4/7/2020 Pressure Measuring - MIT E-Vent | MIT Emergency Ventilator

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Pressure Measuring
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Updated 4 April 2020

This page summarises the importance of pressure measuring and monitoring even in the simplest ventilation
scenarios. A pressure gauge attached to the manual facilitator’s sensing port, while better than nothing, provides
only partial information and cannot be used for triggering alarms or detecting inspiration in a non-paralysed patient Search
and providing Assist Control, which is explained on the Clinical page.

NEWS
The pressure sensor, described in Electrical Hardware and Controls, is to be connected in a position so as to allow
sensing of pressure in the patient’s airway, as shown in Plumbing. Because pressure transducers with the correct Bag Sizes & Failure Modes

speci cations to sense human respiration are in low supply, these sensors should not be single-use. To protect the
pressure sensor, a small inline HEPA lter should be placed on the sensing line between the patient and the sensor Plumbing, Pressure Sensing, Study #4.

to prevent viral migration and patient to patient infection.

Plumbing & Dead Space

Key Readings
Updated Study Results & Non-invasive

The rst three readings should be displayed to the clinician and the fourth is a condition that must be detected. Ventilation

Study Results
1. PEEP – (positive end-expiratory pressure) – This is manually set by the PEEP valve 
2. Plateau Pressure – This varies as a function of airway resistance
RECENT COMMENTS
3. PIP (Peak Inspiratory Pressure) – This varies as a function of airway resistance

4. Inhalation Detection – This dip in pressure, with relation to the resting PEEP pressure, indicates that a non- RAMANA KALGANI on Safety First

paralysed patient is attempting to breathe and should initiate a cycle. Roy Hunter on Mechanical
Roy Hunter on Mechanical

Sanity Checks & Alarms ramin rezaei on Pressure Measuring

MAREESAN BOSE on Bag Sizing
There should be checking each cycles for relations and consistencies among PEEP, Plateau, and PIP and when
discrepancies an alarm condition should be triggered accordingly:
TERMS AND CONDITIONS

1. In Volume Control ventilation, it is expected that PIP > Plateau. Read the terms of use for this website

2. It is expected that Plateau > PEEP in order to have a positive driving pressure. (Driving pressure = Plateau – PEEP)

3. PEEP should not fall below a predetermined value, to prevent alveolar collapse, and the displayed value should
match the value set manually with the PEEP valve.

4. Plateau should not exceed a predetermined value, nominally 30 cm H2O in ARDS.

5. PIP should not exceed a predetermined value; 40cmH2O in general. This value should be set (hard coded) to below
the cracking pressure of the pop-off valve.
6. A leak or disconnect in the system will be detected as plateau pressure below a predetermined level, e.g. 5 cm H2O.

Assist Control

Assist Control is dependent on a well executed pressure detection system, namely the ability to also read negative
de ection of pressure when pressure falls below PEEP or baseline during a “detection window period” towards the
end of expiration phase. For more information see Assist Control under Controls.

22 Replies to “Pressure Measuring”

Michael Krasowski 5 April 2020 at 09:42 Reply

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Michael Krasowski 5 April 2020 at 09:42 Reply

Cannot nd, but wondering if you are using hydrophobic insuf ation lter line sets between the ventilator gas
circuit and your pressure sensor to mitigate against moisture and pathogens entering the pressure sensor.
Thanks.

Yueh Lee 5 April 2020 at 12:53 Reply

Almost certainly the easiest approach. other option is simple syringe lter in front of the sensor? essentially
what you said, but slightly different “source” of material.

Eric Becker 5 April 2020 at 09:50 Reply

Hi E-Vent Team,
I tested a diaphragm with 2 chambers and was able to get accurate pressure readings with limited attenuation.
I’m not sure if this a viable solution, but this could mitigate the risk of contaminating the pressure sensor. The
part I used was a back- ow protector from Sprectra breast pumps. These can also be sterilized. I’ve prototyped a
PVC and latex glove version, which also worked.
Keep up the great work!
Best,
Eric

Hemant Singh 5 April 2020 at 12:10 Reply

Others have said a HEPA lter tends to clog and change pressure readings. One will have to clean the HEPA lter
periodically.

Isn’t there disinfectant spray to sanitize the pressure sensor before moving the device to another patient?

larry gessman 6 April 2020 at 07:10 Reply

Both peep and patient exhaled air ltering can be accomplished by using a peep water column as shown in
the link below:
https://www.google.com/amp/s/www.researchgate.net/ gure/Figure-1Schematic-diagram-of-indigenously-
prepared-NB-CPAP_ g1_309619056/amp

If a disinfectant were added to the water in the peep column, the hepa lter would not be needed.

Arshad Sherazi 5 April 2020 at 14:40 Reply

Hi there, wish you all the best. Do you recommend any speci c OEM for the pressure transducer? Any
recommended part numbers? Thank you

Thiago Ennes 5 April 2020 at 15:00 Reply

Would it be possible to instead of differential sensors, two absolute sensors be used and subtracted from each
other? Absolute sensor are way cheaper and easier to nd. We are going to need thousands of those devices.

Shudhant Gautam 5 April 2020 at 16:21 Reply

Hello,

Can someone please tell me what air pressure sensor they used as their input? I cannot nd a differential one
with a range of at least 100 CM H2O. Please advise!

