How the bubble respirator used by Italian doctors to fight coronavirus works

Italian doctors fighting on the coronavirus front are uusing “bubble respirators” to treat critically ill patients who need mechanical assistance. The devices – a transparent and hermetic helmet – have proven useful in assisting critically ill patients. They help them breathe easier and improve their chances of survival.

A traditional respirator is a machine that helps breathe by bringing oxygen to the lungs and removing carbon dioxide from the body. The ventilator is usually connected to the patient through a mask, with a tube placed in the mouth or nose and down the trachea.

But bubble respirators are different. Experts from the University of Chicago first tested the device in 2016 and found that it “made a substantial difference” for patients with ARDS, the acute respiratory distress syndrome. The syndrome causes fluid to build up in the lungs, and can lead to death.

The study, published by the Chicago team in the prestigious journal of the American Medical Association, divided 83 patients into two groups. Half were given helmets, while the others had the standard mask attached to their face and to cover their nose, mouth and chin.

After reviewing the data, the scientists said the face masks exposed patients to “greater risks.” They added that Helmets, which are sealed with a soft, airtight collar that wraps around the neck, have “several benefits”.

One of them is that leaks less likely, which means that doctors can pump more air for patients with respiratory difficulties. They were also found to be more comfortable and allow patients to watch TV, speak and read due to their transparency.

But also, lBubble-shaped respirators do double duty amid the relentless pandemic: While pumping oxygen to patients’ lungs, they also help prevent infected patients from spreading the virus through tiny particles, saliva, or mucus., which typically spread from 1 to 1.5 meters.

From vacuum cleaners to respirators

When he received an email last week from the British government, vacuum cleaner manufacturer Nick Gray thought it was a joke. But now he’s on the front lines of fighting the coronavirus by making respirators for critically ill patients.

After verifying that the sender of the message was really a member of Boris Johnson’s executive, this businessman from Worcester, in the center of England, decided to call.

“He said, ‘I’m working on a special project for the prime minister and we need 30,000 respirators in two weeks,'” he explains at his factory, Gtech, where he normally makes vacuum cleaners.

Incredulous at first, Gray began looking for how to make those devices that the public health service, the NHS, so desperately needs. Johnson put his executive on a war footing to deal with the covid-19 pandemic, which is rapidly progressing in the country, raising fears that hospitals will soon be overwhelmed.

On Tuesday the Health Minister announced the opening next week of a temporary field hospital in a gigantic conference center in London with capacity for 4,000 people. But many of them will need a respirator and are hard to find at this time.

The NHS, which was under pressure from the seasonal flu before the covid-19 pandemic, only has 8,175 of these machines for the most severe patients.

So the head of government appealed to manufacturers like Dyson, JCB, Rolls-Royce and Unipart to make their production a collective effort unprecedented since World War II.

In Worcester, a city known for its 11th-century porcelain and cathedral, Gtech engineers designed a machine in 24 hours, Gray explains. This device can be assembled in “10 minutes” by a single person using parts in a workshop anywhere in the world, he adds.

Due to the urgency of the order, they had to cope with what they had on hand, using resuscitation bags and syringes. The first three machines were ready to roll off the production line on Tuesday. If approved by the government, the company could produce 60 to 80 respirators a day. The simple design of the devices allows to quickly increase the manufacturing rate.

“We understand the language of air,” explains the businessman. “We just had to adapt things in terms of air volume” because “we didn’t have time to learn about the lungs or breathing.” The experts’ instructions were sufficient.

These life-saving machines need to blow regularly: 400 ml of oxygen enriched air, 12 to 15 times per minute. “That’s all that people need, and that’s what we’re going to do,” says Gray. He claims that thousands of respirators can be made every day, as long as there are people who produce the parts and assemble them, and people in hospitals who fit and calibrate them. “All we have to do is jump in,” he says.