RTWB proposed solution has found it's inventors
Post date: Oct 07, 2015 2:5:8 AM
Students invent potentially life-saving, low-cost device to treat critically ill infants in developing nations.
Two WMU undergraduates have designed a respiration support device that could be life saving for premature babies born in parts of the world where access to expensive medical equipment may be limited.
Babies born preterm sometimes have underdeveloped lungs and need some degree of respiratory life support. While U.S. hospitals typically have advanced respiratory treatment tools, that’s not always true in other parts of the world.
WMU seniors Stephen John and Joseph Barnett teamed up to develop a mechanism to expand treatment options in less well-resourced areas.
Both of these premed students have a strong interest in medical care and share similar backgrounds working in underserved communities in economically disadvantaged countries.
Pending approval by institutional review boards and the Nepal Health Research Council, the device, which carries a provisional patent, could be tested at two teaching hospitals in Nepal as soon as this summer.
“Our primary goal is to equip medical centers in developing countries to deliver more comprehensive care for neonates struggling with Respiratory Distress Syndrome, ultimately saving lives,” Barnett says.
“We want it to have a broad impact. (The device is) inexpensive to manufacture and that’s the goal—to deliver it at a very, very low cost to regions of Africa, Nepal, India, Asia—wherever medical care is hard to access.”
Serving the medically underserved
Though young men, these two friends have spent many years volunteering in and around mission hospitals in places where infant mortality rates are high—John in Nepal and Barnett in Honduras.
Their experiences abroad may be a foreshadowing of their future careers. They envision treating patients as doctors one day, but also want to design medical equipment specifically for poorly resourced medical centers.
Already, they’ve witnessed the challenge of providing patient care in settings that lack adequate funding, are not flush with medical staff and that don’t have sophisticated equipment.
And they’ve come to recognize that, aside from the expense of equipment, health care practices and tools that work well in the states, for instance, may not be feasible or suitable in the developing world.
John is U.S. born, but lived in Nepal for about 10 years where his father, a pediatrician, and his mother, an engineer, worked at the United Mission Hospital in Tansen, some 200 miles west of Kathmandu.
The family resettled in the states when John was 16, but they have continued to return to Tansen during summers.
“I think it’s more rewarding to practice medicine there because there’s just a huge need; you end up doing much more,” says John, a mechanical engineering and biomedical sciences major.
As a pediatrician in the states, his father was one of many in his community.
“But when my dad was in (the Nepalese hospital), he was the only pediatrician. You can see this really tangible benefit. People who would not have otherwise received care are treated.”
John served in the Tansen hospital last summer repairing medical equipment and installing software. He hopes to continue that work this summer before he begins medical school at the University of Michigan in August.
Though Barnett also plans to begin medical school in the near future, growing up, he says he had no desire to become a doctor.
“But after seeing the intense poverty and need for medical care in Honduras, India and other countries, I realized medicine was something meaningful that I could do with my life,” he says.
For the past five years, the Oklahoma native has worked at a rural hospital in Colon, Honduras. At Hospital Loma de Luz, he’s repaired malfunctioning biomedical equipment, helped medical staff in daily outpatient clinics and tutored early elementary students at a local school.
“Right now, neither of us are doctors, but through our experiences we’ve cared for people. It is rewarding work,” Barnett says.
After completing his degree in biomedical sciences at WMU this summer, he plans to spend a year in Honduras before beginning medical school.
Engineering to help babies breathe
The respiratory device the students teamed up to develop can be traced back to a conversation a few years ago.
John, researching ideas for his Lee Honors College thesis and senior engineering design project, contacted Eric Cheng, the co-founder of Respiratory Therapists Without Borders.
RTWB is a registered Canadian charity that exists to improve respiratory health through work with healthcare education partners worldwide.
Cheng had worked with John’s father in Nepal to train hospital staff in the use of bubble CPAP—continuous positive airway pressure—therapy for treatment of newborns experiencing respiratory distress.
Cheng expressed to John the need for an inexpensive device capable of administering non-invasive airway ventilation at two levels of pressure—oscillating between low and high—for premature infants with weak or underdeveloped lungs needing more than bubble CPAP could offer.
But this dual-level treatment—non-invasive positive pressure ventilation or NIPPV—has traditionally required sophisticated equipment that is not readily available to rural areas, says Cheng, who’s been a respiratory therapist for seven years.
He pitched the idea of a mechanism that would harvest the excess “bubble energy” from a bubble CPAP setup to power NIPPV therapy.
John devised the main design and brought Barnett on board to further develop it. Together, they’ve focused on refining the device, working in the laboratory of Dr. Peter Gustafson, professor of mechanical and aerospace engineering at WMU.
A “bubble” CPAP setup uses pressurized air supplied by a motor and a fan, with one branch of tubing sending air to the patient and one branch submerged in a container of water or acetic acid.
The depth of the submerged tubing determines the pressure delivered to the baby. Any excess pressure is bled off as exhaust bubbles, hence the term “bubble” CPAP.
The students’ version of NIPPV connects to an existing bubble CPAP setup and uses its exhaust to power a mechanism they created to deliver alternating low and high air pressure to support respiration, preventing lung collapse and recruiting alveoli, tiny air sacs in the lungs in which oxygen is exchanged.
“Ours (NIPPV device) is unique because it’s inexpensive and powered by bubbles,” Barnett explains. “Because this will be an add-on to existing CPAP setups, this won’t require any additional energy.”
Broad impact
A year and a half ago, the students began developing their NIPPV solution in the kind of setting in which many innovative tools have begun life—John’s basement.
“We started out with ChapStick tubes and milk cartons,” Barnett says.
Since then, their design has gone through several iterations and has greatly advanced from its earliest version. A Kalamazoo-area manufacturer contributed to their work by machining prototype parts.
The students are seeking additional grant support and have an ultimate goal of widely distributing their low-cost NIPPV, perhaps through the World Health Organization.
“All the design and testing done by Stephen and Joseph at Western Michigan University have produced staggering results in a small amount of time,” Cheng marvels.“I’m proud of what they’ve done and excited about the
implications this will have for the medical practice available in underdeveloped places.”
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