History
Where we came from
MINIVAP’s development dates back long before the first clinical trials were deducted
1966
The beginning
About 50-60 years ago, low-resistance vaporizers (“drawover” – gas is inhaled through the vaporizer) dominated inhalation anesthesia, but were later supplanted by more precise high-resistance vaporizers (“plenum” – gas passes under pressure 100 times greater than that experienced during inhalation). At the turn of the millennium, the renowned anesthesiologist Nunn GF posed a challenging question: “Why did drawover anesthesia stop?” despite its important advantages (independence from high-pressure gas sources and rapid control of anesthesia depth).
Therefore, it was natural to want to solve a “precise problem”: to create an evaporator with a stable concentration without exceeding the permissible breathing resistance (during anesthesia, approximately 100 Pa (10 mm H2O) at a gas flow rate of 10 l/min).
It’s a jewelry design because, at low resistance (e.g., 5-10 Pa at a gas flow rate of ≤ 2 l/min – low-flow anesthesia), secondary disturbances (pressure and temperature fluctuations, density variations (sevoflurane vapor is 7 times heavier than air) are comparable in magnitude to the control parameter (resistance or pressure drop) of the vaporizer’s concentration regulator (gas valve).
This story begins with the work of Semyon Glukhov and Alexander Semyonovich Perelmut, one of the main creators of Soviet anesthesia and respiratory medical equipment. In the spring of 1966, when graduates of the Moscow Institute of Chemical Medicine were being assigned to work on a new anesthesia project at the All-Russian Research Institute of Medical Instrumentation, then known as VNIIMIO, requested new specialists. Glukhov’s opinion played an important role in sending the young Alexander Berlin to this institute instead of another research center where Berlin had originally hoped to work.
1967 – 1980
First anesthesia devices
The first important development was the “Anestezist-1”, a high-resistance anesthetic evaporator. It used a special labyrinth-shaped chamber without the thick wicks commonly found in other devices. Instead, the anesthetic liquid was spread through a system of small nozzles. For mass production, L. B. Taflinsky suggested replacing these with small watch stones, which performed the same function.
A few years later came the “Anestezist-2”, a low-resistance evaporator that allowed air to pass through more freely. Its evaporation chamber contained porous metal plates inspired by natural gas-exchange systems, such as the respiratory organs of animals and the gills of fish. This was followed by the “NARKON-2”, an anesthesia machine designed for military field use. It could be transported in two packs weighing about 15 kilograms each and was tested in cities including Kuibyshev, Odessa, and Kaliningrad.
These experiences later influenced the development of much smaller devices. From 2000 onward, miniaturization became a major goal. The first prototype, called “MINIVAP-20,” had an evaporation chamber about the size of a tuna can and weighed only 300 grams.
This period of work continued until 1980. A year earlier, Leonid Ilyich Nemirovsky, a specialist in medical technology, advised Alexander Berlin to turn a rejected doctoral dissertation into a practical book. Together with physician Alexey Viktorovich Meshcheryakov, he published “Anesthesia and Anesthetic Dosing.” The book contained useful formulas and experimental results that continued to serve as a practical reference for calculating and controlling anesthesia.
2000 – 2005
Second Series of Anesthesia Evaporators
The second series of anesthesia evaporators began about 20 years later, in 2000. Alexander Berlin, together with his son Leib and engineer Viktor Mazin, received a public-private research grant in Israel through LaminarTechnology Ltd. They created a small laboratory and spent several years developing a compact evaporator. After five different versions, they produced the “MINIVAP-20.”
Near the end of this project, the team travelled to Germany to meet specialists from Dräger and to England to visit Penlon, two well-known manufacturers of anesthesia equipment. They hoped these contacts would lead to cooperation and further development of the device.
However, the second series effectively came to an end in 2005. The main reason was the extremely high cost of the technical and medical testing
2005 -2013
Improving manufacturing
The renowned Russian anesthesiologist, Professor Nikolai Evgenievich Burov, came to their aid. He first breathed through the new vaporizer himself and then showed it to Russia’s chief anesthesiologist, Professor Igor Vladimirovich Molchanov, in the adjacent office at Botkin Hospital (see I.V. Molchanov’s report in the “REVIEWS” section).
Understandably, the process of state technical and medical testing dragged on for almost five years. It began with the assistance of Alexey Alexandrovich Svitsov, CEO of the membrane company “NPF TEKO” (based at the D.I. Mendeleyev Moscow Chemical Technology Institute), and was successfully completed thanks to financial support from the State Innovation Fund in 2009.
