On the other side, this shows how slowly ideas can spread even in globalization times. I'm a pediatrician in Brazil and have used and been taught to use improvised bubble CPAP, with great results, since the nineties. I've heard reports of its successful use since, at least, the 80's decade.

I hope those devices can swiftly be fully scientifically validated and reach all needing regions of the world.

edited: grammar

I don't see how your comment is "silly".

1) The lack of proper/popular communication channels between medical communities (apart from the academic ones)

2) The fact that these improvisations are often deemed as undesirable or inadequate (even shameful) without the due scientifical scrutiny, only because they are cheap or simple

If hospitals don’t compete on price, what really motivates them to find a cheaper ventilator?

If they aren’t all that motivated to find a cheaper ventilator, are the ventilator manufacturers motivated to develop a simpler and cheaper version of their technology? Not so much. They might be more motivated to lobby for regulations making cheaper solutions illegal to protect their business.

And so forth.

Fascinating. Demoralizing.

The water bottle is there because it's difficult to control the amount of pressure. Sinus tissues and lungs are very delicate, and pressurized air also messes with blood/gas ratios, so it's important to use the minimum pressure you can get away with. The bottle of water allows the pressure to be controlled simply and precisely, by adjusting the depth of the hose.

its preparation was described in a 1,600-year-old text, in a recipe titled, "Emergency Prescriptions Kept Up One's Sleeve". At first, it was ineffective because they extracted it with traditional boiling water. Tu Youyou discovered that a low-temperature extraction process could be used to isolate an effective antimalarial substance from the plant; Tu says she was influenced by a traditional Chinese herbal medicine source, The Handbook of Prescriptions for Emergency Treatments, written in 340 by Ge Hong, which states that this herb should be steeped in cold water. This book contained the direction to immerse a handful of qinghao in the equivalent of two litres of water, wring out the juice and drink it all. After rereading the recipe, Tu realised the hot water had already damaged the active ingredient in the plant; therefore she proposed a method using low-temperature ether to extract the effective compound instead. The animal tests showed it was completely effective in mice and monkeys.

https://www.bbc.com/news/business-40498395

People like him should win the Nobel Peace prize.

In reading the article, though, I don't think it took him 20 years to make it. Instead, I think it means he made a promise to do something about children dying from pneumonia and it took him 20 years to figure out how to do it. I base this on the following paragraphs in the article:

In 1996, Dr Mohammod Jobayer Chisti was working in the paediatric department of the Sylhet Medical College Hospital in Bangladesh. That evening he made a promise that he would do something to stop children dying from pneumonia.

When asked how he feels to be fulfilling that promise he made 20 years ago he replies: "I have no language to express this."

After two decades of research, Dr Chisti has now come up with a low-cost device with the potential to save thousands of babies' lives.

One of the situations where a lack of strict health regulations on medical devices is saving lives.

Lack of health regulations can bring about low-cost innovations, but it also bring about all sorts of useless quackery. As a consumer of medicine, I'd first prefer the treatments being performed on me to be proven to work. If that's not an option, due to cost, or lack of data, that's another thing.

If you lose 10% to contaminated bottles, 15% to various malfunctions, and another 5% for things related to the procedure I can't even begin to consider, that's 30% mortality rate for this procedure.

But if another has 0% mortality rate but due to some other factor is not available in appropriate quantities, let's say there are only enough resources to service 10 cases a day, then your 11th case can either take a 100% mortality rate for doing nothing, or a 30% mortality rate with the other procedure. You take the better chance.

And I was agreeing that it is saving lives, but that it is not particularly indicative that regulation is killing people.

That the incident of a disease may be so prevalent or that access to modern hospitals may be so scarce that in certain cases, taking an unregulated approach is better than no approach.

This is in India. This would never be discovered in a developed nation because there is no need for it. A ventilator has a far better success rate. However, in India, in other developing nations, this is necessary. And the fact that it is simple to set up, that it can be set up by someone with little training, etc are all benefits in those situations. That even with what would be considered a pretty poor mortality rate, it's still better than the alternatives at their disposal.

The comment higher up the chain covered some of the potential failure methods of the new system.

> If you lose 10% to contaminated bottles, 15% to various malfunctions, and another 5% for things related to the procedure I can't even begin to consider, that's 30% mortality rate for this procedure.

That comment also seems to demonstrate a fundamental lack of understanding of what's being discussed, since contaminated bottles are vanishingly unlikely to infect the patient — the air goes from the patient to the bottle, through a dry plastic tube, not vice versa.

Discussing the minutiae is immaterial.

https://www.bbc.com/news/business-40498395

Basically, they don't have access to ventilators. The current recommendation still has a mortality rate of 1:7 but the bottle method seems to be around 1:56 (if I'm reading that right).

So, the order of preference is ventilator, shampoo bottle, then low-flow oxygen. In other words, what I said. This is a case of not having access to the best method, but having something that works better than the other secondary methods.

This will not and should not replace ventilators in modern hospitals, but in places where ventilators are unavailable, this is a good solution.

edit: though based on the abstract available at the URL, it's not clear to me which of the mentioned methods is the innovative one, if any (??)

edit 2: Found a youtube video with some actual description of how the machine is built, from the doctor himself, from 2015 (google keywords: "Chisti bubble CPAP"): https://www.youtube.com/watch?v=HM1E8yMJd5Q

Can't be said enough.

I hope that much of today's advanced, complicated, and expensive tech will eventually make that next step to simplification based on huge accumulated experience and knowledge.

this does put a massive black mark on the medical device industry and medical industry as a whole, trying to profit off what should be basic needs of hospitals. in general, companies making profits is only natural, and some of their research does require heavy research funding, but to the extent where their pricing may be killing off people is a little contradictory. i imagine the device costs have been subsidized by some governments of rich countries, but these standards cannot be applied to all countries. this is certainly a political issue, where are all the funds for bangledesh heading?

this also reminds me of the efforts going on at fourthievesvinegar.org we need more open source medicine and medical devices, this seems to be a lot more meaningful than creating enterprise software or social apps.

https://www.semanticscholar.org/paper/CPAP%3A-a-guide-for-cl...

In those cases we use a Y piece connecting air and oxigen flows to the inspirarory limb.

The role of the blender is to control the percentage of oxigen offered. With the Y piece we can control that by the equation:

%O2 = (O2flow + Airflow * 0.21) / Total flow

If you can use Total flow of 8L/min (reasonable in most cases) the approximations table below is of easy memorization and precise enough:

  O2 flow - Air flow - %O2

    8 - 0 - 100%
    7 - 1 - 90%
    6 - 2 - 80%
    5 - 3 - 70%
    4 - 4 - 60%
    3 - 5 - 50%
    2 - 6 - 40%
    1 - 7 - 30%
    0 - 8 - 21%