventilation by a mechanical ventilator implemented to bring life-support by automating a resuscitation bag and closely controlling ventilatory parameters. Physiological parameters were monitored in eight sedated animals (t0) prior to inducing deep anaesthesia, and during the next six hours of mechanical ventilation (t1-7). Hemodynamic conditions were monitored periodically using a portable gas analyser machine (i.e. BEecf, carbonate, SaO2, lactate, pH, PaO2, PaCO2) and a capnometer (i.e. ETCO2). Electrocardiogram, echocardiography and lung ultrasonography were performed to detect in vivo alterations in these vital organs and pathological findings from necropsy were reported. The mechanical ventilator properly controlled physiological levels of blood biochemistry such as oxygenation parameters (PaO2, PaCO2, SaO2, ETCO2), acid-base equilibrium (pH, carbonate, BEecf), and perfusion of tissues (lactate levels). In addition, histopathological analysis showed no evidence of acute tissue damage in lung, heart, liver, kidney, or brain. All animals were able to breathe spontaneously after undergoing mechanical ventilation. These preclinical data, supports the biological safety of the medical device to move forward to further evaluation in clinical studies.