The objective of this study is to evaluate the efficacy and safety of the Unisabana-Herons invasive mechanical ventilator designed to provide the basic ventilatory support necessary to preserve the life of patients with respiratory failure and indication of mechanical ventilation, especially for those who suffer from acute respiratory distress syndrome (ARDS) when conventional commercial invasive ventilators are not available in the context of the health emergency due to the COVID-19 epidemic. The Unisabana-Herons ventilator allows to precisely configure the respiratory rate, tidal volume (or inspired air volume), inspiratory time, the inspiration: expiration ratio, the positive pressure at the end of expiration (PEEP), the inspired fraction of oxygen and inspiratory air flow, parameters that allow managing the respiratory failure associated with COVID-19. The ventilator also monitors peak inspiratory pressures (PIP), mean, PEEP, plateau, and graphs in real time the pressure-time, volume-time, flow-time curves, which allows detecting when one of these is at levels dangerous to induce ventilator trauma (barotrauma and volutrauma) and thus ensure effective and safe ventilation, so as to avoid ventilator-induced lung injury.
The Unisabana-Herons ventilator is an invasive mechanical ventilator that works on the same
principles of invasive positive pressure mechanical ventilators that have existed for 80
years. Although the effectiveness of ventilatory assistance in saving human lives was known
since biblical times, the first mechanical ventilators only appeared in 1800 and it was in
1900 when the first positive pressure ventilators were manufactured, which have a turning
point in 1940 as a result of the polio epidemic, when invasive positive pressure mechanical
ventilators were developed that could be used massively and have evolved to current models.
These positive pressure fans completely replaced the first negative pressure models, have
abundant support in the scientific literature, and are the most commonly used today.
Since the beginning of the COVID-19 epidemic in Colombia, the University of La Sabana, a
multidisciplinary team in order to find solutions to deal with the disease, and its first
project, consisted in the design and manufacture of an invasive mechanical ventilator
(Ventilator Unisabana-Herons) able to supply the basic ventilatory needs of the patient with
severe respiratory failure due to COVID-19 at the time when the installed capacity of classic
commercial mechanical ventilators is exhausted. The Unisabana-Herons ventilator was built
based on those recommended by INVIMA, the MHRA (UK Medicines and Devices Regulatory Agency)
and the FDA, to provide efficient and safe volume controlled ventilation to patients with
indications. of mechanical ventilation for respiratory failure according to the ventilatory
modes already affected that have strong scientific evidence.
This study seeks to evaluate the effectiveness, usability and safety of the Unisabana-Herons
ventilator for the management of patients with an indication for invasive mechanical
ventilatory support, admitted to level III and IV university hospitals with Intensive Care
services enabled through a cohort study of 5 patients with a 24-hour follow-up.
Device: Invasive mechanical ventilation using the Unisabana-Herons Ventilator during 24 hours
Recruited patients will receive volume-controlled mechanical ventilation (assist-control mode) using the Unisabana-Herons ventilator for 24 hours. Information on clinical, hemodynamic, and respiratory variables will be recorded from 30 minutes before the start of mechanical ventilation with the Unisabana-Herons ventilator. Recordings will be made in the first 4 hours every 15 minutes in the CFR, except for arterial blood gases which will be taken every 30 minutes. In the following 20 hours, arterial blood gas controls will be taken at hour 12 from the start of the ventilator and at hour 24. Other hemodynamic and respiratory variables will be recorded every hour from hour 4 of ventilator start until hour 24.
Inclusion Criteria:
- Patients older than 18 years and younger than 70 years with indication of
volume-controlled mechanical ventilation for more than 24 hours.
- Patients with acute respiratory failure (PaO2 / FiO2 <300) requiring volume-controlled
mechanical ventilation. These patients may or may not have COVID-19 (at the current
time of the epidemic, it is assumed that every patient with an indication for
mechanical ventilation is a possible case of COVID-19).
- Postoperative patients who require ventilatory support and are expected to need it for
more than 24 hours.
- Patients with traumatic brain injury and indication of mechanical ventilatory support
with an expected duration greater than 24 hours
- Patients with acute intoxication and respiratory depression and indication of
mechanical ventilatory support with an expected duration greater than 24 hours
Exclusion Criteria:
- Pregnant women
- Patients with hypotension MAP <65 mmHg
- Patients with PaO2 / FiO2 <100
- Cerebral edema in cerebral protection and / or suspected endocranial hypertension
- SOFA >9
- For those patients who are already receiving mechanical ventilation, the presence of
one or more of the following criteria: PEEP> 8 cmH2O, plateau pressure> 30 cm H2O or
FiO2> 70%
- COVID-19 confirmed by RT-PCR.
Fundacion Neumologica Colombiana
Bogotá, Bogota, Colombia
Universidad de la Sabana
Chia, Cundinamarca, Colombia
Clinica Universidad de la Sabana
Chía, Cundinamarca, Colombia