Planet Arduino

This article was written by César Garcia, researcher at La Hora Maker.

This week, we will be exploring the Apollo Ventilator in detail! This project emerged at Makespace Madrid two months ago. It was a response to the first news about the expected lack of ventilators in Spain because of COVID-19.

Several members of the space decided to explore this problem. They joined Telegram groups and started participating in the coronavirus maker forum. In this group, they stumbled upon an initial design shared by a doctor, that would serve as a starting point for the ventilator project.

To advance the project, a small but active group would join daily at “Makespace Virtual.” This virtual space used open-source video conferencing software Jitsi. Each one of the eight core members would contribute with their expertise in design, engineering, coding, etc. Due to the confinement measures in place, access to the space was quite limited. Everyone decided to work from home and a single person would merge all advances at the make space physically. A few weeks later doctors from La Paz Hospital in Madrid got in touch with the Apollo team, looking for ways to work together on the ventilator.

One of the hardest challenges to overcome was the lack of medical materials. The global demand has disrupted supply chains everywhere! The team had to improvise with the means at their disposal. To regulate the flow of gases, they created a 3D-printed pinch, that would collapse a medical-grade silicone tube in the input. This mechanism is controlled using the same electronics used in 3D printers: an Arduino Mega 2560 board with a RAMPS shield!

In respect of sensors, they decided to go for certified versions that could be sterilized in an autoclave. They looked everywhere without success. A few days later, they got support from a large electronics supplier to provide them an equivalent model suited for children or adults up to 80 kg.

They decided to work on a shared repository to coordinate all the distributed efforts. This attracted new members and talents, doubling in size and sparking new lines of development. The Apollo Ventilator is an open-source project, meaning that new people can learn and create together new features.

Based on their expertise sourcing components, they wanted Apollo to be flexible. Most other certified ventilators are too specific. But they want to become “the Marlin for ventilators!” Marlin is one of the most used firmware in the world to control 3D printers. This software can manage all kinds of boards and adapt to different configurations easily.

In the case of the Apollo Ventilator, the initial setup runs on a single Arduino Mega board. It uses the attached computer as the display. Current code can be configured to use a secondary Arduino board connected by serial port as a display too. As for the interface, there are several alternatives using GTK and QT. It’s also possible to send this data using MQTT, so data from many ventilators can be centralized. Other alternative builds used even regular snorkeling pieces! The Apollo Ventilator aspires to serve as the basis for several new projects and initiatives where off the shelf solutions are not available. Another potential outcome would be low-cost ventilators for veterinary practice or education.

The Apollo Ventilator is currently under development. They plan to expand the tests on lung simulators right now. Next steps would involve working with hospitals and veterinary schools. They will tackle these phases once the medical services are less overwhelmed.

The Apollo Ventilator takes its name from the famous Apollo missions to the moon. They managed to overcome all obstacles to take us where humanity had not been before. This project shares the same goals in regards to open-source ventilators. They are trying to overcome one of the biggest contemporary challenges, the COVID-19 pandemic. 

To learn more about the Apollo Ventilator, you can check out its repository. At this link you can also find an interview (in Spanish) to Javi, Apollo Ventilator’s project leader.

If you’d like to know more about Makespace Madrid, visit their website.

Arduino staff and Arduino community are strongly committed to support projects aimed at fighting and lessening the impact of COVID-19. Arduino products are essential for both R&D and manufacturing purposes related to the global response to Covid-19, in building digital medical devices and manufacturing processes for medical equipment and PPE. However, all prototypes and projects aimed to fight COVID-19 using Arduino open-source electronics and digital fabrication do not create any liability to Arduino (company, community and Arduino staff members). Neither Arduino nor Arduino board, staff members and community will be responsible in any form and to any extent for losses or damages of whatever nature (direct, indirect, consequential, or other) which may arise related to Arduino prototypes, Arduino electronic equipment for critical medical devices, research operations, forum and blog discussions and in general Covid-19 Arduino-based pilot and non pilot projects, independently of the Arduino control on progress or involvement in the research, development, manufacturing and in general implementation phases.

