Publications

Assessing tidal volume during mechanical ventilation is critical to improving gas exchange while avoiding ventilator-induced lung injury. Conventional flow and volume measurements are usually carried out by built-in pneumotachographs in the ventilator or by stand-alone flowmeters. Such flow/volume measurement devices are expensive and thus usually unaffordable in low-resource settings. Here, we aimed to design and test low-cost and technically-simple calibration and assembly pneumotachographs. The proposed pneumotachographs are made by manual perforation of a plate with a domestic drill. Their pressure-volume relationship is characterized by a quadratic equation with parameters that can be tailored by the number and diameter of the perforations. We show that the calibration parameters of the pneumotachographs can be measured through two maneuvers with a conventional resuscitation bag and by assessing the maneuver volumes with a cheap and straightforward water displacement setting. We assessed the performance of the simplified low-cost pneumotachographs to measure flow/volume during mechanical ventilation as carried out under typical conditions in low-resource settings, i.e., lacking gold standard expensive devices. Under realistic mechanical ventilation settings (pressure- and volume-control; 200-600 mL), inspiratory tidal volume was accurately measured (errors of 2.1% on average and <4% in the worst case). In conclusion, a simple, low-cost procedure facilitates the construction of affordable and accurate pneumotachographs for monitoring mechanical ventilation in low- and middle-income countries.

JTD Keywords: calibration, flow measurement, low- and middle-income countries, mechanical ventilation, pneumotachograph, Calibration, Flow, Flow measurement, Low- and middle-income countries, Lung injury, Mechanical ventilation, Pneumotachograph, Pressure-drop, Resistance, Tidal volume

High ambient temperature and humidity greatly increase the risk of hyperthermia and mortality, particularly in infants, who are especially prone to dehydration. World areas at high risk of heat stress include many of the low-and middle-income countries (LMICs) where most of their inhabitants have no access to air conditioning. This study aimed to design, evaluate, and test a novel low-cost and easy-to-assemble device aimed at preventing the risk of infant hyperthermia in LMICs. The device is based on optimizing negative heat transfer from a small amount of ice and transferring it directly to the infant by airflow of refrigerated air. As a proof of concept, a device was assembled mainly using recycled materials, and its performance was assessed under laboratory-controlled conditions in a climatic chamber mimicking realistic stress conditions of high temperature and humidity. The device, which can be assembled by any layperson using easily available materials, provided sufficient refrigerating capacity for several hours from just 1–2 kg of ice obtained from a domestic freezer. Thus, application of this novel device may serve to attenuate the adverse effects of heat stress in infants, particularly in the context of the evolving climatic change trends. © 2021 by the authors. Licensee MDPI, Basel, Switzerland.

JTD Keywords: air conditioning, ambient-temperature, death, heat, heat index, heat shock, heatwave, high ambient temperature, hyperthermia, low-cost refrigeration, low-middle income countries, mortality, negative heat transfer, Air conditioning, Algorithm, Article, Climate change, Cost benefit analysis, Environmental temperature, Heat index, Heat shock, Heat stress, Heat transfer, Heating, Heatwave, High ambient temperature, High temperature, Humidity, Hyperthermia, Low income country, Low-cost refrigeration, Low-middle income countries, Middle income country, Middle-income countries, Negative heat transfer, Prevention study, Refrigeration, Temperature stress, Thawing