Individuals from Leeds Teaching Hospital Trust and the University of Leeds have collaborated to make modifications to sleep apnoea machines in order to create vital ventilators to treat patients suffering from Coronavirus.
Engineers, physicists, academics and clinical staff have utilised the ‘Nippy3’, a device that is being phased out of service, to create lifesaving ventilators.
The devices’ original use was to aid individuals with sleep apnoea and there are around 100 of these devices in Leeds hospitals and thousands of similar devices across the NHS.
The introduction of this innovative modification has therefore led to an extra layer of desperately needed respiratory support in the peak of crisis across the nation.
The team has transformed the apnoea machine by reconfiguring the supply of oxygen so that it flows to the face mask worn by the patient, making it easier for them to breathe.
The machine operates using CPAP mode (constant positive airway pressure), with a raised pressure inside the mask. Due to the fact that this modification concerns a device that is already widely available, it does not need to be regulated through an approval process.
This means that the modified machine can be utilized instantaneously across the country, providing 40%-60% enriched oxygen to patients suffering from the virus, leading to a complementary and immediate solution to supplement the vital ventilation equipment available to the NHS.
Dr David Brettle, Head of the Medical Physics team at LTHT and Honorary Professor at the University of Salford, said:
“This is another example of the long-standing collaboration we have between our Trust and the University of Leeds. We know there could be pressure on the NHS for more ventilators during the current coronavirus outbreak and this was a way of coming up with a potential solution.”
The process to create this device began as the university medical physics department at the Leeds University Hospital Trust created a working model of the modified Nippy3 device which involved both air and oxygen being fed into the device and then onto the patient.
This primary model was presented within four days. The model was then developed further alongside engineers and the clinical team to receive air from the device and oxygen directly from the hospitals’ supply system in order to achieve more efficient use of hospital oxygen provision.
Through developing the model further, the team managed to progress from a device that needed to be fitted with seven new components with a manufacturing system, to create a modification in which hospital teams can perform themselves using already available equipment.
Dr. Pete Culmer surmised the final modification process as “chang(ing) some of the settings, filters and the way oxygen reaches the patient”. This modified CPAP device may be able to provide intermediary support for patients who could surpass full ventilation. This would prevent some patients from needing to be fully sedated which is required for full ventilation.
The immediate need for respiratory equipment has also been highlighted by the fact that other university engineers and large corporations such as Mercedes have also worked tirelessly to provide support to the NHS.
The leading car brand and University College London both announced last week that they had successfully reversed engineered a CPAP device that had widely been used in China. The device they created has regulatory approval and can be rapidly manufactured.
However, the modified device suggested by the team at Leeds surpasses the need for regulation or manufacturing, therefore creates immediate availability across the nation from existing machinery. The significance of surpassing the manufacturing stage is all the more prevalent as COVID-19 has placed a large demand on supply chains, vastly limiting manufacturing capabilities.
The technical note which explains the Leeds Teams’ findings summarises the way the new modification functions; “The outcome is that the device delivers CPAP with oxygen-enriched air for therapeutic intervention using standard equipment and fittings, whilst minimizing the oxygen demands on hospital infrastructure when treating large numbers of patients.”
This report has become immediately available on ‘MedRxiv’ online platform to rapidly disseminate to researchers across the globe in order to aid the fight against corona virus and continue to provide relief to hospitals providing lifesaving care.
Images Credited to the University of Leeds.