The Team:

University of College London engineers

University College of London Hospitals’ clinicians

Mercedes Formula One technicians

Oxford Optrimix, a niche manufacturer of oxygen monitors

The brief:

Fast mass production of Continuous Positive Airway Pressure (CPAP) devices, which deliver oxygen to the lungs without needing a ventilator.

The aim:

Keep as many COIVD-19 patients off ventilators as possible.

What is a Continuous Positive Airway Pressure device?

A Continuous Positive Airway Pressure (CPAP) device is something already used in hospitals to deliver oxygen to a patient’s lungs without needing a ventilator. They do more than a simple oxygen mask, but are not as extreme a medical solution as a ventilator.

They work by pushing pressurised oxygen into the nose and mouth. This mask must have a tight seal onto the face, or a head hood, in order to maintain the pressure. The pressure is important because it means that the lungs are held open, allowing more oxygen to enter the system.

Why are they useful to treat COVID-19 patients?

COVID-19 can cause the alveoli (air sacks) in the lungs to collapse. The patient’s breathing becomes very laboured and requires a huge amount of effort. A CPAP device does a lot of this work for them to support their breathing while they heal.

In Italy, they found that 50% of COVID-19 patients who used a CPAP device didn’t need a ventilator.

A ventilator may be required if the disease progresses. This involves the patient being sedated and intubated – having a tube down their throat  – so the machine can take over the lungs’ job entirely.

Professor Mervyn Singer, a UCLH critical care consultant said: “These devices are a halfway house between a simple oxygen mask and invasive mechanical ventilation which requires patients to be sedated. They will help to save lives by ensuring that ventilators, a limited resource, are used only for the most severely ill.”

Are there any downsides to CPAP devices?

They do come with a warning for the health workers caring for patients using CPAPs.

University of Oxford, Prof of Intensive Care Medicine, Duncan Young said: “The use of CPAP machines in patients with contagious respiratory infections is somewhat controversial as any small leaks round the mask could spray droplets of secretions on to attending clinical staff.”

Well-sealed CPAP masks and helmets for the patients, and the proper PPE for hospital staff, are the solution to this risk.

Success

The speed at which this has been turned around is amazing. In one week, this team of experts have done the quickest R&D project imaginable. And the most valuable.

They have:

  • reverse-engineered the existing CPAP device
  • made it better
  • altered it ready for large scale manufacture
  • got approval from the Medicines and Healthcare products Regulatory Agency (MHRA)

Director of UCL Institute of Healthcare Engineering, Professor Rebecca Shipley, told the BBC: “Normally medical device development would take years but we’ve done that in days because we went back to a simple existing device and “reverse engineered” it in order to be able to produce them quickly and at scale.”

What next?

ULCH and three other hospitals in London are already trialling 40 of the new CPAP devices. Once they’re happy with them, production can start in earnest. Mercedes-AMG-HPP are ready to start making 1,000 devices per day form next week.

Mind blowing work.

Jamie Smith