News PC Vendor Maingear to Manufacture Low-Cost Ventilators

Olle P

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Doesn't look like a ventilator on the picture.
Where's the (single patient use) air hose? Can it have oxygen attached?

Cutting cost is mainly done by foregoing the couple-of-years spent on testing and validation before getting an FDA approval. (As is usually required. I don't know if there are any temporary changes in requirements.)
 
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alextheblue

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Cutting cost is mainly done by foregoing the couple-of-years spent on testing and validation before getting an FDA approval. (As is usually required. I don't know if there are any temporary changes in requirements.)
The situation has caused them to temporarily suspend a lot of that, as it was hampering the production and supply of critical medical equipment we are short on.

I think the more burning question is... can it run Crysis?
 

InvalidError

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Cutting cost is mainly done by foregoing the couple-of-years spent on testing and validation before getting an FDA approval. (As is usually required. I don't know if there are any temporary changes in requirements.)
A respirator that meets the absolute barest requirements (only one mode, no feedback, minimal instrumentation and only the most basic adjustments by adjusting levers, weighs, valves, set screws, etc.) can be made from ~$200 worth of stuff from a hardware store as a dumb mechanical or pneumatic contraption.

What drives cost and complexity up is making the smallest machine possible that can do every possible variant of every possible mode with all programmable parameters and all optional patient comfort without requiring that the operator also be a mechanic.
 

bit_user

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A respirator that meets the absolute barest requirements (only one mode, no feedback, minimal instrumentation and only the most basic adjustments by adjusting levers, weighs, valves, set screws, etc.) can be made from ~$200 worth of stuff from a hardware store as a dumb mechanical or pneumatic contraption.

What drives cost and complexity up is making the smallest machine possible that can do every possible variant of every possible mode with all programmable parameters and all optional patient comfort without requiring that the operator also be a mechanic.
I gather that standard hospital ventilators need to be a swiss-army-knife, because hospitals often have only a few and need to use them to handle the gamut of different scenarios. So, perhaps the standard ventilators are something of a "Cadillac", when all we really need is a stripped-out Civic.

However, I'm sure a lot goes into reliability, testing, and ensuring that the device will both provide adequate ventilation without over-pressurizing the lungs, not allowing mold to develop in the tubing/valves, and half-a-dozen other issues you probably haven't even thought of.

If faced with a choice about whether to have no ventilator or a hackup-up model, the obvious choice is to go with the ventilator you can get. However, if there's a possibility of getting a no-frills design that's at least battle-proven, that's what I would want. And, I'm sure a lot of developing countries don't use the kind of high-end models that most US hospitals are accustomed to buying. My hope would be that, at the very least, they're using a proven design and just repurposing PC housings and power supplies.

There should be no need to reinvent the wheel, here.
 
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InvalidError

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However, I'm sure a lot goes into reliability, testing, and ensuring that the device will both provide adequate ventilation without over-pressurizing the lungs, not allowing mold to develop in the tubing/valves, and half-a-dozen other issues you probably haven't even thought of.
If mechanical engineers can put together engines, pneumatic and hydraulic systems that can handle extreme loads for hundreds of hours and billions of cycles on end between service intervals, they should be able to design something capable of reliably driving a flesh bag at a rate of one cycle per 6-10 seconds for days at a time with relative ease.

Preventing over-pressure is trivial: ventilation pressures are spec'd in H20 column height because pressures used to be regulated by water columns. If you over-pressure, it blows the water out, the excess pressure gets relieved and the water comes back down from its catch can. You can achieve the same result with weighed or spring-loaded valves, basic relative pressure regulators.

Preventing mold is also trivial: simply add a sufficient amount of dry bypass air to keep moisture well below saturation during exhale cycles.
 
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gg83

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Just like during war times, we will see some major advances in certain technologies. Jet engines from WWII. A global pandemic is the only way to financially motivate big business. Also everyone wants to help. Look at Folding@home! I just read an article about CERN is using their 15,000 resercher team to focus on this. Going from a machine so complicated its miles long to a "simple" ventilator should be a piece of cake! I always have faith in humanity. Its too bad our backs need to be against the wall to do anything. We are a reactionary species.
 
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I’m not even going to bother discussing the technical specs of this thing because I think it goes without saying that this is nothing more than a desperate way of getting free publicity. Which parts of this “ventilator” is Maingear actually making them selves? Everyone thinks they are engineers all of a sudden. Would anyone in their right mind actually want to be hooked up to this thing if their life depended on it? Chinese ventilator fighting the Chinese virus.
 