Thanks.

Nolber Rumbo Avila 5 April 2020 at 22:44 Reply

Hi Shudhant Gautam
The MPX10D could work ne It have a 0 to 10 Kpa range
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The MPX10D could work ne. It have a 0 to 10 Kpa range
Rgds
Nolber

Hector Molina 6 April 2020 at 00:07 Reply

MPX10 have correct pressure range, but is necesary add external ampli er an temperstura compensation.
MP5010 have all internally and out signal is ready for use with any micrprocessor
B regards
Hector

Shudhant Gautam 6 April 2020 at 02:13 Reply

Hi Hector,

Thanks for your response.

So the MP5010 is the one you would recommend using?

Thanks.

Shudhant Gautam 6 April 2020 at 02:12 Reply

Hi Nolber,

Thanks for getting back to me.

MIT here says that it must be able to sense negative vacuum air pressures, but you are saying the
MPX10D would only measure 0-10 kPa? Could you please elaborate as to how the machine would detect
inhalation if the sensor only works with positive air pressures?

Thanks

Dmitry Vasiliev 6 April 2020 at 06:04 Reply

Anyway it is negative in relation to PEEP pressure, so actually is positive. Becides 5010 is able to
show at least -5 cm H2O as its’ zero voltage is around 0.2V

Shudhant Gautam 6 April 2020 at 13:55 Reply

Hi Dmitry,

Thanks for the information. So would you say that the MP5010 is suitable for use for this
project? Could you please send me the link as to where I can buy this product? I cannot nd it
for sale anywhere.

Thanks!

Robby Candra 5 April 2020 at 23:10 Reply

Same question here.

Ashis Panda 6 April 2020 at 04:33 Reply

Hi all,
I am from India.
Keep up the good work !
I have been working to develop a proof of concept low lost design for a mechanical ventilator controller.
I used an I2C BMP180 sensor along with a Arduino Nano to get the airway pressure readings on the LCD. I
calibrated the sensor to 0 when the airway is open to atmosphere ( exhale) and then used to get the
readings in cm H2O. It displays +ve when I blow through the airway and displays -ve when I try to suck

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air in through the tube. Am I mising something ? Any suggestions ?

Thanks !

Shudhant Gautam 6 April 2020 at 13:57 Reply

Namaste Ashis bhai,

Kaise ho?

I am wondering how you got the pressure sensor to read negative values for the inhalation
component of the ventilator? Do I really need a differential pressure sensor for this, or can I just a
normal positive-only pressure sensor and somehow code around that?

Madat ke liye shukriyaa.

Shudhant

Michael Ilewicz 6 April 2020 at 13:17 Reply

Just a raw Idea:

Very thin U-Tube (2-3mm) lled with Oil (Water will evaporate) with one end open to atmosphere and one end to
what you want to measure. A phone with the camera facing the tube and using image detection to measure the
pressure over time.

Such a tube would be 3D-printable. it might have to be calibrated once and a calibration value might be QR
coded onto the tube for the phone to detect it. Temperatur calibration could be done when the oil is known by
lling it with a certain weight and calculating the full Volume. The Oil would need to have as low viscosity as
possible and be incompressible

Does anybody know if that would have the required precision and response time? What Oil would be needed?

Aamir Abbas 6 April 2020 at 14:36 Reply

I was wondering if you’ve considered the addition of esophageal manometry connected to the Arduino via a
pressure transducer to measure lung compliance and subsequently prevent over or under-in ation. This
measurement can be used to titrate PEEP and avoid barotrauma from the vent and can be done using readily
available materials (a uid lled Foley catheter, for example). This has been clinically validated and is especially
useful in situations like ARDS. https://www.nejm.org/doi/full/10.1056/NEJMoa0708638. I understand the desire to
keep things simple and avoid extra tubes going to the patient but something to consider if you’re running into
issues transducing pressures directly from the circuit.

Eric Baicy 6 April 2020 at 23:21 Reply

Can someone help me understand the speci cations here? This is what I’ve gathered:

1. Differential Sensor
2. Max Range -100 cm H2O to +100 cm H2O (9807 Pa, 1.42 psi, 0.1Bar, 39.37 “ h2o)
3. Min Resolution +/- 0.5 cm H2O (49.035 Pa, 0.0071 psi, 0.0005 Bar, 0.19685 “ h2o)

However I’m confused about a few things as I’ve never worked with pressure sensors.
A. Won’t we really be measuring the change in atmospheric pressure relative to breathing? So an absolute sensor
could also measure the peaks and drops, right?
B. Also with a PEEP in place there will always be some positive pressure above the room nominal pressure, Is a
differential sensor required?
C. If a differential sensor is used should it be a 2 port with one port exposed to room pressure? Or is the
connection a single port that is connected to a “T” on the airway?
D. Is a vented gauge or absolute gauge a good alternative to a differential one? Or am I missing something here?

Thanks!

Eric Baicy 7 April 2020 at 00:56 Reply

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Also to add to this the Medtronic device that released their design details appears to use an absolute
pressure sensor for their device.

ramin rezaei 7 April 2020 at 05:29 Reply

Hi
I read most of the comments, but I don’t think the electronic suggestions for the hospital environment and the
patient are very accurate.
I work on all-mechanical ideas. If I get a good result, I will de nitely raise it

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