This article was written by César Garcia, researcher at La Hora Maker.

SARS-CoV-2 virus has been spreading around the world since December 2019. The virus causes a coronavirus disease 2019, also known as COVID-19. This respiratory illness can cause a severe acute respiratory syndrome. Critical patients often require a ventilator during their stay at Intensive Care Units, thus the demand for ventilators has skyrocketed, with traditional manufacturers not able to keep up. Because of this, teams around the world are looking for alternatives and are creating ventilators using Arduino! 

In this new series on ventilators on the Arduino blog, we will explore these devices more detail. We will focus on the steps needed to test a ventilator. Also, on the different technologies available to move the air in a precise way. We will highlight what clinical variables do doctors need. And we will interview some of the teams working on these devices. Let’s start with a brief overview of ventilators using Arduino as a control system!

At the beginning of the crisis, most people started looking for open source ventilators. There were several models available but one of the most popular was MIT Low-Cost Ventilator. This model uses an Ambu, also known as Bag Valve Mask (BVM). These bags are used by paramedics on emergencies. They press the bag to insufflate air into the patient. Given they have to press it by hand, it gets a very tiresome movement after a few minutes. MIT Low-Cost Ventilator automates this movement, saving doctors or nurses of this manual task. Even though, the paper describing the ventilator is quite useful and complete, this model did not pass any clinical trials. It was released on 2010 and nobody took development further until this year.

One of the first teams to launch a new project was the Reesistencia Team. This virtual team, based on Asturias and the Canary Islands in Spain, started working together after meeting in a Telegram group. The team consists of a doctor and several engineers, working to create a DIY open source ventilator, based on Arduino. This model is based around a Jackson Rees bag instead of an Ambu bag. This should allow the device to operate longer than the ones based on emergency bags. This team is active on Twitter, were you can find some of their initial designs.

This spark of maker ingenuity inspired several other teams to launch their own versions and prototypes in Spain. Oxygen team embraced rapid prototyping, starting with a machine made of scraped wood up to an industrial machine. SEAT, the Spanish car company, has produced five hundred of these devices so far. 

MIT E-Vent team has recovered the original MIT ventilator and evolved the concept further. They have done already several tests on animals to evaluate the new version. The AmboVent team from Israel has shared another BVM ventilator based on Arduino Nano, and they have provided very complete documentation.

Given the current pace of development it is very hard to document all the processes and steps involved. One of our favorites in this regard is University of Florida Health Open Source Ventilator. They have shared all design documents on their repository along with short videos. They even provide a live stream showing the stress tests for their ventilator!

Next week, we will explore the steps involved in creating a ventilator from scratch. This will help us discover common milestones and give us better tools to evaluate current designs.

Warning: Ventilators are complex machines mean to be operated by trained doctors. They need oxygen and compressed air supplies to operate. Patients are fully dependant on these machines to survive, so they need to run flawlessly. Please, explore this topic with caution and check documentation about previous trials before trying to replicate some of these projects. Not all of them have passed all required clinical trials and validations!

If you’d like to know more about ventilators, check the “Combating COVID-19 Conference” videos.

Arduino staff and Arduino community are strongly committed to support projects aimed at fighting and lessening the impact of COVID-19. Arduino products are essential for both R&D and manufacturing purposes related to the global response to Covid-19, in building digital medical devices and manufacturing processes for medical equipment and PPE. However, all prototypes and projects aimed to fight COVID-19 using Arduino open-source electronics and digital fabrication do not create any liability to Arduino (company, community and Arduino staff members). Neither Arduino nor Arduino board, staff members and community will be responsible in any form and to any extent for losses or damages of whatever nature (direct, indirect, consequential, or other) which may arise related to Arduino prototypes, Arduino electronic equipment for critical medical devices, research operations, forum and blog discussions and in general Covid-19 Arduino-based pilot and non pilot projects, independently of the Arduino control on progress or involvement in the research, development, manufacturing and in general implementation phases.