Costing around £150, the CPAP (continuous positive airway pressure) device uses a simple electrical fan to assist breathing, rather than relying on the high pressure air or oxygen found in many hospital settings. The prototype, described in Frontiers in Medical Technology, was developed by a multidisciplinary team from the University of Leeds, Leeds Teaching Hospitals NHS Trust, Bradford Teaching Hospitals NHS Foundation Trust, Medical Aid International and the Mengo Hospital in Uganda.
“In the UK, CPAP has been effective as the mainstay of respiratory treatment for severe Covid-19 and helps to keep patients from needing advanced ICU care such as ventilators,” said researcher Dr Tom Lawton, consultant in Critical Care and Anaesthesia at Bradford Teaching Hospitals NHS Foundation Trust.
“In many countries, resource limitations mean that even CPAP is difficult to come by and more severe disease frequently leads to death. Simple CPAP devices, designed to operate in a resource-limited setting, can help reduce global healthcare inequality and save lives both now with Covid-19 and potentially with other diseases in the future.”
Conventional CPAP machines can cost upwards of £600, while ventilators used in intensive care units can be as much as £30,000. As a result, access to this type of respiratory equipment is often limited in low and middle income countries. During the prototype design, the researchers adapted the principals of ‘frugal innovation’, stripping back complexity while trying to maintain the highest level of functionality.
“By adopting the approach of frugal innovation, we have been able to redesign an important piece of medical equipment so it can function effectively in poorer resourced healthcare settings,” said Nikil Kapur, Professor of Applied Fluid Dynamics at the University of Leeds.
“We have stripped away unnecessary complexity and ensured the device will work in settings where oxygen supplies are scarce and need to be conserved. The prototype is an important step in developing a device that will create greater access to critical-care technology and help save lives.”
A pilot study on ten healthy volunteers has already been conducted in the UK. The next phase of testing will see the device used on sick patients at the Mengo Hospital in Kampala, Uganda. The country has a decentralised healthcare system, with patients being referred from community and district health centres and clinics to regional and national hospitals only when they are very sick.
“It is only the regional referral and the national referral hospitals that have access to CPAP,” explained Dr Edith Namulema, an epidemiologist in Uganda involved in the research project.
“Yet patients first present to the lower-level facilities when they have breathing difficulties and by the time they arrive to the regional referral centres, in some cases, it is too late. The ability to hook a patient onto ventilation when they need it potentially saves many lives and reduces the hospital stay. Also, as a country we have about 500 ICU beds for 42 million Ugandans which is very few.”