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23 July, 2020 - 10:11 By Tony Quested

IfM and Papworth trial new ventilator sharing device

A new ventilator sharing device for COVID-19 patients is being tested by Institute for Manufacturing engineers at Cambridge University and Royal Papworth Hospital anaesthetists.

The device is being developed in collaboration with technology hothouse Cambridge Design Partnership and is said to improve on and address concerns about previous ‘ventilator splitter’ designs, allowing one ventilator to be used by two patients more safely.

The system incorporates respiratory parts that are available in the UK supply chain and which can be easily changed and replaced.

Initial details of the device – which is still in testing – are now freely available on the Institute for Manufacturing website.

Full design and testing details will subsequently be released so that the system can be developed for use in other countries.

In response to the COVID-19 pandemic, volunteers from the Institute for Manufacturing (IfM), University of Cambridge, responded to a request from clinicians at Royal Papworth Hospital to develop a device that, if needed in an emergency, could be attached to a ventilator to enable two COVID patients to receive tailored respiratory support.

Due to the success of the Government’s Ventilator Challenge UK, Royal Papworth Hospital NHS Foundation Trust, along with other NHS hospitals, received enough ventilators to meet the surge in demand from COVID-19 patients and continue to have a healthy reserve stock of ventilators.

However the new device – which is still in testing and not yet approved for clinical use – illustrates that it is possible to split the air flow from one ventilator to mechanically support the breathing of two sedated patients with different lung capacity and changing breathing needs.

Although ventilator demand in the UK has reduced, this system could be adapted to provide emergency support to hospitals in other countries which are still facing significant challenges with the pandemic, or for longer-term use in countries that have ongoing ventilator capacity shortages.

The active ventilator sharing device prototype has so far been tested on artificial lungs with a number of different ventilators, showing promising results.

The specification of the active ventilator sharing device was detailed by two anaesthetists – Professor Andrew Klein and Dr Chinmay Patvardhan – who initially feared that they may not have enough ventilators for patients during the pandemic and, when looking for alternative emergency solutions, were not confident in the ‘ventilator splitter’ setups they saw described online.

Professor Klein said: “In case there were insufficient effective ventilators available due to the COVID-19 outbreak, we wanted to have the option, in an emergency, to split and isolate the air delivery from one ventilator between two patients.

“Therefore, we also needed to have the ability to measure and control the air flow to each patient individually and have confidence that if there was a decline or improvement in breathing in one patient this would have no effect on air delivery to, or monitoring of, the other.

“It was also essential that the setup was easy to assemble. The first tests of the device using artificial lungs are very encouraging; the solution developed both meets and exceeds our expectations of many of the other options developed elsewhere around the world.”

Dr Patvardhan added: “This device could allow medical professionals to instantly double the capacity to ventilate patients safely in a crisis situation which would be invaluable for any future emergency of the scale we have seen with COVID-19.

“It could play an important role in those countries still seeing a rise in infections, or be used in places where the capacity of the healthcare system is particularly strained.”

The IfM developed the solution in collaboration with Cambridge Design Partnership as well as Royal Papworth Hospital, with generous support from a wide selection of respiratory equipment manufacturers across the UK and the world.

The system was designed to incorporate respiratory parts that are available in the UK supply chain in a layout that facilitates parts to be easily changed and replaced. The overall ‘box unit’ provides isolated respiratory lines to two patients and enables quick assembly to a ventilator.

The IfM-designed readout meter delivers real-time measurement of tidal volume to each patient as well as monitoring the total pressure and airflow in the device. Easy-to-access valves enable fine tuning of air flow to match the requirements of each patient.

Dr Ronan Daly, who led the IfM team, said: “We have received incredible support for this initiative across the University and beyond. 

“The team of engineers are making great progress with the device, from the detailed design and fabrication work to preparing regulatory documents, but a wider expertise from colleagues in finance, buildings management, purchasing and safety meant we responded at incredible speed. This project is a small example of a wider national attitude and response of which we should be proud.”

• Photograph courtesy – Ronan Daly, Institute for Manufacturing.

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