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Darkbreeze

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I guess nobody told these guys that the real problem was that Covid-19 was displacing an iron ion in the blood, and that pneumonia wasn't actually part of the problem? Maybe they should focus on something that can filter the displaced iron ions out of the blood stream so that it doesn't damage the lungs, rather than trying to supply the lungs with additional oxygen that it can't use anyhow because it's lost it's ability to carry oxygen in the blood? Maybe next week these guys will catch up and have to start thinking about retooling all over again. Sad to see everybody rushing to build machines that are effectively almost useless in the majority of people with respiratory distress, since it's caused by something completely different than what those machines are intended to help with.

The early indication is, these are probably not very helpful in the majority of cases.

https://www.thailandmedical.news/news/must-read-research-reveals-that-covid-19-attacks-hemoglobin-in-red-blood-cells,-rendering-it-incapable-of-transporting-oxygen--current-medical-protoco
 
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InvalidError

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I guess nobody told these guys that the real problem was that Covid-19 was displacing an iron ion in the blood, and that pneumonia wasn't actually part of the problem?
Your lungs filling with fluid is a problem regardless of what other effects covid-19 may have elsewhere and respirators are something that we've been building for decades vs no known safe and effective treatment for its symptoms and no specific timeline for those either.
 

Darkbreeze

Retired Mod
I can't find a single article written in the last few days, or at all really, from anybody working in the thick of things, that indicates they believe ventilators are helping anybody at all. They all say exactly the opposite. If the doctors are saying this, then who is it that is saying these are needed and are helpful? Maybe that is a question that needs to be answered?

We have ways to get fluid out of the lungs, and they don't involve the use of a ventilator for the most part. In some cases, the ventilator itself causes pneumonia, which may be part of the whole problem. I'm no doctor, I don't have answers. But I see this going in a totally different direction before long.
 

InvalidError

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I can't find a single article written in the last few days, or at all really, from anybody working in the thick of things, that indicates they believe ventilators are helping anybody at all.
People get put on respirators when they cannot breathe on their own power anymore. You cannot find evidence of anyone disputing their usefulness because by the time they get put on it, the alternative is practically certain immediate death.

A day or two ago, one hospital in the USA celebrated its first patient coming out of the ICU after two weeks on respirator. Pretty sure that patient would have died about two weeks ago without it.
 

Darkbreeze

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I can't argue that any one case is a success, but I'm not sure I agree that the patient would have died without it, or that they might not have lived anyhow regardless of a lack of ventilator. Most doctors are saying that they do not believe that the people who ARE pulling through, wouldn't have pulled through anyhow even without a ventilator. I'm sure there are definitely some exceptions, and cases where they are absolutely essential because of OTHER pre-existing conditions, but overall, I'm seeing a theme here. As was mentioned in another conversation, it is looking very much like this is a BLOOD disease, not a respiratory disease.



COVID-19 glycoproteins bond to the heme groups, and in doing so the oxidative iron ion is “disassociated” (released) from red blood cells.

Without the iron ion, hemoglobin can no longer bind to oxygen, rendering the red blood cells useless.

It is very likely that this is more the case, rather than developing a form of ARDS or pneumonia.

Many doctors are starting to believe that they are operating under a false notion of pneumonia, & possibly treating the wrong symptoms on a systematic basis throughout the country.

Ventilators may not be treating the root cause, as many of the patient’s lungs aren’t ‘tiring out’, they’re pumping just fine.

It is instead that the affected hemoglobin have been stripped of their ability to carry oxygen, resulting in hypoxia.
https://threadreaderapp.com/thread/1247628906472980482.html

As mentioned before, it doesn't much matter if the lungs keep working or not, if the blood is not carrying oxygen, and the blood can't carry oxygen if it's mechanism is broken. In those cases, ventilators are doing nothing, at all, so far as these doctors are concerned and that makes sense to me despite not having any sort of medical training at all. I don't claim to, but if doctors say a shirt is red, and I look at it, and sure enough it looks red to me, then it's probably red. But I agree, if it were ME in that bed, and the only thing they could do to TRY and help me is ventilate, I guess I'd probably be in favor of them at least trying it, even though the end result would probably be the same with or without it.

