Low-Cost, Easy-to-Use Breathing Device to Help Cope with Surge in COVID-19 Cases in Poorer Resourced Healthcare Settings

A simple electrical fan is the key component of a low-cost, easy-to-use breathing-support device designed to cope with the surge in COVID-19 cases in low to middle income countries.

The device developed by researchers at the University of Leeds (Leeds, UK) provides a form of oxygen therapy called CPAP or continuous positive airway pressure, which has proved effective in helping patients struggling to breathe because of moderate to severe COVID-19.

According to the team developing the device, a pilot evaluation involving 10 healthy volunteers has shown that it “...can be used safely without inducing hypoxia (low levels of oxygen in tissues) or hypercapnia (build-up of carbon dioxide in the bloodstream) and that its use was well tolerated by users, with no adverse events reported”. The researchers used the principals of “frugal innovation” to design and develop the breathing aid, to ensure the device remains simple while being both robust and able to meet clinical demands in poorer-resourced health settings.

A key innovation was to generate the required air flow using a simple electric fan, akin to the fans used to cool electronic devices, to overcome the lack of access to high-pressure air and oxygen supplies. The cleverly designed fan system provides a safe air flow supply without needing more complex - and costly - control systems or a high-pressure air source. This provides a simple and robust means to generate airflow sufficient to open the patient’s airways, so oxygen can get into the tiny air sacs in the lungs, without risk of adverse effects. The oxygen concentrator is used to enrich this airflow with oxygen, conserving valuable supplies.

The device can generate four different levels of air pressure dependent on clinical need. According to the researchers, desirable oxygen saturation levels in the blood – between 96% and 100% – were maintained in the healthy volunteers taking part in the trial. The CO2 range at the end of exhalation is between 3.6 and 4.9 pKA, again within accepted healthy limits. Components for the protype device cost around USD 207. Conventional CPAP machines can cost from around USD 800 - and a ventilator used in an intensive care unit can cost more than USD 40,000.

“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 and the supervising academic on the project. “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.”

“In many countries, resource limitations mean that even CPAP is difficult to come by and more severe disease frequently leads to death,” added Dr. Tom Lawton, Consultant in Critical Care and Anesthesia at Bradford Teaching Hospitals NHS Foundation Trust and a member of the research team. “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.”

Related Links:
University of Leeds