A team of Naval Medical Center Portsmouth’s (NMCP) Anesthesiology Department staff members built a ventilator in an effort to help fight the Novel Coronavirus Disease 2019, or COVID-19, pandemic.
The pandemic has led to shortages of essential goods and services - from hand sanitizers to masks to beds to ventilators. Several countries have already experienced a shortage of ventilators.
The team of NMCP staff members includes Lt. Jacob Cole and Lt. Cmdr. Scott Hughey, senior anesthesia residents, Lt. Gregory Booth, assistant director of the Anesthesiology Residency Program, and Hospital Corpsman 3rd Class Christopher Rector, assigned to Explosive Ordnance Disposal Expeditionary Support Unit Two (EODESUTWO), who came together to construct a prototype in their efforts to fight the spread.
“We had been tracking the COVID-19 pandemic’s need for ventilators worldwide,” Hughey said. “From a medical and resource management standpoint, we brainstormed ways that we could meet the need for ventilators to help patients. We went from just paper sketches and discussions to a full working prototype which was successfully tested in a command-approved animal research study in 28 days.”
A ventilator is a machine that provides mechanical ventilation by moving air and oxygen in and out of the lungs, to deliver breaths to a patient who is physically unable to breathe, or breathing insufficiently. They are predominantly used in intensive-care medicine, home care, emergency medicine and in anesthesiology.
“A ventilator is designed to pressurize air and push it, using positive pressure, into a patient’s lungs,” Cole said. “It provides extra support for a patient when they’re, for whatever reason, having trouble breathing.”
For patients with the worst effects of a respiratory infection, a ventilator can offer the best chance of survival.
“The four of us came up with the idea to build and test a ventilator in response to what we’re seeing nationally and internationally, which is an increased ventilator demand,” Hughey said.
The prototype had been tested on three specific models, including two high-fidelity lung simulators and in an animal trial using a swine model. During the command-approved animal trial, the ventilator was compared head-to-head with a conventional veterinary ventilator. It was found to provide non-inferior, if not superior, ventilation.
“There is a continuum of people involved in this process,” said Cmdr. Jason Longwell, department chair of Anesthesiology. “We have some of our junior staff, senior residents, and corpsmen who are making this process happen without any major industrial support. We have branched out to where now we are collaborating with NASA to help validate the engineering pieces.”
The collaboration, which started with four individuals, has expanded to include legal agreements with NASA for further development, testing and a pathway to market.
“This is a massively scalable, effective and inexpensive mechanical ventilation solution for this current pandemic that’s been shown to be reliable and safe,” Cole said. “No other ventilator on the market or being brought to the market in development is going to meet our price point, roughly $250. It’s a simple device, but despite that simplicity, it is absolutely effective in providing mechanical ventilation. The ventilator was also specifically tested under conditions simulating changes in lung function characteristic of the effects of COVID-19 with very favorable results.”
The ventilator is unique in that it’s not a major company making it. It was made from parts that can be bought at major retailers, as well as specialty parts that can be purchased online. The group designed and built the electronics control mechanism such that it can be ordered from a manufacturer and easily assembled into the breathing circuit system.
“This prototype allows us to make open source plans available to medical institutions who need extra ventilators,” Cole said. “It allows them to fabricate their own ventilator that is safe, reliable and effective to use as the demand rises.”
The teams’ hope is the pandemic will not reach a point where it is so severe that there are needs to rely on a ventilator. If that point is reached, they envision this device being rapidly deployed and used to fill the gap of respiratory needs.
“As anesthesiologists and critical care physicians, our role is to hope for the best but plan for the worst, so if things get bad we are prepared,” Booth said.
Additionally, the team foresees that for future pandemics, areas where the medical need isn’t being met by current technology, this project can fill that gap as well.
“The impact for this on NMCP is that it’s a great example of the amount of talent we have working in our ranks,” Longwell said. “It’s an example of how we are able to adapt, create, innovate and deploy projects like these.”
As the U.S. Navy's oldest, continuously-operating military hospital since 1830, Naval Medical Center Portsmouth proudly serves past and present military members and their families. The nationally-acclaimed, state-of-the-art medical center, along with the area's 10 branch health and TRICARE Prime Clinics, provide care for the Hampton Roads area. The medical center also supports premier research and teaching programs designed to prepare new doctors, nurses and hospital corpsman for future roles in healing and wellness.
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