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There is a large amount of future work needed to move open source ventilators up to the level considered scientific-grade equipment, and even further work needed to reach medical-grade hardware. With the considerably larger motivation of an ongoing pandemic, it is assumed these projects will garner greater attention and resources to make significant progress to reach a functional and easily-replicated system. The results of this review found that the tested and peer-reviewed systems lacked complete documentation and the open systems that were documented were either at the very early stages of design (sometimes without even a prototype) and were essentially only basically tested (if at all). Next, the existing Internet and gray literature are reviewed for open source ventilator projects and designs.
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possessing accessible design source files, bill of materials, assembly instructions, wiring diagrams, firmware and software as well as operation and calibration instructions). These articles are analyzed to determine if the designs are open source both in spirit (license) as well as practical details (e.g. In this study, after providing a background on ventilators, the academic literature is reviewed to find the existing and already openly-published, vetted designs for ventilators systems. Fortunately, with the recent development and widespread deployment of small-scale manufacturing technologies like RepRap-class 3-D printers and open source microcontrollers, mass distributed manufacturing of ventilators has the potential to overcome medical supply shortages. For more granular details of changes see individual responses to reviewers.Ĭoronavirus Disease 2019 (COVID-19) threatens to overwhelm our medical infrastructure at the regional level causing spikes in mortality rates because of shortages of critical equipment, like ventilators. Added references throughout text and fixed minor typos. Qualified conclusions that are changing rapidly. Added concept of expanding Good Samaritan laws.
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Added discussion of need for transparent quality control, standards and qualifications. Deleted earlier claim about easier replication in developing communities and replaced it with a call to streamline regulation while maintaining standards. Added a paragraph on the need and current status for ventilator testing. Discussed the use of sharing incomplete designs and status tags. Stressed the need to share plans Future work Added a section on best practices for sharing a design Included points about the need for multi-disciplinary collaboration, the need to involve medical personnel, and to aim to publish in the medical literature. Updated grey literature review, added the Read review, many of the other major teams and projects, and listed the approaches. Increased discussion about need for diversity of solutions needed in a pandemic. Existing peer reviewed literature Added detailed analysis of new study, which is the first fully documented ventilator in the peer-reviewed literature. Analysis of the literature Added a much more explicit section detailing the meaning of open source as well as provide examples of it being misused. Expanded considerably what files are for in open hardware to help better introduce those outside of the open hardware community to the concept as well as make it clearer why they need to be included. Enhanced the description of distributed manufacturing in this context. The manuscript was updated in several ways: Introduction Based on recent news about the Italian patent infringement lawsuit this example was removed entirely.