Simple and easy to build mechanical ventilator for pandemic health crises in resource-limited areas

This is the authors' abstract. We don't add key points for this paper.

Background The COVID-19 pandemic exposed critical shortages of mechanical ventilators, particularly in low-resource settings. Disruptions in global supply chains and dependence on specialized components highlighted the need for scalable, locally manufacturing alternatives for emergency respiratory support. Aim To describe and evaluate a simplified, supply-chain-independent mechanical ventilator assembled from widely available automotive and simple hardware components, and intended as a last-resort solution. Methods The ventilator is based on a reciprocating air pump driven by an automotive windshield wiper motor coupled to parallel shaft bellows and readily assembled passive membrane valves, only requiring materials available from standard hardware retailers, minimal tools, and basic manual skills. Ventilator performance was assessed through bench testing using a patient model simulating severe lung disease in an adult (R=20 cmH₂O·s/L, C=15 mL/cmH₂O) and pediatric (R=50 cmH₂O·s/L, C=10 mL/cmH₂O) patients. Realistic proof of concept was performed in four mechanically ventilated 50-kg pigs. Results The device delivered tidal volumes up to 600 mL and respiratory rates up to 45 breaths/min with PEEP up to 10 cmH₂O, covering pediatric and adult ventilation ranges. In vivo testing showed that the ventilator maintained arterial blood gases within the targeted range. Technical details for ventilator construction are provided in an open-source video tutorial. Discussion This low-cost ventilator demonstrated adequate performance under demanding conditions. Although not a substitute for commercial intensive care ventilators, its simplicity, autonomy, and independence from fragile supply chains provide a potentially life-saving option in resource-constrained emergency scenarios.