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Breathing Systems Deployed in Indonesia to Battle COVID-19

Indonesia’s fragile healthcare system is on the verge of collapsing. Due to the large-scale travel during last June’s Hari Raya Aidilfitri and the spread of the highly contagious Delta variant, daily new cases have reached all-time highs in the last month. In Indonesia, the lack of beds, oxygen, and ventilators has forced doctors to make the agonising decision of who will live and who will die among their Covid-19 patients.

To address this issue, the Indonesian Institute of Sciences (LIPI) Research Centre for Electronics and Telecommunications (P2ET) is developing a smart ventilator with two operating modes: CPAP and BiPAP. The purpose of developing this ventilator is to assist in dealing with the country’s COVID-19 situation.

“CPAP and BiPAP are the most effective non-invasive (without surgery) treatment systems and are the first and most widely used options for patients with respiratory problems”, said LIPI P2ET researcher.

The availability of breathing apparatus such as ventilators is critical in assisting every health facility in dealing with the growing number of critical COVID-19 patients. The ventilator is currently being developed by a LIPI researcher and his team. The CPAP (Continuous Positive Airway Pressure) mode of ventilation is a ventilator that produces one level of positive air pressure that is constant and continuously delivered to the patient in order to keep the patient’s respiratory tract open.

Whereas the BiPAP (Bi-level Positive Airway Pressure) mode is a ventilator that can produce two levels of positive air pressure, namely when inhaling (inspiration) and exhaling (expiration), it is more comfortable for patients to use because it will follow the rhythm of breathing while maintaining the required end-expiratory pressure (PEEP).

According to the researcher, doctors usually recommend a ventilator with CPAP and BiPAP modes for patients with sleep apnoea (serious sleep disorders), which is a symptom in which the patient’s respiratory system stops for a short period of time during sleep.

The CPAP or BiPAP ventilator mode is a pressure-based ventilator mode that aims to prevent airway obstruction, which many COVID-19 patients experience, as well as to train the respiratory muscles before the patient can breathe normally. The researcher also stated that the purpose of using the ventilator is to keep the patient’s respiratory tract open, while the basic difference between the CPAP and BiPAP modes is the issue of comfort when the patient breathes.

In CPAP mode, the ventilator will work by providing a continuous (constant) positive pressure airflow through the tube to the nose and or through the mouth, which can cause fatigue in the patient, particularly during the exhalation process (expiration), which requires more force or force to resist the pressure.

Similarly, in BiPAP mode, this type of ventilator will provide different pressures when the patient breathes (inspiration) and exhales (expiration), allowing the patient to breathe more comfortably while maintaining the required PEEP pressure.

The smart ventilator has gone through a series of testing stages, beginning with laboratory-scale testing, which focuses on technical issues with reference to established standards. The function test consists of a series of tests, including system performance (performance), system endurance (endurance), and electrical safety for 21 days without interruption.

OpenGov Asia reported that the demand for medical devices will be driven by the expansion of private and government hospitals and clinics as well as improvements in existing facilities. Another factor behind this expected demand is the rise of non-communicable diseases and the diagnosing of which require advanced and high-tech equipment.

The Indonesian government has taken a number of decisive steps in its efforts to control the COVID-19 outbreak, including, but not limited to, expanding healthcare facilities, lifting duties and import taxes on many medical items to increase domestic stocks, and allowing commercial imports of medical supplies previously restricted only to government institutions and public service agencies.

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