Objective The paucity of mechanical ventilators necessitates development of innovative respiratory support devices.

Methods We developed the Artificial Breathing Capability Device (ABCD) to automate compression of self-inflating bags (SIB), while controlling peak inspiratory pressure (PIP), ventilation rate (VR) and inspiration to expiration time (I:E) ratio (as in a conventional ventilator). ABCD has additional smart features including self-regulatory checks, auto cut-off during cough, endotracheal tube disconnection and blockage alarms, and SIB disconnection alarm. ABCD was tested non-stop for 60 days with 396 user combinations, using adult-size and paediatric-size SIB. The device was evaluated for robustness, reliability and precision.

Results ABCD did not have mechanical, electrical or electronic failures during continuous testing under various ambient conditions, confirming robustness. Reliability and precision evaluated by the proportion of user combinations showing <10% deviation from the set parameters showed: PIP 100%, VR 100% and I:E 84.3% with an adult SIB. The corresponding proportions with a paediatric-size SIB were 85.4%, 100% and 95.5%. With both SIB, the only combinations showing >10% deviation were outside the physiologic range.

Conclusion ABCD is a safe, efficacious and cost-effective option, which could be considered for adults and children in the context of ventilator shortages especially during the COVID-19 pandemic.