“WHEN LIVES ARE AT STAKE, THERE IS NO ROOM FOR SELLING EQUIPMENT,” SAY THE MANUFACTURERS OF AN ALTERNATIVE ARTIFICIAL LUNG VENTILATOR
It will be a real success if their device saves at least one life. All four of them are convinced that, regardless of whether one is a doctor or a natural scientist, everyone should be able to hold a screwdriver. Ph.D. students Samuel and Daniel Furka from the Faculty of Natural Sciences of Comenius University along with Patrik Palacka, who is the head of the Department of Outpatient Chemotherapy at the National Cancer Institute, and Dalibor Gallik, a medical student from the Faculty of Medicine of Comenius University, spoke of how even Kofola bottles and one screwdriver can help save a human life.
WHAT MOTIVATED YOU TO START WORKING ON ARTIFICIAL LUNG VENTILATION (ALV)?
It was when we noticed how bad things were in Italy. My brother and I began to think about ways we could help in this situation. We sat down and suggested several solutions. Since the situation in Italy revealed that there was an acute lack of lung ventilators, our aim was to find a cheap alternative that would help in cases of a major crisis.
COULD YOU EXPLAIN IN SIMPLE TERMS HOW YOUR ALTERNATIVE ALV WORKS AND HOW IT CAN HELP?
Firstly and most importantly, we need to stress that this is not a full substitute for an artificial lung ventilator. Standard ventilators have applications ranging from a 12-hour transplantation to months-long life support. Our device is deliberately designed to be as simple as possible. It aims to cover the most critical moments when no lung ventilators are available, and it will be necessary to get through a period of time that is probably no longer than 24 hours. In the current situation, it is often necessary to connect the patient to some form of ventilation for a few hours or less than that until a standard ventilator is available. And since this is a matter of life or death, every alternative is important.
WHAT IS YOUR LUNG VENTILATOR MADE OF?
Our vision has been to pack everything into a box and send it. This is one of the reasons why we paid the greatest attention to the availability of components. Most of the device is created using 3D printing. The base is made of plywood, the outer cover is plastic and the rest are common medical devices available in every hospital. Everything can be done either on the spot if they have the possibility to print the components, or we put the parts in a box, attach a simple 5-step manual, and they can then put it together with a screwdriver.
THAT SOUNDS LIKE SOMETHING BOTH FUNCTIONAL AND AFFORDABLE
Standard lung ventilators start from 40 thousand euros. Our alternative costs 80 euros in its basic version. However, various modules will also be accessible with the device, which individuals will be able to fit later on as needed. In its more advanced version, the device will cost about 150 euros. However, we are not selling the product or do we plan to. We are talking here about the cost of the individual components. We do not demand any amount from anyone for anything. The ventilator is primarily intended for people who have a problem and need a solution. We think that in such a situation there is no room for selling something.
HOW MANY PROTOTYPES DID YOU GO THROUGH BEFORE GETTING THE FINAL VERSION?
We developed three functional prototypes, but some had significant mechanical constraints and removing them would have incurred higher costs. For the first model of the device, we used ordinary two-litre Kofola bottles instead of an expensive bag-valve mask. Thanks to this, we learned what else needed to be improved and how complicated this is. But then our team member Gallik from the Faculty of Medicine came up with a good idea on how to improve the device. Being a medical student, he provided us with some interesting know-how. Together with him and Senior Doctor Palacka, we went through the individual parameters that these devices should have in order to be usable in hospitals. From that moment we started working on the "Q-Vent".
Q-VENT? IS THAT NAME SYMBOLIC?
The device was named using the first letter of the word “Quest”, because the high pressure of these crisis situations creates an impetus to develop alternative solutions.
WHAT DOES THE CURRENT VERSION OF THE Q-VENT LOOK LIKE?
When creating it, we took into account all the requirements of clinical anaesthesiologists. In addition to the bag-valve mask, which we replaced with Kofola bottles, we added a PEEP valve to maintain exhalation pressure, which is very important with patients who have pneumonia. It will also be possible to adjust the level of oxygen, as in severe cases a higher oxygen concentration than what is in the air is required. We can also regulate the frequency of breathing and the volume of each breath, and we can humidify and heat the air. If the air flowed directly from the bottle or the environment, it would be too cold and could cause a muscle spasm. The device also has a specially designed double circulation system for separating inhaled and exhaled air. The air filters for the used double circulation were developed by a team from the Slovak University of Technology under Associate Professor Janek. They are designed to trap even the smallest particles that could pollute the air.
SO WHO IS IN THE TEAM?
It is not just the four of us. We are also consulting with other experts. At this point, cooperation is a key element of our work because this is too complex a subject for us to manage by ourselves. We started to produce the first model thanks to the support of the whole team at the Faculty of Natural Sciences, because that is how things are done there. When someone comes up with something, we all try to support each other. The Faculty of Medicine's Simulation Centre is helping us with current measurements. Thanks are also due to the faculty's dean, Juraj Šteňo, who in consultation with top anaesthesiologists informed Gallik about the bag-valve mask concept. We are also cooperating and consulting with other doctors who could help us with contacts abroad, and many Slovak companies, particularly in engineering, have offered to help in the mass production of the device. We currently have a capacity of making only 15 devices a day.
HAVE YOU DONE THE RELEVANT TESTING OF THE DEVICE YET?
So far the device has been tested only experimentally on a dummy fitted with sensors that simulate the environment and measure the flow rate of gas, pressures, and other quantities. The bench test runs for several hours, and we assess whether the mechanics, electronics, and other device components and add-on modules can stand the strain put on them. At present, clinical trials in Slovakia are out of the question. Since we have enough standard ALVs, using alternatives would not be ethical. Real patient testing is theoretically possible only in areas where standard ventilators are missing. There are those who have volunteered to go abroad with the ventilator and test it. Also, some medical students have volunteered to just sit down and assemble the device. If everything goes well, we could ideally have the first field test results in the first half of April.