My point really wasn't that there are NO situations where ventilators are warranted, but moreso that there isn't really a need for every other company to develop and manufacture a slew of ventilators when we're finding out that they are probably not directly responsible for those who have managed to pull through a serious case of this.
 

InvalidError

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Most doctors are saying that they do not believe that the people who ARE pulling through, wouldn't have pulled through anyhow even without a ventilator.
When you are at the stage where you cannot breathe on your own, no ventilator is a definitive death sentence - they literally require assistance with the mechanical function of breathing.

What the articles you linked pointed at is that many people with covid-19 can still breathe and talk fine despite their O2 saturation level being at extremely low (~70%) levels, no mechanical assistance required there so the logical thing to do should be to use less invasive methods of increasing O2 intake. The problem is that the standard to put people on respirators for previously known illnesses has been 93%, so many covid-19 patients automatically get put on respirators despite not actually needing help with anything a respirator can actually help with.
 

bit_user

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I guess nobody told these guys that the real problem was that Covid-19 was displacing an iron ion in the blood, and that pneumonia wasn't actually part of the problem?
Without addressing the accuracy of your statement, rest assured that lots of people are tackling this virus from all angles.

However, even though the survival rate of COVID-19 patients who end up on ventilators is poor, it's still more than 0%. So, until treatments emerge that can prevent most patients from ever needing to be put on a ventilator, they are still in high-demand and saving lives.

And let's not only think about the developed world, here. Ventilators are much scarcer in most poorer countries. They will need affordable ventilators, which will benefit them even after this pandemic has subsided.

Really? ThailandMedical.news? Had you ever hard of that site, before? Do you even have a clue if they're at all reputable?

Try this:

If you don't have a good source on something, maybe you shouldn't be sharing it. Fake news about COVID-19 can be almost as dangerous as the virus, itself.
 
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bit_user

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I can't find a single article written in the last few days, or at all really, from anybody working in the thick of things, that indicates they believe ventilators are helping anybody at all. They all say exactly the opposite. If the doctors are saying this, then who is it that is saying these are needed and are helpful?

Even if it's only 20%, that's still a lot of people. Without ventilators, the fatality rate of those patients would be 100%.

We have ways to get fluid out of the lungs, and they don't involve the use of a ventilator for the most part.
It's not as simple as that. The lung tissue is inflamed.

In some cases, the ventilator itself causes pneumonia, which may be part of the whole problem. I'm no doctor, I don't have answers.
Yes, there are risks. That & shortages are why ventilators are used as a last resort. Especially when they're in critically short supply.

I trust the medical profession enough that if they say they need ventilators, there's not just some obvious alternative intervention they're all ignoring that would save thousands of lives.

You do seem to talk like you have answers to offer.
 
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Darkbreeze

Retired Mod
I don't do Twitter. Those links are 100% valid data which you obviously didn't bother to look at before sounding off against them. The Twitter posts they are rebroadcasting were in fact first brought to my attention by another member of the moderation team who I assure you does not pass along unsubstantiated information. If you bothered to actually read the tweet and watch the video, from the doctor in New York, you'd know that the sources I'm pointing to are much less relevant than the source material itself. Feel free to visit twitter or Youtube to view the actual content. I don't, so it is what it is. I don't support twitter so I won't post direct links to it here but that does not change the fact that there are very legitimate posters from the medical field that DO use it.

At least know what you are talking about before you start making accusations like the idea that I'm spreading misinformation or malware links. I don't post sketchy links, ever. If you knew what threadreader was, you wouldn't even suggest that. It simply "unrolls" existing tweets into a readable web page.

Whatever though, any half intelligent person can create seemingly merited arguments against any fact, position or argument, regardless of content, so I guess it's a waste of time to also point out, despite your comment that "you trust the medical profession enough to trust what they say when they say they need respirators" that the information I linked to was all FROM medical professionals and that it is a currently evolving early swing in the opinion of the healthcare community.

Again, the whole point wasn't to argue any of this, but only to say that every company out there that currently has no need or demand for the products they normally make doesn't need to be making ventilators. We're going to end up with a billion ventilators that are useless because they are not needed. A few million are probably fine, and yes I'm being rather loose with no numbers and have no desire or need for accurate statistics on the subject. Suffice to say, if you need a bushel, ten bushels are not needed. Even factoring in the needs of other countries, it would be overkill for ALL these companies that are gearing up to create ventilators, to ALL being doing it. Once one or two of them get going, in addition to the companies that normally make them, I think there will be more than enough for the cases that actually might require them.
 

bit_user

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Those links are 100% valid data which you obviously didn't bother to look at before sounding off against them.
No, it was debunked. The hemoglobin thing is fake news. That's why you can't find it reported from any reputable source.

