How to Make a Ventilator

…For the most part, the various open-source initiatives underway make no claims that they’re building critical-care ventilators. Govind Rajan, an anesthesiologist at UC Irvine’s medical school and a contributor to the Bridge Ventilator Consortium ventilator project, described the use-case for that project as “only in situations where you don’t have any ventilators available and the patient needs a ventilator.” In collaboration with the consortium, Virgin Orbit has designed a ventilator of the “automating-a-manual-resuscitator” variety. It’s nowhere near as complex as a critical care ventilator.

However, Rajan also described scenarios where “there comes a time when you have to be weaned off a ventilator,” and said his team’s design could serve the needs of patients who need to be weaned off and don’t need a critical-care device (i.e., acting as a “bridge” between critical care needs and being off of the ventilator). On its website, Virgin Orbit also describes the ventilator (which has still not been approved by the FDA) as potentially serving “the huge volume of patients with moderate COVID-19 symptoms.”

This seemingly contradictory description—a ventilator that’s somehow both a worst-case-scenario only option and serving an intermediate stage of COVID-19 treatment—introduces a serious medical ethics question in the drive for more ventilators. For doctors trying to save patients by any means necessary, a minimum viable ventilator is better than having no ventilator at all. Rajan recalled his own experiences when he began his career working in India 35 years ago, where ventilators were often in short supply and manual resuscitation was sometimes the only option for keeping a patient breathing. Getting to choose between the last-resort tool and a critical care device is a privilege that some doctors just don’t have right now…

Read more of the Vice article.