A year later, the “iron and jet-powered” I.K. Gorlin (See the “Participants” section for more details), whom I spent three years persuading, obtained state registration and certification for the Anesthesia Machine “Colibri” and MINIVAP evaporators (an impossible task even for a persistent “artisan”).
At the same time, in 2010, Boris Samuilovich Yakubovich, CEO of TSENTRKONTROLAVTOMATIKA, agreed to first manufacture pilot samples of the MINIVAP-20 evaporators, and then a production batch, in the experimental workshop of JSC Aviamotor Scientific and Technical Complex “Soyuz” (CEO Lev Nikolaevich Shvedov).
Three relatively complex technological challenges needed to be solved with minimal expense: manufacturing a thin-walled housing, distribution device components (valve system) with relatively high precision (±10 µm), and final volumetric brazing of the stainless steel housing components. These tasks were professionally and enthusiastically addressed by the experimental workshop team (headed by Viktor Ivanovich Sizov), who had the necessary equipment.
During 2011, during the second stage of the state contract with the Foundation, new models of portable Anesthesia Machine “Colibri” based on the MINIVAP-20 vaporizer were tested at Bely Klyk, the largest chain of veterinary clinics (Head of Anesthesiology A. Yu. Pavlyuchenko, PhD E. V. Skachenko – see the Abstract in the “Reviews” section).
Thus, we identified a promising market niche for mini-devices. The minimum parameters of our devices are precisely suited to the main patient population (dogs, cats, mice, birds).
2022 -2026
A new generation
What happened now
Thus, we identified a promising market niche for mini-devices. The minimum parameters of our devices are precisely suited to the main patient population (dogs, cats, mice, birds).Thus, we identified a promising market niche for mini-devices. The minimum parameters of our devices are precisely suited to the main patient population (dogs, cats, mice, birds).Thus, we identified a promising market niche for mini-devices. The minimum parameters of our devices are precisely suited to the main patient population (dogs, cats, mice, birds).Thus, we identified a promising market niche for mini-devices. The minimum parameters of our devices are precisely suited to the main patient population (dogs, cats, mice, birds).Thus, we identified a promising market niche for mini-devices. The minimum parameters of our devices are precisely suited to the main patient population (dogs, cats, mice, birds).Thus, we identified a promising market niche for mini-devices. The minimum parameters of our devices are precisely suited to the main patient population (dogs, cats, mice, birds).
2027-
In the future
A happy ending to this story could be the normal mass production of mini-vaporizers (for example, as at Penlon and Drager, or even as in the “Soviet” 1980s), of course, with the involvement of powerful and professional resources.
The “Anestezist-2” vaporizer, adopted for military use back in the 1970s, featured the main components of a stabilized low-resistance vaporizer: a direct-flow concentration regulator and an evaporation chamber with slotted channels (analogous to the human respiratory tract and the mass-exchange system of fish), which distinguished it from well-known foreign analogs at low gas flow rates (< 3-4 l/min).
However, at lower flow rates (≤ 1 l/min), this stability was also disrupted. Due to the difference in vapor density between the anesthetic and gas.
Despite the very small scale and significance of our products, one can still ask the question, “How did it work?”
In 2000, we attempted to continue our unsuccessful attempts at designing evaporators without an independent concentration regulator (we made five experimental prototypes, and secured the same number of copyrights and patents).
At the same time, we continued the conceptually old (but practical) “Anestezist-2” design with radical modifications:
– horizontal orientation of the concentration regulator with its level aligned with the evaporation chamber (the minimum gas flow rate became 0.2 l/min instead of 2 l/min);
– miniaturization;
– coolant with a “liquid ↔ solid” phase transition (first unsuccessful attempts with glycerin, which, according to the reference book, has a melting point of 18°C), then “paraffin” traces on the internet and contacts with dealers of foreign companies, and finally, Borya Reiderman and his friend Mikhail Mitrofanov found the necessary paraffin in 2010.
In 2011 alone, they managed to increase the sevoflurane concentration in the MINIVAP-20 by almost 1.5 to 2 times, to 6% (in response to valid comments from anesthesiologists at Filatov Hospital and Lina Vladimirovna Soboleva, Head of the Anesthesiology and Resuscitation Department at the Dental Center), by equalizing the resistance across the entire concentration range and “licking” the evaporation chamber (combatting gas flow and flowing around the evaporation surfaces).
At the same time, they reached 15% sevoflurane by volume in the MINIVAP-200 evaporator, guided by the inspiring words of V.V. Subbotin, Head of Anesthesiology and Resuscitation at the Vishnevsky Institute of Surgery.
As always, ≥90% of the time is rough work (trial and error). Even the greats Pushkin, Tolstoy, and Babel threw 10 pages in the trash and only the 11th was published.