Feel free to visit twitter or Youtube to view the actual content.
Twitter and youtube are not reputable sources. You can claim to be anyone, on Twitter. Youtube is so full of conspiracy theories that I call it ConspiracyTube. That "doctor" could be a Russian troll, for all we know. Even if he's a real medical doctor, there are a few quacks out there.

If you knew what threadreader was, you wouldn't even suggest that. It simply "unrolls" existing tweets into a readable web page.
Why would I use that? If it's a reputable source, just post the original URL. I don't use intermediaries, like tinyurl and such.

And what about ThailandMedical.news ? If this is not fake news, why isn't it covered on a better site than that?

Whatever though, any half intelligent person can create seemingly merited arguments against any fact, position or argument,
That's exactly why you need to use reputable sources. Neither you nor I have the expertise to know, for sure, whether someone is a quack or not. Good reporting involves looking at & verifying someone's credentials and looking at their data, analysis, methodology, seeing if it scientifically holds water, and how it's regarded by their peers.

I guess it's a waste of time to also point out, despite your comment that "you trust the medical profession enough to trust what they say when they say they need respirators" that the information I linked to was all FROM medical professionals and that it is a currently evolving early swing in the opinion of the healthcare community.
If you want to discuss this in good faith, please don't twist my words. I did not say I trust anyone claiming to be a doctor, or even someone who actually is a doctor.

What I said is that I trust the profession, writ large. Which is to say that if the medical professionals, as a whole, are saying that they don't have enough ventilators for the patients who have no chance of survival without them, then I'm not going to second-guess them on that. That was the argument, as I understood it. New York was recently even doubling-up patients on ventilators, which is a dangerous and difficult thing to do, and I trust those patients would not be on those ventilators if their doctors didn't think they needed to be, in order to have a chance of survival.

Again, the whole point wasn't to argue any of this,
Uh, well, then why'd you post it? And why are you now arguing it? It sounds to me like you want to have it both ways - put it out there and squash debate over it.

I'll make you a deal: if you delete your posts about it (or edit out those links and discussion of the iron/hemoglobin), I'll delete mine. Otherwise, I don't think it's fair to post stuff and get upset if it's called into question.

Whatever the case, it's not personal. If it's not a fringe, crackpot theory, then there will be no shortage of reputable sources on it. And getting such information out there would be a net good. On the other hand, if there's no independent, trusted authority to back it up, then it needs to be called out as highly questionable (to say the least). I just want what I think you probably want, which is to spread accurate information and quash anything else - whether it's about computer hardware or COVID-19. We should really be on the same side, here.

but only to say that every company out there that currently has no need or demand for the products they normally make doesn't need to be making ventilators. We're going to end up with a billion ventilators that are useless because they are not needed.
I broadly agree with your skepticism about how much of this effort is useful and worthwhile. However, I didn't always think that.

Over the past month, I've had an evolution of thinking about this. About a month ago, the apparent ventilator shortage was clear and it seemed like hardly anyone was doing anything about it. Now, we see what seems to have been an overreaction. Not the best outcome, but better than everyone sitting around and waiting for someone else to do something.

Anyway, I'm not about reflexively applauding everyone who's doing anything to address what legitimately seems/seemed like a ventilator crisis. Yet, I still think it's understandable that people wanted to help, and I'm probably not as suspicious of their motives as perhaps you are.
 
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InvalidError

Titan
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Even factoring in the needs of other countries, it would be overkill for ALL these companies that are gearing up to create ventilators, to ALL being doing it. Once one or two of them get going, in addition to the companies that normally make them, I think there will be more than enough for the cases that actually might require them.
The only reason there is a rush to make ventilators today is because most governments didn't order them years ago ahead of the next pandemic where they may be needed. The Trump GOP got the report from Obama's pandemic office before disbanding it two years ago saying that the US government was 740k respirators short of what it could potentially need for the next SARS or Spanish flu. If Trump had started working on that back then, the USA could easily have been 100k ventilators ahead of where it is today, which would have extended the amount of time before hospitals needed to start sharing them between patients by several weeks if not avoid it altogether, possibly long enough for the situation to stabilize and not require panic-buying.
 

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